Manufacturers and retailers often made unsubstantiated and exaggerated claims for the concoctions they were peddling.  The public was told that the patent medicines would cure cancer, tuberculosis, arthritis, impotency, baldness, or simply that they were cure-alls for a long list of maladies.  Pervasive advertising, hopeful expectations from patients used to folk remedies, and relative inexpensiveness compared to prescription drugs, all combined to make patent medicine a big business.  The pills and potions, which might contain cocaine, morphine, alcohol, or other addictive drugs, were sold through the mail, in drug stores, and at traveling medicine shows like the one lampooned in this cartoon.  Some of the "patent" medicines were not protected by trademark, and therefore their ingredients were secret.

In 1821, the first school of pharmacy in the United States was established at the University of the Sciences in Philadelphia.  In 1852, the City of Brotherly Love was also the site for the founding of the American Pharmaceutical Association.  But for much of the nineteenth century, anyone with a lecture room and a couple of textbooks could run a medical or pharmacy school and award diplomas.  Most pharmacists at that time, however, entered the occupation through apprenticeship without an educational degree. 

In the nineteenth century, pharmacists, or druggists, bought chemicals and drugs in bulk, measuring and mixing them in backroom laboratories to produce medicines that filled prescriptions from physicians.  The attitude of pharmacists toward patent medicines was complex.  The unregulated concoctions undermined any quality control by the druggist, and threatened to make his medical role entirely obsolete.  Yet, many pharmacists sold patent medicines in order to survive financially.  This practice caused tension with physicians who abhorred the patent medicines.  

Doctors also charged that druggists refilled prescriptions without approval, or simply dispensed their own medicines without any prescription.  Pharmacists suggested that physicians place their own house in order before criticizing druggists, since most patent medicines carried a physician's endorsement.  Medical societies, however, increasing argued that doctors should fill their own prescriptions, and the rise of wholesale drug manufacturers and the development of the concentrated tablet made it easier to do so.  The doctor's medicine bag soon resembled a miniature pharmacy. 

Beginning in the 1880s, and increasingly in the 1890s and early-twentieth century, state legislatures started regulating pharmacy and the rest of the medical profession.  The requirements included passing a state board examination in order to obtain the newly mandated state license for practicing pharmacy (or medicine).  In the 1890s, as reflected in this cartoon, there was a push toward making a degree from an accredited pharmacy school mandatory, and in 1900, the American Association of Colleges of Pharmacy was founded.  However, state legislatures did not always require an accredited degree until decades later.  

In the late-nineteenth and early twentieth centuries, the patent medicine business came under fire as concern over drug and alcohol abuse grew, and as muckraking journalists exposed patent-medicine scandals.  Congress passed the Pure Food and Drug Act in 1906 and the Harrison Narcotics Act of 1914, both of which limited the possibility of unsafe patent medicines entering the market.  The patent medicine industry was also affected by national prohibition under the Eighteenth Amendment in 1919, since so many of its products used alcohol as a key ingredient.  During the twentieth century, pharmacists increasingly became the dispensers of drugs regulated by the government, manufactured by large corporations, and prescribed by physicians.