Patent medicine is the somewhat misleading term given to various medical compounds sold under a variety of names and labels, though they were, for the most part, actually medicines with trademarks, not patented medicines. In ancient times, such medicine was called nostrum remedium, "our remedy" in Latin, hence the name "nostrum," that is also used for such medicines; it is a medicine whose efficacy is questionable and whose ingredients are usually kept secret. The name patent medicine has become particularly associated with the sale of drug compounds in the nineteenth century under cover of colourful names and even more colourful claims. The promotion of patent medicines was one of the first major products of the advertising industry, and many advertising and sales techniques were pioneered by patent medicine promoters. Patent medicine advertising often talked up exotic ingredients, even if their actual effects came from more prosaic drugs. One memorable group of patent medicines — liniments that allegedly contained snake oil, supposedly a universal panacea — made snake oil salesman a lasting synonym for a charlatan.

Patent medicines and advertising

The phrase patent medicine comes from the late 17th century marketing of medical elixirs, when those who found favour with royalty were issued letters patent authorising the use of the royal endorsement in advertising. The name stuck well after the American Revolution made these endorsements by the crowned heads of Europe obsolete. Few if any of the nostrums were actually patented; chemical patents came into use in the USA in 1925, and in any case attempting to monopolize a drug, medical device, or medical procedure was considered unethical by the standards upheld during the era of patent medicine. Furthermore, patenting one of these remedies would have meant publicly disclosing its ingredients, which most promoters wanted to avoid.

Instead, the compounders of these nostrums used a primitive version of branding to distinguish themselves from the crowd of their competitors. Many familiar names from the era live on in brands such as Luden's cough drops, Lydia E. Pinkham's vegetable compound for women, Fletcher's Castoria, and even Angostura bitters, which was once marketed as a stomach remedy. Many of these medicines, though sold at high prices, were made from quite cheap ingredients. Their composition was well known within the pharmacy trade, and druggists would sell (for a slightly lower price) medicines of almost identical composition that they had manufactured themselves. To protect profits, the branded medicine advertisements laid great emphasis on the brand-names, and urged the public to accept no substitutes.

At least in the earliest days, the history of patent medicines is coextensive with the history of medicine itself. Empirical medicine, and the beginning of the application of the scientific method to medicine, began to yield a few effective herbal and mineral drugs for the physician's arsenal. These few tested and true remedies, on the other hand, were inadequate to cover the bewildering variety of diseases and symptoms. Beyond these patches of knowledge they had to resort to occultism; the "doctrine of signatures" — essentially, the application of sympathetic magic to pharmacology — held that nature had hidden clues to medically effective drugs in their resemblances to the human body and its parts. This led medical men to hope, at least, that, say, walnut shells might be good for skull fractures. Given the state of the pharmacopoeia, and patients' demands for something to take, physicians began making "blunderbuss" concoctions of various drugs, proven and unproven. These concoctions were the ancestors of the several nostrums.

Touting these nostrums was one of the first major projects of the advertising industry. The marketing of nostrums under implausible claims has a long history. In Henry Fielding's Tom Jones (1749), allusion is made to the sale of medical compounds claimed to be universal panaceas:

''As to Squire Western, he was seldom out of the sick-room, unless when he was engaged either in the field or over his bottle. Nay, he would sometimes retire hither to take his beer, and it was not without difficulty that he was prevented from forcing Jones to take his beer too: for no quack ever held his nostrum to be a more general panacea than he did this; which, he said, had more virtue in it than was in all the physic in an apothecary's shop.''

Within the English-speaking world, patent medicines are as old as journalism. "Anderson's Pills" were first made in England in the 1630s; the recipe was allegedly learned in Venice by a Scot who claimed to be physician to King Charles I. The use of letters patent to obtain exclusive marketing rights to certain labelled formulas and their marketing fueled the circulation of early newspapers. The use of invented names began early. In 1726 a patent was also granted to the makers of "Dr. Bateman's Pectoral Drops"; at least on the documents that survive, there was no Dr. Bateman. This was the enterprise of a Benjamin Okell and a group of promoters who owned a warehouse and a print shop to promote the product.

A number of American institutions owe their existence to the patent medicine industry, most notably a number of the older almanacs, which were originally given away as promotional items by patent medicine manufacturers. Perhaps the most successful industry that grew up out of the business of patent medicine advertisements, though, was founded by William H. Gannett in Maine in 1866. There were few circulating newspapers in Maine in that era, so Gannett founded a periodical, Comfort, whose chief purpose was to propose the merits of Oxien, a nostrum made from the fruit of the baobab tree, to the rural folks of Maine. Gannett's newspaper became the first publication of Guy Gannett Communications, which eventually owned four Maine dailies and several television stations. (The family-owned firm is not related to the giant Gannett Corporation, publisher of "USA Today.")

