treated chronic conditions and according to the testimonial letters she published in her advertising, the majority of her customers were working people and farm families who could not afford the high cost of private doctors' fees and who received her medical remedies and treatment advice by mail order. Rebecca Keck considered herself to be a fully qualified physician by virtue of her long years of experience treating her family, neighbors and public customers. She owned a large medical library and advertised herself as an Eclectic practitioner. The Eclectic School of medicine, which grew out of the sectarian medical reform movements of the 1830s, was an active and publicly accepted school of medicine in the mid 19th century in the Midwest that competed with homeopathy and allopathic (or regular, scientific) medical approaches. Eclectic treatments combined an emphasis on botanical remedies with a willingness to use regular medical techniques in certain cases. There is no evidence that Rebecca Keck ever graduated from an Eclectic medical school although most of them were open to women by the 1870s. She did not enroll for regular medical training at the University of Iowa's new medical school which opened for men and women in 1871. Either she could not afford the time and money required (because of her six children and her family's bankruptcy in 1873) or she did not consider a professional degree to be necessary for her practice as a physician. Fame grows With the exception of Lydia Pinkham, Mrs. Dr. Keck appears to be the only woman to have earned substantial wealth on her own behalf in the lucrative but highly competitive and bruising profession of selling patent medicine in 19th century America. Like Mrs. Pinkham, Mrs. Dr. Keck began her career because of family bankruptcy caused by the Panic of 1873. Unlike Mrs. Pinkham, Rebecca Keck not only believed herself to be a practicing physician, but became the top executive of the family's business and ran it herself, with the assistance of her two oldest daughters, Belle Alexander and Charlotte Dorn, while her husband played only a peripheral role and her only son contributed even less to the operations. It is difficult to know Mrs. Dr. Keck's exact income, but she was able to purchase her infirmary in 1879 for $12,000 in cash, and at the time of her death, her life insurance payout of $15,520 was one of the largest made