Quackery

1

Mercury

Of Roman Gods, Toilet Archeology, Drooling Syphilitics, an Immortal Wannabe, and Erroneous Snakes

The baby's hands and feet had become icy, swollen, and red. The flesh was splitting off, resembling blanched tomatoes whose skins peeled back from the fruit. She had lost weight, cried petulantly, and clawed at herself from the intense itching, tearing the raw skin open. Sometimes her fever reached 102 degrees.

"If she was an adult," her mother had noted, "she would have been considered to be insane, sitting up in her cot, banging her head with her hands, tearing out her hair, screaming, and viciously scratching anyone who came near."

Later on, her condition would be called acrodynia, or painful tips, named so for the sufferer's aching hands and feet. But in 1921, they called the baby's affliction Pink's Disease, and they were seeing more and more cases every year. For a while, physicians struggled to determine the etiology. It was blamed on arsenic, ergot, allergies, and viruses. But by the 1950s, the wealth of cases pointed to one common ingredient ingested by the sick kids—calomel.

Parents, hoping to ease the teething pain of their infants, rubbed one of many available calomel-containing teething powders into their babies' sore gums. Very popular at the time: Dr. Moffett's Teethina Powder, which also boasted that it "Strengthens the Child . . . Relieves the Bowel Troubles of Children of ANY AGE," and could, temptingly, "Make baby fat as a pig."

Beyond the creepy promise of Hansel and Gretel–esque results, there was something else sinister lurking within calomel: mercury. For hundreds of years, mercury-containing products claimed to heal a varied and strangely unrelated host of ailments. Melancholy, constipation, syphilis, influenza, parasites—you name it, and someone swore that mercury could fix it.

Mercury was used ubiquitously for centuries, at all levels of society, in its liquid form (quicksilver) or as a salt. Calomel—also known as mercurous chloride—fell into the latter category and was used by some of the most illustrious personages in history, including Napoleon Bonaparte, Edgar Allan Poe, Andrew Jackson, and Louisa May Alcott. Why? That's a longer story.

Calomel: Purging It All Away

Drawing from the Greek words for good and black (named so for its habit of turning black in the presence of ammonia), calomel was the medicine from the sixteenth to the early twentieth century. Despite what it sounds like, calomel is nothing like caramel, though it sometimes carried the stomach-churning monikers "worm candy" and "worm chocolate" for treating parasites. By itself, calomel seems fairly innocuous—an odorless white powder. But don't be fooled: It's as harmless as your khaki-clad next-door neighbor who hides a basementful of bone saws. Taken orally, calomel is a potent cathartic, which is a sophisticated way of saying it will violently empty out your guts into the toilet. Constipation had long been associated with sickness, so opening the rectal gates of hell was a sign of righting the wrongs.

Some believe the "black" part of its name evolved from the dark stools ejected, which were mistaken for purged bile. Allowing bile to "flow freely" was in harmony with keeping the body balanced and the humors happy, a theory that harkened back to the time of Hippocrates and Galen. And if the insides of the bowels were dark and slimy, wasn't it better to rid the body of such toxins?

The "purging" occurred elsewhere, too—in the form of massive amounts of unattractive drooling, a symptom of mercury toxicity. A calomel consumer could give a rabid dog a run for its money. If the bad stuff was expelled via copious salivation, that was good, right? In the sixteenth century, Paracelsus believed that "effective" (i.e., toxic) doses of mercury were achieved when at least three pints of saliva were produced. That's a helluva lot of spit. And so, at a time when overflowing privies and gallons of loogie were the answer to a multitude of ailments, physicians found their drug of choice in calomel.

Benjamin Rush was one such physician. A founding father who signed the Declaration of Independence, Dr. Rush advocated for women's education and the abolition of slavery. He pioneered the humane treatment of psychiatric patients, but unfortunately thought that mental illness was best treated with a dose of calomel. He suggested this for the treatment of hypochondria:

Mercury acts in this disease, 1, by abstracting morbid excitement from the brain to the mouth. 2, by removing visceral obstructions. And, 3, by changing the cause of our patient's complaints and fixing them wholly upon his sore mouth. The salivation will do still more service if it excite some degree of resentment against the patient's physician or friends.

