In the 18th and 19th centuries, patent medicine use became fairly widespread in the US. The concepts of general anesthesia and surgical hygiene were still in their infancy during the American Civil War. With such a dearth of knowledge about bacteria and the foundations of disease, a large area of medicine was left up to the imagination. Entrepreneurs marketed a wide variety of elixirs to fill the gap. They were supposed to treat diseases as diverse as incontinence, cancer, stomach aches, colic, and many others. Patent medicines were tagged like we tag our blog posts today, to touch on as many diseases as possible to increase their audience. Most patent medicines were formulated from substances that were known at the time to induce some form of euphoria or drunkenness. Alcohol, Opium, Cocaine, Arsenic, Radon, and a host of other ingredients were common in patent medicines.
Today, we look back on the patent medicine era and wonder at the naivete that produced so many dangerous medicines. The truth is that we still live in the age of patent medicine, despite the advances in science since the Victorian Age. We’ve developed treatments for many of the ailments that traditional patent medicines were meant to cure, but we’ve replaced them with new ailments and cures. Yesterday’s stomach ache is today’s lack of energy. In some ways, it’s an easier ailment to cure with a patent medicine. You only have to make the customer feel more alert, not cure a specific pain. Including a large dose of sugar or caffeine is usually sufficient to create a sense of alertness and energy.
We’ve become obsessed with energy drinks, muscle building compounds, and diet aids. The US doesn’t regulate “herbal supplements” like regular medicines. They’re treated as food supplements instead of drugs. This distinction allows the manufacturers to make claims and use ingredients that would not be allowed in regular drugs. Just like the patent medicine era of the 19th century, we only hear about the ill effects of these drugs when someone dies. Ephedra as an ingredient was banned in the US after a series of deaths brought its use in energy drinks and diet aids to light. As the ill effects of Ephedra became more widely known, the supplement industry created a public relations firm to assure the public that its use was safe. In addition to lobbying congress, they sponsored clinical studies to prove that Ephedra use was safe. For almost a decade, Ephedra remained in energy drinks. It wasn’t until the high profile deaths of professional football and baseball athletes that the ban gained any traction.
The regulations that govern dietary supplements are fairly loose. As long as a product does not introduce a new compound, or claim to cure a specific illness, it can be marketed freely as a supplement. That’s why most supplements are sold as diet aids without specific claims beyond weight loss. “Promoting general body health” is the term that’s usually used by regulators. It’s eerily similar to the marketing campaigns used by the patent medicines of the last century. We feel like we live in a modern society, immune from dubious drugs and protected from callous marketing. The Ephedra Education Council is a modern example of patent medicine. We may not even be aware of the dangers that some of these supplements pose. Metabolife, one of the largest manufacturers of Ephedra based dietary aids, was sited by the FDA for withholding customer complaints and injuries. It wasn’t until the dangers of these products were publicly exposed that it became clear that Metabolife was marketing a product known to cause deaths in their customers. The real naivete in our society is to suppose that these products are uniformly safe because of an advertising campaign or a corporate sponsored clinical study.
The problem isn’t restricted to dietary supplements, either. Most orange juices, even the ones that are labeled as 100% orange juice, use supplements to change the flavor of the final product. In order to store orange juice, companies remove all of the oxygen from the raw juice. This retards the decay process and allows the company to store the juice for up to a year before they process and package it. Removing oxygen from orange juice also deadens the “orange” flavor of the juice. In order to re introduce flavor into the juice, companies use unregulated additives. Since the additives are derived from extracts, they are not regulated as part of the orange juice. Indeed, the companies can market their orange juice as 100% natural, even though it has been modified with chemicals and fragrances.
Patent medicine is thriving in our new world of loose regulations. When the government introduced new packaging requirements in response to the “Fat Free” craze, companies lobbied to create loopholes in the new laws. In order to call a food “Fat Free” there can not be more than .5 grams of fat in each serving. Pam famously circumvented this requirement for their fat free spray by reducing the serving size to .25 grams. Even though the product is almost entirely based on fat, the smaller serving size allows them to market it as fat free. Without a chemistry degree, it’s nearly impossible for a consumer to recognize which foods are truly healthy, and which ones are simply products of clever marketing. The adage “buyer be ware” doesn’t apply anymore because companies have found innovative ways to obfuscate the true ingredients in their products.