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U.S. Department of Health and Human Services

For Consumers

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Patent medicines have had a long and ignominious history in the U. S., reaching their zenith in the late 19th century. As the population became more urban and somewhat more capitalized, a ripe target emerged for some post-industrial entrepeneurs, entrepreneurs who would thrive in a marketplace best characterized by the dictum, 'caveat emptor'. Communications had expanded, and the printed word became a crucial venue for the proliferation of patent medicines. The rise of advertising in America, not coincidentally, parallelled the rise of nostrums. At the same time, the biomedical sciences in this country were still in their infancy, and medicine was ill-equipped to deal with most diseases. An army of enterprising individuals were prepared to step in and alleviate the suffering.

Nostrums permeated American society by the late 19th century; Products appealed to exotica, the medical knowledge of Native Americans, death, religion, patriotism, mythology (a natural for this industry!), and especially new developments in science. There was nothing to stop patent medicines makers from claiming anything and putting anything in their products, clearly seen in the famous morphine- and alcohol-laced soothing syrups for teething and colicky babies. Cancer and arthritis cures, baldness remedies, bust developers, manhood restorers--wherever a need existed, patent medicine makers stepped in. They did not have a monopoly on the market, though. The ethical pharmaceutical industry, those firms that advertised for the most part directly to health professionals, sold their share of nostrums as well.

Quacks developed successful marketing techniques, but they also promoted their interests in more surreptitious ways. For example, they subdued any curiosity in the press with their economic strength. By the 1890s, patent medicine manufacturers used so-called "red clauses" in the their advertising contracts with newspapers and magazines. These muzzle clauses voided the contract if a state law regulating nostrums were passed. Thus, not only were many editorials silent on the need for such laws, they actively campaigned against them.

But quacks and their trade associations were not able to stifle the entire fourth estate. A few muckraking journalists helped expose the red clauses, the false testimonials, the nostrums laden with harmful ingredients, the unfounded cures for cancer, tuberculosis, syphilis, narcotic addiction, and a host of other serious as well as self-limited diseases. The most influential work in this genre was the series by Samuel Hopkins Adams that appeared in Collier's on October 7, 1905, entitled "The Great American Fraud." Adams published ten articles in the series, which concluded in February 1906; he followed it up with another series on doctors who advertised fake clinics. The shocking stories of the patent medicine menace were accompanied by startling images, such as "
Death's Laboratory."

That same month saw the publication of another work which, more than any other single event, spurred on passage of the 1906 act. Socialist writer Upton Sinclair published The Jungle, a fact-based novel about immigrant life in the meat-packing industry of Chicago. Sinclair's shocking and revolting story, verified by government undercover investigators, primed the final push for a federal law.

The first federal Food and Drugs Act was passed four months later. The expos?s of muckrakers like Adams and Sinclair had a major impact on passage of the bill, as did the untiring work of the General Federation of Women's Clubs, state food and drug officials, the American Medical Association, and the American Pharmaceutical Association. Most notable among the reformers was the head of the Bureau of Chemistry of the U. S. Department of Agriculture, Harvey Washington Wiley, who stumped for remedial legislation since his arrival in Washington in 1883 (though Wiley was much more concerned with food supply). The law prohibited adulteration and misbranding of food and drugs, and though it had many shortcomings, it was arguably the pinnacle of Progressive Era legislation. It did not put quackery out of business; that still thrives. But it brought some disclosure and accountability into the marketplace, an important first step in consumer protection.

Colliers, October 7, 1905

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