Resentment against your doctor and BFF is a fantastic side effect! But in truth, Rush was replacing hypochondria with heavy metal toxicity. Another side effect was mercurial erethism, a neurological disorder that includes depression, anxiety, pathological shyness, and frequent sighing. Together with tremors of the limbs, these symptoms were often called mad hatter's disease or hatter's shakes (for the hat-making workers who used mercury in the felting process). In addition, toxic patients could suffer from lost teeth, rotting jaw bones, and gangrenous cheeks that produced facial holes, exposing ulcerated tongues and gums. Okay, so what if success meant that Rush's patients turned into extremely moody Walking Dead extras?

When the mosquito-borne Yellow Fever virus hit Philadelphia in 1793, Dr. Rush became a passionate advocate of extreme amounts of calomel and bloodletting ("heroic depletion therapy"). Sometimes, ten times the usual calomel dose was employed. Even the purge-loving medical establishment found this excessive. Members of the Philadelphia College of Physicians called his methods "murderous" and "fit for a horse." Earlier, in 1788, author William Cobbett had labeled Rush a "potent quack."

At the time, Thomas Jefferson estimated the Yellow Fever fatality rate at 33 percent. Later, in 1960, the fatality rate of Rush's patients was found to be 46 percent. Not exactly an improvement on the status quo.

Ultimately, it was Dr. Rush's influence on improving Philadelphia's standing water problem and sanitation—plus a good, mosquito-killing first frost of autumn—that ended the epidemic. Alexander Hamilton, a friend of Dr. Rush, had become ill himself, but turned to another doctor who employed gentler methods. "In his theory of bleeding and mercury," Hamilton wrote, "I was ever opposed to my friend . . . whom I greatly loved; but who had done much harm, in the sincerest persuasion that he was preserving life." Hamilton survived, but Dr. Rush's reputation didn't. By the turn of the century, his medical practice dwindled to nothing.

Still, calomel continued to be used. It wasn't until the mid-twentieth century that mercury compounds finally fell out of favor, thanks to a solid understanding that heavy metal toxicity was actually, you know, bad.

Quicksilver: A Beastly Beauty

Most people know of elemental mercury as that slippery, silvery liquid once used with ubiquity in glass thermometers. If you were a child before helicopter parenting or organic anything, you might have had the opportunity to play with the contents of a broken thermometer. The glimmering balls skittered everywhere and delighted children for hours.

There was always something mystical about "quicksilver," as it was often called. Its older Latin name, hydrargyrum, spoke to its astonishing uniqueness—"water silver"—and gave rise to its Hg abbreviation on the periodic table of elements. The only metal that is liquid at room temperature, it's also the only element whose common name was taken from its association with alchemy and a Roman god.

So it almost makes sense that people expected magical things from mercury. Qin Shi Huang, First Emperor of the Qin Dynasty (246–221 bce), was one of them. Desperate for the secret to immortality, he sent out search parties to find the answer, but they were doomed to fail. Instead, his own alchemists concocted mercury medicines, thinking that the shining liquid was the key.

He died at the tender age of forty-nine from mercury poisoning. But hey, why stop there? In an attempt to rule in the afterlife, Qin had himself buried in an underground mausoleum so grand that ancient writers described it flowing with rivers of mercury, its ceiling decorated with jeweled constellations. It's also reportedly booby-trapped, Indiana Jones–style, with arrows that fire when disturbed. Happily for him and chillingly for everyone else, Qin made sure his concubines and tomb designers were buried alive right along with him. Brrr. Thus far, the tomb is unexcavated due to the toxic levels of mercury that threaten to release if it's opened.

Quite a bit later, when Abraham Lincoln was immortalizing himself in history, he too was a victim of liquid mercury. Before his presidency, Lincoln suffered from mood swings, headaches, and constipation. In the 1850s, an aide noted, "[W]hen he hed no passages he alwys had a sick headache—Took Blue pills—blue Mass." These "sick headaches" were also known as "bilious headaches" and could conceivably be cured by a good cathartic that also "allowed" bile to flow.

