10 Dubious Victorian Cures From the First Merck Manual of Diagnosis and Therapy

Wellcome Images // CC BY 4.0 (cropped)
Wellcome Images // CC BY 4.0 (cropped)

In his work Of the Epidemics, the Greek physician Hippocrates encouraged doctors to “have two special objects in view with regard to disease, namely, to do good or to do no harm.” Yet the history of medicine has been an exercise in trial and error, with remedies sometimes proving more dangerous than the disease.

Examples of such dubious and sometimes potentially deadly cures abound in the first edition of The Merck Manual of Diagnosis and Therapy, the oldest continuously published English-language medical textbook. First published by the American drug manufacturer Merck & Co in 1899, the manual’s original edition suggests remedies such as hot baths for heat exhaustion, coffee for insomnia, nitroglycerin for headaches, and opium for constipation.

“What’s most fascinating to me are drugs that have an immediate dangerous effect,” says Robert S. Porter, M.D., editor-in-chief of the manual’s 20th edition, which was published earlier this year. “Cocaine for angina? Cocaine is a vasoconstrictor that causes heart attack. Give it to someone with angina and they might die. The bulk of the book is things that simply don't work—that are useless or odd—but these ones really raise questions as to how people could recommend them.”

Here's a selection of puzzling remedies from the first edition, some of which went on to be recommended for decades.


A page from the Merck Manual about anemia
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

Arsenic was one of the top remedies the manual recommended for anemia. Though arsenic had been known as a poison since ancient times, medicines containing small doses of the substance were long used for conditions ranging from anthrax to syphilis to anemia. By the 19th century, arsenic was being inhaled as vapors, ingested, injected, and given in enemas for a variety of ailments. In fact, so many people suffered symptoms—such as rashes, stomach distress, and headaches—from taking arsenic remedies during the Victorian era that their ailments are now sometimes referred to as “Fowler’s disease," after the popular remedy Fowler’s Solution, which contained potassium arsenite.


A page from the Merck Manual about chickenpox
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

Before chickenpox vaccinations became available in the U.S. in 1995, an average of 4 million people each year suffered through itchy outbreaks. When the Merck Manual was first published, part of the comprehensive treatment plan for an "eruptive fever"—whether it was chickenpox, smallpox, or scarlet fever—was laxatives, ideally a dose of castor oil. The idea was to purge the body of the infectious disease, but such treatment usually just compounded the misery and forced the patient to stay close to the toilet.


A page from the Merck Manual about constipation
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

Even a tiny dose of strychnine can cause convulsions. Yet the Merck Manual, following the medical practice of the day, recommended small amounts as a treatment for acute constipation. Commonly derived from the plant Strychnos nux-vomica, strychnine was thought to improve gastric function. (Strychnine injections were also recommended for both flatulence and ulcers.) Opium and turpentine were also recommended, but patients probably derived more relief from the less dramatic manual-recommended regimens, such as eating apples and figs or drinking coffee.


A page from the Merck Manual about hiccups
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

Bad case of the hiccups? Today, you might be told to hold your breath or drink water. But in 1899, your doctor might recommend inhaling chloroform. An organic compound that also a popular anesthetic in the 19th and early 20th century, chloroform eventually fell out of favor because of its potential to damage the nervous system, liver, and kidneys. Other hiccup remedies listed in the Merck manual included nitroglycerin and the slightly less toxic sugar and vinegar.


A page from the Merck Manual about asthma
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

As counterintuitive as it seems today, the manual noted that "smoking is sometimes beneficial" for asthma, adding that “cannabis indica can be used in chronic cases.” The manual was far from alone in recommending the practice; throughout the late 19th and early 20th centuries, inhaling the fumes of tobacco and cannabis, as well as stramonium (a hallucination-inducing nightshade) and lobelia (a flowering plant known for its sedative properties) were popular treatments for asthmatics. There were even special anti-asthma cigarettes. We now know that inhaling any kind of smoke has been shown to damage and eventually reduce the number of cilia—the fine lung filaments which, when healthy, help transport mucus in the lungs—which only leads to a worsening of asthma symptoms.


A page from the Merck Manual about nausea
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

Bloodletting—with leeches or other means—has been used to treat various ailments, including excessive bleeding, for thousands of years. The Ancient Greek physicians thought that it was sometimes necessary to balance blood and other bodily fluids, known as humors. The practice remained a standard treatment for many ailments, including nausea and morning sickness during pregnancy, well into the 19th century. It was thought to regulate the pulse, alleviate fever, and calm pain. While bloodletting can actually help with a few conditions, such as hemochromatosis (a genetic disorder leading to abnormal iron accumulation in the liver), doctors eventually realized that bleeding could also weaken patients and that frequent cutting could lead to infections.

