Chapter XVII

Not long ago the periodical _John Bull_ sent to the institute a
special investigator, who came away perfectly satisfied “that the
Tremol treatment is an honest one and ably applied,” and that “it
distinctly merits the praise of _John Bull_.” The investigation
seems to have consisted in “roaming over the whole of the carefully
kept records of the thousands of cases treated” and apparently
accepting everything that was told--not a very scientific method
of investigating a treatment on which the health of thousands of
patients may depend. The investigator was told, among other things,
that the treatment is applied to five classes of diseases of the
leg--(1) ulcers of every description; (2) eczema and skin diseases;
(3) varicose veins; (4) tuberculous disease (diseased bone); and
(5) swollen and painful legs (phlebitis, etc.); and we are told
that “the treatment is able to cure all the diseases included in
the classes (1) and (2); but of the classes (3), (4), (5), those
only are selected which the medical history and circumstances of the
particular case convince the doctor are at least curable.” Speaking
of the remedies used, _John Bull_ says they are secret, but “the
composition was freely disclosed to us ... and the ingredients
are not of a harmful nature; indeed, some of the most valuable
and beneficial drugs known to the medical faculty are included in
them, but this particular combination has never before been used in
medicine, and some of them are quite new.” One would like to know
which of the ingredients revealed by analysis _John Bull_ considers
quite new; it cannot be the chloride of calcium or the chloride of
iron, or the infusion of rhubarb, or the prepared chalk, or the zinc
oxide, or the lead carbonate--perhaps it is the peppermint water.
As far as our analysis reveals, the combination is a heterogeneous
mixture of anything that might possibly be of use, regardless of
chemical combinations that may result, and we fail to detect any
trace of any new drug. We have only found the very commonest drugs
in ordinary use. There can be little doubt that in the interests
of the public health it is necessary that there should be a full
investigation of the National College of Health and Hospital for Bad
Legs. If there is a registered medical man connected with the place,
he is certainly acting in a way that makes him liable to be arraigned
before the General Medical Council; and, if there is no registered
practitioner, then the use of the term “fully qualified medical man”
is most misleading to the public.

An attempt to purchase the remedies through one of the usual channels for proprietary medicines only elicited an intimation that they were not sold in that way, but were supplied in accordance with particulars to be furnished of the case for which they were intended. An application to “The National College of Health” brought a “Diagnosis Form” to be filled up, with a letter stating that the fee for the full course of Tremol treatment is £2 2s. A publication was also sent, entitled _Good News about Bad Legs; or “Cures by the Cured,”_ consisting of twelve pages of the size of an ordinary newspaper page, containing portraits of patients and letters, etc., about cases, as well as much printed matter about Tremol treatment and “Views of the National College of Health, Limited.” Attached to the front page of this was a conspicuous separate slip, worded thus:

Important. The Board of Directors wish it to be distinctly understood
that every Patient who undergoes the Tremol Treatment is under the
direct supervision of a fully qualified Medical Man.

A few extracts from this publication will serve to indicate the methods of the National College of Health, Limited. The opening paragraphs have a curiously familiar ring, and might be paraphrased from the pamphlets of almost any quack-medicine maker; they are as follows:

For centuries Bad Legs have ranked with Cancer and Consumption as one
of the diseases over which the power of man could not prevail. For
generations thousands of sufferers have lived lives of misery, become
thoroughly worn out, and have gone down to their graves before their
time through sheer exhaustion: all human skill being powerless to
save. Their resources exhausted, ignorant of any agent in Medicine or
Nature competent to cure, it came to pass that the Medical Faculty
were reduced to the expedient of ordering sufferers long periods of
rest in bed. This in itself was a confession of failure and of no
avail.

It has been computed that Bad Legs have caused more misery and
suffering than all the wars ever undertaken by the world’s rulers.
And why? War is but an incident in a nation’s history, but the evil
of Bad Legs is ever present, ever constant, ever taking its toll of
suffering humanity. In the face of all this, Medical Science fell
back, helpless, baffled, and beaten.

At last, after years of scientific research, after thousands
of painstaking experiments, the Tremol Method of Treatment was
discovered, and the cure of Bad Legs, once for all, established and
placed on a sure and scientific basis.

