¹ Paul Starr, The social transformation of American medicine: the rise of a sovereign profession and the making of a vast industry, New York, Basic Books, 1982; J T H Connor, ‘Minority medicine in Ontario, 1795–1903: a study of medical pluralism and its decline’, PhD thesis, University of Waterloo, 1989; Elizabeth MacNab, A legal history of health professions in Ontario: a study for the Committee on the Healing Arts, Toronto, Queen's Printer, 1970, pp. 9–12; R D Gidney and W P J Millar, Professional gentlemen: the professions in nineteenth-century Ontario, University of Toronto Press, 1994, pp. 85–105; R D Gidney and W P J Millar, ‘The origins of organized medicine in Ontario, 1850–1869’, in Charles Roland (ed.), Health, disease and medicine: essays in Canadian history, Toronto, Clarke Irwin for the Hannah Institute for the History of Medicine, 1984, pp. 65–95; Ronald Hamowy, Canadian medicine: a study of restricted entry, Vancouver, Fraser Institute, 1984.

² Sydney A Halpern, ‘Dynamics of professional control: internal coalitions and crossprofessional boundaries’, Am. J. Sociol., 1992, 97: 994–1021; R M J Schepers and H E G M Hermans, ‘The medical profession and alternative medicine in the Netherlands: its history and recent developments’, Soc. Sci. Med., 1999, 48: 343–51.

³ Katherine Miller has discussed the dynamics of professional identity formation in ‘The evolution of professional identity: the case of osteopathic medicine’, Soc. Sci. Med., 1998, 47: 1739–48. Specific case studies of identity formation are many, including Starr, op. cit., note 1 above; C David Naylor, ‘Rural protest and medical professionalism in turn-of-the-century Ontario’, J. Can. Stud., 1986, 21: 5–20; Terrie Romano , ‘Professional identity and the nineteenth-century Ontario medical profession’, Histoire Sociale/Social History, 1997, 30: 77–97; R J Clark, ‘Professional aspirations and the limits of occupational autonomy: the case of pharmacy in nineteenth-century Ontario’, Can. Bull. med. Hist., 1991, 8: 43–63.

⁴ I am using the terms “pharmacist” and “druggist” interchangeably here. By the end of the nineteenth century the two were effectively the same in Canada. I recognize that the struggle between physicians and apothecaries at the turn of the eighteenth century was over activities far beyond compounding medicine. I use other terms, such as “apothecary” only when the sources are using those terms.

⁵ S W F Holloway has demonstrated that the British Apothecaries Act (1815) went one step further, and through a series of court battles actually subjected general practitioners to the rules of the Society of Apothecaries: Holloway, ‘The Apothecaries' Act, 1815: a reinterpretation. Part I: The origins of the Act’, Med. Hist., 1966, 10: 107–29. Irvine Loudon discusses multiple interpretations of the Apothecaries' Act in Medical care and the general practitioner: 1750–1850, Oxford University Press, 1986, especially chs 6, 7 and 8; S W F Holloway , ‘The Apothecaries' Act, 1815: a reinterpretation. Part II: The consequences of the Act’, Med. Hist., 1966, 10: 221–36; Clark, op. cit., note 3 above.

⁶ S E D Shortt, ‘Physicians, science, and status: issues in the professionalization of Anglo-American medicine in the nineteenth century’, Med. Hist., 1983, 27: 51–68.

⁷ Harold J Cook, ‘Good advice and little medicine: the professional authority of early modern English physicians’, J. Br. Stud., 1994, 33: 1–31; Gidney and Millar, Professional gentlemen, op. cit., note 1 above; Romano, op. cit., note 3 above; Gert H Brieger, ‘Classics and character: medicine and gentility’, Bull. Hist. Med., 1991, 65: 88–109; Rebecca J Tannenbaum, ‘Earnestness, temperance, industry: the definition and uses of professional character among nineteenth-century American physicians’, J. Hist. Med. Allied Sci., 1994, 49: 251–83.

⁸ Gidney and Millar, Professional gentlemen, op. cit., note 1 above, pp. 3–5.

⁹ For an overview of the relationships between pharmacists and physicians, see David Cowen, ‘Pharmacists and physicians: an uneasy relationship’, Pharm. Hist., 1992, 34: 3–16.

¹⁰ Holloway, ‘The Apothecaries' Act, Pt II’, op. cit., note 5 above.

¹¹ S W F Holloway, ‘Orthodox fringe: the origins of the Pharmaceutical Society of Great Britain’, in W F Bynum and Roy Porter (eds), Medical fringe and medical orthodoxy, 1750–1850, London, Croom Helm, 1987, pp. 129–57.

¹² Clark, op. cit., note 3 above.

¹³ Starr, op. cit., note 1 above, pp. 3–29.

