"Now you see it, now you don't!"

This signature pronouncement, long the mantra of shell game operators on the street, has infiltrated modern sales techniques, pulling a slick, sophisticated bolt of wool over the eyes of the American consumer, particularly in the area of new medicines.

The driving forces of such merchandising, be it of products or services, are promises - and the 'Promises Land' is advertising. In that Oz-like world, the bait is irresistible and the proffered rewards equally so, but there are often devils in the details and flimflams in the fine print. That is to say, what you see is not exactly what you get - and what you don't know at first can hurt you at last. For example, the TV ad promises you more hair where you want it, less hair where you don't, livelier sex, deader allergies, longer-lasting life, shorter lasting heartburn, or a cure for your erstwhile incurable ailment. Then the ominous super text at the bottom of the screen informs you that you may receive in exchange for the the promised boon less desirable tradeoffs like angina, diarrhea, cramps, constipation, mood swings, fainting spells, blurred vision, insomnia, enlarged pores, bad smells, or even croakage, if you really hit a bad patch. And if you're pregnant, thinking about getting pregnant, nursing, or just naturally unlucky, forget about it and settle for whatever you have that you wish you didn't.

For some of us, specifically we hypochondriacs, that variation of Russian Roulette is a cruel game. I am, you must understand, plagued with most of the maladies trumpeted during 'short breaks" on TV, come to think of them...of which I wouldn't come to think except for the damned commercials!

Although I've never, thank God, had cancer, most of the danger signals have been weekly visitors all of my adult life; and after seven decades of hearing about the "heartbreak" of Psoriasis, I finally contracted it this year...and any septuagenarian male who wouldn't opt for better (or maybe just a little) sex is lying in his longish teeth.

Besides doing a nasty deed to Hypos like me, not to mention legitimately suffering humankind, these "take-away teasers" must be the worst affliction to health care professionals since the arrival on the scene of malpractice attorneys, since they typically caution that you can't get the magic potion without a prescription, for which reason you're exhorted to "ask your Doctor whether Neonostrum is right for you."

Until this type of "come-on" advertising became fashionable, the latest "prescriptions du jour" were offered exclusively to Doctors, who then introduced them to such patients as had need for them. The new approach seems to be self-diagnosis, then disturbing the peace of your health care provider with the suggestion that you, during a pause in your favorite sitcom, uncovered a course of treatment of which he or she is ignorant.

Were I, not to mention his scores of other patients, to call Dr. Bernie (whose holy mission it is to keep my functionally obsolescent body parts functioning) every time a new unpronounceable medication exploded from the laboratory of some corporate drug pusher, he would soon either give up the profession, sue me for stalking, move to Des Moines, or (most likely) abandon his Hippocratic Oath and administer unto me a deadly medicine.

As though these side effects and misdirects were not a sufficiently mortal sin against society, modern marketing techniques have dragged out of the shadows certain subjects that, while always in the realm of reality, were regarded, in kinder, gentler days, as unmentionable, except between doctor and patient or in discreet powder room whispers.

I never felt, for example, the need to know the intimate details of incontinence, impotence, yeast infections, feminine itching, or acute flatulence - but all of these unpleasant conditions and more are as common on the boob tube as ants on a picnic pie. Clearly, it would now be as practical to return to the relative innocence, good taste and straight shooting that once prevailed in merchandising as it would be to refold the average road map, but one Genie could easily be put back in the bottle: Leave the diagnosis of disease and the prescription of potions to the trained professionals.

If people who are their own lawyers have fools for clients, surely the dumbest patients are those who would prescribe for themselves on the basis of a TV drug ad, following the one that promises them orgasmic ecstasy through driving a new car, with microscopic subtext that would, were it possible for them to read it, drag them rudely back to the no-free-lunch world of reality.

On the other hand, hype is what fuels the economic engine of America, so why not its citizens as well?