By Rachel Kang

Introduction

During the nineteenth century, options for entertainment were limited. Many rural-dwelling people did not have the time or money to regularly go to town for fun. However, every so often, a wagon would traverse through mountains, forests, and bogs to reach these small towns. Children would shout in excitement; adults would gather their friends and family around the town center; and everyone would watch as the waggoneers began setting up their props and wares. A medicine show (Figure 1) had arrived.

History

Medicine shows were touring performances accompanied by musicians, circus performers, and comedians that traveled mostly to rural communities to sell a patented “miracle cure”. Unlike prescription drugs that can only be procured from a pharmacist, patent medicines are non-prescription medicines whose recipes are protected by trademarks and are sold by the patent owner – who may or may not have any medical background. This secrecy allowed patent owners to advertise their medicines as a cure for any sort of disease or ailment, without having to list out the active ingredients on the label, if it contained any to begin with. Most patent medicines were made before the establishment of governmental regulatory bodies like the Food and Drug Administration (FDA), and due to increased scrutiny and stricter regulations, patent medicines are no longer sold today.  

You might have heard of something like patent medicine referred to as “snake oil,” which is a colloquial term for a scientifically unsound or fraudulent treatment. The term comes from a traditional Chinese medicine meant to help with muscles aches and arthritis. Practitioners of this folk remedy obtained oil from the fat sacks of Chinese water snakes (enhydris chinensis) and applied it directly to a patient’s skin to soothe aches and pains.  Modern studies have revealed that this remedy may have some scientific backing: the snake’s oil is high in omega-3 fatty acids, which may prevent and treat pain by decreasing inflammation, though more studies are necessary to be fully sure of its benefits^1,2.

In the 1900s, many Chinese immigrants who came to America to build the transcontinental railroad would use this traditional medicine to recover from a hard day of work. This medicine eventually caught the attention of exploitative entrepreneurs like William D. Rockefeller Sr., father of John D. Rockefeller. These entrepreneurs were often unaware that traditional Chinese medicine had centuries of history surrounding its preparation and proper use, knowledge that was diligently passed down from doctor to apprentice. The exoticism and mysticism of the East was an appealing sales pitch for many Westerners, and that was enough for entrepreneurs to market themselves into making a fortune – even without having any background in science or medicine. The term “snake oil” began to catch on when a prominent snake oil salesman Clark Stanely the “Rattlesnake King” was declared guilty by the United States government for selling faulty products.

Medicine Shows

It might be easy to attribute medicine shows’ success to the audience’s ignorance. After all, many of the rural target population may have lacked formal education. However, it is important to consider the dubious nature of “healthcare” during the nineteenth century.

Medical practice has historically been made into a spectacle: from mystics performing religious ceremonies to summon a god’s miracle, to surgeries being performed publicly in theaters for all to watch. Moreso, procedures like surgeries were not attractions because they were feats of scientific marvel; instead, many attended surgical performances to witness the horrors that patients were forced to undergo. During the 1800s, the survival rate of these surgeries was so low that patients were often forced to pay upfront before undergoing the procedure. Surgeries were not the delicate, meticulously controlled procedures that we think of today. Before the advent of anesthesia, the best surgeons were the ones who were able to perform the procedure the quickest. Surgeries continued to have high mortality rates even after the mainstream use of anesthesia because doctors were using the same instruments between patients without sterilizing them between uses.

Medicine shows were not successful because the audiences were particularly gullible; rather, they were successful because “professional” medical practices at the time were also dubious in nature³. Furthermore, the elevation of western medicine over all other traditional medicines eradicated generations of cultural medical wisdom from rural communities. This erasure left those living with limited medical access with too few resources to help their sick and dying. Patent medicines were sometimes the only option accessible to these communities.