What modern Astronomy is to the old discredited Astrology, what
Scientific Chemistry is to the Alchemy of olden times, even that and
more is Tremol System of Treatment to all other so called treatments
for Bad Legs. Other treatments are empirical, this Treatment is
scientific; other treatments end in failure, this System cures
to stay cured. Once again has Mother Nature yielded to patient
scientific investigation one of her greatest secrets, the secret of
how, by means of the Tremol System, to cure Bad Legs with certainty,
with rapidity, scientifically, and with no possibility of failure.

Other extracts are:

Universally accepted as the one and only cure for Bad Legs, the
Tremol System stands to-day before the world unchallenged and
unrivalled. Men of science accept it. Medical men recommend it. The
thinking public endorse it, and the thousands of happy men and women
cured by it hail it with a delight words fail to express....

As sure as day follows night, so certain is it that this new and
great discovery will cure every case of Bad Leg to which it is
applied.

Remember, in all our cases, this System of Treatment has had to begin
where others have left off. Sufferers who apply to us for relief
and cure are only those whom doctors have finished with, or on whom
ointments have proved useless, lotions abortive, pills impotent, and
blood mixtures futile.

These last two extracts scarcely seem to be in harmony with the announcement which is made rather conspicuously: “Incurable cases not accepted.” On the back page appears in large letters:

There is no Guess-work. No Pain. No Experimenting. No Lying Up. No
Operation. No Relapse. NO FAILURE. No matter how Difficult the Case
may be. No matter what form it may have Assumed. No matter how many
Doctors, Specialists, or Hospitals may have failed to help you. The
Tremol Treatment, the New Therapeutic Discovery for Bad Legs, IS
CERTAIN TO CURE YOU, AND MAY SAVE YOUR LIFE. No claim or statement is
made that is not borne out by Facts and Living Witnesses.

A document was sent with the medicines, marked “Legal Guarantee to Cure.” It is worded as follows:

We, the National College of Health, Limited, hereby Agree and
Undertake to refund on demand to you the whole of the money paid by
you to us for our Treatment, if we fail to cure you after we have
applied the Tremol Treatment for a reasonable length of time. This
Guarantee is subject to the Conditions set forth on the back hereof.

Then follows a facsimile of the signature of the Governing Director; it is not decipherable with certainty, but might be “E. F. Guest.”

The conditions set forth--in quite small type--on the back are as follows:

The Tremol Treatment is only devised to cure bad legs--but if a case
is accepted by us for personal treatment, then unless otherwise
agreed at the time, this guarantee holds good. To ensure the
bona-fides of the patient it is necessary that within seven days of
starting the Treatment you give notice in writing to us that you
accept the offer contained in this guarantee, and in this respect
time shall be of the essence of the contract. This guarantee only
applies where the Treatment is personally applied by us. It will
be readily understood that we cannot guarantee cures when we have
no guarantee that our Treatment is properly applied. We must be
the judges of what is a reasonable time. We give no warranties.
Warranties may mean anything or nothing. We simply return the money
paid to us while we are personally treating you as aforesaid, and
this is the limit of our liability. Any dispute between you and us
as to any claim under or upon this agreement or as to any question
arising hereunder shall be determined by arbitration in accordance
with the Arbitration Act, 1889.

Since this “Legal Guarantee to Cure” is sent with the medicines, the person receiving it would naturally suppose that it would apply to his case; and it is only on careful examination that it is discovered that (1) it only applies to cases where the treatment is “personally applied” by the company, and therefore not to a case where the medicine is sent out; (2) even in “personally” treated cases, it does not apply unless the patient gives notice in writing within seven days of _beginning_ the treatment that he intends to insist on it; and (3) since the company is the sole judge of what is a “reasonable time” within which the cure is to be obtained they can insist on continuing the treatment (as long as the patient will pay for it) in any case in which a claim is made. Not even the most ignorant person could regard such a “guarantee” as of the slightest value if he understood the conditions. It would appear that it is not the “bona fides of the _patient_” that needs to be ensured.

The “Diagnosis Form” sent was as follows; the words in italics are the particulars of an imaginary case that were supplied:

1. Date.

2. Christian name.

3. Surname.

4. Male or Female. _F._

5. Married or Single. _Widow._

6. Full Address.

* 7. What is your age? 53.

