The increase of empiricism and of patent medicines within the 19th century, is an evil over which the friends of science and humanity can never cease to mourn
-- House Report No. 52,
30th Congress, 2nd Session, 1849
Conflicting versions often arise concerning the circumstances of momentous discoveries, and so it is with the Panacea of William Swaim. The inventor was a resident of New York or Philadelphia. He was a harness maker or a bookbinder. He either encountered the recipe which was to make him famous in the pages of an old volume he was repairing or had it handed him in the prescription of a doctor whom he had consulted because of an ailment .
When Swaim got the formula, at any rate, he knew what to do with it. His success, particularly the techniques he employed in gaining it, brought forth against him the most vigorous campaign America had yet witnessed in pitting the ranks of regular medicine against an individual maker of a packaged medicine. These events took place during the age of Jackson, not only an era in which the common man insisted on medical democracy but also a time in which no seeming evil of society went unchallenged, no inhuman practice unrebuked.
According to the most probable of the varying accounts of his career, William Swaim was pursuing the craft of bookbinding in New York when, afflicted with some illness, he consulted a highly reputable physician with the inappropriate name of Quackinboss. After a period of taking the remedy prescribed, Swaim recovered his health. He was much impressed, and somehow managed to discover from his physician the nature of the curative agent. A more exact formula he found printed in the pages of a New York medical journal. Giving up bookbinding, Swaim moved to Philadelphia with his recipe to become a medicine manufacturer. His first concoction was launched in 1820. He christened it with a powerful word. Not, he was to explain modestly, that he intended anything "ostentatious or empirical" in the designation he selected. The word "panacea" had often been employed "both by the ancients and moderns, in the restricted sense of a remedy for a large class of diseases, and not in its literal and more comprehensive meaning." Nonetheless, Swaim felt, this name for the nostrum, of all he could find, "would best express its peculiar merit." 
In the same spirit, we may assume, the ex-bookbinder went about choosing a symbol for his product. Not that Hercules had performed all the labors in the world, but the twelve he had accomplished were more than sufficient to establish his lasting reputation for strength. The adventure in which he killed the many-headed Hydra could serve with especial vividness to signify the valiant potency of the Panacea in successful conflict with the many evil faces which disease presents to a suffering mankind. Therefore, Swaim had America's leading wood engraver -- a man trained as a physician, at that -- design for him a block showing the husky hero with knotted club upraised to dispatch with devastating blow the hideous Hydra .
From his former profession Swaim brought to his new pursuit a respect for the authority of the book. He began in 1822 to issue a series of small volumes -- most of them bound, it would seem -- to make known the merits of his product. The edition published in 1824 bore the title, A Treatise on Swaim's Panacea; Being a Recent Discovery for the Cure of Scrofula or King's Evil, Mercurial Disease, Deep-Seated Syphilis, Rheumatism, and All Disorders Arising from a Contaminated or Impure State of the Blood. The Hydra, unquestionably, was grim enough, and Swaim's Hercules notably ambitious. The book contained not only persuasive promotional prose, not only page after page of triumphant case histories, but also commendations from some of the most distinguished physicians in America.
"I have within the last two years," wrote Dr. Nathaniel Chapman in 1823, "had an opportunity of seeing several cases of very inveterate ulcers, which, having resisted previously the regular modes of treatment, were healed by the use of Mr. Swaim's PANACEA; and I do believe, from what I have seen, that it will prove an important remedy in scrofulous, venereal, and mercurial diseases."
Dr. Chapman was one of the most illustrious students of Benjamin Rush. He had also pursued his medical training in Edinburgh and London. Proprietor of a medical journal, author of a text on the materia medica, professor of the institutes and practice of physic at the University of Pennsylvania, Chapman was destined to become the first president of the American Medical Association.
One of Chapman's colleagues at the medical school, Dr. William Gibson, testified in behalf of the Panacea with equal enthusiasm. He had used it "in numerous instances," had found it especially useful "in secondary syphilis and in mercurial disease," and had "no hesitation in pronouncing it a medicine of inestimable value." Dr. Gibson, indeed, had brought to a lecture hall crowded with medical students two patients who had been afflicted with frightful ulcerations. All the regular methods of treatment, Gibson had told the students, were unavailing, but Swaim's Panacea had restored them to perfect health .
