Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-25T01:36:08.720Z Has data issue: false hasContentIssue false

Doctors and Patent Medicines in Modern Britain: Professionalism and Consumerism

Published online by Cambridge University Press:  11 July 2014

Get access

Extract

In the late nineteenth century professionalism and consumerism collided in a vociferous debate over the commodification of health. In medical journals, before government panels and through independent publications, doctors condemned “quackery,” especially patent medicines—the Victorian appellation for over-the-counter drugs. They dismissed myriad pills, tonics and appliances as addictive, dangerous, or useless. This professional critique, doctors claimed, was an altruistic defence of patients. Their commercial opponents, patent medicine men (and frequently the press), countered that the professional critique was rooted in a pecuniary struggle to achieve monopoly. While ascribing different motivations to each other, both sides assumed that medical professionals were unanimous in their condemnation of so-called “secret remedies.” Peter Bartrip has shown, though, that professional opposition to patent medicines was far more complex and muddied by self-interest. The British Medical Journal, while criticizing patent medicines, carried ads for them, which made the BMA the focus of allegations of hypocrisy in the Journal of the American Medical Association and before the Select Committee on Patent Medicines (1912). At the organizational level, Bartrip has established that the financial interests of the British Medical Association undercut its opposition to patent medicines. This compromised position, I will argue, permeated the profession. If the British Medical Association could not resist the advertising revenue derived from patent medicines, it was equally true that many doctors could not resist recommending patent medicines to patients. Far from epitomizing professional altruism, the patent medicine question demonstrates the reluctance of doctors to abandon individual self-interest in the wake of consumerist challenges that would ultimately transform twentieth-century medical practice. In doing so, the patent medicine debate engages and complicates arguments about the role of collective social mobility in the history of the professions.

Type
Research Article
Copyright
Copyright © North American Conference on British Studies 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 See Bartrip, Peter, “Secret Remedies, Medical Ethics, and the Finances of the British Medical Journal,” in Baker, Robert, ed., The Codification of Medical Morality (Boston, 1995), pp. 191204CrossRefGoogle Scholar. For the criticism in JAMA see 3 February 1912, p. 349.

2 See Carr-Saunders, A. M. and Wilson, P. A., The Professions (Oxford, 1933)Google Scholar and Reader, W. J., Professional Men: the Rise of the Professional Classes in Nineteenth-Century England (London, 1966)Google Scholar.

3 Durkheim, Emile, Professional Ethics and Civic Morals (London, 1957)CrossRefGoogle Scholar; Tawney, R. H., The Acquisitive Society (London, 1921)Google Scholar; Talcott Parsons, “The Profession and Social Structure,” in idem, Essays in Social Theory (London, 1950), pp. 34–59; Lewis, R. and Maude, A., Professional People (London, 1952)Google ScholarPubMed.

4 See Perkin, Harold, Origins of Modern English Society (London, 1969)CrossRefGoogle Scholar and later The Rise of Professional Society: England Since 1880 (London, 1989)Google Scholar.

5 Johnson, T. J., Professions and Power (London, 1972)Google Scholar.

6 Freidson, Eliot, Profession of Medicine: A Study in the Sociology of Applied Knowledge (New York, 1971), p. 370Google Scholar.

7 See Noel, and Parry, Jose, The Rise of the Medical Profession: A Study of Collective Social Mobility (London, 1976), p. 79Google Scholar; Berlant, J. L., Professions and Monopoly (Berkeley, 1975)Google Scholar; Witz, Anne, Professions and Patriarchy (London, 1992)CrossRefGoogle Scholar.

8 Larson, M. Sarfatti, The Rise of Professionalism: A Sociological Analysis (Berkeley, 1977), p. xviiiGoogle Scholar.

9 See Foucault, M., Discipline and Punish (Harmondsworth, 1982), p. 27Google Scholar.

10 Corfield, Penelope, Power and the Professions in Britain 1700–1850 (London, 1995), p. 19Google Scholar.

11 For example, Takahiro Ueyama sees professional opposition to the Medical Battery Company, maker of the Harness Electropathic Belt, as an expression of professional elitism. See Capital, Profession and Medical Technology: The Electro-therapeutic Institutes and the Royal College of Physicians 1888–1922,” Medical History 41 (1997): 150–81CrossRefGoogle ScholarPubMed. For a contrasting, earlier interpretation in which professional assaults against patent medicines are viewed as being in the public interest see, Young, J. Harvey, Toadstool Millionaires (Princeton, 1961)Google Scholar.

