the product which was luring innocent women to ine- ARTICLE briety and destroying their lives. In the early 1900s the UK Alliance launched a campaign to restrict the sale Desperate housewives: Th e rise and fall of of medicated . It failed by 1914, I will argue, be- the campaign against medicated wines in cause temperance reformers relied on medical evidence twentieth-century Britain to bolster their case: in fact it undermined it. Opportunistically, but fatally, temperance tethered Lori Loeb its social construction of the medicated menace to the professional medical lobby. On the face of it, this Abstract approach seemed logical. In the l890s the British Med- In the early twentieth century British temperance re- ical Journal, under the editorship of Ernest Hart, had formers tried to restrict the sale of medicated wines, a launched an assault on the general category of patent popular form of patent medicine. Medicated wines usu- medicines. In a series written on behalf of the British ally contained between 15 and 20 per cent alcohol. Medical Association, and later published in 1909 and With vague labels, department store retailing and fl or- 1912 as Secret Remedies and More Secret Remedies, doc- id advertising, they were very popular. Th e United tors argued that patent medicines were addictive or po- Kingdom Alliance – the leading temperance organiza- tentially lethal, that they masked symptoms, that they tion at the time – attacked medicated wines in print, delayed vital professional treatment, and that they of- before the Select Committee on Patent Medicine in fered false cures.4 1914, and in a court case in 1913. Th ey were not suc- Contemporaneously, the Pharmaceutical Society of cessful, because their own testimony revealed divided Great Britain had lobbied to secure the 1908 Pharmacy professional opinions about the effi cacy of medicated Act. Th e Pharmacy Act stipulated that a patent medi- wines. cine which contained more than one per cent of co- caine, morphine or opium could only be sold by phar- Introduction macists.5 Temperance reformers thought that they Th e spectre of female teetotallers soaked in liquor, dirty could capitalize on both recent professional eff orts. and lying in the gutter, made compelling propaganda Th ey hoped to focus an already whetted public interest for temperance in early twentieth-century Britain. Re- on the secret presence of alcohol in medicated wine.6 formers argued that many unsuspecting women were To achieve victory they needed to be wholly convinc- being led down a slippery slope to alcoholism by med- ing. I will show that they failed dismally in print prop- icated wines. Medicated wines or tonics were a form of aganda, before a Select Committee of the House of patent medicine (or over-the-counter drug).1 Taken dai- Commons, and in court. In the end they held passion- ly as an apparently harmless pick-me-up, they were sold ate opinions, but they simply did not (or would not) under trade names that were famous to Victorians – appreciate the divisive nature of professional opinions Wincarnis, Hall’s Wine, Guy’s Tonic, Vin Mariani and about alcohol at the turn of the twentieth century. Sanatogen. Few were actually patented.2 Th eir composition var- Th e temperance critique of medicated wine ied; some had beef extract, some had . But all In terms of chemical composition, medicated wines contained large quantities of alcohol, generally between looked like an easy target for restrictive legislation. 15 and 20 per cent alcohol, as opposed to the average Medicated wines were largely products founded in the which contained only 9 per cent alcohol.3 late nineteenth century, though some purported to have Consumers were encouraged to think otherwise. First, a longer history.7 Th ough hard to defi ne, in popular makers were not required by law to declare the alco- parlance a medicated wine or tonic was generally a wine holic content of medicated wines on product labels. that was one blended with other ingredients. But med- Second, fl orid advertisements for medicated wines por- ical, pharmaceutical and legal understanding of the trayed them as innocuous remedies for general conva- term varied. Doctors such as Robert Hutchison, physi- lescence, fatigue and ailments associated with mater- cian to the London Hospital, posited that ‘medicated nity. Th ird, depending on the district, many medicated wines are concoctions, the basis of which is port or wines were sold in unlicensed department stores and , to which has been added extract of beef, extract grocery stores. of malt, peptone, pepsin, cocoa leaves, cocaine, cincho- To members of the leading temperance organiza- na, iron or some other dietetic or medicinal substance’.8 tion, the Alliance (UK Alliance), Chemists were quite precise about the proportion these three factors constituted a misrepresentation of of wine to medicine: the British Pharmacopeia stated

16 PHARMACEUTICAL HISTORIAN · 2020 · Volume 50/1 that if a wine contained a grain or more of quinine per be sold virtually anywhere. Indeed, most medicated fl uid ounce it was then a medicine.9 Th e government, wines were sold in department stores or unlicensed gro- for the purpose of excise, tax, and licensing, favoured a cery stores.13 Th e department store boom – that had more amorphous assessment. Th e government required begun around 1889 with the founding of William only that ‘the characteristic feature of “medicated wine” Whiteley’s store in London – allowed women in par- [is] that it shall not be capable of being used as a bever- ticular to buy a medicated wine during a generally re- age.’10 Accordingly, packaging and advertising empha- fi and female-oriented shopping trip. Alcoholic sized medicinal eff ects (Figure 1). drinks could only be sold in a licensed establishment, an arena few respectable women would dare to frequent without a male escort. Medicated wines fell within a grey area of the law. A medicated wine could be sold in an unlicensed shop provided that it was to be used as a medicine, not as a beverage. Th e judgement about whether a wine was so medicated as to be incapable of use as a beverage was left to the police. One district might require a license for the sale of medicated wine; another might not. Th e result was that many products with high alcohol con- tent were made broadly (but unevenly) accessible to consumers at many grocery stores and department stores. Th e availability of medicated wine in shops fre- quented by women was a concern to temperance advo- cates. Medicated wine, however, was given its greatest boost by its wide availability in most chemists’ shops, where it appeared to have a professional seal of approv- al. Despite the united movement in the early 1900s within the pharmaceutical profession to restrict the sale of morphine and opium, the sale of alcohol elicited more varied opinions. Th at should have been a sign to temperance enthusiasts that restricting medicated wine might be diffi cult. Th e Pharmaceutical Journal, the or- gan of the Pharmaceutical Society of Great Britain, did not condone the sale of medicated wines by chemists. Figure 1. Advertisement for Hall’s Wine (Source: Illus- It took the position ‘that we have always endeavoured trated London News, 21 January 1899: 101) to discourage the taking out of licenses to sell wine as being inconsistent with the pharmacist’s proper busi- Science Siftings, the popular scientifi c magazine and ness’. Since many of the ‘so-called medicated