So what was this mysterious "blue mass"? A peppercorn-sized pill containing pure liquid mercury, licorice root, rosewater, honey, and sugar. Because liquid mercury is poorly absorbed in the intestine, druggists gleefully exercised their repressed aggressions by repeatedly pounding the liquid beads into relative oblivion, a process called extinction. Unfortunately, this violent compounding also allowed the mercury to be more readily absorbed in vapor form within the intestine.

Like a caffeine junkie guzzling down mislabeled decaf, Lincoln only grew worse after taking the pills. There are several accounts of his volatile behavior at the time, with bouts of depression mixed with rage, as well as insomnia, tremors, and gait problems, all of which could theoretically be blamed on mercury toxicity. He, too, may have suffered from erethism.

Lincoln, to his credit, seemed to recognize that the blue mass might be making him worse rather than better, and he apparently decreased his use once he entered the White House. And not a moment too soon. One shudders to imagine a mercury-toxic, pathologically moody leader of our nation calling the shots during the Civil War.

"A Night with Venus, a Lifetime with Mercury"

Mercury has had an entwined relationship with syphilis for centuries. In the fifteenth century after the French invasion of Naples, Italy, the disease began to make its way across Europe. As Voltaire noted, "On their flippant way through Italy, the French carelessly picked up Genoa, Naples, and syphilis. Then they were thrown out and deprived of Naples and Genoa. But they did not lose everything—syphilis went with them."

Soon, the "Great Pox" became a true nuisance and deadly accompaniment as it spread throughout Europe. That historical strain of Treponema pallidum (which is the responsible bacterium) was particularly virulent. Genital sores sprouted after exposure to an infected sexual partner and progressed to rash and fevers. Later, foul-smelling abscesses, pustules, and sores spread over the body, some so severe that they ate away at face, flesh, and bone. Yes. Out-of-control syphilis is pretty revolting.

People were desperate for a cure. By the sixteenth century, mercury came to the rescue with the help of the rather bombastic and vehement Paracelsus, who argued against Galen's humoral theory. He believed instead that mercury, salt, and sulfur would bring about all manner of bodily cures, having earth-bound, physiologic, and astrological qualities.

Another salt, mercuric chloride, arrived on the scene. Unlike calomel, mercuric chloride was water-soluble and easily absorbed by the body, making its poisonous results seem all the more effective. It burned the skin when applied ("It hurts! Therefore, it works!"), and the copious salivation was considered a sign of successful purging.

Syphilitic patients also received what sound like the worst spa packages ever. Elemental mercury was heated for steam baths, where inhalation was considered beneficial (and is a potent route of mercury absorption). Mercuric chloride was added to fat, and the resultant unction rubbed dutifully into sores. Sometimes, bodily fumigations occurred, where a naked patient was placed in a box with some liquid mercury, their head sticking out of a hole, and a fire lit beneath the box to vaporize the mercury. Sixteenth-century Italian physician Girolamo Fracastoro remarked that after mercury ointments and fumigations, "You will feel the ferments of the disease dissolve themselves in your mouth in a disgusting flow of saliva."

Treatment for syphilis was vastly unsexy. What was worse, these regimens would often continue for the rest of the sufferer's life. There was no denying a common saying at the time: "A night with Venus, and a lifetime with mercury."

Niccolò Paganini, one of the most famous violinists in history, likely suffered from mercury toxicity after he was diagnosed with syphilis. Besides suffering from hypochondria and excessive shyness from erethism, he also began shaking uncontrollably, contributing to his withdrawal from the stage in 1834. He had tree-trunk legs and coughed gunk up chronically. He complained, "I easily expectorate the mucus and pus . . . three or four saucerfuls . . . the swelling in my legs has risen to behind the knees so that I walk like a snail." His teeth fell out, his bladder was constantly irritated, and his testicles became inflamed to the size of "a little pumpkin." Damn you, syphilis, for ruining the adorableness of little pumpkins everywhere.

Luckily, or unluckily, poor Paganini's horrid life of mucus production, mollusk-like speed, and gourd-sized nether regions didn't last long. Within a month after he stopped performing, Paganini was dead.

Nowadays, we do know that mercury and other metals such as silver can kill bacteria in vitro. All scientists know, however, that what's good in the petri dish isn't necessarily good in the human body. It's unclear if syphilis sufferers were cured by their mercury treatments or if they simply moved on to the next phase of the illness, which could consist of many symptom-free years.