12 Jewson, N., “The Disappearance of the Sick Man from Medical Cosmology 1770–1870,” Sociology 10 (1976): 225–44CrossRefGoogle Scholar; Fissell, Mary, “The Disappearance of the Patient's Narrative and the Invention of Hospital Medicine” in British Medicine in an Age of Reform, ed. French, R. and Wear, A. (London, 1991)Google Scholar.

13 Peterson, M. Jeanne, The Medical Profession in Victorian London (Berkeley, 1978)Google Scholar.

14 Digby, Anne, Making a Medical Living: Doctors and Patients in the English Market for Medicine 1720–1911 (Cambridge, 1994), p. 168Google Scholar.

15 Alternative practices refer to those practices that did not conform with the beliefs, standards, or practices of the dominant professional group. See Bynum, W. F. and Porter, R., eds., Medical Fringe and Medical Orthodoxy 1750–1850 (London, 1987)Google Scholar; Cooter, Roger, ed., Studies in the History of Alternative Medicine (Basingstoke, 1988)CrossRefGoogle Scholar; Nicholls, Phillip, Homeopathy and the Medical Profession (London, 1988)Google Scholar.

16 Porter, Roy, Health for Sale: Quackery in England 1660–1850 (Manchester, 1989)Google Scholar.

17 Loudon, Irvine, Medical Care and the General Practitioner (Oxford, 1986)Google Scholar, and Digby, , Making a Medical Living, p. 168Google ScholarPubMed.

18 See Granshaw, Lindsay, “Fame and Fortune by Means of Bricks and Mortar: the Medical Profession and Special Hospitals in Britain 1800–1918,” in Granshaw, L. and Porter, R., eds., The Hospital in History (London, 1989)Google Scholar.

19 Bartrip, , “Secret Remedies,” p. 203Google Scholar.

20 For the origins of consumerism see McKendrick, Neil, Brewer, John, Plumb, J. H., Birth of a Consumer Society (London, 1982)Google Scholar and Campbell, Colin, The Romantic Ethic and the Spirit of Modern Consumerism (London, 1979)Google Scholar.

21 Benson, John, The Rise of Consumer Society in Britain 1880–1980 (London, 1994), p. 4Google Scholar.

22 Stearns, Peter, “Stages of Consumerism: Recent Work on the Issues of Periodization,” Journal of Modern History 69 (03 1997): 102–17CrossRefGoogle Scholar.

23 See Miller, Michael, The Bon Marché: Bourgeois Culture and the Department Store 1869–1920 (Princeton, 1981)CrossRefGoogle Scholar; Nevett, T. R., Advertising in Britain (London, 1982)Google Scholar; Loeb, Lori, Consuming Angels: Advertising and Victorian Women (New York, 1994)Google Scholar; Richards, Thomas, The Commodity Culture of Victorian England (Stanford, 1990)Google Scholar.

24 See Haug, Marie and Lavin, Bebe, Consumerism in Medicine; Challenging Physician Authority (Beverly Hills, 1983)Google Scholar.

25 The first remedy patented was “The Bitter, Cathartic Salt of Epsom Water” in 1695, but advertised proprietary remedies may be found as early as 1662. See Pharmaceutical Journal (6 01 1892): 558Google ScholarPubMed.

26 In 1912 there were 312 patents for drugs. Report on the Select Committee on Patent Medicines, (London, 1914), p. xxxiGoogle Scholar [hereafter cited as Select Committee].

27 For examples see Brown, P. S., “Providers of Medical Treatment in Mid-Nineteenth Century Bristol,” Medical History 24 (1980): 297334CrossRefGoogle Scholar.

28 For the stereotype see Sewill, Henry, “Quackery,” Vanity Fair (19 05 1910): 628Google Scholar. Sewill was a member of the BMA, but his series in Vanity Fair did not mention that he was a doctor. Comparable language was used in the American series in Collier's, reprinted in Adams, Samuel Hopkins, The Great American Fraud (New York, 1905)Google Scholar.

29 Fruit Salt,” Chemist and Druggist (27 06 1938): 738–39Google ScholarPubMed.

30 See Berridge, Virginia, Opium and the People (New York, 1981)Google Scholar and Parssinen, Terry, Secret Passions, Secret Remedies (Philadelphia, 1983)Google Scholar.

31 The legislative control of patent medicines would emerge only when a greater tolerance for state intervention had been established during the formation of the welfare state. Then “the advertising of proprietary medicines” would be cast as a problem that “undermines public confidence in a State medical service and in the registered medical practitioners at whose hands such a service must be provided.” See Linstead, Hugh, “Patent Medicines,” The Lancet (24 08 1946): 276Google Scholar.