wines… forerunner of Science, analyzed brands such as Guy’s admit to being used as beverages, no real distinction Tonic, Wincarnis, Vibrona and Vin Mariani. It conclud- can be drawn between them and other alcoholic bever- ed that ‘fi guratively speaking…[a medicated wine or ages, and thus their sale lies outside the scope of strict tonic] may mean anything’,11 but most medicated wines pharmaceutical practice’.14 contained more alcohol than the average table wine. In districts where the licensing laws were interpret- Vin Mariani contained 14 per cent alcohol; Guy’s Tonic, ed strictly, some chemists even took out wine licenses Hall’s Wine and Buckfast Tonic Wine each contained 15 in order to be able to off er their customers the medi- per cent alcohol; and Wincarnis contained 19.5 per cent cated wines they demanded. For chemists, navigating alcohol. In contrast, the average table wine contained the transition from ‘bespoke’ products to ‘off -the-peg’ only 9 per cent alcohol.12 Alcoholic content was almost (as Stuart Anderson has put it), business considerations never listed on the product label, nor was it required by made it risky to refute the claims of prominent makers, law. Th e high percentage of alcohol in medicated wines and especially to refuse to stock them.15 As one chemist attracted a lot of temperance attention. put it ‘prudence [urges] that it would be bad policy to Point of sale was another problem for temperance teach customers to go to some other class of shop when advocates. Unlike table wine, medicated wines could they want medicine of any kind’.16 Th e Chemist and

PHARMACEUTICAL HISTORIAN · 2020 · Volume 50/1 17 Druggist reported that the number of chemists applying were generally sold in three sizes, ranging from 1s 1d to for a wine license was increasing in the 1890s. In 1892 11s 1d per bottle (compared to, say, Beecham’s Pills that 28 new wine licenses were granted, 27 were granted in started at 9d and rose only to 2s 9d for the largest size). 1893 and 45 were granted in 1894. It concluded that In addition to the relatively high price, the advertising ‘chemists are preparing in growing numbers to meet the – especially prominent in women’s magazines and in demand which undoubtedly exists for medicated the religious press – targeted women, both explicitly wines’.17 and implicitly. Makers claimed that medicated wines At the chemists’ shops, wines were removed from were universal panaceas for sleeplessness, weakness, ex- the potential stigma of a licensed shop and seemed cred- haustion, infl uenza and nervous disorders. But adver- ible as bona fi de medicines. In the words of one judge tisements repeatedly emphasize female complaints – who assessed a licensing dispute, the sale of medicated anaemia (most common in menstruating women), wines by patent medicine dealers was a way ‘to com- recovery from childbirth, menstrual pain and ‘mater- mand a large sale of rather inferior port at a compara- nity weakness’.19 tively high price with the aid of persons who do not Florid advertising imagery emphasized the female ordinarily sell wine to persons who do not ordinarily orientation of the market through the visual trope of buy it’.18 Th is latter point seemed more compelling to the female invalid and the angel. Women were born reformers than diff ering points of view within the phar- again through use of medicated wine. An advertisement maceutical profession. It will become clear that temper- for Sanatogen pictures a female patient who stands, sup- ance reformers should have heeded confl icting opinions ported by her nurse, arms outstretched before an open among chemists as ominous for their eff orts to restrict window. Imitating the converted, who has risen to gaze the sale of medicated wines. towards heaven, the woman looks into the sky and sees It seemed plain enough that medicated wines were her saviour, Sanatogen, spelled out in a rainbow (Fig- being pitched as products for middle-class women, an ure 2).20 aspect that held potential as a rallying cry for protective Other advertisements picture angels with gigantic legislation. Th e price point was high. Medicated wines wings,21 or dramatize before and after conditions. For

Figure 2. Advertisement for Sanatogen (Source: Illustrated London News. 19 August 1911: 317)

18 PHARMACEUTICAL HISTORIAN · 2020 · Volume 50/1 example, a woman sits slumped in her chair, her cheek and the galling use of religious imagery in the Christian resting on one hand. Her nurse stands by with the doc- press, were all calls to action for temperance advocates. tor, off ering a glass of Wincarnis. In the ‘after’ picture, Temperance critics thought they were on solid ground, she is a smiling hostess serving tea to the doctor and her not just because of the merit of their arguments, but beaming husband.22 Th e popular commercial gambits because patent medicines as a general category had been of the fl uttering angel and the risen invalid focused on so routinely vilifi ed not just in the British Medical Jour- women, especially women of child-bearing age. nal, but in British literary circles. Th e other major marketing strategy of medicated George Eliot, in Felix Holt (1866), had described wine-makers was to proclaim endorsement by chemists them as ‘absurd’ and likened their ‘gulling advertise- and doctors. Quotes from chemists tended to empha- ments’ to pickpocketing.26 Joseph Conrad, in Th e Secret size sales rather than effi cacy. For example, one chemist Agent (1907), had characterized their inventors as ‘mor- reported ‘the sale is certainly satisfactory; another that al nihilis[ts]’ who ‘live on the vices, the follies or the he sold ‘almost nothing but Guy’s’; yet another that baser fears of mankind’.27 Perhaps most famously, H.G. there was a ‘tremendous turnover’.23 Careful scrutiny Wells in Tono Bungay (1908) had portrayed the suppos- shows that the chemists were focusing on retaining cus- edly quintessential patent medicine maker, Edward tomers, but a cursory glance at the list of quotes and Ponderevo, as a confi dence trickster who markets an chemists’ names might easily suggest product endorse- out-of-date remedy which is ‘slightly injurious rubbish’ ment. Testimonials from doctors, which were extreme- through ‘alluring’ advertisements.28 ly common in medicated wine advertisements, were Vanity Fair, Th e Times, and the Saturday Review more clearly endorsements of the effi cacy of the prod- suggested colourfully that the patent medicine business uct. For example, in an advertisement for Wincarnis an was the ‘safest of all fi elds for cynical knavery’ which image dramatized a transformation from prostration to off ered ‘large incomes to the greatest numbers of vulgar convalescence. Text below the image proclaimed ‘Over imposters’,29 the most ‘parasitic in modern 6,000 Testimonials received from Medical Men’ (Fig- civilization’30who ‘plunder[ed]’ and ‘injur[ed]’ the 24 ure 3). ‘trustful’.31 Within this climate, in the fi rst decades of the twentieth century, British temperance reformers projected their opposition to the menace of medicated wines in three venues: to its own constituency in its of- fi cial organ, the Alliance News; to a broader public through the expert testimony of Dr Mary Sturge before the House of Commons’ Select Committee on Patent Medicine in 1911; and fi nally in court, in the case of Bendle versus the Alliance News in 1913. As we shall see, their construction of the medicated wine menace was fatally fl awed.