The testimonials of Chapman and Gibson were genuine and sincere. Swaim cited many others from "among the brightest ornaments of our country." The ex-bookbinder also could say, truthfully, that his remedy had been employed in the Philadelphia Hospital and the Philadelphia Alms House Infirmary. At the latter institution, Swaim himself had held at least a quasi-position on the staff. A promoter who could elicit such recommendations from medical dignitaries, and who, moreover, could entice a doctor on the Alms House staff to resign and go to Europe as his merchandising agent, was indeed gifted in the arts of persuasion. It was no wonder that the Panacea, even at three dollars a bottle, was doing famously on the market. It was no wonder that a host of imitators sprang up to seek a share of the profits .
Three of the ingredients in Swaim's golden liquid require attention. The first of them is sarsaparilla. Basically the Panacea was a syrup of sarsaparilla. Swaim's use of it was by no means new. An extract from the roots of certain plants native to Latin America, sarsaparilla had been one of the first American botani-cals imported into Europe and used for medicinal purposes. In the 16th century the root acquired a vast reputation as a cure for syphilis, then fell into disuse, to be revived in the mid-18th century as a remedy for venereal disorders, scrofula, and ailments of the skin. Regular doctors blessed its healing properties, and nostrum makers turned its fame to their profit. About 1811 the sarsaparilla revival reached America. A New York physician created a sensation by using a French proprietary version, called "the rob of Laffecteur," to cure, so he said, "the case of a gentleman labouring under a loathsome complication of disease, the sequelae of syphilis, and the repeated and irregular use of mer-cury." Many other New York doctors adopted the vogue, one of them the physician consulted by William Swaim, and another the author of the article in which Swaim found the Laffecteur formula. The ambitious bookbinder had doubtless noted well that the French proprietary was retailing for seven and eight dollars a bottle .
Sarsaparilla syrup was thus a reputable weapon in the arsenal of regular medicine when Swaim sought to market his version of it. Indeed, in the year that his first bottles appeared, the first edition of the Pharmacopoeia of the United States was issued, and it contained a formula for sarsaparilla syrup. The Panacea's clever proprietor, by acknowledging that his remedy contained the wonder root, could profit from the public interest spurred by the enthusiasm of regular medicine. This too helps explain Swaim's initial success in appealing directly to doctors. Here was a version of a remedy that was all the vogue, at less than half the price of the imported French article. Try it out, Swaim could say, observe the results. Physicians who were convinced that the French proprietary had cured the ailing, were as easily persuaded that the Panacea would work wonders. Several delegates to the convention which had framed the Pharmacopoeia were among Swaim's enthusiastic supporters .
Swaim's hope for success lay in large sales direct to the public. In the purses of the common people lay his fortune. To make his appeal the more effective, he wanted the testimonials from leading physicians. But he had no hesitation in exaggerating. Regular doctors used the syrup of sarsaparilla for a restricted list of diseases. Although asserting that his Panacea was not necessarily sovereign over all illness, Swaim strove valiantly to suggest that it did not miss by much. The mystery of its composition was not dispelled by publication in a medical journal. Indeed, Swaim sought to make secrecy itself appealing. His remedy, he said, had powerful healing ingredients not known to any published formula, absent from all competing syrups of sarsaparilla. As a result, the Panacea could cure a longer list of diseases and cure them more effectively .
In Swaim's formula there was indeed an ingredient new to medicine. It is the second of the three constituents in the complex composition of the Panacea that must be noted. In place of the sassafras in the published formula which Swaim appropriated, he substituted gaultheria, or oil of wintergreen, derived from the bark of the sweet birch and from the roots, stalks, and berries of other plants. Where the bookbinder came upon this idea is not known, but it proved sheer inspiration. The oil added immeasurably to the sales appeal, not, of course, because it healed hitherto incurable diseases, but because it had a very pleasing taste .
