The Quack Doctor

Source: The Patriot (London) 12 September 1853

It is no misnomer Cordial! —no stupefactive, deadly narcotic! —but a veritable preservative of Infants!

Regular readers of The Quack Doctor might be able to hazard a guess at the active ingredients of this product. Like other infant quieteners, it did contain a narcotic, and, like them, it was a killer.

One unusual thing about Atkinson and Barker’s Royal Infants’ Preservative, however, was a particularly dubious form of promotion.

A few hours after my son was born in 2007, the only person in the post-natal ward who noticed I was there was a sales rep who came to present me with Pampers vouchers and sign me up to mailing lists for catalogues full of baby-related crapola. In hindsight I am mildly outraged at the tackiness of this marketing ploy, but at the time I was happy to see a friendly face, and handed over my details. The only harm done was a bit of junk mail that’s still turning up three years later. What I didn’t know at the time was that a similar practice was in operation in the 1870s, with far more sinister results.

In 1876, Kilburn doctor William H Platt wrote to the medical journals to highlight an issue he’d discovered quite by accident. Local parents were finding flyers for the Royal Infants’ Preservative enclosed with their children’s vaccination papers. At this period, vaccination against smallpox was compulsory, and these official documents were sent out to all who had registered a birth. Platt surmised that someone from the company had done a dodgy deal with the Board of Guardians to come up with this plan.

The result, he believed, was:

…to induce the people receiving these papers, many of them poor and ignorant, to believe that these so-called infant preservatives are recommended by the same authority which enforces vaccination.

The handbills involved would have been something like the above, and as you can see, they also purport to have the ultimate celebrity endorsement. Atkinson and Barker were ‘Chemists to Her Majesty in Manchester’, but quite how often she popped into their Bowdon warehouse I don’t know. The relationship mainly involved the company trumpeting the royal connection and boasting about the time they sent the Queen a gift of the Preservative in a classy bottle.

The mixture’s composition was listed in the Druggist’s General Receipt Book in 1878.

Carbonate of magnesia 6 drs.
White sugar 2 oz.
Oil of aniseed 20 drops
Spirit of sal volatile 2 drs.,
Laudanum 1 dr.,
Syrup of saffron 1 oz.,
Caraway water to make a pint.

(‘dr’ refers to drachms)

The amount of laudanum was pretty small, but then so were the people who received it. In 1886, an inquest on the body of a six-week-old baby decided that a mere six drops of Royal Infants’ Preservative had been enough to kill it, as it was already weakened by illness. Surgeon Mr H S Leigh told the jury that when he saw the baby the morning after the dose,

…its pupils were contracted to the size of a pin’s head; it was covered with a cold, clammy sweat; it was breathing about six in the minute, and was apparently moribund.

The child ‘lingered on till evening, when it died.’

The Preservative had been around since the 1790s. In the 1830s, artist O. Hodgson satirised parents’ reliance on such products with the following cartoon.

Image credit: Wellcome Images

Mrs Easy, on the right, is informed that her house is about to fall down with her child inside.

‘Never you mind,’ she says. ‘I gave it a bottle of Infant’s Preservative before I come out so there is no danger.’

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The Hull Packet, 1 November 1803

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What is any self-respecting quack to do in the face of criticism?  

The answer in 1804 was exactly the same as it is now – turn nasty and threaten to sue the arse off everyone.  

The name ‘Ching’s Worm Lozenges’ might suggest that this will be an icky-parasite post, but in a way I wish it were. Instead, this story is incredibly sad.  

There were two kinds of lozenge – yellow and brown – that had to be taken at different times of day. Both contained white panacea of mercury. The travelling sales agents, however, were under strict instructions to assure customers that ‘not a single particle’ of mercury was in them.  

On 4 December 1803, a little boy called Thomas Clayton, aged 3, was given the Lozenges, followed three days later by a repeat dose. He went into a high state of salivation – one of the symptoms of mercury poisoning. His parents sent for medical help, but to no avail.  

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…the mouth ulcerated, the Teeth dropped out, the Hands contracted, and a Complaint was made, of a pricking Pain in them and the Feet, the Body became flushed and spotted, and at last Black, Convulsions succeeded, attended with a slight delirium; and a Mortification destroyed the Face, which proceeding to the Brain, put a period (after indescribable Torments) to the life of the little sufferer, on Sunday, the 1st instant, Twenty-Eight Days after he had taken the Poisonous Lozenges.  

The coroner’s verdict was ‘Poisoned by Ching’s Worm Lozenges’ and the above description is from a handbill written by the child’s father, also called Thomas Clayton. Clayton was a printer and bookseller, so was able to produce loads of these leaflets and personally deliver them all around his local neighbourhood in Kingston-upon-Hull. In them, he noted that the main Hull papers (the Packet and the Advertiser) had ignored both the death and the coroner’s verdict – probably because they received so much advertising revenue from Ching’s.  

John Ching himself had died in about 1800. The business was ostensibly carried on by his widow, but really came under the control of a dodgy cove called Mr Butler.  

Signing himself R. Ching, Butler responded with a broadside of his own, attacking the grieving father and threatening to prosecute him for publishing the case. He called Clayton’s words ‘malicious invective,’ ‘AN INFAMOUS ASSERTION and ABOMINABLE FALSEHOOD,’ and said he had ‘FLAGRANTLY LIBELLED TRUTH.’ These handbills were printed by Robert Peck of the Hull Packet – who, like many newspaper printers, was a vendor of patent remedies and was firmly on Butler’s side.  

I don’t know whether Clayton’s grief and campaigning activities led him to neglect his business or whether he was already in financial trouble, but he was declared bankrupt about a month after his son’s death. Although the newspapers hadn’t reported the poisoning, they were quick to advertise the sale of all the Claytons’ property. In a particular act of despicableness, Robert Peck allegedly turned up at the sale and boasted to Mrs Clayton that her husband would not get away with the libel.  