Attacking medicated wines in print Temperance advocates publicized the dangers of medi- cated wines within the pages of the Alliance News. Th e Figure 3. Advertisement for Wincarnis (Source: Illustrat- Alliance News was the weekly newspaper of the UK Al- ed London News. 1 June 1901: 802) liance, with an estimated circulation of about 20,000 by the 1890s, of which about 5,000 copies were distrib- Th e supposed endorsement by medical professionals, uted to the unconverted. Generally, its focus was in- highly memorable female imagery and wide availabil- sider news about the temperance campaign, local meet- ity formed a winning combination. By 1910 medicated ings, leaders and activities, and temperance products. wines were big business. Th e proprietors of Wincarnis Attempts to generate a wider circulation that would and Hall’s Wine wielded a capital of £250,000 and make it competitive with national weeklies had largely £175,000 respectively.25 stalled due to the narrowness of its content. But it re- Th e scale of the business, the use of alcohol in the mained an important in-house organ for temperance product, the publication of what temperance advocates reformers to communicate about issues to each other.32 assumed to be phoney endorsements from chemists and With regard to medicated wines, the focus of cri- doctors, the targeting of unsuspecting women (the tiques in the Alliance News was inadequate labelling backbone of the teetotal and temperance movements) and danger to women. Doctors – as authors and cited

PHARMACEUTICAL HISTORIAN · 2020 · Volume 50/1 19 experts in articles – described a series of problems. No tion in the press for its controversial assertions of the consumer could rely on the labels on the bottles for con- eff ect of parental alcoholism on children.38 tent or safe dosing. Many takers, being sick already, Sturge was certainly a prominent name. Moreover, were especially vulnerable. Even worse, some of the vic- to have a female physician speaking to a problem that tims of medicated wines ironically were unaware teeto- purportedly victimized women made rhetorical sense. tallers. But once they took medicated wines they devel- For two days Sturge outlined problems related to dos- oped a habit. Th e danger of medicated wines was that ing, labelling, retailing and advertising. Th e usual rec- ‘…those who indulged in them would probably not take ommended dosage of six ounces a day, she said, was too the ordinary wine, knowing its danger, but thought much. Th is was enough alcohol for a chronic user to that in the medicated wines the danger had been re- develop a dependence on alcohol, especially if the user moved and the eff ect of the alcohol possibly neutral- was a woman. After confi nement, Sturge said, women ised’.33 Women were particularly likely to be duped. existed in a ‘weakened’ state that might make them ‘un- 39 Writers for the Alliance News editorialized that the as- able to resist temptation’. Women had less powers of sociated rise of drunkenness among women had grave resistance than men because ‘Woman’s nervous sys- social consequences: ‘it was bad enough when the father tem…is always working at a stress from childbearing… drank, but when the mother drank life was poisoned at Altogether women have more of a fi ght to get through its foundation’.34 life than men physically, and therefore it is more dan- 40 In addition to the articles in the Alliance News, the gerous for them to be drugged’. Th e vulnerability of UK Alliance produced pamphlets aimed at the non- women to the recommended dosages was the fi rst plank temperance community. Between 40,000 and 60,000 in Sturge’s attack on medicated wines. pamphlets were distributed for ‘magistrates, invalids Another was the fear that poor labelling might make teetotallers the unwitting victims of a ‘morbid al- and the general public’.35 Pamphlets used strong lan- coholic habit’. White Ribboners – young girls who had guage, typically characterizing medicated wines as ‘di- taken the pledge – might take these drinks ‘without the abolically deceptive and insidiously injurious’.36 Th ey least idea that by thus doing they are breaking their always drew on the opinions of eminent medical au- pledge’.41 She off ered narratives of teetotallers corrupted thorities from the British Medical Journal, and ended by medicated wines. Almost always the narratives in- with signatures of doctors who endorsed the pamphlet. volved a promising young woman convinced by others Th e emphasis in the articles of the Alliance News and in to take a medicated wine. Th e innocent woman became its pamphlets for a general audience was on the medi- addicted and ultimately lost all control. Th e stories did cal critique; doctors, they claimed, concurred with tem- not deny volition, but they shifted the focus of culpa- perance advocates that medicated wines were danger- bility onto the medicated wine makers who did not in- ous. form the consumer of alcoholic content. Free choice had been taken away from women by Attacking medicated wines before a Select Commit- deceptive labelling. Here, Sturge had to combat some tee skepticism. As Th ora Hands has sensibly argued, it was Th e parameters of the medicated wine menace sketched reasonable to assume that most consumers of medicat- out in the Alliance News and in pamphlets were elabo- ed wines expected a ‘wine’ to contain some wine.42 But rated by Dr Mary Sturge (1865-1925) in testimony be- Sturge countered that argument with the contention fore the Select Committee on Patent Medicines in 1911. that teetotalers were more ‘gullible’ than other people Sturge – a Quaker and niece of the Birmingham may- because ‘they know less about the whole thing’.43 Ac- or Charles Sturge – held a medical degree from the Uni- curate labelling was necessary to protect the innocent. versity of London. She