Selected Papers of William L. White
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Selected Papers of William L. White www.williamwhitepapers.com Collected papers, interviews, video presentations, photos, and archival documents on the history of addiction treatment and recovery in America. Citation: White, W. (2014). Patent Medicine and Addiction in America. Posted at www.williamwhitepaeprs.com. Patent Medicine and Addiction in America William L. White Emeritus Senior Research Consultant Chestnut Health Systems [email protected] NOTE: The original 1,000+ page manuscript for Slaying the Dragon: The History of Addiction Treatment and Recovery in America had to be cut by more than half before its first publication in 1998. This is an edited excerpt that was deleted from the original manuscript. During the 19th and early 20th most widely distributed to American centuries, both the traditional medical field consumers. and the patent medicine industry provided The story of patent medicines begins drugs with high addiction potential to early in American history. English patent medicate a wide variety of physical and medicines were imported into the colonies psychological discomforts. America’s legal regularly until the time of the Revolutionary drugs came from two institutional sources. War. Some English colonists arrived with The first, referred to as the “ethical” drug patents for particular medicines issued by companies, have traditionally manufactured, the King of England (Gilbert, 1989). These advertised, and distributed medicinal drugs patents allowed the holders, and no one only to doctors, hospitals, and pharmacies. else, to manufacture and sell particular As prescription laws became the rule, the medicines. The term “patent” comes from ethical companies were the primary sources the Latin word patere, meaning “to be open.” of prescription drugs in the United States. The patent process required that the The other branch of the rising contents of the remedy be made public--a pharmaceutical industry was made up of requirement that few of the drug companies “patent” drug companies, which were willing to meet (Haller, 1989, p. 520). manufactured, advertised, and sold what Most so-called "patent" medicines in today we would call “over-the-counter” drugs America were really "proprietary" medicines. directly to the American public. Few formulas for American-made medicines Psychoactive drugs--including alcohol, were patented. Their manufacturers did not opium, morphine and cocaine--appeared in own the formula for their contents, but the products of both ethical and patent instead owned a bottle shape and color, a companies, but it was through the patent product name, or a label design. The term companies that these substances were first patent medicine was usually applied to williamwhitepapers.com 1 products that shared two characteristics: 1) Mother Bailey's Quieting Syrup their ingredients and formulas for their Mrs. Winslow's Soothing Syrup preparation were kept secret, and 2) they Allen’s Lung Balsam were advertised and sold directly to the Dr. Coles Catarrh Cure public (Young, 1953). Patent medicines Jayne’s Expectorant were also known as nostrums or secret Hoopers Anodyne, the Infant's Friend remedies. Dr. Grove's Anodyne for Infants Dr. Moffett's Teething Compound Opium, Cocaine, and Alcohol as Patent Perkin's Diarrhea Mixture Medicines McMunn's Elixir of Opium Patent medicines containing alcohol Ayer's Cherry Pectoral and other drugs came in many forms. They Professor Hoff's Consumption Cure came in their natural form, such as gum Dr. Fowler's Strawberry and Peppermint opium. They came in tinctures--drugs Mixture dissolved in alcohol--such as the Laudanum. Gooch's Mexican Consumption Cure They came in syrups like Mother Bailey’s Kendal Black Drop Quieting Syrup, concentrated solutions of Perry Davis’ Vegetable Pain Killer water and sugar which often contained alcohol and opium. They came as cordials, So many American patent medicines were aromatic liqueurs that contained opium or loaded with opium, cocaine, or alcohol that cocaine, as did Coca Cordial. There were Anstie, in his 1865 text on stimulants and also balsams (ointments filled with other narcotics, referred to them as the "inebriant drugs that were absorbed through the skin), medicines" (Anstie, 1865, p. 85) anodynes (pain-relieving agents), and powdered forms of opium and cocaine. Source and Availability Some products also were mixed with tobacco for smoking. The resin-heavy form Most of the opium that formed the of opium specifically prepared for smoking basis for American narcotic medicines was was not available in the U.S. until the mid- imported. During the 19th century some 1800s. producers tried to cultivate poppies in the Although opium was available in United States--particularly in the South, but crude form during the 18th century, it was not American opium production could never until the 19th century that a patent medicine compete with the prices of opium imported industry arose, with opiate-filled elixirs and from countries such as Turkey. nostrums as the centerpiece of