Clayton wanted to take the precaution of getting a written copy of the coroner’s verdict, but when he went to pick it up, he discovered that the coroner ‘had not time’ to do it. The Deputy Town Clerk was equally unhelpful, but it turned out that Butler was all talk and never went ahead with the prosecution.  

By 1805 Clayton must have managed to get back in business as a printer, because he published An Essay on Quackery, and the dreadful consequences arising from taking advertised medicines; with remarks on their Fatal Effects, with an account of a recent death occasioned by a Quack medicine. The author is anonymous and is usually assumed to be Thomas Clayton himself, but I believe it to be his brother, M. J. Clayton. The 140-page essay appears cobbled together, is understandably emotional, and it reproduces lots of excerpts from other writers, but it also offers a measured, sensible list of recommendations for stamping out quackery by replacing the government’s quack-related income with duties on other activities.  

This government revenue was substantial and goes a long way towards explaining why dangerous medicines were allowed to continue. Each bottle or packet had to carry a stamp – some quacks portrayed this as being a mark of official approval but, like most things in life, it was solely a way for the government to get money. I only have figures for 1839, but at that point the government was making approximately £49,300 per year from stamp duty, advertising duty, licences, patents and paper duty (for the wrappers that many remedies were sold in). It’s an awful lot of money, but the price paid by families like the Claytons was much greater.  

In a letter to the Medical Observer, the Essay author is exaggeratedly humble about his literary talents, but hints at attempts to suppress the book, and confesses himself chagrined at the lack of interest from the medical faculty. He also says that his own two children narrowly escaped the same fate as little Thomas, and so the Essay‘s chilling curse on Butler clearly comes from the heart:  

Dire conscience all thy guilty dreams affright,
With the most solemn horrors of the night.
The screams of infants ever fill thy ears,
And injured heav’n be deaf to all thy prayers.  

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Source: Western Journal of Medicine and Surgery (Louisville, KY), July 1855 Click here for Transcript

There are no prizes for guessing what was in this. First formulated in the mid 1830s by Dr John B McMunn (or M’Munn), it became a big hit in the US once a drug company called A B Sands bought the recipe in 1841. The dosage instructions gave plenty of room for manoeuvre:

To a child a month old, or younger, give from half a drop to two drops; to a child 6 months old, from 3 to 10 drops; and to adults from 10 to 60 drops (or even double or treble that much, if the pain and other symptoms be severe and urgent) mixed in two or three teaspoonsful of water, according to the size of the dose. As the administration of every medicine should be governed by its effects, it is proper to begin with the smallest dose, and increase or repeat it at proper intervals until the desired effects are produced.

Although a ‘secret remedy,’ the Elixir was popular with physicians and was advertised a lot in medical journals. One of its selling points was that it was supposedly ‘denarcotised’, and thought to be safer than laudanum. Not all doctors, however, supported it. In 1850, the Western Lancet (Cincinnati) ran an article suggesting that it was inappropriate for the New York Medical Gazette to promote this dubious nostrum. ‘All this,’ they insisted later, ‘was conceived in the kindest feeling to the editor, and with no other motive than to correct what we conceive to be a serious evil to the profession.’

The editor, Dr D Meredith Reese, didn’t take the ‘kindest feeling’ too well. He called the Western Lancet‘s article an ‘unprofessional attack’ and asserted that the Elixir was not a secret remedy – if the Lancet‘s editors didn’t know what was in it, that was down to their ignorance. The Lancet commented:

Now it is exceedingly amusing to hear the declaration made by Dr. Reese, that this article is not a secret remedy, and yet he is unable to give its composition! This is funny indeed…

…Perhaps his system of ethics, like his favorite elixir, is also a secret.

In 1864 the original recipe came to light, showing the process of treating opium with sulphuric ether to remove the narcotine and make the product safe – a nice idea but narcotine doesn’t have narcotic properties anyway, and the medicine certainly was not safe. It was as addictive as any other opium product –  in the early 20th century, for example, George Pettey M.D. related the case of a woman who had taken the Elixir for 31 years, losing 16 newborn babies to the congenital effects.

Another danger – not entirely the Elixir’s fault – was the possibility of mistakes on the prescription. An 1860s physician prescribed the product for a little girl, but instead of elx. of opium, he put exl., and doctors’ handwriting being what it is, the apothecary interpreted it as ext. (extract) of opium – a much stronger preparation that resulted in the child sleeping ‘the sleep which knows no waking.’

A particularly tragic case occurred in Monroe, NY, in 1875. A 17-month-old boy showed symptoms of worms, and ‘By the advice of an old Florida woman, who said it would cause the worms which were supposed to be in the child’s stomach, to have a good sleep‘, the mother gave him 15-20 drops of elixir every hour, sending worms and baby to sleep forever. When his breathing became rapid and rattly, she carried him to the nearest neighbour, a third of a mile away, but it was too late.

The child never moved a muscle from half past 3 till it died, which was about 11 at night, living some 12 hours after the last dose. It is a sad thing to see the child cut down in health as it were, and at an age when all the cares of the parents and affections of its brother and sister were at its very height of enjoyment. The little fellow was at play in the morning as ever and at 11 at night was a corpse.

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Many thanks to R L Ripples of TweetsofOld for the story from the Monroe Gazette and Courier.

Originating in New York in the 1840s, Mrs. Winslow’s Soothing Syrup was a dangerous concoction. Parents often did not realise that it contained morphine, and sadly, as the American Medical Times put it in 1860, were “relieved of all further care of their infants” through its use.