Lydia Pinkham's Compound survived the Prohibition Amendment of 1919-1933; one of the few legal sources of drinking alcohol. This Amendment 'may' have increased consumption of the Compound manyfold, and encouraged the composition of verses.

Randolph-Legman indirectly explain the verse about her face. "The photograph of Lydia Pinkham with her hair curled and an old-fashioned ruching tucked around her throat, was the first photograph ever to appear in an American newspaper advertisement, as celebrated as the song's chorus." (The Compound was first marketed in 1869; the first images were engravings or woodblocks since the use of photos was much later).