Medical Folkways in America – Part Two: What’s in Your Bottle?

In Medical Folkways in America – Part One: Maggots, Hairballs, and Eels, we looked at how things used to be, way back, when people lived on farms and homesteads and didn’t have access to medical miracles like doctors and hospitals.  In the late 1800s-early 1900s, most Americans, most people in the world, lived in relative poverty and there were no medical experts to guide their thinking.  Any healing remedies that were needed would have been in the form of applying leaves, flowers, moss, animal products, even entire animals like live eels, to a wound or sore spot, or just swallowing something that tasted bad and hoping for a good result.

But in the late 1800s, science entered the picture.  In the Old World, science had always been the province of an elite group of educated people with economic resources, not a playground for the unschooled masses.  But in America, the unschooled masses had ingenuity, ability, and freedom; the freedom to invent and produce new things, anything that popped into their heads.  And especially in America, a particular kind of scientific character developed, combining two important qualities: a scientific bent and an entrepreneurial spirit.

We must applaud the efforts of our forebears to help their fellow forebears; but as this story will show, some of them were as motivated by gain as by generosity.  Does the wish for profit/reward take the purity out of the “pure” sciences?  Or is it the spur that pushes certain people to try new things that can benefit others?  These are thorny questions.  We will look at them as we examine the very American phenomenon of how home remedies became patent medicines, from the manufacturing process to the use of increasingly sophisticated forms of advertising to produce and sustain mass awareness of natural/herbal liquids, liniments, lotions, ointments, pills, soaps, and rubs.

Take the long and notable history of Carter’s Little Pills.  These were the invention of a chemist, Samuel J. Carter, one of the early pioneers in the scientific formulation of American medicinal products.  His most famous product was originally called Carter’s Little Liver Pills.  The pills’ only active ingredient was bisacodyl, an organic compound that is still used in modern over-the-counter laxatives.  We can guess that CLLPs relieved constipation, in a hurry.  Once word got around about the speedy and efficient relief offered, customers started going to Carter’s pharmacy in Erie, PA, asking for Carter’s Little Liver Pills.  An employee made the pills (NOTE: This article will conclude with a recipe for making your own herbal pills at home) to Carter’s prescription.  Carter was considered a scientist, and therefore his word about the pills was taken as reliable.  Carter, like any good snake-oil salesman, might have made a few outrageous claims for his pills, though.  For example, he claimed his little pills cured headaches, too.  It seems that when marketing creeps in, wild claims always follow.  To be fair to Carter, however, relieving constipation can relieve a lot of other discomforts, purging the body of poisons and creating a happy afterglow.

The little pills entered the American folk lexicon, so for a long time (long enough for me to remember) people would say, “he or she or they has or have more [freckles, dogs, shoes] than Carter has pills.”

In the 1950s, the Federal Trade Administration, charged with analyzing advertising claims on radio and television, cast its eye on Carter’s Little Liver Pills.  The commission concluded they could be called little pills, minus the “liver”—since the pills were not made of, nor did they offer any curative effects on, liver of any kind (the medicine had been touted by those who then owned the name, as “increasing the flow of bile to the liver”).

Carter’s Little Pills are still sold today as a laxative.  Their label makes the claim that they are “sodium free” and the price is higher than other products with precisely the same active ingredient: bisacodyl.  But there are many who still swear by the Carter brand and will pay extra for the reputation of the name.

Which brings us to a valid point: the longevity of a medicine (a long-standing brand or a familiar generic name) definitely contributes to its success, no matter what it’s made of.  That is why today, the old medicines have kept or reverted to their old labels, reasoning that the look of something as old, retro, or vintage makes it more attractive to its potential clientele, people who revere the past.

