Where It All Started
In the late 1800’s and early 1900’s, before FDA legislation, the sales of uncontrolled medicines flourished
and became widespread. Many of these products were called patent medicines, which signified that the
ingredients were secret, not that they were patented. The law of the day seemed to be more concerned
with someone’s recipe being stolen than with preventing harm to the naïve consumer. Some of these
patent medicines including toxic ingredients such as acetanilide in Bromo-Seltzer and Orangeine and
prussic (hydrocyanic) acid in Shiloh’s Consumption Cure.
Most patent medicines appear to have been composed largely of either colored water or alcohol,
with an occasional added ingredient such as opium or cocaine. Hostetter’s Stomach Bitters with 44%
alcohol could easily have been classified as liquor. Sale of Peruna (28% alcohol) was prohibited to Native
Americans because of its high alcoholic content. Birney’s Catarrh Cure contained 4% cocaine. Wistar’s
Balsam of Wild Cherry, Dr. King’s Discovery for Consumption, Mrs. Winslow’s Soothing Syrup, and several
others contained opiates as well as alcohol.
The medical profession of the mid and late 19th century was ill prepared to do battle with the
ever-present manufacturers and distributors of patent medicines. Qualified physicians during this time
were rare. Much more common were medical practitioners with poor training and little scientific
understanding. In fact, many of these early physicians practiced a brand of medicine that was generally
useless and frequently more life-threatening than the patent medicines themselves.
In 1905, Collier’s Magazine ran a series of articles called the “Great American Fraud,” Which
warned of the abuse of patent medicines. This brought the problem to the public’s attention. Collier’s
coined the phrase “dope fiend” from “dope,” an African word meaning “intoxicating substance.” The
American Medical Association (AMA) joined in and widely distributed reprints of the Collier’s story to
inform the public about the dangers of these medicines, even though the AMA itself accepted
advertisements for patent medicines that physicians knew were addicting. The publicity created
mounting pressure on Congress and President Theodore Roosevelt to do something about these
fraudulent products. In 1905, Roosevelt proposed that a law be enacted to regulate interstate commerce
of misbranded and adulterated foods, drinks, and drugs. This movement received further impetus when
Upton Sinclair’s book The Jungle was published in 1906 – this nauseatingly realistic expose detailed how
immigrant laborers worked under appalling conditions of filth, disease, putrefaction, and other extreme
exploitations at Chicago’s stockyards.
Two substances used in patent medicines helped shape attitudes that would form the basis of
regulatory policies for years to come: the opium derivatives (narcotic drugs, such as heroin and
morphine) and cocaine.