was only the second woman to Finally, the point of purchase – often at unlicensed practice medicine in Birmingham and was a physician grocers and chemists – was a problem. Sturge contend- at the Birmingham and Midland Hospital for Women. ed ‘I fi nd the most harm is done by the druggists press- Part of an activist family, whose public service dated ing their sale on ignorant women’.44 She cited a young from the abolitionist activities of Joseph Sturge, she was pregnant woman, her own patient, whose symptoms a member of the Birmingham Society for Women’s Suf- seemed curious until Sturge noticed a large bottle of frage and a lifelong supporter of temperance.37 She had Wincarnis in the bedroom. She discovered that the also recently co-authored with Sir Victor Horsley (1857- woman was drinking two bottles a week. She began 1916) – the prominent neurosurgeon from University taking it on the ‘strong recommendation of the drug- College, London – Alcohol and the Human Body (Mac- gist next door’.45 Sturge reported that there were two Millan, 1907), which had garnered considerable atten- grocer’s shops near her hospital; one with a window full

20 PHARMACEUTICAL HISTORIAN · 2020 · Volume 50/1 of wines and one without. Th e grocer who did not sell advertisements. Sturge alleged that thousands of signa- them conceded that while he upheld moral principles, tures were obtained from doctors using this method.48 he would ‘make [a] fortune’ if he relented.46 In each Th e advertising of doctors’ recommendations was a cha- case, profi t motivations prevented the vendor – even the rade, the ultimate form of false advertising. Speaking professional one – from disclosing the alcoholic con- on behalf of the UK Alliance, Dr Mary Sturge gave tent. Unlicensed establishments, Sturge argued, should dramatic testimony. not sell alcohol because their advice was not reliable. As a woman doctor from a prominent family, she Beyond the labelling and licensing arguments, seemed at fi rst glance to be a credible witness. She Sturge devoted a good part of her testimony to terrify- spoke as if she represented the entire medical profes- ing tales drawn from doctors themselves. Th e medical sion in her blanket opposition to medicated wines for testimony was crucial to her case. One doctor wrote of inadequate labelling, inadequate licensing and false a female patient, 22 years of age, of substantial means, advertising. But this was far from the case. While refi nement and education, who was found ‘unkept and some doctors – and certainly most who supported the unwashed…the stale smell of alcohol pervading the at- temperance lobby – agreed with her opposition to al- mosphere…laughing, crying and shrieking in turns… cohol, it was well known that there were doctors who [She was later discovered] lying drunk in a lane a few defended the medicinal use of alcohol for analgesia yards from her home’. Another doctor described a shop- and even nutrition. keeper’s wife reduced to homelessness. A third wrote of If Sturge and Horsley had simply been on the tem- a woman recovering from childbirth who ended up perance side of a legitimate medical debate, they might ‘hopelessly insane’.47 A common theme was an ending have still seemed credible. But much of their case had that would be especially horrifi c to a respectable wom- been discredited just the year before. Th e very data on an; dirtiness, homelessness or insanity. which they based their opinions had been very publi- Terrifying tales told by scores of doctors were part cally questioned. Temperance advocates must have of the temperance strategy against medicated wines. known that in 1910 prominent scientists, including the Th is made the advertising tactics of the medicated wine noted mathematician Karl Pearson, had rebutted Hors- makers especially egregious. Advertisements for medi- ley’s statistics about the eff ect of parental alcoholism on cated wines almost always included testimonials from children. doctors. According to Sturge, these testimonials were Th e controversy had spilled over from the pages of solicited and presented duplicitously. At the bottom or the British Medical Journal and Th e Lancet into Th e side of most advertisements for medicated wine was a Times. In an editorial on 13 January 1911, the editors coupon (Figure 4). of Th e Times advised the public to ‘disregard the din of the controversy’ – in eff ect to ignore Sturge and Hors- ley on the evils of alcohol. Letters appeared on the sub- ject every day for two weeks.49 Th e temperance lobby had chosen an expert whose fi ndings had been serious- ly questioned the previous year. Th e credibility of their main medical witness was shaky. Even if large parts of her testimony had nothing to do with parental alcohol- ism, readers of the report of the Select Committee might well wonder if her testimony was reliable or trustworthy in the light of what they had read recently in Th e Times. Temperance lobbyists may have thought that the public would not be able to follow the intricacies of the statistical debate. But they must have known that a cru- Figure 4. Advertisement for Wincarnis (Source: Illustrat- cial part of her testimony rested on an assumption for ed London News. 4 March 1905: 325) which she had no proof. Sturge assumed that no doctor would really endorse any patent medicine, let alone a If the doctor signed it and sent it to the company offi ce medicated wine. Here, she assumed that doctors would the patient could receive a free sample. Any doctor who follow medical ethics, which had stipulated since Per- refused a patient’s request to sign a coupon was put in cival’s Medical Ethics was published in 1803 that no an awkward position. But if he did sign it, his signature doctor should recommend a medicine if the contents was then reproduced in a phoney endorsement in later were unknown.

