The Quack Doctor

I had this post all specially planned for 21 May 2011 and now you tell me today has nothing to do with ruptures? Honestly, I don’t know why I bother.

Well, I might as well post it anyway – I get the feeling not many Quack Doctor readers will be going to heaven any time soon, so you’ll need something to peruse as you while away the Tribulation.

From The Penny Illustrated Paper, 16 July 1904

When the W. S. Rice Rupture Cure arrived on the market in the late Victorian period, traditional rupture trusses had been around for centuries, and were constantly being re-invented in the hope of improving them. Many severe-looking designs – like the American one pictured below – jostled for supremacy, so to stand out from the crowd, new products had to offer something different.

Truss by Levi Westinghouse, St Louis, Missouri, 1877. I assume this is supposed to be a woman, otherwise that's a damningly small leaf.

The Rice Method offered to cure, rather than simply support, ruptures. And if you had a hernia, I would imagine absolutely anything that might get rid of it would have been worth a go. Although the Rice method included an ‘appliance’ for temporary use, the lasting cure would be performed by a liniment called Developing Lymphol. Twice a day the patient had to remove the appliance, sprinkle some Lymphol onto the rupture and rub it in thoroughly. This must have been pretty empowering for people otherwise faced with the grim prospect of indefinite truss-wearing.

The Lymphol comprised essential oils of origanum, spearmint and peppermint, with tincture of capsicum and red dye, all padded out by rectified spirit. Its accompanying appliance was described by the BMJ in 1908 as ‘an elastic band to go round the body, fitted with an adjustable pad and an understrap.’

Rice was London-based but advertised the product widely in the US, Canada, Australia and New Zealand. Representatives travelled around offering free trials where sufferers could have the method ‘demonstrated to you right on your own rupture.’

‘Are you tired of that binding, hampering, uncomfortable old truss?’ asked one of Rice’s 1920s advertisements before exhorting the reader to come along to a demo. ‘[The Rice Method] is modern, up-to-the-minute, abreast of the latest scientific developments. It is the one Rupture Method you are not asked to take on faith alone—’

San Jose News, 23 May 1928

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.

Reynolds's Weekly Newspaper, 2 August 1857

A deaf person seeking treatment in 1850s London appears to have had plenty of options, judging by these advertisements in Reynolds’s Weekly Newspaper. The only problem was, the advertisers all belonged to the same gang – and if you knew what was in their medicine, you would not let it anywhere near your ears.

Multiple ads under different names were a mid-19th-century scam that I’ve written about before. A patient might well try more than one practitioner in their search for a cure – so if one person posed as all those doctors, he could take the same victim’s money time and again.

Patients consulting by post from outside London were a good source of income, but those visiting in person posed more of a risk. The quacks had to keep up with who they’d seen under which alias, otherwise things could go badly wrong…

In 1857, Miss Mary Scattergood visited ‘Surgeon Coulston’ in response to an advert that promised a cure in ten minutes. She soon discovered that this came at the extortionate price of ten guineas, which she could not afford, but she agreed to pay five on the proviso that a hearing apparatus was part of the deal. She expected to undergo some procedure that would have an immediate effect, but Coulston sent her away with a bottle of mixture instead. By the next morning, he told her, she would certainly be cured – though he continued with less certainty by saying ‘Use it again the following night in case you are not.’

The mixture gave Miss Scattergood sore ears and a headache – added to which, she had never got the apparatus she paid for, so she returned to Coulston’s premises. He wasn’t there, and his assistant (who considerably resembled him) said he had gone away for a few days.

Miss Scattergood called again several times but the assistant eventually told her Coulston had gone to Madeira, so she had to wave goodbye to her five guineas and put this one down to experience. It wasn’t until about two years later, when she accompanied a friend to an ear-doctor called Dr Matton (or Dr Watters according to some reports), that she discovered it was the same bloke – and this time she wasn’t going to let him get away with it.

Coulston/Matton/Watters’ real name was John Gibson Bennett, and he and his younger brother William were former card-sharpers now running a multiple-ad scheme along with a few other dodgy characters. William recognised Miss Scattergood and made a rapid exit, but she had seen enough. She had the older Bennett summoned to Westminster County Court, and other witnesses came forward to testify that he had conned them too – one man told how Bennett had called him a ‘grey-headed old rascal’ and threatened to throw him down the stairs.

J G Bennett, who ‘wore a moustache, and appeared to be about 40 years old’ denied everything, claiming never to have seen Miss Scattergood in his life. William, who also wore a moustache and was about ten years younger, tried to pin the blame on the non-existent Surgeon Coulston, but the judge ruled in favour of Miss Scattergood – she got back her five guineas and J G Bennett was indicted for perjury.

He didn’t turn up to his hearing at Bow Street Police Court, but some interesting evidence came out. The prosecutor, Mr Bowen May, acted on behalf of a newly formed anti-quackery society called the London Medical Registration Association, which had helped Miss Scattergood bring Bennett to trial. This Association had performed an analysis on Bennett’s mixture and found it to comprise urine and alum. A former porter to the gang told of a ‘place where urine was kept’ and that he had helped to make up the bottles (he was only doing his job, guv).

Then Claude Edwards, the Bennetts’ factotum, described how John and William Bennett both posed as Dr Watters even though there was a real Dr Watters involved too. In one incident, the younger Bennett left Edwards to treat a patient while he went to the pub, only returning to collect the money and saying ‘I think I must let Mr King off for twelve guineas, but if I can drop it into him for more I will.’ Mr King ended up paying more than 30 pounds for what he was told was a traditional remedy discovered by ‘Dr Watters’ in China or Japan.

The Morning Post 1 August 1857. John Nicol Watters was a real person who allowed the Bennetts to use his name. More about Dr Watters another time.

The magistrate issued a warrant for the arrest of both Bennett brothers, but by then their whereabouts ‘appeared somewhat uncertain.’

Although the Bennetts had legged it, the law later managed to catch up with other members of the gang. That’s a story for another post, but during one hearing, Edwards confirmed that the brothers’ liquid medicines were mainly urine and that their powders were nothing but sawdust.

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(Note: The court hearings were reported in numerous newspapers and the quotations above are repeated in several sources, but some examples are The Morning Chronicle 10 February 1859 and The Era 6 March 1859)

In honour of UK Census Day, here’s one way in which phrenology proved of great help in 1891:

Source: The Hampshire Telegraph and Sussex Chronicle, 11 April 1891

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From The Graphic, 15 Feb 1890

There’s often something a bit fishy about patent remedies, but this one appeared before the advent of canned tuna and, for the average non-sea-going punter, the name did not have the piscatorial associations it has now. A company called Fels and Davis began promoting it in 1879, but by the following year Davis had quietly disappeared from the adverts and the business became Fels and Co.

The remedy was promoted as ‘a strictly vegetable compound’, and its trademark suggests that the vegetable in question was a prickly pear species, which produces edible fruit known as tuna. Given that The Strand is not renowned for its supply of cacti, the product wasn’t necessarily made from real tuna fruit, but it’s odd that the advertising doesn’t go all out to create an exotic background story. Instead, the unique selling point was the free dose offered to anyone who called in person at Savoy House.

From The Graphic, 11 Jan 1890

The experiences of one such caller are set out in a testimonial on an 1879 pamphlet, which is a good example of a proprietor portraying an apparently sceptical customer whose eyes are opened to the wonders of the remedy. The customer, a neuralgia sufferer called J Flynn, starts off thinking of Tuna as ‘only another remedy cracked up by quacks’, and goes to Savoy House purely out of curiosity when he happens to be in the area. After receiving his free dose, he is not convinced, so the Tuna representative gives him another, and still nothing happens. Unable to hang about any longer, J Flynn goes on his way, when the inevitable occurs:

But mark! Before I had gone less than a mile the pain entirely left me, and I have not had the slightest symptoms since, and this was after three weeks’ incessant pain, from which I could barely sleep or eat food.

Flynn goes from writing off Tuna as just another quack potion to viewing it as ‘a godsend to mankind,’ and concludes by thanking Fels and Davis for being ‘extremely kind in curing me and not charging me one halfpenny’. The technique of showing the conversion of sceptic to believer is a common one in patent medicine advertising - here, it’s elegantly combined with a reminder to the reader that there’s absolutely nothing to lose from a visit to Savoy House.

When Nancy Harborough took her sick child to a local celebrity doctor in 1844, she probably didn’t expect to receive advice worthy of Matthew Hopkins two centuries earlier. As it was, the whole sad episode ended up in court, and as the Hull Packet put it:

The facts of the case speak but little indeed for the boasted ‘march of intellect of the nineteenth century’.

The doctor, Sago Jenkinson, is a shadowy figure who seems to have enjoyed sudden and brief fame in 1840s Hull. He gained a reputation as ‘The French Doctor’, although in a later court case (not the one that concerns us here) he said he was not French and couldn’t even speak the language. He was, he claimed, a Muslim from Constantinople – and this must have gained some credence, for one of the local names for him was ‘Dicky Mahomet’. One anonymous person, however, piped up in court to say that Jenkinson was the son of a woman from Drypool who used to hawk greens in the streets.

An imagined quarrel

Nancy Harborough’s consultation with Jenkinson at the Noah’s Ark in Witham did not result in him sending her home with a dangerous potion. Instead, he (allegedly) told her that the child did not need medicine but would be cured if she did as he suggested. He informed her that she had quarrelled with a neighbour. She did not recall doing anything of the sort so he told her to come back when she remembered.

Jenkinson’s consultations were so packed with people that it was difficult for Mrs Harborough to see him again. But she persevered, and when she next consulted him he asked her to come back in an hour with details of the supposed argument. Presumably preoccupied and frightened about her child’s condition, Mrs Harborough clutched at straws and managed to dredge up a memory about the child bickering with the offspring of one unsuspecting Mrs Sharp.

Drawing blood from a witch

Jenkinson allegedly told Nancy Harborough that Mrs Sharp must have ‘overlooked‘ the child and put an ‘evil hand‘ on it – in other words, ‘witched‘ it. In order to relieve the symptoms, Mrs Harborough must draw blood from the witch with a pin or – better still – a worsted needle.

Nancy Harborough was concerned that if she went ahead, Mrs Sharp might bring the law against her. She did not carry out the proposed assault, but did mention to her neighbours the doctor’s strange advice. When her child sadly died, the neighbours thought something was up. Mrs Sharp, described by the local newspaper as ‘a decent looking woman, about thirty-five‘, found herself ostracised by the community and the subject of unpleasant pranks. She discovered what was going on when a local shopkeeper pointedly said ‘Ah, that poor child is dead; nobody can hurt it now.‘ Mrs Sharp elicited an explanation and went on to instruct her lawyer to threaten Mrs Harborough with prosecution for slander. Mrs Harborough’s best option was to try to bring the ‘doctor’ to court.

Exceedingly dirty in his person

The Hull Packet no doubt wanted to entertain its readers by denigrating the defendant, so its description of Jenkinson must be taken with a pinch of salt, but it is nevertheless quite amusing:

The prisoner, who was exceedingly dirty in his person and linen, and who had on a grey shoddy surtout and a Prussian cap decorated with a rim of gold lace, has an emaciated appearance, and seemed when brought into court to have been indulging in spiritous liquors.

Witchcraft, and such like tomfoolery

While the court did not exactly approve of Jenkinson’s activities, it decided that the case was too silly to continue with. Magistrate Mr Atkinson said it was clear Jenkinson had endeavoured to incite Mrs Harborough to a breach of the peace. He was surprised, however, to discover that anyone still believed in witchcraft these days and ‘blamed the woman for her simplicity, as well as the man for his duplicity.’  Atkinson hoped that the publicity of the case would stop people ‘giving credence to the notions of witchcraft, and such like tomfoolery.’ Sago Jenkinson was discharged and the whole thing blew over.

