The Quack Doctor

The Daily Advertiser 5 August 1735

As the old saying goes, ‘A night with Venus, a lifetime with Mercury,’ and Dr Newman’s Anti-Venereal Pills were just one of a plethora of clap and pox remedies advertised in 18th-century newspapers. The relatively anonymous purchase of a pea-sized bolus offered the customer a level of secrecy, but that was by no means the only reason for preferring an advertised remedy over consulting a doctor at home.

Notable physician and prolific writer Daniel Turner, in Syphilis. A practical dissertation on the venereal disease (1717) describes the standard treatment for the pox – salivation. Turner has a fluid style of writing that imparts elegance to even the most revolting of details, but the horror of the orthodox treatment shines through and sheds some light on the popularity of patent medicines.

In preparation for salivation, the patient should undergo purging medicines or bleeding and, for some, a warm bath was advisable. Women should have the treatment just after menstruation, and the temperate seasons of late spring and early autumn were the best time to carry it out – though of course it was not always possible to wait for the perfect time of year.

Turner recommends a dose of 15 grains of calomel twice a day. Initially the sufferer could expect violent diarrhoea and ‘horrid torture of the bowels,’ which in some cases would be quite sufficient to get rid of both disease and patient permanently, but after a few days came the initial signs of ptyalism – the copious production of saliva from which the treatment gets its name.

…we usually observe the Fauces to inflame, the Inside of their Cheeks to lie tumid, or high and thick, being ready to fall in betwixt the Teeth, upon shutting the Mouth; the Tongue looks white and foul, the Gums also stand out, the Breath stinks, (which is a good Omen of its coming on) and in general the whole Inside of the Mouth appears shining, seems as it were parboiled, lying in Furrows, much after the manner as it does in those who have lately held strong Spirits therein for the Tooth-ach.

By this point the patient wouldn’t be able to eat, but puking up phlegm was a good sign. While the unfortunate person was in this state, there wasn’t much the physician could do other than ‘to encourage your Patient chearfully to go on, and refresh him sometimes with a little mull’d wine.’

Turner’s experience suggested that at the high point (or low point) of the salivation, the patient could be producing up to five pints of saliva a day. This would subside and be resolved (one way or another) in about three weeks to a month.

All this, however, was just for a mild pox – a ‘stubborn and rebellious’ one would also require the patient to rub mercurial ointment into their limbs in front of the fire, and then wrap up in layers of flannel clothing. Along with the mercury, a salivating patient could expect aggressive treatment of the side effects – bleeding, emetics and laxatives were all part of the experience.

So this was the prospect if you consulted a doctor about the pox – not to mention the fact that your spouse and neighbours would find out what you had been up to.

A single, discreet dose from an advertiser seems not so much the preserve of the gullible as the self-preservation of the wary.

I will be hosting the next edition of Carnivalesque on 21 March, so am now inviting nominations of your favourite recent blog posts on any aspect of early modern history.

You can use the Carnivalesque form, or contact me direct. Please nominate specific posts rather than whole blogs, and don’t be modest – I positively encourage you to recommend your own posts as well as other people’s!

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I’m also starting an email newsletter – at least I will if enough people sign up for it. This will go out about once a month and will highlight new additions to The Quack Doctor – especially the lesser-known corners of the site – plus extra history of medicine content, links to useful resources and pretty much anything I think is interesting. If you would like to sign up, please use the form in the sidebar. (This is new and I’ve only tested it a few times so if it doesn’t work, please let me know.)

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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.

Source: London Evening Post, December 27, 1755

The Dr Linden of the advert is Diederick Wessel Linden, a physician from Westphalia who came to Britain in 1747 and settled in Flintshire. Better known for his writings about spa waters, and for featuring in an amusingly earthy scene in Smollett’s Humphry Clinker, he deserves a post of his own at some point, so today I’m just going to do a round-up of a few unusual remedies for gout.

The Gout, James Gillray, 1799

Should you be planning to ‘indulge in rich meats and sauces, racy wines, strong beer and cyder, and use but little exercise’ this Christmas, it might be worth keeping some of the following treatments handy:

In 1680, Sir William Temple, Bart, had published his experiments with the ancient Eastern practice of moxibustion (applying a small quantity of mugwort to the skin and setting it alight). This was still in print at the time of the above ad, though more as an historical curiosity than a source of advice:

Upon the first burning, I found the skin shrink all round the place ; and whether the greater pain of the fire had taken away the sense of a smaller or no, I could not tell ; but I thought it less than it was: I burnt it the second time, and upon it observed the skin about it to shrink, and the swelling to flat yet more than at first.

