Medical Misogyny and Marketing Addiction: How the Nineteenth-Century Patent Medicine Industry Exploited Women

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Today, nearly half of young American women report negative interactions with healthcare providers. Research suggests that these experiences contribute to women pursuing alternative medicines at higher rates than men.^[1] In the last decade, therapeutic ketamine has surfaced as a novel alternative to mainstream medical treatment for a variety of physical and mental health conditions, with hundreds of for-profit clinics emerging nationwide. Virtually all of these clinics advertise “off-label” ketamine as a cutting-edge treatment for women with historically mistreated conditions like endometriosis, osteoporosis, postpartum depression, and premenstrual dysphoric disorder, among others. While some research supports ketamine’s short-term antidepressant effects, there is little evidence supporting its safety or efficacy in treating the aforementioned conditions.^[2]

Like those pushing ketamine today, hawkers of commercial treatments in the past also exploited medical misogyny, or a systemic bias against women within healthcare institutions that leads to misdiagnosis and dismissal of symptoms. The rise of America’s patent medicine industry in the nineteenth century offers an early illustration of this pattern. As nineteenth-century physicians misinterpreted and mistreated women’s pain, patent medicine companies intervened with promises of relief. They advertised ineffective, addictive preparations that led many women to opiates and made addiction an increasingly gendered problem.

From Care to Capitalism

Throughout the seventeenth and early eighteenth centuries, women were entrusted with the health of their families. In this capacity, women sometimes administered opium to help family members manage pain and nervousness. During the early 1800s, as the United States began to develop its medical infrastructure, demand for opium increased and became a staple in nearly every physician’s bag.^[3] These physicians were usually white, middle-class men who built their practices by attending to white women of comparable social standing. Unlike men, who were expected to endure their afflictions without pain medication, white women were generally regarded as delicate and were therefore encouraged to seek medical care.^[4]

This assumption, combined with the limited understanding of many physical and psychological conditions in the nineteenth century, contributed to frequent misdiagnoses. Physicians mistakenly attributed unrelated complaints of debilitation, chronic pain, and psychological distress to uterine disease.^[5] Sexual taboos aimed at preserving white women’s purity often hindered the research needed to investigate these complaints and physicians turned to opiates for symptomatic relief.^[6] By 1900, middle- and upper-class white women made up nearly two-thirds of people with opiate use disorders. While many historians attribute this to professional overprescription, there was another significant agent of addiction: the patent medicine industry.^[7]

Over the course of the nineteenth century, American pharmacy moved away from its apothecary model, and pharmaceutical companies and entrepreneurs came to produce most medicinal preparations in the form of patent medicines.^[8] The term “patent medicine” itself originated in seventeenth-century England, where the crown issued patents granting inventors a monopoly over a specific formula. Over time, it was adopted for similar mass-produced preparations in the United States. This term helped sellers evoke a sense of official endorsement, although manufacturers usually only registered a trade name with the U.S. Patent Office and not a list of ingredients.^[9] Most patent medicines contained opium and alcohol, which manufacturers were not required to disclose before the 1906 Pure Food and Drug Act, and could be purchased in stores or by mail-order without a prescription.

Patent medicine companies realized that accessible products with specific names and purposes would appeal to middle-class white women, who were conditioned to see themselves as perpetually unwell but often misdiagnosed by physicians. As a result, women’s health became a specific industry branch, and patent medicine companies were able to advertise their unique products without restriction. Unrestricted advertising abilities gave companies an additional advantage over physicians, as commercialism was considered unscrupulous by members of the medical profession.^[10] Companies eagerly exploited this advantage, and medical misogyny, in nationwide campaigns that promoted addictive nostrums for women.

Dr. Pierce’s ‘Favorite Prescription’

In the 1800s, many popular patent medicines for women, including Lydia Pinkham’s Vegetable Compound and Piso’s Tablets, ran such campaigns. However, campaigns for Dr. Pierce’s “Favorite Prescription” were exceptionally exploitative and prolific.

Dr. Ray Vaughn Pierce, a Buffalo physician turned businessman, abandoned the belief that physicians should not advertise when he left formal medicine. By the turn of the century, he had become the nation’s leading patent medicine seller. His “Favorite Prescription” – a tincture of opium, alcohol, and digitalis – claimed to be the “most potent specific for all those chronic weaknesses and diseases peculiar to women.”^[11]

Although Pierce had been a doctor and used that label to market his product, his ads leveraged medical misogyny by portraying physicians as incompetent in treating women. An 1886 newspaper ad titled “The 13 Useless Doctors” opened with a poem about a sickly woman whose symptoms bewildered thirteen physicians.^[12] It offered the “Favorite Prescription” as the solution to her suffering and an alternative to repeated, fruitless medical examinations.

