Promoting passion in book collecting
By the time Harvey & Co began marketing Sir Astley Cooper’s Vital Restorative in 1863, the nostrum’s namesake had been dead over two decades. But renowned surgeon Sir Astley Cooper was an ideal name to evoke in the intensely competitive market of patent medicine; simultaneously violent and compassionate, Cooper had earned both fame and fortune as he revolutionized the profession of surgery. Cooper was also suspicious of patent medicines and certainly never would have lent his name to one!
Patent medicines originated in England, where physicians who provided medical care to the royal family were granted “patents of royal favor” for their medicinal compounds. One of the earliest patents was for Anderson’s Pills, which was purportedly made from a formula procured in Venice by a Scotsman who later claimed to have been a physician to King Charles I. But it wasn’t until the eighteenth century that the patent medicine industry exploded. It was an era of both intense superstition and burgeoning enlightenment, a time of scientific exploration and systematic knowledge-building.
Nevertheless, much medical knowledge was still based on unproven theory.The Greek physician Galen’s theory of the four humours (blood, phlegm, black bile, and yellow bile) remained quite influential, and medications designed to bring the body’s humours back into balance were called galenicals. Though sixteenth-century chemist Paracelsus refuted Galen’s theories–and even publicly burned his works–they maintained a hold until well into the nineteenth century.
Meanwhile it was commonly assumed that the more noxious a remedy, the more efficacious it would be. Three London hospitals published a dispensary that included ingredients like dried horses’ hooves and wood lice. Robert Boyle, usually forward thinking, advocated remedies that, as Oliver Wendall Holmes put it, contained “most of the substances commonly used as fertilizers of the soil.” Indeed, using dung and urine as ingredients was quite common; famous Puritan diviner Cotton Mather devoted an entire chapter to the therapeutic properties of human and animal waste.
It should be no surprise, then, that patent medicine (which, by the eighteenth century seldom actually had patents) often contained a whole host of substances…not all of them safe for human consumption. Venice treacle, also called theriaca, reportedly contained over sixty ingredients. Numerous patent medicines contained copious quantities of alcohol, while others contained morphine, opium, and cocaine. In some cases, these compounds were prescribed to children with fatal results.
Why were people so willing to embrace quackery and chicanery? Quite simply, medical care was in short supply. By 1784, deaths outnumbered births in London. Rural peasants were also migrating to the city in droves, pushed off their farmland by the enclosure movements. Despite this population boom and the clear need for more medical professionals, the London College of Physicians refused to admit new members. The organization also discouraged laboratory work, so physicians possessed about the same knowledge as laypeople. Thus people sought medical care wherever they could find it, which often meant they got care from surgeons (then more like barbers), apothecaries, traveling healers, or peddlers of the latest patent medicines. And surgery was often a grisly proposition, so people were likely to seek alternative treatments, even if their curative powers were dubious.
It was in 1784 that Sir Astley Cooper entered the medical profession. It proved a fortuitous time to be a surgeon, though Cooper didn’t immediately embrace the profession. Born in Norfolk in 1768, Cooper had an unusual upbringing. His father, the local minister, was known for his vanity: the family showed up to church every Sunday in a coach and four, even though they lived right next door. Cooper’s mother, Maria Susannah Cooper, was an author of popular epistolary novels in the sentimental tradition of the era. The family lived well.
Young Cooper was apprenticed to a local farming family. An apocryphal story holds that Cooper saw his foster brother run over by a cart. He placed pressure on the boy’s femoral artery until the surgeon arrived, saving the boy’s life–and spurring his own interest in surgery. In reality, every surgeon was otherwise occupied, and the boy bled to death. By all accounts, Cooper exhibited little interest in the boy’s anatomy (or his death, for that matter). A career in surgery would be an unusual one for a boy of Cooper’s background. Surgeons weren’t held in high esteem; the barber often also acted as surgeon, and surgeons generally lacked the university training that physicians had.
Thus Cooper took the next step in his surgical career not out of interest but out of expediency. Denied the military position he’d desired, Cooper fell back on nepotism. His uncle William Cooper was a surgeon at Guy’s Hospital in London, and it was decided that young Cooper would apprentice under his uncle. Cooper was all but enthusiastic. He had virtually no interest in the practical or intellectual attributes of surgery. And had Cooper been living with his uncle, his surgical career would likely have ended before it even began.
But Cooper was living with Henry Cline, another Guys Hospital surgeon who was known for his radical politics. The Cline home was frequently filled with liberal agitators and religious dissenters. Cooper was swept away with their ideals and soon became an advocate for democracy. Softened by the boy’s enthusiasm, Cline took Cooper under his wing and endeavored to reverse his professional apathy. One day, when Cooper skipped his dissection class, Cline showed up at home with a human arm. He tossed it on the table in front of Cooper and demanded that the boy dissect it on the spot. Something about the experienced awakened Cooper’s interest in anatomy and surgery, because from that point forward he tried to dissect something every day.