Another medicinal longevity award has to go to Ms. Lydia Pinkham (1819-1883).  From a Quaker family, Lydia was a member of an abolitionist organization in her teens.  Her husband Isaac was an unsuccessful entrepreneur, but Lydia turned out to be a successful one who saved the family by selling her home remedy for “women’s complaints.”  At first, she bottled this herbal mixture, which significantly contained black cohosh, still in use today by naturopaths for menopausal symptoms, and gave it away.  One of her sons suggested turning this charitable endeavor into an industry, and Lydia Pinkham’s Vegetable Compound was born.  Over the years, Lydia’s liquid has continued to sell, though the ingredients have gradually changed.

As reported by Wikipedia, the original formula for Lydia Pinkham’s Vegetable Compound consisted of: unicorn root (Aletris farinosa L.) 8 oz; life root (Senecio aureus L.) 6 oz; black cohosh (Cimicifuga racemosa L.) 6 oz; pleurisy root (Asclepias tuberosa L.) 6 oz; Fenugreek seed (Trigonella foenum-graecum L.) 12 oz; and—ta da!—18 % drinking alcohol, to make the medicine go down!  The current formula was vetted by the federal government and changes were made, as with Carter’s pills.  Lydia’s liquid still includes black cohosh and pleurisy root, but other herbs have been substituted and the alcohol has been eliminated.  I found Lydia Pinkham’s Herbal Tablets and Lydia Pinkham’s liquid supplement at my favorite Mayberry mom-n-pop drugstore, and these remedies are also sold online and at several big box stores.

Another healing liquid that sprang up in that time came to be called “Father John’s Medicine.”  Father John O’Brien was a Catholic priest who, with his brother and fellow priest Timothy, came to the U.S. from Ireland and worked in Lowell, Massachusetts, starting a school for girls and a medical clinic for the poor and oppressed Irish Catholics of the region, battling always against the larger community’s prejudice against this immigrant group.  According to the archives of UMass in Lowell, “Tradition has it that Father John O’Brien was taken ill in 1855.  He made his way to the pharmacy of Carleton and Hovey on Merrimack Street to get something for relief.  He was given a tonic that was composed of cod liver oil and had a licorice taste.   Unlike many other medicines of its time, the prescription contained no alcohol.  It worked so well for the priest that he began recommending folks to visit the apothecary and ask for ‘Father John’s Medicine’—a legend was born.” Carlton and Hovey gave the good father a small kickback for the use of his picture, and we assume he used this for charitable purposes.

To be sure, the company that turned out the good father’s syrup also claimed its efficacy in dealing with a large variety of ailments, and like Carter’s pills and Pinkham’s drink, by government mandate, the original formulation for this cough syrup was gradually altered and its scatter-gun brags of myriad healing powers was snipped back to one: simple cough relief.  These days the medicine, still marketed with Father John’s picture on the box and on the old-fashioned bottle, contains the original ingredients, listed as “inactive,” along with a common modern cough remedy, the only active component, dextromethorphan.  In defense of the original syrup, licorice is known among herbalists as a natural anti-inflammatory, and cod liver is vitamin-rich.  Like chicken soup, Father John’s medicine couldn’t hurt you.

Born in 1848, Earl Sloan was the son of Irish immigrants whose father, Andrew, brought the family to Ohio.  Andrew was known to have a talent for veterinary doctoring.  Legend has it that he got a secret substance from the local Indians and, from it, developed a liniment for horses.  When one of his human customers rubbed it on his own aching shoulders with happy results, the medicine was reborn as “fit for man and beast.”  Earl took on his father’s assumed title of doctor and turned the liniment into a very prosperous business during the horse-and-buggy era, making great use of newspaper advertising.  Then, as now, the primary ingredient in the Sloan’s Liniment was capsaicin, found in chili peppers.  The heat generated by this herbal cure often gives relief from muscle pain and is used widely in other modern meds.

It’s important to remember that in the late 1800s, most hospitals were grim places where tortures were performed in the name of science; anyone could call himself a doctor; medicines often contained poisons like mercury; and actual cures were unpredictable at best.  Many bogus medical practitioners abounded and a lot of people didn’t trust them.  They were much more likely to trust the claims and cures of someone like Lydia, who answered every letter sent to her personally, or Samuel Carter, whose neighbors vouched for the efficacy of his product.  This word-of-mouth advertising was all that the early-science salespeople had to go on for promotional purposes.  Consider the power of that simplest of media in preserving the reputation of these healing remedies to the current day.  A power based on trust.