Advertising testimonials – usually of unclear origin and questionable authenticity – were also used in marketing. One came from a woman referred to as Mrs. Morgan, whose “uterine troubles” exhausted the care of three separate physicians but seemed “perfectly cured” with consistent doses of the “Favorite Prescription.” If Mrs. Morgan was real, though, she likely only seemed “cured” because the opiates and alcohol masked her pain.^[13]

Such claims eventually raised questions about the product’s ingredients as knowledge of narcotic addiction grew during the late-nineteenth and early-twentieth centuries. Medical treatises like Dr. Frederick Hubbard’s 1881 The Opium Habit and Alcoholism urged physicians to avoid opium, and journalists urged consumers to avoid patent medicines.^[14] In 1887, the “Favorite Prescription” began to advertise as a “perfect specific” rather than a “potent specific,” signaling that the medicine was free of dangerous ingredients. Ads also asserted the “Favorite Prescription” was “purely vegetable” and “perfectly harmless,” but critics remained unconvinced.^[15]

In 1904, the Ladies’ Home Journal published an analysis of the “Favorite Prescription” by the German chemist Fritz Haber. It revealed significant traces of digitalis, opium, and alcohol. Editor Edward Bok criticized women who took the medicine, stating they had “no moral right” to take or administer a medicine without knowing its contents.^[16] Fearing the impact on sales, Pierce sued the journal. It printed a retraction that claimed Haber’s analysis was made in 1879 and that new analyses by Pierce’s own chemists revealed no such traces.^[17] In such disputes, companies continued to profit from women’s medical repression while journalists denounced their efforts to pursue alternative care options.

These debates were also part of a national push for federal food and drug regulations that intensified during the Progressive Era.^[18] Despite being targeted by drug companies and journalists, women played an important role in food and drug reform movements. Before 1906, the Women’s Christian Temperance Union’s Anti-Narcotics Department focused on women’s use of opium-based patent medicines, while the General Federation of Women’s Clubs International coordinated a “massive letter-writing campaign” for regulatory legislation.^[19] Their efforts contributed to the passage of the 1906 Pure Food and Drug Act, which required manufacturers to list the exact percentage of any habit-forming drugs. The law was a major victory; nevertheless, loopholes allowed exploitative practices like false therapeutic claims to persist.

Rebranding a History of Oppression

The growing popularity of ketamine clinics today shows that these gendered patterns of exploitation and addiction are far from history. One Florida clinic promotes its services as an effective treatment for a variety of gendered medical issues including hypoactive sexual drive disorder, post-mastectomy pain syndrome, and sexual abuse trauma. Like Dr. Pierce, the clinic positions these therapies as alternatives for women for whom “treatments within the scope of traditional medicine have proven ineffective or harmful.”

Such rhetoric is risky due its exploitative nature and lack of scientific backing. In 2024, an anonymous source from the UK – where therapeutic ketamine has also recently gained popularity – reported feeling duped after costly ketamine treatments failed to alleviate her post-menopausal anxiety. Speaking to Women’s Health UK, she stated, “I cringe because I feel like they must have seen me coming, in their fancy clinic with their puff pieces in the press.” Rates of ketamine addiction in both the UK and the US have increased dramatically since the mid-2010s, perhaps partially fueled by misleading discourse surrounding the drug.

Recently, in the US, the musician Halsey and social media influencer Jen Affleck have spoken publicly about their experiences with ketamine therapy for postpartum depression and to assist couples therapy. Like Edward Bok, we may feel inclined to criticize these women. But historical perspectives remind us that these products become popular because they offer women a chance to find agency and relief within a medical industry that consistently fails to value or investigate their pain.

While ketamine providers seem to promise women agency, many end up reproducing the very failures they claim to address. Motivated by financial gain, they promote a one-size-fits-all, pseudo-scientific intervention, often without adequately investigating symptoms or acknowledging addictive potential. The high cost of treatment further excludes working women and women of color, who are most impacted by sexist and racist medical orthodoxy. This complicated situation reminds us that, since the rise of the patent medicine industry, it has been difficult to discern which therapies genuinely support women and which merely offer a rebranding of oppressive, ineffective, and often dangerous practices. Perhaps our criticisms are best directed, not at women seeking relief, but at the many architects of exploitation.

