CLEVELAND, O., Dec. 23—.Two live lizards three and a half inches long, several smaller ones, and a number of lizard eggs, were taken from the stomach of Lovel Herman, nineteen, four days before she died. A postmortem examination showed that the wall of the stomach had been attacked by the animals, the doctors say. The heart had enlarged to three times its normal size.

For several years she had been ill, complaining that something was clawing at her stomach. Specialists were puzzled until finally Dr. McIntosh, working on the theory it was a tapeworm, found the lizards.

Miss Herman drank water from a spring in which there were lizards, when she lived at Millersburg, 12 years ago, and it is believed that she swallowed the eggs or the young animals at that time and that they grew while in her body. She craved meat and eggs during the last months of her life, and it is believed she demanded such nourishing food because the lizards, as well as her body, had to be fed. She ate ravenously, but weighed only 80 pounds.

Incidentally, the health officials refuse to accept the certificate of death based upon the lizards theory, declaring that no such case has been reported since the days of primitive medicine.

The Tacoma Times, (Washington), 23 December 1910

Valentine's Meat-Juice, The Medical World May 1914

The Quack Doctor is not a hearts and flowers kind of person, so was interested to learn of a dark side to this product’s history.

Brought into production in Richmond, VA, in 1871, Valentine’s Meat-Juice became popular with orthodox physicians and was advertised in professional publications, including the British Medical Journal. Its inventor, Mann S. Valentine, told of its origins in his A Brief History of the Production of Valentine’s Meat Juice, together with Testimonials of the Medical Profession (1874).

A family member (not identified in the booklet but thought to be his wife, Anna Maria Grey Valentine), was in great danger from ‘a severe and protracted derangement of the organs of digestion.’ She could not take normal food, yet none of the available invalid preparations could sustain her. She needed a safe, digestible and nutritious substance to keep her from starvation.

Through experimentation, Valentine worked out a process of rendering all the goodness of raw meat into a highly condensed form. Unlike other meat extracts, which were manufactured through boiling or roasting, his product resulted from mechanical compression and low heat, retaining all the protein of the raw flesh.

The standard dose was from half a teaspoon to two teaspoons diluted in water and taken by mouth, but some physicians preferred an even less romantic means of administration, and introduced it per rectum. An enema described in The Philadelphia Medical Journal in 1900 comprised one egg, one tablespoon of Valentine’s Meat-Juice, 4oz sterilised milk, ½oz. brandy, ½ tsp. salt, and 5oz of sterilised water. Two ounces of this mixture was to be administered every two hours ‘as high up in the large bowel as possible.’

Although it is difficult to tell the size of the bottle from this picture, it was tiny – only about 3″ tall yet said to contain the juice from 4lb of beef. In 1909, the American Medical Association reported that the product did not contain any coagulable protein and was effectively no different from the average ‘meat extract’ produced with the use of heat.

It was, however, through no fault of the manufacturer that Valentine’s Meat-Juice became embroiled in one of the most sensational murder cases of the 19^th century. In 1889 a little bottle, laced with a solution of arsenic, formed part of the evidence in the trial of Florence Maybrick, who subsequently spent fifteen years in prison for the murder of her husband. The case is notorious enough that you don’t need me to go into it here, so I’ll finish by wishing you a happy (or at the very least, murder-free) Valentine’s Day.

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Cover of the first instalment of Bleak House, March 1852

Between March 1852 and September 1853, monthly instalments of Bleak House tempted readers with their eyecatching illustrated covers and affordable price of one shilling.

Within these covers, the ‘Bleak House Advertiser’ promoted commercial products, from new publications to false teeth and from wigs to bedsteads. Inserted in part fourteen, however, after chapters 43 to 46, was an 8-page advertisement containing a narrative creation of its own.

Ali Ahmed’s Treasures of the Desert were a set of three remedies whose proprietor created an aura of eastern mystique to present them as traditional and natural alternatives to harsh western medicine. The range comprised the Sphairopeptic Pill for liver and digestive complaints, the Pectoral Antiphthisis Pill to fight off colds, asthma and consumption, and the Antiseptic Malagma – a plaster for use on ulcers, wounds and gangrene. With a month to wait until the next instalment of Bleak House, readers probably went back to the advertising inserts as stop-gap reading material, and the advertiser therefore had the opportunity to get them on side by offering more than just a hard sell.

