Cautionary Tales with Tim Harford - The True Scandal of Lydia E. Pinkham’s Vegetable Compound
Episode Date: April 14, 2023It could cure any 'female ailment' - even cancer - said the adverts. But Lydia E. Pinkham’s Vegetable Compound was, in fact, just a concoction of herbs and alcohol of no proven medicinal merit. That... didn't stop desperate American women from buying bottles of the stuff - and writing to Lydia Pinkham for medical advice. Why did her customers shun 'expert' doctors and opt instead for quack medicines? And why, when Lydia Pinkham finally came in for criticism, did no one question the efficacy of her vegetable compound? For a full list of sources for this episode, go to timharford.com.See omnystudio.com/listener for privacy information.
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A fearful tragedy declared the newspaper, all caps of course. It was after all the 1880s. A fearful tragedy, a clergyman of Stanford, Connecticut, killed by his own wife.
But why?
What were the circumstances?
Could the tragedy have been prevented?
Never fear.
The full explanation is forthcoming.
But be warned.
This is not actually a news report.
It's an advertisement, apparently based on a true story.
A fearful tragedy.
A clergyman of Stratford, Connecticut, killed by his own wife.
Insanity brought on by 16 years of suffering with female complaints, the cause.
Lydia E. Pinkham's vegetable compound, the sure cure for these complaints,
would have prevented the direfledede.
Well, well, it's quite a tale, and quite a claim. Gather round, ladies and gentlemen,
and take a comfortable seat. For I am about to tell you a tale of direfledede's aplenty
and of female complaints, and of the most efficacious vegetable compounds
you could wish for.
I'm Tim Harford and you're listening to cautionary tales. Lidia Estes Pinkham was born Lidia Estes in the city of Lynn Massachusetts in 1819.
The tenth child of a modestly wealthy family of Quakers.
If you'd met Lydia as a young woman, you wouldn't have imagined that she'd get into
the business of herbal treatments for female complaints.
She would have seemed more like
a social activist, even an anti-racist. Lydia, her mother and some of her sisters, were
among the founder members of the Lin Female Anti-Slavery Society. Lydia and her sister,
Julielma, were friends with a great abolitionist activist, Frederick Douglass. He was about their age,
and had moved to Lynn after escaping slavery, and the girls put their reputation on the line for
Frederick Douglass. Lydia stood in the way of a railroad conductor who was trying to send
Douglass to the car reserved for blacks and Irish. She left the Quaker faith because it wasn't staunch enough in its demands for the abolition
of slavery. Julia Elmer created a scandal after being seen walking arm in arm with Douglas.
She was thrown out of her church when she refused to rule out, marrying a black man.
Color would make no difference to me in a husband, I would look only upon a man's character.
Both Lydia and Julia Elmer were founding members of a new debating and lecture society.
No person shall be excluded from full participation in any of the operations of this society,
on account of sex, complexion, or religious or political opinions.
Frederick Douglass became the society's president,
and Lydia, its secretary, a debating society
upholding feminism, anti-racism, and religious tolerance.
It's quite a start to a remarkable career.
Then came the second stage of Lydia's life,
that of wife and mother.
At the age of 24, she married one of her fellow debaters,
Isaac Pinkham, a widower, and a gentleman described by a contemporary as kindly but,
of no great vigor. That seems implausible, for one thing, the Pinkham's had four sons
and a daughter. For another, Isaac's problem seemed less to be lack of vigor, but
restless activity. He had big dreams and questionable business judgment. Lydia's father had given
them a house in the centre of the city, but Isaac, always with an eye on the next prize,
sold up and moved the family eight times. As a career, he tried first shoe-making,
then kerosene manufacturing, then produce trading,
farming and building.
Lydia's biographer, Sarah Stage,
writes that he changed occupations
as often as some people changed clothes.
Lydia Pinkham, meanwhile,
was trying to keep everything together at home.
Lidia's second son, Daniel, died in infancy of gastroenteritis.
It must have been terribly hard for all two common in the 19th century.
She also named her next baby Daniel.
Life had to go on.
