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JAMA 100 Years Ago
December 8, 2010

Medical News

JAMA. 2010;304(22):2540. doi:10.1001/jama.2010.1740

LONDON LETTER(From Our Regular Correspondent)

LONDON, Dec. 3, 1910.

Quackery and Nostrums in Great Britain

There are signs that the government will abandon the indifference which has rendered this country an unrestricted happy hunting-ground for quacks and nostrum exploiters. Recently the government sent forms to the 1,600 health officers of the United Kingdom inviting their opinion on “whether the practice of medicine and surgery by unqualified persons is assuming larger proportions and as to the effect produced by it on the public health.” The result is embodied in a recent report. On the whole the answers do not point to a large increase in unqualified practice, though such might have been expected from the profusion of advertisements of quack remedies and “specialists.” The increase seems to be most marked in huge centers of population, but curiously, quackery appears to flourish less in London than in provincial towns. The most extensive form of unqualified practice is prescribing by pharmacists, which is practically universal. They constantly prescribe for minor ailments or what are believed to be minor. The poor are particularly fond of resorting to them because it costs less than going to a doctor. In some districts a doctor seldom sees a child of the working class which has not been purged or otherwise treated for several days by a pharmacist. Diseases of the skin, the eye, and venereal diseases are much treated by pharmacists, who often also undertake dentistry, and are the chief agents for the sale of nostrums. But they sell the latter only when demanded; they prescribe their own preparations if possible, for the profit on their sale is much greater. Next to pharmacists come “herbalists”—persons with no pharmaceutical qualification whatever, who sell herbs and other drugs as far as the law allows. The only restriction they suffer under, compared to pharmacists, is that they cannot sell poisons. They are numerous and rapidly increasing in the large manufacturing towns of Lancashire and Yorkshire. As they have no legal status they are more reckless than pharmacists. They treat all sorts of diseases, and even visit patients—a thing seldom done by pharmacists. “Bonesetters” are extensively in vogue in some parts, especially in mining districts, and some of the large friendly societies even accept their certificates as equivalent to that of a physician. . . . In Yorkshire and Durham the practice prevails of diagnosing and treating ailments by persons in a hypnotic state. One great evil from unqualified practice is the spread of infectious disease from failure to diagnose it. Cases are quoted of small-pox, diphtheria, scarlet fever and other diseases being spread in this way. In cancer valuable time is lost because the disease is not recognized in its early stage and is then treated by useless drugs.

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