32 See McGinnis, Janice Dickin, “Carlill v. Carbolic Smoke Ball Co: Influence, Quackery and the Unilateral Contract,” Canadian Bulletin of Medical History 5 (1988): 121–41CrossRefGoogle Scholar; Electric Belt Quackery Exposed,” Science Siftings (6 08 1892): 216–17Google Scholar; Bile Beans Litigation,” Chemist and Druggist (15 07 1905): 8285Google ScholarPubMed.

33 For example, Thomas Holloway, the founder of Holloway's Pills and Ointment, transformed himself into a venerable philanthropist who endowed a hospital for the mentally afflicted in Surrey (now run by the NHS) and more famously Royal Holloway College. At his death in 1886 his fortune was estimated to be £6 million. See Mr. Thomas Holloway,” Chemist and Druggist (15 01 1884): 11Google Scholar.

34 Braun, John, Advertisements in Court (London, 1965)Google Scholar.

35 At best, only 20% of patent medicines were sold by pharmacists; economies of scale made it possible for department stores to offer lower prices. The quote reflects concern about losing remaining customers. Patent Medicine Trade,” Chemist and Druggist (5 01 1889): 17Google ScholarPubMed.

36 See Matthew, Leslie, History of Pharmacy in Britain (London, 1962)Google Scholar and Holloway, S. W. F., The Royal Pharmaceutical Society of Great Britain 1841–1991 (London, 1991)Google Scholar.

37 Patent Medicine Journal (03 1892): 6Google Scholar.

38 Select Committee, p. 201.

39 Percival, T., Medical Ethics (Manchester, 1803), pp. 4445Google Scholar.

40 See Styraps's, JukesCode of Medical Ethics (London, 1878), pp. 2728Google Scholar.

41 Poisonous Patent Medicines,” British Medical Journal (28 01 1882): 127Google Scholar.

42 See Bartrip, P. W. J., Mirror of Medicine: A History of the British Medical Journal (Oxford, 1990)Google Scholar, and Themselves Write Large: the British Medical Association 1832–1966 (London, 1996)Google Scholar.

43 “Poisonous,” p. 127.

44 Patent Medicines Bill,” British Medical Journal (29 03 1884): 647–48Google ScholarPubMed.

45 “The Stamp Act and Proprietary Medicines,” British Medical Journal (16 August 1884). The tax originated in 1783. It amounted to 12% of the retail price on compounded medicines. Drugs were exempted if they were pure or “known, admitted and approved remedies.” See Alpe, E. N., Handy Book of Medicine Stamp Duty (London, 1888), p. 1Google Scholar.

46 The War Against Quackery,” British Medical Journal (28 09 1907): 837Google ScholarPubMed.

47 The Press, the Quacks and the Public,” British Medical Journal (27 01 1894): 208Google Scholar.

48 Review of Exposures of Quackery, British Medical Journal (November 7, 1896).

49 “The War,” p. 837.

50 British Medical Association, Secret Remedies (London, 1909)Google ScholarPubMed and More Secret Remedies (London, 1912)Google ScholarPubMed.

51 Smith, Russell Gordon, Medical Discipline: the Professional Conduct Jurisdiction of the General Medical Council (New York, 1994)Google Scholar.

52 Registered Practitioners and Patent Medicines,” British Medical Journal (24 09 1904): 784Google Scholar.

53 Letter, 13 August 1904, p. 360.

54 Relations of Medical Men to Patent Medicines,” 2 01 1909, p. 69Google Scholar.

55 Select Committee, p. 140.

56 Ibid., p. 93.

57 Ibid., p. 188.

58 Ibid., p. 268.

59 Ibid., p. 97.

60 Ibid., p. 210ff.

61 Ibid., p. 97.

62 Ibid., p. 268.

63 Ibid., p. 195.

64 Ibid., p. 398.

65 Ibid., p. 559.

66 Ibid., p. 464.

67 Ibid., p. 543.

68 Ibid., p. 525.

69 Ibid., p. 259.

70 Ibid., p. 308.

71 Ibid., p. 407.

72 Ibid., p. 456.

73 Ibid., p. 598.

74 Ibid., p. 597.

75 Ibid., p. 559. The total number of practitioners on the Medical Register ranged from approximately 28,000 in 1890 to approximately 35,000 in 1900. See Digby, , Making a Medical Living, p. 16Google Scholar.