As well as this traditional remedy, the manual’s first edition also recommended cocaine, the wonder drug of the day, to treat all kinds of nausea. Better and less stomach-turning effects could have been achieved with another recommended remedy: cinnamon.


A page from the Merck Manual about insomnia
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

Alcohol, cannabis indica, and “cold douches” were effective remedies for insomnia, according to the Merck Manual. Cold douches—being blasted with cold water—might not seem sleep-inducing, yet in the late 19th and early 20th century this form of hydrotherapy was recommended as a way to improve circulation, fight infection, and treat headaches as well as insomnia. “By this means, the brain is enabled to resume a healthier mode of action, and sleep follows as a matter of course,” wrote Dr. Henry M. Lyman in his 1885 book Insomnia and Other Disorders of Sleep. Other remedies the manual recommended for insomnia included coffee, alcohol, and putting hot water bags on your feet while applying cold ones to your head.


A page from the Merck Manual about colic
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

Misguided medical notions were also applied to easing colic—the severe bouts of stomach pain often suffered by very young babies. The Merck Manual recommended ammonia, turpentine, and belladonna—a poisonous plant in the deadly nightshade family—for relief from colic spasms. Belladonna is still used modern medicines for adults (it's the main ingredient in the drops your eye doctor uses to dilate your eyes), but according to the FDA, “there is no known safe dose or toxic dose of belladonna in children.” In 2010, the FDA warned against its use in homeopathic teething tablets.


A page from the Merck Manual about leeches for earaches
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

Using leeches for an ear infection might sound disgusting at best, but there was some medical justification for the manual's recommendation. Once leeches are firmly attached to their host, they can numb pain, while peptides and proteins in their saliva prevent blood clotting, so they can help drain an infection. Modern medicine has recently taken another look at leeches: In 2004, the FDA decided the creatures met the definition of a live medical device, since their tiny jaws (and anticoagulants) keep blood flowing, which helps wounds to heal. They can also be used to break up blood clots, treat varicose veins, and improve other circulatory disorders.


A page from the Merck Manual about alcoholism
Merck's 1899 Manual of the Materia Medica, Internet Archive // Public Domain

In the 1880s, Sigmund Freud helped popularize the idea of using cocaine to treat alcoholism, calling it a “magical drug.” In its heyday, cocaine was also promoted as a cure for morphine addiction, depression, anxiety, fatigue, and migraines. It was available over the counter in tonics, powders, wines, and soft drinks. Patients likely felt energized by regular cocaine infusions, but they soon became habituated. (Freud experimented on himself for a few years until the mounting evidence of cocaine’s addictive nature proved too much to ignore; the drug was made illegal in the U.S. in 1914.) The 1899 manual also offered simpler, less dangerous—but also likely ineffective—ways to battle alcohol cravings, including slowly sucking an orange or drinking water hot ("one pint drunk as hot as possible an hour before meals will remove craving"), or cold in small sips.

These Are the Top 25 Highest Paying Jobs in the U.S. Right Now

Pattanaphong Khuankaew/iStock via Getty Images
Pattanaphong Khuankaew/iStock via Getty Images

If you assumed that the most lucrative careers right now were in the healthcare, tech, finance, and legal fields, you are absolutely right. In a new study, Glassdoor compiled salary data from the past year to identify jobs with the highest base salaries, and their findings aren’t exactly surprising.

To create the list, Glassdoor collected user-submitted salary information, grouped jobs with synonymous titles together under one label, and analyzed its findings using an algorithm that factored in variables like location and seniority.

With a median base salary of $193,415, physicians are (unsurprisingly) the top earners—beating out the runners-up, pharmacy managers, by nearly $50,000 (which, on its own, is just under the median U.S. base salary of $53,950). Dentists and pharmacists round out the top four slots, and then the list becomes overwhelmingly tech-heavy with a smattering of finance and legal positions.

The unifying theme among all the jobs is a high level of skill, gained through years of advanced education, experience, or both. And as companies try to adapt their business models to the digital landscape, people who can understand and interpret data are a hot commodity, as evidenced by position titles like data architect, data scientist, and analytics manager.

Whether you’re deep in the throes of your own job search or you’re just curious to see how your current position measures up against others, scroll on for the full list of America’s highest-paid workers.