PHARMACEUTICAL HISTORIAN · 2020 · Volume 50/1 21 ing that many doctors did indeed endorse them, just as the advertisements claimed.

Attacking medicated wines in court Th e temperance lobby found itself unprepared not only before the Select Committee, but also in court. In 1913 the UK Alliance was taken to court for libel by a mak- er of a medicated wine. Th e Alliance had published a pamphlet, authored by a solicitor, Robert Batty, de- nouncing medicated wines. Among the products named was Bendle’s Malt-Port Nutrient. Th e Batty pam- phlet was typical in its hyperbolic denouncements. It called the products ‘wines of death’ and said that mak- ers were ‘veritable masters of mendacity’. It included signatures of doctors, and took particular aim at the maker’s claim that such wines were nutritious, even strengthening. Batty suggested in the pamphlet that ‘these wines contain such a ridiculously small quantity of beef extract that they cannot be really strengthening, and that the claim by their makers for their use on this ground is positively absurd’.53 In fact, Batty claimed, all it contained was 20 per cent alcohol, as proven by a chemical analysis published in the British Medical Jour- nal. In court, the makers of Bendle’s Malt-Port Nutrient argued that they had been damaged by the pamphlet. Figure 5. Advertisement for Hall’s Wine (Source: Illus- Th ey showed that the analysis published in the British trated London News. 8 March 1919: 347) Medical Journal was incorrect. (Indeed, the British Medical Journal published a correction two issues later Following Sturge’s testimony, proprietors of major after complaints by the manufacturer, but Batty had medicated wine manufacturers were called to testify. failed to take the correction into account). Expert tes- Shockingly, manufacturers were able to produce thou- timony by Mr Pary, Fellow of the Chemical Society, sands of legitimate medical endorsements. Not only did and Dr Willcox, Senior Analyst to the Home Offi ce and they have bona fi de testimonials, but Hall’s Wine had Physician at St. Mary’s Hospital, London, suggested twenty-one doctors who were large shareholders, and that the wine did indeed have nutritive content. two doctors on their board of directors.50 Hall’s Wine On this basis the UK Alliance was found guilty of was not alone. Th e makers of Wincarnis similarly had libel, and banned from naming Bendle’s Malt-Port Nu- over 10,000 letters from doctors.51 Following the release trient in any future publication.54 Clearly, this was an of the Select Committee Report, Hall’s Wine took out embarrassing outcome for the temperance lobby. Th e a full-page advertisement that emphasized ‘Th e Voice court case, like the testimony before the Select Com- of Medical Opinion’ above a picture of a mature man, mittee, rested on infl amed rhetoric rather than sound presumably a doctor (Figure 5). Th e text reads: medical support. Th e use of the medical profession by the temperance lobby did not work. Th ousands of doctors have written asking for sup- Th e temperance lobby underestimated the divisive plies for urgent cases – others say they have tried stature of alcohol and patent medicine within the med- Hall’s Wine, or used it in their own homes, to the ical profession. Alcohol itself was still controversial. Th e benefi t of themselves and their families. Hundreds British Medical Temperance Society had been formed of others send a word of thanks for the results in 1876; by 1898 it had over 900 members. Certainly, achieved. Th ese letters from doctors are eloquent tes- this group challenged the effi cacy of alcohol in medical timony to the benefi t derived from Hall’s Wine.52 treatment. But the profession as a whole was fraught with internal divisions about the eff ect of alcohol on the Th e Select Committee, which might have given the UK human body, about whether the craving for alcohol Alliance its shining moment, in fact wound up reveal- might be inherited, and about the relationship between

22 PHARMACEUTICAL HISTORIAN · 2020 · Volume 50/1 inebriety and insanity. For example, members of the tient some control; she picked the remedy for her own Society for the Study of Inebriety, founded in 1884, fa- complaint. voured the disease model of alcoholism, and opposed As John Crellin has demonstrated, by the turn of temperance colleagues as ‘unscientifi c’ and zealous. the century there was an increasingly pluralistic medi- Similarly, moderationists opposed them; they fa- cal market for self-care.60 Th e convenience, access and voured drinking in moderation.55 Th ere was no uni- lack of stigma attached to medicated wine made it a formity. In practice, many doctors continued to recom- popular product, one that was diffi cult for legislators to mend alcohol as a treatment for common complaints. take restrictive action against without much more con- Th e Bendle’s Malt-Port Nutrient court case in 1913 vincing arguments than the ones temperance advocates showed that the nutritive properties of alcohol, a long- were able to provide by 1914. standing debate in the medical literature, might still be an open question. As late as 1891 the treatment of in- Conclusion fl uenza with alcohol was so popular that it was satirized In the end the temperance attack on medicated wines in Punch.56 Clearly there were internal divisions within failed. While rhetoric against medicated wine purport- the medical profession over the use of alcohol, which ed to be scientifi c, much of it relied on terrifying tales did poke holes in the temperance