In the 19th century, Pink Pills for Pale People offered hope. And if that didn’t work, there was always Dr. Wilson’s Blue Pills for Blue People. Or Red Pills for Pale and Weak Women.

Directions for use of the Pink Pills for Pale People

At a time when little about the human body or medicine was understood, millions of people sent away for patent medicines. These remedies were sold on street corners and in theaters, and in the pages of newspapers and periodicals. Despite the name, few were actually patented. To do so would have meant revealing the secret ingredients that made these pills, powders, and elixirs so appealing. Instead, the names were trademarked and the ingredients proprietary.

These patent medicines are what most people think of when they hear the word “quack.” Bottles filled with dangerous mixes of alcohol or opium, aromatics, and coloring, sold by charlatans masquerading as doctors or scientists preying on the innocent and uninformed. But the actual story is a bit more fuzzy.

Sure, some people out to make a quick buck sold potentially lethal remedies. But many were sold by people who truly believed in the remedies they sold. Lydia Pinkham, for instance, sold a vegetable compound for female complaints based on a remedy she had used for years that riffed on several recipes found in John King’s American Dispensatory, a popular botanical handbook. Pinkham’s remedy contained a lot of alcohol – 18% – a not uncommon phenomenon among these remedies, but it’s harder to say if she was a true charlatan. As medical historian Roy Porter has written, “The historian cannot peer into the souls of ‘quacks’ and find foolproof evidence of fraud.”

Many other proprietary remedies were sold by actual doctors. Doctoring didn’t quite pay in the 19th century what it does today (in fact, as unbelievable as it sounds today, many doctors had two jobs to get by) so some doctors came up with their own remedies to sell and support their families. Others believed they had found a truly miraculous remedy that they wanted to offer to the public. Still other doctors prescribed patent remedies to patients.

All of this is to say that patent medicines, the realm of the quack in the popular imagination, are far more complicated than they at first appear.  Right or wrong, patent remedies promised affordable relief to many people who could not afford or did not have access to medical care.

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