That is, if the mercury toxicity didn't kill them first.

The Caduceus: A Snake Switcheroo

Calomel fell from favor gradually, as safer and more effective treatments replaced the "heroic medicine" of purging. In the United States and around the world, mercury was banned from felting in the 1940s and gold and silver mining in the 1960s. Calomel wasn't removed from the British pharmacopoeia until the 1950s because it took that long to finally realize mercury was the cause of acrodynia. Even now, you can still find mercury thermometers (they're more accurate than the red-colored alcohol ones), but regulations are phasing them out worldwide.

Though the element is no longer used in mainstream medicine, mercury has managed to slither its way into many a doctor's office. It is perhaps oddly appropriate that the symbol for the god Mercury was the caduceus—two snakes entwined on a winged rod. The symbol is commonly and incorrectly associated with the medical establishment, due to a mistake when the US Army Medical Corps adopted the symbol in 1902. Soon after, it became a ubiquitous sign of healing. But in fact, the caduceus represents Mercury—the god of financial gain, commerce, thieves, and trickery.

The Rod of Asclepius, which has a single serpent entwined on a simple rod, was held by the Greek god Asclepius, the patron of health and healing. This was the rod mistakenly missed in 1902 and is currently used by most academic medical establishments today.

In 1932, Stuart Tyson argued about the misuse of the caduceus in The Scientific Monthly, stating that Mercury was "the patron of commerce and of the fat purse . . . his silver tongued eloquence could always make 'the worse appear the better cause.' . . . Would not his symbol be suitable for . . . all medical quacks?" Indeed.

2

Antimony

Of Oliver Goldsmith's Last Folly, the Fake Basil Valentine, Captain Cook's Cup, and Everlasting Poop Pills

In 1774, Oliver Goldsmith was feeling rather off. The forty-four-year-old author of The Vicar of Wakefield and She Stoops to Conquer had a fever, headache, and suspected kidney problems. In his life, he'd graduated at the bottom of his class at Trinity College, attempted but did not complete a degree in medicine in Edinburgh, and wandered Europe after exhausting his funds. He finally managed a degree of success as a writer, though some, like Horace Walpole, called him "an inspired idiot."

It was, however, his incomplete doctorate in medicine and briefly held position as an apothecary's assistant that led to action at that moment. He must cure himself.

It was time for St. James's Fever Powder.

Now, St. James's Fever Powder was famous in its time. Created and sold by one of the eighteenth century's most famous patent medicine doctors, the powder claimed to cure fevers "accompanied by convulsions and light-headedness," gout, scurvy, and cattle distemper virus. Dr. Robert James was so secretive about his formula that he even lied on his patent application for fear others would steal it. But the main ingredient, a toxic metal called antimony, was extremely good at what Oliver Goldsmith thought he needed—nay, demanded—to get him out of his sickbed.

He wanted to vomit.

Goldsmith, who called himself a doctor despite not being one, asked an apothecary to bring him St. James's Fever Powder. The apothecary resisted, begging him to consult a real physician. But Goldsmith ended up getting what he asked for.

Eighteen hours later, after a lot of vomiting and convulsions, Oliver Goldsmith was dead.

Oliver Goldsmith, author and "inspired idiot."

A Brief History of Hurling

We'll get back to poor Mr. Goldsmith and his coveted antimony prescription. But first, let's take a brief pause to examine why he wanted to vomit so badly that it killed him.

Emesis, or vomiting, is the body's way of ridding itself of its stomach contents, against both gravity and the body's normal digestional direction. By irritating the lining of the stomach, eliciting the gag reflex, and tickling the "vomiting center" in your brain (yes, that's a real neural location), you can induce this reverse digestion. Emetics like antimony are substances you take on purpose to make you spew, and they have a long and glorious history. Herodotus reported that the ancient Egyptians employed monthly emetics to maintain their health. Hippocrates, too, advocated regular vomiting. The recommendations go on and on through several millennia. Up until only a few decades ago, emetics were still considered an important part of the medical formulary.

Much of emetics' use linked back to humoral theories of the body: It was believed that when the body's blood, black bile, yellow bile, or phlegm was unbalanced, sickness occurred. So rebalancing via vomiting, diarrhea, sweating, or salivation was necessary. Basically, if it could ooze out of a pore or projectile shoot out of an orifice, it balanced you.

