Medicine and healing in the Civil War
Soldiers and Self-dosing –
A Brief History of Patent Medicine in the Civil War Era
Len Overcash, Sr
The Civil War revealed that some human actions will probably never change, especially in the area of medicine and healing. Much has been written about how unsanitary conditions contributed to deaths of the wounded and sick soldiers and how rural volunteers became sick and often died when exposed to illnesses that were common in the cities of those days. Today, as in that time, the ill and afflicted are looking for the magic cure, the magic bullet that will stop the progression of disease and make them healthy again. Today, we have chemotherapy, radiation, transplants, precise laser-surgery, sterile operating rooms and antibiotics. In the 1800's, those seeking cures often found that the medicine did them more harm to them than good. But that didn’t stop them from self-diagnosing and self-dosing with nostrums and herbs and “granny” remedies.
In the early 1800's, the United States had few doctors due to several factors. Most rural populations, whose citizens largely farmed at a subsistence level, could not support a doctor so the doctor had to farm or seek another career to provide a steady income. In addition, doctors were not held in high esteem, and no standards for the profession existed. To earn a degree, one merely had to attend a “medical” school which consisted of four or five months of lecture – no text books, no exams, and no questions from the students allowed – after which a diploma was issued. In large cities like Chicago or New York anyone could mail in a few dollars and be sent a medical certificate with a name and date of “graduation.” Anyone could simply call himself a doctor without benefit of education and many did. In those days, patients diagnosed their own problems and took medicine based on what it did to and for them. Often they took patent medicines, which promised to cure almost every illness known at that time.
The person most responsible for the family’s health was the wife. Doctors had to travel great distances either on horseback or in a buggy and lost a lot of time traveling. Often by the time the doctor arrived, it was too late for the patient. So the task of curing the illnesses of childhood and dealing with the frequent outbreaks of cholera, dyptheria, or measles fell to the woman of the house. She often relied on the counsel of her peers, using home remedies such as poultices, soups, and teas containing herbs or animal fat and bones. Often the treatment was laced with mercury or other dangerous chemicals like turpentine, kerosene, or arsenic.
Regardless of the “kill or cure” consequence, the patient needed reassurance that his illness was not being ignored. Sometimes an oral medicine was palatable, but more often it tasted nasty. In the early 1800's the current medical procedures were to dose the patient with calomel until drooling and vomiting occurred or to bleed the patient until he fainted. In those days, the use of powerful purgatives and cathartics, referred to as “heroic” treatments, had to match the power of the illness to provide a cure. Neither was pleasant, nor did they cure the patient. Calomel is a tasteless white powder of mercury chloride and had very nasty side-effects in addition to drooling and vomiting. It also caused the bleeding gums, tooth loss, mouth sores, bloody stools, and patients hated taking it. Early medical treatment was assaultive and not for the faint hearted.
Into this arena stepped the patent medicine salesmen, and the Age of Quackery began. Though most people associate patent medicines with the Old West, they originated in England in 1712 when a patent was issued. In reality, few of the manufactured medicines were patented, which would force disclosure of the ingredients, so what was patented [that is registered] was the brand name, or the shape of the bottle, or label information. As most people know, the major ingredient in these “medicines” that promised to cure every known illness was alcohol. Few contained the ingredients that were claimed on the label and none could heal anything.
