Side Effects, Special Effects or No Effects at All: Quack Medicine in Pictures

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We put so much faith in our doctors. Who but an educated, licensed and certified medical professional would you knowingly allow to drug you into unconsciousness and take a sharp instrument to your skin? Or to stab you with a needle and fill your body with an unidentifiable serum? Or to plan and manage your fight against cancer or HIV? Because modern medicine is based on trust between patient and physician, the idea of a doctor whose practices are incompetent, ineffectual, unproven or outright fraudulent is a true horror. So what is our name for this disconcerting figure? The quack, of course! Generally, a quack is understood to be any kind of charlatan or imposter in the field of medicine, whether a profit-driven peddler of useless treatments, or a simple incompetent, who pretends to have more knowledge than he or she actually does. In this old cartoon, the local quack is visited by the bereft spirits of patients who perished at his hands.

This is a 16th century illustration of trepanning -- the process of drilling a hole into the skull of a live human being. Though there are to this day several real reasons a doctor might need to remove part of the skull (often to access the brain for surgery), in the ancient and medieval world, trepanning was mostly a false cure, designed to relieve mental illness by allowing demons and other baleful spirits to evaporate from the cranium through the hole. The example of trepanning allows us to make an interesting distinction about quack medicine: The practitioner doesn't have to be a conscious fraud. While some cynical medieval profiteers probably employed the surgery knowing full well that it was not effective, it's clear that many others sincerely believed in the efficacy of trepanning. They really were trying to help -- they were just wrong.

Trepanning, also known as "trephination," is often alleged to be the oldest surgery performed by humans. While we can't know this for sure, it's obvious from archaeological evidence that this ritual was undertaken long before anesthetics, long before neuroscience or germ theory, and certainly long before surgical sterilization standards. In fact, trepanning goes back to the Stone Age. Mesolithic to Neolithic skeletons found in France and the Ukraine show holes and indentations in the skulls that are consistent with trepanning -- what's more, many of the holes show signs of healing and smoothing over time, which indicates that people often survived the procedure. This helpful how-to illustration comes from the 13th century.

If we look back through history, we can see that the record is set firmly against medicines that claim to cure everything. Typically, they have cured absolutely nothing. There's no telling how long ambitious medicine-cookers have been selling "cure-all" tonics, but such treatments have proved ineffective since ancient history, and when they have been successful in one way or another, it's usually by accident. This Renaissance-era woodcut illustrates the production of a contemporary cure-all being distilled. Next, you'll see how long in history junk medicine has persisted.

This tobacco auction, held in 1939 in Durham, N.C., was as good a place as any to buy a miracle in a bottle. For hundreds of years, the market for "patent medicine" was strong among farmers and townsfolk throughout America. One of the most famous patent medicines in American history was Clark Stanley's "Snake Oil Liniment," which was supposedly made from an extract of slaughtered rattlesnakes, but was, in reality, just mineral oil with a few additives like red pepper and beef grease. Got a bad back? Rub some snake oil on there! What about a toothache? Oh, snake oil's great for that too! Patent medicines like these were usually successful on the basis of enthusiastic vendors and clever marketing, rather than any real medicinal value.

This is Dr. John R. Brinkley -- one of America's best-known quacks. We've all heard stories about some weird experimental treatments, but Brinkley's early-20th-century impotence "cure" really takes the cake. For men lacking sexual vitality, Brinkley prescribed xenotransplantation, which is the excision of cells, organs or tissue from one species and transplantation into another. In this fraudulent surgeon's case, the organ transfer went from goat to man. Brinkley eventually came to advertise the surgical implantation of goat glands as a cure not only for sexual dysfunction, but for everything from acne to insanity. Needless to say, the practice of cramming gonads from farm animals into the human body has not found support in the modern research community.

Electroshock treatment, now known by the more sober title of "electroconvulsive" therapy, is a widely accepted method of treating mental illness. In this procedure, doctors attach leads to the patient's head and briefly run an electrical current through his or her brain to summon a seizure. While naturally occurring seizures are nothing to go looking for, a controlled seizure of this kind can help "reset" the nervous system and clear some problems with brain function -- especially in people suffering from conditions like major depressive disorder (MDD). However, despite the seemingly salient value of electroconvulsive treatment, the earliest days of electroshock were improperly regulated, and some patients experienced side effects ranging from amnesia to bone fractures brought on by convulsions.

