The whole approach to medication in the 19th century was completely different from ours. These days a medicine that you buy in a pharmacy or get on prescription from the doctor has been properly tested, so you know what the ingredients are, and it has been studied in clinical trials to prove that it works. Neither of these things happened in the 19th century. Suppliers of a medicine didn’t even need to tell you what was in it.

It’s a shocking truth that almost all the medicines used in Victorian Britain were at best worthless. But some of them were dangerous too.

Traditional treatments
Medicines were commonly prescribed or purchased to treat illness throughout the nineteenth century, but doctors often attached far greater importance to three time-honoured methods of treating their patients which persisted until the last few decades of the century. Medicines were invariably an accompaniment to these three interventions, which were the bedrock of medical practice. We now know they were of no value whatsoever, and yet they had been used for centuries and few people dared to doubt their worth.

The first of these was bleeding. Patients either had a vein opened with a sharp instrument and were encouraged to bleed into a bowl, or slug-like creatures called leeches were used to suck the blood out. This treatment was believed to cleanse the blood of impurities, but it often weakened patients who were already dangerously ill.

The second widely-used approach was the use of purgatives or cathartics to supposedly rid the bowel of toxins. Victorian doctors were obsessed that the ‘dirty’ contents of the bowel were responsible for disease, and administered these medicines by mouth or rectally to promote diarrhoea. They did this even when the patient’s condition was already causing diarrhoea – for example in those suffering from dysentery – and it undoubtedly led to the dehydration and speedier death of some patients.

The third nonsense treatment that was practised was to damage the skin to allegedly help it excrete poisonous substances. This was done by, for example, applying blistering plasters.

Ingredients
The so-called ‘active’ ingredients used in 19th century medicines fell broadly into three groups: animal-derived, minerals and acids, and plants. Some of the animal medicines used in the early 19th century were bizarre, and examples include horse’s milk for tuberculosis (TB), goat’s blood to promote sweating, elk’s hoof to treat fitting, the jawbone of the pike to ease labour, and ladybirds for toothache.

The so-called mineral medicines provoke an equal shudder in modern minds because well-known poisons were widely used as medicines or as ingredients in medicines, including mercury, arsenic, antimony, lead and nitric acid.

There was a particular obsession with mercury – the curious liquid metal which was then known by the far more charming name of ‘quicksilver’. It was used to treat everything from venereal disease to cholera to gout, but we now know that it is very poisonous. Our ancestors often took it by mouth in a form that was known as ‘calomel’.

However, medicines derived from plants predominated. From common plants found in gardens and parks such as dandelions and willow bark to foreign imports such as sarsaparilla and swamp root.

Their therapeutic uses were sometimes based upon centuries of folklore and rumour, but many of the alleged benefits were simply invented by the manufacturer. No one ever considered lining up a dozen patients giving them the herb concerned and observing them to see if they improved. This scientific approach would have been a totally alien concept in the 19th century.

Marketing and supply
The main ‘respectable’ suppliers of medicines were apothecaries and chemists. These roles had overlapping functions since both professions made, recommended and sold medicines. However, apothecaries were recognised as doctors from the 18th century onwards so could issue prescriptions. These days most members of the pharmacy profession prefer to be called pharmacists, but the historical adoption of the terms ‘chemist’, ‘druggist’ and ‘pharmaceutical chemist’ mean that until recently pharmacists were widely referred to as chemists.

The apothecaries and chemists of the 19th century were ‘quacks’ by modern standards – almost anyone could sell medicines and you were allowed to make any claims you liked for them. So, if you wanted to mix some cheap household ingredients into a colourful sweet syrup and call it ‘Dr Smith’s Cure for Asthma’, then you could.

Victorian publications are filled with adverts making highly dubious claims for medicines. Makers of medicines used all sorts of tactics to entice a vulnerable and gullible public to buy. A common technique was to include testimonials from satisfied patients. In one typical advert, a patient called Mr Cochrane wrote of Mother Seigel’s Curative Syrup: I feel better and stronger than I ever I did in my life before. Often the writers weren’t even named. For example, a “retired army officer of rank” writes an advert for Dr Townsend’s American Sarsaparilla: I can vouch for it as nourishing to the blood and system.

Purchasers were told of the value placed upon a treatment by the medical profession and warned to be wary of cheap imitations. And the fact that the ingredients were often declared to be ‘secret’ added a certain mystique to the alleged curative properties of the medicine concerned. It was also common to invoke a doctor’s name in marketing, and many medicines exploited this. It seemed to suggest a medical legitimacy: Dr Clarke’s Blood Mixture, Dr Kilmer’s Swamp Root Kidney Liver and Bladder Cure, and so on.

Evidence
The fact that 19th century doctors continued to use these worthless medicines seems scandalously unprofessional and ill-informed to modern minds. To understand them, it helps to appreciate the approach to medical science in those times. We now know that most diseases are caused by factors such as microorganisms, genetics and allergy. But 19th century doctors had no knowledge of these subjects, and tended to assume that diseases were caused by the things that they did know about such as behaviour, environment, and diet. In particular, immoral behaviour or changes in the weather were widely blamed for disease. Many infectious diseases were thought to be caused by the bad smell that accompanies infection – this ‘miasma’ was believed to be some sort of gas that invisibly spread from person to person.

Doctors also relied heavily on the opinions, ideas and observations of other doctors to guide them: if a noted chest doctor recommended a treatment, then the rest of the profession followed slavishly. There was no scientific assessment of treatments, no clinical trials. Bizarrely, even the opinions of physicians from centuries before, such as the Roman physician Galen, were still held in high regard until the mid-19th century because there was simply nothing else to take its place.

Some medicines were targeted at specific diseases, but many were claimed to treat a vast array of different disorders. Unlike today, no one was particularly interested in medicines for heart complaints, dementia or cancer because these were much less common in a century where the average life expectancy was less than 50 years of age. Manufacturers focused on the diseases that worried people at the time such as chest complaints, TB, venereal disease, and cholera during the great Victorian epidemics of this disease.

Some medicines were promoted for a bewilderingly wide range of complaints. Holloway’s Ointment, for example, was claimed to treat “inveterate ulcers, sore breasts, gout, rheumatism, sore heads, boils, insect bites etc”.

The dangers
Since the production and supply of medicines was completely unregulated, this caused a whole range of problems for our ancestors. A medicine could contain inappropriate substances or hazardous amounts of the active ingredients, so that patients who took them for legitimate reasons were poisoned. Mrs Winslow’s Soothing Syrup for Infants, for example, was used to settle babies while they were teething or suffering from colic. Unfortunately, it contained dangerous quantities of opium and it killed some babies.

Medicines often contained active poisons of all kinds, so it was quite common for patients who took them for legitimate reasons to be poisoned by them. Adults also took overdoses deliberately in attempts to commit suicide, or by accident because they didn’t follow the instructions, and children who found bottles of medicines lying around, might help themselves with fatal consequences. Unfortunately, there weren’t the antidotes or Accident & Emergency departments that we have access to these days, so poisonings were often fatal.

Modern medicines on prescription from a doctor are not free from risk, but at least you know what you’re getting, the side effects have been studied, and the manufacturer has to prove that the medicine works. Our ancestors were not so lucky.

In the print edition
Read Simon’s article about French prisoners of war in Britain in Issue 4 of Discover Your Ancestors, out now in newsagents around the world or from discoveryourancestors.co.uk .