And since 3000 bce, antimony, a grayish metalloid mined from mineral deposits around the world, was the substance du jour for this purpose. It's well known that some people have enjoyed emetics for their ability to empty themselves out after a gluttonous meal, as Roman emperors Julius Caesar and Claudius were known to do. Seneca the Younger, counsel to Emperor Nero, mentioned some Romans who "vomited to eat, and ate to vomit, and did not deign to digest their repasts furnished from all parts of the world." An antimony-containing wine was reportedly used for such purposes. (Interestingly, the term vomitorium was long thought to be an area provided to bingeing Roman partygoers. But in actuality, it was simply an exit area of an amphitheater for crowds to "purge" and leave the building. That's right. It's an architectural term that equates people with vomit.)

Unfortunately, to get the body to reverse its normal processes, sometimes you have to introduce it to something it desperately wants to remove, like poison. Scholars and healers alike recognized antimony's toxic potential. It could cause liver damage, severe inflammation of the pancreas, heart problems, and death. Still, they were confident that doctors could rein in its lethal power. A common thought at the time regarding antimony was that "a poison is not a poison in the hands of a physician."

Too bad that Oliver Goldsmith got his antimony, despite his doctors' disagreement.

Monk Killer or Wonder Drug?

Sixteenth-century celebrity physician Paracelsus believed in a more mineral-based philosophy as opposed to humors, a radical divergence of thought that brought him plenty of followers and enemies. One must understand the natural sciences before understanding the body's ailments, he believed. Earthly substances like antimony or mercury were the perfect elements to set things right. Antimony in particular "purifies itself and at the same time everything else that is impure," he claimed.

You'd think the endorsement of the Renaissance's Dr. Oz would be enough to make you the go-to vomit inducer, but it wasn't until antimony received a mythical monk's stamp of approval that it really took off.

Antimony's name supposedly draws from a story about a fifteenth-century German monk named Basil Valentine. Legend has it, he belonged to the Canon of Benedictine Priory of St. Peter and died at an astounding 106 years old. His mysterious epitaph read: "post CXX annos patebo" (after 120 years to clear, or, perhaps, pass), and right on the mark, one of the priory's church pillars reportedly burst open to reveal hidden books written by Valentine, the existence of which no one ever knew.

He's got good aim, doesn't he?

Valentine extolled the virtues of antimony in a manuscript entitled "The Triumphant Chariot of Antimony." He even recommended it to fatten up pigs. Rumor told that after having a good effect on the swine, he tried it on monks, who promptly died. Hence the meaning of antimony—"anti-monk" or "monk killer." (This is unlikely the true origin. Antimony more likely derives from the Greek word antimonos, for "a metal not found alone," due to its natural affinity for other elements like sulfur. Just as "Basil Valentine" is more apt a name for a sleazy lounge singer.)

Valentine's manuscripts had magically entered the hands of one Johann Thölde, a salt boiler, salesman, and the likely true author of the texts. He also happened to be a skilled chemist. In the early 1600s, he made a pretty penny spreading Valentine's writing around, and antimony experienced a surge in use.

And an intellectual war began.

Galenical physicians who extolled the virtues of humoral theory were in a rage about the doctor-chemists who followed Paracelsus and Valentine and adored the purgative powers of mercury and antimony. Bitter fights and court battles ensued over the intersection of chemistry and medicine, with antimony at their center. The faculty of medicine in Paris decreed antimony was a "virulent poison." One of the loudest seventeenth-century French critics, physician Guy Patin, exclaimed, "May God protect us from such drugs and such physicians!"

And yet, many believed antimony would "perfect the body" and would purify anything impure it came to touch. It was used for everything from asthma and allergies to syphilis and the plague. When King Louix XIV fell deathly ill in 1658, he received a dose. He recovered (miraculously), and that ended the antimony debate in France with one shiny, metalloid winner.

And what of Thölde and the possibly fictitious Valentine? No one really cared that the salt boiler/chemist was likely the true author of the texts. It seemed quite impossible that a fifteenth-century monk would have written the manuscript because "Valentine" referenced things that happened after