A Short History of Quackery

And Byways In

JANET J. LIEBERMAN possible to buy medicine (Bettmann 1956). In addi- STANLEY J. LIEBERMAN tion, a prescription sent to a dozen different phar- macies would yield as many differents remedies, dif- fering in appearance odor, taste, and, we suppose, effectiveness. The bubonic plague, smallpox, and syphilis took their toll, but the quack survived. Downloaded from http://online.ucpress.edu/abt/article-pdf/37/1/39/32529/4445041.pdf by guest on 26 September 2021 Blood-Letting IT IS DIFFICULT TO DISTINGUISH between a From earliest times doctors theorized that life con- quack and a legitimate medical practitioner, if their sists of juices. The body was only the container in prescribed remedies work. Most people feel that a which the juices flowed. Four of these juices, or quack is one who engages in some aspect of the heal- humours, originated from the four elements of Em- ing art without proper qualifications; but he who has pedocles-earth, air, fire, and water. The organs were qualifications may also be a quack. merely preparers of the juices. In case of disharmony The difference appears to be based on the criteria in the body, excess juices had to be dispelled. Aside of place and time-and of intent. The "witch " from the ordinary portals of release of these juices, oc- of long-ago Africa may really have believed he had curring in good health and illness, the in- the power to cure. If he made serious attempts to vented another portal in the form of blood-letting. tend the injured and ill, he was considered a healer. Blood-letting was even practiced in the Stone Age. But if his intentions were fraudulent-if he knew Sharp flints, shells, fishbones, and wood splinters the magic incantations and worked only on were used to pierce a vein and permit excess blood to the patient's psyches, and if he used these mainly be released (Glasscheib 1963). Gardner (1965) notes for personal gain, power or money- he was a quack. that Celsus, first-century Roman medical encyclope- Although the exact origin of the term "quack" is dist, details blood-letting of that era. Glasscheib lost in antiquity, it may have come from the Dutch (1963) goes on to say that of all the ancient civiliza- word Kwaksalver, which refers to a salve for sebace- tions, alone withstood the epidemic of blood-let- ous cysts (Jameson 1961) or a seller of such salves ting. The Chinese developed instead. (Maple 1968). Quackery had its origins in our prehis- Philosophies on blood-letting varied through the toric past. By the time of the Roman Empire, quacks ages. Some phlebotomists (blood-letters), would existed in great numbers. They sold cosmetics, eye make a small opening in the vein in that area of the salves, and love philters. The quacks' remedies often body opposite the diseased side. Others preferred came from their Greek antecedents. bleeding the same side. The operation had to corres- pond to the proper phases of the moon. Thus, elaborate blood-letting calendars were designed Apothecaries of the Middle Ages (Maple 1968). Maple notes that in the Middle Ages monks were obliged by ecclesiastical law to undergo When the Greco-Roman civilization fell, there fol- regular blood-letting to regulate the decay of the lowed twelve or more centuries in which anything juices. Eventually, laymen, too, had to submit to that had been previously learned about the mainten- prophylactic phlebotomy. ance of health in the human body was completely forgotten. During these times anyone who practiced The authors (wife and the healing arts did so as well or as badly as his husband) live at 928 Monte rivals. Quacks had a field day in the Middle Ages Vista Dr., West Chester, when one epidemic after another swept through Pa. 19380. Janet J. Lieber- man is currently a doctoral Europe. candidate at Temple Uni- The apothecary dispensed remedies along with free versity, Philadelphia. For medical advice. During the plague, when many phy- biographical information, sicians fled, the apothecary became nearly the sole see ABT 35(6):315. Stanley Ef authority on health. The apothecaries charged exor- J. Lieberman is the senior member of Lieberman & Kelley, Attorneys at Law. He is also a lecturer in business law at bitant fees for their elixirs, potions, and philters. As Immaculata (Pa.) College and is on the board of trustees of a result, the average patient generaaly found it im- West Chester State College.