And go on it did. One of Lydia's many house-wifely
chores was to brew up a vegetable tonic at home. This wasn't unusual. Home-brewed medicines
were ubiquitous since doctors were expensive and have doubtful help and disease was an
ever-present threat. Lydia Pinkham's tonic was based on an existing formula,
adapted after some kitchen experiments
and a close reading of the American dispensatory,
a comprehensive description of herbs
and their medical uses.
A tonic contained a variety of botanical ingredients,
including golden ragwort, unicorn root, fenugreekreek, butterfly weed, black cahosh and alcohol.
It was, in her opinion, the finest remedy of my experience.
Remedy for what?
Four female complaints, of course.
Painful, irregular or heavy menstruation, a prolapsed uterus,
menopausal symptoms, etc. etc.
Lydia gave away pints of the stuff to her neighbours.
It was only in 1875, after Isaac Pinkham's latest scheme,
real estate speculation, catastrophically failed,
that Lydia was finally tempted into commerce.
She was in her mid-50s.
Her father was long dead.
The family money long spent,
and the pinkums desperately needed some cash.
The story goes that two strangers
rode up to the pinkum residence in a handsome carriage,
said they'd come five miles up the coast from Salem,
and offered Lydia five5 for six bottles
of her famous vegetable compound.
That was easily a week's wages.
And although somewhat embarrassed,
Lydia Pinkham accepted the price and made the sale.
It was the start of the third and most remarkable phase
of Lydia Pinkham's life,
that of Healer, Entrepreneur, and Agony Aunt all rolled into one.
The idea first came from her 27-year-old son, Dan.
Mother, if those ladies will come all the way from Salem to get that medicine,
why can't it not be sold to other people?
Why can't we go into the business of making it and selling it, same as any other medicine?
Did he a pinkum and her children put Lydia's vegetable compound on the market,
promoting it with matronly images of Lydia e-pinkum herself,
and promoting the tonic with a four-page pamphlet,
in which Lydia offered frank health advice by a woman for women.
Dan Pinkham set out to spread the word of his mother's miraculous vegetable compound.
He paced the streets of Boston and New York, hustling for sales to drugstores, going door to door handing out leaflets,
haggling with printers over the cost of printing those leaflets,
and writing letters home, asking for money.
For God's sake, whose management is it that keeps me from having what I actually need?
Now in consequence of your cussed judgment, I shall have to live upon a cracker diet.
There is no use in writing.
I actually can't spare three cents to buy a stamp with.
Dan's advertising ideas were imaginative but impractical.
He littered New York's parks and graveyards with little cards, with faux-handwritten notes
on them, giving the impression that someone had been meaning to post a message, recommending
Lydia E. Pinkham's vegetable compound to a friend but had dropped the card before it
reached the mailbox, several thousand times.
Dan also fantasized about draping a banner from one end of the Brooklyn Bridge to the other.
His younger brother Will was working smarter, not harder. After making a big sale to the Boston
wholesaler, Weeks and Potter, Will Pinkham swung past the offices of the Boston herald
and asked how much it would cost to put an advertisement
with his mother's picture on the front page.
$60 came the response.
Will Pinkham had $84 in his pocket, so he slapped down the cash
and went home to tell his mother what he'd done.
To her, it was a disaster as echo of her rash husbands' business gambles.
That was like a thunder clap out of a clear sky, and we all sat down and had a good cry.
But within two days, borders from Boston drugstores emptied the pinkham stock of vegetable compound.
Stores which had bought a dozen bottles at a time
now play stores for a hundred or more.
The lesson was clear.
It paced to advertise, especially if you advertise
with the matronly image of Lydia E. Pinkham.
Lydia E. Pinkham's vegetable compound cures female complaints,
such as dragging sensations, weak back, falling and displacements,
inflammation and ulceration, and organic diseases,
and it dissolves and expels tumors at an early stage.
Women suffering from any form of female weakness
are invited to write Mrs.
Pinkham, Lynn Massachusetts, for advice. The Pinkham's bought another front page
advert the following week and got much the same result as they sank more money
into advertising sales continued to soar. Mrs. Pinkham was on her way to having
one of the most famous faces in America, hair
in a bun, slightly graying, neck concealed by a starchy rough, fastened centrally by a simple
brooch. She was the very picture of middle-aged respectability and wisdom. Her vegetable compound
would soon become legendary. It's the all-American rags to rich history.
But there is one nagging question. Did the vegetable compound cure anything?