¹⁴ The relationship between science and physicians is far from inarguable; and the debates continue. Paul Starr argued that scientific advancement was but one part of the growth of doctors' social and cultural authority. See Starr, op. cit., note 1 above, especially ch. 3, ‘The consolidation of authority’, pp. 79–144. Shortt, op. cit., note 6 above, placed the growth of doctors' authority squarely upon command of the language of science, which provided Anglo-American physicians a door into elite society. Actual scientific discoveries came later. This perspective seems validated in John Harley Warner's Therapeutic perspective (Cambridge, MA, Harvard University Press, 1986) in which the use of scientific diagnostic techniques fundamentally altered therapeutics prior to the advent of laboratory medicine. Duffin's exploration of the therapeutics of a mid-nineteenth-century Canadian country doctor strengthens the observation that doctors were using new techniques, although they continued to hold fast to older ones, such as bloodletting. See Jacalyn Duffin, Langstaff: a nineteenth-century medical life, University of Toronto Press, 1993. Nevertheless, science was limited in its explanatory power, as Jonathan Zimmerman notes with respect to the scientific temperance movement. See Jonathan Zimmerman, ‘“When the doctors disagree”: scientific temperance and scientific authority, 1891–1906’, J. Hist. Med. Allied Sci., 1993, 48: 171–97. The relationship between clinicians and laboratory scientists was, and continues to be, often strained, as demonstrated in Russell C Maulitz, ‘“Physician versus bacteriologist”: the ideology of science in clinical medicine’, and Gerald L Geison, ‘“Divided we stand”: physiologists and clinicans in the American context’, both in Morris J Vogel and Charles E Rosenberg (eds), The therapeutic revolution: essays in the social history of American medicine, Philadelphia, University of Pennsylvania Press, 1979, pp. 91–107, 67–90.

¹⁵ The Act was modified soon after its creation to include a provision regarding education.

¹⁶ David L Cowen, ‘Pharmacy and freedom’, Am. J. Hosp. Pharm., 1984, 41: 459–67.

¹⁷ Quebec's Pharmacy Act passed in 1875; Nova Scotia's in 1876, Manitoba, 1878; New Brunswick, 1884; British Columbia, 1891; Prince Edward Island, 1905; Newfoundland, 1910.

¹⁸ One caveat about geography: the location of the writers may not reflect the attitudes of practitioners in the countryside. What Holloway noted for the pharmacists in Britain may have held true for Canada: beneath a tension between doctors and pharmacists was a tension between rural and urban health provision. Records do not permit that issue to be explored here. See Holloway, ‘Orthodox fringe’, op. cit., note 11, above.

¹⁹ Canada East was half of the Province of Canada, united from the two colonies, Lower Canada (later Quebec) and Upper Canada (later Ontario) in 1840. For more on the early years of Quebec pharmacy, see Johanne Collin and Denis Béliveau, Histoire de la Pharmacie au Québec, Montreal, Musée de la pharmacie du Québec, 1994; Johanne Collin, ‘Genèse d'une profession: les pharmaciens au Québec au XIX^e siècle’, Can. Bull. med. Hist./Bulletin canadien d'histoire de la médecine, 1997, 14: 241–62, pp. 253–57.

²⁰ Collin, ‘Genèse d'une profession’, op. cit., note 19 above, p. 245. Stanley William Jackson, The first Pharmacy Act of Ontario, Toronto, Ontario College of Pharmacy, 1967, p. 2; Consolidated Statutes of Canada (1848) Section 16.

²¹ Archibald Hall, Letters on medical education (originally published in the Montreal Gazette) addressed to the Members of the Provincial Legislature of Canada, Montreal, Armour & Ramsay; Kingston, Ramsay, Armour, 1842, pp. 24–7.

²²Medical Chronicle, 1857, 4: 333.

²³ Ibid.

²⁴ Ibid, p. 334.

²⁵ ‘An Act to amend Chapter Seventy-One of the Consolidated Statutes for Canada East, respecting the medical profession and the sale of drugs’, Chapter 51, Statutes of Canada (27–28 Victoria) pp. 269–70 Section 1. Montreal Witness, 30 Dec. 1869.

²⁶Medical Chronicle, 1857, 4: 333.

²⁷ Ibid.

²⁸Br. Am. J., 1860, 1: 46.

²⁹Can. med. J., 1865, 1: 395–6.

³⁰ Gidney and Millar, Professional gentlemen, op. cit., note 1 above, pp. 22–5, 415 n85. See also Brieger, op. cit., note 7 above; Tannenbaum, op. cit., note 7 above; Cook, op. cit., note 7 above. Cook notes that this preoccupation with moral character declined by the 1700s, yet others have noted the persistence of the centrality of professional character in defining medical authority.

³¹Globe, 28 Jan. 1871.