39 Leeching and Cupping

Leech , another method of blood-letting, is mentioned in Pliny's Historia Naturalis (circa 100 A.D.) Galen (a Greek and philosopher of the 2nd century) was concerned with what should be done if a leech was inadvertently swallowed (Lasagna 1962). Physicians and barber surgeons had long em- ployed the leech in popular medicine. However, in the late 18th and early 19th century, particularly -in , leeching became the rage. French ponds were quickly emptied of these valuable worms and they had to be imported from other countries. Between 1827 and 1836, Paris hospitals alone used five to six million f+:S~'i leeches annually (Glasscheib 1963). Applied by the hundreds to a patient's abdomen, the leeches could Fig. 1. A lady of quality is bled. After the procedure the suck up to one ounce of blood apiece before dropping surgeon bandages the cut by her elbow. Engraving by off engorged. Because the leech injected an an- Abraham Basse, in Glasscheib (1963). (Reprinted with per- Downloaded from http://online.ucpress.edu/abt/article-pdf/37/1/39/32529/4445041.pdf by guest on 26 September 2021 ticoagulant into the wound, blood continued to flow mission from Rowohlt Verlag Gmbh, Reinbek bei Hamburg, even after the leech fell off. Germany, and MacDonald & Co., London.) The practice of cupping was an allied art. Into a cup was placed some cotton or paper which was then mother-of-pearl, and porcelain. According to Glas- ignited. The cup and burning contents were placed scheib (1963), Louis XIII was subjected to 47 immediately over the patient's skin. A vacuum was phlebotomies, 215 purgings, and 312 clysters all in a created as the fire extinguished itself, drawing the six-minth period. (One would assume that the royal underlying tissue into the cup. Blood too was pulled throne was largely unoccupied during that time.) It be- into the area. If the skin was left unpunctured a came the mode at the French court of Louis XIV to hematoma (tumor filled with blood) developed; this take anemata even three or four times a day. was dry cupping. Wet cupping required the skin to be Clyster mixtures ranged from holy water, used to ex- pierced before the cup was applied, resulting in blood- orcise devils from possessed nuns, to , extracts of letting. Hippocrates mentions cupping, and it ap- orange blossoms or roses, and tobacco smoke, which parently gained and waned in popularity up to the was said to have a purifying effect and to ease present. Lasagna (1962) says that the medical profes- stomach cramps and fainting fits. sion had by the 20th century given up the practice, yet Although it may appear that the blood-letting, he also mentions that in 1929 author George Orwell purgings, and clysters were part of the legitimate prac- was cupped for pneumonia in a French hospital. It tice of medicine at the time, some people realized how appears that "old wives" still use this remedy in many senseless and potentially damaging these measures parts of the world. were. Contemporary writers and poets mocked them. Moli'ere ridiculed them in his plays, but this also their use. One had to be copiously Purging, served to popularize bled and one's intestines thoroughly evacuated in all cases of joy and sorrow. The poisons had to be dispelled from the body, even if it cost the patient his life. In addition to blood-let- ting, there was also the practice of purging. If the poisons could not be expelled through the veins, they fmust be forced out through the intestines. Use of emetics and purgatives became common medical prac- tice, both in the curing of ills and for prophylactic purposes. Even this was not enough, however, and the use of the , or clyster, became the . Ac- cording to Lasagna (1962) and Glasscheib (1963), the enema was applied by the Egyptians. Pliny suggested that the Ibis, a bird sacred to the Egyptians, used its curved beak, aided by its very long neck, to give itself a rectal infusion of Nile water. In the 15th century the clyster syringe once again became popular. There followed three-hundred years during which the clyster was enjoyed as one of the most popular remedies for all cases of physical dis- Fig. 2. A sick woman about to receive a clyster. Engraving comfort. Louis XI had enemata administered to his pet by Abraham Basse, in Glasschieb (1963). (Reprinted with dogs. Louis XIII collected clyster syringes that were permission from Rowohlt Verlag Gmbh, Reinbek bei Ham- works of art; some of , others of tortoise shell, burg, Germany, and MacDonald & Co., London.)