Nancy Harborough was the only one left suffering – the loss of her child was a tough price to pay for her lack of education and her desperation to find someone who might help her.

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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Above: Christmas at the Middlesex Hospital, Illustrated London News, 3 January 1874

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On Christmas Day 1898, one of the house surgeons at the London Hospital dressed as Father Christmas and did the rounds of the wards, accompanied by a medical student togged up as Pierrot and pushing a trolley full of presents for the patients. The children received toys and sweets, and adults received practical gifts such as items of clothing. All 702 patients also got a Christmas card, and those well enough to have a good appetite sat down to a turkey and roast beef dinner followed by a huge plum pudding that arrived flaming with brandy. For patients (or inmates as they were known) whose home lives were characterised by drudgery and often downright squalour, there were worse places to spend Christmas than in one of London’s large hospitals.

Some late-Victorian newspapers had a tradition of reporting on hospital festivities, and while newspaper stories inevitably have their own agenda – in this case wanting to provide a heart-warming tale for their readers (and probably sucking up to the great and the good on the hospital committees) – they do give an insight into the dedication of the hospital staff and the extent of the charitable giving that brought some Christmas cheer to sick and impoverished people.

Westminster Hospital patients were in for an early start when the staff started carol singing at 6am and then held a worship service at 6.30. The patients went on to receive a variety of gifts including warm garments, purses and workboxes, and in the afternoon the male patients were allowed to light up pipes – an indulgence normally against hospital rules. Allowing the men to smoke on Christmas afternoon was a popular hospital tradition – at St Mary’s, Paddington, for example, a pipe and tobacco was the standard gift for the chaps.

The same year, the Middlesex Hospital had a huge Christmas tree, flowers sent by a local philanthropist, and toys for the younger patients courtesy of the Duchess of York. The Morning Post stated that: ‘Under the supervision of Miss Thorold, the lady superintendent, the 300 patients enjoyed a thoroughly festive Christmas day‘ – under such supervision, I suspect they enjoyed it whether they liked it or not.

Decoration of the hospital wards usually fell to the nurses, sometimes with the help of medical students. Evergreen branches and greetings with letters cut out of cotton wool made the wards festive. Some hospitals did not allow evergreens in case they harboured germs, but most had at least one Christmas tree, and St George’s had a gigantic tree in every ward, lit with electric lights. St George’s was known for its classy decorations, and in 1897 The Morning Post explained this by saying ‘St George’s is an aristocrat among hospitals, and is noted for doing all things well.‘

At St Bart’s that year, 19st of beef and 700lb of plum pudding were just enough to give all the patients a hearty meal, while the custom at Guy’s Hospital was for the medical and nursing staff to have their Christmas lunch with the patients.

On Christmas afternoon, most hospitals (except those specialising in infectious diseases) allowed patients to invite visitors for tea, and this was particularly important for those in the children’s wards, who could spend the afternoon with their parents. Entertainment was often provided, ranging from impromptu songs by the more musical among the nurses and students, to fully fledged amateur dramatics involving the physicians and surgeons. At St Thomas’s and St Mary’s in 1899, the staff had pianos put into each ward for a good old sing-along.

Christmas in hospital is never going to be wonderful, but these Victorian nurses, ward sisters, students, physicians and surgeons did everything they could to make it a happy occasion for their patients. Let’s be thankful for them and for their modern equivalents who are on duty right now, caring for people who are ill or injured.

Thank you to everyone who has read, commented on and retweeted The Quack Doctor over the past year. I wish you all a joyful Christmas and a new year filled with happiness, hope – and especially health.

Source: The Graphic 11 July 1891

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From the moment of his sudden rise to fame in Portsmouth in 1887, Sequah knew how to win friends and influence people. He built up an almost cult-like following by giving the crowds what they wanted – miraculous cures, affordable medicines, and a lot of Wild West-style entertainment.