The tonic consisted of a few herbs preserved with a generous splash of booze.
The advertising claimed it was so efficacious for female complaints that it would prevent
menstruating or menopausal women
from direfully murdering their husbands, even that it would prevent cancer.
Was that actually true?
It wasn't a question that people seemed to be interested in asking. caution retails. We'll return after the break.
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podcast. Mrs. Pinkham was not the first entrepreneur to make money selling unusual concoctions.
The wave of enthusiasm for such remedies had begun before she was born.
Oddly, these remedies were called patent medicines, although no patents were involved. Instead, entrepreneurs used trademarks
to protect their brand image, which is telling in its own right.
This was a world of style and snake oil over substance
and fakes and quacks prospered.
As a newspaper editor complained as early as 1800,
the vendors of patent medicines in almost every capital town in the United States
are fattening on the weakness and folly of a deluded public. One of those vendors was Thomas
Diet, a penniless immigrant from England looking to make a mark on Philadelphia. By day, he polished
shoes. By night, he manufactured the black shoe polish. He soon had more shoe polish than
he could use. Opened a store, then a warehouse, then a bottle factory, before finally realizing
that if he was to spend his days putting gloop into bottles, the dismal gloop would be
far more profitable. Even at the time there were many critics of such tonics and potions.
They would be dismissed as Trumpery, by which they meant fraud or showing nonsense.
It's a good word.
But the critics didn't dampen the vigorous demand, and Thomas Diet took full advantage.
Diet sold a wide variety of cures, his own concoctions, the popular medicines of his rivals,
and above all, treatments perfected by his grandfather, the noted Dr. Robertson of Edinburgh.
Dr. Robertson's vegetable nervous cordial. Dr. Robertson's gout and rheumatic drops.
Dr. Robertson's infallible, worm-destroying lozenges, and Dr. Robertson's
cure for a certain disease, presumably something or everything involving the male-never
regions.
Diet was proud of his ancestor, Dr. Robertson, despite the fact that the Philadelphia
Medical Journal scathingly explained that there had been no noted Dr. Robertson
in Edinburgh for two centuries.
No matter.
Thomas Diet was soon claiming to be a physician himself.
And more to the point, by the 1830s, he was enormously wealthy, making the equivalent
of ten million million a year.
He kept a grand estate and was driven around in a fine English coach with half a dozen
outtriders.
He kept expanding his operations, even setting up a bank.
Why was he so successful?
Certainly because he was a master of vivid clever advertising. But was it because his worm-destroying lozenges
actually were infallible? Not a chance. And when diets fortunes turn, which they did in 1837,
it wasn't because people stopped buying useless treatments from a fake doctor with an imaginary
grandfather, it was because diets bank collapsed in the midst of a nationwide banking panic.
If it's duck to selling the non-existent Dr. Robertson's far from infallible worm-destroying rosanges, he'd have been fine.
Why do people buy treatments without any evidence that they work. In some ways it's a timeless
question. As Lydia Pinkham was perfecting her vegetable compound in the 1870s, Western
Egyptologists had just obtained papyrus which contained detailed accounts of Egyptian medical from 1500 BCE, three and a half thousand years ago.
And as one medical historian explains,
Quackery is an ancient tradition.
These papyrus, the oldest proper medical instructions of our species,
contained potions and salves and drugs,
whose effectiveness was a fantasy.
The first doctors in the world were frauds.
For the next three and a half thousand years, little changed.
Even today, there are plenty of phony cures, especially when conventional medicine can't help.
Quackery abhors a vacuum, so when the SARS-CoV-2 virus was discovered in early 2020 and no proven treatment or vaccine
was available for COVID within weeks, people were on social media recommending special red soap
or treatments for malaria, or even using a USB flash drive as a bio-shield.
There's a lot of money to be made by selling snake oil to the fearful or desperate. But while Quackery began at least three
and a half thousand years ago and continues to the present day, its golden age
may have been the 19th and early 20th centuries. The age of Dr. Robertson's
worm-destroying lozenges and Mrs. Lydia E. Pinkham's vegetable compound.