8. What is your weight? _About 12 stone._

9. What is your Occupation? _Housekeeper._

* 10. Is it your right leg, your left leg, or both your legs that are
affected? _Right._

11. How long has your Leg troubled you? _About a year._

12. Does your Leg pain you? _Yes._

13. Does the pain of your Leg keep you awake at night, or in any
way interfere with your comfort. If so, fully explain in what way.
(Describe the pain.) _There is a constant acute pain from the open
wounds, and a great deal of itching as well; the irritation, in
addition to the pain, often causes sleeplessness._

* 14. Is the portion of your Leg affected Itchy or Scaly? _Very
itchy._

15. Have you consulted any person? If so, who, how many, and what did
each tell you and what did they advise? _No._

16. Have you attended any hospital? If so, state which. _No._

17. Have you ever received an injury to your leg? _It was broken 20
years ago._

18. Is the pain worse when standing up or lying down? _Pain worse
when standing; itching worse when lying._

19. How did you first hear of the Tremol Treatment? _Thro’ an
acquaintance in Yorkshire._

20. Name the various remedies you have tried, and the methods you
have adopted to effect a cure and the effect each has had upon
your leg? _At first cold water bandaging; recently zinc ointment.
Practically no effect._

* 21. Are there any ulcers, wounds, or holes in your Right Leg, or is
it a red, itchy or scaly patch only? _Three open wounds and a big,
red itching patch._

* 22. Are there any ulcers, wounds, or holes in your left leg, or is
it a red itchy, or scaly patch only? _No._

#Don’t fail to reply to this.#

* 23. If there are ulcers, wounds, or holes, state how many, and the
position and size of each, cut out on pieces of paper and send to
us the sizes of the wounds or ulcers on each leg (N.B.--Be careful
to distinguish the size of the wound or ulcer from the size of the
surrounding redness or inflammation.) _The three open wounds are
each about ³⁄₄ inch across; they are about 2¹⁄₂ inches apart in an
irregular triangle; they are in a red itching patch about 4 inches
across, on the outer side of the leg, about half-way down._

24. Is there now, or has there ever been proud flesh in the wound?
_No._

* 25. Are your bowels habitually costive or free? _Free._

26. Have you ever suffered from a white leg? _No._

27. Did your Leg first begin to trouble you through a hurt, after
confinement, or how? _It came on gradually without apparent cause, at
first as a small itching red spot._

28. Has your Doctor advised Rest? _Have not had a doctor._

29. Have you rested, if so, has it done you any good? _Have rested a
good deal, but it doesn’t seem to make much difference._

30. Have you spent much idle time trying to obtain a cure? _No._

31. Has your leg ever been healed, if so, was it with Skin or with
Scab? _Not since the wounds became raw._

* 32. At what portion of the leg is the breaking out? _On the outer
side, about half-way down._

33. Have you been growing worse lately? _Yes._

* 34. Is there much inflammation or fiery redness round the wound?
_Yes._

35. Have you Varicose Veins? If so, state extent, of how long
standing, and what caused them. _No._

* 36. Please to give the names and addresses of any persons in your
district or elsewhere, whom you may know to be suffering from Bad
Leg. This information will be treated as strictly confidential and
exclusively private.

Remarks.--Write on a separate piece of paper any facts relating to
your case or conditions that have not been indicated by the above
questions. Describe your case fully in your own words and all you
have suffered and gone through; in short, give us a general history
of your case.

This was sent with two guineas to “The National College of Health, Ltd.” The medicines sent in return consisted of a bottle of “Tremol Blood Mixture,” a bottle of “Tremol Lotion,” a box of “Tremol Ointment,” and a box of “Ointment No. 2,” with two bandages. Two typed sheets of directions accompanied these, headed “Instructions for applying No. 14 course of Tremol Treatment.” Each of the four preparations is priced separately at 11s., by post 11s. 4d.

TREMOL BLOOD MIXTURE.

The bottle contained 8 fl. oz. It bore a printed label, and there was nothing on the label to suggest that it was in any way modified for the particular case for which it was intended. The directions on the label were the same as those given in the paragraph on the typed sheet, which was as follows:

HOW TO TAKE YOUR MEDICINE.--It is absolutely necessary for you to
take this Blood Mixture prescribed specially for your case, all the
time your leg is being dressed with the other preparations. To obtain
permanent results it is imperative to continue taking this medicine
for your blood, for some time after your leg is well.

Directions.--Take one drachm (one small teaspoonful) morning and
evening after your meals, in a wineglassful of water sweetened to
taste with one or two lumps of sugar. We strongly advise you to use
a Medicine measure instead of an ordinary teaspoon, so that the dose
will accurately measure one drachm.

Analysis showed the mixture to contain calcium chloride, ferric chloride, small quantities of free hydrochloric acid and alcohol, peppermint water, and a preparation of a vegetable drug; the latter had a slight flavour of rhubarb, but showed no definite active principle and no characters by which it could be positively identified. The proportions of the definite ingredients were determined, and found to be as given in the following formula. A mixture prepared according to this formula agreed very well in regard to the vegetable drug, and perfectly in other respects.

Calcium chloride 224 grains
Solution of ferric chloride 300 minims
Dilute hydrochloric acid 200 „
Concentrated infusion of rhubarb (¹⁄₇) 100 „
Peppermint water 2 fl. oz.
Water to 8 „
A deposit slowly falls, from which the clear liquid is decanted.

Estimated cost of the ingredients, 1¹⁄₄d.

TREMOL LOTION.

The bottle contained 8¹⁄₄ fl. oz.; it bore a printed label, and there was nothing on the label to suggest that it was in any way modified for the particular case for which it was intended. The directions on the typed sheet were the same as those on the label, as follows:

Dilute the Lotion with an equal quantity of water. Cut out a piece
of Lint slightly larger than your Ulcer, so that the Lint will cover
the surface of the Ulcer as completely as half-a-crown covers a
shilling. After a thorough cleansing (see directions for so doing)
well soak the Lint in the dilute Lotion for two or three minutes, and
then apply to the Ulcer. You are not to apply the Lint containing the
Lotion too wet, that is dripping, neither are you to squeeze it out
too dry, just thoroughly moistened and on the wet side.

Analysis showed the liquid to consist of solution of chlorinated soda containing 2.9 per cent. of available chlorine (which is slightly above the minimum strength of the official solution) with the traces of impurities usually found in it.

Estimated cost of the liquid, 2d.

TREMOL OINTMENT.

This was in a wooden box containing 14¹⁄₂ oz.; it bore a typewritten label: “The Tremol Ointment. To be used as directed.”

The directions on the typed sheet were as follows:

HOW YOU ARE TO APPLY TREMOL OINTMENT. Cut out a piece of soft lint
slightly larger in circumference (about ¹⁄₄ in. larger all round)
than the Lint on which the Tremol Lotion is applied. Spread the
Ointment thickly on the plain surface, then place it on top of the
Lint on which No. 2 Ointment is spread, but over the Ulcer, and
therefore covering the Lint which is soaked in the Lotion. You will
therefore have over the Ulcer three layers of Lint. FIRST, two layers
of Lint containing Lotion. SECOND, the layer of Lint on which the
Ointment No. 2 is spread, and covering the red and inflamed part.
THIRD, the layer of Lint on which Tremol Ointment is spread and
covering the portion where the Ulcer is situated. Therefore over
the red inflamed part there is one layer only, that on which No. 2
Ointment is spread, but over the Ulcer there are three. When you are
dressing your leg do not remove Ointment No. 2 that adheres to the
skin. Apply fresh dressing on the top of the adherent ointment.

Analysis showed the ointment to contain:

Prepared chalk 70.3 parts.
Soft paraffin 29.0 „
Yellowish-brown colouring matter traces.

The colouring matter appeared to be one of the coal-tar dyes, but was not present in sufficient quantity for exact identification; the chalk contained the small quantities of impurities usually occurring in it. No other ingredient was found.

Estimated cost of the ingredients, 2¹⁄₂d.

OINTMENT NO. 2.

This was in a wooden box containing 10¹⁄₂ oz.; it bore a typewritten label, “Ointment No. 2. To be used as directed.” The directions on the typed sheet were as follows:

HOW YOU ARE TO APPLY OINTMENT NO. 2.--Cut out a piece of Lint large
enough to cover the red and inflamed portion of your leg. On this
spread pretty thickly the special Ointment labelled No. 2, and apply
it; at the same time covering the Lint which is soaked in the Lotion.

Analysis showed the ointment to contain zinc oxide, a lead compound which appeared to be the carbonate, sodium benzoate, sodium acetate, water, lard, and a pink colouring matter which was evidently a coal-tar dye. No other substance was found. The quantities of the different ingredients were determined, and the results agreed with the following formula:

Zinc oxide 19.8 parts.
Lead carbonate 3.5 „
Sodium benzoate 0.3 „
Sodium acetate 0.7 „
Water 9.6 „
Colouring matter traces.
Lard to 100 parts.

Estimated cost of the ingredients, 7d.