Early in 2005 Professor Kaye Ibbertson, the relentless grand vizier of the Marion Davis Library and Museum, asked David Cole to offer the Medical Historical Society some comments about the history of unorthodox medicine. He was in the process of assembling several convincing excuses, when Ibbertson turned off his hearing aid and any excuses were set aside. This article is based on the talk which resulted.
Snake Oil started out as a quasi-respectable arthritis relieving liniment, widely used in the 1880s in the US. Since then it has morphed into a derisory term implying dishonesty, deception and shady dealing. The nature of this topic leads one into the exotic ‘before and after’ coloured photos, to testimonials of spectacular positivity, and striking diagrams of the marvellous devices that quacks are prone to use. For example:
- the Grand Celestial Bed hired out for a night at 500 guinease, “In which children of most perfect beauty would be begotten”;
- hot air tobacco enemas utilising bellows;
- our own home-grown water energiser the Scalebuoy of Dr Abbot’s fame;
- or my favourite, from the NZ Listener, inflatable pantaloons which, worn overnight, squeeze the fat away from the nether regions… if doing nothing for happy marital relations.
But in the interests of conciseness we cannot pause in that fruitful orchard. Due to the vagaries of Gondwanaland, and without any help from St Patrick, this country is mercifully free of snakes and even an up-market Chinese herbalist in Auckland, despite hundreds of bottles of ‘natural’ remedies displayed, had never heard of snake oil. But in Asia snakes, if not ground up for a powder to relieve male deficiencies and other ailments, are frequently eaten. David Lange in his autobiography noted that, at a banquet in Beijing in his honour, snakes were brought in alive, beheaded, skinned and cooked in front of him. Whether it did him any good he did not say.
But back to the ubiquitous world of quackery. There was no trouble finding references. After some hours on the internet, the Quackwatch site and perusal of some of those entrancing books from the Marion Davis Library, I got quite enthralled and wondered why I had not been more tolerant of our unorthodox brethren.
So, to take things a little more seriously, it might be interesting to pause and look at the rather unlikely historical association between medicine and snakes, and start with the ancient snakes or serpents.
In the Beginning
The resident serpent in the garden of Eden, was, to quote Genesis 3, “more subtle than any wild creature”. As a thoracic surgeon I was delighted to think a serpent witnessed the first recorded rib removal with an excellent therapeutic result. As we know, the serpent persuaded Eve to eat of the forbidden fruit, but this snake-trick angered the Lord who delivered the verdict to the serpent – “on your belly you shall crawl” and “dust you shall eat”. By implication the snake lost his legs but do we know how many were there originally?
A bit later when the Israelites were in the wilderness, Moses got very worried about many deaths from snake bites. The Lord told him to erect a fiery bronze serpent on a pole and I quote from Numbers 21: “everyone who is bitten, when he sees it, shall live.” So here is the first evidence of any association with healing even if it was a bronze snake.
A few years later the ship on which St Paul was travelling was wrecked on Malta. He survived a bite from a viper which crawled out of a bunch of twigs he had gathered for a fire. He too must have had some divine immunity, or perhaps it was adrenaline or cortisone or endorphins or anti-oxidants, boosting his immunity. I don’t think he had access to Echinacea.
We need to turn to the Greek myths to uncover a more likely connection.
Aesclepius was the Greek God of medicine who had a rather complicated start to life as son of Apollo and a nymph Coronis. This poor lady was dealt with rather harshly by her sister-in-law and Aesclepius was delivered by what came to be called post-mortem Caesarian section.
For 1700 years the art of medicine was based on the legends of Aesclepius but they also tell of his coming to a sticky end when Zeus organised a personal thunderbolt for him. It appears that Hades in his underworld was complaining that the healer was doing so well that there were not enough people dying and entering his domain.
The Aesclepian temples, including the one that Hippocrates ran on the island of Cos, all featured snakes who apparently were part of the therapy, representing their ability to shed their old skin and become young and healthy again. People would sleep the night in the temple among these non-venomous snakes and presumably felt much better for the experience.
It is no surprise that, when it comes to marketing, tigers are more attractive than snakes who, come to think of it, are not equipped to suffer from arthritic limb joints.
So a snake entwined on a staff (the latter an authority emblem) became the medical symbol, representing strength and solidarity and the unwavering ethics of medicine, later to be formalised by Hippocrates. Some medical organisations use the two snakes around a staff, but for purists this is wrong; they say the two snake version is a separate symbol, the Caduceus, representing Hermes, the messenger of the gods, and is seen to denote communication.
There is a little discrepancy here, for the US Medical Corps badges mistakenly uses the double snakes as does — shock horror — the Auckland Medical History Society.
Despite the Bible and the Greeks and all this symbolism, the truth is that in recent time snakes have never had a good name as suggested by ‘snake in the grass’ or ‘viper in the nest’ and we are lucky to avoid them in this country — but metaphor of their oil continues.