Another method of publicity undertaken mostly by smaller firms was the "medicine show," a traveling circus of sorts which offered vaudeville-style entertainments on a small scale, and which climaxed in a pitch for the nostrum being sold. Muscle man acts were especially popular on these tours, for this enabled the salesman to tout the physical vigour offered by the potion he was selling. The showmen frequently employed shills, who would step forward from the crowd and offer "unsolicited" testimonials about the benefits of the medicine for sale. Often, the nostrum was manufactured and bottled in the same wagon that the show travelled in. The Kickapoo Indian Medicine Company became one of the largest and most successful medicine show operators; their shows had an American Indian or Wild West theme, and employed many Native Americans as spokespeople. The medicine show lived on in American folklore and Western movies long after they had vanished from public meeting places.

Ingredients and their uses

Supposed ingredients

Some level of exoticism and mystery in the contents of the preparation was deemed desirable by their promoters. Unlikely ingredients such as the baobab fruit in Oxien were a recurring theme. A famous patent medicine of the period was Dr. Kilmer's Swamp Root; unspecified roots found in swamps had remarkable effects on the kidneys, according to its literature.

Native American themes were also useful; Natives, imagined to be noble savages, were thought to be in tune with Nature, and heirs to a body of traditional lore about herbal remedies and natural cures. One example of this approach from the period was Kickapoo Indian Sagwa, a product of the Kickapoo Indian Medicine Company of Connecticut (completely unrelated to the real Kickapoo Indian tribe of Oklahoma), supposedly based on a Native American recipe. This nostrum was the inspiration for Al Capp's "Kickapoo Joy Juice," featured in the comic strip, "Li'l Abner". Another benefit of claiming traditional native origins was that it was nearly impossible to disprove. A good example of this is the story behind Dr. Morse's Indian Root Pills which was the mainstay of the Comstock patent medicine business. According to the text printed on a wrapper that accompanied every box of pills, Dr. Morse had been a trained medical doctor who enriched his education by travelling extensively throughout Asia, Africa and Europe. He also supposedly immersed himself among the natives of North America for three years during which time he discovered the healing properties of the various plants and roots that would eventually combine to yield Dr. Morse's Indian Root Pills. It is unknown if Dr. Morse ever actually existed.

Other promoters took an opposite tack from timeless herbal wisdom. Just about any scientific discovery or exotic locale could be used as a key ingredient in a patent medicine. Consumers were invited to invoke the power of electromagnetism to heal their ailments. In the nineteenth century, electricity and radio were gee-whiz scientific advances that found their way into patent medicine advertising, especially after Luigi Galvani showed that electricity influenced the muscles. Devices meant to electrify the body were sold; nostrums were compounded that purported to attract electrical energy or make the body more conductive. Albert Abrams was a well known practitioner of electrical quackery, claiming the ability to diagnose and treat diseases over long distances by radio.

Towards the end of the period, a number of radioactive medicines, containing uranium or radium, were marketed. These apparently actually contained the ingredients promised, and there were a number of tragedies among their devotees; most notoriously, steel heir Eben McBurney Byers was a supporter of the popular radium water "Radithor". He contracted fatal radium poisoning and had to have his jaw removed in an unsuccessful attempt to save him from bone cancer after taking more than a thousand bottles of "radium water." Water irradiators were sold that promised to infuse water placed within them with radon, which was thought to be healthy at the time.

Actual ingredients

While various herbs, touted or alluded to, were talked up in the advertising, their actual effects often came from procaine extracts, cocaine, or grain alcohol. Those containing opiates were at least effective in relieving pain, though they could result in addiction. This hazard was sufficiently well known that many were advertised as causing none of the harmful effects of opium (though many of those so advertised actually did contain opium). In the case of medicines for "female complaints", the principal "complaint" that the medicine was intended to treat was early pregnancy; such products contained abortifacients, ingredients capable of inducing abortion, such as pennyroyal, tansy or savin.

Until the twentieth century alcohol was the most controversial ingredient; for it was widely recognised that the "medicines" could continue to be sold for their alleged curative properties even in prohibition states and counties. Many of the medicines were in fact liqueurs of various sorts, flavoured with herbs said to have medicinal properties. Peruna was a famous "Prohibition tonic," weighing in at around 18% grain alcohol. A nostrum known as "Jamaican ginger" was ordered to change its formula by Prohibition officials; to fool a chemical test, some vendors added a toxic chemical, cresyl phosphate, an organophosphate compound that had effects similar to a nerve agent. Unwary imbibers suffered a form of paralysis that came to be known as jake-leg. Some included laxatives such as senna or diuretics, in order to give the compounds some obvious medical effects. The narcotics and stimulants at least had the virtue of making the people who took them feel better, and in the eyes of the advertisers this was scored as a "cure."

Clark Stanley the "Rattlesnake King" produced Stanley's snake oil, publicly processing rattlesnakes at the World's Columbian Exposition in Chicago. His liniment, when seized and tested by the federal government in 1917, was found to contain mineral oil, 1% fatty oil, red pepper, turpentine and camphor. This is not too unlike modern capsaicin and camphor liniments.