The pamphlet draws the reader in with an unexpectedly up-front reference to quackery:

WHAT! more atrocities in the quack line? More conspiracies against the poor stomach? Such we can easily believe to be the exclamation of the reader as he scans the heading of this paper.

It’s all very well to think that when you’re in fine fettle, however. The pamphlet goes on to remind us that we might suffer health problems in the future and would do well to keep these remedies in mind.

Ali Ahmed Mascueli was supposed to have been a Persian physician, who spent most of his life in Syria and developed the remedies using local herbs. On his deathbed, he confided the recipes to his relatives, who handed them down through the generations until, in the 19^th century, they attracted the attention of  ‘an excellent and philanthropic Englishman’ who saw it as his duty to share them with the world. The pamphlet used a decorative border and examples of calligraphy (described by Bernard Darwin in his 1930 book The Dickens Advertiser as ‘lovely Arabic curly-wiggles’!) to lend an air of exoticism, emphasising the long tradition of eastern medicine from which the remedies had sprung.

Ali Ahmed’s Treasures of the Desert – cover of advertising insert. Image credit: http://www.ibiblio.org/dickens/html/42058.html

After a brief introduction, the pamphlet features a letter from a friend of the proprietor in Damascus, who had introduced the remedies there to the fury of the resident French and Italian doctors. The letter writer becomes a ‘character’ in the pamphlet’s narrative, entertaining the reader with a tale of a doctor so incompetent that he once ordered a large supply of sodium chloride, believing it to be a medicine.

In preference to such ‘scientific’ idiots, the letter-writer lauds ‘the simple native physician,’ whose drugs are ‘the kindest gifts of nature to suffering humanity.’ Unlike the violent substances such as strychnine and morphine prescribed by European doctors, the eastern practitioner’s drugs are ‘simple and pure; the mountainside furnishes him with herbs and roots, and the plains are bountiful in bulbs.’

The notions that a remedy stems from ancient, traditional knowledge, that it is safe and natural, and that narrow-minded orthodox doctors hate it are all, of course, to be found in dubious advertising today.

Punch pointed out that the medicines would probably work if taken as part of the lifestyle enjoyed by Ali Ahmed. Together with a sparse diet, only water to drink, and plenty of horseback exercise, they would no doubt remove ‘the worst congestion of the liver that ever affected alderman.’

So, just how exotic were these medicines? Cooley’s Cyclopaedia of Practical Receipts, Processes, and Collateral Information in the Arts, Manufactures, Professions and Trades, including Medicine, Pharmacy and Domestic Economy (Fourth Edition 1864) gave the ingredients as follows:

The Antiseptic Malagma comprised lead plaster, gum thus (frankincense or, more likely, thickened turpentine), salad oil and beeswax, spread onto calico. The Pectoral Pills were myrrh, squills, ipecacuanha, white soft soap, aniseed oil and treacle, while the Sphairopeptic Pills contained aloes, colocynth pulp, rhubarb, myrrh, scammony, ipecacuanha, cardamom seeds, soft soap, oil of juniper and treacle. The advertising also claims that the pills were ‘silver-gilt in the Oriental style’, a practice traditionally thought to have originated with tenth-century Persian physician Avicenna.

Ali Ahmed, from an advertisement in vol. XV of Bleak House (May 1853) Image credit: http://www.ibiblio.org/dickens/html/42059.html

In celebration of the bicentenary year, The Quack Doctor plans some further posts tenuously related to Charles Dickens, so look out for them on the blog soon. In the meantime, happy 200th birthday, Mr. Dickens!

Why would you visit The Quack Doctor to read about the famous Beecham’s Pills, when five seconds of Googling will give you more information than you could possibly read in a lifetime?

Well, obviously you wouldn’t, so that’s why I’ve never blogged about them. I just wanted to do a quick post, however, to show this advertisement from 1909, which is a fine example of a witty response to criticism, and far better PR than threatening to sue anyone who’s a bit of a meany.

