Michael Torbenson, M.D., Norman Barker, M.S., R.B.P

Patent medicines were extensively used in the late 1800’s and early 1900’s and played an important role in the history of medicine.  Patent medicine manufacturers used images to communicate notions of health and disease in their advertisements and these images demonstrate several recurrent motifs:  slaying the beast of disease; the use of Native American knowledge of plants and herbs; the sick patient motif; literal illustrations of medicinal effect; gender appeals; and utilization of new scientific wonders.  Each motif conveyed ideas on health and disease to the public and their examination provides insight into this important time in the history of medicine.


Figure 1. Mason & Pollard Anti-Malarial Pills.  (image date to circa 1885).  In this image, medicine is shown fighting the “enemies of mankind”, which are portrayed as devils.  These diseases are not stemming from disrupted humors, but are instead specific entities outside the body that can be defeated.

Figure 2.Hunts Remedy (circa 1880).  A bottle of Hunt’s remedy is literally used as a club to combat a skeleton, which represents death.

Figure 3.Hostetters Stomach Bitters (1923).  This image comes from an issue of the Cosmopolitan and further extends this imaging motif of medicine defeating an external force that represents disease.

Figure 4. No-To-Bac (date unknown).   The motif of medicine intervening in an external source of illness was also extended to addictions, as shown in this early advertisement for a tobacco cure.

Figure 5. Dr. Morse’s Indian Root Pills (circa 1883).  In this trade card, Native Americans are referenced in the context of a medicinal cure.

Figure 6. Friedrichshaller Bitterwasser (circa 1880).  This trade card literally shows use of this medicine.  On the actual trade card, the bottle is made of cellophane and contains sand; when the card is flipped over to see the reverse, the sand can be seen in the chamber pot.

Figure 7. J Linden’s Improved Oleum (circa 1877).  In this scene, the sick mother is surrounded by a caring and attentive family.

Figure 8. David Nicholson’s Liquid Bread (circa 1885).  In this image, the medicine forms a visual link between the patient and the nurse, symbolically bridging the gap between disease and health.

Figure 9. Colton’s Nervine Strengthening Bitters (date unknown).  “Before and After” trade cards were used to advertise a wide variety of household items including medicines.  The thin and suffering individuals on the right are noticeably healthier in appearance after the use of the cure.

Figure 10. Lydia Pinkham’s Vegetable Compound (circa 1900). The child shown on this trade card is the picture of health.  The text is directed towards women and their health concerns.

Figure 11. Viavi (circa 1907).  In this striking art deco image, Viavi illuminates the way to health for a group of young women.

Figure 12. Howard Galvanic Shield (date unknown).  Manufacturers of patent medicines sooner or later adopted electricity, magnetism, and most other scientific advances of the era.

Figure 13. Electric Inhaler (date unknown). Electricity was particularly popular and referenced in a wide variety of medical devices.  This trade card advertises an inhaler and is a type of card referred to by historians as a “mechanical card” because the eyes and mouth would open when the tongue was pulled..

Introduction

Patent medicines played an important role in the history of medicine in the United States. Patent medicines are also referred to as quack medicines, nostrums, or proprietary medicines. The composition of the medicines was almost never patented, but instead the precise ingredients and formulations were generally kept secret. In contrast, traditional medicines were compounded by apothecaries from standard and published recipes.

The peak time of the patent medicine era extended from about 1860 to 1930 (Torbenson et al. 2007). The reasons for the enormous popularity and success of patent medicines during this time includes many important factors: (1) the rapidly growing population of the United States, much of whom had limited access to traditional medicine, (2) the limited effectiveness of traditional medicine, (3) the civil war, in which both armies suffered much illness and soldiers often self-medicated with patent medicines (Young 1961), (4) technological improvements in printing with the introduction of lithography, a printing technique that allowed cheap and rapid production of color images—prior to this time almost all printed images were black and white (Last 2006), and (5) technological improvements in glass manufacturing that led to machine made bottles, in contrast to the more expensive and labor intensive method of hand blowing glass (Miller et al. 1991).

For much of this time, patent medicines were unregulated both in production and advertising. Some companies advertised their products with the most flagrant of false claims for their medicines. Other companies produced medicines that actually contained harmful substances such as mercury and opium (Young 1961). Eventually, the federal government began to regulate patent medicines, with major legislative acts in 1906 and 1913 (Young 1961). These and other regulatory acts contributed to the decline of the patent medicine industry. In addition, great improvements in the quality and availability of traditional medicine also contributed to the decrease in public use of patent medicines.

During the time in which patent medicines were widely used, the understandings of many basic medical principles were being increasingly refined. Human anatomy was understood in ever-more detail, the fruit of several centuries of diligent and sometimes dangerous work of early anatomists. The early studies of physiology, the discovery of microorganisms or “germs,” and the discovery of electricity, radiation, magnets and other scientific wonders all found their way into the growing fund of traditional scientific knowledge. However, they also found their way into the advertisements of patent medicine manufacturers. In the following section, we explore some of the recurrent image motifs used to communicate these evolving understandings of health and disease to consumers by examining examples of patent medicine advertisements.