But this trust could be abused.  In the early twentieth century, no better example of medical chicanery can be found than “the goat gland” doctor, John Brinkley.  Born in North Carolina in 1885, his father having been a medic in the Civil War, the unscrupulous Brinkley was determined to become a doctor.  He studied at a third-rate medical school, learning just enough about the human glandular system to become dangerous, left the school with unpaid bills, bought a diploma, and finally hit on the idea of transplanting goat glands to the testicles of human males experiencing sexual disorders.  Both a bigamist and a kidnapper, Brinkley nonetheless garnered some credibility and popular fame in the 1920s-30s by using the new, exciting medium of radio to tout his “cures.” His broadcasts, deemed obscene, were banned in the U.S. by the Federal Radio Commission, and Brinkley lost his license to practice medicine for “charlatanism” after signing death certificates for too many people who had showed up at his clinic in apparent good health.  He then moved his operation to the border radio-stations blooming in northern Mexico.  These same stations were popularizing country music in the American south/southwest by blasting out the songs of such legendary artists as the Carter Family.  Brinkley exploited the Mexican airwaves not only for his medical “miracles” but also, in a dazzling display of chutzpah, to try to run for governor of the state of Kansas, the very state that had pulled his medical license.

The sad truth is that many men, perhaps isolated on farms or small towns in the south, heard the radio broadcasts and wanted to believe that Brinkley’s goat-gland scheme could rejuvenate their waning sexuality.  Some paid for that simple-minded faith in Brinkley’s “science” with their lives.  His nefarious actions, though, unfortunately paved the way for others with a bit more polish, who used radio, and then TV, to advertise health products and cure-alls that had little, if any, actual value.  The gradual emergence of the TV hucksters and their relationship to the world of legitimate pharmacology will be the subject of Medical Folkways in America, Part Three.

Brinkley and those like him (though only a handful were so outrageous or caused as much damage) gave ample support to this statement:  “The medicine man’s key task quickly became not production, but sales, the job of persuading ailing citizens to buy his particular brand from among the hundreds offered.  Whether unscrupulous or self-deluded, nostrum makers set about this task with cleverness and zeal.” (Young, James Harvey. 1961. The Toadstool Millionaires; a social history of patent medicines in America before Federal regulation).  You can judge for yourself whether this statement might apply to Big Pharma in the twenty-first century.

Now, as promised, the recipe for making your own “little pills”:

Everyone knows that herbal capsules are easy to “manufacture” for those who have the patience to fill the capsules.  I take ginger and cinnamon in capsule form, bought from a vitamin wholesaler.  Once, in a spice emergency, while throwing together some fruit bread, I emptied out a dozen or so of my cinnamon caps into the bread mix.

You, too, can make pills using herbs, just like Carter’s assistant in the pharmacy.  The only tools you’ll need are a grinder and a rolling pin.  I have a coffee grinder and a mortar and pestle.  Either works fine, though the grinder saves time and would be better for tougher leaves.  The other ingredient needed, besides the herbs themselves, is known as an excipient (on medicine bottles this is the “inactive ingredient”).  Excipients can include slippery elm and arrowroot, known for their sticky quality.  The excipient and water will bind the herbs into a dough.

The website herbaffair.com usefully offers this proportion: 10 T. of ground herbs to 1 T. slippery elm bark powder, mixed together, with water added little by little until a dough-like consistency is reached.  Flatten out the dough and cut it into small squares.  Roll the squares into pill-sized balls.  Preserve them by heating them in the oven.  They suggest: “When using your herbs to make pills, the pills will contain about half of the dose that a capsule would, so when calculating dosages and following a dosage schedule, use twice as many pills as you would capsules to substitute.”