 The Penny Illustrated Paper 11 December 1909

On 2 January 1909, the British Medical Journal published an analysis of Beecham’s Pills as part of its exposé of proprietary remedies. The verdict wasn’t that harsh compared with the damning reports on other medicines, but it revealed that the pills comprised just aloes (an ingredient of most bog-standard laxatives), ginger and soap. The formula had not been top secret before this, but when the Journal’s reports were published as Secret Remedies: What they Cost and What They Contain (1909), it was brought to wider public attention.

This advert forms part of Beecham’s public response, taking ownership of the term ‘secret remedy’ and presenting it as something honourable; a shared secret between the company and the loyal customers who knew best about their own health. The last paragraph of the following advertisement also appeals to people’s trust in their own judgement, and engenders suspicion of the critics’ motives.

It is perfectly reliable although it is “a Secret Remedy,” it has been tried by the Public for upwards of sixty years, and in spite of all opposition, and in the face of calumny prompted by jealousy caused by success, the voice of the people is practically unanimous in favour of Beecham’s Pills.

Lloyd’s Weekly Newspaper, 12 December 1909

Beecham’s Pills were pitched as a ‘Remedy for the People’, not for the establishment. Whatever some high-falutin BMA analyst might say, the advertising cleverly flattered potential punters that they – who knew what it was like to be ill – were the real experts.

P.S. I’m on Google+ now – feel free to add me.

This advertisement for Eno’s Fruit Salt appeared in the special Royal Wedding Edition of the Penny Illustrated Paper on 8 July 1893. The edition commemorated the nuptials of Prince George, Duke of York and Princess May of Teck – the future King George V and Queen Mary. Click the image to enlarge.

From the Morning Post 18 August 1803

It must be at least a couple of months since we last heard from our old friend Ascaris lumbricoides, so it’s time he made another appearance on The Quack Doctor together with a few of his helminthic chums.

I’m putting together a talk about the career of John Gardner, a former soldier and picture-framer who became a medicine vendor and Methodist preacher in the 1780s. Gardner’s best-known nostrum was a vermifuge, relieving his patients of some spectacular parasites that he collected and preserved in his museums at Long-Acre and Shoreditch.

Last week I went to the Wellcome Library to have a look at a broadside (c. 1822) advertising Gardner’s collections, and its cheerfully disgusting exuberance was a joy to read. These specimens had the job of persuading new patients that their symptoms resulted from something equally revolting, and judging by the advertising, this would have worked a treat.

My useless attempt at taking a sneaky picture when no one was looking. The line under the address says 'Dr. G. aged 70 and without enemies - God has done much for him.'

Early 19th-century anti-quackery publications portrayed Gardner as a hypocrite whose conspicuously pious attitude was just a front for charlatanry. The specimens, they claimed, had not passed through any human sphincters but were made by Gardner himself out of everyday substances. His tapeworms were chicken guts and his roundworms vermicelli, while ordinary insects and lizards played the part of the other strange beasts.

Gardner’s shop displayed the sign ‘The Universal Remedy Under God,’ but a critic in the 1820s accused him of holding ‘a poisonous nostrum in one hand, and the Holy Bible in the other,’ and his Methodism perhaps provided him with a get-out clause for patients who weren’t cured. A correspondent to the Medical Adviser in March 1824 described a butcher going to complain that the worm remedy had made him worse. It transpired that the butcher worked on Sundays and didn’t go to church, so Gardner allegedly told him:

God help you, it is an affliction of the Lord for your wickedness. I can do nothing for you, it would be impious to attempt relieving you; good day, I am sorry for you, young man.

(The butcher replied ‘So am I: good day, doctor.’)

John Gardner at the age of 74.

There is another side to Gardner’s religion, however – he was the founder of the Stranger’s Friend Society for the relief of the poor in 1785. By his own account in The Grain of Mustard Seed (1829), he got the idea while visiting a destitute fistula patient in a garret. Gardner began to put by a penny a week to help those less fortunate, and encouraged his neighbours to do the same. The society grew, inspiring similar organisations across the country.

Back to the worms, however. The following is a small selection of the exhibits detailed in Gardner’s broadside. A. lumbricoides is here referred to as Teres – Gardner tended to use the term ‘ascarids’ for threadworms instead.

Worms, from 1 inch to 130 in length, some with 150 suckers; others in the form of caterpillars; another species like woodlice, 12 feet to each; a wolf of the stomach, expelled from a lady at Hoxton, who had nearly fallen victim to its ravages!!