The Revolutionary War stopped England from exporting patent medicines to the colonies. A small group of men went into the business after the United States was formed and the use of patent medicines went west with the flow of the population. Almost every general store had patent medicines on the shelf, frequently a large selection of them. They were convenient and took far less time to work than waiting for the doctor and the sufferer felt that something was being done. Confidence in doctors was very low. Most people could not afford the price of a visit and his ministrations seldom produced a cure, so it’s not hard to understand why people began diagnosing their illnesses and self-medicating. In early American cities, living conditions were appallingly unsanitary. The contents of chamber pots were tossed out windows and collected in the gutters along with the horse and other animal manure. Epidemics of diseases like cholera, measles, and yellow fever ravaged the concentrated populations in the 1800's. Farms were no more sanitary; outhouses – if the farm had one – and barns were often built close to the houses and manure was tracked inside. People seldom bathed because bathing was considered an eccentricity. Night air was thought to be “poisoned.” Salt pork was consumed often, but vegetables were hardly eaten at all. The women were not only charged with running the house but also provided medical care; doctors were considered the last resort for the sick. Folk remedies were what she relied on, usually recipes given her by family or friends. If the remedy worked on one person at one time that was sufficient proof that it could cure. Folk medicine was a combination of plants, herbs, animal parts, and some mysticism. The main expectation for a remedy at that time was that it taste terrible. Hundreds of remedies were passed on, some only varying slightly in the ingredients. Dried pumpkin seed tea was used for tape worms and saffron to combat measles. To cure itching, soft soap was applied with a corn cob, followed by sulphur and lard, and goose grease was used for about anything. But more and more frequently, the cure was sought in the wild promises of patent medicines.
Alcoholism was also rampant in the 1800's, to a much greater degree than it is today. Everyone, including children, drank alcohol instead of water or bacteria-laden milk. Wine, rum, cider, applejack, rye and whiskey were consumed daily. It isn’t hard to understand why patent medicines became so quickly popular. Along with high alcohol levels [Hostetter’s Celebrated Stomach Bitters was 44.3% alcohol by volume], many patent medicines contained opium, cocaine, or morphine. The tonics, bitters , elixirs , and other nostrums became a part of the self-medicating society and increased not only the abuse of alcohol, but also created a dependence on the drugs.
Prior to the war, patent medicines were sold by hucksters and peddlers on street corners and open lots. These peddlers wove tall tales and appealed to the distrust of doctors. By the 1860s, more than fifteen hundred different remedies were competing for advertising space in magazines and newspapers. At the outbreak of war in April of 1861, thousands of young men, many right off the farm, began living in squalid Army camps. Unaware of basic hygienic matters, these civilian-soldiers were fed fetid green salt pork, weevil ridden hard tack, and drank muddy water gathered downstream from the sinks. Diseases such as dysentery, fevers, measles, the pox, and various bowel maladies become a real danger to them.
The Regimental Surgeons and medical doctors of the era were largely suited to swift and crude amputations and little else, because they were ignorant of the sources of the diseases. Many surgeons were appointed by the governors of their states, and had no medical knowledge. A few Army Doctors appointed at the beginning of the war, were patent medicine peddlers who prescribed their nostrums for complaining feverish or constipated patients. Soldiers quickly determined that the hospital tents and surgeons were to be avoided at all costs.
When the Civil War began, the Army Medical Department, which was responsible for the care of the sick and wounded in the Federal Army, was unprepared. The tiny staff of 90 doctors assigned to the various regiments was experienced in dealing with the health problems of small military outposts. None of them had any knowledge of how to deal with the large scale medical and logistical problems that war would bring. The fact that disease would be the greatest killer became known early in the war when two soldiers died of diseases for every soldier killed in battle. Lacking immunity to these diseases, rural area soldiers suffered most and about 56,000 soldiers died of disease during the war years.
The Civil War had a tremendous influence on medical quackery and gave patent medicine manufacturers the opportunity to display their patriotism. See's Army Liniment was introduced, The Union Hair Restorative was marketed, Holloway's Pills issued a poster showing a blue-clad officer hurrying a box of the remedy to a sergeant. The Hostetter firm, manufacturing Hostetter’s Celebrated Stomach Bitters , successfully pleaded with the Surgeon-General to give the Bitters a trial in army hospitals. Federal Quartermasters ordered Hostetter's Bitters by the boxcar. Civil War soldiers were urged to drink Hostetter’s Bitters to gain “a positive protective against the fatal maladies of the Southern swamps, and the poisonous tendency of the impure rivers and bayous.”
The Army’s ration of whiskey to its troops had been abolished in 1832, so the Civil War soldiers had to purchase their supplies. Soldiers also quickly realized that though whiskey was taxed at $2.00 per gallon in 1862, patent medicines weren’t – and they achieved the same state of intoxication from the patent medicines.