  1. Physician // $193,415

  1. Pharmacy Manager // $144,768

  1. Dentist // $142,478

  1. Pharmacist // $126,438

  1. Enterprise Architect // $122,585

  1. Corporate Counsel // $117,588

  1. Software Engineering Manager // $114,163

  1. Physician Assistant // $113,855

  1. Corporate Controller // $113,368

  1. Software Development Manager // $109,809

  1. Nurse Practitioner // $109,481

  1. Applications Development Manager // $107,735

  1. Solutions Architect // $106,436

  1. Data Architect // $104,840

  1. Plant Manager // $104,817

  1. IT Program Manager // $104,454

  1. Systems Architect // $103,813

  1. UX Manager // $102,489

  1. Site Reliability Engineer // $100,855

  1. Cloud Engineer // $98,626

  1. Attorney // $97,711

  1. Data Scientist // $97,027

  1. Information Security Engineer // $95,786

  1. Analytics Manager // $95,238

  1. Financial Planning & Analysis Manager // $94,874

[h/t Thrillist]

25 Facts About The West Wing on Its 20th Anniversary

James Sorensen/NBC/Newsmakers
James Sorensen/NBC/Newsmakers

Twenty years ago, one of the most influential, acclaimed, and quoted TV shows of all time aired its series premiere on NBC. The brainchild of a screenwriter who’d never wanted to write television in the first place, aired by a network that wasn’t sure a show about politicians could work with viewers, The West Wing rose above early doubts to become one of most celebrated shows of its era, winning four consecutive Outstanding Drama Series Emmys and turning its ensemble cast into major stars.

Even now, 20 years after it arrived, The West Wing remains a binge-worthy fan favorite, and has earned its place among the greatest television series of all time. So, to celebrate two decades of the Bartlet White House, here are 25 facts about The West Wing.

1. Aaron Sorkin didn’t want to do TV.

"The West Wing" show creator Aaron Sorkin accepts the "Heritage Award" for the "West Wing" onstage during the 2006 Summer TCA Awards held at The Ritz-Carlton on July 23, 2006 in Pasadena, California
Frederick M. Brown/Getty Images

The seed for The West Wing was planted when screenwriter Aaron Sorkin, fresh off the success of films like A Few Good Men and The American President, was asked to take a meeting with TV producer John Wells, who was still riding high from the success of ER at NBC. Sorkin agreed to the meeting, though he had “never thought of doing television,” and the night before meeting with Wells he had a conversation with his friend, screenwriter Akiva Goldsman, who referenced Sorkin’s The American President and suggested the idea of a TV series about a senior staffer at the White House. Sorkin still resisted the idea of a TV show, but couldn’t get the idea out of his head.

“The next day I walked into the restaurant and immediately saw this wasn't what I thought it was going to be,” Sorkin told Empire. “This wasn't just a ‘hello, how are you?’ meeting, because John was sitting with a couple of agents and studio executives from Warner Bros. Right after I sat down, he said, ‘So what do you want to do?’ And instead of saying, ‘I think there's been a misunderstanding, I don't have an idea for a television series,’ which would've been honest, I said 'I want to do a television series about senior staffers at the White House.' He said, ‘Okay, you got a deal.'"

2. It was assembled from The American President leftovers.

With a deal made, Sorkin then had to go back and begin scripting what would become the pilot of The West Wing, but he wasn’t short on material. Thanks to his work on The American President, Sorkin already had ideas for what his senior staffers at the White House might do that he hadn’t been able to fit into that script. One of them became the first storyline for the series’ pilot episode.

“If I'm writing a script, really 90 percent of it would be just walking around, climbing the walls, just trying to put the idea together. Then the final 10 percent would be writing it,” Sorkin said. “Fortunately I had written a very long first draft of The American President: about 385 pages, when what you want is 130 or 140. So there were these tiny shards of ideas and one of them, about Cuban refugees, I was able to spin into a pilot.”

3. A Bill Clinton scandal delayed The West Wing's start.

Wells took The West Wing to NBC, where he wanted to set the show as part of a deal he’d made with the network after the success of ER. Network executives were hesitant, fearing that no one would watch a show about politicians. While Sorkin was writing the pilot, news broke of President Bill Clinton having an affair with an intern in the White House, which only served to bolster the network’s reluctance to put the show on the air.

“The Lewinsky scandal was happening at the very time I was writing the pilot and it was hard, at least for Americans, to look at the White House and think of anything but a punch line,” Sorkin recalled. “Plus a show about politics, a show that took place in Washington, had just never worked before in American television. So the show was delayed for a year.”

According to Wells, NBC held on to the show because they didn’t want it to go to another network under the terms of Sorkin’s deal. In the year while The West Wing was on hold, Sorkin and director Thomas Schlamme managed to launch a different TV series, Sports Night, on ABC in the fall of 1998. That series helped executives better understand Sorkin’s style and, at Wells’ urging, NBC greenlit The West Wing.

