Scientists, physicians, and pharmacists continually urged their govern-ments to establish some kind of control over the production and sale of drugs. Part of their goal was to eliminate competition from the unscrupu-lous patent medicine industry and the traveling drug peddlers who hawked their wares amid circus acts and sing-alongs. Of greater concern, though, was the increasing number of people becoming addicted to the narcotics and alcohol that made up the bulk of these nostrums. It was becoming clear that patent medicines posed a greater risk to public health than did beer or whiskey, the favorite targets of temperance movements.
In the United States, such laws were not passed until the first decade of the 20th century, after a series of articles exposed the hazards to public health that were being marketed by the patent medicine char-latans. Journalists writing for big-city newspapers and for magazines such as Collier’s Weekly exposed the “miracle cure trusts” the way that other so-called muckrakers exposed the unsanitary conditions of the meatpacking industry and the domination of American commerce by railroad monopolies. The articles described how patent medicines could poison the patients they were meant to heal or get people hooked on alcohol or narcotics.
The Biologics Controls Act of 1902 was the first attempt to regu-late the sales of microbes, viruses, and biologically produced medicines such as vaccines in the United States. The law required drug compa-nies to have their plants licensed by the Public Health and Marine Hospital Service. The service’s Hygienic Laboratory, which would become the National Institute of Health in 1930, tested each drug’s strength and purity. Also, each package of medicine had to be properly labeled and dated, and each company had to agree to “reasonable inspection” of its property at any time.
Regulation of the patent medicine racket, though, had to wait until Congress passed a new law for food and drug companies and ordered the
Department of Agriculture to enforce these standards. Under the Pure Food and Drug Act of 1906, medicine makers were told to redesign their packaging to list how much alcohol, morphine, opium, and other dan-gerous chemicals were in their remedies. Drug package labels were pro-hibited from displaying “false and misleading” claims. The new rules also gave inspectors the ability to obtain mail-order patent medicines and test them for arsenic and other dangerous chemicals.
The first case brought by the government under the 1906 law was against Harper’s CUFORHEDAKE BRANEFUDE (pronounced
“cure-for-headache brain-food”). The company did not tell buyers that its headache cure was mostly alcohol, mixed with some coal tar for color and flavoring. The jury in the case was not asked to decide whether the product was medically effective or safe; the jurors were charged only with deciding whether the label was misleading. Their verdict: the company was guilty, if only for calling its product “brain food.”
Of the first 1,000 prosecutions under the Pure Food and Drug Act—
BRANEFUDE included—376 were against drugs that made exagger-ated claims to cure everything from blood disorders to insomnia; impure drugs; and drugs containing unidentified compounds. Sometimes the government had to be satisfied with small victories. A product called Humbug Oil claimed to cure diphtheria, a throat and lung infection that
Dr. Pierce’s Favorite Prescriptions, which had its “World’s Dispensary”
in Buffalo, New York, was typical of the patent medicine industry as it existed until well into the 20th century. (Courtesy of the Buffalo and Erie County Historical Society)
can cause fevers, make breathing difficult, and damage heart and nerve tissue. As government prosecutors learned, the “cure” was a mix of codeine (a narcotic cough suppressant), linseed oil (which is used in paints and varnishes), and alcoholic ammonia and turpentine (both of which are poisonous). The company that made Humbug Oil was fined five dollars and forced to take the product off the market.
The most important result of the 1906 act was the reduction of alcohol and narcotics in patent medicines. In general, though, things did not improve greatly. Unscrupulous drug makers still were able to get away with selling useless concoctions as medicine. The authority of the federal government was restricted to a relative handful of violators, such as those who sold their wares through the mail, and courts repeat-edly narrowed the definition of what made an advertisement “false and misleading.”
It would take Congress two more tries before it passed drug regu-lations that actually worked: the passage of the Food, Drug, and Cos-metics Act in 1938—following the death of more than 100 people from a particularly fatal elixir—and a series of amendments in 1962. Drug companies now had to prove to the Food and Drug Administration that the drugs were safe and did what their makers claimed.
With basic science research revealing the causes of disease and cre-ating drugs to fight them, medicine was about to enter a new era. A gap remained between professional pharmacists and the drug companies, though. It was as though trained pharmacists wished to avoid the
“snake-oil salesman” image that, rightly or wrongly, was associated with all drug makers, legitimate or not.
When the manufacturers became involved in research and began discovering the drugs that they proceeded to manufacture, attitudes changed. The stage was set for some near-miracles in pharmacology.