One animal, with ears like a mouse, from a gentleman. Another with 4 horns, 6 legs, and 12 feet, which lived 9 days, from a child of 9 years; a Tape Worm, its edges like the teeth of a saw; a Stomach Worm by a lady’s mouth, 7 inches long, in the act of emitting its young; male and female Teres, one emitting her young, were preying in the vitals of a gentleman five years, who could find no relief in Paris, nor Edinburgh!!!

A round Worm, 10 inches long, from the mouth of a child, aged 20 months, at the Palace; a Worm, resembling a small snake from the bowels of a man; 44 round Worms, 9 inches each, from a child; a narrow Tape Worm from a young woman’s mouth, 18 feet—she also voided 40 feet downwards, had been afflicted 16 years.

An insect from a young woman’s stomach, of a caterpillar form: it lived 7 weeks in a bottle, and gnawed through two corks!!

Two hundred worms resembling wood-lice, expelled from Mr. A— Hollywell Mount, which had tormented him for many months; a Bamboo Worm, with 4 horns and 12 legs, expelled from a man, whom it had nearly destroyed. Worms from the mouth, nose and ears of Mrs. T.——, and in the milk of the breast of Mrs. P.——, Bishopsgate Road.

From The Graphic, 10 Nov 1888

Sometimes, patent remedies killed people. The Live-Long Candy did manage to get mentioned at an inquest, and there’d be a particular irony in a product of this name carrying someone off – but I reckon it’s innocent.

Eight months before this ad appeared, 16-year-old Belinda Balls, housemaid to Mrs Waspe at Gusford Hall in Suffolk, was suffering abdominal pain. This was nothing new for her, but as she hadn’t been in her job very long, she tried not to make a fuss. On Saturday 24 March 1888, however, she was in such agony that she had to ask her fellow servants for help.

The cook, Jane Mallett, gave her a cup of ginger and Belinda struggled on with her work. By ten o’ clock that evening she was in serious trouble. Her mistress gave her some hot water, which made her vomit, and she went on to have a bad night, cared for by Mrs Mallett in their shared room.

On Sunday, Belinda took some ‘family pills’ (laxatives) to no avail, and had to stay in bed all day. That night, Jane Mallett sat up with her until she fell asleep, then helped her when she fell out of bed at four o’ clock in the morning.

When the cook next awakened at dawn, she was shocked to find her young companion dead.

Mr G H Hetherington, surgeon to the East Suffolk hospital, examined the body and found it to be ‘that of a woman well developed.’ Other than this observation, he could pass no comment until he had done a post mortem examination, when he discovered severe ulceration of the stomach. In his opinion, the cause of death was peritonitis. Mr Hetherington felt that Belinda’s habit of taking Live-Long Candy after meals had exacerbated her disease. Such quack remedies, he said, tended to alleviate the pain, but would cause constipation and ultimately be harmful. The implication was that the Live-Long Candy contained opium – but no analysis was carried out.

The Candy’s proprietor, J C Shenstone, at once wrote to the Essex Standard to set the record straight. The recipe had been around for 50 years, he said, since his predecessor Thomas Smith brought it to public attention and gained the endorsement of the Duke of Wellington. You might expect a dodgy practitioner to leap to an immediate and hysterical defence of his practices. Shenstone, however, defied any accusations of quackery by being completely reasonable and failing to threaten to sue anyone.

Shenstone was a dispensing chemist with premises on Colchester High Street. In around 1834, the shop had been established by Thomas Smith, who began selling the Live-Long or Digestive Candy a few years later. Certainly by 1844 he was doing a brisk trade in the stuff, and at around the same time employed an apprentice, James B. B. Shenstone, (a descendant of the 18th-century poet William Shenstone) who travelled all the way from Bath to take on the role. After his apprenticeship, Shenstone started his own business at Wells in Norfolk, but later returned to Colchester as junior partner to Smith. Thomas Smith died in 1864 and the business, including the Live-Long Candy recipe, went into the Shenstone family.

