Indeed, the status of medical knowledge, medical need, and medical
ethics in the 18th century permitted patent medicines to fit quite
comfortably into the environment. As to what actually caused diseases,
man knew little more than had the ancient Greeks. There were many
theories, however, and the speculations of the learned often sound as
quaint in retrospect as do the cocky assertions of the quack bills.
Pamphlet warfare among physicians about their conflicting theories
achieved an acrimony not surpassed by the competing advertisers of
Stoughton's Elixir. The aristocratic practitioners of England, the
London College of Physicians, refused to expand their ranks even at a
time when there were in the city more than 1,300 serious cases of
illness a day to every member of the College. The masses had to
look elsewhere, and turned to apothecaries, surgeons, quacks, and
self-treatment.[51] The lines were drawn even less sharply in colonial
America, and there was no group to resemble the London College in
prestige and authority. Medical laissez-faire prevailed. "Practitioners
are laureated gratis with a title feather of Doctor," wrote a New
Englander in 1690. "Potecaries, surgeons & midwifes are dignified
acc[ording] to successe."[52] Such an atmosphere gave free rein to
self-dosage, either with an herbal mixture found in the pages of a
home-remedy book or with Daffy's Elixir.
[51] Fielding H. Garrison, _An introduction to the history of
medicine_, Philadelphia, 1924, pp. 405-408; and Richard H.
Shryock. _The development of modern medicine_, New York, 1947,
pp. 51-54.
[52] Kittredge, _op. cit._ (footnote 25).
In the 18th century, drugs were still prescribed that dated back to the
dawn of medicine. There were Theriac or Mithridatum, Hiera Picra (or
Holy Bitters), and Terra Sigillata. Newer botanicals from the Orient
and the New World, as well as the "chymicals" reputedly introduced by
Paracelsus, found their way into these ancient formulas. Since the
precise action of individual drugs in relation to given ailments was
but hazily known, there was a tendency to blanket assorted
possibilities by mixing numerous ingredients into the same formula. The
formularies of the Middle Ages encouraged this so-called
"polypharmacy." For example the _Antidotarium Nicolai_, written about
A.D. 1100 at Salerno, described 38 ingredients in Confectio Adrianum,
35 ingredients in Confectio Atanasia, and 48 ingredients in Confectio
Esdra. Theriac or Mithridatum grew in complexity until by the 16th
century it had some 60 different ingredients.
It was in this tradition of complex mixtures that most of the patent
medicines may be placed. Richard Stoughton claimed 22 ingredients for
his Elixir, and Robert Turlington, in his patent specification, named
27. Although other proprietors had shorter lists or were silent on the
number of ingredients, a major part of their secrecy really lay in
having complicated formulas. Even though rivals might detect the major
active ingredients, the original proprietor could claim that only he
knew all the elements in their proper proportions and the secret of
their blending.
Not only in complexity did the patent medicines resemble regular
pharmaceutical compounds of the 18th century. In the nature of their
composition they were blood brothers of preparations in the various
pharmacopoeias and formularies. Indeed, there was much borrowing in
both directions. An official formula of one year might blossom out the
next in a fancy bottle bearing a proprietor's name. At the same time,
the essential recipe of a patent medicine, deprived of its original
cognomen and given a Latin name indicative of its composition or
therapeutic nature, might suddenly appear in one of the official
volumes.
For example, the formula for Daffy's Elixir was adopted by the
_Pharmacopoeia Londinensis_ in 1721 under the title of "Elixir Salutis"
and later by the _Pharmacopoeia Edinburghensis_ as "Tinctura sennae
composita" (Compound Senna Tincture). Similarly the essential formula
for Stoughton's Elixir was adopted by the _Pharmacopoeia
Edinburghensis_ as early as 1762 under the name of "Elixir Stomachium,"
and later as "Compound Tincture of Gentian" (as in the _Pharmacopoeia
of the Massachusetts Medical Society_ of 1808). Only two years after
Turlington obtained his "Balsam of Life" patent, the _Pharmacopoeia
Londinensis_ introduced a recipe under the title of "Balsamum
Traumaticum" which eventually became Compound Tincture of Benzoin, with
the synonym Turlington's Balsam. On the other hand, none of these early
English patent medicines, including Stoughton's Elixir and Turlington's
Balsam, offered anything new, except possibly new combinations or new
proportions of ingredients already widely employed in medicine.
Formulas similar in composition to those patented or marketed as "new
inventions" can in every case be found in such 17th-century
pharmacopoeias as William Salmon's _Pharmacopoeia Londinensis_.