The advertising targeted toward the soldiers promised that various remedies could cure diarrhea and dysentery. The nostrum makers realized that bowel complaints were the most prevalent ailments among Federal troops and caused the most deaths. Self-treatment with harsh laxatives must have aggravated many simple disorders into health disasters. Many soldiers recovered naturally from their ailments despite self-dosing, but some soldiers assumed – and the patent medicine peddlers naturally claimed – that the nostrums deserved the credit. Because of this, the patent medicine makers did not lack for military testimonials. An officer in the Shenandoah Valley considered Hostetter's Bitters "The Soldier's Safeguard." Piper's Magical Elixir gathered testimony into a pamphlet so that its claim as a remedy for diarrhea might be known to "those noble braves, so many of whom have fallen a prey to disease at the Seat of War."
The themes that Patent Medicine promoters used in linking their nostrums to the war were cunning and limitless, including painting the names of their medicines on rocks, trees, barns, fences, or any place where the name would be visible . Morse's Indian Root Pills were advertised on the back of facsimile Confederate currency. Drake's Plantation Bitters embossed a message on the mica covering the face of encased postage stamps which were issued in place of small change. A doctor in Chicago distributed a card containing the ballad, "Mother, Is the Battle Over?"; on the reverse was his pitch for contraceptives and a remedy for male weakness.
The appetite for news from the fighting fronts increased the size of daily papers, their circulations and their advertising space, which provided another means for the growth of patent medicines. The advertising in the Civil War newspapers had its impact on the military. Since they distrusted the surgeons assigned to their units, the soldiers turned to self-dosing with patent medicines like Hostetter’s Bitters and Peruna. These, and many others, were touted in weekly newspapers like Harper’s and Frank Leslie’s and could be purchased from the sutlers visiting the camps. Peruna contained about 19% alcohol and claims to cure only catarrh – and Dr. S. B. Hartman of Ohio, who owned the company, defined catarrh as whatever ails you at the moment. One can only wonder as to how the consumption of such strong, but accepted, “medicine” affected the outcome of some battles in the Civil War.
When the fighting ended, thousands of soldiers began returning home, many of them having regularly used the patent medicines which they and their families would purchase in the future. Quite a few of these soldiers had become chronic alcoholics [called Peruna Drunks] or acquired drug habits [known as the Army Disease] – and habit was a driving force in their “medicine” buying. They returned to civilian life with ruined digestive systems, malaria, battle wounds, emotional disturbances, and other ailments that would trouble them for the rest of their lives. The nostrum makers were aware of this situation and many of the old soldier’s aches and pains helped them maintain their volume of production after the war. In 1865, Hostetter's, which had an annual gross income of $750,000 during the war, was prepared and proudly announced the ability of Hostetter’s Celebrated Stomach Bitters to conquer disease. Yet the nation was aware of the dependence on the nostrums and offered to help the old soldiers to kick the Peruna habit. However, the cure was as bad as the problem. The Sears catalogue advertised a product as a cure for the Opium and Morphine habit, but it was 41% alcohol.
The history of Patent medicines in America is appalling, but they thrived in a marketplace truly best characterized as “caveat emptor.” The peddlers appealed to a gullible public by making use of the mythology of Native Americans, the fear of death, religion, comedy skits, tall tales, patriotism, and superstition. During an era when doctors were still ill equipped to deal with most diseases, the patent medicine makers offered their remedies – for a price, it seems, far greater than the coins needed to purchase a bottle. The patent medicine makers claimed that their products would cure any illness and wouldn’t hesitate to put any chemical, poisonous or not, into their products. Cancer and arthritis cures, baldness remedies, bust developers, manhood restorers – whatever the physical condition or illness, patent medicine makers stepped in with a concoction to cure it. They created a business that was more show than cure and greatly increased the alcohol and drug abuse in America during and after the Civil War.
published in Battlefield Journal 2003