Intended for healthcare professionals

Feature Christmas 2009: Years Like This

Patent medicines and secret remedies

BMJ 2009; 339 doi: (Published 14 December 2009) Cite this as: BMJ 2009;339:b5415
  1. Jeffrey K Aronson, clinical pharmacologist
  1. 1Department of Primary Health Care, University of Oxford, Oxford OX3 7LF
  1. jeffrey.aronson{at}

    As arguments between doctors and advocates of alternative medicine continue, Jeff Aronson describes how the secret ingredients of patent medicines were uncovered a century ago

    Patent means open (box 1), but patent medicines have traditionally contained secret ingredients. The Oxford English Dictionary defines a patent medicine as “a proprietary medicine manufactured under patent and available without prescription.” However, the term and its current definition are historically misleading. From the start, the hallmarks of patent medicines were that they were advertised direct to the public and sold over the counter. They were rarely patented because it was advantageous to be secretive about ingredients that were often ineffective and even hazardous. If a product had a patent it was generally because the remedy was effective—Epsom salts, marketed by Nehemiah Grew in the late 17th century, contained magnesium sulphate as a purgative.

    Box 1: Etymologies

    Patent comes from the hypothetical Indo-European root PET, to spread or open out. Petals spread out; patellas, spatulas, and spades look like open dishes; space is an open area; and paella is cooked in an open pan. According to the Oxford English Dictionary, letters patent (Latin litterae patentes) were originally open letters from a monarch or government, intended “to record a contract, authorize or command an action, or confer a privilege, right, office, title, or property”; the term then came to mean documents that grant “for a set period the sole right to make, use, or sell some process, invention, or commodity.” It was subsequently shortened to patent.

    Quacks, originally quacksalvers, supposedly quacked or boasted about their salves; a mountebank was a man who would mount a soapbox (Italian: montare in banco) to shout his wares at a fair; charlatans were wont to prattle (Italian: ciarlare) about their medicines1

    Patent medicines could be purveyed by physicians and apothecaries …

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