[Illustration: Figure 6.--BOTTLES OF BATEMAN'S PECTORAL DROPS, 19th
century (left) and early 20th century (right), from the Samuel Aker,
David and George Kass collection, Albany, New York. (_Smithsonian photo
44287-A._)]
Whatever similarities existed between the canons of regular pharmacy
and the composition of patent medicines, there was a decided difference
in the methods of marketing. Although patent medicines were often
prescription items, they did not have to be. The way they looked on a
shelf made them so easily recognizable that even the most loutish
illiterate could tell one from another. As the nostrum proprietor did
so much to pioneer in advertising psychology, so he also blazed a trail
with respect to distinctive packaging. The popularity of the old
English remedies, year in and year out, owed much to the fact that
though the ingredients inside might vary (unbeknownst to the customer),
the shape of the bottle did not. This was the reason proprietors raised
such a hue and cry about counterfeiters. The secret of a formula might,
if only to a degree, be retained, but simulation of bottle design and
printed wrapper was easily accomplished, and to the average customer
these externals were the medicine.
This fundamental fact was to be recognized by the committee of
Philadelphia pharmacists in 1824. "We are aware" the committeemen
reported, "that long custom has so strongly associated the idea of the
genuineness of the Patent medicines, with particular shapes of the
vials that contain them, and with certain printed labels, as to render
an alteration in them an affair of difficulty. Many who use these
preparations would not purchase British Oil that was put up in a
conical vial, nor Turlington's Balsam in a cylindrical one. The stamp
of the excise, the king's royal patent, the seal and coat of arms which
are to prevent counterfeits, the solemn caution against quacks and
imposters, and the certified lists of incredible cures, [all these were
printed on the bottle wrappers] have not even now lost their
influence." Nor were they for years to come.
Thus after 1754 the Turlington Balsam bottle was pear-shaped, with
sloping shoulders, and molded into the glass in crude raised capitals
were the proprietor's name and his claim of THE KINGS ROYAL PATENT.[53]
Turlington during his life had made one modification. He explained it
in a broadside, saying that "to prevent the Villainy of some Persons
who buying up my empty Bottles, have basely and wickedly put therein a
vile spurious Counterfeit-Sort," he had changed the bottle shape. The
date molded into the glass on his supply of new genuine bottles was
January 26, 1754.[54] This was, perhaps, a very fine point of
difference from the perspective of the average customer, and in any
case the bottle was hidden under its paper wrapper.
[53] "From past times an original bottle of Turlington's Balsam,"
_Chemist and Druggist_, September 23, 1905, vol. 67, p. 525;
Stewart Schackne, "Bottles," _American Druggist_, October 1933,
vol. 88, pp. 78-81, 186-188, 190, 194; Frederick Fairchild
Sherman, "Some early bottles," _Antiques_, vol. 3, pp. 122-123;
and Stephen Van Rensselaer, _Early American bottles and flasks_,
Peterborough, New Hampshire, 1926.
[54] Waldo R. Wedel and George B. Griffenhagen, "An English
balsam among the Dakota aborigines," _American Journal of
Pharmacy_, December 1954, vol. 126, pp. 409-415.
The British Oil bottle was tall and slender and it rested on a square
base. Godfrey's Cordial came in a conical vial with steep-pitched
sides, the cone's point replaced by a narrow mouth.[55] Bateman's
Pectoral Drops were packaged in a more common "phial"--a tall and
slender cylindrical bottle.[56] Dalby's Carminative came in a bottle
not unlike the Godfrey's Cordial bottle, except that Dalby's was
impressed with the inscription DALBY'S CARMINATIV.[57] Steer's
Opodeldoc bottles were cylindrical in shape, with a wide mouth; some
apparently were inscribed OPODELDOC while others carried no such
inscription. At least one brand of Daffy's Elixir was packaged in a
globular bottle, according to a picture in a 1743 advertisement.[58]
Speculation regarding the size and shape of the Stoughton bottle
varies.[59] At least one Stoughton bottle was described as "Round
amber. Tapered from domed shoulder to base. Long 5 in. bulged neck.
Square flanged mouth. Flat base."[60]
[55] Sherman, _op. cit._ (footnote 53).
[56] Schackne, _op. cit._ (footnote 53).
[57] George S. and Helen McKearin, _American glass_, New York,
1941.
[58] _Daily Advertiser_, London, October 29, 1743.
[59] George Griffenhagen, "Stodgy as a Stoughton bottle,"
_Journal of the American Pharmaceutical Association, Practical
Pharmacy Edition_, January 1956, vol. 17, p. 20; Mitford B.
Mathews, ed., _A dictionary of Americanisms on historical
principles_, Chicago, 1951, 2 vols.; Bertha Kitchell Whyte,
_Wisconsin heritage_, Boston, 1954; Charles Earle Funk, _Heavens
to Betsy! and other curious sayings_, New York, 1955.
[60] James H. Thompson, _Bitters bottles_, Watkins Glen, New
York, 1947, p. 60.
Hooper's and Anderson's Scots Pills were, of course, not packaged in
bottles (at least not the earliest), but were instead sold in the
typical oval chip-wood pill boxes. On the lid of the box containing
Hooper's Pills was stamped this inscription: DR. JOHN HOOPER'S FEMALE
PILLS: BY THE KING'S PATENT 21 JULY 1743 NO. 592. So far no example or
illustration of Anderson's Scots Pills has been found. At least one
producer, it will be remembered (page 157), sealed the box in black wax
bearing a lion rampant, three mallets argent, and the bust of Dr.
Anderson.