The Newsmagazine of Long Beach Island and Southern Ocean County

By Rick Mellerup | on August 03, 2022

It’s a tough time for circuses, as evidenced by the Ringling Bros. and Barnum & Bailey Circus giving up the ghost in 2017 due to dwindling attendance, animal rights protests and high operating costs.

The circus isn’t dead, but it’s heyday is clearly over. However, a cousin of the circus, the medicine show, is not only alive, but growing, albeit in a different form.

Medicine shows roamed the country in the 19th century. They would feature acts such as acrobats, magicians, ventriloquists, strongmen, trick shooters and freak shows to attract a crowd, who usually could attend for free. Medicine shows made their money from a salesman, almost always claiming to be a doctor, selling his “miracle elixirs” during breaks in the entertainment.

The elixirs promised to cure a wide variety of ailments, with a few shills in the crowd offering up miraculous testimonials.

The “patent medicines” would often make people feel immediately better. No wonder, considering they typically had a high content of alcohol, opium or cocaine. They didn’t cure diseases.

A good example of a cure-all elixir was Clark Stanley’s Snake Oil Liniment. According to an advertisement, his liniment could cure “rheumatism, neuralgia, sciatica, lame back, lumbago, contracted cords, toothache, sprains, swellings, etc.” Wait, there’s more – “For frost bites, chilblains, bruises, sore throat, bites of animals, insects and reptiles.” It was declared “good for man and beast,” and it claimed “immediate relief.”

The oil from Chinese water snakes has been used for centuries in Chinese traditional medicine to treat joint pain. But the Bureau of Chemistry, the precursor of the Food and Drug Administration, tested Stanley’s liniment in 1916. It contained no snake oil, but mineral oil, and a few other cheap and easily found ingredients. The bureau found the liniment to be drastically overpriced and of limited value and Stanley soon faced federal charges, for which he pleaded nolo contendere and received a fine.

The demise of the traveling medicine show was caused by new entertainment options such as vaudeville, motion pictures and radio. And by the early 20th century, reliable commercial pharmaceuticals were produced on an industrial level, giving miracle elixirs a run for their money. A very few medicine shows survived into the 1950s, but the arrival of TV rang their death knell.

Or did it? Why would quacks travel the country looking for rubes when they could reach millions on TV or online? You’ve likely seen plenty of ads for supplements promising weight loss, increased energy, relief from pain and more.

Like the old-time medicine shows, the ads often feature people who rave about their experiences with the products, including B-list celebrities – don’t you think they’re getting paid like the shills were? But ads for supplements have some modern twists.

Many of the ads claim their product has been clinically tested, an easy claim to get away with. After all, how many customers are going to demand the test results? There is no official definition or regulation of the term “clinically proven.” Prescription drugs have to undergo rigorous testing before being approved by the FDA; that’s not the case with supplements. Indeed, the FDA does not have the authority to approve dietary supplements for safety and effectiveness, or to approve their labeling, before the supplements are sold to the public. Talk about “let the buyer beware.”

Another claim that’s sure to pop up in many ads for supplements is “made from all natural ingredients.” It turns out plants are chock-full of chemicals, and scores of drugs and medicines derive their active ingredients from plants. Many, though, are poisonous, even deadly. Natural is no guarantee of safety.

Some supplements advertise exotic ingredients. Remember those Prevagen ads that said the supplement was powered “by an ingredient originally discovered in jellyfish”? That ingredient turns out to be apoaequorin.

Here’s what the Alzheimer’s Drug Discovery Foundation said about the drug:

“Serious doubts about apoaequorin are raised by a chemical structure that is most likely broken down in the gut before reaching the brain.”

I’m not saying Prevagen is dangerous. Even the foundation didn’t do that.

But is it effective? The Federal Trade Commission and the New York state attorney general didn’t think so and filed a lawsuit against the makers of Prevagen, charging them with “making false and unsubstantiated claims that the product improves memory, provides cognitive benefits, and is ‘clinically shown’ to work.”

Supplement manufacturers must list a product’s ingredients on their packaging. Let’s look at the label on another big-selling supplement, 5-hour Energy: niacin, vitamin B6, folic acid, vitamin B12, taurine, glucuronic acid, malic acid, N-Acetyl L tyrosine, L-phenylalanine, caffeine, xitocoline, purified water, natural and artificial flavors, sucralose, potassium, sorbate, sodium benzoate, EDTA.

Whew, try checking out what all those ingredients can do and if they are safe. The kicker, though, is the caffeine. 5-hour Energy has 200 mg of caffeine packed into a 1.93-fluid ounce container, about the same amount of the stimulant in a 10-ounce cup of coffee. Caffeine’s half-life is about five hours, suggesting how the product got its name and that caffeine is carrying its load. And for about the same price as a single bottle of 5-hour Energy you can buy a 16-count package of caffeine pills!

Some supplements are simply rip-offs. Others are potentially dangerous. In 2015 a study published in the New England Journal of Medicine determined that dietary supplements send some 23,000 people to emergency rooms in the U.S. each year. The most common reasons were irregular or rapid heartbeat or chest pain. Nearly three-fourths of the ER visits were related to the use of weight-loss or energy-boosting supplements.

The problem could easily get worse. In 2019 then FDA Commissioner Scott Gottlieb wrote: “In the 25 years since Congress passed the Dietary Supplement Health and Education Act, the law that transformed the FDA’s authority to regulate dietary supplements, the dietary supplement market has grown considerably. What was once a $4 billion industry comprised of about 4,000 unique products, is now an industry worth more than $40 billion, with more than 50,000 – and possibly as many as 80,000 or even more – different products available to consumers.”

Who knows how many there are out there now, what with some people deciding to fight off COVID-19 with supplements instead of getting vaccinated?

The medicine show and its collection of nostrums never disappeared. It just moved onto television and the web.

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