Quack, Quack, Quack: The Sellers of Nostrums in Prints, Posters, Ephemera, & Books
The popular circus showman P.T. Barnum once warned that "humbug" was everywhere in the medical profession. In Quack, Quack, Quack, William Helfand, a historian of pharmacy, proves Barnum right. A chronicle of quackery in picture and prose, Helfand's book examines the depths of medical chicanery in Western culture over the past 400 years. "Quacks have been with us forever," explains Helfand. Never "static," quackery has "modified its offering to adjust to new therapeutic discoveries and new means of communication," as well as "to almost any prevailing political and regulatory system." Helfand demonstrates the adaptability of quackery with 183 fascinating images of promotional material, along with the popular and professional reactions they inspired. Mined from various archives and libraries, the images depict nostrum peddlers ranging from those found at French country fairs to those involved in the popular Indian medicine shows inspired by the North American frontier. There are quack products for addiction, such as No-To-Bac for smokers, as well as addiction-causing products such as Vin Mariani, a cocaine-based panacea. Readers will enjoy learning about Samuel Solomon's Balm of Gilead that targeted "masturbation, scrofula, and related ills" and the "Health Jolting Chair," which was advertised as a convenient exercise to preserve "the most highly prized feminine attractions." Helfand also includes musical scores such as those for the "Water Cure Polka" and "Blue Glass Gallop," which illustrate the popularity of hydropathic and light-ray treatments during the Gilded Age. Other paintings, illustrations, and title pages lampoon quacks and their "cures." One satirical cartoon from mid-19th-century England depicts a victim of an overdose of James Morison's vegetable pills with carrots, cabbage, and corn sprouting from his limbs. Although the images are instructive on their own, Helfand adds insightful commentary and, when necessary, English translations. Within the book's brief 50 pages of text, Helfand defines "quack" as "a pejorative term" used by members of the established medical community to disparage "irregulars" who ignore or reject medical orthodoxy. Along with their status as outsiders, quacks, Helfand explains, possess certain characteristics that signify their trade. These often undereducated and itinerant doctors and druggists engage in aggressive advertising, exaggerating the effectiveness of their abilities or products. Perhaps most important, quacks have proved themselves to be talented entertainers capable of wowing audiences with enthralling theatrics and bombastic rhetoric. Yet Helfand concedes that although regular and irregular doctors differ in style, they share many similarities, particularly since irregulars frequently imitate certain features of orthodoxy, such as medical jargon, in order to establish legitimacy or respectability. The boundary between regulars and irregulars was never clear. In fact, "in unsophisticated times," says Helfand, "the results of treatment might well have ended the same." Helfand's suggestion that quackery and irregular medicine were synonymous represents one shortcoming of the book. Were all irregulars quacks? Certainly not. For example, aspects of hydropathic and homeopathic medicine, both featured in the book, gained greater acceptance among mainstream physicians in the 20th century. Helfand ignores the emergence of osteopathic and chiropractic medicine, both of which the American Medical Association dismissed as quackery for decades. Had Helfand accepted conscious deceit as the essence of quackery, his definition would have been tighter. However, as he correctly points out, conscious deceit is difficult to prove. Overall, Quack, Quack, Quack is an enlightening and enjoyable book suitable for academics, health care professionals, and the general public alike. The images, many of which are in color, reveal in an entertaining format the long-standing tradition of quackery in Western medicine. "Despite what we do," concludes Helfand, "the quacks and their nostrums will be with us forever." I hope that there will be more books like this one to chart their development as we go.Eric Juhnke, Ph.D.Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.