Plagued by gout? Tortured by rheumatism?Troubled by pains in the head, face, teeth, breast, side, stomach or back? If you (or your horse) were living in late 17th or early 18th-century America or Britain you might have been tempted to purchase a pair of the marvellous patent metallic 鈥渢ractors鈥� invented byElisha Perkins. Stroke them over your (or the horse鈥檚) afflicted part and all would soon be well. Perkins himself was a physician. Alas, he was also a quack. But it is not on account of his own exploits that he deserves to be remembered. It is more forthe deeds of others actingfor and against him. The indirect consequences of the Perkins hocus-pocus include an epic poem of majestic awfulness, s a successful clinical trial, an early appreciation of the placebo j effect, and perhaps even thefoundation of Yale School of 1 Medicine. Not bad for a charlatan.
PERKINS鈥橲 tractors were a product of the age of electromagnetic quackery. Their inventor was an energetic, confident doctor and occasional mule-trader who practised medicine in the town of Plainfield, Connecticut. A mixture of thought and experiment had convinced him that certain metals could exercise a beneficial but neglected effect on the body.
The instruments he devised to exploit this effect 鈥� his 鈥渢ractors鈥� 鈥� were a pair of metal rods that were alternately stroked over the afflicted part, so drawing off the 鈥渘oxious electrical fluid鈥� that had created the problem. The rods were flat on one side, round on the other and tapered to a point. Critically, one was made of an alloy of zinc, copper and gold, the other of iron, silver and platinum.
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Patented in 1795 and retailing for $25 a pair, the tractors found some high-profile customers including a supreme court chief justice and, so it is said, George Washington. But many of Perkins鈥檚 fellow doctors were sceptical. They threw him out of the local medical society. Perkins wasn鈥檛 bothered; sales were brisk, profits were good. By the time the public started to lose faith he had accumulated a tidy sum.
Meanwhile his son Benjamin had joined the business. A natural publicist, Perkins junior set out to spread the word across the Atlantic. As soon as he reached London he took out another patent on the tractors and set up shop.
One of his first actions was to arrange the publication of a book of case histories from Denmark. The tractors had caught on there following the return to Copenhagen of a diplomat whose wife had discovered them in America. The book had already been translated into German. Benjamin arranged for it to be translated into English, adding some extra cases collected in Britain and 鈥� because the veterinary trade shouldn鈥檛 be denied a piece of the action 鈥� a shorter section describing 鈥渟everal experiments on brutes鈥�, mainly horses.
Some of the cures described were little short of miraculous. Take, for instance, the case of Mr Wheeler, a book-keeper at the Rummer Tavern whose rheumatism had confined him to bed for six weeks. 鈥淚 drew the tractors over his right shoulder,鈥� reports his surgeon, a Mr C. C. Langworthy, 鈥渆xtending them along the deltoid muscle, down his arm in the course of the nerve to the end of his fingers鈥t the expiration of fifteen minutes he declared that the pains were entirely removed.鈥�
The book was published in 1799. The introduction includes helpful information on obtaining the instrument: 鈥淭he Tractors, with printed Directions for their use in families, may be had of the Editor at his house in Leicester Square, price Five Guineas the set.鈥� Each came with a signed certificate guaranteeing authenticity. And to help those without five guineas to spare, Benjamin Perkins advocated the creation of a charitable clinic where the poor could be tractorised for free.
鈥淎t the expiration of fifteen minutes he declared that the pains were entirely removed鈥�
The hero of this story, however, is neither Elisha Perkins nor his son but an English physician, Dr John Haygarth, who had retired from practice in the northern city of Chester in 1798 and moved to the spa town of Bath. Still interested in medicine, he grew profoundly sceptical of the therapeutic value of the tractors, which by now were all the rage. Writing to a medical friend at Bath Hospital he outlined his doubts and suggested what might be done to debunk them.
鈥淭he Tractors,鈥� he pointed out, 鈥渉ave obtained such a high reputation at Bath, even among persons of rank and understanding, as to require the particular attention of physicians. Let their merit be impartially investigated鈥repare a pair of false, exactly to resemble the true Tractors. Let the secret be kept inviolable, not only from the patient but from every other person. Let the efficacy of both be impartially tried.鈥�
The friend, Dr William Falconer, acted on Haygarth鈥檚 suggestion. 鈥淲e contrived two wooden tractors of nearly the same shape as the metallick, and painted to resemble them in colour.鈥� He began with five patients, four suffering from chronic rheumatism in the knee, ankle, wrist and hip, and one with gouty pains. All had been ill for several months. Four of the five reported their pain much relieved following application of the fake tractors.
Another doctor, Richard Smith of Bristol, enlisted some colleagues to help him carry out more elaborate experiments: 鈥淚n order to add solemnity to the farce, Mr Barton held in his hand a stop watch, whilst Mr Lax minuted the effects produced.鈥� In other cases they used 鈥渢wo common iron nails coated with sealing wax鈥�, and also pieces of lead, bone, pencil and painted tobacco pipes.
Haygarth collected the various findings and wrote them up as a book called Of the Imagination as a Cause of Disorders of the Body as Exemplified by Fictitious Tractors. His insight was impressive. 鈥淚 have long been aware of the great importance of medical faith,鈥� he wrote. 鈥淥n this principle we may account for the marvellous recoveries frequently ascribed to empirical remedies, which are commonly inert drugs.鈥� Remedies work even better, he noted, when prescribed by 鈥渁 famous physician than by an inferior character鈥�. In other words the placebo effect, a term that wasn鈥檛 to be minted for well over a century.
Benjamin Perkins fought back. One popular journal that had ridiculed the tractors was the Monthly Review. Perkins printed a four-page pamphlet describing a selection of cases not previously reported, and somehow contrived to have it inserted into the journal without the editor鈥檚 knowledge.
And that wasn鈥檛 all. He enlisted an American lawyer, Thomas Green Fessenden, to write a poem about tractors. In one of the most imaginative promotional schemes ever devised in medicine, Fessenden hit on the oblique but clever idea of having a fictitious doctor condemn rather than praise tractorisation. His book-length epic, addressed to the Royal College of Physicians, was titled Terrible tractoration!! A poetical petition against galvanising trumpery, and the Perkinistic Institution.
Its hero, Dr Caustic, is a man who thinks highly of his own achievements:
鈥淣o case to me was problematic;
Pains topical or symptomatic,
From aching head to gouty toes,
The hidden cause I could disclose.鈥�
Having detailed his successes, Caustic goes on to bewail the recent loss of his livelihood. His career has gone down the pan 鈥� undermined by the spectacular success of the Perkins tractors:
鈥淏ut I, in spite of my renown,
Alas! Am harass鈥檇, hunted down;
Completely damn鈥檇, the simple fact is,
By PERKINS鈥橲 METALLIC PRACTICE!鈥�
Why this dreadful doggerel should have sold so well, never mind promoted use of the tractors, is hard to fathom. In the end, of course, tractorisation fell from grace and young Benjamin had to admit defeat, although he returned to America 拢10,000 the richer.
If quacks are people who peddle cures they know to be bogus, maybe his father was not all bad. In 1799, New York experienced an outbreak of yellow fever. Perkins, armed with his tractors and bottles of a snake oil he had invented, travelled to the city to offer his services. Alas, he contracted the very fever he鈥檇 gone to fight. On 6 September he died.
And the infamous tractors had positive side effects too. Some of the staff at Yale University, together with members of the Connecticut Medical Society, were so disgusted by the tractors affair that they moved to prevent it happening again. Their remedy? To found a new institution rooted firmly in science: Yale School of Medicine.
