In 1906, the United States decided to pass its first federal law prohibiting the manufacture, sale, and transportation of adulterated food and drug products. It was the “end of the horse-and-buggy era,” as the patent medicine industry’s “great and gaudy noon reached meridian” on the last day of the year (Holbrook 4). The American public was beginning to realize the lack of true regulation of its everyday goods, so various groups of individuals championed the creation of consumer protection policies. From the medical community to muckraking journalists, many Americans found “quackery” to be dangerous not only to their health, but also to society's moral authority and soundness as a whole. Federal legislation on regulating these goods ultimately became a way in which the country tried to overcome its state of “in-betweenness,” and in doing so, the first Pure Food and Drug Act acted as a symbolic solution to the struggle of establishing a national, pure “body” of Americans, in both the physical and figurative sense. Thus, I will explore the social, political, and institutional factors that pushed the country to realize the dangers of tainted food and drug products, which ultimately contributed to the discussion of what it meant to be American. 

            Before the twentieth century, American medicine was in a state of deregulation, fraud, and ignorance. Even though more scientific advances and specialization within medicine emerged, there were little to no standards that the physician had to abide by. Most American doctors did have some kind of formal education, but the basic standard was low compared to that of European medicine. They acted as general practitioners—physician, surgeon, and midwife—and were faced with the overwhelming challenges of diagnosing and curing diseases that they knew nothing of. There was no sense of community among American doctors, as medical societies failed to unite them and raise professional morale. Moreover, the declining prestige of orthodox physicians during the Jacksonian era led to the rise of the “irregulars,” medical sects that challenged the heroic therapy of “regular” doctors and offered the public “a surer, safer, and often cheaper way to health” (Numbers 87). Thomsonians advocated the use of roots and herbs, while a variety of empirics lauded the efficacy of natural, folk remedies. Although they tried to provide better alternatives to allopathic treatment, which consisted largely of bleeding, blistering, and vomiting, the “irregulars” also failed to cure illnesses effectively.

The lack of medical standardization across the board not only exacerbated the uneven standards of education and practice, but also allowed those without any medical knowledge to take advantage of weak licensing laws and sick individuals who sought unconventional methods of treatment. These “quacks,” so-called doctors who capitalized on their clientele’s gullibility, invented instruments, techniques, and remedies that would cure all kinds of illnesses from consumption to epilepsy to infant irritability. In “Device Quackery in America,” James Harvey Young asserts that some empirics were simply greedy and exploited the popularity of modern scientific advancements of electricity and magnetism by creating devices like the “Health Jolting Chair” and the “Electric Belt,” which promised instant relief from pain. They successfully benefitted from public fascination and curiosity with these cure-all gadgets and drugs. However, not all individuals selling nostrums were doing it only for profit. Mrs. Joe Person, a famous musician and patent medicine entrepreneur, genuinely believed that her Native American herb remedy could cure scrofula, as it did for her daughter. However, "well-established" physicians refused to take her seriously, as the male-dominated medical industry doubted the abilities of a woman as well as the true efficacy of homeopathic remedies. 

Nonetheless, by 1906, the patent medicine industry was enormous, as it generated over $80 million annually (Holbrook 4). By filling up the pages in newspapers, journals, and almanacs, nostrums were advertised heavily in local communities across the U.S. and appealed to the masses, for they promised to act as a panacea for common maladies afflicting all Americans. Little did they know, a vast majority of these nostrums comprised of high alcohol content, ranging from 94 proof up to 172 proof, as well as excessive percentages of drugs like opium and cocaine. They were immensely popular not only through the power of advertising but also due to their addictive chemical nature, for a strong dash of morphine temporarily relieved pain for many hard-working men and women and knock out crying, sick children. As expected, the conflict between homeopathic remedies and the professional community was at an all-time high, as the latter feared that alternative medicine was undermining their authority. American medicine itself was in a state of "in-betweenness," as doctors argued amongst themselves about the standards of their field and how to go about professionalizing medicine. Many physicians sincerely wanted to improve their patients' daily lives and health but felt limited by the presence of "quack" doctors and nostrums that defamed their legitimacy and efficacy. 