contention that doc- of women sodden with liquor. Th e tales were memora- tors opposed the use of medicated wine. ble but anecdotal. Temperance advocates tried in the Second, the revelation that doctors had written pages of the Alliance News, before the Select Commit- bona fi de endorsements for medical wines and were tee and in court, to bolster their anecdotal evidence even shareholders exposed the harsh reality that the re- with medical opinions. But unfortunately, they pre- lationship between orthodox medicine and commercial sented medical opinions about which there was little medicine was often murky. Th eoretically, doctors were consensus. Th e case against medicated wines ignored not supposed to recommend medicated wines, because altogether the divisions within the profession about – like all patent medicines – their composition, and temperance; it was by no means clear on the eve of the therefore, potentially detrimental eff ects, were un- First World War that alcohol had no therapeutic effi - known. Th is had been laid out in Th omas Percival’s cacy. Medical Ethics in 1803;57 and endorsed in an 1888 reso- Nor it could it be proven that medicated wine had lution of the Royal College of Physicians.58 no nutritional merit; this too was open to scientifi c de- But, as Peter Bartrip has shown at the organiza- bate. Even basic facts about chemical composition were tional level, the reality was often very diff erent.59 Doc- quoted incorrectly in anti-medicated wine literature. tors, at the grass-roots level, similarly were not im- Th e scientifi c evidence wound up being inconclusive. mune to mass marketing, including advertising. Some Th e revelation that doctors themselves endorsed patent doctors may have been seduced by free samples; some medicines and sat on boards of directors of medicated may have genuinely found a particular product thera- wine companies underscored the divisions in the pro- peutically useful; and some may have been pressured fession. Temperance advocates were left with sensation- by patients. Temperance doctors, such as Sturge, al tales of women in the gutter. It was simply not clearly hoped that even doctors who supported the enough. therapeutic use of alcohol would not support the use Medicated wines continued to be marketed to mid- of patent medicine. Th ey were wrong. It appeared that dle-class women throughout the twentieth century. Af- the temperance lobby had misrepresented a signifi cant ter the Pharmacy and Medicine Act of 1941 required part of their case. labelling of active ingredients, including alcohol,61 Finally, in the absence of wholehearted medical many medicated wines reinvented themselves, at least condemnation, many observers must have wondered if in advertisements, by focusing on vitamin content. Th e a little self-medication with alcohol disguised as medi- alcohol remained and the products continued to be sold cine was really so bad. If doctors were prepared to use without a license. alcohol therapeutically, many customers were prepared Th roughout the 1960s and 1970s the alcohol con- to drink it for health. Medicated wines provided a way tent was only thinly disguised in advertisements which for customers who would not buy regular wine or spir- emphasized the utility of the product as an escape for its to consume alcohol under the cloak of taking med- women who thought ‘kids are murder!’62 Today, Sana- icine. For those who sought relief from minor aches and togen is still on the market as a ‘tonic wine with added pains or who needed a pick-me-up, medicated wines iron’.63 Vin Mariani relaunched in 2014 as ‘an excep- were convenient and readily accessible, without the tional fortifi ed with Peruvian cocoa trouble of contacting the doctor. Th ey also gave the pa- leaf’ 64 and 22 per cent alcohol; and Wincarnis is sold

PHARMACEUTICAL HISTORIAN · 2020 · Volume 50/1 23 currently by Ian MacLeod Distillers as a ‘Tonic and 6. On drink policy see Greenaway, John. Drink and Brit- Ginger Wine’ fortifi ed with ‘energy-giving Vitamin B ish Politics Since 1830: A Study in Policy Making. London: Pal- Complex’ and 14 per cent alcohol, enjoyable ‘on its own grave MacMillan, 2003. On drink in Victorian society see Brian Harrison’s classic Drink and the Victorians: Th e Temperance Ques- 65 or as a Gin and Win’. tion in 1815-72. London: Faber and Faber, 1971; also Today, most medicated wines are made and sold by Dingle, A.E. Th e Campaign for Prohibition in Victorian England. wine merchants and distillers. In contrast to the female London: MacMillan, 1989; Fahey, David M. Temperance and orientation of the market for Edwardian medicated the Liberal Party. Journal of British Studies. 1971: 10:132-59; wines, some of the most popular medicated wines now Fahey, David M. Th e Politics of Drink: Pressure Groups and the Liberal Party 1883-1908. Social Science. 