76 Quack Medicines and Lying Testimonials,” British Medical Journal (17 12 1904): 1652Google Scholar.

77 Secret Remedies,” British Medical Journal (13 07 1912): 86Google ScholarPubMed.

78 Dixon was a member of the first graduating class of the University of Manitoba. See Heagerty, John Joseph, Four Centuries of Medical History in Canada, 2 vols. (Toronto, 1928), 2: 137Google Scholar.

79 The Capsuloid prospectus enthuses, “How enormous such incomes [those of patent medicine firms] are will be best appreciated by remembering that among the numerous patent medicines which have made fortunes for their owners may be mentioned Pink Pills, the proprietor of which left about £1,600,000 though he had advertised the remedy extensively for only about sixteen years.” See PRO, BT 31 12665/101565

80 The name was derived from the slogan “Cures Indigestion, Constipation, Flatulence and Acidity.”

81 PRO, BT 31 12665/101565

82 Company News,” Chemist and Druggist (26 08 1905): 384Google ScholarPubMed.

83 PRO, BT 31 12665/101565

84 Legal Reports: A Capsuloids Claim,” Chemist and Druggist (20 01 1912): 41Google ScholarPubMed.

85 Beecham's Archive, BP/43/1–3, Cicfa Return Book.

86 The Composition of Certain Secret Remedies: Medicines for Indigestion,” British Medical Journal (3 06 1911): 1324–27Google ScholarPubMed.

87 Ibid., p. 1325.

88 Wellcome Institute, London, Contemporary Medical Archive, BMA/SA D176

89 Ibid.

90 This was not the first time the company had encountered problems. In 1906 a fire at its Holborn offices required 35 fire engines to subdue it and resulted in heavy losses. See Fires,” Chemist and Druggist (15 09 1906): 419Google ScholarPubMed. In 1908 it was sued by the Motor Bus Advertising Co. Ltd. for reneging on an agreement to advertise on twenty London buses, a suit won by the advertising firm, who were awarded damages. See Capsuloid Advertisements,” Chemist and Druggist (31 10 1908): 679Google ScholarPubMed. Financial troubles in 1911 required the wife of the company director to use her £10,000 life insurance policy on her husband as security to pay for advertisements (Beecham's Archive, BP/4/3/1–3, Cicfa Minute Book, 10 March 1911). Dixon alleged that financial troubles arose from a batch of mouldy Capsuloids that were returned to the manufacturer and that had damaged the firm's reputation. But litigation against the packager, Duncan, Flockhart & Co., manufacturing chemists, was unsuccessful, resulting in additional legal expenses (“Legal Reports: The Capsuloid Case,” Chemist and Druggist (24 02 1912): 58Google ScholarPubMed. In 1918 Capsuloids paid £277 to the solicitors of the Daily Mail to withdraw action taken by Mrs. Bosher for a testimonial in which her names was mentioned. See BP/4/3/1–3, Cicfa Minute Book, 4 January 1918.

91 Letter to Alfred Cox from Managing Director, Capsuloids, 13 February 1920, Wellcome Institute, BMA/SA D176.

92 Memorandum from Alfred Cox submitted to the Standing Ethical Subcommittee, 9 March 1920, Wellcome Institute, BMA/SA D176.

93 Letter from Alfred Cox to Dr. D. Scott, 19 September 1924, Wellcome Institute, BMA/SA D176.

94 Memorandum from Alfred Cox to the Standing Ethical Subcommittee on 9 March 1920, Wellcome Institute, BMA/SA D176.

95 See Food and Drugs for Infants,” Chemist and Druggist (8 08 1908): 235–36Google ScholarPubMed.

96 Prescribing Proprietary Medicines,” Chemist and Druggist (10 07 1920): 66Google Scholar.

97 Bremer, L., “Prescribing Proprietary Medicines,” Pharmaceutical Journal (24 09 1892): 242–43Google Scholar.

98 Select Committee, p. 42.

99 Ibid., p. 152.

100 Ibid., p. 134.

101 Ibid., p. 598.

102 Ibid., p. 624.

103 Ibid., p. 634.

104 Wellcome Institute, BMA/SA D176

105 Letter from Dr. R. Langdon-Down to Alfred Cox, 21 April 1920, Wellcome Institute, BMA/SA D176.

106 15 September 1924, Wellcome Institute, BMA/SA D176.

107 Letter from Alfred Cox to Dr. Langdon-Down, 10 May 1920, Wellcome Institute, BMA/SA D176.

108 Beecham's Archive, BP/4/3/1–2.