Prog Health Sci 2012, Vol 2 , No1 Running quacks mountebanks Running after quacks and mountebanks… Ohry A.1*, Tsafrir J.2 1 Rehabilitation Medicine, Sackler Faculty of Medicine, Tel Aviv University 2 Medical Librarian ABSTRACT __________________________________________________________________________________________ The phenomenon of quackery is reviewed, and that some treatments considered unacceptable in the illustrated with examples from history, the literature past have sometimes proved their efficacy over and the present. A distinction is drawn between time, and should not always be dismissed out of impostors or charlatans, and unorthodox but hand. professional healers. The lessons drawn to suggest Key words: quackery, professional healers, history __________________________________________________________________________________________ *Corresponding author: Rehabilitation Medicine Sackler Faculty of Medicine Tel Aviv University Private address: P.O. Box 2342 Savyon 56530, Israel E-mail: [email protected] (Avi Ohry) Received: 9.12.2012 Accepted: 24.03.2012 Progress in Health Sciences Vol. 2(1) 2012 pp 171-174. © Medical University of Bialystok, Poland 171 Prog Health Sci 2012, Vol 2 , No1 Running quacks mountebanks When Daniel Defoe wrote about "running manipulative surgeon," Sir Herbert Atkinson- after quacks and mountebanks for medicines and Barker [1869-1950], who achieved fame and remedies" in "A Journal of the Plague Year"(1) he recognition, although he was not medically distinguished clearly between quacks and "real qualified. On his return to England after some doctors." The Oxford English Dictionary (2) years in Canada, he became apprenticed to his defines quack: "abbreviation of quacksalver. i: an cousin John Atkinson, who worked as a bonesetter, ignorant pretender to medical skill; one who boasts a profession he had learnt from the famous Robert to have a knowledge of wonderful remedies; an Howard Hutton. The ambitious Herbert soon empiric or impostor in medicine; ii: one who opened his own "clinics", when he was only 21, in professes a knowledge or skill concerning subjects Glasgow and Manchester. He had a natural talent, of which he is ignorant; iii: as quack-doctor; to a strong personality, total devotion and loyalty to quack is to play the quack; to talk pretentiously his patients. He also knew exactly where not to and ignorantly, like a quack, to puff or palm off touch and manipulate. The medical and surgical with fraudulent and boastful pretensions, as in establishment despised him, mainly because he quack-medicine; to treat after the fashion of a had used commercial and business methods to quack; to administer quack medicines; to seek to promote his clinics. remedy by empirical or ignorant treatment." In 1911, Dr F W Axham was struck from "Quack" is also the harsh cry of a duck, and the the physicians' register because he gave anesthesia term may have been used to denote something for Mr. Barker. However, many celebrities were noisy or boastful [3] treated successfully by him, and an article Quackery is generally equated with published in 1912 in The Times, defended Mr. charlatanry: it is said that one Latan, a famous Barker's successes after many doctors had failed, quack, used to go about Paris in a splendid under the title: "What is a quack?" The general charabanc, in which he had a traveling dispensary. public stood firmly behind Mr. Barker. When war A man with a horn announced the approach of this broke out, the establishment refused to call Barker magnate, and the delighted sightseers used to cry to treat soldiers. The question was discussed in out "Voila le Char de Latan!" In Italian, the term is Parliament and even the Archbishop of Canterbury ciarlatano, a babbler or quack [4]. And was involved. Some years passed, and in 1926 "mountebank"? This was the bank or bench on Herbert Barker was knighted. Only then did Sir which shopkeepers of your displayed their goods - Herbert retire to the Channel Islands. The British street vendors used to mount on their bank to Orthopaedic Association invited him in 1936 to patter to the public. show his expertise at St Thomas' Hospital, as In the "Dictionary of Phrases and Fables" reported in The Lancet on 27/2/1937. In 1941 he [4] we see also: Rock, a quack: so-called after a was offered a post at Noble's Hospital, Isle of Man, certain Mr. Rock, a well-known quack who as a Manipulative Surgeon. No other bonesetter, practiced during the reign of Queen Anne. The "quack," feldsher or other non-medically qualified physician-poet George Crabbe wrote of him: "Oh, person ever equaled his fame. when his nerves had once received a shock, Sir It should be pointed out that even the Isaac Newton might have gone to Rock" Katerfelto "feldshers", those practitioners of medicine with is another generic name for a quack or charlatan. below-university level education, but well-trained, He was a celebrated "influenza doctor." A tall wrote an important and illustrious chapter in the man, who dressed in a long black gown and square history