An American doctor named Elisha Perkins had an even simpler patent cure-all than the mineral oil liniments and heady tonics hawked by some of his contemporaries. Instead of producing consumable medicine, Perkins invented a form of therapy that involved "metallic tractors," which were small, sharp metal rods that the good doctor claimed capable of curing inflammation and pain by way of some mysterious electro-magnetic absorption. This caricature of Perkins's method was illustrated by the obviously somewhat skeptical British satirist James Gillray, who ridiculed the over-promotion of these tractors by comparing them to obvious nonsense such as alchemy.

We might be developing a theory: The more you look like a mad scientist in a low-budget 1950s sci-fi movie, the more likely you are to promote unproven or fraudulent medical technology. This bespectacled gentleman is Dr. Albert Abrams, who devised a theory known as the Electronic Reactions of Abrams (ERA), which taught that both health and disease were functions of different frequencies of electrical "vibrations" within the body. Using the principles of ERA, Abrams built machines like the one above, which was supposedly able to diagnose a host of medical facts about a person by blasting a sample of his or her blood with radio waves. Abrams' theories were eventually exposed as nonsense, and his machines are now known to have been worthless fakes.

A large part of the history of medicine is made up of half-cures and unfortunate side effects. Until the 20th century, the ravages of syphilis were often treated with chemicals like arsenic and mercury, the latter shown above. These treatments, both dangerous poisons themselves, may have had some effect at fighting the disease. Now to those of us who have had the benefit of seeing Terminator 2: Judgment Day (1991), putting this mirror-skinned liquid metal into the human body seems like a shockingly bad idea, but for much of history, people didn't know how toxic mercury was -- or at least they believed that the benefits outweighed the costs. These days, a syphilis infection can be treated safely with penicillin.

Before medical science had firm principles and methods to stand on, people put their trust in all kinds of counterintuitive treatments and preventative measures. This storefront in Cologne, Germany, displays Eau de Cologne -- a pleasurable perfume, to be sure, but certainly not the miracle cure it was believed to be by Europeans for hundreds of years. How on Earth is a simple perfume supposed to protect your body against the bubonic plague? Yet many people put their faith in this fragrant bottle. An important question arises here: Why would people continue to believe in the efficacy of a treatment that has no traceable physiological benefit?

What do you say if your brother-in-law tells you that he rubbed his injured leg down with a bit of Snake Oil, and by golly, the pain really did seem to go away? Some apparently bogus medical treatments, despite a lack success in clinical trials and no clear understanding of the somatic mechanism in action, actually do seem to make some people feel better. In these cases, especially if the drug is designed to treat pain or any other subjective experience, what's operative may be the placebo effect. Shown above, a placebo is an inert, simulated medicine, often just a pill containing a small amount of sugar. They are typically used to control clinical studies, to make sure that the drug being tested is more successful than the mere idea that you are being treated. Though for some people, that mere idea is plenty. Study after study shows that some subset of people will always believe that unevidenced treatments, from sugar pills to snake oil, really have cured what ails them. Who are we to argue? All we can say is that the science doesn't yet confirm.

Yeah, it's pretty creepy. This 18th-century illustration of an Irish healer shows "touch healing" or "contact therapy." There are endless variations on this type of healing, where the afflicted person is cured by touching, stroking, laying-on of hands, or manipulation of his or her "energy field," which usually involves near-touching. Though ritualized physical contact of this kind may have an emotional, psychological or spiritual benefit, medical science has not shown these forms of therapy to be helpful in treating diseases or injuries. Next up: Do you know where the word "mesmerize" comes from?

Franz Anton Mesmer (1734-1815) was an 18th-century German doctor who might just be considered the King of Quacks. This illustration shows Mesmer's consulting room in Paris, where after publication of his first major work on so-called "animal magnetism," Memoire sur la decouverte du magnétisme animal, Mesmer treated subjects with an array of bizarre methods that included special music and lighting, among other trademarks of showmanship. In the center of the drawing above, you can see one of Mesmer's favorite props -- a closed tub of liquid laced with iron, which was implied to assist with the treatments of Mesmerism.

Mesmer's animal magnetism theory was based on the belief that a "universal fluid" pervaded the human body and was responsible for the conditions of human health. When the plumbing of this supposed fluid became backed up, Mesmer advertised the ability to correct and redirect its flow with the use of magnets -- including his own body, which was apparently possessed of an "animal magnetism" that he could project at will to manipulate his patients' dysfunctions. Though Mesmerism is now considered bunk, it enjoyed raging popularity throughout Europe in its heyday. Next up: Why would someone take a tonic that he or she knew to have no medical value?