One of the principal methods of advertising patent medicines was through trade cards (Torbenson et al. 2001, Jay 1987). Trade cards were generally about the size of today’s baseball cards and were given out freely and by the millions. The trade cards commonly contained text advertising, but the image was of primary importance in initially capturing the interest of consumers and in shaping their impressions of the product (Torbenson et al. 2001). These images are of particular interest as they were used to communicate notions of health and disease. Major trade card collections can be examined at several institutions including the Library of Congress. Other significant collections are assembled and studied by collectors and historians. The trade cards used to illustrate motifs in this paper come from the collection of one of the authors (MT).

Motifs in Advertising Patent Medicines
Slaying the beast of disease

In the 1800s and early 1900s, western medicine was undergoing an important transition in understanding the etiology of disease. Prior to this time, the Galenic notions that disease resulted from an imbalance in the body’s internal humors heavily influenced much of medical thought. However, during this time Galenic ideas on health and disease were gradually eroded by newer understandings that external factors such as sanitary and environmental conditions could cause disease. The discovery by scientists of microorganisms or “germs” accelerated the growing understanding that many diseases were caused by agents outside of the body (Duffy 1990). For example, Louis Pasteur established that germs (bacteria and other microorganisms) caused diseases, including common diseases that were familiar to all people. On May 3, 1880, he presented to the French Academy of Sciences a paper entitled “Extension Of The Germ Theory To The Etiology Of Certain Common Diseases” (Pasteur 1880).

This important transition in fundamental ideas on the nature of disease is graphically demonstrated in the motif of “slaying the beast of disease”, where disease is shown as an external demon or monster that could be defeated by the patent medicine, not as an internal force that needed to be balanced. In one example (Figure 1), the demons of fever, ague and malaria are defeated by Mason & Pollard’s Anti-Malarial Pills. In another example of this motif (Figure 2), disease is represented by a skeleton and is clubbed into submission with a bottle of Hunt’s remedy. This theme was further expanded by the use of images of a knight slaying a dragon, as shown on the label of Hostetter’s Bitters (Figure 3). Hostetter’s Bitters was one of the most successful patent medicines of its time. This image appears to be modeled after the popular religious image of St. George slaying the dragon (one example being Raphael, St. George and the Dragon. c.1505-1506, National Gallery of Art, Washington DC). Many medicine manufacturers adopted the more general image of a person slaying a beast of any sort as a common advertising motif. In a thematically related image from the No-To-Bac Company, the hero is explicitly labeled “King No-To-Bac” and the defeated enemy “Nicotine” (Figure 4)

Doctrine of Signatures

The “Doctrine of Signatures” was an important element of medical thinking in early colonial days (Young 1961).  It held that God had placed the cures for diseases in the very land in which the disease occurred.  Thus, the fevers and diarrheas of the new world were best treated with remedies from the new land and Native Americans’ knowledge of herbs and plants was highly regarded in preparing useful remedies.  Many patent medicine manufactures exploited this in marketing and specifically linked their remedies to Native Americans, usually fraudulently.  The fraud occurred on two levels, as the reported origins from Native Americans were generally untrue, as were the claims to cure various diseases.  In this example, the trade card advertises Dr. Morse’s Indian Root Pills (Figure 5).  Also, note the continuing imagery of an individual slaying a beast.

Literal Illustrations of Medicine Effect

During most of the 1800’s, the prevailing medical explanation for disease was based on the notion that each person had four humors (blood, black bile, yellow bile, and phlegm) and disease was caused by an imbalance in these humors.  Treatment was designed to restore humors and relied heavily on bleeding, blistering, causing vomiting, and causing diarrhea.  These treatments were often painful and lasted over many days.  Often, the treatments were literally worse than the disease.  George Washington, for example, is felt to have been helped to an untimely grave by excessive bleeding (Duffy 1993).   Patent medicines manufacturers rejected these harsh treatments and their medicines promised to cure without having to resort to such heroic methods.  Many patent medicines were either mild stimulants or laxatives and the consumer would quickly feel the medicine “working”.   You don’t have to understand German to understand the therapeutic effect offered by Friedrichshaller Bitterwasser (Figure 6).

The Sick Patient Motif

The sick patient motif powerfully conveys the image of sickness and healing.  This motif had many variations, from prostrate individuals whose near death was avoided by taking the medicine, to images of a patient being treated by a doctor, to images of a patient surrounded by caring family (Figure 7).   In another interesting variation of this theme (Figure 8), the medicine was shown between the sick individual and the health (and healthy) care provider—visually and symbolically bridged the distance from illness to health.  Images that showed the sick patient before and after treatment were also very effective and combined both the sick patient motif and the use of direct illustrations of medicinal effect, discussed in the preceding section (Figure 9).

