The World’s First Mail Order Doctor

I have in my collection a book published in 1908 titled The People’s Common Sense Medical Adviser, by “Dr. R. V. Pierce.” It’s a modest little volume that I purchased in a used book store in Madison, Wisconsin some years ago. First published in 1875, the book was tremendously popular in its day, going through more than 80 editions with over 2 million copies printed.

“Dr. R. V. Pierce” was Ray Vaughn Pierce (1840-1914), a graduate of the Eclectic Medical Institute of Cincinnati, the center of alternative medical training in the 19th century. Pierce moved to Buffalo, where he founded the World Dispensary Medical Association, which manufactured and marketed his patent medicines and nostrums, including his Favorite Prescription, “Extract of Smart Weed.” He later founded, also in Buffalo, the Invalids Hotel and Surgical Institute. Pierce was probably second only to the legendary Lydia Pinkham (1819-1883) as a marketer of mail order nostrums. He placed advertisements for his products in newspapers across the country and plastered his ads on the sides of buildings and barns.

Mail order doctoring has a long history. One of the most famous mail order doctors was the Swiss physician, Samuel Auguste David Tissot (1728-1797). In addition to being the author of a popular medical self-help tract Avis au peuple sur la santé (Health Advice for the People), Tissot maintained a flourishing mail-order medical business. More than a thousand patients, representing a wide cross-section of society, wrote to Tissot at his home in Lausanne seeking his medical advice.

But Tissot was hardly to first doctor to open a mail order medical practice. As far as I can tell, that honor goes to the 16th century Italian surgeon and medical celebrity Leonardo Fioravanti, who began his mail order business while living in Rome in the 1550s. According to Fioravanti, the Portuguese ambassador first suggested the idea: 

The ambassador couldn’t get enough of seeing me work my cures, and with his help, every day I medicated diverse sick people various in cities of the world without even seeing them. It was enough that they wrote to me describing the nature of their illness. I would send them advice along with the most important secret remedies pertaining to their cases. Thus in every city of Italy, and even outside Italy, I treated countless sick people, and they always turned out with happy success.

Leonardo Fioravanti

Though medical consultation by mail would become commonplace by the 18th century, the practice was entirely new during Fioravanti’s time. He was looking for new and different ways to market his patent drugs and his “new way of healing”—an alternative medical system that he claimed was far superior to orthodox ways. The piazzas swarmed with healers competing with one another and with the regular doctors.  To succeed, Leonardo had to be stay a jump ahead.  His mail-order business was designed to appeal not casual urban dwellers strolling through the piazza, but literate professionals who might become buyers and readers of his books. 

Originally, Fioravanti’s mail-order business may have been intended as a way to enhance his income, but Leonardo quickly saw its potential as a means to publicize the “new way of healing.”  That must have been what motivated him to publish a selection of the letters in his book, The Treasury of Human Life (1570).  With the letters before them, Fioravanti explained, readers could learn from the experience of others and take heart, so that they might heal themselves: 

 For those who read the letters will hear about wonderful cases that have been communicated to me by various persons and will understand the many sicknesses that have been cured with our remedies; so that with the help of these things people will themselves become experts, and many that suffer from various infirmities will make up their minds to go ahead cure them with our medicaments, which are so easy to make and so profitable to use that it’s something marvelous. And if someone should be stricken by similar infirmities, in imitation of these others, he can have the courage to cure himself with our instructions, even if they find themselves in distant countries, as many have and continue to do.

Leonardo was correct: The cases are wonderful. Filippo Arcioni, the chamberlain of the Bishop of Troia (Puglia), for one, wrote from Rome to tell Leonardo about being cured of a “vile sickness” with a dose of Leonardo’s drug Dia Aromatica. Arcioni’s doctors had advised against taking the drug, warning that he would not last ten days if he followed the prescribed course, but Filippo went ahead anyway. After a light supper, he took the dose. This is what happened next:

 As I was speaking with the Monsignor, I suddenly began to feel queasy and the whole castle seemed to turn upside-down.  Suddenly, I was overtaken by a bout of vomiting so strong that I threw up my meal and along with it about ten pounds of choler and phlegm.  Among other things, I threw up a worm with a hairy head, as long as a palm and a half, which was something marvelous.  Immediately I began to feel better.

In reply, Leonardo tells Filippo that he’s pleased with the results. At the distant patient’s request, he encloses a vial of Quintessence, another of Fioravanti’s nostrums, for which Filippo paid (in advance) 12 ducats.

The letters continue with glowing reports from readers. Hercole Romani writes that while visiting Rome he noticed that all his friends were talking about Medical Caprices. Pietro Jacopo Petruccio, writing from Pesaro in 1567, proudly owning five of Leonardo’s books, which he consulted regularly to treat illnesses among members of his household.  “I showed your Medical Caprices to some physicians and they recommended against your counsel. They told me that I should be prepared to depart from this world if I used your remedies.”  Nevertheless, against the advice of his doctors, he decided to go ahead and treat himself with Leonardo’s remedy, with complete success.  “Everywhere I go,” wrote Petruccio, “in palaces, shops, and courts, I hear of your fame.” 

Although many of the letters are from physicians, pharmacists, and surgeons, most come from individuals seeking Fioravanti’s help.  In return, they sent payments, either in money or in kind.  Paolo Zanotto of Parma sent some cheese and 200 eggs in recompense for a cure for his wife’s stomach pains.  Rarely does Fioravanti refuse treatment. An exception arose when Paolo Sandrini of the village of Roccabianca, near Parma, who sends two hams and six sausages along with a request for a remedy to cure his cousin’s disorder; sadly, Leonardo wrote in reply, the ailment was “totally incurable.”  In another letter, he informs the physician Giovanni Ornaro that he cannot send his eye water because he had recently shipped his entire supply to England.

What are we to make of these letters, with their over-the-top praise of Fioravanti and their hyperbolic style? Doubtless some of the language can be attributed to the period’s deliberately flattering epistolary conventions.  Also, the letters were selected to delineate a persona and confirm the truth of the “new way of healing.” 

Could they all be merely fakes? Forgeries crafted by the masterly hand of Fioravanti himself? That would be the way of the charlatan. But the detailed descriptions they contain of places and people, as well as of events and personalities that can be independently verified, lends veracity to the letters—at least to a point.  He selected the letters in order to craft a narrative, and probably edited them as well. As always, Fioravanti was in control.

Although R. V. Pierce probably knew nothing about Fioravanti, he followed the practice—that of publishing testimonials—that Fioravanti started and which by then had become standard for the trade. Pierce’s testimonials, many from women, are equally wondrous. Here’s one example, from Miss Cleora Ottaway:

Dear Sir—I cannot praise your medicine enough for what it has done for me. Over-work at school a year ago caused suppression which would last from three to four months. I had no appetite, slept poorly, and was in a state of nervous collapse. I doctored with our home doctors but they did not do me any good so I consulted you explaining my condition and you advised me to take Dr. Pierce’s Favorite Prescription and “Golden Medical Discovery,” which I did. Will continue to take your medicine until I regain perfect health.

Today, mail order doctoring has a reach that extends far beyond anything that Fioravanti or Pierce could ever have imagined. The ability to market drugs through the internet has enabled vendors to reach not hundreds or thousands but millions of customers.  Neither Pierce nor Fioravanti would ever have dreamed of such a possibility; but we can be sure that they would have been among the first to try it.

Readers interested in learning more about Leonardo Fioravanti and his mail order medical business may refer to my book, The Professor of Secrets: Mystery, Medicine, and Alchemy in Renaissance Italy (National Geographic Books, 2010)

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