Fortunately for these medical professionals, several Americans knew that much of proprietary medicine was a sham and sought to expose its quackery. A muckraking journalist, Samuel Hopkins Adams, was commissioned by Collier’s Weekly to do an exposé on the patent medicine industry. Published on October 7, 1905, “The Great American Fraud” unveiled these evils and accused the quack doctors of deceiving “Gullible America” into swallowing “huge quantities of alcohol, an appalling amount of opiates and narcotics… and, far in excess of all other ingredients, undiluted fraud” (Adams 3). He took particular aim at the catarrh curing business and its most popular remedy, Peruna, concocted by Dr. Samuel Brubaker Hartman. The physician profited enormously from its success by first and foremost defining catarrh as the root of most, if not all, diseases. Pneumonia was the catarrh of the lungs; chronic indigestion, catarrh of the stomach; cancer sores, catarrh of the mouth. Advertisements claimed that Peruna led “the world as a remedy” of this illness and printed pages of testimonials from notable local leaders praising it as “a cure for the almost universal complaint of catarrh” (The Times Ad). Adams, however, uncovered the true composition of Peruna, which was a mixture of half a pint of 190 proof spirits, 1.5 pints of water, a flavor cube, and a little burned sugar for color. Even Dr. Hartman freely admitted that no drugs could cure disease. Rather, “the belief of the patient in Peruna, fostered as it is by the printed testimony, and aided by the ‘gentle stimulation,’” produced good results (Adams 13). Adams also released an official document of the U.S. Department of the Interior, Office of Indian Affairs, which prohibited the sale of Peruna on Native American reservations because “as an intoxicant, it [had] been found too tempting and effective” (14). This proved that daily consumption of Peruna was the “first step in the making of a drunkard or drug fiend” (16). 

Adams’ muckraking exposé on the quackery of most homeopathic remedies had a profound effect on the public. It uncovered the actual ingredients of popular drugs like Peruna, which mainly consisted of alcohol, and of other nostrums that contained addictive narcotics like cocaine and heroin. Ordinary Americans had no idea that the medicine from their kitchen cabinets was composed of substances that they explicitly considered immoral. No respectable Christian mother would feed her baby whiskey and morphine, but thanks to Adams’ report, the public became immediately concerned for the physical and moral welfare of their families and children. As Young argues in The Toadstool Millionaires, more Americans caught the reform spirit of sensational journalism and began to adopt the language of Progressivism. The general public slowly began to realize how impure drug products implicitly indicated big business’s suppression of individual freedom and health. Industries like that of patent medicine refused to take the American’s welfare into consideration, and in doing so, they had harmed the well being of public health and morality. In addition, illustrations like "Death's Laboratory" and "Death's-Head Doctors" further established the idea that nostrums inflicted the ultimate harm on society, death itself, and caused the public to fear patent medicine as a source of human demise. 

Another muckraking reporter who had a profound effect on the passage of the food and drug act was Upton Sinclair. Dedicated to “the workingmen of America,” The Jungle was published in 1905 in order to condemn the “ruthless powers of capitalistic industrialism” and the grim conditions of the Chicago meatpacking industry (Duvall 5). Sinclair denounced the corrupt leaders of the “beef trust” for taking advantage of the working class and forcing them to toil in horribly unsanitary factories, filled with “rivers of hot blood, and carloads of moist flesh, and rendering-vats and soap-caldrons, glue-factories and fertilizer tanks, that smelt like the craters of hell” (Sinclair 328). Investigating undercover for months in the Chicago stockyards, Sinclair wrote the novel to raise public sympathy for organized labor and socialism, but instead hit the public “in the stomach” and helped expedite the passage of the bill (Kantor 1205). 

However, the most important person behind the enactment of the food and drug law was Dr. Harvey W. Wiley, considered the “Father of the Pure Food and Drug Act.” In 1902, Congress commissioned the Chief Chemist of the Department of Agriculture to study the effects of food preservatives on a group of human subjects, dubbed the “Poison Squad.” As expected, Dr. Wiley discovered that food additives, like sodium benzoate, were harmful especially when gradually accumulated in the human body, and that federal regulation was necessary in order to protect the public from the dangers of these chemicals. The Progress wrote an editorial about “the man behind the gun in the determined fight made by the government to regulate the preservation of food-stuffs,” who eventually became head of the Bureau of Chemistry, now the Food and Drug Administration (Progress 91). It supported Dr. Wiley’s push for food regulation and reform because the editorial staff also believed that the use of chemical preservatives would allow the manufacturer to sell spoiled goods without getting caught. Reducing the food value by employing “loose methods” and adding chemicals insulted not only the health of the public, but also the daily experience of the “good housewife,” who endeavored to prepare food the natural way. Thus, the editors of Progress defended Dr. Wiley and his campaign to preserve the purity of food because it was essential to the physical and emotional well-being of Americans. 