Handbills and extensive newspaper advertising built up the hype, so that when Sequah arrived in town, a curious crowd would be waiting for him. His painted wagon, brass band and entourage of assistants dressed as cowboys and Indians made for an unusual spectacle, and his displays of speed dentistry would get even cynical audience members cheering.

For all Sequah’s Western get-up and claims about the traditional Native American origin of his recipes, he was a Yorkshireman called William Henry Hartley. About a year after he began his shows, demand for his products – Sequah’s Prairie Flower and Sequah’s Oil – proved so high that he needed to be in two places at once, so Hartley recruited some more ‘Sequahs’ to cover different areas of the country. By late 1890 there were 23 of them, and Sequah grew to be a big-business brand name throughout Britain and Ireland.

Getting the audience on side was a vital part of Sequah’s modus operandi. The entertainment provided by his apparent tooth-drawing expertise was just the prelude to the main part of the show. Rheumatism sufferers would be carried up on stage to undergo a theatrical process of massage with Sequah’s Oil. Afterwards, they walked jauntily away, apparently cured.

It sounds a con, but these patients were not shills – they were local people known to others in the crowd. One example is Michael Casby of Sheffield, who informed Sequah that he had suffered from rheumatism for 16 years. Consultations with numerous doctors had been to no avail so Sequah’s attendants carried him forward for treatment. Soon the pain had gone, and Casby and Sequah danced a jig together.

One audience member, John Roadhouse, was suspicious. He asked around and discovered that Casby was an outdoor labourer on the Duke of Norfolk’s Sheffield estate. He had missed only half a day’s work in the past three months, and his colleagues expressed surprise that he had been carried onto the stage, as they had never known there was anything wrong with him. Casby later tried to explain away his actions by saying he had knee pain. His motivation appears to have been to buy into the hype surrounding Sequah and become part of the performance. For other patients, the collusion with the theatrical atmosphere was probably subconscious – caught up in the excitement, they might exaggerate their condition and play to the audience’s expectations of a cure.

Above: Sequah pulls a tooth while his brass band  plays in the background. The bulb on his forehead is an electric light. Cheshire Observer 15 March 1890

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Sequah also insinuated himself into influential people’s good books by giving money to local charities, but there was one group he did not get on with – medical students.

In Edinburgh in 1888, a note travelled round the University’s medical department suggesting a demonstration against Sequah (the original one). At Waverley Market that night, according to the Dundee Courier & Argus, Sequah was ‘greeted by a considerable number of young men with jeers and cries of “Quack.”’ Allegedly, one of them leapt forward and coshed a performer (possibly Sequah himself) with a stick. The assaulted party retaliated and knocked him out, to the delight of the crowd, who began shouting ‘Down with the students!’ The disturbance must have been anticipated, however, because the police were out in force and used ‘energetic measures’ to quell the kerfuffle and haul the students away.

Police involvement was a regular occurrence at Sequah shows, but they were not always so heavy-handed. In 1889 a police sergeant managed to rescue one unfortunate young man when the crowd turned ugly on him. The show included a ‘thanksgiving’, where former patients were invited to testify to the power of Sequah’s treatment, but once the man got up on stage, he said what he really thought about its failure to cure him. On his return to the crowd, he was set upon and had to be pulled back onto the wagon, where the sergeant also scrambled up to protect him until the show was over. Afterwards, a mob followed the wagon as far as the police station, shouting ‘Lynch him!’ Once inside the charge office, the frightened chap managed to escape via a side door, having learnt that upsetting a quack’s loyal followers can be a matter of life and death.

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There is a vast quantity of surviving evidence pertaining to Sequah and his medicine company – enough, in fact, to fill a whole book rather than a blog post, so it’s possible that Sequah will show up again on The Quack Doctor. For further reading, however, I can highly recommend W. Schupbach’s paper, Sequah: An English “American Medicine” Man in 1890, which is available at PubMed Central.

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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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