40 THE AMERICAN BIOLOGY TEACHER,JANUARY 1975 wand in hand, drifted from one patient to the next. With the odor of incense all about and to plaintive background The 16th-century physician Phillipus Aureolus music, the patients, holding hands, fell one by one to Theophrastus Bombastus von Hohenheim, who called the floor in ecstatic convulsions. Mesmer's himself Paracelsus (greater than Celsus), was con- treatment of psychosomatically ill patients resulted in sidered a quack by his peers. His revolutionary teach- immense success. His seances offered ing and his burning of the standard textbooks of the something for everyone. To the sick he offered a cure; to the time, particularly Galen's works, estranged him from bored, a new experience; to the sexually the rest of the medical profession. His contribution to repressed, sensual gratification. Mesmerism swept France like a hurricane. scientific and medical knowledge was considerable. He He might have in was the first to put forward the theory of the presence continued this state of adoration were it not for of magnetic forces in the human anatomy. three occurrences which impaired his Paracelsus advocated sowing some seed in the career. Louis XVI appointed a commission to inves- Mesmer's of the ground and then stroking a patient with a magnet im- tigate animal magnetism. Some com- mission's illustrious members were pregnated with Mummy. According to Lasagna (1962), Benjamin Fran- klin, Antoine Lavoisier, and Dr. Joseph Guillotin. Mummy was perhaps sea foam hardened on rocks, This commission concluded, "L'imagination fait le bits of human flesh from the bodies of travelers, or tout,

magnetism nul" (Jameson 1961). The Downloaded from http://online.ucpress.edu/abt/article-pdf/37/1/39/32529/4445041.pdf by guest on 26 September 2021 fluid exuded from exhumed bodies. Bettmann (1956) Royal Society of Medicine, in a says Mummy was powder of Egyptian mummies. similar investigation, reached the same conclusion. The third and most serious impairment to Jameson (1961) indicates that Paracelsus preferred his career as a mental healer was the French Mummy made from criminals that had just been Revolution. His hanged. After the patient had been stroked with the popularity waned, and when heads began to roll, Mesmer fled to Switzerland where he Mummy-impregnated magnet, the magnet was thrust retired to the life of an obscure country doctor. into the earth where the seeds had been sown. As the seeds germinated and grew, the patient's symptoms would disappear and he would be cured. Franz Anton Mesmer, a late 18th-century physician, was introduced to the magnet by his friend, as- tronomer Maxmilian Hell. After a few successful attempts in curing patients' stomach cramps with a pass or two of his magnet, Mesmer decided that he had a cure for all ills. Since this cure was painless, even inducing a pleasant excitation of the nerves, it immediately became a welcome respite from the pain- ful blood-letting, constant purgings, and clysters. In a very short time, Mesmer was the most successful and sought after doctor in Vienna. His alleviated, at least temporarily, the symptoms of the genuinely ill and cured the hypochon- driacs. It was not long before he magnetized his fish pond. A dozen or so patients at a time could dangle their feet into the marble fountain and holding hands would allow the magnetism to pass through them to effect a cure. He magnetized drinking water and the beds and clothing of the ill; he even magnetized mirrors so that they would reflect magnetic power. The magnetized trees in his garden, in addition to the fish pond, ac companied by magnetic music from magnetized musical instruments, produced significant results. Mesmer's attempts at curing the blind-since-birth piano virtuoso, Maria Theresia Paradies, brought a great outcry from the Viennese medical community, especially when he took the young girl into his home for closer observation (Glasscheib 1963). Eventually Mesmer had to flee to Paris, where he found everyone suffering from the "vapours." Hysteria and hypochondria were also at great heights. In Paris, Mesmer established a clinic *with fantastically ap- Fig. 3. Samuel Christian Friedrich Hahnemann pointed treatment rooms. Here patients (1755-1843). Artist unknown, in Glasschieb (1963). (Re- gathered in printed with permission from Rowohlt Verlag Gmbh, Rein- large numbers around magnetic sources, while bek bei Hamburg, Germany, and MacDonald & Co., Lon- Mesmer, wearing a lilac colored gown and magnetic don.)