King of the Rattlesnakes
Among the cornucopia of secret remedies with animal overtones, Snake oil came to prominence in the earth 19th century as one of the plethora of remedies offered in the American travelling medicine shows. Snake oil had an extensive and compelling pedigree:
- Greek medicine;
- Chinese herbal tradition which later was introduced to the US by coolies recruited to build the railroads;
- Native Americans were said to use it — linking it with indigenous people.
This animal extract, mostly confined to the US, was peddled as a liniment, emollient, balm or embrocation (marvellous words, better than ‘ointment.’) It was particularly effective, so the salesmen proclaimed, for arthritis and indeed any chronic pain.
The leading hawker was a medicine man, Clark Stanley, of Rhode Island; he became known as the Rattlesnake King. At a medicine show, Stanley would kill rattlesnakes on his mobile stage in full view of the audience. He then boiled the snakes to make a liniment from the tallow. It was sold on the spot.
What was in it? In 1989 when a modern Chinese version was analysed 75% was a harmless oily ‘carrier’ and 25% various substances including camphor, menthol, clove oil and an Omega 3 substance, so it was not entirely without merit – as many of the other scams were.
In the 19th century, before radio/TV and, in particular, the introduction of the US Food and Medicines Act of 1906, the travelling medicine show was at its heyday. Many health peddlers would amalgamate to form a show with colourful banners, brass bands, dancing girls – as well as employees planted in the audience to give flowery testimonies about the efficacy of the remedy. Before the purchases could be tested these hucksters wisely and hastily moved on.
Now a striking thing about these remedies is that many were often associated with a wild animal, perhaps to give power and vitality to the nostrum. So snake oil is joined by Tiger Balm, bear bile (gathered from surgical fistulas), shark fin and not to forget Lion Beer and Leopard Lager.
Tiger Balm is an intriguing example as it survives to this day and is sold in 80 countries. At my pharmacy I paid $11 for a tiny bottle which, to quote the label, was “originally developed to provide relief for a Chinese emperor”. In 1926 a father and two sons brought the remedy down from China to Singapore. They did a spectacular marketing exercise; many of you will have visited Singapore’s Tiger Balm gardens or seen their sponsorship of environmental issues and educational scholarships.
When analysed it has mint, cinnamon, cloves, menthol and camphor and no animal products! The use of the word balm did no harm.
When I consulted Google I found 1.5 million sites for Tiger Balm but 3.9 million for snake oil, now an obsolete substance. The explanation was that in the arcane world of computers where encryption is needed for secrecy, the term snake oil merchants is used to describe shonky software hawkers who peddle fake programmes designed to secure data. And there must be a lot of them!
Which brings us to a conclusion that snake oil, a very similar health remedy to Tiger Balm, had its day, and was overcome by competitors using happier names.
But the word snake oil survived and metamorphosed into a generic catch-phrase for dishonest and misleading statements made by charlatans – and not just in the medical field. During last year’s election someone called Winston Peters a snake oil salesman, which seems a bit harsh, but, given his style, it must have been tempting to his opponents. He certainly didn’t deserve another election comment about his ‘reptilian smile.’
Snake oil salesmen
Google is a wonderful friend for those bereft of ideas. So, among the references, I found a promising item — ‘snake oil salesmen’ but this turned out to be a pop band in New York.
Some famous names came up: William Rockefeller sold cancer elixirs in the late ’80s. He was also a ventriloquist and hypnotist, using these skills at the medicine fairs to attract customers. His son, and later millionaire, John D Rockefeller wisely chose to market fuel oil, leaving snake oil to his father.
True itinerant salesmen were at their most numerous in the US in the early and mid 19th century. The American Medical Association was very active in Quack Busting and had a department fully occupied in exposing medical scams. Their spokesman Maurice Fishbein (editor of the Journal of the American Medical Association) led the charges but overdid the rhetoric and Hoxsey of cancer fame, won a case against him. Damages were assessed at one dollar…
The secret ingredient
Woman quacks were rather fewer but another famous remedy illustrates the factors that ensured success. Lydia Pankhouse’s Vegetable Compound, while stressing the vegetable aspect, contained over 15% alcohol, which was not revealed until the 1906 Food & Drug Act required labelling. Much of her success was achieved by concentrating on disorders of females and it was touted as a “sure cure for prolapsed uterus” and all matters connected with the “monthly travail”. She also wrote a Guide to Women which in the 1920s had a print run of 11 million per year. Surprisingly 22 years after her death ‘she’ was still replying to letters about women’s health.
But there were plenty of examples of gifted conmen like the charismatic religious preacher at the medicine show supported by seven daughters whose combined hair length was 37 feet. Not unexpectedly he offered a cure-all for hair loss, but after a spirited address to the public also sold copies of his sermons for two cents.
It brings to mind a genuine example of a cunning salesman avoiding the requirements of the Food and Drugs Act by a carefully worded negative ‘promo’ on the bottle of hair restorer: “Do not rub this lotion on any area you do not want hair to grow”.
Dental extractions were also part of the travelling show. In France a ‘Doctor’ Fallet had a mobile dental surgery shaped like a tooth. He offered total extractions and, it is said, was so fast he kept one tooth in the air all the time.