A few years ago, the economist Werner Trösken published a study of the US market for unproven
concoctions in this golden age. He concluded that even after adjusting for inflation, people spent more than 100 times as much on these dubious
patent medicines in 1939 firmly in the modern age than they had back in 1810 when Thomas
Diet was just starting out. Across that period, demand for patent medicines grew 20 times faster than
the economy as a whole, and these strange potions became
a major industry in their own right.
So why did people buy them?
The simple answer?
Sometimes they made people feel better.
There are two reasons for that.
One is the placebo effect.
People do often benefit simply from the belief that they're being treated.
Many quack medicines included ingredients such as chili, alcohol and opium, producing plausible
highs, lows and tingles.
The chili was fine.
The opium was a problem.
Parents could and tragically sometimes did medicate their own children to death.
Lydia Pinkham's vegetable compound contained neither chili nor
opium, but it was 20% alcohol, making it a drink as strong as port or cherry. A small glass
of that and well you might indeed relax and feel a little differently about your female
complaints. And then there's the fact that most people who feel bad feel better in
due course. If they're suffering from an infection, the immune system kicks in, period pains
pass with each monthly cycle. The symptoms of menopause usually fade after a few years.
And if you happen to be taking medicine when your sufferings abate, well, perhaps you'll
give the medicine the benefit
of the doubt and tell your friends.
There was another reason for the popularity
of patent medicines.
People bought them because they didn't trust the doctors.
The doctors of the day had a habit of prescribing calomel,
a compound of mercury, which was distinctly toxic
and caused inflamed gums and ash and
complexion, and in extreme cases, a rotting away of the jaw.
Women in particular had reason to be wary of doctors in the 19th century.
Evidence was slowly emerging that physicians were accidentally killing their female patients
by attending births while their hands were contaminated
from disease from other patients, or from dissecting corpses. The medical profession, however,
was outraged at this suggestion and refused to consider the evidence that it was true.
Charles D. Meag's, an American obstetrician spotted that doctors are gentlemen and gentlemen's hands are clean.
If the alternative was jaw rotting calumel, crude surgery or death from infection, after
a doctor prodded your uterus with cadaver juice under his fingernails, all at vast expense,
well small wonder that people flocked to the patent medicine sellers, especially those, like Lydia
Pinkham, who offered relief for female complaints.
It's hard to read the economist Werner Trusken's research, without thinking not just of the
Trumpery of patent medicines, but Trumpery of the more political kind.
All across the world, left and particularly right-wing populists have been in
the ascendancy, while old-fashioned centrists have been out of fashion. The parallels are
inescapable populists, like Peyton Medsons' sellers, often suggest approaches which offer a
short-term pick-me-up, even if they only make things worse over time. Populists, like patent medicine
sellers, thrive when the establishment has let people down. The doctors of the 19th century
talked confidently, but looked down on their clients and offered their own ineffective
remedies. Are political centrists so different today? Populists like patent medicine sellers rely on marketing,
huge adverts, bold claims, attention-grabbing stunts. In the 19th century, it was common for
Clack medicine sellers to operate alongside a circus, modern populists try to generate a circus
all of their own. And populists like Peyton Medsonssellers are quick to claim that the people
are on their side. Consider this newspaper editorial from 1881.
There is no such thing as medical authority. The people are and are obliged to be. The only judges of
Medsons and of physicians. The people are the only true judges, and the people have had enough of experts.
If people like what's on offer, whether it's tough talk about immigration or a vegetable
compound, well, isn't that all the proof of effectiveness that anyone would need?
It was attempting claim about patent medicines then, and it's attempting claim about politics
today.
Because one thing that infuriates people, whether the reactionary voters of today or the
suffering patients of the 19th century, it's feeling that you're not being listened to
by the people who should be looking after you.
Listening to people was something Lydia Pinkham did very well indeed. Dear Mrs. Pinkham, I have been afflicted with amality that my physician frankly tells me
that he has never met with before, and I write to ask you the cause and what the cure
is.
It is in affection of the gums and mucus membrane of the mouth.
The gums turn white and a layer easily rubs off,
leaving them very red and angry.
The inside of my cheeks and corners of my jaw
are white and look and feel hot.
Such letters to Mrs. Pinkham were common.
Adverts for the Pinkham Company actively encouraged
suffering women to write in for advice.
No man would ever read their letter, they were assured.
In this case, Lydia Pinkham's response was to the point.
