Cramp, Arthur J.

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The Work of the Bureau of Investigation

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THE AMERICAN MEDICAL AssOCIATION'S WORK FOR CONSUMER PROTECTION 51cerning mineral salts and vitamins would be exploited to the public by manufacturerswho would not hesitate to exaggerate the qualities of their wares in order to increasetheir sales, the Committee on Foods was established to do a similar work in this field.Unquestionably this philanthropic work on the part of the American MedicalAssociation has meant vast savings in health and life, and a saving of money to theAmerican people. Much of the work of the Consumers' Research and similarorganizations is based on this pioneer work by the American Medical Association.It should again be emphasized that no manufacturer is permitted to pay one cent inrelationship to the examination of his product and that no member of the public isever charged for the information that is supplied. The money necessary to carry onthis work is made by the publications of the American Medical Association, includingprincipally The Journal of the American Medical Association.Moreover, from the first, the work of these councils and bureaus has been givenadequate support through the publicity department of the American Medical Asso-ciation, through all of its periodicals, and through the absolutely consistent refusalto accept the advertising of any products that could not meet the standards of thevarious committees and councils.It must be realized that the Food and Drugs Act protects the consumer so far asthe package of the product is concerned, but bears no relationship to advertisingseparate from the package. This arrangement has made necessary the work of thesecouncils. It is conceivable that the passage of new food and drugs legislation likethat now proposed, which plans to control claims made in advertising as well asclaims made on the package, will give the consumer the protection needed.THE WORK OF THE BUREAU OF INVESTIGATIONARTHUR J. CRAMP*The Bureau of Investigation of the American Medical Association is an outgrowthor by-product of the Council on Pharmacy and Chemistry, although the Bureau hasno connection with the Council. The Council on Pharmacy and Chemistry wasbrought into being in i9o5 for the purpose of subjecting to scientific scrutiny theinnumerable proprietary medicines that were offered to the medical profession forprescription purposes and passing on to the profession the results of such investiga-tions. As the medical profession awoke to the way in which it had been deceivedand humbugged by the exploiters of unscientific proprietaries, they began also to takean interest in those crude proprietary medicines known colloquially but incorrectlyas "patent medicines"--that is, package medicines, usually of secret composition, soldto the public for the self-treatment of self-diagnosed ailments. Repeated and in-sistent requests for information coming first from physicians and later from theaM.D., x9o6, Wisconsin College of Physicians and Surgeons. Director of Bureau of Investigation,American Medical Association. Author of Nostrums and Quackery (i92i).LAw AND CONTEMPORARY PROBLEMSpublic brought into existence the activity of the American Medical Association thatis now known as the Bureau of Investigation.Twenty-five years ago it was a rare thing for the Bureau to receive an inquiryfrom a layman. Today letters from laymen run into thousands annually. Duringthe past few years the authors of certain school and college text-books on such subjectsas General Science, Civic Science, Biology, Hygiene, etc., have incorporated in theirpublications material dealing with the nostrum evil and quackery as one of thehealth phases of community life. Some of these text-books urge the student to write-o the Bureau of Investigation for information and to obtain supplementary readingand study the books and pamphlets prepared and issued by the Bureau. Each letterreceived is answered and, whenever possible, informative material sent to its writer.In addition to receiving letters from individual laymen asking for informationabout specific nostrums or quacks, and from college and high school students seek-ing data for use in their classes, there is another phase of the Bureau's work that onehears little about, but which is having a far-reaching influence. For years thoseinterested in truthful advertising have kept in close touch with the Bureau of Inves-tigation and have sought from it information that could be obtained from no othersource. The National Better Business Bureau and affiliated local Better BusinessBureaus have been in close co6peration with the Bureau of Investigation since itsinception. Many advertising managers of newspapers and magazines seek informa-tion from the Bureau of Investigation in an attempt to keep the advertising pagesof their publications as free as possible from objectionable medical "copy." Requestsfor information from such sources come in daily. The influence that the Bureau ofInvestigation is exerting in this way will never be generally known and is appreciatedonly by those who are thoroughly familiar with its daily work.Another class from which the Bureau receives many inquiries is laymen who havewritten municipal, state, or federal officials for information that they assumed theseofficials could furnish. Instance: Some widely-advertised fake is exploited, w~e shallsay, from Chicago. A layman reading an advertisement wishes to make some in-vestigation before parting with his money, and he writes to the Department ofHealth of the City of Chicago. That department notifies him that it is not in aposition to answer his inquiry and refers the letter to the Bureau of Investigation ofthe American Medical Association, which sends the information requested, if it hassuch information-and it usually has.Again: A group of quacks is operating in a certain state and a resident of thatstate, impressed with the plausibility of the advertising but still skeptical, writesto his State Board of Health for information regarding the quacks. The boardreplies that it has no information regarding these people and suggests that