of medicine [8]. The story of 'physicians' or cap, he exhibited his solar microscope in London surgeons' assistants: the blood-letters, the barber- in 1782, and gave rise to tremendous excitement surgeons, midwives, "wundartz", and others, has by showing the infusioria of (muddy) water "and not yet been fully told. Sometimes the non- Katerfelto with his hair on end, at his own wonders qualified practitioners were called "quacks" wondering for his bread"[5]. There have been although they never claimed to be "doctors or numerous allusions to quacks and charlatans in the surgeons," and some of them proved to be quite literature [6; 7] successful in their healing abilities. In Thomas Hardy's "Jude the Obscure," There are certainly lessons to be learned Vilbert " was an itinerant quack-doctor, well from history: when the experienced and literate known to the rustic population, and absolutely surgeon-lithotomist-herniotomist, [Valentine unknown to anybody else, as he, indeed, took care Rawsworme (or Rosswurm(] one of Paracelcius' to be, to avoid inconvenient investigations." pupils, left Switzerland and settled in England, he There were, of course, some famous or was regarded by the British surgeons as a quack. notorious "quacks" in the history of disease and its The competition for wealthy patients in 16th cures - some were qualified practitioners who were Century London led the local surgeons to make involved in fraud, or who behaved unethically. On unjustified judgments [9]. the other hand, there is the story of the "bone- Even later, "it was perfectly plausible setter", or as he used to call himself "a around 1800 to represent Jennerian vaccination as 172 Prog Health Sci 2012, Vol 2 , No1 Running quacks mountebanks balderdash" [7]. There was also some historical such an evil; 3) a person - the quack - who claims confusion between the Italian "quack doctors of special knowledge or power to cure the particular Cerretani, who begged for alms for medical and evil; 4) a person - the orthodox medical religious foundations as a profession," and the practitioner - who holds out little or no hope of Preci School surgeons (admittedly not as famous cure." Other factors may play a part: the desire for as their colleagues at Salerno or Montpellier) who a cheap cure, rebellion against authority, hope, the performed lithotomy, phlebotomy and castration, elements of mystery, the natural repugnance to designing and making their own instruments, and surgical operation when such is the only remedy practicing cauterization and disinfection by fire recognized by the orthodox practitioner, the desire [10]. Some of the confusion arose with the for secrecy, etc. satyrization of physicians, and medicine in general, According to one, view expressed on the in the 17th and 18th centuries. There was very little "Quackwatch" homepage [24]: "Quackery is not an confidence in scientific healing, and doctors were all-or-nothing phenomenon," and although most portrayed in the "comic tradition of stupid, greedy definitions suggest that "quackery involves physician-quacks" [11]. deliberate deception," its paramount characteristic Porter [12] points out that the pre-modern is "promotion (the "quacking'" aspect), rather than medical world should not be "divided neatly fraud, greed or misinformation". In this discussion, between physicians and surgeons practicing their Barrett believes that "quackery could be broadly vocation, and disreputable businessmen selling their defined as "anything involving over promotion in proprietary pills to a gullible public." Medicine in the field of health, including doubtful ideas as well that period was an occupation rather than a as questionable products and services, and vocation, and both "regular" medical practitioners independently of their promoters". This leads us to and quacks were subjected to the vagaries of market conclude that if we are to make such a distinction, forces. so that the practice of "unconventional medicine" Chiropractic manipulation was long may keep its place alongside orthodox practices, regarded as quackery, but in recent years it has there should be a clear-cut boundary between acquired scientific backing as a beneficial and cost- effective, complementary or alternative medicine, effective procedure, especially in the case of low on the one hand, and "quackery" for the sake of back pain [13]. purely financial gain, on the other. A randomized, What about the remedies offered by these controlled study was designed to test the quacks or charlatans? We hear of the anodyne hypothesis that experts who review papers for necklace, for example, [14], or of "quack doctors" publication are prejudiced against an alternative in today's China, who extract "toothworm" from form of therapy [25]. Reviewers showed a wide toothache sufferers [15]. Another example of a range of responses to two versions of a certain dental quack was William Salmon, in 17th Century paper, with a significant bias in favor of the London [16], and Tim Bobbins "Lancashire Hob orthodox-conventional version.