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To be both quackery and fraud, the quack must know they are misrepresenting the benefits and risks of the medical services offered (instead of, for example, promoting an ineffective product they honestly believe is effective).

In addition to the ethical problems of promising benefits that can not reasonably be expected to occur, quackery also includes the risk that patients may choose to forego treatments that are more likely to help them, in favor of ineffective treatments given by the "quack".

The publication was composed of 20 chapters, organising the work by sections according to the ailments the medicines claimed to treat.

Each remedy was tested thoroughly, the preface stated: "Of the accuracy of the analytical data there can be no question; the investigation has been carried out with great care by a skilled analytical chemist." The book did lead to the end of some of the quack cures, but some survived the book by several decades.

A quack is a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, knowledge, qualification or credentials he or she does not possess; a charlatan or snake oil salesman".