its offerings. Beginning in the mid-19th century, The industry used crude opium and patent medicines filled with alcohol, opiates, morphine, as well as another narcotic and cocaine were available from doctors, alkaloid—codeine--isolated by the French drugstores (without a prescription), grocery Chemist Robiquet in 1832. stores, mail-order houses, and traveling During the 18th and early 19th peddlers who went from town to town selling centuries, a number of patent medicines their chemical wares. In his containing opium or opium derivatives autobiographical account of addiction, became quite popular, including: William Cobbe wrote about buying opiates in drug stores "which sell the poison as Dovers Powder (ipecac and opium indifferently as they sell toilet soap" (Cobbe, powder) 1895, p. 127). Laudanum Drug products could be ordered in Paregoric Elixir (camphorated tincture of secret and delivered with discretion, in what opium) may have been the first appearance of the Godfrey's Cordial "brown-paper wrapping." In advertising, the testimonials to these products called out to williamwhitepapers.com 2 those seeking physical and emotional vulnerability and told it readers how to comfort. The fancy bottles, with their protect themselves or self-treat those government patent and copyright stamps, diseases--with patent medicines. which really applied only to the bottle or the The patent medicine industry reached its label, gave the impression of official peak level of profit and visibility between government endorsement. 1870 and 1930. Its growth was explosive. David Musto’s exploration of the role The value of the "proprietary medicine" of the physician in the spread of addiction industry, as it called itself, rose from suggests that addiction was a harmful side- $3,500,000 in 1859 to $74,500,000 in 1903 effect of 19th-century medicine. Musto (Young, 1961). During this period, the described three patterns of iatrogenic traveling medicine show and the patent (physician-caused) addiction: 1) an medicine catalogue served as forms of inadvertent role in prescribing a new product entertainment and the primary source of like heroin, which was not yet known to be health care for many Americans. Medicine addictive; 2) a negligent role prescribing shows performed by the Kickapoo Indian narcotics out of fear the patient would simply Medicine Company or Hamlin’s Wizard Oil seek a new doctor if refused; and 3) an Company mixed the sale of patent intentional role in helped an alcoholic medicines, which were universally referred become addicted to morphine on the to as "snake oil," with the high drama of grounds that morphine was believed to be minstrels, bands, animal shows, contests, less harmful than alcohol (Musto, 1985). burlesque, comedy, and Wild West shows. The cultural perception of opiates The patent medicine almanac was a contributed to their widespread availability. mixture of calendar, advice column, and Taking an opium-based medicine, for stories, all mixed with testimonials to the example, was viewed during the nineteenth miraculous powers of the sponsor's century as taking an aspirin might be viewed particular potion. During the last quarter of today. It was a part of everyday life, seen as the 19th century, the manufacturer of an ordinary form of relief for physical Hostetter's Stomach Bitters (which was discomfort and pain. The average citizen did more than 80-proof alcohol) distributed not come to consider opium a dangerous between 10 and 13 million copies of each and potentially addictive drug until the late edition of its yearly almanac. The ever- nineteenth century. Before then, opium-, present patent medicine almanac in the local morphine- and cocaine-laced products were toilet served two purposes, one of which was widely available and aggressively advertising (Young, 1961). advertised. The best evidence of the growth in American opiate use can be found in the The Growth of the Patent Medicine annual figures for importation of opium, Industry figures kept quite carefully for tax purposes. The volume of crude opium and smoking The patent medicine industry grew in opium imported into the United States rose a mutually dependent relationship with from 450,925 pounds during the 1840s to another phenomenon: the development of more than 6 million pounds during the American newspapers. The patent medicine 1890s. During this period the annual per- industry needed the newspaper’s power of capita opium use rose from 12 grains in 1840 promotion, and the newspaper industry to 52 grains in 1890 (Musto, 1973; Mark, needed the advertising income from the 1975; Rankin, 1976). patent medicine makers. The American patent medicine industry boomed in the mid User Profile to late nineteenth century, at a time fears were rising of such dreaded diseases as In 1928, Charles Terry and Mildred typhoid, yellow fever, and cholera. Pellens took a survey of what was then Newspapers spread the word of public known about American opiate use for the williamwhitepapers.com 3 Committee on Drug Addiction of the Bureau another. She finally recovered after her stay of Social Hygiene.