On the third burning, he was able to set his foot down without pain, but tended the burns by applying a clove of garlic and a Diapalma plaster. Temple also recounted some interesting remedies he had heard about on his travels, such as that recommended by Prince Maurice of Nassau:

…to boil a good quantity of horse-dung from a stone horse of the Hermelinne colour, as he called it in French, which is a native white, with a sort of a raw nose, and the same commonly about the eyes : that, when this was well boiled in water, he set his leg in a pail-full of it, as hot as he could well endure it, renewing it as it grew cool for above an hour together ; that, after it, he drew his leg immediately into a warm bed, to continue the perspiration as long as he could, and never failed of being cured.

A surgeon in Lorrain, meanwhile,

had undertaken to cure it by a more extraordinary way than any of these, which was by whipping the naked part with a great rod of nettles till it grew all over blistered;

(An alternative to nettles was holly – is that what’s happening to the Jolly Huntsman in the gallery?)

Origin of the Gout, Henry William Bunbury, 1815 print, courtesy of the National Library of Medicine Image Gallery

In the mid 18th century, one of the free books given away by Mr Burchell of Anodyne Necklace and Sugar Plums for Worms fame intriguingly offered:

‘The Easy Way of Curing the GOUT, by Transplantation: that is, By giving it to some Good-for-Nothing DOG, or CAT, and thereby Freeing the Person from it.’

(Transplantation didn’t mean anything surgical, you just had to get the dog or cat to lie on your feet.)

A poetical correspondent to The Morning Post and Daily Advertiser on Christmas Day 1786, however, put forward a different view. Though beginning with an agonised ‘Hence, loathed Gout! most dreaded fiend to Ease,’ he weighed up the pros and cons of the lifestyle that had led to his condition, and concluded:

But what is life, without or love or wine,
Without the orgies of the mystic bowl?
Let moralists their mental joys define,
But sweeter far the midnight flow of soul.
Gout! Then attack – I’ll brave thy greatest ill,
And fall, like valiant BEVILL, on the topmost hill.

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Wishing you all a very happy and gout-free Christmas!

STeel Spring or Jointed Trusses for the help and cure of Ruptures for Men, Women and Children in the Navel, Cod or Groin. Belt Trusses, made without Iron or Steel Bow, the Belt or Girdle is with Neats Leather, Silk or Velvet, being very easy, with a Spring good for all tender Bodies, especially for the Female Sex, keeping up the Rupture with more Ease and Certainty than any pretended new invention. Good for all Travellers either by Sea or Land. Strait Stockings, with other Instruments to help the infirm, made and sold by GUY NUTT at the White Naked Boy in Westmoreland Court in Bartholomew Close. His Wife helps those of her own Sex, being very skilful in the Business. To be spoke with every Day at his own House.

Source: The London Journal 7 Jan 1727

By the time of this advert, trusses were already a long-established treatment for hernia. The woodcut below, from Peter Lowe’s A Discourse of the Whole Art of Chyrurgerie (1597) shows an example of a 16th-century truss of the type advocated and popularised by Ambroise Paré.

Trusses, however, were only one way of dealing with a hernia. You could try taking herbs orally, such as in this recipe given by Robert Boyle in 1696:

Having well-cleans’d the roots of Sigillum Salmonis, scrape one Ounce of them into a Quart of Broth, and let the Patient take a Mess, or a Porrenger full of it for his Break-fast; or else give half a Dram or two Scruples of the Powder of it at a time, in any convenient Vehicle.

The likelihood of this working seems slim, but it was more pleasant than an ancient Egyptian remedy described by Prospero Alpini, who had encountered a modern version of it during his travels in Egypt in the 1580s. A pyramid of goat’s dung – or, alternatively,  mushrooms – was moulded over the hernia and set on fire in order to cauterise it. The method was still used in Alpini’s time, but with a mound of linen strips rather than dung.

Throughout the 18th century, the plethora of potential remedies included caustics, powders, plaisters, anointing the hernia with eggs, applying a decoction of camomile flowers, and administering tobacco-smoke clysters – which, according t0 William Buchan in Domestic Medicine (1769), ‘have been often known to succeed where every other method failed.’

Should the hernia become strangulated, however, there was nothing else for it but to undergo an operation. Percivall Pott described the process in A Treatise on Ruptures (1756) – the full account of the operation is too long to reproduce here, but you can get a general idea of what it’s like from the beginning:

When the operation shall be thought necessary, the manner of performing it is this:

The pubis and groin must be shaved clean, and the patient laid upon a table of convenient height, on his back, with his legs hanging easily over the end of it, then with a straight dissecting knife an incision must be made thro’ the skin and membrana adiposa, beginning just above the ring of the abdominal muscle, and continuing quite down to the inferior part of the scrotum…

Fortunately for most sufferers, the safest and most practical option was to wear a well-fitted truss indefinitely. Pott advised that:

With a truss properly made, and carefully wore, the meaner kind of people may be rendered fit for all the offices of life, will be capable of labour of any kind, of walking, of riding, &c. as all those find themselves to be, who are willing to do these kind of things

He warned, however, against unqualified practitioners who would misdiagnose other conditions as ruptures, and send patients away with a truss on their venereal bubo or abscess. Pott’s comments on ruptured patients’ reluctance to consult a physician are pertinent to quackery on a wider scale:

With this opinion and this fear, these pretenders are well acquainted, and very lucrative use do they make of them ; they well know, that the man who looks on his disorder as a material imperfection in his form, or as the cause of any debility, will be glad to be rid of it at almost any expence or trouble : hence the ignorant and credulous are subjected to tedious confinements, painful applications, and hazardous operations, while the timorous and bashful are cheated out of large sums of money for imaginary diseases or pretended cures.

Above: some examples of 18th-century trusses, engraved by Thomas Jefferys. This and the 16th-century image are used courtesy of Wellcome Images.

Source: Detroit Medical Journal August 1905

As you can see, this ad is aimed at the medical profession, and the product was accepted by orthodox practitioners of the time – it was the claims made about their efficacy that pushed these items into the nether regions of quackery.

After the 1906 Pure Food and Drug Act, US promoters of medicines had to be very careful what they said in their advertising and packaging, but this did not apply to non-drug medical devices. The dilators, (patented in 1892 by Frank E Young but not widely promoted until the early years of the 20th century), were touted as ‘A Radical Cure’ for piles and constipation, the idea being that well-trained muscles in the area in question would be able to cope with even the most solid of ‘solids’. The newspaper ads of 1907 and 1908 (aimed at ordinary punters rather than doctors) included assertions like: ‘cure even the worst cases’; ‘guaranteed to cure’; ‘positive and lasting cure.’ Had they been talking about a drug, the manufacturers would have been in trouble.

To take advantage of the supposed benefits, here’s what you had to do:

First warm dilator in warm water; then lubricate outside of dilator with Dr Young’s Piloment (or if it is not available, with vaseline) and while in a squatting position—or while lying on the side with knees drawn up—gently insert in the rectum as far as the flange or rim. Hold in place a minute and the anal muscles will hold and retain it. Sit or lie down and allow it to remain for half an hour or an hour to get the best results. Ten minutes will accomplish much. When ready to go on to the next larger size, it is best first to use for a few minutes the same size you have been using, inserting and withdrawing it a few times.

In case you’re wondering, the big ‘un was 4 inches long and an inch in diameter. Although at the time of this ad they were made of rubber, Bakelite was later used, and the design changed so that the flange at the bottom was flat and the dilators could stand upright, as in this photo of the exhibit at Glore’s Psychiatric Museum in St Joseph, Missouri (with thanks to cometstarmoon on flickr for the pic).

It wasn’t until 1938 that the new US Federal Food, Drugs and Cosmetics Act encompassed the sale of medical devices, and once that was in force it didn’t take long for the dilators to fall foul of the courts. In 1940, a shipment of dilators and their lubricant, Piloment, was seized at New York and the US Attorney for the Southern District of NY filed libels against them, alleging that they were misbranded.

The misbranding allegations related to the claims that the dilators would permanently cure constipation and piles, that they had many other benefits including promoting refreshing sleep, and that the instructions advised ‘you need have no fear of using them too much.’

The hearing accepted that ‘it would be dangerous to health when used with the frequency and duration prescribed, recommended, or suggested in the following labeling,’ and the consignment was condemned and destroyed.

Similar products, however, survive to this day – you can buy ones almost identical to the above on Amazon, though I’ll refrain from giving a link as I’m sure if you’re that keen you can find them for yourself.

Important Notice to the Afflicted
ALL Persons suffering from PARALYSIS, SPINAL
AFFECTIONS, RHEUMATISM, NEURAL-
GIA, ASTHMA, Pain in the Head, or all cases of INFLAM-
MATION or CONGESTION, should at once try Mr G. W.
Gedney’s VACUUM APPARATUS, by Dr. Junod, which has
been practised with great success for upwards of 40 years.
Testimonials of the highest character on application to
Mr. G. W. GEDNEY,
64, Victoria Street, London Road, Ipswich.

Source: The Ipswich Journal, Sat 24 June 1871

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The apparatus referred to was developed in the 1830s by Victor Theodore Junod, and as Mr Gedney here clearly acknowledges Junod, it seems likely that he just had one in his possession rather than that he was claiming any credit for inventing it.

