It looks, swims and quacks like a quack: so does that make it a nostrum or patent medicine?

Pandemics, our unwelcome guests for millennia, are ultimately all about disease and cure. Well, not quite “all”. This Kat will leave the science, pharmacology, and epidemiology of the pandemic to others. But wearing his trademark hat, what intrigues him is the descriptive language that has been adopted in such circumstances. Take, for example, “super-spreader” and “elbow-bump”, both of which have been draped with new meaning in our current moment, here.

But there is nothing new here. The 17th century, for instance, was cursed with its own plagues and medical challenges. Then, as now, terms arose to describe what was taking place. While those events are long past, we still use some of that same language to describe our current situation.

Waiting to be convinced? You need go no further than consider the terms “quack” and “nostrum”. For those Kat readers who regale in the “what” and “how” of such lexical persistence, what follows is especially for you.

So, let us first set the historical context, as described in sciencehistory.org/distillations, as follows:

In 1665 an outbreak of bubonic plague ravaged London. Those with the financial means to escape to the countryside did just that. Unfortunately for those left behind, the flight from the city included many of its most prominent doctors.

The London College of Physicians, which governed the licensing of doctors within a 7-mile radius of the city, had no rules demanding its members stay in residence during a plague or pandemic. They were free to run in the opposite direction of danger.

What were London’s working classes to do? They turned to the quacks, of course.

As English surgeon Dale Ingram later observed, without licensed physicians, ‘recourse was had to chymists, quacks . . . every one was at liberty to prescribe what nostrum he pleased, and there was scarce a street in which some antidote was not sold, under some pompous title.’

The term quack originates from quacksalver, or kwakzalver, a Dutch word for a seller of nostrums, medical cures of dubious and secretive origins. (Nostrums were the over-the-counter medications of the early modern world, available without a doctor’s prescription and taken at one’s own risk.

Quacks during this time were unregulated practitioners, many of whom were too uneducated to enter physicians’ guilds or too ‘low-born’ to be welcomed by medical colleges. Instead they plied their trade on street corners and at country fairs, hawking homemade remedies in loud, attention-grabbing voices—hence the term quack, likening their cries to noisy ducks or geese.

So, there we seem to have it. “Quacks” (and “quackery”) and nostrums were already around in the early 17th century, terms hardly used in a complimentary way. Fast forward to the present. Merriam-Webster defines “quack” as—

an ignorant, misinformed, or dishonest practitioner of medicine.

Merpel reminds us, however this dictionary entry also refers to the term as “to make the characteristic cry of a duck”. So, already in the late Middle Ages, in the ears of the public, traders of medical cures in the Low Country, in flogging their products {“nostrums”), conjured up a sound that invited the listener to liken the chatter of ducks to the promotional appeal to an often gullible public. And, from there, the term migrated to England, reformulated as “quack”.

The term “nostrum” took a quite different 17th century lexical route to adoption. Here, we begin with a word known to anyone who has studied Latin— “noster”, meaning "our” or ours”. One form of the word, depending upon how it is used in the sentence, is “nostrum”. But, already by 1602, “nostrum” had also become a self-standing noun referring to remedies. As Merriam-Webster explains—

Some people think that specially prepared medicinal concoctions came to be called nostrums because their purveyors marketed them as our own remedy. In other words, the use of nostrum emphasized that such a potion was unique or exclusive to the pitchman peddling it.

How exactly this adjective was transformed into a noun in this context is not wholly explained, although use of the Latin term, “nostrum remedium”, meaning "our remedy”, was apparently recognized, here. What is notable is how the product was wholly intertwined with the person flogging it-- “The medicine that I am selling, it is ours/me”. This connection was reinforced by the fact that the composition of the nostrum was often understood as secret [but see below] to the pitchman.

[Merpel muses: might not this interconnection between product and person in a nostrum suggest the moral right in the copyright regime, where the creator’s self is part and parcel of the work itself.]

The term “nostrum” was also used as a type of synonym for “patent medicine”. One should be careful, however. The term “patent medicine” took root in the late 17th century in the context of the product being granted a letters patent from the Crown, here. However, not all nostrums were treated as a “patent medicine”. Further, the notion of “patent medicine” has fallen into disuse (unlike “nostrums”).

Still, one should be careful to ascribe too negative a view to the quacks and nostrums of that time. Some quacks were respectable medical types who fell outside the three-tiered medical hierarchy of the College of Physicians, Surgeons and Apothecaries, here. Social class certainly also played a part. Indeed, some quacks had at least a partial form of medical education; some of them keep secret the contents of their medical products, yet others did not.

As for the cures themselves, it has been noted that–

… whether regular or irregular, seem to have depended heavily upon nature's healing power or the placebo effect, and the relatively small number of genuinely effective ingredients – such as opium for dulling pain, mercury for syphilis, or bark or antimony as febrifuges – tended to be common to faculty and quack remedies alike (indeed one of the grouses of the medical colleges was that quacks pilfered from the official pharmacopoeia).

That was, lexically speaking, then. But quacks and nostrums are also part of our current coronavirus conversation, albeit usually shorn of the nuances in meaning that were present in earlier times. Consider the following report from April 2020—

COVID Quacks Get Warned—'Hucksters and quacks are warned in Texas about advertising fake cures for COVID. In Japan, a politician touts gargling as a cure and people believe him.’

But not only are quacks mentioned in connection with the pandemic. This Kat is probably not alone in recalling the substance of following, as published by quackwatch.com:

Promoter of bleach nostrum wrote to Trump before his bleach blunder. Mark Grennon, the self-styled ‘archbishop’ of Genesis II Church of Health and Healing, the largest producer and distributor of chlorine dioxide bleach as a ‘miracle cure’ has announced that he wrote to President Trump last week to advise him that the bleach product ‘Miracle Mineral Solution’ (MMS) is ‘a wonderful detox that can kill 99% of the pathogens in the body’ and ‘can rid the body of Covid-19’.

The Plague of 1665 is long gone. But, making and selling cures, and convincing the public of their efficacy and safety, all with an eye towards distinguishing between the true and the not true, remain, as does the manner by which we describe these remedies, and the people behind them. Quacks and nostrums, then and now--and likely future as well.

By Neil Wilkof

Picture on right is by William Hogarth, “Visit with the Quack Doctor”, and is in the public domain.

Picture on left is by Beatrix Potter and is in the public domain.