4. NBC sent some strange early notes on the series.

Though NBC agreed to make The West Wing after seeing Sports Night, executives remained nervous about the series in its early stages, and offered up a number of interesting notes that Wells and Sorkin ultimately resisted. Among their suggestions, according to Wells, was that the president on the series should not be a liberal democrat, but rather “a populist, somebody who's a wrestler or a race car driver or a football player coming in from the outside and shaking things up.”

“We chose not to do that,” Wells recalled.

Another suggestion about the pilot episode, which featured Josh Lyman attempting to deal with Cuban refugees coming into Florida, was that Josh and Sam Seaborn should be “in the water” during the incident to create more action. Sorkin and Wells also chose not to do that.

5. Bradley Whitford almost played Sam Seaborn.

Winner for Outstanding Supporting Actor in a Drama Series "The West Wing", Bradley Whitford at the 53rd Annual Prime-Time Emmy Awards held at the Shubert Theatre, Los Angeles, CA., Nov. 4, 2001
Kevin Winter/Getty Images

It’s hard to think of anyone other than The West Wing’s eventual main cast playing their roles now, but as the casting process for the show began there were a number of different potential actors in mind for key characters, including one actor who was up for two roles. Sorkin had written the role of Deputy Chief of Staff Josh Lyman specifically for Bradley Whitford, while the role of Deputy Communications Director Sam Seaborn was offered to Rob Lowe. At one point in the process, though, there was concern over whether or not Lowe would actually sign on to the show. The network asked the creators to begin looking at other actors to play Sam, and Whitford found himself suddenly in consideration to play the best friend of the character who was written for him.

“I got a phone call saying that I was in the show but I was playing Sam,” Whitford told Empire. “I remember I was in a gas station in Santa Monica and I had no right not to be thrilled but I called Aaron and I said, 'I'm not Sam! I'm not the guy with the hooker, I'm the guy bashing the Christian right!'"

Fortunately for Whitford, Lowe ultimately did join the show as Sam Seaborn, and he got to play Josh Lyman.

6. Donna Moss was not meant to be one of the show's stars.

Janel Moloney originally read for the role of C.J. Cregg during The West Wing audition process. Sorkin knew she wouldn’t get that role, but wanted Moloney to find a way into the pilot somehow, and offered her the role of Donna, Josh Lyman’s assistant, who was initially meant to only have a couple of lines. Moloney was warned she shouldn’t expect anything more than an occasional recurring appearance, but along the way Sorkin added a second short scene between Josh and Donna to beef up the pilot a bit. He liked the chemistry between the two characters so much that he just never stopped.

"I was hostessing at an Italian restaurant in Beverly Hills called Il Pastaio, and I kept my job at the restaurant at first,” Moloney told The Hollywood Reporter. “But by the third episode, I knew that they were never going to get rid of me.”

7. CCH Pounder almost played C.J. Cregg.

C. C. H. Pounder attends the premiere of Warner Bros. Pictures and Legendary Pictures' "Godzilla: King Of The Monsters" at TCL Chinese Theatre on May 18, 2019 in Hollywood, California
Frazer Harrison/Getty Images

When it came time to cast White House Press Secretary C.J. Cregg, Sorkin and company found themselves with two talented actresses in mind for the part: Allison Janney was a major contender thanks to her performance in the political comedy Primary Colors, but CCH Pounder—fresh off an Emmy-nominated three-season run on ER—was also up for the role.

“CC would have been fantastic, but we just couldn't not give the part to Allison,” Sorkin said.

Janney later remarked that she suspected a big reason she won the role was a major pratfall she took in Primary Colors, because one of the first things we see C.J. do on the show is fall off a treadmill. Janney went on to win four Primetime Emmy Awards, including three consecutive wins, for her work as C.J.

As a bit of a consolation prize, Pounder would also later appear on the show in a one-episode guest appearance as HUD Secretary Deborah O’Leary.

8. Eugene Levy almost played Toby Ziegler.

When it came time to cast the brilliant but grumpy Communications Director, Toby Ziegler, Sorkin and company again found themselves down to two great actors. One was Richard Schiff, who eventually won the role, and the other was Eugene Levy, best known for his comedy work in films like Best In Show.

“[Levy] really gave Richard a run for his money but there was just something undeniable about Richard where you knew he was going to elevate not just the role but the show—you couldn't look away,” Sorkin said.

Sorkin’s confidence in Schiff paid off, as Schiff won an Emmy for playing Toby in the first season of the series.