The device, known as the haemospasic apparatus or exhausting apparatus, was an alternative to blood-letting, producing the supposed beneficial effects without the dangers of blood loss. The picture below (taken from the London Lancet in 1853, but it was a woodcut that was also used elsewhere) shows how it worked, and this description from The Journal of Health (Grindrod, London, 1852) explains further:

…a tin boot, into which the leg of the patient is inserted, and from which the atmospheric air is gradually withdrawn, by means of a small air pump, the top of the boot being kept in air-tight apposition to the leg, by means of a broad belt of vulcanised india-rubber.

The idea was like dry cupping on a larger scale – the blood would be sucked into the limb (the device could be also be used on the arm), therefore withdrawing it from general circulation, weakening the pulse and possibly even causing the patient to faint. This, Junod believed, would reduce fever and palliate any inflammatory conditions.

The effects, while not gruesome, don’t sound very pleasant:

No pain, but only a slight uneasiness, is experienced in the limb enclosed in the boot, which is found, on being withdrawn, to be much increased in size, and the blood does not entirely return into the circulation, and the leg resumes its original size, at first for twenty-four hours. (Journal of Health).

The invention was popular in French hospitals and when it was displayed at the Great Exhibition, its potential to replace blood-letting resulted in it being tried out in British hospitals too, with mixed results. Army surgeon A. MacLean M.D. (quoted in The Medical Times, July-Dec 1853) was somewhat underwhelmed:

I have to report that this apparatus has been tried in a variety of cases in this hospital, with the view of testing its power as a therapeutic agent; and have to state that the beneficial results have been very partial, and in many instances no effect of a favourable character was obtained.

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Source: The Medical Directory for Scotland, 1853 (click to enlarge ad or see transcript below.)

This product was reviewed by The London Lancet, (vol.1 1851) which heartily endorsed it as a way of creating rapid and healthy circulation of the blood on the surface after bathing. “Rubber” here means something to be used for rubbing, rather than india-rubber. I’m not sure why it was electric – perhaps the rubbing action built up static, allowing you to experiment with sticking yourself to the ceiling, or maybe the proprietor was just trying to jump on the bandwagon for up-to-the-minute electric products.

The Rubber was composed of tightly twisted alternate bands of wool and flax, and… oh, I can’t think of any way of making it sound exciting. It was a towel. That’s all.  Sorry.

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HEALTHY SKIN
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The Valuable properties of the
ELECTRIC RUBBER FOR THE SKIN
Are still but little known. It has received the valuable testimony of many of the first Members of the Medical Profession, and also private Gentlemen. The utility of a daily application, particularly after the cold bath, or sponging, both in restoring the heat of the blood and skin, without in any way injuring the skin, will be self-evident upon the making one trial of the Electric Rubber, manufactured solely for
LUDLAM’S
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159 & 160 OXFORD STREET

Pure   and   Healthy   Leeches.—Potter
and HAILEY beg to assure the Profession, Druggists, &c., that the
Leeches they offer are such as can be recommended for Purity, Health, and
Readiness of Biting.
POTTER AND HAILEY, Importers of Leeches and Turkey Sponge,
Herbalists, &c., 66, Farringdon-market, London.

Source: The Medical Times and Gazette, 3 July 1852

Thank goodness they are keen to bite – there’s no one worse to work with than an unmotivated leech.

Henry Potter’s leech, herbs and seeds business started up in 1812 in Farringdon Street, where the proprietor kept leeches in ponds in his garden. By the time of this advert it had been taken over by his nephew, also called Henry Potter, who went into partnership with his uncle’s former apprentice, George Hailey, and imported leeches from Hungary. The company is still going today as the apostrophe-shunning Potters Herbal Medicines.

The “Turkey sponge”  referred to in the ad sounds like some kind of frozen food product spawned from the mating of Bernard Matthews and your worst nightmares, but it was actually just a sponge. Harvested from the Smyrna region of the Mediterranean, it was the highest quality sponge available and was in demand by surgeons for mopping up the various substances emanating from the human body.

For more fun with leeches, view this amusing clip from Bernard L Kowalski’s 1959 low-budget horror flick, Attack of the Giant Leeches:

Attack of the Giant Leeches

Source: The Era (London)  Sunday 23 October 1853

Bailey was a respectable supplier of  ”every description of Anatomical, Dissecting, Amputating and Post-Mortem instruments” as well as trusses, support stockings, ear trumpets, railway conveniences (male and female), water beds and chest expanders. His adverts appeared in distinguished publications such as the Lancet as well as in the popular press.

Mr Bailey also made artificial arms, which could be useful for the Venus de Milo here if she should suddenly notice the fact that curvature of the spine is the least of her worries.

Invisible crutches were intended to the keep the shoulders up – the top part fitted under the arms and there was a steel attachment that fixed into the stays. The pictures below show the difference made to the posture by such contraptions i.e. not enough to be worth the effort.

Source: Health and beauty : or, woman and her clothing considered in relation to the physiological laws of the human body, Caplin 1864