1979: 54; 76-85. have a distinctly masculine consumer base. For exam- 7. Wincarnis was founded in 1881 by Liebig, and by the ple, Buckfast Tonic Wine, a caff einated wine with 15 per late 1880s was produced by Coleman & Co. Ltd. and is still on cent alcohol from Devon – fi rst marketed by Buckfast the market. Vin Mariani was founded in 1863 by Angelo Mari- Abbey in 1880 and today sold by J. Chandler & Co. – ani, a French chemist from Corsica, and produced by him until is among the best-selling alcoholic beverages in Britain; his death in 1914; it was remarketed in 2014. Sanatogen was founded by Bauer Chemists in 1898 and is still on the market. it has a notorious linkage with violent male crime. In Hall’s Wine was founded in 1888 by Henry James Hall (trading 2015 the Scottish prison service reported that over 43 as Stephen Smith & Co). Buckfast Tonic Wine, made at Buckfast per cent of inmates drank Buckfast Tonic Wine before Abbey in Devon since about 1880, was sold from the Abbey it- their previous off ence.66 self until its wine license was withdrawn in 1927. Remarketed Th e medicinal use of alcohol has become notorious by J. Chandler, it has become one of the best-selling alcoholic beverages in Britain. once again. One hundred years after the 1914 Select 8. Hutchison, R. (Note 1) 1900: 389. Committee report, despite the fervent eff orts of the UK 9. Medicated Wines. Metropolitan Police, Correspondence Alliance in print and in court, medicated wines thrive. and Papers, 1914-1927. Th e National Archives, Kew, London, Th ough their opponents’ fame has faded with time, the MEPO 2/2049. brand names Wincarnis, Sanatogen and Buckfast Tonic 10. Th e Sale of Medicated Wine. Th e Pharmaceutical Jour- nal. 30 January 1892: 620. Wine, for good or for ill, are still recognizable as an in- 11. Th e Taking of Tonics. (Note 3) 1897: 204. Some con- tegral part of modern British consumer culture. tained cocaine, but this was more unusual because the presence of cocaine required that the product be labelled poison and sold Author’s address: Dr Lori Loeb, associate professor, De- only by chemists. Th e original Vin Mariani contained 6 mg of co- partment of History, University of Toronto, Canada. caine per fl uid ounce of wine in Britain and 7.2 mg for export to the United States. See Homan, Peter. Medicated Cheer. Th e Phar- Email: [email protected]. maceutical Journal. 2003: 271; 867. Th e American Dr John Pem- berton made a wine based on the Vin Mariani formula and sub- Endnotes and References stituted sugar syrup for wine in 1886, producing Coca . See 1. Hutchison, R. Food and the Principles of Dietetics. Lon- Estes, J. Worth. Th e Pharmacology of Nineteenth-Century Patent don: Edward Arnold, 1900: x. Medicines, Pharmacy in History. 1988: 30; 3-18; Helfand, Wil- 2. To patent a medicine was to reveal the formula to com- liam. Vin Mariani. Pharmacy in History. 1980: 22; 11-19. petitors, though some makers did use it for a variety of reasons, 12. See Guy’s Tonic. (Note 3) 1895 and Vin Mariani especially in the eighteenth century. See Mackintosh, Alan. Au- (Note 3) 1897. thority and Ownership: the Growth and Wilting of Medicine 13. Th e railway, the postal system, accelerated mass produc- Patenting in Georgian England. British Journal for the History of tion, and the development of department stores and multiples, Science. 2016: 49 (4); 559. moved the retail location away from the London booksellers who 3. Th e Taking of Tonics. Science Siftings. 17 July 1897: had sold patent medicines in the Georgian period. For the book- 204. For specifi c tonics see Guy’s Tonic. Science Siftings. 16 No- sellers of the Georgian period see Macintosh, Alan. Th e Patent vember 1895: 70; Mariani Wine. Science Siftings. 17 April 1897: Medicine Industry in Late Georgian England: A Respectable 6; Hall’s Wine. Science Siftings. 4 February 1905: 244. Alternative to both Regular Medicine and Irregular Practice. 4. Secret Remedies. London: British Medical Association, Social History of Medicine. 2017; 30 (1): 22-47 and Macintosh, 1909; More Secret Remedies. London: British Medical Associa- Alan. Th e Patent Medicine Industry in Georgian England. Lon- tion, 1912; Coley, Frederick C. British Medical Journal. 10 Sep- don: Palgrave MacMillan, 2018. tember 1898: 2 (1967); 715-716. 14. Th e Sale of Medicated Wine. (Note 10) 1892: 620. 5. Earlier legislation, the Pharmacy Act of 1868, had re- 15. Anderson, Stuart. From ‘Bespoke’ to ‘Off -the-Peg’: quired that pharmacists only could dispense opium and other Community Pharmacists and the Retailing of Medicines in dangerous drugs, but had exempted patent medicine; the Sale of Great Britain 1900 to 1970. Pharmacy in History. 2008; 50 (2): Food and Drug Act of 1875 had required labels alerting consum- 43-69. ers that a medicine contained a dangerous substance, but again 16. Th e Patent Medicine Trade. Chemist and Druggist. patent medicines were exempted. Comprehensive legislation that 5 January 1889: 17. would require makers to list ingredients would not come until 17. Chemists and Wine Licenses. Chemist and Druggist. the Pharmacy and Medicine Act of 1941. For a full account of 18 October 1894: 580. the legislation see T.A.B. Corley’s excellent article, UK Govern- 18. Hutchison, R. (Note 1) 1900: 370. ment Regulation of Medicinal Drugs, 1890-2000. Business His- 19. Advertisement for Phosferine. Christian Age. 15 April tory. 2005: 47 (3); 337-51. 1910: iii.

