Marketplace of the Marvelous (34 page)

Manufacturers of patent medicines reversed the standard production process of the era. Rather than collect and fill orders, patent-medicine makers made a product and created demand through psychological lures and vivid advertising; it was a new way of doing business that pioneered the modern systems of manufacturing, advertising, and distribution.
⁷⁷

The host of contemporary publications condemning patent-medicine sellers as ignorant and inept contributed to the rise of the modern conception of consumer protection. Sensational exposés in the nation's newspapers and magazines along with the cries of regular doctors whipped up government and public concern about the contents and practices of patent medicines. The American Medical Association lobbied for legislation affirming its belief that drug decisions should be left to regular doctors alone. In 1905, the AMA began requiring drug companies that advertised in its journals to prove that the drug worked as it was claimed to do. Progressive Era legislators, however, while expressing faith in science to reveal the truth, also strongly believed that people must be given information in order to make their own decisions. The same idea motivated the muckraking journalism of Upton Sinclair against the meatpacking industry and Samuel Hopkins Adams's “The Great American Fraud,” a multipart exposé of patent medicines: the right of the public to know. While Adams's work, along with the two-volume
Nostrums and Quackery
, a compilation of articles from the
Journal of the American Medical Association
, named names of patent sellers and assigned blame fearlessly and bluntly, neither succeeded in shutting down patent medicine. The first federal drug regulation, the 1906 Pure Food and Drug Act, prohibited false or misleading drug labels and required sellers to list the presence and amount of dangerous ingredients, including alcohol and cocaine, but not every ingredient. The act did not prohibit false therapeutic claims, and though subsequent legislation attempted to do so,
proving an intent to defraud or harm on the part of the manufacturer turned out to be virtually impossible. In short, the law allowed patent-medicine makers to determine what their labels said for the most part but demanded that whatever they said about the ingredients at least be true. It was up to the public to read the label and assume responsibility for its choices: in other words, buyer beware.
⁷⁸

The Reinhardts' business ended with their expulsion from the medical field in Wisconsin. Although they boasted hundreds of happy patients, not every case turned out well. Once patients ran out of money, the Reinhardts proclaimed them cured and turned them away if they tried to come back. If a patient got an attorney to enforce his claim, the Reinhardts nearly always settled out of court and returned some of the money. One man, after paying more than five hundred dollars for treatment of his “sexual weakness,” told the Reinhardts that he “had paid them sufficient money to be cured” as they were treating him “for all diseases that human flesh is heir to.” The Reinhardts locked the door and told the man he could not leave until he paid them an additional hundred dollars for treatment. He gave them everything he had, eighty dollars, so they would release him and stop all further treatment.
⁷⁹
This and other cases led the state to restrain the Reinhardts on civil and criminal charges. The charges did not stick, but in 1908, the Milwaukee County district attorney reached a settlement with the brothers that forbade them from running or participating in any medical business in Wisconsin ever again.
⁸⁰
It was a decision hailed in the pages of the
Journal of the American Medical Association
, which commended the Wisconsin Board of Medical Examiners for its persistence in finally securing the closure of the Wisconsin Medical Institute.
⁸¹

Lydia Pinkham's Vegetable Compound, on the other hand, is still on the market. Though Pinkham herself died in 1883, her company carried on. The remedy that saved her family from financial ruin in the 1870s created a fortune that her descendants, unfortunately, fought bitterly over for decades into the twentieth century. But the product, if not the original formula, survived, and Pinkham's face still graces packages of her eponymous remedies, still giving comfort, if not care, to those in pain. Other patent medicines are still available in the twenty-first century. Proprietary remedies touting proven formulas for weight loss, energy, stamina, and immune health abound in health food and vitamin stores and in the pages of popular magazines.