You have taken virulent poisons in the form of medicine
that has caused disease of the mucus membranes.
It's the typical response of the quack healer,
blame mainstream medicine for the affliction.
But given that these symptoms were typical
of calomel poisoning,
pinkum was probably right.
Mrs. Pinkum recommended instead the dry form
of her compound, which was alcohol-free,
supplemented by some healthy living.
Bay yourself all over every night in hot water,
eat farenacious food and broths, ride
out and walk out, dig, use the trowel, take the compound according to instructions and
let doctors alone.
That might work or it might not, but it sounds better than Kalamau.
Unlike the doctors, Mrs. Pinkham seemed to be listening, and she was listening with
the benefit of her own experience as one of the Pinkham companies' advice books explained.
It takes a woman to understand a woman.
Take for instance, the long list of diseases and discomforts, which come directly from
some deraidagement of the female generative organs.
Do you think it's possible for a man to understand these things?
That still doesn't answer the question of whether Lydia E. Pinkham's vegetable compound
actually worked.
But then, what did the doctors have to offer that was better?
Nothing.
The Pinkham Company was set up as a partnership between Lydia Pinkham's four children, and
it remained within the family for decades. But at the start of the 20th century, the Pinkham's
became a tempting target for a backlash against patent medicines in general. In 1905, Edward
Bach, the editor of the Ladies' Home Journal, launched a ferocious attack on the Pinkams.
He published a discomforting pair of contrasting images on the left, a recent advertisement for Lydia Pinkams' vegetable compound,
urging women to write to Mrs. Pinkham for advice, on the right, a photograph of an ornate monument in a cemetery in
Lynn, Massachusetts to Lydia E. Pinkham, showing that she had died on May 17, 1883, 22 years
earlier. The implication was clear, the pinkams were liars.
Corsinoetales will return after the break.
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Edward Box Attack was an uncomfortable moment for the Pinkham family business, which was
being run by Lydia's son, Charles. They were encouraging people
to write to Mrs. Pinkham, but Mrs. Pinkham had been dead since the early years of the
company. The Pinkham defence was to brazen it out. They issued a statement noting that
the Mrs. Pinkham mentioned in the advertisement was Lydia's daughter-in-law, Jenny, and she
supervised the company's correspondence with
female customers. The company explained that they had never claimed that Lydia, E. Pinkham
answered all the letters, and declared optimistically that the general public understands this
very well. But why were prominent commentators such as Edward Bock so keen to attack the Pinkham operation.
Not because there was any suggestion that the vegetable compound did not work. Nobody
seemed to care about that. Instead, just as Thomas Diet had been undone not by selling
phony cures but because of a bank run, campaigners such as Boc worried less about whether Payton Medsons helped women and more
that they contained alcohol.
One of Boc's articles was titled The Paytoned Medicine Curse.
It included a table showing the alcohol content of Lydia Pinkham's vegetable compound and
three dozen other Paytoned Medsons.
No woman has a moral right to give a medicine to her child or to any member of her family
or to take the medicine herself, the ingredients of which either she does not know or has not
the assurance of a responsible physician to be harmless.
Boc finished with a flourish, arguing that to give a medicine containing alcohol to a child would be to strike at his very soul,
planting the seed of a future drunken.
As for the women themselves, Boc sneered at their symptoms.
They feel sluggish after the all-winter indoor confinement.
They feel that their symptoms need a toning up.
The idea that some women might be suffering agonizing, disabling pain doesn't seem to have occurred to Edward Bach.
But then, despite the fact that he edited the ladies' home journal,
he was almost proud to declare weirdly in the third person,
that he knew nothing about them. It is a curious fact
that Edward Box's instinctive attitude towards women was one of avoidance. They had never
interested him, of women therefore he knew little, of their needs less. Nor had he the slightest
desire even as an editor to know them better or seek to understand them.
desire even as an editor to know them better or seek to understand them. Three things, however, he did understand. First, the medicine contained alcohol. Second,
in the opinion of Edward Bock, women were inventing their symptoms. And third, the Pinkham
Company was inviting women to write to Mrs. Pinkham, even though Mrs. Pinkham was dead.
What more did anyone want?
Well, if you were suffering from female complaints, perhaps a cure?