It was not the oil of wintergreen in Swaim's concoction that began to worry some orthodox physicians, nor was it the sarsa-parilla, nor even an as yet unsuspected third ingredient. Swaim's methods of promotion got him into trouble. He himself had noted that the regular doctors who had praised his medicine had done so without regard "to the oblique censure which their more fastidious brethren might choose to cast upon them." A Phila-delphia medical journal had raised doubts soon after the Panacea had first appeared. But the ranks of the fastidious were not augmented to the point of making much show until 1827. Then the Medical Society of the City of New-York created a Committee on Quack Remedies.
Condemnation of quackery was not new in America. Even in colonial days an occasional voice was upraised against the wandering mountebank or the fantastic claims made in behalf of some packaged nostrum. The Virginia Gazette had copied a flight of satirical fancy from a London paper, describing an ointment made by a Chinese sage five millennia before the "Mosaick Creation," which would bring about a regeneration in five days when applied to the stump of an amputated arm or leg . Perkins had had his critics. Dyott had been disparaged. Thomson was even yet under heavy attack from the embattled regulars. As patent medicines expanded in American life, their enemies saw even greater dangers against which to sound the alarm. The report of the New York committee may be regarded as an opening salvo in a heavier barrage of criticism that was to assail quackery in the age of Jackson during the broader battle for reform.
Insofar as Swaim was the target, the New York committee's salvo was not unduly devastating. Hopes were still high as to the curative powers of sarsaparilla. The physicians of Swaim's former city admitted, more or less, that the Panacea would work as well as other forms in treating certain ailments, including secondary conditions of syphilis. The trouble was that Swaim made too sweeping claims for his remedy and kept his formula secret. On his list of diseases within the curative scope of the Panacea, its proprietor included cancer, scrofula, rheumatism, gout, hepatitis, the early stages of syphilis. For these ailments, noted the New York doctors, a sarsaparilla syrup was not effective .
More reprehensible was the "air of mystery and concealment" in which Swaim enveloped his nostrum. This was, the New York committee acknowledged, effective as a sales device. The very remedies which, in the hands of the trained doctor, "never excited much attention," could, "in the hands of the pretending empiric . . . perform miracles, command the confidence of the public, and call forth the encomiastic approbation of reputable physicians." Such a state of affairs, the committee warned, injured the public welfare and degraded the character of the profession. "If the untaught empiric could be permitted to seize upon the approved remedies of the art, and, in order to speculate on suffering credulity, veil them under the specious garb of secrecy, their partial successes will confer upon their order, an importance and charac-ter that could not be otherwise attained, to the serious detriment of the healing art." 
If Swaim's Hercules wore a disguise, and if his Hydra had too many heads, what could be done about it? Let every physician abstain from prescribing such a secret nostrum, advised the New York committee, and let them warn the public constantly against risks involved in its use .
In Philadelphia, Swaim had enlisted champions from the ranks of the most eminent medical practitioners. There was, therefore, a certain temerity involved, on the part of the Philadel-phia Medical Society, in appointing a committee on quack medicines and setting its members upon Swaim's trail. Some months after its New York counterpart, the committee delivered its report. By this time, in late 1827, the new prophet was no longer so honored as he had first been in the land to which he had come to make his medicine. The Philadelphia doctors condemned Wil-liam Swaim with spirit and with force.
The Panacea, they said, was neither effective nor safe. The case histories which Swaim had quoted so glowingly were much less than the whole truth. One by one the committee recounted these tales to indicate that the cures were either nature's work, or else not cures at all. One of the most famous of Swaim's testimo-nials, based on an Alms House case, ended not in recovery but in death. The ex-bookbinder's assertions that his remedy might "be administered to the tenderest infant" was a callous falsehood, charged the committee of doctors, and there were cases on record in which the Panacea might be considered the primary cause of death. The ingredients in the nostrum were badly mixed, so the Panacea was not of uniform quality. This was a particular hazard because "in an evil hour, the plan of mixing corrosive sublimate with at least certain parcels of the Panacea was adopted; and ignorance, vexatious before, was then armed with an instrument of mischief and destruction."