“Snake Oil” Today

Patent medicine may no longer be around, but its spirit remains. As you browse TikTok or Instagram, you may be exposed to countless advertisements or content for home remedies, fad diets, and exercise routines meant to treat all sorts of ailments (Figure 2). Examples include the carnivore diet for “improving general health,” alternative COVID-19 cures, and homeopathic medications being advertised as effective alternatives without any scientific backing. Social media health influencers have hundreds of thousands of followers, many of whom fall prey to their endorsements of these miraculous “health cures,” despite the spokesperson sometimes lacking a medical background. As in the past with medicine show crowds, followers of these health influencers are not simply uneducated or ignorant. With the current state of healthcare, these publicly available alternative medications might be the only resource accessible for some.

The American healthcare system is overburdened, especially in rural areas. Appointments sometimes must be made months in advance to see a primary care provider. Often, scheduling an appointment requires a person to take time off from work, potentially losing some of their weekly earnings. Furthermore, pharmaceuticals and medical procedures can be cost-prohibitive for much of the population. When faced with the decision of putting food on the table or buying insulin, which can cost up to $350 a vial, the $10 herbal supplement you saw on TikTok that promises to manage your diabetes better than insulin begins to look extremely tempting.

Medicine, for better or worse, is a human practice, and many things can go wrong. Patients can be misdiagnosed, ignored for years, or denied access to healthcare by insurance and state governmental policies. It can be difficult placing your health or the health of loved ones in the hands of agencies who may not have your best interest in mind. Instead, many turn to putting their own wellbeing in their untrained hands, because for them, it is the only option available.

With all that said, I do not believe that all alternative medicines are fraudulent. I use ginger to help calm my stomach and drink mint tea to soothe headaches. If eating a paleo diet or having a juice “detox” works for you and there are no negative health effects, you should do whatever makes you happy. However, alternative medicines are simply not sufficient for most ailments that require medical intervention. Efforts need to be made on a societal level to increase individuals’ medical knowledge so that they can make informed decisions and obtain more agency regarding their own health. While modern medicine has its faults, these faults are not a reason to abstain from receiving healthcare completely. If you are someone who has a medical or scientific background, be a resource for the people around you. You are someone others trust, and keeping your door open to offer medical advice or helping that person navigate scientific articles to do their own research can mean the world to someone. Be educated, stay informed on the latest scientific findings, and keep yourself healthy!

TL;DR

• Snake oil was an actual traditional Chinese medicine that was appropriated by Western salespeople and sold at medicine shows, similar to other “patent medicines.”
• “Snake oil-like” (fraudulent) healthcare products are still around today, often being advertised on social media like Instagram or Tik Tok.
• Be wary of products and fads that promise miracles. Word of note: cure-alls cure nothing.

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Reference

1. Pérez-Piñero, S., Muñoz-Carrillo, J. C., Victoria-Montesinos, D., García-Muñoz, A. M., Andreu-Caravaca, L., Gómez, M., Schölzel, M., García-Guillén, A. I., & López-Román, F. J. (2023). Efficacy of Boswellia serrata Extract and/or an Omega-3-Based Product for Improving Pain and Function in People Older Than 40 Years with Persistent Knee Pain: A Randomized Double-Blind Controlled Clinical Trial. Nutrients, 15(17), 3848. https://doi.org/10.3390/nu15173848

2. Soens, M. A., Sesso, H. D., Manson, J. E., Fields, K. G., Buring, J. E., Lee, I.-M., Cook, N. R., Kim, E., Bubes, V., Dushkes, R., Serhan, C. N., & Rathmell, J. P. (2024). The effect of vitamin D and omega-3 fatty acid supplementation on pain prevalence and severity in older adults: A large-scale ancillary study of the VITamin D and OmegA-3 triaL (VITAL). Pain, 165(3), 635–643. https://doi.org/10.1097/j.pain.0000000000003044

3. Alexander, J. W. (1985). The contributions of infection control to a century of surgical progress. Annals of Surgery, 201(4), 423–428.

4. Robinson, D. H., & Toledo, A. H. (2012). Historical Development of Modern Anesthesia. Journal of Investigative Surgery, 25(3), 141–149. https://doi.org/10.3109/08941939.2012.690328