Preface to The Medical Messiahs
A Social History of Health Quackery
in Twentieth Century America
James Harvey Young PhD
In The Toadstool Millionaires I sought to describe the origin, development, and criticism of patent medicines in America from the importation of British brands during colonial days to the enactment in 1906 of the first federal restraining statute, the Pure Food and Drugs Act. This present book is a sequel to the former one: The medical messiahs are the 20th-century successors of the toadstool millionaires.
Many reformers who worked diligently to secure the 1906 law would not have thought that a sequel would ever be required. The editor of the Nation greeted the new law by asserting that medical quackery had now been dealt a death blow. The New York Times and the American Medical Association's Journal also predicted the imminent doom of harmful nostrums.
In our own day, when we consider some of the trends since 1906, we too may be surprised that a sequel has proved necessary. For in the six succeeding decades the arsenal of antiquackery weapons has been vastly augmented. The rigor of legal controls has been increased. Standards of medical education have been upgraded, licensing laws improved, hospital regulations tightened. Scientific knowledge about the human body and illnesses that assail it has progressed so far that 1906 seems by comparison a dark age. In that year there was but the merest hint of the coming revolution in chemotherapy. The educational level of our citizenry has been markedly raised. Surely, if not in 1906, at least in 1966, amid all this enlightenment and law, quackery should be dead.
But of course it is not. Indeed, it is not only not dead; never in previous history has medical quackery been such a booming business as now. A reasonable guess as to the "overall annual quackery take," estimated John W. Miner, a lawyer in the district attorney's office of Los Angeles County who specializes in medicolegal crimes, speaking in October 1966, would be two or more billion dollars. "It exceeds," Miner went on, "the research total expended on disease."
The Medical Messiahs is concerned with this paradox, the concurrent rise in 20th-century America of modern medical science and of pseudo-medical nonsense. Thus the setting within which quackery has been viewed is necessarily broad. Trends in quackery, for example, are seen within the wider compass of self-medication. Laws have not sought to abolish self-medication but to make it safe and to ensure honesty in the promotion of self-dosage wares. Where lie the legitimate limits of autotherapy has been a question for continuing debate, with no firm consensus as to the exact border between quackery and non-quackery.
An effort has been made also to interpret quackery and self-medication in relation to trends in science, marketing, and government. Medical, pharmaceutical, and nutritional sciences have been revolutionized during the 20th century. Advertising has acquired a calculated psychological sophistication merely blundered upon occasionally in earlier days. Legislation to protect the consumer has expanded enormously during several waves of 20th-century reform. All of these major forces have influenced the stage upon which the quack has played his wily role.
Laws to curb quackery, indeed, form such a central part of the whole enterprise that they provide a major structuring principle for this book. The 1906 law—How did it succeed? How did it fail? How did promoters innovate to elude its modest restraints?—furnishes a key early theme. When Congress provides the Food and Drug Administration with more stringent laws, these questions are repeated. The Post Office Department, striving to restrain fraudulent use of the mails, and the Federal Trade Commission, seeking to keep advertising honest, also receive major attention. So too do the educational efforts to combat quackery of such groups as the American Medical Association, the National Better Business Bureau, and writers of books and for the press.
Case examples of medical messiahs from various important areas are given—the mail-order male-weakness treatment, the alleged tuberculosis-curing liniment, the potent weight-reducer, the vitamin and iron tonic ballyhooed at gargantuan medicine shows, the complex array of nutritional products vended by an itinerant "lecturer," the diabetes and the cancer "clinic." In such various ways did shrewd operators sometimes make fortunes that their 19th-century predecessors would have envied. It should perhaps be said that my concern has been with the promotion of drugs, food supplements, and devices, either direct to lay users, or to practitioners who in turn use these wares and machines in treating patients. I am not concerned with medical cults or sects as such.
Any individuals, societies, or organizations discussed in this book are mentioned without malice. To the best of my knowledge I am reporting the truth, not with the intent to harm but to inform to the best of my ability as a scholar who has devoted years of research to this significant social theme. The common good requires that such a major hazard to health be given public comment. All interpretations of the evidence are, of course, my own.
The major research for The Medical Messiahs was done during a sabbatical year while I held a fellowship from the Social Science Research Council. My research and writing also have been supported, over a span of several years, by Public Health Service Research Grant GM 07199 from the Division of General Medical Sciences. I am most grateful for this generous help. Also I greatly appreciate the courteous and valuable aid given me during the course of my research by officials, archivists, and librarians at various agencies, organizations, and repositories. Some of these debts are indicated in my Note on the Sources. Indispensable to the accomplishment of my task was permission from the Food and Drug Administration to consult archival records not barred to me by law and from the Post Office Department to study fraud order manuscripts.
I wish to thank Miss Ruth Walling, Emory reference librarian, for coming up with answers to my difficult questions; Mrs. John Lyon for serving as my research assistant for a year under the Public Health Service Grant; and Mrs. James Shaw for typing the manuscript.
Valuable suggestions were given me by three friends who graciously yielded to my request that they read the manuscript: Thomas W. Christopher, Dean of the School of Law, University of New Mexico; Harry F. Dowling, Chairman of the Department of Medicine, College of Medicine, University of Illinois; and Winton B. Rankin, Deputy Commissioner of the Food and Drug Administration. Abraham Levine, an attorney in the Office of the General Counsel of the Post Office Department, kindly read and commented on Chapters 4 and 13.
1 am grateful to R. Miriam Brokaw and Dorothy Hollmann of Princeton University Press for their continuing interest in my project and expert help with the manuscript.
Most of all my thanks go to my family. My wife, Myrna Goode Young, my sons, Harvey Galen and James Walter, all took notes for me that found their way into the pages of my book. And, as for my earlier writing, my wife continues first reader and key critic.
- James Harvey Young
- Emory University November 1966
In an afterword written for this new edition, I have sought to summarize what has happened regarding health quackery in America during the nearly quarter century that has elapsed since I sent the original manuscript to press. The paradox there chronicled continues: while scientific medicine has made marvelous discoveries, pseudomedicine has continued to expand, rather than to decline. Between them, indeed, the battle for the allegiance of the people rages more bitterly than before.
For their help in getting this new edition to press, I should like to thank Deborah Tegarden and Timothy Mennel of Princeton University Press.
- July 1990
- J. H. Y
This page was posted on December 19, 2001.