Corrosive sublimate was the most rigorous medical form of mercury. Here, then, was the third key ingredient in the Panacea, and Swaim claimed his bottled nostrum as a cure for mercurial poisoning! The Philadelphia committee assumed the presence of this potent metal on the basis of the physiological symptoms of patients who had taken the medicine. Although the angered proprietor was to swear an oath that the Panacea contained no mercury, three separate chemists, within a year or so, were to prove by analysis that he lied. The pharmacist from whom Swaim had gotten his mercurial supply was also to be made known .
Swaim's guilt must be shared, the committee said, by physi-cians who had sanctioned his nostrum. But here the Philadelphi-ans trod lightly. There was no need unduly to embarrass their fellow doctors, especially since they had recanted of their heresy. Indeed, the most telling evidence in the report consisted of new quotations from Dr. Chapman and other repentant physicians.
Chapman did penance. He admitted to having once "overrated the value of the Panacea," but now "for a long time" he had "entirely ceased to prescribe it." He had in his files, moreover, not a few cases relating to Swaim's remedy in action which were "eminently calculated to alarm the public on the subject." In like fashion, Swaim's other early enthusiasts changed their optimistic tune in light of sober experience. As to the Alms House and the Philadelphia Hospital, the committee discovered, the Panacea had not been used at the former since 1825, and at the latter it had been employed in but a single case .
"The Panacea by Swaim," the committee was forced to con-clude, was "on the same footing with all the quack medicines." Hercules was, after all, a myth .
In answer to the committee's 37-page attack, the unchastened proprietor offered a 52-page rebuttal. "I have not passed through life without making some observations," he wrote, more aptly, doubtless, than he was aware, "and among others, that assertions, however broad and unfounded, if permitted to pass into the mind of the hearer, without contradiction, will frequently be received with the acquiescence due only to established truth." 
It was clear too that, for Swaim, even assertions that had been contradicted were not devoid of merit. In his answer to the doctors, the medicine man boldly reprinted the very testimonials they had criticized, including the original commendations from the physicians who had changed their minds. But he sought to profit with the laity not only by continuing to use the now-repudiated medical praise. The clever promoter tried also to turn the newer condemnation to his account. Swaim boasted that most empirics had been "merely despised" by orthodox medicine, whereas he had "risen to the dignity of being hated." He was no ordinary quack. He was a prophet condemned by the Pharisees. "Is it not a singular spectacle," Swaim asked of the man in the street, "a learned body striving with all the might of authority to crush an unsupported, unfriended individual, who has risen to notice, not by occult arts, but by curative miracles, performed in open day? 
As time went on, Swaim had even more reason to adopt the role of martyr. Other physicians and chemists joined the ranks of his persecutors from as far afield as his Panacea was selling. Out in the West, Daniel Drake, an inveterate foe of the untutored in medicine, added Swaim to his gallery of quacks . Indeed, the condemnation of Swaim's Panacea was but part of a vigorous crusade against medical quackery in all its forms. The year after the New York City society report was printed, the state medical society in New York adopted one of the first formal codes of medical ethics in America, which termed patent medicines incompatible with the duties of a physician and hence not to be "professionally countenanced." Scores of resolutions, addresses, articles, even a Phi Beta Kappa oration, echoed the same sentiment .
The American imitations of the old English patent medicines also came under attack. So chaotic was the situation in this field that the newly organized Philadelphia College of Pharmacy created a committee to look into the matter. When this group gathered recipes by which these English nostrums were being prepared by American apothecaries, they found confusion twice confounded. In some cases two formulas bearing the same English name did not contain one single ingredient in common. After considerable study, the committee issued a pamphlet in 1824 stating the ingredients and their proportions which, the members felt, eight of these old English patent medicines ought to contain. Turlington's Balsam of Life, for example, had been intended originally as "an elegant and rich balsamic tincture," and the committee prepared a formula seeking to respect this purpose, while reducing the number of ingredients from the twenty-seven listed in the 1744 English patent specifications to nine .