The crime of medical fraud is usually perpetrated by the doctor or medical supplier on an unsuspecting patient, but some forms of quackery take two to tango. During the 1930s in America, some booze-laden "medicines" and "tonics" survived on an implicit game of let's-pretend played by both customer and manufacturer. Jamaica ginger extract, commonly known as "Jake," was sold in drugstores around the country as an ostensible headache reliever and digestion aid. It's not hard to imagine, however, that Jake's 70-percent alcohol content was probably the real reason the herbal remedy proved so popular during the Prohibition Era. Unfortunately, people who took too many doses of this particular medication wound up with more than just a hangover. The name "Jake-leg" came to describe the condition of muscular paralysis and weird ambulation brought on as a side-effect of over-imbibing Jamaica ginger.

Believe it or not, lobotomies were once considered The Next Big Thing. Dr. Walter Freeman, shown above, was one of the pioneers of this procedure, which attempted to ameliorate mental disorders such as schizophrenia and obsessive compulsive disorder by severing connective nerve tissue within the prefrontal lobe. As you can see, this surgery could appear frightful, even crude and amateurish, to onlookers, since Freeman eventually decided the best way to gain access to the brain was by hammering a small metal icepick through the eye socket. At the height of his work rate in the 1940s, Freeman was performing sometimes more than 20 lobotomies every day -- some of them without anesthesia. Unfortunately, many patients suffered from serious lingering side effects, such as emotional apathy and the inability to concentrate. Today, lobotomies have been almost entirely discontinued.

Those accused of quackery can sometimes face harsh measures -- even mob violence. While a fast-talking tonic huckster in Colonial America might risk being tarred and feathered or "run out of town on a rail," someone suspected of occult practices in conjunction with medical fraud faced even more danger. The alleged sorcerer and quack John Lambe of England, shown above, was stoned to death by an angry mob in London in 1628.

Much fraudulent medicine is simply a matter of over-promotion of benefits. Revalenta Arabica, a diet staple which was marketed as "the best food for infants and invalids" under the enthusiastic heading "NO MORE PILLS OR ANY OTHER MEDICINE," was really no more than a pulverized legume, or "ground pease-meal." There's certainly nothing wrong with helping people incorporate more healthy foods like these into their diet, but when you pretend you're dealing in miracles and panaceas, you cross the line into fantasy -- and when you charge money for a fantasy, you are simply a crook. Next, you'll see the inventor of another staple food that is harmless in itself but figures big in the history of quackery.

Who doesn't love a breakfast of good old-fashioned corn flakes? Well, the inmates at the Battle Creek Sanitarium in Michigan may not have been the keenest. Dr. John Harvey Kellogg, who was the director of the sanitarium, invented the popular cereal as part of a quest to develop a diet of bland food products that would not risk stimulating sexual impulses, something Kellogg was convinced any flavorful or exciting food would do. Kellogg maintained a puritanical attitude toward sex that made its way into his medical practice. He even advocated applying sharp instruments or painful doses of acid to the genitals of boys and girls suspected of damaging their health through sexual impurity. Yikes.

Feel around your head for bumps, lumps, ridges and humps. Got it? OK, now look up those bumps on the chart above. Do they describe your mental and emotional characteristics perfectly? No? Then congratulations! You have become the umpteen-billionth person to discover that phrenology is hogwash.

Phrenology was the study of the shape of the skull as it applied to characteristics of the personality. We now know that phrenology has absolutely nothing useful to say about the human body or mind -- and in fact, many medical experts knew this as early as the first half of the 19th century. So how did phrenology continue to be taught more than 100 years later? Pseudoscience has a persistent ability to thrive even under the harsh conditions of scientific scrutiny, simply based on the fact that some people will always want to believe. As hard as it is to fathom, there exist even today some few people who believe phrenology is a useful study. This is perhaps to be taken as evidence that quackery and nonsense can never be wholly eliminated, and that all the scientific community can do to fight it is research and teach, research and teach.

If you can't judge a book by its cover, how could you hope to judge a person by a bunch of skin? This illustration was designed to demonstrate the principles of physiognomy, which is another historical pseudoscience, similar to phrenology in that it used the exterior appearance or form of the body to make predictions about personality and character. Physiognomy focused on the physical characteristics of the face. If physiognomy were true, think how easy it would make law enforcement and the justice system. "Ah, you have the cheekbones of a vandal and the eyebrows of a horse thief. Off to the jailhouse with you!" Actually, that sounds like a rather horrible world to live in, doesn't it? We might therefore be glad that physiognomy is now discredited as a scientific discipline.