Appeal to Gender

Overall, there is limited information on the proportion of patent medicine manufacturers that were women.  In one of the few studies to address this question, women were found to comprise 7% of patent medicine manufactures in Baltimore, Maryland (Torbenson and Erlen 2007).  Many, though not all, woman-owned companies emphasized that their product was uniquely designed by and for women.  Of these, the Lydia Pinkham Company is probably the best-known example.  She advertised her product as a woman’s medicine with slogans such as “only a woman can understand a woman’s problems”.  She encouraged women to write in for medical advice and usually recommended Lydia Pinkham’s Vegetable Compound along with exercise, good diet, and cleanliness.   Her medicine was also recommended for infertility with the advertising promise of “a baby in every bottle” (Figure 10).

Another example of a company that marketed their products specifically to women was the Viavi Company (Figure 11).  The Viavi Company had offices in many medium sized and larger American cities.  The company products were marketed only to women and some of the adverts suggest that only women staffed the offices.  They also produced medical literature, some of which was of high medical standards for its time and provided some of the more readily available and accurate information on the normal physiological changes during pregnancy and birth.

Incorporation of New Scientific Advances

Rapid advances in scientific knowledge took place during the heyday of patent medicines, many of which had relevance to medicine.  Of these scientific advances, advertisers of patent medicines commonly used the exciting discoveries of electricity and magnetism.  The basis of the galvanic shield (Figure 12), and many similar patent medicine devices, relied on using two metals to create a small electrical current.  The principle was first described in 1780 by Luigi Galvani who reported that he could cause the leg of a frog to move by stimulating the nerve with a device made with strips of two different metals.  How it worked was unknown to Galvani, but he called it “animal electricity”.  This discovery and subsequent ones by Alessandro Volta laid the groundwork for the eventual development of batteries of the sort we still use today. 

Galvani’s discovery also laid the groundwork for literally centuries of subsequent patent medicine devices based on the use of two different metals to create a “galvanic current” (Figure 12).  Other companies sold devices that also referenced electricity as a cure, but do not appear to have actually been based on the galvanic principle (Figure 13).

Summary

In conclusion, images on trade cards were effectively used to communicate to consumers key understandings about health and disease.   The motif of slaying a monster or beast showed consumers that disease could originate outside the body and thus could be directly intercepted by medicines.   Images of Native Americans emphasized the importance of regional herbs in curing regional diseases.  Other images literally showed the effect of the medicines, particularly advertisements for laxatives, while other motifs showed directly or symbolically the medicine healing the sick person.  Advertising at times touted the nostrums as specifically designed for women (and sometimes by women).  Rapid advances in the sciences and medicine were quickly adopted by patent medicine producers and used to sell their wares.  In sum, these image motifs were effective in communicating to consumers and contributed significantly to the success of patent medicines.   In fact, a careful perusal of some of today’s magazines will show that descendents of these motifs have survived to our times.

References

1. Torbenson M., Erlen J. 2007. A Quantitative Profile of the Patent Medicine Industry in Baltimore from 1863 to 1930, Pharmacy in History 49:15-27

2. Young J. H. 1961. The Toadstool Millionaires; a Social History of Patent Medicines in America before Federal Regulation. Princeton, N.J.: Princeton University Press

3. Last J. T. 2006. The Color Explosion - Nineenth-Century American Lithography Santa Ana, CA: Hillcrest Press

4. Miller G.L., Sullivan C. 1991. Machine-Made Glass Containers and the End of Mouth-Blown Bottles. in, Approaches to Material Culture Research for Historical Archaeologists. (Michigan: Society for Historical Archaeology)
 
5. Torbenson B., Erlen J., Torbenson M. 2001. Lash's Bitters: From the Bathroom to the Barroom, Pharmacy in History 43:14-22

6. Jay R.,1987. The Trade Card in Nineteenth-Century America, University of Missouri Press

7. Duffy J., 1990. The Sanitarians: A History of American Public Health, University of Illinois Press

8. Pasteur L., 1880. Extension of the Germ Theory to the Etiology of Certain Common Diseases, Comptes rendus de l'Academie des Sciences xc:1033-1044

9. Duffy J. 1993. From Humors to Medical Science: A History of American Medicine, University of Illinois Press

Authors

Michael Torbenson is an associate professor of Pathology and specializes in hepatic and gastrointestinal pathology.  His laboratory work focuses on viral hepatitis and hepatocellular carcinoma.  He has a long-standing interest in the history of medicine and has published several articles on the patent medicine industry.  He has an extensive collection of trade cards and has used them as the basis for his research in the history of medicine.  He can be contacted at mtorben@jhmi.edu.

Norm Barker is an associate professor of Pathology and Art as Applied to Medicine at the Johns Hopkins University, School of Medicine. He specializes in photomicroscopy and macro photography. He is a fellow of the Biocommunications Association and his work appears in textbooks, journals and museums worldwide. His work is in the permanent collections of more than thirty museums including The Smithsonian, The George Eastman House, The American Museum of Natural History and The Science Museum in London. He has just co-authored a new book entitled Seaweeds: Wonders of the Ocean Realm and the exhibit will open at The Charleston Museum in November and runs thru April 2007. He can be contacted at nbarker@jhmi.edu.