The Pure Food and Drug Act of 1906 and subsequent regulations helped to constrain some makers and curbed the use of narcotics, cocaine, and alcohol, but it also pushed some toward medical devices, which were more lightly regulated. Electrical belts, brushes, and vests proved particularly popular in the early twentieth century. Williams' Electric Batteries, an electric box with different applicators attached, claimed to help rheumatism, neuralgia, and nervousness while also affording “constant amusement in the home circle.”
⁸²
The government also placed restrictions on drug advertising to consumers through most of the twentieth century, but in 1997, the Food and Drug Administration issued new guidelines that allowed for direct-to-consumer advertising as long as the drug maker provided information about risks and benefits—the long list of side effects that zip by in small print and speed reading on television and radio. Drug makers once again have a direct and independent relationship with consumers just as they did in Lydia Pinkham's day. Federal laws now regulate the extravagant claims and harmful ingredients of the past, but the Reinhardts' “sexual weakness,” rebranded erectile dysfunction, and other ailments are now treatable in pill form (in this case, Viagra and Levitra) by regulars. Though many of these remedies still require a prescription, patients ask for remedies by name, and doctors often have trouble denying their requests, particularly with a payment structure based on patient satisfaction.
⁸³

Patent medicines made many promises to their users, the most potent of which may have been their claim to treat seemingly intractable problems. Holes in medical knowledge provided opportunities to medical entrepreneurs and reformers alike in the late nineteenth century, and into one of these gaping holes stepped the osteopaths and chiropractors.

Daniel David Palmer demonstrates his chiropractic method of spinal adjustments, designed to alleviate pressure on the nerves that he believed caused disease.

 

Time began on September 18, 1895. Or at least it seemed that way to magnetic healer Daniel David Palmer, who restored Harvey Lillard's hearing with a touch. An African American janitor at Palmer's Davenport, Iowa, office building, Lillard had lost his hearing seventeen years earlier while working in a cramped and stooped position. He told Palmer he suddenly felt something “give way in his back.” Suddenly, the world went mute, so much so that he “could not hear the racket of a wagon or the ticking of a watch.” Learning of Palmer's healing skills, he came seeking help.

Palmer listened to Lillard's story with interest. He'd been investigating the cause of disease and exploring drugless approaches to healing for several years. “One question was uppermost in my mind in my search for the cause of disease,” wrote Palmer. “I desired to know why one person was ailing, and his associate, eating at the same table, working in the same shop, at the same bench, was not. Why?” Examining Lillard, Palmer found a vertebra out of alignment—the possible source of that feeling of movement Lillard felt in his back. Intrigued by the possible connection, Palmer persuaded Lillard to let him try to knock the vertebra back into place. Palmer “racked it into position” with two adjustments, freeing the nerves that had “been paralyzed by the pressure.” Soon, Lillard could hear as well as before.
¹

That September day soon assumed legendary proportions in chiropractic lore. The “First Adjustment” became year zero, the point in time from which all else could be measured, according to the masthead
of the chiropractic periodical
Fountain Head News
. From that moment on, each passing year gained one “A.C.,” the number of years “After Chiropractic.”
²

Palmer was not alone in the late-nineteenth-century medical marketplace for manual manipulation. Osteopathy had emerged in the 1870s and offered patients another form of drugless therapy based on bodily adjustment. The similarity did not end there. Both systems began in the Midwest and found their most enthusiastic followers and practitioners in predominantly rural areas. Both pushed for legitimacy, not by fighting against laws and standards as the Thomsonians had before them, but by fighting
for
licensing laws and implementing guidelines to improve the quality of their schools and practitioners nearly from the start. Both were riven by internal disputes between those who remained true to their founders' vision and those who saw the benefit of dabbling in many forms of healing. And perhaps most strangely of all, both systems were founded by haphazardly educated frontiersmen born in log cabins, who, as adults, were known for their scraggly beards and dynamic personalities, and who at one time practiced magnetic healing and claimed divine inspiration for their theories.

