Nostrums and Quackery and Pseudo-Medicine By Arthur J. Cramp, M.D. Formerly, Direct<»' of the Bu-rem, of Investigation (1906-1936) of the American Medical Association With a Forewordby GeorgeH. Sim~ons, M.D.,LL.D. Editor and General Manager Emeril11s,American Medical Assot'iat·io11 VOLUME III Pazss o:v AMBRICAN MBDICAL ASSOCIATION 535 NOllTH DBAlUIOllN ST., CHICAGO, ILL. 1936 COPYRIGHT 1936 BY AMERICAN MEDICAL ASSOCIATION CuICAGO I !· Printed and Piiblislied in tlie United States of America FOREWORD It is unnecessary to remind those whose memory carries them back twenty five or thirty years, and who are at all interested in the subject, that during this period there has been a remarkable· change for the bet­ ter in the so-called "patent medicine" business ; that the deliberate mis­ representation and downright fraud that characterized much of the newspaper and magazine advertising of a quarter of a century ago is much less in evidence ; that the claims on labels and circulars which go with the bottle or package are now ultra-conservative compared with what they were. Several factors have been responsible for this change: The Great American Fraud series by Samuel Hopkins Adams published in Colliers' in 1905-6; the Ladies' Honie J oiirnal crusade of about the same time; the passage of the National Food and Drugs Act; the activities of federal and of some state health officials; the influence of the Better Business Bureau movement; the awakening of newspaper pub­ lishers to the fact that fraudulent medical advertising tended to destroy public confidence in all advertising-all of these, some of them more or less sporadic and ephemeral, were influential in bringing about the change. But one of the most important factors has been the persistent, week-in and week-out campaign of education and enlightenment waged for nearly thirty years by the American Medical Association through its official organ, The Journal,, and, later, its health journal, Hygeia. The credit for this campaign, so far as it applies to "patent medicine" and to quackery, is largely due to Dr. Arthur J. Cramp. He it was who devel­ oped and became director of what is now called the Bureau of Investiga­ tion of the American Medical Association, a department which gathers, and makes available to the public and to the medical profession, informa­ tion on "patent medicines," quackery, and pseudo-scientific medicine. This book reveals the scope and activities of the bureau. As Editor of The Journal for more than a quarter of a century, I had intimate knowledge of the work, of the various problems involved, and of the responsibilities realized and assumed by the Director, Dr. Cramp, who, with the neces­ sary caution, with courage and with unswerving honesty of purpose, carried on until ill health forced him to retire, December 1935. This book, which he has prepared since his retirement, is tangible evidence of his continued interest in a subject that, for the past twenty-nine years, has been his life-work. GEORGEH. SIMMONS. October 1936. PREFACE TO VOLUME III A quarter of a century ago-in 1911-the first volume of "Nostrums and Quackery" came from the presses of the American Medical Association. It was a book of five hundred pages and contained practically all of the material on "patent medicines," quackery and pseudo-medicine in general that had appeared in The Journal A. M.A. from 1907 to the date of publication. The book received a good press, being extensively reviewed both in medical and lay publications. As a result, the edition was exhausted in a few months and a second edition of the first volume containing some two hundred additional pages appeared in Janu~ry, 1913. It is now out of print. · Eight years later-in 1921-enough material had accumulated to make another book and Volume II was brought out. This was a book of some eight hundred pages set in wider measure than the first volume and containing a large amount of material. It did not contain any of the material that had appeared in Volume I, but it did have a duplex index listing the subjects in both Volume I and Volume II. By 1930, more than enough material had accumulated to make another volume, but unfortunately the economic situation at that time made it impractical to get out Volume III. It was not until early in -1936 th~t it was feasible to prepare the third volume of "Nostrums and Quackery" which constitutes this book. Here again, no attempt has been made to duplicate material and with very few exceptions products, persons or concerns dealt with in this book have not been dealt with in Volume I or V{)lume II. The few exceptions comprise those cases in which later material has acclimulated and made it necessary to duplicate the reference. The present volume differs fundamentally from the previous volumes. In the first and second volumes, the articles as they had appeared in The Journal A. M.A. were republished in full. It has always been the aim in the preparation of such articles not merely to give the bare facts but to show in some detail the methods by which the faddist, the quack or the nostrum exploiter works. In other words, it has seemed just as important to explain in detail the ways that are dark and the tricks that are vain of the medical faker as it is to give such facts as might be developed in any individual case. Unfortunately, the amount of material that has accumulated since 1921 has made it quite impractical to use this method in preparing the present volume. Those who are interested in the methods as distinguished from the products or results of the faddist, the quack or the "patent medicine" maker must be referred to Volume II of "Nostrums and Quackery" which is still available, or to the many inexpensive pamphlets prepared and issued by the Bureau of Investigation of the American Medical Association. The present volume is mainly a factual record. Only in certain cases has it been necessary to deal in some detail with the facts set forth. The material that makes up this book is a condensation by the author of longer and more detailed articles prepared by him between 1921 and 1936 and published in The Jottrnal A. M. A., Hygeia, the many pamphlets issued by the Bureau of Investigation and one or two of several that appeared in the American Mercury. Many of the original articles were based on investigation ·made by the author in his capacity of Director of the Bureau of Investigation, supplemented when necessary by analytical work done by the American Medical Association Chemical Laboratory. Other articles here condensed had for their basis some of the splendid vi PREFACE work of the federal authorities, especially that done by the officials of the Food and Drug Administration, who enforce the National Food and Drugs Act of 1906, and by the Solicitor's Office of the Post Office Department. In but few instances have the articles had for their basis work done by state officials for it is unfortunately a fact that but few of the states make any effort to protect their citizens against the wiles of the medical faddist, the quack or the "patent medicine" exploiter. It is often ~barged-wholly without justification-that the medical profession's opposition to quackery and nostrum exploitation is motivated by self-interest. The facts are that if the medical profession looked at the "patent medicine" business from a dollars-and-cents viewpoint it would raise no opposition to it for, next to the "patent medicine" maker himself and the newspapers that take such a large share of the nostrum triaker's profit, ther~ is no other social group that is so widely benefited as the medical profession by "patent medicine" advertising. Every piece of advertising devised to convince the public that a pain in the lower part of the back means kidney disease will send, probably, as many people to the family physician as it will send to the drug counter. The medical profession is not opposed to the "patent medicine" industry because it cuts into its income­ for it doesn't-but because it is inimical to public health. The chapters that go to make up this book comprise an arbitrary list. The material dealing with many of the products, concerns or individuals in a given chapter might with equal logic have appeared in some other chapter. References will be found at the end of practically every item giving the source of the informa­ tion contained in that item. The excellent work done by the Food and Drug Administration, whether under that, its present name, or some other earlier name, has been heavily called on in making up this volume. Such information regarding "patent medicines" that have been declared misbranded under the National Food and Drugs Act of 1906 is given in bulletins issued by the Department of Agriculture lmown as Notices of Judgment. These are numbered and dated. Such references have been abbre"{iated thus: (N. J. 21586; 1934.) This means that the facts given appeared in a Notice of Judgment numbered 21586, issued in 1934. It should be borne i~ mind that the date of issuance of a Notice of Judgment is always later, and not infrequently considerably later, than the date on which the product was seized by the federal authorities. An entire chapter has been given to some of the investigations in the field of pseudo-medicine carried on by the Post Office Department in its efforts to protect the public against medical frauds carried on through the instrumentality of the United States mails.