It may be ironic that the first significant action of the first American college of pharmacy was to sanction the preparation of patent medicines. But the step had been undertaken for a worthy end, to strip the various imitations on the market of "their extravagant pretensions."
The proprietors of American nostrums of secret composition came in for even harsher rebuke. These men, in Dr. Oliver Wendell Holmes' phrase, were "the mushroom, say rather, the toadstool millionaires."  Holmes and his colleagues condemned them as greedy, dishonest, obscene, and heartless. There was no end to the quack's effrontery. He pretended to be a trained physician when he was not. He fabricated testimonials. He created diseases. He gave his nostrums foreign names and said they were imported from abroad. He asserted they were made of rare and expensive ingredients. He used the poor as decoys for the rich, trumping up a false philanthropy in claiming to treat the indigent for nothing. He crept under the mantle of all the persecuted scientists of history, asking self-righteously if Galileo and Harvey, Copernicus and Franklin, had not been treated with skepticism by the learned of their day. He faked statistical evidence of alleged cures. He insisted that his nostrums could cure with dispatch diseases that could be cured only slowly. He boasted that his remedies could cure with certainty diseases that could not be cured at all .
Quacks were adept at prescribing for general symptoms as well as for specific diseases. Whatever the illness, if it became chronic, certain conditions were apt to appear, such as general weakness, ill-defined pains in the back and sides, sick headache, fluttering about the heart, night sweats, an oppressive fullness of the stomach, irregularity of the bowels, loss of weight, nervousness, despondency. Patent medicine promoters listed dozens of such symptoms, some of which indeed might occur in a person not really sick at all. These afflictions, as a doctor pointed out, seemed "very definite and clear to a patient or his friends, but beautifully indefinite to a penetrating and acute physician." 
All this had the most disastrous consequences. People who were not really sick were frightened into the medicine habit. Once started, they kept on, if only to get their money's worth from what they had bought. The continued use of laxatives was especially dangerous. "Few patients among the lower classes," wrote a doctor, "now apply to a physician, who have not previously aggravated their complaints by swallowing numbers of these pretended speciflcs."  Another habit that nostrums might engender was alcoholism. The temperance crusade was in full swing, and many Americans were signing the pledge. But some of them, unknowingly, were imbibing quantities of alcohol in the remedies they relied on, including many patent medicines advertised as containing none. A fate even more dire lay in the opium habit. Nothing could be more cruel than the fastening of this insidious monster on the backs of innocent men, women, and children. To make things worse, the disease often became more serious while the patient, his pain deadened by the narcotic, acquired a false impression that he was on the road to recovery.
The delay in consulting an expert physician that often resulted from the use of nostrums, the critics charged, could amount to murder. The "most usual effect" of the employment of patent medicines, according to one doctor, was "to convert medicable into incurable disease, with its train of domestic distresses and bereavements." Sometimes the threat of life was even more direct. Many nostrums contained poisonous ingredients in high proportion, or in small quantities but badly mixed. All in all, one doctor was convinced, "nothing is more certain . . . than that quackery kills a larger number, annually, of the citizens of the United States than all the diseases which it is pretended to cure, together with all the explosions that take place on our steamboats, all the accidents which occur on our railroads, and all the houses that tumble down on their inmates." 
For such a dire threat to the life and health of the American people, the nostrum maker was not alone to blame. He had allies, if often unwitting ones, who must share the awful responsibility. There were the "old aunt Betsies," the "female would-be missionaries," who went from door to door giving bad advice about patent medicines to the sick. The clergy, in this respect, were a positive menace. Their motives might be commendable, but in suggesting nostrums to ailing members of their congregations, ministers were ducks sadly out of water. When the recommendation came in the form of an endorsement to adorn advertisements spread across the pages of the nation's press, the situation was ten times worse. "How often," inquired one doctor, "do we see the filthy patent nostrums rendered palatable and find ready sale by the indorsement of some minister of the Gospel?" 'What if the shoe were on the other foot, asked another physician, and doctors of medicine went around recommending books filled with "the subtle poison of infidelity"? In such a case, "would not every pulpit, from Maine to Mexico, thunder forth with anathemas against the medical profession"? And would not the charge of "warring against Christianity" be absolutely just?"