As a young surgical apprentice, Cooper didn’t have ready access to dissection subjects. He took to stealing his neighbors’ pets–and corpses. Cooper had a voracious appetite for anything related to anatomy and physiology. He attended lectures by famous surgeon John Hunter twice in consecutive years. After the second lecture, Cooper criticized Hunter for changing his opinions from one year to the next. Hunter replied that he hoped so, reminding Cooper that opinions may change with thorough investigation and that scientists should be open to adapting to new knowledge.
Soon Cooper’s surgical career was blossoming. He also continued to involve himself in radical politics. In 1791, Cooper married a woman from a wealthy family. She shared his political ideals, and the following year the couple took their honeymoon in revolutionary France. The choice illustrated their idealism and Cooper’s dedication to his work. Though the couple enjoyed the culture of France, Cooper also took time to tour French hospitals, study in dissecting rooms, and attend political addresses at the National Assembly. As the French Terror escalated, Cooper found plenty of opportunities to observe complicated surgical cases…and to steal a few body parts. The couple barely escaped France with their lives, and they audaciously brought with them a collection of body parts that would be the start of Cooper’s anatomical collection.
Cooper returned to London poised for an excellent career. The charismatic and attractive young surgeon had established a network of body snatchers to supply him with bodies to dissect. He’d also already developed a curved needle for operating on aneurysms. (He even hired people to follow his patients after their procedures and procure their bodies if they died.) And most importantly, thanks to institutional nepotism, Cooper would presumably inherit his uncle’s position at Guys Hospital when his uncle retired. But when that time came in 1800, Cooper’s uncle vehemently opposed his nephew’s taking the post. He objected to Cooper’s liberal politics. Faced with the forcible end of his career, Cooper had no choice but to publicly renounce his political views.
After assuming his position at Guys Hospital, Cooper developed a surgery to treat deafness that involved piercing the tympanic membrane in patients with obstructed Eustacian tubes. Fifty years earlier, William Cheselden had asked for permission to perform the same surgery on criminals condemned to death and was denied. But Cooper didn’t ask permission. He just performed the surgeries, documented the results, and presented his findings. That take-no-prisoners approach probably helped Cooper to make a number of anatomical discoveries and originate new procedures. For example, he was the first to tie of a carotid artery and the first to perform a ligation of the abdominal aorta.
Unlike other surgeons of the era, Cooper was hardly turned off by violence or inflicting physical pain. On the contrary, he was known for performing procedures without permission or warning because he believed it was the surgeon’s responsibility to force submission if the patient was too squeamish or frightened. While this seems like a particularly callous outlook, it was also humane in many cases. Cooper had seen plenty of patients refuse necessary surgeries, only to suffer and die. Thus Cooper is remembered for his embodiment of a violent and odd mercy.
Cooper went on to advise Parliament on the Anatomy Act of 1832, which set out provisions for surgeons to legally obtain bodies for dissection. He also operated on King George IV’s sebaceous cyst, earning a baronetcy. Cooper would be the sergeant-surgeon to George and also to Queen Victoria. He earned the Royal Society’s Copley Medal, the organization’s most prestigious award. Cooper also made a lasting mark on surgical education, elevating the prestige of the profession. His most famous student, John Keats, gave up surgery but left behind notes from one of Cooper’s lectures.
Cooper was undoubtedly an esteemed personage in England, not only during his lifetime but also for decades after he’d passed away. The Bronte children are said to have named Cooper among the greatest Englishmen of history, and the family had no personal connection to the surgeon to bias them in his favor. Modern history has largely forgotten Cooper, possibly because his nephew Bransby Cooper (also a surgeon) tried to sanitize his uncle’s life for fit Victorian morals when he wrote the great surgeon’s biography.
Cooper does leave one legacy–completely unwittingly. Always suspicious of unproven therapies and treatments, Cooper eschewed the pharmaceutical options of his day. He would not have approved of Sir Astley Cooper’s Vital Restorative, which Harvey & Co. hailed as “The only successful remedy for the removal of general, local, and nervous debility.” The drop title of the Short Account of Sir Astley Cooper’s Vital Restorative is “The Guide to Manly Vigour,” and the promotional treatise promises that the patent medicine was a sure remedy for “the forms of Indigestion and Consumption in all their varieties, resulting from secret inadvertency in youth, or from sensual excesses.” Readers were exhorted to send a urine sample and twenty pounds sterling to receive a diagnosis. Cooper himself would have viewed such claims askance, yet the proprietors of Harvey & Co weren’t worried about that; they were more interested in cashing in on Cooper’s stellar reputation.
The history of patent medicines is full of spuriously named products, but few offer such an opportunity to delve into the history of an overlooked figure in medical history as Sir Astley Cooper’s Vital Restorative.