Helfand's Introduction offers a readable general overview of the practice of quackery in Western medicine, with a short but useful bibliography. He notes some important milestones in the field, such as Britain's Medical Registration Act of 1858, and points out the symbiotic relationship between quacks and the newspapers, publishers, booksellers, and others who printed and distributed their marketing media. The real value of this book, however, is in its rich array of illustrations, many in color. The book is a valuable resource in making these ephemera more available to readers.

Helfand's review of the collection even includes sheet music commissioned by irregulars, which (with a musical comedy and an opera about quacks) point to a relation between music and science, as well as between music and advertising. The collection also demonstrates how irregulars' sustained criticism of "heroic therapy," in common use by physicians through the early nineteenth century, helped fuel a shift away from forceful medical practices such as bleeding and purging.

Quack includes advertisements for well-known nostrums such as Morison's Pills or Vin Mariani (which contained a coca derivative). Although quacks peddled cures for addictions to tobacco, alcohol, and opium, some of these preparations contained the very drug that patients sought to avoid. Quack also shows how many nostrums offered cures for various sexual ailments, including masturbation, impotency, venereal disease, unwanted pregnancy, and painful childbirth. Many of the cures and lectures about sexuality play to a general lack of knowledge about reproductive anatomy and include appeals to a "manly" or "womanly" ideal.

Many of the quacks tout their use of "natural" and herbal ingredients, making innovative use of folk medicine in the marketing age. Some, like the makers of the Electropathic Belt or Health Jolting Chair, look to the future instead, suggesting (as the Medical Battery Company claims) "that legitimate alliance between Science and Capital without which Science would languish" (199). Some agents, like rattlesnake venom, are still of interest to scientific investigators seeking new drugs; other cures, like "blue light," are clearly useless but foreshadow twentieth-century treatments like phototherapy with ultraviolet light for skin disorders, or light-box therapy for seasonal affective disorder.

This book might be of especial interest for those studying eighteenth--and nineteenth-century visual culture, the rise of advertising, collections of curiosities and anatomical museums (often a front for quackery), public speaking and itinerant lecturers, politics (quacks are a staple of political cartoons), images of crowds or performance, and the orientalizing portrayal of exotic ethnicities within modern Western culture. Browsing through the images in the book provides striking evidence of irregulars' frequent claims to Eastern or Native American remedies, such as East India Tiger Fat or Kickapoo Sagwa.

Quack would work well paired with texts like H. G. Wells's Tono Bungay (e-text at: http://www.gutenberg.net/dirs/etext96/tonob10.txt), Weir Mitchell's The Autobiography of a Quack (see annotation in this database and link to e-text), both of which examine the claims of quackery and patent medicines; images from both appear in the book. Also relevant is the online text of "Street Doctors," a four-page segment from John Thomson's 1877 book of photographs with commentary, Street Life in London (http://www.victorianlondon.org/publications/thomson-7.htm).