Notes

1. M. Alwhaibi and U. Sambamoorthi, “Gender differences in the use of Complementary and Alternative Medicine among Adults with Multiple Chronic Conditions,” Value in Health 18, no. 3 (2015): 90. ↑
2. Orly Lipsitz, Roger S. McIntyre, Nelson B. Rodrigues, Yena Lee, Danielle S. Cha, Hartej Gill, Mehala Subramaniapillai, Kevin Kratiuk, Kangguang Lin, Roger Ho, Rodrigo B. Mansur, Joshua D. Rosenblat,“Intravenous ketamine for postmenopausal women with treatment-resistant depression: Results from the Canadian Rapid Treatment Center of Excellence,” Journal of Psychiatric Research 136 (2021): 451; Gilmar Gutierrez, Melody J.Y. Kang, Gustavo Vazquez, “IV low dose ketamine infusions for treatment resistant depression: Results from a five-year study at a free public clinic in an academic hospital,” Psychiatry Research, 335 (2024). ↑
3. Steven R. Kandall & Wendy ​​Chavkin, “Illicit Drugs in America: History, Impact on Women and Infants, and Treatment Strategies for Women,” Hastings Law Journal 43, no. 3 (1992): 616; Elizabeth Kelly Gray, Habit Forming: Drug Addiction in America, 1776 – 1914 (Oxford University Press, 2023), 23. ↑
4. Ibid., 6. ↑
5. Carroll Smith-Rosenberg and Charles Rosenberg, “The Female Animal: Medical and Biological Views of Woman and Her Role in Nineteenth-Century America,” The Journal of American History 60, no. 2 (1973): 334-5. ↑
6. Ann Douglas Wood, “‘The Fashionable Diseases’: Women’s Complaints and Their Treatment in Nineteenth-Century America,” The Journal of Interdisciplinary History 4, no. 1 (1973): 28, 30; Gray, 32. ↑
7. Stephen R. Kandall, Substance and Shadow: Women and Addiction in the United States (Harvard University Press, 1996), 3. ↑
8. Elizabeth Siegel Watkins, “From History of Pharmacy to Pharmaceutical History,” Pharmacy in History 51, no. 1 (2009): 4. ↑
9. Ibid.; Bryan Denham, “Magazine Journalism in the Golden Age of Muckraking: Patent-Medicine Exposures Before and After the Pure Food and Drug Act of 1906,” Journalism & Communication Monographs 22 no. 2 (2020); Gray 176. ↑
10. Nancy Tomes, Remaking the American Patient: How Madison Avenue and Modern Medicine Turned Patients into Consumers (University of North Carolina Press, 2016), 20, 26, 28. ↑
11. “Dr. Pierce’s ‘Favorite Prescription,’” The Indianapolis Journal, April 7, 1886. ↑
12. “The 13 Useless Doctors,” The Milan Exchange, February 20, 1886. ↑
13. Ibid. ↑
14. Frederick H. Hubbard, The Opium Habit and Alcoholism (A.S. Barnes & Co, 1881), 1-2. ↑
15. “Words of Praise,” The Savannah Tribune, April 6, 1887. ↑
16. “The Patent-Medicine Curse,” Ladies’ Home Journal, May 21, 1904. ↑
17. “Doctor Pierce’s ‘Favorite Prescription’ a Retraction,” Ladies’ Home Journal, July 1904. ↑
18. “The Food and Drug Administration: the Continued History of Drug Advertising,” Weill Cornell Medicine Samuel J. Wood Library, accessed November 20, 2025, www.library.weill.cornell.edu/food-and-drug-administration-continued. ↑
19. Arnold Jaffe, “Addiction Reform in the Progressive Age: Scientific and Social Responses to Drug Dependence in the United States, 1870—1930,” Order No. 7824401, University of Kentucky, 1976, 103; “General Federation of Women’s Clubs International,” Britianica, accessed November 21, 2025, www.britannica.com/topic/General-Federation-of-Womens-Clubs-International. ↑

 

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Featured image caption: Advertisement headline for Dr. Pierce’s ‘Favorite Prescription’ features a poem entitled “The 13 Useless Doctors.” (“The 13 Useless Doctors,” The Milan Exchange, February 20, 1886)