Henry Beasley, in The druggist’s general receipt book, gives the recipe as follows:

Powdered rhubarb, 60 grs.
Heavy magnesia 1oz.
Bicarbonate of soda 1dr.
Finely powdered ginger 20 grs.
Cinnamon powder 15 grs.
Powdered white sugar 2oz.
Mucilage of tragacanth q. s.
Beat together, and divide into parallelograms of 20grs. each,

The younger Shenstone’s letter was no-nonsense but polite. He offered a £200 reward to anyone who could prove that the product contained opiates or any other ingredient likely to cause constipation. He stated that he was ‘quite prepared to satisfy Dr. (sic) Hetherington privately as to the nature of all the ingredients used in the preparation,’ and included a note from the physician and surgeon of Essex and Colchester Hospital saying they had used the candy and found it beneficial. This could all have been done in an arsey passive-aggressive way, but in my opinion the tone of the letter is assertive but calm; an understandable response to someone who had made unfounded assumptions about the nature of the remedy.

Just a few months later, Mr Hetherington had more pressing matters to think about when his vehicle was overturned by a runaway horse – but perhaps that’s another story.

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Thank you to everyone who has voted for The Quack Doctor as Best Literary Medical Weblog in the Medgadget Awards! If you haven’t voted yet and would like to, polls are open until 12 midnight (EST) on Sunday 13 Feb. For once in my life I would like not to be the wheezy unpopular kid trailing at the back, so if you can sling a vote my way I’d be very happy!

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Surgeon P Power's handwriting. Image via www.canada.com

Regular readers of The Quack Doctor might remember that back at the end of September last year, I blogged about a news story surrounding the National Archives’ Surgeons at Sea project. The Archives’ press release focused on a 12-year-old Irish girl, Ellen McCarthy, who apparently had the misfortune to vomit up a whopping 87-inch parasitic worm while voyaging to Quebec in 1825.

Except that, in my opinion, she didn’t. To me, it looked as though the ship’s surgeon, Mr P Power, had scribbled his notes so hastily that he made a rather workaday 8½-inch ascarid look like a monster. (Though frankly, chundering up an 8½-inch ascarid would be quite sufficient to fuel a lifetime of nightmares in anyone’s book.)

Over Christmas and New Year, I spoke to a Canadian journalist, Randy Boswell, who had also looked at the digitised records and concluded that the worm was indeed a measly 8½-incher. He contacted the National Archives, who responded politely and promptly, alluding to the possibility that their experts had misinterpreted the records. Randy ran a story across his group of newspapers, complete with quotations from your very own Quack Doctor, and here it is:

Monster parasitic worm may have been only a fraction of the size

Surgeons at Sea is a brilliant project and I own up to being a total killjoy over this one small aspect of it. I love a good story as much as the next person, and I’m glad that this worm captured enough journalists’ imaginations to give Surgeons at Sea so much publicity.

That it turned out to be only 8½ inches might be disappointing, but c’est la vie.

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Source: The Liverpool Mercury, 30 December 1851

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Phlegm is generally white, greyish, or of a yellow colour, with streaks of black; its consistency varies from the limpidity of water to the thickness of jelly.

This vivid description is from Parisian chemist Paul Gage’s Treatise on the Effect and Disorders produced by Phlegm in the Human Frame – the pamphlet referred to in the advert above. The 16-page essay is elegantly written and, rather than trumpeting the medicine’s properties in the exaggerated fashion typical of quacks, Gage uses more sophisticated tactics to persuade the reader of its efficacy.

Phlegm, Gage believed, was implicated in virtually all diseases – the sheer amount of the stuff was evidence for this. He estimated that if all the phlegm in the human body were collected together, the quantity would ‘surpass the weight of all other evacuations.’ Medical men might argue over this, but they were too inclined to follow fashions in diagnosis and put their own opinions above the welfare of their patients. Gage uses the common quack ploy of discrediting the medical profession, politely accusing them of disagreeing amongst themselves, observing only what they wished to observe and ignoring ancient systems of medicine.

At the time of the Treatise’s publication in English (1851), disorders of the blood were the ‘in thing’ and according to Gage, doctors did not look much beyond blood-letting as a treatment. Drawing of bad blood, however, was useless as it would simply be replaced by more bad blood if the cause – that is, the phlegm – were not removed.

‘For heaven’s sake,’ appealed Gage, ‘overcome the principle before attempting to overcome the symptom.’