9. Several legendary actors were considered for President Bartlet.

'The West Wing' cast: Front row, L to R: Allison Janney, Bradley Whitford, Martin Sheen, Richard Schiff, and Janel Moloney; Back row,  L to R: John Spencer, Rob Lowe, and Dule Hill
NBC/Newsmakers via Getty Images

With the key members of the senior staff cast, including John Spencer as White House Chief of Staff Leo McGarry, Schlamme began working on rehearsal for The West Wing pilot, but one key piece of the puzzle was missing: The President, who wouldn’t appear in the show until the final scene of the first episode.

According to Sorkin, the first actor who was actually offered the role was Sidney Poitier, but the legendary Oscar winner's salary demands were “too rich for our blood.” From there, the show considered Jason Robards, but his poor health led to concerns that he wouldn’t be able to keep up with a recurring TV schedule. John Cullum and Hal Holbrook (who ultimately did land a role on the show as Under Secretary of State Albie Duncan) also read for the role, but the search stopped when Wells suggested Martin Sheen, who had already worked with Sorkin in The American President. After reading the script, Sheen agreed to take the part.

10. The President was originally supposed to be a guest star.

When Sheen accepted the role of President Josiah “Jed” Bartlet, he did it thinking he would be a recurring cast member only, appearing in just a handful of episodes each season. Sorkin originally intended to use the President sparingly on the show, keeping the focus on the staff out of fear that having the Leader of the Free World pop up all the time would “take up all the oxygen in a room.” When Sheen showed up to work on the show, though, in the famous final scene of the pilot in which he berates a group of hypocritical ministers, everyone knew Sheen would be sticking around.

“Aaron's whole thing was that he didn't want the pomposity of the presidency. He didn't want everybody to do exactly what, in the final scene, everyone does, which is stand still and be respectful and just listen to what the President has to say,” Schlamme recalled. “But once we cast Martin and we realized Martin's incredible accessibility, nothing felt pompous or aloof. If the show is about all the planets, let's end it with the sun.”

11. Martin Sheen came up with President Bartlet’s background.

After the pilot convinced Sorkin, Schlamme, and company that President Bartlet should be a main cast member rather than occasional guest star, Sheen went back to the table to renegotiate his contract for an increased number of appearances on The West Wing. When he did, he offered up a couple of conditions that proved to be key contributions to the Jed Bartlet character.

“I had to renegotiate a long-term contract after the pilot and I asked two things: that they make Bartlet a Catholic—because I wanted him to form all of his opinions from a moral frame of reference and as a Catholic myself, that's the way I framed all of my actions,” Sheen explained. “And I also asked that he be a graduate of the University of Notre Dame. Aaron agreed to both of them and they became a staple of the character.”

12. It was Thomas Schlamme who suggested the now-iconic “walk-and-talk” shots.

As The West Wing came together and Sorkin began delivering scripts, the design of the show's visuals fell to Schlamme, who quickly realized he had to find new ways of making a bunch of scenes that were essentially people have high-stakes meetings into something that would look dynamic and exciting on a TV screen. It was out of this need that the show’s trademark “walk-and-talk” sequences of characters have long conversations while moving through corridors was born.

“I thought his language had motion, so why not get people up and have them say that language while they're also moving? It was driven by the idea that there is no wasted time,” Schlamme said. “If you went from one place to another, that had to be a meeting!”

The walk-and-talks required tremendous precision on the part of camera operators and cast members, who all had to make sure they remained in frame even as they tried to keep their movements through the halls as natural as possible. While this created various issues like falling cameramen and loads of cast bloopers, the actors still found it rewarding.

“You were in a relay race and if you had to come in on the third hallway pass and you f***ed up, it was like, ‘Oh my God!’ It was this really exhilarating game and the perfect way to keep a show about politics active, exciting, and fast-paced,” Janney said.

13. Sorkin demanded the dialogue be exactly what he wrote.

Even then, after his film writing and time in the theater, Sorkin was famous for the rhythm and pacing of his dialogue. And by the time The West Wing came along he’d taken great pains to make sure the language that was on his page was the same language spoken by his actors in the finished product. Sheen later recalled that it was actually a part of Sorkin’s contract that the dialogue he wrote had to be repeated exactly by the cast, and while the actors could make suggestions for rewrites, improvisation was never encouraged.

“I had been used to improvising and even in the audition I was feeling free to rearrange Aaron's words a little bit, as lovely as they were. I didn't find out until after I got the part how furious Aaron was at me for doing that,” Schiff recalled. “They said, ‘He was livid. He did everything in his power not to jump down your throat!’ But I came to realize that Aaron was writing in meter and the rhythm of the language is very important.”

