As for the quacks, patent medicines, and universal remedies, I need only mention their names. Prince Hohenloe, Valentine Greatrakes, John St. John Long, Doctor Graham and his wonderful bed, Mesmer and his tub, Perkins's metallic tractors – these are half-a-dozen. Modern history knows hundreds of such. It would almost seem as if human delusions became more unreasoning and abject as their subject is greater in importance.

—P.T. Barnum, Humbugs of the World

That Dr. Ben Carson, an accomplished man of science, and a gifted physician, and one of the most ridiculous men ever to walk into American public life, has found himself tangled up as a candidate in his earlier career as a pitchman for what the 21st century has for patent medicine, is a development so rich with irony that I have to sit down for a brief nap after having attempted to take the business in whole. Carson has gone from denying any involvement at all, to acknowledging that, yes, he did make some videos in which he seemed to be extolling the virtues of some nostrums brewed up by something called the Mannatech Corporation, to blaming the media for confronting him with the details of his own biography. It's remarkable to me that Carson is audible at all, given the number of cocks that must be crowing in the background when he speaks.

Mannatech is a quack operation, and Ben Carson is a political quack of the first rank. His economics are blissfully untouched either by math or by any social and political development that has occurred since the Panic of 1857. His grasp of history is deeply informed by his devotion to the absurd writing of one Cleon Skousen, a man so far to the right that he made even the Goldwater campaign nervous. So to see Carson struggling with his connection to actual quack potions in the middle of a campaign based almost completely on political and historical snake-oil is to hear history singing in harmony, and to enjoy the majestic spectacle of 100 chickens soaring home to roost as one.

Patent medicine is not a uniquely American invention. (A variation of patent medicines is mentioned in Henry Fielding's Tom Jones, among other places.) But, like so many things, once the idea got to America, where there was freedom of the press, and a national economy one step above the wild kingdom, and an almost limitless frontier filling up with an almost limitless supply of suckers, the promotion and sale of patent medicines exploded into a mass-market phenomenon. In 1878, for example, a physician from upstate New York named Andrai Kilmer concocted something he called "Dr. Kilmer's Swamproot," which purported to clean out the kidneys and other mechanisms of a human being's lower plumbing. Despite the fact that Kilmer's first factory burned down, by 1882, Kilmer was filling 2000 bottles an hour and employing hundreds of people in and around Binghamton. The firm was so wildly successful that Kilmer's brother, Jonas, another physician, moved to Binghamton from New York City to join the family business. Willis Kilmer, Jonas's son, came along as director of advertising and marketing.

(It probably didn't hurt sales that the swamproot potion was something like 19 percent alcohol.)

By 1905, according to one magazine's survey, Americans were spending over $75 million on various concoctions. There were no government regulations on the content of these "medicines"—cocaine and various opiates were very popular ingredients, as you can imagine—and there was no government regulation of the tactics used to foist them on the unsuspecting public. So, things went along swimmingly for the Kilmers until 1906, when the passage of the Pure Food and Drug Act pretty much killed the patent medicine business. But Willis Kilmer had made an estimated $15 million from the sale of the swamproot, enough for him to become a real-estate tycoon in and around Binghamton, and also to become a successful breeder of racehorses. In 1918, his Exterminator won the Kentucky Derby and, 10 years later, a horse he'd bred named Reigh Count won the same race.

Think about how easy it would be for, say, Dr. Ben Carson to work the story of the Kilmers into a narrative about how the iron-toed jackboot of federal regulation crushed a longtime family-owned small business in Binghamton, New York. (After all, in his book, The Naked Socialist, Cleon Skousen, Carson's historical amanuensis, specifically mentions the Pure Food and Drug Act in his list of offenses against freedom committed by the Progressive Movement of the early 1900's.) Think of the applause he would get from a hand-picked crowd of Republican voters. Think of Doctor Ben Carson, running for president from the back of a covered wagon, working the rubes in the dim light of farm lanterns along an old plank road.

It wasn't hard, was it?

As the patent medicine business grew along with the country, fine entertainments and low-rent spectacles grew around the basic fraud. Thus was born the medicine show, with its shills, its dancing ladies and its muscle men. They toured the sticks, giving the farmers and small business types something to watch besides cows humping in the pasture. And here is the most overwhelming irony of all as regards to what's happening with Doctor Ben Carson and his former career as a Mannatech shill. The entire Republican primary process has been rendered a travelling medicine show, and he's just one wagon in the caravan.

After all, what is Republican economics, if not supply-side quackery and sleight of hand? All the candidates are playing the muscle men, flexing at Vladimir Putin and at Hafez al-Assad and at ISIL from across an ocean. Come early, bring the kids, watch the Magic Asterisk do its work, and make gold fall from the sky into your pockets!

The process began with Ronald Reagan, the greatest patent-medicine salesman of them all. It was he who marketed the economic snake-oil with a wink and a smile. It was he who taught them how to flex and pose – fiercely denouncing terrorism while selling missiles to the mullahs. It was he who gulled the country with tales of Sandinistas driving jeeps across the Rio Grande, and dangerous Cuban adventurism in Grenada, while Marines were being slaughtered in their barracks. He was the best show in town. The starstruck rubes flocked to see him. The country swallowed the swamproot whole.

Now, because it sold so well, and because the audiences were so easily gulled, that's all there is—a decent vagabonding entertainment, rolling from town to town, pitching signs and wonders and miracle cures and can-I-get-an-Amen? So Doctor Ben Carson once was a front for some magic cancer elixir? What was that, if not the best training you can have to be a Republican candidate for president in the biggest medicine show of them all? Step right up, my friends. Step right up and be amazed. The sun is down and the lights are up. The stars are out and the music is beginning to play. Step right up, rubes. Step right up.

Charles P. Pierce Charles P Pierce is the author of four books, most recently Idiot America, and has been a working journalist since 1976.

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