History of Medicine

QUAKER, DOCTOR, DRUG CRUSADER

 Does anyone remember Squibb toothpaste?

Edward R Squibb.

     Edward Robinson Squibb never sold or made toothpaste but this unusual doctor-founder of the Squibb Co. was an important pioneer in medicine and pharmacy. Born in Wilmington, Delaware, in 1819 into an established Quaker family, he served an apprenticeship to a pharmacist, acquiring early skills in compounding medicines. He then obtained a medical degree at Jefferson Medical College, a three year curriculum. At the onset of the Mexican-American War he enlisted in the Navy, a move that forced him to leave the Society of Friends. He didn’t see combat but served almost two years in the Mediterranean aboard the frigate Cumberland, an experience he published (Amer J Med Sci 1852, 23: 54-68). The article provides a unique window on naval medicine in the mid-eighteenth century. Cholera, other diarrheal diseases, and venereal disease topped the list of problems. More important for our story is that the medicines he used in the Navy were almost invariably adulterated or of bad quality due to the Navy custom of purchasing them from the lowest bidder without regard to purity.

     On his return he was assigned to the Brooklyn Naval Hospital under Dr. Benjamin Franklin Bache, great-grandson of the founding father and nephew of Dr. Franklin Bache, professor of chemistry at Jefferson Medical College (chemistry had been one of Squibb’s favorite subjects). There Squibb was provided with a laboratory allowing him to make drugs of high and consistent quality for the Navy.  He made several medications but focused on ether. Surgeons were unsettled by inconsistent effects of the newly discovered ether, and Squibb found this to be related to variations in its purity. He invented a steam distilling process that avoided the dangers of distilling the alcohol-sulfuric acid mixture by flame, attended to caliber of ingredients, and produced a reliable, pure product. He never patented the process, feeling it wrong to patent something of such human value. He also made pure chloroform (from chloride of lime and alcohol) and did extensive testing of available drugs, measuring and documenting their impurities such as straw, chalk, and plaster of Paris.

Steam distilling apparatus, diagram. From Internet Archives

     Meanwhile he had married the sister-in-law of his boss and, unable to support her on his Navy pay, resigned from the Navy in 1857 and briefly entered, with partners, a drug-making concern. But with civil war looming on the horizon the Army told Squibb that if he could put together his own lab they would keep him supplied with orders. He accepted, raised the money, and resigned from his other firm. The new lab was again in Brooklyn and was soon busy. But tragedy struck.

     One day a young employee, dizzy from pouring ether into small bottles, knocked one over. The volatile liquid ran down the long table toward a candle at the end. Flames leapt up, larger bottles exploded, and a sheet of flame roared up between where Squibb was and the exit stairways. Squibb ran for all his books with notes on experiments, formulas, and the like (his life’s work), dropped them, picked them up again, then charged through the flames, setting his hair and clothing on fire. As he burst out onlookers wrapped his torso to put out the fire on his clothing and gaped at his absent hair and his blackened face and hands.         

     Recovery was slow. Although he retained his vision his eyelids were so damaged that he had to wear protective goggles when going outside and tape his lids shut at night. His hands were severely scarred as was his face, inducing him to grow a beard to partly cover it. But Squibb was undaunted. A group of local physicians and pharmacists raised money (beyond insurance funds) to rebuild the lab, this time done with concrete. Squibb paid all the money back even though it had been intended as a gift. He was soon back to work.

     The Civil War did indeed keep the Squibb Company busy and the firm expanded. Medical supplies often were not readily available to battlefront surgeons since they were transported in large wagon trains, so Squibb developed a “medical pannier” – a smaller container for medicines, dressings, etc, that was small enough (up to 88 pounds) to be carried by a horse, mule, or ambulance directly to the front. (It can be seen at: http://www.civilwarhome.com/medicalstaff.html) Eventually the Army opened its own manufacturing facilities as Squibb became overwhelmed.

     One of Squibb’s best friends from medical school, George White, a physician then practicing in Georgia, asked Squibb during the war to provide food or aid to certain southern soldiers in northern prisons. Squibb readily did so, lamenting the bitterness of the war. During this time his wife developed epileptic seizures, another worry. She even went through a couple of pregnancies with seizures, though they ceased after menopause.

     After the war his lab’s reputation for high quality products continued to rise, leading to orders from as far away as Japan. He was rigid in his manufacturing demands, and people knew it. As late as 1899 The Boston City Hospital could state that of the ethers used, “Squibb’s is still preferred by most house officers” (Bost Med Surg J v 141: 312, 1899). The lack of wartime pressure, however, allowed Squibb time to exercise a wider nobility of purpose, likely related to his Quaker upbringing – improving the quality of all drugs. He became a member, in 1860, of the convention that revised the U.S. Pharmacopoeia every ten years. He helped to throw out useless preparations and raise standards for purity. Less successful was an attempt in the 1870s to have control of the Pharmacopoeia transferred to the AMA, provoking a revolt from the pharmaceutical community. He wrote pure food and drug acts for New York State and for New Jersey, paving the way for a national act later.

Inside vol.1 of An Ephemeris. From Internet Archive

     He fought to have an 1848 law to “prevent the importation of adulterated and spurious drugs and medicines” enforced, though to little avail.  As a further step he created his own publication, An Ephemeris of Materia Medica, Pharmacy, Therapeutics, and Collateral Information, the first issue appearing in January, 1882. In it he offered updates for physicians on medications, but more importantly he exposed useless patent medicines and gross adulterations, and advocated laws against these abuses.

     As he grew older Squibb spent less time in the shop. His two sons, having obtained their medical degrees, were filling in, and the firm was renamed E.R. Squibb and Sons. The scarring from his burns persisted, and in 1896 his left hand was amputated for a carcinoma that had developed. At the surgery he administered his own anesthesia until he lost consciousness. He died in 1900 of cardiac failure.

     Edward Squibb is remembered chiefly for his many pharmaceutical contributions, his drive for reform, and his irreproachable integrity.

Works consulted:

Blochman, Lawrence G: Doctor Squibb: The Life and Times of a Rugged Individualist. 1958

Navy Medicine 2005, v 96 (3,4): 24-27 in each. (Biography of Squibb)

Bost Med Surg J. 1899, v141: 312-14  Ether at Boston City Hosp

J Hist Med Allied Sci 1958. v13 (2): 382-94. The Squibb Lab in 1863.

Amer J Med Sci 1852, 23: 54-68. Mediterranean experience.

An Ephemeris of Materia Medica, Pharmacy, Therapeutics, and Collateral Information,     

       Scattered articles.

Am J Health-Syst Pharm 2000. v57: 475-89.Pharmacy in the Civil War.