Others besides the clergy were rebuked by physicians for providing testimonials for patent medicines. "Men may be wise and just princes, proud and wealthy lords, . . . sagacious and eminent statesmen, and shrewd and wily lawyers," observed an Alabama doctor, "and yet fail to be the best possible judge of a medical doctrine."  There was the continuing problem of the black sheep within the medical fold: the regulars who behaved so badly they drove their patients into the arms of quackery; the editors who accepted nostrum advertising for the pages of medi-cal journals; the doctors who wrote testimonials as eloquent as those of the veriest clergyman; worst of all, the physicians who themselves made and vended secret remedies. In the orations and in the resolutions about such erring brethren, the tone was perhaps more often pleading than execrating. But it was criticism nonetheless, it kept on and on, and medical societies took action against the worst offenders.
The masses of the American people, noted the critics, were fundamentally responsible for the magnitude of the patent medi-cine evil, for they bought the medicines. Yet they were more sinned against than sinning, ignorant victims of their own credulity. The common man could not handle evidence rationally. The vigor of an argument rather than its sense seemed to persuade him. Man's reasoning seemed to flounder particularly when the issues related to things medical, which constituted, one doctor felt, the "most difficult, obscure, and complicated" of all branches of human learning . In such a confusing field, people tended to hearken to the voice of authority, whether or not it was qualified to speak. Hence nostrum testimonials were so effective. Common-sense logic often persuaded a man of the value of a patent medicine. He was sick, he dosed himself with a nostrum, he got well-ergo, the patent remedy cured him. It was so easy to feel sure that an event which came first in time was therefore a cause. That nature healed most illnesses, sometimes in spite of nostrums, was not easy to perceive. Most people adhered stubbornly to their privilege of making their own medical decisions and acting on them. "A man's [medical] ignorance," said Dr. Holmes, sadly, "is as much his private property, and as precious in his own eyes, as his family Bible .
All these hazards to sound judgment were made more frightful, anti-nostrum writers indicated, when illness was present. People "tortured by pain, or distressed by affliction," were very prone to look to "delusive sources for relief." They preferred to hear what was hopeful and agreeable rather than what was true, "and the flattering and confident promises of the empiric, often out-weigh[ed] the cautious and candid decisions of the physician." This was particularly true when the disease was grave, and honest doctors could offer little hope. Then the quacks gave forth their most deceptive assurances. What of the young man whose parents, brothers, and sisters have died of consumption, when he detects the first symptoms of this dread affliction? He sees an advertisement promising a cure. "His heart is cheered, his fears are in a measure dispelled, and with eagerness he procures and takes the medicine." For several weeks he may feel better, since the nostrum is doubtless "of a stimulating nature." Then he declines, and "with four-fold rapidity the poor victim is hurried into eternity." 
Some medical observers were gloomy. The credulity of the people, they believed, was an inborn trait which nothing could change. Quackery, therefore, was "peculiar to no particular age, or country, or state of society." "It has existed," proclaimed one of the discouraged, "from the earliest periods, and will continue to exist as long as human beings are found upon the earth." 
In the age of the common man, it was the aristocratic die-hard
who was thus pessimistic about human potentialities. The weight
of opinion, even of the medical opinion that made itself heard,
was hopeful. If man could be shown the error of his ways, he would
improve. "Quackery . . . is the legitimate offspring of ignorance,"
asserted an orator at the opening of a new medical school in the
West, "and can only be abridged by elevating the standard
of medicine, and disseminating a correct public senti-ment."
In "an intelligent community," the orator was persuaded,
"quackery could not flourish. "  Optimistic doctors
set about try-ing to make their communities intelligent. The very
volume of the anti-nostrum literature is a token of the confidence
of the critics, for the articles and orations -- often printed
to give them a wider circulation -- were themselves a part of
the campaign to enlighten. The public did not realize the magnitude
of the evil and must be taught. "If the people were aware
of the immense amount of such [patent medicine] sales, and of
the impaired health, the ruined constitutions, and the premature
deaths, which they occasion, they would be astounded." 
