Patent medicines or nostrums were originally so named in the 17th century because those finding favour with the reigning monarch were given letters patent, which authorised the use of the royal endorsement in their advertising. It does not have anything to do with the modern concept of patenting. Indeed, throughout their history, most were not patented but trademarked instead, as patenting would have forced them to disclose the formula – something quite a few of them desperately wanted to avoid.
During the 18th century medicine was in flux. Old ideas – Galen and the Hippocratic tradition – were slowly on their way of being phased out as doctors influenced by Enlightenment sought to make medicine into a science, although it would take a very long time before medicine truly could be called scientific. At the same time, increased access to exotic plants brought to Europe during the Age of Exploration encouraged experimentation. People speculated freely on diseases, how best to treat them and systematise medicine. In addition to scientific progress – though slow – the 18th century gave rise to quackery on an unprecedented scale, some of which survives to this day, homeopathy being the most famous and widespread example.
This was also an age of therapeutic toleration, people with no medical training certainly produced, marketed and sold new mixtures, some of them gaining huge popularity, for example Dr Bateman’s Pectoral Drops. Despite the name, the inventor was not a doctor called Bateman, but a businessman named Benjamin Okell. Interestingly, the choice of the name gives a clear hint of what was to follow: quacks up to today have sought legitimacy by appropriating medical titles. Before restrictive legislation they were free to use whatever titles they liked, modern ones have to resort to diploma mills and institutes of dubious character.
Patent medicines and nostrums were popular for several reasons. Even when you could have an access to a doctor or a surgeon, you did not pay the doctor’s fee and then a separate price for the preparation of the prescription, you just bought the product. They were claimed to cure a whole host of conditions, a typical example being the claims made for Anderson’s Scots Pills:
Comfort and strengthen the stomach . . . purge Choler and Melancholy, but chiefly Phlegm and Waterish Matter . . . they comfort the Bowels and remove all obstructions in those parts.
Strengthen the Head and Senses . . .Giddiness and the Megrim . . . as they comfort and purge the Stomach, they do the like to the Head and Heart.
Kill all kinds of Worms . . .
Purge and throw out by stool all Choler in the Stomach and Bowels.
Hinder the procreation of many diseases . . . defend the body against Surfeit in Eating and Drinking, which frequently beget crude Humours; and are a sovereign help for the Gravel, Scurvy, Cholic, Dropsy, Green Sickness and Palsy.
If the Head, subject to defluctions, keepeth intelligence with a moist and Foaming Stomach . . . these Pills will stop their stream . . . be free from Gout and all other diseases of the joints, so also inward and outward rheumatism.
Extremely useful to all seafaring persons, especially in long voyages . . . kept from costiveness which is the cause of most sickness at sea, and preserved from scurvies, pestilential fevers and other malignant distempers frequent in Foreign Countries.
(This is a much-shortened version of a pamphlet in the Museum of the Royal Pharmaceutical Society)
The ingredients were Barbados aloes, soap, colocynth, gamboge and aniseed oil, making this product an aniseed-flavoured laxative. This was also another sign of times to come: incredible claims were made for a product that never had a chance of delivering those promises, a trend that continues to this day in alternative medicine.
These nostrums were also advertised as widely as could be for their time, so people were aware of their availability. Manufacturers and sellers used advertisements in the fledgling newspapers, printed and distributed broadsides and pamphlets extolling their virtues, and sold them from their booths and platforms. Interestingly, the word ‘mountebank’, meaning a charlatan, comes from Italian montimbanco, someone mounted on a bench, indicating a mode of gaining the attention of prospective buyers.
(Picture credit: Wikigallery.org)
The products were also the first to use branding by using very distinctive bottles. This feature also helped illiterate customers to pick the correct product. Despite being helpful in marketing, it also created a problem for the manufacturers: nothing prevented people from acquiring empty bottles and filling them with their own imitation mixture. This is why most advertisements of the time contained stern warnings about purchasing only the genuine article.
Another feature used in the early advertisement that still plagues us today in alternative medicine marketing was the use of testimonials. Robert Turlington, the inventor and manufacturer of a popular nostrum, Turlington’s Balsam, published a 46-page brochure that included numerous testimonials. Most of these came from ordinary people – a porter, the wife of a gardener, a hostler, a bodice-maker – who were all praising the product for restoring them to health. (This product actually had some medicinal properties.) It is unfortunately now very difficult to ascertain how large a part testimonials played in the 18th century marketing, as very little of such ephemera has survived. As today, most of the advertising printed material was thrown away.
What is certain, however, that there was a large market for these products. An incomplete list published in 1748 lists 202 proprietary medicines and by 1830 British parliament records list 1,300 of them. They were exported all over the British Empire, being especially popular in Colonial America, losing their popularity only during the Revolutionary War when they were not available and domestic substitutes were produced. British products never regained their market share in America.
What did these medicines contain? I already gave the ingredients for the widely popular Anderson’s Scots Pills – which indeed were manufactured until 1916. Many contained no active ingredients whatsoever, others had substances long used in medicine: alcohol, honey, opium, mercury, silver, arsenic, willow bark, quinine and other vegetable substances. For example, another popular preparation, Dalby’s Carminative, contained carbonate of magnesia, oil of peppermint, oil of nutmegs, oil of aniseed, tincture of castor, tincture of asafoetida, tincture of opium, spirit of pennyroyal and peppermint water. This medicine would have been effective against indigestion and diarrhoea, for which it was marketed. An example of a preparation which would have never had any medical effect – apart from possibly being a mild laxative – was Beecham’s Pills, which was advertised to cure 31 different medical conditions, but contained only soap, aloes and ginger (I know it’s from the 19th century, but it’s similar to many older preparations and I have the formula for it).
Thus the 17th and 18th century introduced changes in the way people thought of their health care. Mass-produced medicines were now widely available, complete with branding and marketing, and people resorted to these more readily than to the traditional homemade concoctions, though these were certainly not abandoned. Clever marketing created trust in their efficacy and value, and as everyone else was apparently using them, most people who could afford it wanted to stay with the trend. The comparative inaccessibility of regular medicine (though the term is somewhat misleading this early, Royal College of Medicine notwithstanding) also assisted the perceived value of these products. This change in thinking paved way to the patent medicine explosion in the next century.