When journalists and physicians began focusing on the narcotic contents of the patent medicines, some of their makers began substituting acetanilide, a particularly toxic non-steroidal anti-inflammatory drug, discovered in 1886, for the laudanum they used to contain. This ingredient change probably killed more of the nostrum's users than the narcotics did, since the acetanilide was toxic to the liver and kidneys.

Supposed uses

Patent medicines were supposedly able to cure just about everything. Nostrums were openly sold that claimed to cure or prevent venereal diseases, tuberculosis, and cancer. Bonnore's Electro Magnetic Bathing Fluid claimed to cure cholera, neuralgia, epilepsy, scarlet fever, necrosis, mercurial eruptions, paralysis, hip diseases, chronic abscesses, and "female complaints." A panacea so universally effective cannot be bought today at any price. William Radam's Microbe Killer, a product sold widely on both sides of the Atlantic in the 1890s and early 1900s, had the bold claim 'Cures All Diseases' prominently embossed on the front of the bottle. Ebeneezer Sibley ('Dr Sibley') in late 18th and early 19th century Britain went so far as to advertise that his Solar Tincture was able to "restore life in the event of sudden death", amongst other marvels.

Every manufacturer published long lists of testimonials in which all sorts of human ailments were cured by the compounds. Fortunately for both their makers and users, the illnesses that they claimed were cured were almost invariably self-diagnosed, and the claims of the writers to have been healed of cancer or tuberculosis by the nostrum should be considered in this light. In fact many, if not most, patent medicines were products of quackery, and were of little or no therapeutic benefit.

The end of the patent medicine era

Muckraker journalists and other investigators began to publicize instances of death, drug addiction, and other hazards from the compounds. This took some small courage on behalf of the publishing industry that circulated these claims, since the typical newspaper of the period relied heavily on the patent medicines, which founded the U.S. advertising industry. In 1905, Samuel Hopkins Adams published an exposé entitled "The Great American Fraud" in Collier's Weekly that led to the passage of the first Pure Food and Drug Act in 1906. This statute did not ban the alcohol, narcotics, and stimulants in the medicines; it required them to be labelled as such, and curbed some of the more misleading, overstated, or fraudulent claims that appeared on the labels. In 1936 the statute was revised to ban them, and the United States entered a long period of ever more drastic reductions in the medications available unmediated by physicians and prescriptions.

The patent medicine makers moved from selling nostrums to selling deodorants and toothpastes, which continued to be advertised using the same techniques that had proven themselves selling nostrums for tuberculosis and "female complaints." One survival of the herbal exoticism that once characterized the patent medicine industry is the marketing of shampoos, which are often promoted as containing perfumes such as vetiver or ylang-ylang, and foods such as mangoes, bananas, or honey; consumers are urged to put these ingredients in their hair despite lack of any evidence that these ingredients do anything other than make the hair smell like the ingredients.

In more recent years, also, various herbal concoctions have been marketed as "nutritional supplements". While their advertisements are careful not to cross the line into making explicit medical claims, and often bear a disclaimer that asserts that the products have not been tested and are not intended to diagnose or treat any disease, they are nevertheless marketed as remedies of various sorts. Weight loss "while you sleep" and similar claims are frequently found on these compounds (cf., Calorad, Relacore, etal.). One of the most notorious such elixirs, however, calls itself "Enzyte", widely advertised for "natural male enhancement" — that is, penis enlargement. Despite being a compound of herbs, minerals, and vitamins, Enzyte formerly promoted itself under a fake scientific name Suffragium asotas. Enzyte's makers translate this phrase as "better sex," but it is in fact ungrammatical Latin for "refuge for the dissipated."

Surviving consumer products from the patent medicine era

A number of brands of consumer products that date from the patent medicine era are still on the market and available today. Their ingredients may have changed from the original formulas; the claims made for the benefits they offer have typically been seriously revised. These brands include:

666 Cold Medicine
Absorbine Jr.
Andrews Liver Salts
BC Powder
Bromo-Seltzer
Carter's Little Liver Pills (Currently sold as Carter's Little Pills)
Chlorodyne
Doan's Pills
Fletcher's Castoria
Geritol
Goody's Powder
Lobeila Cough Syrup
Luden's Throat Drops
Phillips' Milk of Magnesia
Lydia E. Pinkham's Vegetable Compound
Smith Brothers Throat Drops
Vicks VapoRub

A number of patent medicines are produced in China; among the best known of these is Shou Wu Chih, a black, alcoholic liquid which is claimed to turn gray hair black.

Products no longer sold under medicinal claims

Some consumer products were once marketed as patent medicines, but have been repurposed and are no longer sold for medicinal purposes. Their original ingredients may have been changed to remove drugs, such is the case with Coca-Cola. The compound may also simply be used in a different capacity, as in the case of Angostura Bitters, now associated chiefly with cocktails.

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