14. Real White House staffers served as consultants.

Moira Kelly, Dule Hill, Rob Lowe, Richard Schiff, Martin Sheen, John Spencer, Allison Janney, and Bradley Whitford in "The West Wing
NBC, Getty Images

Though Sorkin was the driving force behind The West Wing’s stories in its first four seasons, with a writing credit on nearly every single script, he didn’t just spin all of those plots out of thin air. Many of the most famous West Wing stories were based on or inspired by anecdotes that came to Sorkin and his writers room from various consultants who’d previously served as White House staffers.

Among the former staffers who joined The West Wing in some capacity over the years were former Clinton press secretary Dee Dee Myers, former George H.W. Bush press secretary Marlin Fitzwater, Clinton economic adviser Gene Sperling, and famed Reagan speechwriter Peggy Noonan. The writing staff itself also boasted former staffers, including Carter staffer Pat Caddell, Al Gore speechwriter Eli Attie, and now-MSNBC host Lawrence O’Donnell, who served as chief of staff to U.S. Senator Daniel Moynihan and eventually wound up as an actor on the show, playing Bartlet’s father in flashback in the episode “Two Cathedrals.”

Among the storylines on the show that were inspired by consultant anecdotes: Someone getting left behind by the presidential motorcade because it has to keep moving (“20 Hours in America,” Season 4); a foreign diplomat showing up to the White House drunk (“The Lame Duck Congress,” Season 2); and the complications of the U.S. Census (“Mr. Willis of Ohio,” Season 1).

15. The MS subplot came from researchers.

In the season 1 episode “He Shall, From Time to Time,” First Lady Abigail Bartlet (Stockard Channing) reveals to Leo McGarry that President Bartlet has multiple sclerosis. This secret, which wasn’t really brought up as a plot device again until the season 2 premiere, became the driving narrative force late in the second season, as a Congressional investigation into whether or not Bartlet had defrauded the public by concealing his illness got underway. Bartlet’s MS ultimately became one of the show’s most potent dramatic elements, but during a 2016 panel at the ATX Television Festival, Sorkin admitted he initially gave the President the disease simply because he wanted to do a story about Bartlet taking a sick day and needed an excuse for the First Lady to come rushing home to take care of him.

“I said, ‘Kevin [Falls, The West Wing writer and co-executive producer], can you get the researchers on something? I need just the right disease.’”

Sorkin picked multiple sclerosis and moved forward with the episode, only to find that the next time he faced questions from the Television Critics Association, everyone wanted to know when the MS storyline would come up again. So, Sorkin had to figure out what happened next.

16. Allison Janney did "The Jackal" in real life.

Talk to die-hard West Wing fans about their favorite moments in the history of the show, and you’ll hear “The Jackal” come up a lot. In the season 1 episode “Six Meetings Before Lunch,” after the staff wins a Senate confirmation for a Supreme Court Justice, they celebrate in the White House, and C.J. performs a dead-on lip sync of the Ronnie Jordan song “The Jackal” for the assembled staff. According to Janney, that was one of the pieces of the show pulled from real life on the set.

“Richard Schiff and I would constantly think of terrible ways to spend our time waiting to work,” she recalled. “We started doing just ridiculously silly things in my trailer like playing air guitar and lip-syncing to crazy songs. We made Aaron come in to see us do ‘The Jackal,’ and then he put it in the show.”

17. One piece of the original ensemble didn’t fit.

Moira Kelly And Bradley Whitford Star In The West Wing
NBC, Getty Images

Over the course of its first season, The West Wing continued to garner critical acclaim and an ever-growing audience that would ultimately make it one of the most talked-about and celebrated shows of its era. That season would ultimately garner five Primetime Emmy Awards, including Outstanding Drama Series, a Peabody Award, and numerous other accolades. Despite all of this, one part of The West Wing machine wasn’t working out: The character of Mandy Hampton, a former Bartlet campaign staffer who was introduced to the show as a foil for Josh Lyman and ultimately became the Bartlet White House Media Director.

Mandy, played by Moira Kelly, was embroiled in a subplot late in the first season in which a playbook for defeating Bartlet that she’d written was stolen from her computer and leaked, and by the second season premiere the character had disappeared from the show entirely without explanation. So, where did Mandy go? According to Sorkin, there’s no great mystery to solve. It just didn’t work out.

“Moira was a joy to work with, a total pro who understood as time went on that for whatever reasons—and those reasons had nothing to do with her considerable talent—it just wasn't working,” he later said. “She was a model of graciousness.”

18. Joshua Malina requested his role on the show.

After three seasons of award-winning success, change began to come to The West Wing in a form even bigger than a cast member leaving unceremoniously after just one season. Midway through season 4, Rob Lowe—who, when the show began, had been a key selling point of the series for both audiences and network executives—announced that he would leave The West Wing behind.

“Tommy, John, and I did everything we could to try to change his mind, but Rob had his own plans, and after he gave us his best for three-and-a-half years, we wanted the best for him,” Sorkin recalled.

Sam Seaborn was written out of the show after a failed Congressional campaign in California, leaving room for a new Deputy Communications Director in The White House. Joshua Malina, who’d worked with Sorkin and Schlamme on Sports Night, heard the reports of Lowe’s departure and basically asked if he could have a job on the show.

“I read that Rob Lowe was thinking about leaving, and I really needed a job,” Malina told The Hollywood Reporter. “I sent [Aaron] an email, the contents of which basically were: ‘What about a less well-known, less good-looking actor who would work for less money?’ It was shameless, but to my surprise, Aaron's response suggested that he had already talked to Schlamme about the idea. I drove to meet him at the Four Seasons for lunch, and he said, ‘Here's the character I'm thinking of for you.’"

Malina was introduced in the season 4 episode “Game On” as Congressional campaign manager Will Bailey, who befriended Seaborn before taking his place in the White House staff.

19. Aaron Sorkin never watched the seasons he didn’t write.

Rob Lowe’s departure turned out to be the lesser of two major shake-ups on The West Wing in its fourth season. After Lowe announced he was leaving, Sorkin and Schlamme also announced that the fourth season would be their last, leaving The West Wing without its creative driving force. Though Sorkin’s name was always on the show as a creator, the last episode he wrote was the season 4 finale “Twenty Five,” which left a cliffhanger involving Bartlet’s kidnapped daughter and a new interim President for Wells and company to pick up in season 5.

As he left The West Wing behind, Sorkin got a call from another famous television writer who’d recently departed a hit series, who gave him a key piece of advice.

“Larry David had left Seinfeld a few seasons before the show ended and he called me and said, ‘You can never watch The West Wing again. Either the show is going to be great without you and you're going to be miserable, or the show is going to be less than great without you and you're going to be miserable.’ I thought, ‘Well, this is Larry David; he's kind of professionally miserable.’ So I had them send a tape of the first episode that I didn't do,” Sorkin admitted. “I put it in the VCR and I don't think I got 15 seconds in before I leaped up and slammed it off! It felt like I was watching somebody make out with my girlfriend. Except for that 15 seconds, I've followed Larry's advice. I've never seen a West Wing episode in seasons five, six or seven.”

20. Matt Santos and Arnold Vinick were based on Obama and McCain (sort of).

Though Wells later admitted the months following Sorkin and Schlamme’s departure was a tough time for the show, The West Wing evolved and eventually found its stride again in its final three, Sorkin-less seasons. One of the reasons for this was the sense that the show needed a new driving force, and found it in season 6 in the form of a campaign to find the man who would succeed Bartlet as President at the end of his second term. The show ultimately set the stage for a showdown between an idealistic liberal with a minority background from the Democratic Party and an older, maverick conservative from the Republican Party. This all unfolded on the show more than two years before the 2008 President election, so there’s no direct correlation between that campaign and this fictional one. Even so, the character of Congressman Matt Santos of Texas (Jimmy Smits) did end up being partially based on the then-theoretical rise of Barack Obama.

“[Political consultants] basically laid out for us what they thought the campaign strategy would have to be for [Obama] to ever run for president, although they kept telling us the whole time, ‘It'll never happen, of course,’” Wells recalled.

Senator Arnold Vinick of California (Alan Alda), the Republican candidate, was based a bit more directly on John McCain, who’d already staged a formidable run for the White House in 2000 only to lose in the primary to George W. Bush.

“Vinick was based on John McCain and a number of possible centrist Republican candidates. The rise of the Tea Party, that very militant side of the Republican Party, hadn't really forced people into the positions that Republican presidential candidates have to take now. So we were looking for someone far more moderate, what would now be considered an establishment Republican,” Wells said. “The 2008 election was very odd. We called the political consultants we'd worked with and said, ‘You guys kind of knew what you were talking about!’”

21. Vinick almost won the election.

After the season 6 finale set the Democratic ticket for President as Matt Santos and Leo McGarry (who by then had left full-time West Wing employment following a heart attack and become a special counselor), season 7 dug deep into the general election for President, as the show’s writers tried to create a convincing scenario in which either candidate could win. Though the show’s main cast were of course supporting Santos, Wells and the writer spent a lot of time building up Vinick as a noble, principled leader who the audience could root for and respect. It turns out that’s because Vinick was originally intended to win the election. The death of actor John Spencer on December 16, 2005—midway through the seventh season—forced numerous last-minute changes to the show’s final episodes. According to Sheen, one of them was a Democratic victory, with Leo McGarry dying of a heart attack on election night.

“Up until his death, the Republican was going to win the election,” Sheen recalled. “Jimmy Smits would be defeated and that wonderful actor Alan Alda would win. But with John's death they said no and, against history, the Democrats would continue.”

22. There was almost a season 8.

Actor John Spencer, of "The West Wing " television program, attends the 2002 Service to America Medals Awards November 13, 2002 in Washington, DC
Mark Wilson/Getty Images

Spencer’s death at the age of 58 devastated The West Wing’s cast and crew, but it was agreed that he would have wanted them to carry on with the story, which now included losing him.

“You don't want to exploit anything, but we all felt that honoring his character in the show would have been something he'd be comfortable with,” Whitford recalled.

That meant rewriting the remaining scripts to include Leo’s election night death, and the addition of an episode titled “Requiem” that served as both a funeral for Leo and a reunion and communal goodbye for the cast and crew.

“The episode where we actually had to carry his casket because his character had died ... it was an empty casket, but it wasn't an empty casket,” Dule Hill, who played Charlie Young, later said.

Spencer’s death also meant that discussions for an eighth season that would have focused on Santos’s rise to power and the early days of his administration, with Bartlet acting as elder statesman, were ended. Though there could have been more story, no one felt right carrying on without Spencer.

“[W]hen John died, they folded the tent,” Sheen, who compared losing Spencer to losing a brother, said. “It was over, and we thought, ‘No, we can never go back there.’”

23. Richard Schiff and Allison Janney didn’t like where their characters went.

Actress Allison Janney (R) arrives at the premiere of her new miniseries "A Girl Thing" with co-star of television series "The West Wing" Richard Schiff (L), January 10, 2001 in Hollywood, CA
Lucy Nicholson/Newsmakers via Getty Images

The John Wells era of The West Wing included a number of different shake-ups and ambitious new plotlines, and that included new directions for some of the show’s key characters. Early in the sixth season, Leo McGarry suffered a near-fatal heart attack, and Bartlet named C.J. Cregg the new White House Chief of Staff. Though it added some new energy to the show, Janney wasn’t exactly a fan.

“I liked the dynamics the way they were. Me having to be the boss of everyone wasn't as fun for me in the room and the comedy wasn't there,” Janney recalled. “When C.J. became Chief of Staff it was a strange shift for me on the show and I wasn't comfortable in that shift."

The change was even more radical for Toby Ziegler, who went from one of the president’s most trusted advisors to a disgraced criminal when it was revealed in the season 7 episode “Mr. Frost” that he’d been responsible for leaking classified information about a military space shuttle to the press. Schiff hated the turn for his character, and believed Toby would never have betrayed Bartlet.

“What was done to Toby [in the final season] was wrong. I was deeply, deeply hurt by that” Schiff said. “They gave me this scene where I reveal myself as the White House leak and I thought, ‘Oh, maybe I'm taking the fall for somebody.’ So I played that out kind of heroically, like maybe I'm falling on my sword. I did not know that they wanted to shorten the number of my episodes! I hope it was just a bad idea that they thought was great and that there was nothing beyond that—but it was a really bad idea and very insulting to me.”

24. Janel Maloney always knew Donna was in love with Josh.

One of The West Wing’s many, many running narrative hallmarks was the Will They/Won’t They? energy that developed between Josh Lyman and his assistant Donna Moss. While some fans were never keen on the two hooking up, others were always dying for it to happen, and the sexual tension finally came to a head in season 7, when Josh and Donna fell into bed together during the heat of the campaign’s final days and ended up trying to make a go of things as a couple. According to Moloney, it may have taken that long for the writers to bring them together, but in her mind Donna was in love with Josh from the very beginning of the show.

“The whole basis of my character, before I even started on day one, was ‘Donna is drop-dead, head-over-heels, 100 percent would die for Josh,” Moloney said in 2016. “Every file I signed, every policy I asked about, the subtext was ‘I just love you so much, I would do anything for you at any moment.’”

25. Aaron Sorkin came back for the series finale.

Sorkin resisted opportunities to look back on The West Wing after he left at the end of the show’s fourth season, never returning to guest script an episode and heeding Larry David’s advice to never watch what other writers had taken over from him. The seventh and final season of the show was full of reunions, though, including the returns of characters like Sam Seaborn and frequent guest Ainsley Hayes (Emily Procter) for an episode or two, and it turned out Sorkin also wanted to at least be present for the farewell. He makes a brief but prominent cameo appearance in the series finale, “Tomorrow,” as a man seated on the stage during Matt Santos’ inauguration.