             Like Dr. Wiley, other physicians and scientists became aware of their potential influence on federal policies regarding public health. However, because they had been so far a disintegrated group of individuals, they had yet to act upon their ability to impact American society. By the 1890s, physicians from different medical institutions, e.g., universities, licensing agencies, and professional associations, all had common aims to upgrade the profession’s standards and develop fields of specialized medicine (Stevens 55). In doing so, the medical community actually became a united group of trained, knowledgeable physicians who demanded more respect and political power. Regardless, it needed to subdue suspicion of “a good many Americans [who] were still dubious of laws which seemingly gave a monopoly to physicians and lawyers” (Duffy 294). Furthermore, the problem of quackery still plagued medical licensing boards, for it was too difficult and expensive to litigate against fraudulent doctors. A way in which the medical community mobilized together was their participation in the Progressive Movement and its push to improve and reform American society as a whole. By the turn of the century, the American Medical Association, the largest organization of physicians in the country, began a campaign against “the proprietary evil that existed within the medical profession [and] the more widely spread evil of patent medicines and quackery” (AMA 7). It allied with muckraking reporters like Adams by reprinting and disseminating their articles in tens of thousands of booklets to the public. The AMA also published its own reports on the necessity of the Pure Food Bill in the Journal of the American Medical Association and effectively lobbied officials in the federal government. Because of their close relationship with the Progressives, the medical profession gained not only stricter legislation banning “nostrums and quackery,” but also began to establish itself as a politically and socially influential group of individuals that cared about the well-being of all Americans. The movement helped establish professional standards and codes of ethics for the physician and nurtured a sense of skilled elitism and exclusivity amongst credentialed doctors.

            Lastly, the public itself had a vested interest in the passage of the Food and Drug Act. When Americans read Adams’ series of articles exposing the fraudulence of the patent medicine industry and Sinclair’s sensational novel on the evils of the meatpacking industry, they were simply stunned with the “horrible and almost unbearable details” of the production of everyday goods (Sinclair). Most people had no idea that their beloved Pinkham’s Vegetable Compound, a household staple, contained high doses of liquor; neither did they know that factories would use various chemical additives that were detrimental to the human body. Even despite these exposés, the country knew that something was wrong. In The Pure Food, Drink, and Drug Crusaders, Lorine Goodwin claims that the public understood that the “unusually rapid deterioration in the quality of readily available food, drink, and drugs” had to be a principal cause for physical and moral decay (Goodwin 41). Nineteenth century women in particular were concerned with the poor quality of consumer goods, and out of simple necessity and responsibility, they organized to combat the threat to their families and communities. As they “joined hands to work for better homes and for better care of children,” female reformers encouraged others to join the crusade against adulterated food, drinks, and drugs (40). They argued the importance of a national pure food law, as good food meant a good home: “The hope of the country is in the home; the power here comes from food. Women have a hard problem, but they will master it, when once they see and realize the danger which is lurking in the adulteration of the materials with which they strive to built, rebuild and strengthen the physical bodies of those they love and live for” (MacBride 364). By equating the virtue of the home with the purity of consumer goods, Progressive activists, a majority of whom were homemakers, devoted endless hours to their local clubs, unions, and leagues and demanded unadulterated, safe products for their families. The growing need to protect society from these health threats prompted many women to join the pure food, drink, and drug crusade and help pass the groundbreaking piece of legislation. 

            Once the Pure Food and Drug Act passed on June 30, 1906, the nation finally achieved some form of federal regulation on food and drug products. It banned the commerce of any adulterated or misbranded food, drink, or drug and prohibited the manufacturer from misrepresenting the ingredients of the product. Producers also had to specify the content and amount of certain dangerous drugs. The law did have quite a few limitations, such as the lack of funding guidelines and the failure to address sanitary working conditions, but at the time, it was lauded as “a monumental piece of work” ever passed by Congress (Goodwin 256).

           The danger that impure food and drug products presented to the human body was undeniable. With sick babies to epileptic individuals unknowingly consuming large amounts of alcohol, morphine, and/or cocaine, quack medicine not only caused drug addiction but also worsened the health of sick Americans. Contaminated food contributed to the deterioration of public health as well. This threat to the individual body of the American signified as a larger threat to the body of all Americans, the nation itself. Thus, whatever was detrimental to the health of individual bodies also afflicted the health of the country. Physical deterioration was synonymous with moral decay as well, for they were “a tightly knit series of causes and effects.” The slum dweller could not “remain a productive, churchgoing member” for long because the conditions in which s/he lived in “soon brought disease, depressed vital energies, and, inevitably, lowered the ‘moral tone’ as well” (Rosenberg 114). The parallelism of physical illness and moral degradation seemed obvious to most Americans in the nineteenth and early twentieth century. Hence, low quality food and drugs would cause poor bodily and moral health in each citizen as well as the nation as a whole. Many groups of individuals recognized this danger to society, most notably the muckrakers, Progressive activists, and medical professionals, and worked together to combat problems created by industrial capitalism and lack of government oversight. Whether they did so consciously or not, they attempted to unite the American public with the universal commonality of health and based this “core truth” on democratic principles of fairness and inclusion. Thus, the 1906 Pure Food and Drug Act was a tool that allowed many Americans to cooperate together in improving their social conditions and thus generated a more egalitarian, middle-class American identity. Although several important groups were not included, like African Americans and certain immigrant communities, the fight for better consumer goods pushed the United States in the path towards establishing a national standard for society and moving beyond the liminal stage of “in-betweenness.”