April 19, 2023
Long before mifepristone — the abortion pill dominating headlines — existed, women who knew how to read between the lines could find abortion pills advertised in their local newspapers.
"Ladies — 'Chichester's Pennyroyal Pills' are the best," read one 1904 ad in the Quad City Times, a Midwestern newspaper. "Safe, reliable. Take no other. Send 4c stamps for particulars. 'Relief for ladies' in letter by return mail. Ask your druggists."
Versions of this ad ran in dozens of newspapers across the country from the 1880s until the 1920s, placed by a Philadelphia drug company that specialized in uniquely feminine pills and remedies. The word "abortion" was never used in any of the many ads and marketing materials, since advertising abortion methods was just as illegal as the practice in the late 19th and early 20th centuries. But anyone picking up a crimson tin of Chichester's Pennyroyal Pills got the message.
The catch? The pills weren't necessarily safe, and later testing revealed they didn't contain pennyroyal or any other known abortifacient. They were simply snake oil, designed to target women who had no legal alternatives.
According to the Smithsonian, the Chichester Chemical Company entered business sometime around the late 1800s as a patent medicine firm. It listed various addresses in Madison Square, a two-block pedestrian street in present-day Graduate Hospital, as its headquarters. The company catered to a female customer base, offering a line of beauty products like pimple, freckle and wrinkle removers alongside more dubious items like diet pills and bust enhancers.
Most of its archived advertising, however, is concentrated on the pennyroyal pills. Retailing for $2 (or more than $60 in today's dollars), they came in red tin boxes with gold lettering, many of which can be found on eBay or Etsy. An 1891 trade card claimed these "female" pills "never fail to completely restore and regulate menstrual function," dancing around the most obvious reason why someone's menstrual function might pause. A later 1908 booklet of "helps and hints" offered no information on the pills' ingredients or usage, but did include lists of state nicknames, birth stones, normal pulse rates, poison antidotes and beauty advice like "keep serene."
This coy diversion was hiding some serious potential side effects. Writing in an 1897 issue of the Journal of the American Medical Association, a doctor recalled seeing a 27-year-old patient called "Mrs. H" who took Chichester's Pennyroyal Pills when her period stopped. After consuming 20 tablets over three days, she "began flowing profusely and with extreme pain," later collapsing and taking to bed for several days with a fever and nausea. When doctors discovered what appeared to be blood from a "ruptured tubal pregnancy," she was sent to the hospital for surgery. They discovered an ovarian cyst as well as "considerable debris that was thought to be fetal structures," which were removed. She survived after a three-week recovery.
A few years later, Chichester Chemical Company dropped "pennyroyal" from the product name, marketing its mystery medication as "Chichester's Diamond Brand Pills." The company claimed the change was due to "unscrupulous imitations offered under the name pennyroyal," but the move was more likely protection against future legal action. As concern over the ingredients continued, the American Medical Association undertook an investigation into the pills, once again publishing the findings in its journal.
"A preparation known as 'Chichester's Diamond Brand Pills' is, and has been for years, extensively advertised in newspapers, drug journals, etc." the report began. "While in these advertisements nothing is said regarding the therapeutic uses of the preparation, the public, to a large extent, knows it and buys it as an abortifacient remedy."
Testing revealed that the pills were coated in calcium carbonate and sugar. No pennyroyal, nor other common abortifacients like tansy or ergot, were detected. The main ingredients instead appeared to be aloes and iron sulfate.
That might sound like little more than a sugar pill, but Chichester's product wasn't exactly safe, either. The AMA researchers concluded that each pill contained about 1/2 grain of iron sulfate, equivalent to roughly 32 milligrams. If people like "Mrs. H" were taking several pills each day, they were ingesting a lot of iron, potentially over the recommended daily intake of 18 milligrams for adult women, or 27 milligrams for pregnant women. That would put them at risk of iron poisoning, which can cause nausea, fever, vomiting and even a coma.
In an editorial note, the AMA argued that many pills like Chichester's "are merely fraudulent, rather than dangerous" but some did contain "potent and ...villainous drugs." The medical group concluded:
"As shown by our chemists, Chichester's Diamond Brand Pills seem to simply be the old aloes and sulphate of iron pills with slight modification. While these pills were originally sold as 'pennyroyal' pills, the Food and Drugs Act, which forbids lying on labels, has apparently compelled the manufacturers to omit the word 'pennyroyal.' Since it is well known that there is no drug or combination of drugs which, taken by the mouth, will with certainty produce abortion, it is not probable, to judge from the constituents found in these pills, that they would produce the result desired by the purchaser. Nevertheless, the use of this nostrum is pernicious and in the interest of public health and public morals its sale, and the sale of similar nostrums, should be prohibited."
The following year, Chichester's problematic pills were cited in congressional hearings on the Food and Drugs Act. Lawmakers soon added the Sherley Amendment to the 1906 law, prohibiting manufacturers from making "false therapeutic claims" on their medicines.
By 1927, further federal action led to a court order that Chichester's Diamond Brand Pills be destroyed. It was an especially bad year for the company, which also lost its owner and proprietor Davitt D. Chidester in 1927. His death revealed that the company was vastly overvalued, and a series of complicated legal battles ensued with his estate and later, his widow's estate, over shares of the business.
Chichester's pills may be long dead, but the law that molded their coded advertising still technically lives. The Comstock Act of 1873 was a wide-ranging law that made mailing any drug or medicine intended to cause abortion, or any information about those drugs or simply abortion in general, illegal. Though subsequent court rulings weakened or nullified portions of the Comstock Act, it was never actually repealed, quietly sitting on the books for the ensuing 150 years.
It's now the basis of the argument for banning the mailing of mifepristone that the U.S. Supreme Court is considering.
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