The medical term for one particular form of female complaint is dysmenorrhea. We usually just
call it period pain, and it can be incapacitating in its severity.
The doctors of the late 19th and early 20th century didn't have much to offer, beyond
suggesting that pregnancy was the natural cure.
But surely we can do better in the 21st century.
Can't we?
If you search the medical literature, you won't find many treatments for severe period pain.
Exercise might help a bit, maybe.
The same is true for the contraceptive pill, anti-inflammatory as such as ibuprofen can
help.
Ginger might help.
That's about it.
But intriguingly, a small study conducted in 2013 reported that a safe and widely used drug might provide total pain relief over four
consecutive hours for women suffering dysmenorrhea.
Before you rush to get yourself a packet of this miracle drug, I'm afraid the study
wasn't big enough to rely upon, the researchers ran out of money, and they've struggled to
get funding since.
You can read more about this in Caroline
Criado Perez's book Invisible Women. She interviewed the lead researcher who told her simply
that he thought he'd never get funding for a full trial. So that's annoying. If you're
curious about what this promising little drug is, well, it was originally tested in 1989 as a treatment for angina,
it did not work.
However, all of the trial participants were men, and they reported an intriguing side effect,
magnificent directions, and so the drug, Sildenefil, was repurposed and put on the market
as the wander drug, Viagra.
You can't help but wonder that if women had been on the original trial, we might also
have fortuitously discovered that elusive treatment for severe period pain.
As it was, men got their miracle drug, but women are still waiting.
Given this performance from the medical mainstream,
it's really no wonder that treatments such as
Lydia Pinkham's vegetable compound thrive.
Whether the Pinkham's really believed
in the power of their own medicine is unclear.
Letters from Lydia's sons, Dan and Will, suggest a certain degree of cynicism
about that. But Lydia herself seems to have kept the faith in herbal remedies when the
most testing times came. Here's her diary from 1879, not long after the vegetable compound
had become a best-selling sensation. Daniel Sik in New York recommended to take three of my liver pills, then steep one-half
ounce of pleurcy root and bugleweed, and one-half ounce of marshmallows, taken one-half
cup at a time, three or four times per day.
Dan Pinkham rallied, but only for a time. In October 1880, Dan Pinkham died, stricken by
tuberculosis. He was just 32. His brother Will had the same illness and was too sick to attend
Dan's funeral. Will died at the age of 28, just two months later.
Lydia Pinkham had lost three of her sons.
Dan, Will, and the infant Daniel,
and in all three cases, the cause had been illnesses
which are easily treatable today.
Medicine can make progress.
That progress doesn't come from overconfident doctrine
and it doesn't come from over-confident doctrine, and it doesn't come from a herbal
tonic, cleverly packaged up with some grand motherly wisdom.
Medical progress requires proper testing of treatments.
The tests which weren't done on Kalamal, and which still haven't been properly conducted
to see if Viagra really can treat severe period pain. But you don't need scientific tests to make money out of people who are desperate for relief,
and Lydia E. Pinkham's vegetable compound made plenty.
Like the image of her old friend, Frederick Douglass, Lydia's portrait became one of the most
reproduced images in the world. Indeed, when Queen Victoria died in 1901,
newspaper editors across America
often lacked a portrait of the monarch,
so they decorated their reports and obituaries
with the next best thing,
a picture of the late Lydia E. Pinkham, close enough.
If you don't have the real thing,
you'll find something to feel a gap. The best history of Lydia Pinkham and the business of Women's Medicine is female complaints
by Sarah Stage.
For a full list of our sources, see the show notes at timhalford.com.
Corsionry Tales is written by me, Tim Halford, with Andrew Wright.
It's produced by Alice Fines, with support from Edith Rousselo.
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We're journalists that have traveled all over, reporting on dangers, people, and places.
And every week, we'll be bringing you a new story about organized crime from all over the world.
We know this stuff because we've been there.
We've seen it and we've got the near misses and embarrassing tales to go with it.
We'll mix in reporting with our own experiences in the field and we'll throw in some bad jokes
while we're at it.
The Underworld podcast explores the criminal underworlds that affect all of our lives, whether
we know it or not.
Available wherever you get your podcasts.
The only world podcast explores the criminal underworlds that affect all of our lives, whether
we know it or not.
Available wherever you get your podcasts.