³² Halifax Citizen, 25 April 1874.

³³ Montreal Witness, 30 Dec. 1869.

³⁴ Montreal Witness, 27 Oct. 1869. On John Dougall's reforming zeal in theory, see Paul Rutherford, A Victorian authority: the daily press in late nineteenth-century Canada, University of Toronto Press, 1982, pp. 48–51; for Dougall's reforming zeal in practice, see Peter deLottinville, ‘Joe Beef of Montreal’, Labour/Le Travail, 1981–1982, 8/9: 9–40.

³⁵ Halifax Citizen, 25 April 1874.

³⁶ Halifax Reporter and Time, 28 April 1874. This “Medicus” was not Archibald Hall, who died in 1868.

³⁷ Halifax Reporter and Times, 28 April 1874, emphasis in original.

³⁸ Montreal Gazette, 27 Oct. 1869.

³⁹ Montreal Witness, 27 Oct. 1869.

⁴⁰ Ibid.

⁴¹ See Thomas Haskell, ‘Professionalism versus capitalism: R H Tawney, Emile Durkheim, and C S Peirce on the distinterestedness of professional communities’, in Thomas Haskell (ed.), The authority of experts: studies in history and theory, Bloomington, Indiana University Press, 1984, pp. 180–225.

⁴² Montreal Evening Star, 23 July 1869. Emphasis in original.

⁴³Can. pharm. J., 1869, 3: 133.

⁴⁴ Ibid., p.150.

⁴⁵Can. med. J., 1869, 3: 235.

⁴⁶ Montreal Witness, 6 Dec. 1869.

⁴⁷ Montreal Witness, 14 Dec. 1869.

⁴⁸ Montreal Gazette, 7 Sept. 1869.

⁴⁹ For details on this case, see Daniel J Malleck, ‘Refining poison/defining power: medical authority and the creation of Canadian Drug Prohibition Laws, 1800–1908’, PhD thesis, Queen's University at Kingston, 1998, pp. 106–8.

⁵⁰Globe, 5 Dec. 1870.

⁵¹ Montreal Evening Star, 22 Oct. 1869.

⁵² Montreal Evening Star, 7 Dec. 1869.

⁵³ Montreal Witness, 27 Oct. 1869.

⁵⁴ Edward Blake, quoted in the Toronto Globe, 12 Jan. 1871.

⁵⁵Telegraph, 9 Dec. 1869.

⁵⁶Can. pharm. J., 1871, 4, p. 10.

⁵⁷ See amended Bill 135 (1869–1870 Session), and the list of modifications for Bill 20 (1871 Session). Legislative Journals of Ontario, 1 Feb. 1871, p. 103.

⁵⁸ Quebec physicians had a college from 1847, though it was not until 1876 that the laws were significantlly strengthened to require all doctors in the province to be licensed. See the history of the Collège des médecins du Québec: http://www.cmq.org/pages/sections/college/histoire.html.

⁵⁹ Gidney and Millar, Professional gentlemen, op. cit., note 1 above, pp. 91–8; Romano, op. cit., note 3 above.

⁶⁰ See Miles Weatherall, ‘Drug treatment and the rise in pharmacology’, in Roy Porter (ed.), The Cambridge illustrated history of medicine, Cambridge University Press, 1996, pp. 246–77; Judy Slinn, ‘Research and development in the UK pharmaceutical industry from the nineteenth century to the 1960s’, in Roy Porter and Mikuláš Teich (eds), Drugs and narcotics in history, Cambridge University Press, 1995, pp. 168–86.

⁶¹ See Starr, op. cit., note 1 above, pp. 118–23, on Abraham Flexner 's report and the effects on American medical education.

⁶² John Hunter, ‘Nostrums and proprietary medicines’, Canada Lancet, 1906, 39: 1057–62.

⁶³ Oscar Oldberg, ‘The new pharmacist and the old drug store’, Can. Druggist, 1897, 9: 179 (reprinted from The Apothecary).

⁶⁴ On the patent and proprietary medicine industry, see James Harvey Young, Toadstool millionaires, Princeton University Press, 1961; T J Jackson Lears, Fables of abundance: a cultural history of advertising in America, New York, Basic Books, 1994; in Canada, Glenn Murray, ‘The road to regulation: patent medicines in Canada in historical perspective’, in Judith C Blackwell and Patricia G Erikson (eds), Illicit drugs in Canada: a risky business, Toronto, Nelson Canada, 1988, pp. 72–87; Lori Loeb, ‘George Fulford and Victorian patent medicine men: quack mercenaries or Smilesian entrepreneurs?’, Can. Bull. Hist. Med., 1999, 16: 125–45; Michael McCulloch, ‘“Dr Tumblety, the Indian herb doctor”: politics, professionalism and abortion in mid-nineteenth century Montreal’, Can. