bottles. Early packages of these patent medicines which have been discovered indicate that paper labels were seldom applied to the glass bottles; instead, the bottle was tightly wrapped and sealed in one of these broadsides.

American imprints seeking to promote the English patent medicines were certainly rare. The most significant example may be found in the Library of the New York Academy of Medicine.⁴⁷ In 1731 James Wallace, a New York merchant, became American agent for the sale of Dr. Bateman's Pectoral Drops. To help him with his new venture, Wallace took a copy of the London promotional pamphlet to a New York printer to be reproduced. The printer was John Peter Zenger, not yet an editor and three years away from the events which were to link his name inextricably with the concept of the freedom of the press. This 1731 pamphlet may well have been the earliest work on any medical theme to be printed in New York.⁴⁸

Now and then a physician might frown on his fellows for reading such literature and prescribing such remedies, but he was in a minority. Colonial doctors, by and large, had no qualms about employing the packaged medicines. It was a doctor who first advertised Anderson's Pills and Bateman's Drops in Williamsburg;⁴⁹ it was another, migrating from England to the Virginia frontier, who founded a town and dosed those who came to dwell therein with Bateman's Drops, Turlington's Balsam, and other patent medicines.⁵⁰

Complex Formulas and Distinctive Packages

Indeed, the status of medical knowledge, medical need, and medical ethics in the 18th century permitted patent medicines to fit quite comfortably into the environment. As to what actually caused diseases, man knew little more than had the ancient Greeks. There were many theories, however, and the speculations of the learned often sound as quaint in retrospect as do the cocky assertions of the quack bills. Pamphlet warfare among physicians about their conflicting theories achieved an acrimony not surpassed by the competing advertisers of Stoughton's Elixir. The aristocratic practitioners of England, the London College of Physicians, refused to expand their ranks even at a time when there were in the city more than 1,300 serious cases of illness a day to every member of the College. The masses had to look elsewhere, and turned to apothecaries, surgeons, quacks, and self-treatment.⁵¹ The lines were drawn even less sharply in colonial America, and there was no group to resemble the London College in prestige and authority. Medical laissez-faire prevailed. "Practitioners are laureated gratis with a title feather of Doctor," wrote a New Englander in 1690. "Potecaries, surgeons & midwifes are dignified acc[ording] to successe."⁵² Such an atmosphere gave free rein to self-dosage, either with an herbal mixture found in the pages of a home-remedy book or with Daffy's Elixir.

In the 18th century, drugs were still prescribed that dated back to the dawn of medicine. There were Theriac or Mithridatum, Hiera Picra (or Holy Bitters), and Terra Sigillata. Newer botanicals from the Orient and the New World, as well as the "chymicals" reputedly introduced by Paracelsus, found their way into these ancient formulas. Since the precise action of individual drugs in relation to given ailments was but hazily known, there was a tendency to blanket assorted possibilities by mixing numerous ingredients into the same formula. The formularies of the Middle Ages encouraged this so-called "polypharmacy." For example the Antidotarium Nicolai, written about A.D. 1100 at Salerno, described 38 ingredients in Confectio Adrianum, 35 ingredients in Confectio Atanasia, and 48 ingredients in Confectio Esdra. Theriac or Mithridatum grew in complexity until by the 16th century it had some 60 different ingredients.

It was in this tradition of complex mixtures that most of the patent medicines may be placed. Richard Stoughton claimed 22 ingredients for his Elixir, and Robert Turlington, in his patent specification, named 27. Although other proprietors had shorter lists or were silent on the number of ingredients, a major part of their secrecy really lay in having complicated formulas. Even though rivals might detect the major active ingredients, the original proprietor could claim that only he knew all the elements in their proper proportions and the secret of their blending.

Not only in complexity did the patent medicines resemble regular pharmaceutical compounds of the 18th century. In the nature of their composition they were blood brothers of preparations in the various pharmacopoeias and formularies. Indeed, there was much borrowing in both directions. An official formula of one year might blossom out the next in a fancy bottle bearing a proprietor's name. At the same time, the essential recipe of a patent medicine, deprived of its original cognomen and given a Latin name indicative of its composition or therapeutic nature, might suddenly appear in one of the official volumes.

For example, the formula for Daffy's Elixir was adopted by the Pharmacopoeia Londinensis in 1721 under the title of "Elixir Salutis" and later by the Pharmacopoeia Edinburghensis as "Tinctura sennae composita" (Compound Senna Tincture). Similarly the essential formula for Stoughton's Elixir was adopted by the Pharmacopoeia Edinburghensis as early as 1762 under the name of "Elixir Stomachium," and later as "Compound Tincture of Gentian" (as in the Pharmacopoeia of the Massachusetts Medical Society of 1808). Only two years after Turlington obtained his "Balsam of Life" patent, the Pharmacopoeia Londinensis introduced a recipe under the title of "Balsamum Traumaticum" which eventually became Compound Tincture of Benzoin, with the synonym Turlington's Balsam. On the other hand, none of these early English patent medicines, including Stoughton's Elixir and Turlington's Balsam, offered anything new, except possibly new combinations or new proportions of ingredients already widely employed in medicine. Formulas similar in composition to those patented or marketed as "new inventions" can in every case be found in such 17th-century pharmacopoeias as William Salmon's Pharmacopoeia Londinensis.