It is all very well to mock the medicine shows and the wily salesmen, but they did not have much real competition from the regular doctors whose therapeutic range was still quite limited in the 19th century. But by the 20th century it might have been expected that quacks would diminish as scientific medicine spread its wings. As we all know this was not the case.
Back to the present
Even in the 21st century New Zealanders continue to be caught up in scams, for example, quacks targeting obesity.
In Auckland the Zenith Corporation offered a ‘body enhancer’ which would burn up the fat and detoxify the liver. In two years they sold $2 million at $90 per bottle. They were one of the few to be successfully prosecuted under the Food and Drugs Act. Quite recently a ‘fat melt away’ concoction called Celluslim was described by a NZ judge as a dead loss; he imposed an $80,000 fine.
Consumer magazine (July 05) reported that Grander Living Water would install a flow through water energiser (not just a filter) for the whole house, which could cost from $1692 to $12,000 (NZ Skeptic, No 71). When tested for Consumer, analytical chemists could detect no change in the water. It sold here for 10 years. The Commerce Commission convicted the sellers on nine charges.
A trip around your pharmacy will remind you that the art of selling nostrums is still buoyant. The euphonic Evening Primrose extract is a favourite, second only to the recently demoted (yet again) Echinacea.
On a matter of animal products a colleague’s sharp eyes caught a paragraph in a recent New Scientist journal. In the Healthy Living section of Tesco, Britain’s largest supermarket chain, US company Wild Earth Animal Essences is selling animal ‘liquids’. This included bear liquid as well as cheetah, beaver, butterfly and the inevitable snake liquid. Lest you start to wonder how destroying these animals can be tolerated in modern times, their website reveals that no animal parts are used, not even the strange reproductive ones Chinese men seem to prefer. Their essences are ‘vibrational imprints’ with the energy of the particular animal. The mind boggles at the process of imprinting in which the salesman places a bowl of pure stream water in the centre of a clearing in the Virginia wilderness and walks around it in ever decreasing circles; praying to the particular animal completes the process. It is sold in 30ml lots but a litre of this energised water would sell for $NZ60. But don’t forget homeopathy is also based on imprinting hugely diluted substances in water.
The therapeutic spectrum
I haven’t said much about the modern medical professor’s attitude to some of the deviant qualified doctors I encountered while following up complaints to the Medical Council about their aberrant practices. One way of looking at this is to imagine a spectrum of therapeutic participants. On the left, the scientifically hopeless — iridology, reflexology, colour therapy, aromatherapy (smelly massage) and various black boxes.
On the right are most ordinary doctors, GPs and specialists who base most of their activities on evidence-based medicine. On the very far right are neurologists who in their inverted modesty, claim the top spot.
In between these extremes are more traditional offerings like homeopathy. Curiously it never prospered in the US but was a favourite with the British royal family. Somewhere in the middle you could put chiropracty, osteopathy and acupuncture and there are features of naturopathy with which we would not argue.
One of the matters that has concerned the profession and the Medical Council as its governing body, is the move of some orthodox doctors towards the left in our spectrum.
A de-registered doctor is still deceiving Aucklanders under the guise of a specialist in ‘biological’ or ‘eco-medicine.’ At his formal de-registering hearing he seemed to totally ignore orthodox and ethical medicine, attributing most illness to toxic chemical sprays identified by black box diagnosis and then uses non-pharmaceutical regimens with hyperbaric oxygen, Vitamin C and homeopathic drugs.
As a further example, some years ago I investigated another rather confused Auckland GP who also used the black-box Vega machine to diagnose allergies in young children. Finally three mothers complained and agreed to recount their experiences. While the machine’s diagnosis of toxic rashes and biological scarring from vaccination or sensitivities based on 245T and other herbicides seemed unlikely, what was more worrying was the use of ancient homeopathic explanations going back to Hahnemann himself in the late 1700s — so-called miasms or evil spirits.
The concerned mothers were given an explanatory handout and told the children’s troubles went back to ancestors who were rapists, or whose grandmother had syphilis. One child of three had been reincarnated five times, was involved in Satan worship and had a back pack of 10 miasms which would lead to:
- a possible fatal road accident at 17;
- asthma recurrence at 30;
- diabetes at 60;
- Alzheimer’s at 70.
The GP was severely dealt with by the disciplinary committee.
Sure, these are extremes, but this is what some therapists, including previously orthodox doctors, are offering. And many New Zealanders are still going to them. Some to the Rainbow Clinic in Rotorua, others to Tijuana in Mexico. The ability of many people, some desperate, to fall under the spell of quacks, is something we will never change, although good publicity and a more educated and discerning public may help. A new factor is the internet as a source of information and advice. Medical material from this source is not assessed, as are contributions to a reputable medical journal, and unproven information is taken up. GPs are now familiar with patients bearing scraps of internet print-out.
Professional knowledge, compassion, honesty and integrity must be the base-line for the caring professions but, in the face of the complexity of ill-health management, healthy scepticism nurtured by good science should be hovering around in the background.