24 PHARMACEUTICAL HISTORIAN · 2020 · Volume 50/1 20. Advertisement for Sanatogen. Illustrated London News. through their Retail Pharmacists Union that they should be ex- 13 January 1912: 66. empt from the Licensing Act. See TNA, MEPO 2/2049. 21. Advertisement for Sanatogen. Illustrated London News. 47. HCPP. (Note 25) 1914: 214. 28 October 1911: 689. 48. HCPP. (Note 25) 1914: 217-21. 22. Advertisement for Hall’s Wine. Home Chat. 31 January 49. For a discussion of the intricacies of the debate see Sti- 1914: 207. sler, Stephen M. Statistics on the Table: Th e History of Statistical 23. Advertisement for Guy’s Tonic. Church Family Newspa- Concepts and Methods. Cambridge: Harvard University Press, per. 23 February 1900: 55. 2002: 44-48. See Daily Chronicle, 14, 19 and 26 November 1910. 24. Illustrated London News. 1 June 1901: 802. See the nineteen-column refutation by Horsley and Sturge in 25. House of Commons Parliamentary Papers (HCPP). Re- the British Medical Journal on 14 January 1911; Sir Victor Hors- port of the Select Committee on Patent Medicines. London: ley and the Galton Laboratory. Th e Times, 11 January 1911and HMSO, 1914: xiii. letters following in every issue until the end of January 1911. See 26. Eliot, George. Felix Holt. Oxford: Clarendon Press, also Pearson, Karl and Elderton, Ethel M. Th e First Study of the 1980: 55. Infl uence of Parental Alcoholism on the Physique and Ability of the 27. Conrad, Joseph. Th e Secret Agent. New York: Double- Off spring. London: Dulau & Co, 1910; Th e Second Study, Lon- day, 1953: 25. don: Dulau & Co, 1910; and An Attempt to Correct Some of the 28. Wells, HG. Tono Bungay. Lincoln: University of Ne- Misstatements Made by Sir Victor Horsley and Mary D. Sturge, braska, 1956: 120. See Kennedy, Meegan. Tono Bungay and M.D. London: Dulau & Co, 1911. Burroughs Wellcome: Branding Imperial Popular Medicine. 50. HCPP. (Note 25) 1914: 458. Victorian Literature and Culture. 2017: 45(1); 137-162. 51. HCPP. (Note 25) 1914: 555. 29. Sewill, Henry. Quackery. Vanity Fair. 19 May 1910: 52. Advertisement for Hall’s Wine. Illustrated London News. 628. 8 March 1919: 347. See also advertisement for Phosferine. Chris- 30. Quoted in Quackery for Women. Vanity Fair. 26 May tian Age. 4 March 1910: iii which deploys the testimony of 1910: 661. ‘A London Doctor’. 31. Quackery for Women. (Note 30): 660. 53. Court Alliance. Alliance News. May 1915: 84-6. 32. Dingle, Anthony E. Th e Campaign for Prohibition in 54. High Court Cases: Bendle’s Meat-Port Nutrient. Chem- Victorian England. London: Routledge, 2016: 213. Th e Alliance ist and Druggist. 1 May 1915: 40; Th e Medicated Wines Case. Alliance News. October 1915: 197; Minute Book, U.K. Alliance, News was also limited in space. First published in 1854 as a 30 June 1915. 4-page weekly, it expanded to 16 pages in 1871 and to 20 pages 55. See Woiak, Joanne. A Medical Cromwell to Depose by 1888. Circulation in 1858 (determined not by offi cial statis- King Alcohol: Medical Scientists, Temperance Reformers and tics, but by annual fi nancial statements) was 4,500, which rose the Alcohol Problem in Britain. Social History. 1984: 27; 358-60. to 15,000 by 1869-70 and 20,000 by 1891-2. See also MacLeod, Roy. Th e Edge of Hope: Social Policy and 33. Medicated Wines Denounced, Alliance News, 15 April Chronic Alcoholism 1870-1900. Journal of the History of Medi- 1909: 229. See also Medicated Wines. Alliance News. 17 June cine and the Allied Sciences. 1967: 22; 215-245; McCandless, Pe- 1909: 375; What is a Medicated Wine? Alliance News. 16 April ter. Curses of Civilization: Insanity and Drunkenness in Victo- 1914: 251. rian Britain. British Journal of Addiction. 1984: 79; 49-58. 34. What is a Medicated Wine? (Note 33) 1914: 251. 56. A Cure for Infl uenza. Punch, 20 June 1891: 100; 291. 35. Batty, RB. Th e Medicated Wines Fraud. Manchester: UK 57. Percival, Th omas. Medical Ethics. Manchester: W. Jack- Alliance, 1913. son, 1803: 44-5. 36. Batty, RB. (Note 35) 1913. 58. Styrap, Jukes. Code of Medical Ethics. London: H.K. 37. Crawford, Elizabeth. Th e Women’s Suff rage Movement: Lewis, 1878: 27-8. A Reference Guide 1866-1918. London: Routledge, 1999: 661. 59. Bartrip, Peter. Secret Remedies, Medical Ethics and the 38. On Horsley, see Tan Tze-Ching and Black, Peter. Vic- Finances of the BMJ in Baker, Robert. Th e Codifi cation of Med- tor Horsley: Pioneer of Neurological Surgery. Neurosurgery ical Morality. Boston: Springer, 1995: 203. 2002: 50 (3); 607-11; Lyons, John Benignus. Sir Victor Horsley. 60. Crellin, John K. Home Medicine: Th e Newfoundland Ex- Medical History. 1967: 11 (4); 361-73. Horsley was also a social perience. Montreal: McGill-Queen’s University Press, 1994. reformer, a supporter of suff rage for women and free medical 61. Linstead, Hugh H. Th e Pharmacy and Medicines Act, care for the working classes, as well as a temperance advocate. 1941, and the Sale of Proprietary Medicines. Medico-Legal Jour- He stood for parliament twice, unsuccessfully, as a Liberal and nal. 1941: 9 (4); 247-8. was a prominent medical supporter of the Liberal’s National In- 62. See the private collection of Richard Littler in When surance Act of 1911. Everything’s an Eff ort, You Need Buckfast: Hilarious 39. HCPP. (Note 25) 1914: 214. Ads Reveal how Tonic Wines were Marketed to Bored House- 40. HCPP. (Note 25) 1914: 222. wives. Daily Mail. 11 October 2017. 41. HCPP. (Note 25) 1914: 213. 63. Th e Drinkshop. Available from: https:www.thedrink- 42. Hands, Th ora. Drinking for Health: Proprietary Tonic shop.com. Accessed 27 August 2018. Wines. Drinking in Victorian and Edwardian Britain. London: 64. Th e Drinks Report. Available from: https://thedrinksre- Palgrave, 2018: 113-127. port.com. Accessed 27 August 2018. 43. HCPP. (Note 25) 1914: 221. 65. Th e Whiskey Exchange. Available from: https://www.ian- 44. HCPP. (Note 25) 1914: 214. macleod.com; https://www.thewhiskyexchange.com. Accessed 45. HCPP. (Note 25) 1914: 215. 27 August 2018. 46. HCPP. (Note 25) 1914: 215. On the pharmaceutical 66. Morissy-Swan, Tomé. England gets a taste for Buckfast, profession’s position see Th e Sale of Medicated Wine; Chemists the fortifi ed wine that’s linked to crime. Daily Telegraph, 17 July and Wines Licenses. After 1910 the retail chemists argued 2017.

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