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Quacks, Charlatans and Rogues

This article about some of the notable health risks faced by citizens exposed unwittingly to charletans and rogues in the drug and food industries in the past is the fourth pharmacy article prepared for our website by long-time Rockhampton Pharmacist and pharmacy historian, the late Dr Barry Bryant OAM. The article reminds us that even now, there are risks in buying "cures" over the web or from other uncertain sources.

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We have all been warned to be aware of "dodgy" medications, "quack" cures and the medical "quick fix" offered by practitioners of doubtful integrity and training. It is taught that we should know our medicines and be familiar with drugs taken or handled. We are exhorted to access drugs only from safe sources- be wary of unfamiliar internet sources, unbelievably generous discounts and third-world street markets. We are advised to note how we respond to therapy and with the guidance of our health professionals to be conscious of adverse drug reactions, toxicity or overdose.

Counterfeit and therapeutically suspect medications in modern times have been found with at least the following problems: incorrect or in extreme cases, no active ingredients; insufficient ingredients; fake packaging; high level of impurities; presence of contaminants and toxins; reject or out-of-date products recycled through the marketplace. This recital of problems should be enough to make the most ardent modern hypochondriac pause and consider the outcomes of careless medication use - serendipitous cure or a coronial enquiry and a verdict of death by therapeutic misadventure?

In a well regulated society such as ours, the chance of misadventure may be seen to be small but such was not always the case in past centuries. The enthusiasm with which the Borgias entered upon political assassination, resolution of family disputes and intrigue in Italy is well known. Even with less intent to harm, life could be fragile in the Britain of the seventeenth to nineteenth centuries. Indeed even into the twentieth century, "patent medicines" made up a significant portion of pharmacy stock, often proffered with dubious therapeutic background and even more dubious ingredients.

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In 1624 a legal Statute of James II established the basis of modern patent law allowing manufacturing rights to be reserved to the original inventor of a process or product. This had important future implications for "patent medicines". Patent, proprietary and brand name medicines were direct descendants of the cures peddled in the streets by 17th and 18th century quacks. These products relied heavily on what were common prescription ingredients of the times, completely disregarding the old (and modern) adage that the difference between a drug and a poison is the dose. As they could be bought on the streets or over the counter, they were cheaper than a visit to the doctor. The first patented medicine, thanks to the Statute of 1624 was Epsom Salts, developed by Nehemiah Grew, a London physician. (This product is still with us today). In such a case, to be patented, the ingredient(s) of the product had necessarily to be declared. However in the case of a branded or trademarked remedy the contents remained secret as the patent protected only the name and no formulation disclosure was needed. This made plagiarism by competitors difficult and undoubtedly added to the avid use thereof by the general population as a result of intense advertising. Other more reputable products familiar to the modern reader included Friars' Balsam and Beecham's Powders.

In 1941, in an echo of those far-off days of a cure for every known disease, the (British) Pharmacy and Medicines Act forbade general advertising of cures for specific diseases such as epilepsy, TB, Bright's Disease and abortion. Many of the propriety products contained similar ingredients to contemporary "orthodox' medicines, relying heavily on opium, as well as compounds of mercury, antimony and arsenic.

Some of the documented occurrences of deliberate food contamination (as distinct from inept medicine) in the nineteenth century are discussed below.

Crystals and solutions of iron sulphate and iron ferrocyanide are of a deep green colour. They were found by the unscrupulous grocer to be ideal for brightening the colour to "recycle" used tea leaves. Tea, being an import, would have been expensive and any method of increasing profit margins was probably avidly used.

In 1859, a considerable number of people were poisoned when a baker added what he believed to be lead chromate to his dough mix in an endeavour to give a brighter yellow colour to the buns. Bad enough surely, but compounding the mischief, an untrained shop apprentice had sold the baker bright yellow arsenic sulphide instead. Red lead (more commonly used this century in shipbuilding and preserving steelwork) was used to give "Red Gloucester" cheese its colour.

Similarly, sugar had to be imported from the plantations of the West Indies at great expense. Luckily (for the food merchants) sweets could be bulked out by the surreptitious addition of Plaster of Paris (normally used in plaster casts), thereby lessening the cost and giving new meaning to the term "all day suckers" and "gob stoppers." Perhaps the ultimate in lethal trickery also related to the expensive imported sugar. Lead acetate has been used externally for centuries in lotions and also in "hair restorers". It has the inestimable advantages to the food adulterer of being white, crystalline, soluble in water and tasting sweet. It was obviously ideal to dilute the sugar at minimum cost and maximum profit. Before the days of forensic laboratories and refinements of chemical analysis, the method of detecting adulterated sugar was ingenious even if a trifle bizarre. The suspect sample was exposed overnight to the gases (mainly rotten-egg gas or hydrogen sulphide) given off from the household privy. The fumes from the toilet converted any lead acetate present into black lead sulphide. This discolouration was immediately apparent on inspection, leading to change in one's grocer!

Finally, when we remember the recent scandal of melamine added to baby formulae to produce a misleading increased protein content, it might justifiably be observed that "Plus ca change, plus c'est la meme chose" - the more things change the more they are the same"!

Barry Bryant OAM MSc (UNSW), Hon MSc (CQU), PhC, FPS, MAIBiol, JP(CDec)

05 July 2009