thecorrespondent write to the Bureau of Investigation of the American Medical Asso-ciation. Or: A "patent medicine" swindle, national in scope, interests a layman whowrites to the federal authorities at Washington for information about it. He is toldTHE AmEICAN MEDICAL ASSOCIATION'S WORK FOR CONSUMER PROTCTION 53that they cannot give him any information but that the American Medical Asso-ciation has a department that investigates questions of this sort, and it is suggestedthat he write to the Bureau of Investigation.Then there are letters that come directly to the Bureau of Investigation frommunicipal, state and federal officials themselves seeking information on products orindividuals coming within the scope of the department's activities. Conversely, theBureau plays an important part in bringing to the attention of state and federalofficials schemes and methods that seem to be a menace to the public health, aviolation of the law, or both.The Director of the Bureau prepares articles on "patent medicines," quacks,medical fads and fakes and other phases of pseudo-medicine, and these are publishedweekly in The Journal of the American Medical Association. The material is re-printed in inexpensive pamphlet form, each pamphlet dealing with a group, such as"Consumption Cures," "Cancer Cures," "Epilepsy Cures, .... Cosmetics," etc. Morethan two million pamphlets have gone out to the general public and the medicalprofession. Later the same material is incorporated in the book "Nostrums andQuackery," of which two volumes have been issued. The first volume had twoeditions, the first edition appearing in the latter months of 1911 and the secondedition coming off the press in December, 1912. The second volume was issued inthe latter part of 1921. It is a book of some 8oo pages, containing none of thematerial that appears in the first volume, but having a comprehensive cumulativeindex giving references to articles in both volumes. It is not too much to say thatVolumes I and II of "Nostrums and Quackery" together comprise a veritableencyclopedia on the nostrum evil and quackery.In addition to the books and pamphlets, a number of educational posters, dealingwith various phases of the nostrum evil and quackery, have also been prepared.The first of these were prepared at the time that the Bureau had an exhibit at theInternational Congress on Hygiene and Demography in 1912. Health officials,recognizing their educational value, immediately began making requests for copies.As a result of this demand, many additional posters have been prepared, coveringpractically every phase of "patent medicine" exploitation and quackery. They arebeing used today at health exhibits, county fairs, state fairs, health expositions, "healthweeks," and are also used in schools and colleges.Supplementing the posters, there are a number of stereopticon slides, originallyprepared for the use of the Director of the Bureau in giving illustrated talks onquacks and nostrums. A demand for such slides on the part of physicians, healthofficials and others interested in the public health resulted in a collection of slidesbeing made, so arranged that they themselves tell the entire story ("legend slides"being interpolated between "illustrative slides") or, without the use of the "legendslides," for lecture purposes. These slides are available either for rental or purchaseat or below cost. In addition, the Director of the Bureau gives a limited number ofLAW AND CONTEMPORARY PROBLEMSillustrated talks on the "patent medicine" problem and on those cosmetics whose usemay involve some health hazard.The Bureau collects its information through (a) original investigations oftensupplemented by analytical work done in the Chemical Laboratory of the AmericanMedical Association or in other high-class laboratories; (b) data received from fed-eral sources (the Food and Drug Administration of the United States Department ofAgriculture, post-office fraud orders, Federal Trade Commission, etc.) as well asfrom state and municipal boards of health; (c) information published in technicaland other journals, both domestic and foreign and (d) reports of special commissions,etc.In brief, the Bureau of Investigation is a clearing house for information on thenostrum evil, quackery and allied subjects. It is doing a work that is done bypractically no other agency, a work that theoretically belongs to the state, using theword "state" in its broadest sense. Unfortunately, the exigencies of politics makeit well-nigh impossible for health agencies to tell unpleasant truths when these in-volve huge vested interests. Nevertheless, if the public's health is to be served,these truths must be told. The medical profession of America, recognizing this fact,has assumed this responsibility and is discharging it through the Bureau of Investiga-tion.Naturally, the work of the Bureau arouses widespread opposition on the part ofcertain proprietary medicine interests and of quacks and charlatans whose methodsmay be dealt with in the Bureau's articles. Such opposition not infrequently ex-presses itself in libel suits. Many such suits have been brought against the Amer-ican Medical Association, demanding amounts that total many millions. In the morethan twenty-five years of the Association's work, both through its Council on Phar-macy and Chemistry and its Bureau of Investigation, only two of the many suitsthat have been brought against the Association have come to trial. In one-thatinvolving a large "patent medicine" concern in a southern state-the suit resulted inwhat has sometimes been called a contemptuous verdict in favor of the plaintiff.The American Medical Association was assessed one cent damages and the plaintiffhad to pay his own costs. In the other case, that of an individual exploiting analleged cure for cancer who sued the Association because he had been called a quack,the jury decided that the American Medical Association was quite justified in itscharacterization.'"Both these cases were tried in the federal courts, the first in Chicago and the second at Davenport,

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The Work of the Bureau of Investigation

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