At the other end of the spectrum was the ‘enlightened medical man who has at heart the love of his suffering fellow creatures’ – i.e. Monsieur Gage himself. He pre-empts criticism by pointing out the medical establishment’s tendency to write off any new method as quackery in order to protect their own interests.

It was easy to tell if you were suffering from phlegm: the ‘abundant expectoration of clear and slimy mucus’ was a bit of a giveaway. Other symptoms, however, included dry skin, belching, pale lips, hoarseness and poor digestion. Women and children were the greatest sufferers but phlegm affected everybody – particularly those of weak constitution, sorrowful and melancholy temperament and a sedentary lifestyle.

The Antiphlegmatic Elixir was a laxative, which seems odd for a condition now associated with the respiratory tract, but to Gage phlegm was just as much of a problem in the digestive system. In children, for example, it could generate and nourish intestinal worms. When treated with the Elixir (in conjunction with a decoction of male fern – a standard vermifuge!), the creatures would come out surrounded by masses of the stuff.

As well as worms and the more likely coughs, colds and asthma, the Elixir would cure apoplexy, scrofula, gout, dropsy, palpitations, skin conditions and ‘diseases of women.’

The Treatise contains a list of successful cases, but in a departure from the common quack practice of printing testimonials in the patients’ own words, Gage sets his out in the third person, like the case histories in reputable medical books.

One featured patient was a 28-year-old lady with five children, who had numerous crevices in her right breast and a white swelling on her right elbow. Until the age of 25 she had thrown up large quantities of viscous matter every morning, and when her mother mentioned this to the attending physician, he prescribed the Antiphlegmatic Elixir. After five months the lady was cured.

By writing of a reputable doctor prescribing the Elixir, and giving a lengthy recovery period rather than a miraculous instant cure, Gage subtly dissociated himself from quackery and presented his ideas as equal in status with (but more enlightened than) medical orthodoxy. He appealed to the educated reader with a sense of responsibility for their own health, and in doing so trousered a similarly upmarket 4s. 6d. per bottle.

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The dearth of posts on The Quack Doctor over the last couple of weeks is owing to the fact that I was away in Israel and the occupied Palestinian territory – not on holiday exactly, as I got paid to go and write about it, but nevertheless much more fun than staying at home! For anyone interested, there are some pics here.

While I’m trying to catch up with everything, this brief post is a departure from the usual advertising-related stuff. Today the Guardian and various other newspapers reported on the National Archives’ wonderful Surgeons at Sea project, which has catalogued the records of Royal Navy surgeons and assistant surgeons during the period 1783 to 1880. Selected records have been digitised and are available for download – big files but well worth looking at.

The papers have understandably picked up on a weird and icky story – that of 12-year-old Ellen McCarthy from Cork, who while travelling to Quebec on the ship Elizabeth apparently vomited up a worm 87 inches long. Surgeon P Power, who recorded the case in 1825, displays better penmanship than many of his medical and surgical brethren before and since, but he was scribbling quickly in note form and perhaps the movement of the ship didn’t help either – with the result that I think the case has been misinterpreted.

I’m going to be a killjoy, but I believe the original document says the worm was 8½ inches long, not 87. Disappointing, but there you go. I’ve compared other examples of Mr Power writing ‘½’ and ’7′ and I’m afraid this instance looks very much closer to the ‘½’. (If I’m wrong, fair enough, but I’m pretty sure.) Several days later, Ellen McCarthy expelled two more worms – one 13½ inches long, the other 7. These must have been Ascaris lumbricoides and it is reasonable to suppose that the first one was too.

As for the treatment, described in the Guardian as oil of ‘terebouth’ – well, Power’s handwriting once again leaves a little to be desired but it’s clear he has put ‘terebinth.’

So that’s me being a bit grumpy in my post-holiday er… I mean post-business-trip slump. I’m not usually one to advocate spoiling a good story, but for me the original source wins. And it’s a good reminder that if you want your own words of wisdom to survive the interpretations of posterity, make sure you write neatly!

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To view the original document, go to http://www.nationalarchives.gov.uk/surgeonsatsea/ and download ADM 101/76/9. (28mb)

Thank you to regular reader Michael Power (no relation to P) for pointing me in the direction of this story.

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