QUACKERY AND BYWAYS IN MEDICINE 41 Others studying Mesmer's techniques ultimately which medication produces similar symptoms; and ad- turned Mesmerism from the farce it then was to minister appropriate quantities of the medication to hypnotism, a legitimate part of medical practice today. effect a cure. The most effective dilution was a 10% In addition to Mesmer, such quacks as James solution diluted in thirty times. Fishbein (1925) Graham, Elisha Perkins, and should relates the case of a young child who took the year's be recorded for their efforts with . Elec- supply of a family's homeopathic medicine at a single trotherapy was similar to magnetotherapy, but sitting and had no ill effects. instead of mere magnetism mild electric currents were Hahnemann developed a handful of disciples and passed through the body. soon was publishing a homeopathic journal. Although was banned in many parts of Europe, he Homeopathy was permitted to practice in the Duchy of Anhalt- Cothen (Austria). Here he thrived by demanding Samuel Christian Friedrich Hahnemann was born substantial advance payment. He never made house in Meissen, Germany, in 1755. After completing his calls, on the theory that those who were too ill to visit medical studies he attempted to practice, but because of his timidity and scepticism towards the currently practiced theraputic matters, his practice was generally unsuccessful. The poverty-harried Hahnemann had to leave village after village when Downloaded from http://online.ucpress.edu/abt/article-pdf/37/1/39/32529/4445041.pdf by guest on 26 September 2021 his debts became too great. In order to survive, he translated literary and medical works into German. In translating the works of the medical authority

William Cullen, he learned that cures . Xlt ~(t He disagreed with Cullen's reasoning for the cure and concluded that quinine cures because, when given to a healthy person, it produces symptoms like those of malaria. This hypothesis became the basis for the - system that would soon startle the medical world-homeopathy. It is the hypothesis, similia W. similibus curantur, or likes cure like (Fishbein 1925). v 4 --. Homeopathy was to Hahnemann a revelation. He returned to medical practice and in numerous articles in the public as well as the medical press he accused the court physicians of causing the death of the Holy Roman Emperor, Leopold II, by incorrect treatment. Because of the general indignation this aroused, his name became a household word. Fig. 4. Caricature of the homeopath's infinitesimai closes. "I should like a hundred-thousandths of a decigram of In about 1800 a heavy epidemic of scarlet fever magnesia, please." "I'm sorry, madam, we don't sell such broke out. Hahnemann announced he had a cure, but large quantities." By George Cruikshank, in Glasscheib would withhold the remedy until he received a large (1963). (Reprinted with permission from Rowholt Verlag sum of money as advance payment. Under heavy pres- Gmbh, Reinbeck bei Hamburg, Germany, and MacDonald sure from the medical profession he finally disclosed & Co., London.) his remedy-1/24,000,000th of a grain of belladonna juice (Glasscheib 1963). Hahnemann inisted this cure his office were too ill to be cured by the homeopathic was infallible, and if it appeared ineffectual, it was method. only because of improper usage. Belladona produces When Hahnemann was about eighty his wife died, symptoms similar to those of scarlet fever. Thus, it and he married a thirty-year-old Parisienne. They would, according to the principles of homeopathy, moved his practice to Paris where after eight very prevent and cure scarlet fever. successful years he died in 1843. Hahnemann was so sure of his principle that he Homeopathy had won many converts. It flourished tried his on himself and his children. He in Europe and especially in the . In 1848 noted down each and every symptom that he observed the first homeopathic medical college was opened in for the following thirty or forty days. The result was a Philadelphia. Another opened in New York City in compilation of medications and- all symptoms 1858. Fishbein (1925) notes that by 1900 there were 121 observed for each. Hahnemann concluded that the regular medical colleges, 22 homeopathic colleges, and effect of a medicament increases in proportion to its 10 eclectic colleges. Thereafter, really effective dilution. He therefore prescribed many, many medications and treatments began to replace the dilutions which produced infinitesimally small doses. homeopathic system. He put all this together with rules and basic principles In the final analysis, homeopathic treatment was of homeopathy in his Organun der Rationellen tantamount to giving no treatment at all. If recovery Heilkunde. With this manual in hand, anyone could occurred, it was due to the long forgotten Hippocratic cure any patient according to the prescribed rules: axiom that nature cures. This treatment replaced the observe symptoms of illness in the patient; determine dreaded purges, phlebotomies, and clysters. By com-

42 THE AMERICAN BIOLOGY TEACHER,JANUARY 1975 parison, therefore, homeopathy was the preferred treatment. Despite Hahnemann's errors, his philosophy was a significant phenomenon in in- fluencing the trend of modern medicine in the right direction.