So wrote Lemuel Shattuck in his pioneering report on the public
health. Scores of physicians agreed with him, and with voice and
pen sought to specify the hazards to purse and health posed by
Over and over again, doctors sought to shock the common man into common sense by asking some variation of this theme: "Who would employ a blacksmith to repair a watch, a barber to shoe a horse, a ship-carpenter to make bonnets, or a milliner to build a church? Or who would send a son to a dumb man to learn elocution, or to one born deaf to be taught music? And yet it is quite as reasonable and philosophical to do one of these things, as to expect that the human system should be repaired by one who knows nothing of it."
Some physicians were willing to combine a little legislating with the educational crusade. On the national level, the step proposed was negative rather than positive, to repeal or modify the patent law so that compound medicines could no longer receive this form of governmental protection. This was the recommendation of a select committee of the House of Representatives after an investigation in 1849, but Congress took no action. Still some physicians did not give up hope. "The time will come," predicted one doctor, "when that system of legislation which allows unprincipled men, for their private benefit, to send forth patent medicines under the great seal of the nation, will be seen to be no other than a licensed imposition on the public."° That the time would come when Congress would legislate positively against patent medicines was a possibility not yet dreamed of.
Nor was anti-nostrum legislation on the state level a real possibility during the age of the common man. While laws prescribing the standards for medical practitioners were being repealed in wholesale fashion, other laws controlling the doctor's competition from patent pills and potions stood little chance of passage. The most frequent of the vain proposals made by physi-cians would have required that the names of ingredients and suggested dosage be plainly printed on the label of every patent medicine. This was a sort of enlightenment by fiat. "Let but the composition of secret remedies be once known to the community," insisted one physician, "and the death knell to empiricism will have sounded . But no laws were passed to put such a hopeful prediction to the test.
The educational crusade against the nostrum evil may have deterred some potential purchasers from dosing themselves with alcoholic elixirs and pain-killing opiates. Nonetheless, all the the opponents of quackery were too small a dike to stem the mighty flood of patent medicine advertising. The sale of nostrums grew and grew.
Take the Panacea of William Swaim. The medical societies of the two leading cities of the nation had attacked this remedy and the proprietor's methods of promoting it. Other critics had spoken out against him. Had he been seriously hurt?
In the same year that he issued his pamphlet reply to the attack, Swaim opened in Philadelphia some public baths, with separate apartments for women and men, the latter equipped with a bar room, and a total of fifty tubs, some tin-plated copper, some Italian marble . Was the nostrum proprietor fearful of a decline in the sale of his Panacea, and hence diversifying his economic interests? Or were the baths financed out of the profits from his remedy?
Swaim also cut the price of his Panacea. Did this act stem from a falling market caused by the public reaction to the doctors' condemnations? Or was Swaim fighting the competition created by his own success?
Truth to tell, Swaim was prospering. He might, in fact, have been less angry at the medical committees than he was at the effrontery of a rival, who stole for his own use in advertising the now-repudiated testimonial of Dr. Chapman, merely changing the name Swaim to Shinn. Competition was a problem for the ex-bookbinder. Many sarsaparilla nostrums came on the market, some of them flavored with oil of wintergreen. With regular physicians, the root was to lose caste in a short time, and compound sarsaparilla syrup was to continue in the Pharmacopoeia only because it served as a vehicle for truly active drugs and as a mask for such flavors as castor oil. In the realm of pseudomedicine, however, the sarsaparilla vogue was to be vast and persistent, reaching its apogee in the concoctions of Brandreth and Ayer and Hood .
William Swaim, in the good old 19th-century tradition, triumphed over all obstacles. Neither competition nor criticism seriously deterred his rise to wealth. By mid-century his worth was estimated at half a million dollars, and he later spent considerable time abroad. Decades after its original proprietor had passed from the terrestrial scene, the squat octagonal bottles of the Panacea were still enjoying a brisk sale .
Hercules was still hoisting his knotted club to do battle with the Hydra.