Osteopaths and chiropractors were not the first to notice the potential health benefits of the physical manipulation of the human body. In ancient Greece, Hippocrates described how to correct dislocated joints through pressure and adjustments, techniques that guided practitioners for centuries. The methods described in “On the Articulations” and “Instruments of Reduction” were not for the weak of stomach.
³
For dislocated shoulders, Hippocrates first advised pulling the forearm back to the spine while simultaneously bending the arm upward at the elbow to snap it back into place. For particularly stubborn or chronic dislocations, he advised cauterizing the shoulder by passing red-hot irons through the skin of the armpit until it “burnt to the opposite side” while pushing them “forward with the hand.” The high heat was essential so the irons could pass through “as quickly as possible.”
⁴
Hippocrates also described methods for reducing vertebra displacement on a treatment table fitted with various straps, wheels, and axles that bore a passing resemblance to the modern chiropractic adjustment table. Chiropractors clearly thought so, too, as many still claim Hippocrates as the true founder of the chiropractic technique. In the second century ce, Roman physician Galen won wide acclaim
for reversing the paralysis in the right hand of the scholar Eudemus by adjusting the vertebrae in his neck. Galen's writings include frequent mentions of Hippocrates' manipulative techniques as well as his own recommendations for standing and walking on dysfunctional areas of the spine.
⁵

This ancient and respected origin made manual manipulation an important treatment option for subsequent generations of European doctors. Tenth-century Persian polymath Avicenna included the Hippocratic manipulative methods in his influential five-volume
al-Qanun fi al-Tibb
, or
The Canon of Medicine
, published in numerous editions in Europe and used as a textbook in many medieval European medical schools. In the sixteenth century, French military surgeon Ambroise Paré practiced spinal manipulation and repeated many of Hippocrates' techniques in his writings on the vertebrae. German surgeon Johannes Scultetus carried the tradition into the seventeenth century with the publication of
The Surgeons Store-House
.
⁶

But despite this long lineage, by the eighteenth century regular medicine had largely abandoned the technique. The reasons are not completely clear, but tuberculosis epidemics likely had something to do with it. Force applied to the weakened joints of patients suffering from tuberculosis, a growing problem in overcrowded cities, could seriously harm and even disfigure patients. Bodily adjustment also required close contact with diseased bodies, so many doctors sought to limit their contact with contagious patients. But even as doctors grew more reluctant to use manipulation, public demand for these services persisted. So into the vacuum created by the absence of regular doctors stepped folk healers and amateur bonesetters like Sarah Mapp. Known as “Crazy Sally,” Mapp was a slovenly eighteenth-century Englishwoman perhaps as well known for her drunkenness as for her skill at setting bones. Mapp's talent earned her mention in songs and even the theater, where a comedy called
The Husband's Relief, or The Female Bone-setter and the Worm Doctor
was based on her life.
⁷

Bonesetters weren't new—nor were they all slightly loony drunks memorialized in verse—but they almost certainly found a larger patient base with the abdication of regulars from manual manipulation. Bonesetters did not just set broken or dislocated bones. They also helped with pains in the muscles, ligaments, and joints. These village bonesetters had undoubtedly passed on the tradition for centuries, long before formal recognition by the medical profession, but they
now took a far more visible place in society for people of all classes. Many poor people had long relied on bonesetters for medical care. In England, Friar Thomas Moulton's popular medical manual
The Mirror
, or
Glass of Health
included sections on bonesetting and went through at least seventeen editions in the sixteenth century alone. A century later, Robert Turner published a revised and enlarged edition in London, known as
The Compleat Bone-setter
, aimed at a general user.
⁸
While some people learned from books, more still learned under the supervision of an accomplished master. Bonesetting skills often passed through families like other skilled trades. The homespun nature of bonesetting and its informally trained practitioners likely caused many regular doctors to associate the practice with the ignorant lower classes and to thus deem it beneath their dignity.
⁹