Medicine Shows w- The traveling quacks were the doctors for the com- mon people. Originating in Europe in the Middle Ages, they traveled with their wagons and carts from one village fair to another. A town barker would announce the "theatra," and as crowds gathered, a jester performed and a small orchestra or acting troupe offered entertainment. When the crowd reached the dressed in doctor's proper mood, the quack appeared, Fig. 5. The quack at the . Engraving by Anton robes, and with the appropriate pitch sold his miracle Maulpertch, in Glasscheib (1963). (Reprinted with permission remedies. from Rowohlt Verlag Gmbh, Reinbeck bei Hamburg, Ger- Downloaded from http://online.ucpress.edu/abt/article-pdf/37/1/39/32529/4445041.pdf by guest on 26 September 2021 In Colonial America there were no medical many, and MacDonald & Co., London.) regulations for there were few doctors. The frontier woman had to depend on her own remedies or those of The corporate quack is the purveyor of the cure-all a neighbor or the Indians. The field was fertile for the analgesic. The seller of deodorant that in addition to quack-and he came, with his nostrums that were sure stopping perspiration will also make you popular with cures for all ailments of man or beast. Since there were as yet unfound friends. He is the modern alchemist no legitimate physicians for miles around-and, at who mixes a "mouth wash" that tastes terrible but best, very few in the cities-the medicine shows nonetheless will prevent you from contracting a cold brought "health" to the country. They brought and at the same time help hook a boy friend. And he is minstrels, circuses, and Punch and Judy. And they the creator of countless cures for the . brought their magic painkillers. Perhaps the most There are no advances in medical quackery, only im- famous of these, concocted in the late 19th century, provements in the skill of communicating to the was the "World Famous Kickapoo Indian Oil." gullible public the attributes of the quack's elixir. As Glasscheib (1963) says it contained herbs, camphor, long as people have ills, real or imaginery, there will turpentine, and lard; obviously it was a potent be those who sell hope.... There will be quacks. medicine. Patent medicines such as "Rattlesnake Oil" were equally popular. Most contained alcohol, glucose, REFERENCES and some herbs. With minor variations, similar patent medicines are available today. BETTMANN, 0. L. 1956. A pictoral . Charles C. Thomas, Publisher, Springfield, Ill. Quacks-Sellers of Hope FISHBEIN, M. 1925. The medical follies. Boni & Live- right, Inc., New York. GARDNER. E. J. 1965. Historv of biology, 2nd ed. Bur- The varied, sometimes bizarre, prectices related here gess Publishing Co., Minneapolis. may lead one to conclude that quackery is a matter of GLASSCHIEB, H. S. 1963. The march of medicine. Mac- ancient history. This, unfortunately, is not the case. Donald & Co., Ltd., London. is alive and well and practicing HAGGARD, H. W. 1929. Devils, drugs ana doctors. Medical quackery Harper and Row, New York. pseudomedicine all around us. The current records of JAMESON, E. 1961. The natural history of quackery. governmental control agencies at every level are filled Michael Joseph Ltd., London. with cases of so-called electronic devices to cure LASAGNA, L. 1962. The doctors' dilemmas. BFL Com- cancer. Weight control devices, programs, diets, and munications, Inc., Freeport, N.Y. market. MAPLE, E. 1968. Magic, medicine and quackery. Robert medication are available on the open Hale Ltd., London. Medication in some form, countless publications, or, for the more affluent, "fifteen transistor, battery powered and guaranteed one year" devices are ob- tainable for those who are determined to make Air-Water Relations themselves the patient or the victim of the quack. Legitimate medicine, from its beginnings until the The first comprehensive examination of the interac- present, was and is too expensive for those who need it tive effects of air and water pollution control has been the most-the poor. It is this strata of society that published by the Environmental Protection Agency. most often falls victim to the quack. This group is not The 358-page report, Intermedia Aspects of Air and limited to the economic poor; it includes the poor in Water Pollution Control (EPA-600/5-73-003), is avail- judgment and the poorly educated. It is these un- able for $3.15 from the National Technical Informa- fortunates who are today the victim of the quacks, tion Service, U.S. Dept. of Commerce, and the Govem- both individual and corporate. ment Printing Office, , D.C. 20402.

QUACKERY AND BYWAYS IN MEDICINE 43