How over-the-counter opium led to America’s landmark food-and-drug law
Snake oil was just the beginning
Before Congress stepped in, medical fraud was everywhere in America, from the boomtown auction block to the corner pharmacy in Chicago. And it was becoming everyone’s problem
The products in question were popularly called patent medicine (though few were ever patented), and made for booming business from the Civil War until the early 20th century. (This period was simply its heyday. In truth, the practice of selling something by promising unproven benefits continues through today, to be found in the latest ExtenZe infomercial or Moon Juice dust.) The model operated — more or less — as you would imagine: Some ambitious fellow would manufacture a pill (or a tonic, or a cream, or whatever), come up with some vague reason for its effectiveness (electromagnetism! microbes! Indian recipes!), and spend the lion’s share of his budget on marketing and advertising. In a time before scientific visibility or reverence, it was rather lucrative.
For instance, William Radam, behind Radam’s Microbe Killer, peddled a 99 percent water solution, pegged it to the latest credible science of Louis Pasteur, and claimed that his concoction would cure the patient of microbes in the blood (the source of all diseases, he insisted).
Yet a greater risk to the public came from how many of these medicines used real and potent ingredients. So-called medicines, like Dr. Kilmer’s Swamp Root and Peruna, had alcohol contents ranging from 10 to 30 percent, a happy feature for those in areas of the country where temperance laws made it harder to track down a cocktail, or for women who were discouraged from entering a bar or saloon.
A remedy named Kickapoo Indian Oil contained not only alcohol but opium. A popular variety of so-called “catarrh” medicines frequently contained cocaine. (As did, famously, Coca-Cola, which in the 1890s marketed itself as a “brain tonic,” because why the hell not?) These powerful drugs may have created the illusion of efficacy, by numbing pain or increasing energy or by making an infant stop crying, but their long-term effects amounted to little more than a population of addicts and people who remained sick.
Physicians and professionals long knew these remedies to be bunk, but their publicity rarely extended farther than their own meetings or esoteric trade journals. Those who could have done something about it — journalists — were notably mum on the subject. Why? Because, simply put, medical quacks were reliable advertisers. Their tonics and miracle cures paid for precious space in periodicals everywhere. In fact, the affiliation between medical scammers and reporters become so familiar that once, after a company purchased ad space in a paper, it requested its reporters to do the work of forging the testimonials to fill it.
This tacit coziness was forever changed in a single moment. On October 7, 1905, a man named Samuel Hopkins Adams, who had recently left his job selling magazine ads to write full-time, published the first installment of his eleven-piece expose: “The Great American Fraud.” “Gullible America,” he opened his piece in Collier’s magazine, “will spend this year some seventy-five millions of dollars in the purchase of patent medicines. In consideration of this sum it will swallow huge quantities of alcohol, an appalling amount of opiates and narcotics, a wide assortment of varied drugs ranging from powerful and dangerous heart depressants to insidious liver stimulants; and, far in excess of all other ingredients, undiluted fraud.”
Part of the power of Adams’s reporting was that it did not shy from getting specific or precise. His piece followed anecdotal cases of those harmed by addictive and harmful ingredients, he named the names of guilty brands and culpable proprietors, and cited doctors who were reporting on a public-health catastrophe from the ground. These medicines had preyed upon the desperate and uninformed, swindling customers with claims that ranged from the dubious to the outright deadly, purporting to cure not just headaches and pains but venereal diseases, tuberculosis, epilepsy, and even cancer (thanks to the power of “soothing balmy oils”).
The charlatans behind patent medicine did more than make addicts: they made corpses. Adams collected the names of twenty-three people who ingested the coal-tar byproduct acetanilide through nostrums like Orangeine (taken liberally and without a doctor’s prescription), and later died. Now, the truth about fake medicine captivated the public like never before.
In 1904, Idaho Senator Weldon B. Heyburn spoke to his colleagues on behalf of a long-stalled issue of legislation. “We may extend our lines as a country; we may build battle ships and navies and constitute great armies,” he said, “but if the health of the people is to be undermined by these concoctions of fraudulent and bogus medicines, of what avail is it?” A year after he addressed the Senate floor, Heyburn used the new public-relations momentum to ferry along a piece of legislation that had struggled, in one form or another, for over twenty-five years. Then, in June, 1906, President Theodore Roosevelt signed what was to become a formative bill of the Progressive Era: the 1906 Pure Food and Drug Act.
In terms of its effect on patent medicines, the bill only required that drugs list their ingredients on the bottle. This meant that wiser consumers were now less likely to buy medicine with “opium” on the label — but it was hardly a death knell for quackery (Clark Stanley’s Snake Oil Liniment, for instance, continued to be sold for another ten years.) The government still did not penalize drug manufacturers for lying about a drug’s effectiveness, nor could it make them prove their drugs really worked. But it did open up the door for regulatory bodies like the Food and Drug Administration and the Federal Trade Commission, and set a bedrock for later legislation, namely the Food, Drug, and Cosmetic Act, which passed in 1938 and had far more teeth to penalize those in the medical business who put the public at risk.
