The 19th century produced a significant amount of great medical discoveries and inventions such as germ theory, anesthesia, and the discovery of cells as the building blocks of life; However, the 1800s also had some inventions that were not so great, such as the monowheel, the diplograph, and the star of this text: Dr. Thacher’s Liver and Blood Syrup. Found underneath a (now renovated) MARTA transit station in Atlanta, no one would think of the significance the object has and specifically what is says about the early history of medicine in the United States.
Standing at 4 in ches in height and 2 and a half inches in width with a tunnel shaped neck and circular rimmed opening ( a shape used in many bottles that contain liquids to aid in pouring), a bottle of Dr. Thacher’s Blood and Liver Syrup is an anachronism. Seeing it today, one might think it was a gift shop knick knack, however, the bottle was actually sold as a “cure-all” in the late 19th and early 20th century. The bottle is made out of a dark tinted glass with the words CHATTANOOGA on one side and SAMPLE on the other. The bottle bares a resemblance to liquor bottles at the time (interesting because many quack medicines contained some amount of hard liquor) and interestingly enough has some characteristics of modern medicine bottles, mainly in that the glass is tinted like most medicines today are in order to prevent ultraviolet light from melting any photosensitive medicine that might be contained in the bottle, while also allowing the contents of the bottles to be seen by a user. Interestingly enough, the reason that most beer bottles are not clear is because light can interact with the chemicals in the beer and make it taste bad. So this is why many medicine and alcohol bottles are brown or amber to this day, because their contents are often photosensitive. Dr. Thacher might not have know this when designing his product but it is an interesting chance that his bottles had this feature in common with more modern bottle designs.
The story of this bottle starts in the American South (like many great things, myself included), in the mid 1800s Dr. Thacher moved with his family to Tennesse where he would found Thacher’s Medicine Company of Chattanooga. Most of the company’s products were patent medicines, also known more derogatorily as quack medicines or nostrums (fake ineffective medicine). While Dr. Thacher was a legitimate business man, he was probably a less than legitimate medical practitioner and/or chemist. His products were classic nostrums, with outlandish claims of being able to cure “lady problems”, yellow fever, and even syphilis. However, the only ingredient on Dr. T’s Syrup able to produce any significant effect on the human body was alcohol, and sometimes opiates, perhaps only really offering a cure for sobriety.
In the 1800’s the medical community had a major problem with the patent medicine industry. Medicine back then was not the most advanced (specifically safe), oftentimes doctors could do more harm than good for a patient, in fact it was not until 1846 from the discovery by Ignaz Semmelweis that doctors started washing their hands to deliver babies (a practice midwives had been doing for many years at this point) ultimately reducing the occurrence of oftentimes fatal child bed fever among new born babies. Doctors at this time also had a penchant for bleeding people for any reason. Medical practices in general can be yuck-inducing, but those of the early 19th century and before were particularly so. So with the lack of trust for professional doctors, many people turned to the patent medicine industry for answers (not that the two are mutually exclusive, quack medicine was, and is, sometimes pushed by licensed doctors).
What also enabled the boom of patent medicines was that the US government had no regulatory power over medicine at this time. Anyone that wanted to could sell any home-made concoction without worrying about being sued/fined. And there were no shortage of American entrepreneurs willing to capitalize on this completely unregulated market. A particularly famous example is Clark Stanley and his “Snake Oil” which could cure well just about anything, but not really.
The patent medicine industry filled a gap between the limited amount of scientific knowledge the medical community had and a very human preoccupation about ones bodily health. In a way, quack medicines may have helped people feel as if there was something they could do to have agency in the face of illness. Sadly, any health benefits from nostrums were of course results of a placebo effect (unless you count being high on opiates a health benefit).
In response to the patent medicine industry, the actual medical community banded together to form the American Medical Association (AMA) in 1847. Unfortunately, they had very little power. As such, the patent medicine industry flourished well into the early 19th century. Although, to give credit where it is due, the AMA was the beginning of medicine taking itself seriously and moving from a home-based tinker style science to a collaborative accountable practice with standards.
Anyway, while the medical community was trying to pull itself together, Dr. Thacher’s Syrup did reasonably well, according to some sources it was one of Thacher’s best selling products. However, the boom of patent medicines would not last forever. Many people were beginning to realize the dangers of quack medicines. The progressive movement of the late 19th and early 20th century were particularly critical of the patent medicine industry. What made a big impression on people was the literary and journalistic pieces that touch on the subject of quackery. For example, in Mark Twain’s Tom Sawyer sellers of a nostrum are eventually tarred and feather for their dishonest products. More, notably though, many muckrakers investigate and publish written pieces on the lack of regulatory practices in America and the consequences. Upton Sinclair wrote the Jungle in 1906, which brought the unsanitary meat industry to the public’s eye. More related to medicine however is that in 1905 Samuel Hopkins Adams writes The Great American Fraud, 11 articles that explain the consequences of the patent medicine industry, such as death, injury, and fraud.
Due in no small part to the works of Sinclair, Adams, and other mukrakers Congress passed the first Food and Drug Act of 1906, which said that drugs could not lie about the ingredients in them. This was a big problem because many patent medicines were norstrums, which are (ineffective) drugs that have secret ingredients, which was usually just alcohol, opiates, or laudnum. While this was a major milestone for public health, the law was not heavily enforced for a while. In fact it took until 1917, a decade after the first Food and Drug Act, for the government to fine Dr. Thacher’s Liver and Blood Syrup for mislabeling their product. While the 1906 act did not say it was illegal to lie about the effects of a medicine on a label, Both the states of Georgia and Tennessee complained about the false statements on shipments of the product in notices issued. Dr. Thacher was not even fined, the shipments of his product were just ordered to be destroyed. Although, fines back then were not very expensive, 20 dollars (400-500 in modern USD) would have been the norm.
Eventually the 1906 act was reformed to include false claims on a drug to be illegal. This was detested in 1911 in US v Johnson when the Supreme Court ruled that the 1906 act did not prohibit false claims, only false ingredients. Samuel Hopkins Adams writes another serious of articles railing against the ruling, which get published in the AMA’s journal. In 1917, Food and Drug Act is amended. Is later amended again to include electrical quack devices, specifically to ensure that any device sold has to not cause harm.
It is interesting to discuss America’s public health history. Most people in the United States today take for granted that when we buy food or medicine it will not harm us. But it took awhile for the government and science to actually be able to make this a reality. One would think that with all the regulations on products, specifically medical ones, quackery would not still be a problem. However, it is. But in a different form than in the 19th century.