Though the purveyors of panaceas like Hamlin's Wizard Oil were dangerous charlatans who stole people's hard-won wages in exchange for false hope, they did produce some enduringly strange and sometimes clever advertisements, like this one. While the large text here is focused on the one disease of rheumatism (perhaps to give this patent medicine the aura of medical legitimacy), one notes the fine print below, listing more than a dozen secondary foes that the Wizard Oil boasts it will take on. Next up, you'll see some important figures in the history of medicine who were falsely accused of being quacks.

Unfortunately, sometimes people who have stumbled upon important medical truths are ignored, discredited and even punished in their time. Ignaz Semmelweis, depicted here, was a 19th-century German-Hungarian doctor who speculated that unhygienic conditions in obstetric facilities may have been the cause of puerperal fever -- a common infection that killed many women of the era right after they had given birth. Semmelweis instituted a policy under which medical students were required to wash their hands in a sterilizing solution before helping to deliver babies. This practice dramatically reduced the incidence of the childbed fever. However, for many years, Semmelweis's crucial discoveries were widely misunderstood, ridiculed and ignored. History, however, has seen him vindicated: These days, a properly sterilized operating room is one of the most important features a hospital can have.

Even Louis Pasteur, perhaps the most important advocate of the germ theory of disease in all of history, was initially ridiculed and called a quack for proposing the process now known as pasteurization, and for the idea that tiny parasites like bacteria could be so powerful as to hold sway over human health.

The Nobel Prize winner Dr. Albert Szent-Gyorgyi was certainly no quack, but his important discovery of vitamin C in the 1930s has since been used to debatable effect by people with currently unproven ideas about how to fight cancer. Linus Pauling, a fellow Nobel Prize winner in both chemistry and peace, spent much of his later life promoting the idea of high doses of vitamin C as a prevention and cure for various diseases, including cancer. Research has demonstrated that healthy doses of the vitamin may help prevent the onset of cancer or even slow the growth of tumors, but the potency of vitamin C in the treatment of existing cancer is still debated. There are currently no studies showing that vitamin C alone is effective as a cancer cure. However, doctors may recommend doses of the vitamin as a complementary treatment -- that is, on top of surgery, chemotherapy, radiation or other therapies -- but patients should always, always discuss any plans for alternative treatments of this kind with their doctor before embarking on them.

Cancer quacks are out there. This public service announcement put out by the American Society for the Control of Cancer (now the American Cancer Society) attempted to warn cancer patients and their loved ones of the dangers of relying on unproven cures pedaled by deluded, over-enthusiastic or even criminal figures on the cancer treatment shadow market. Many people who have been diagnosed with a terminal illness are understandably desperate for a savior in any form they can find it, and even persons who would normally be skeptical of poorly researched medicine may seek unproven treatments when fighting for their lives. Nevertheless, when it comes to cancer, listen to your doctor, listen to your doctor, and listen to your doctor. Some alternative treatments may have value, but these programs should be approved by a credentialed oncologist so as not to conflict with your primary modes of therapy. Click ahead to see more of these unproven alternative remedies.

Beginning in the 1920s, an alternative cancer therapy known as the "grape cure" or the "grape diet" was widely promoted by a South African dietician named Johanna Brandt. Her method involved, as one might expect, a diet of grapes. Though grapes, like many fruits and vegetables, contain important antioxidants and other chemical agents that work together to keep the body healthy, there is no evidence that a grape-based diet will vanquish tumors or prevent them from metastasizing. It's possible that some unproven cancer cures, such as the grape diet and other fruit or juice-based regimens, find success not only because they offer strong claims about their efficacy at fighting disease, but also specifically because of what they do not offer: painful surgeries, and draining treatments like chemotherapy and radiation.

This is Harry M. Hoxsey -- another purveyor of cancer "medicines." A man multiply convicted of practicing medicine without a license, Hoxsey sold treatments for decades under the name of the Hoxsey Method, which included herbal concoctions designed to battle cancer in all its forms. These herbal remedies were judged by the medical research community to be wholly without merit, and some even caused side effects. For example, Hoxsey's salve for external tumors was known to cause burns and disfigurement when applied to the skin. Medical authorities from the FDA to the American Cancer Society denounced Hoxsey's treatments as ineffective and dangerous -- especially because many patients were using them not in addition to conventional treatments, but instead of them.

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