Patent medicines in late Georgian England have been misunderstood. Rather than just being visible constituents of irregular practice, they were a separate, substantial, industry providing a wide range of popular products. Most of the prominent medicine owners were either reputable tradesmen who did not practise medicine, or medical professionals; they operated from fixed premises for substantial periods of time, and they employed practices specific to the industry. A minority of nationally-available medicines were indeed owned and distributed by irregulars who were regarded as quacks by contemporaries, yet even these participants attempted to follow regular medicine. Wholesaling was initially led by London booksellers, but later moved to medicine specialists and chemists. The patent medicines industry was a separate entity, different from regular medicine and from irregular practice though linked to both of them, and restoring it to its rightful place changes our picture of late Georgian health care.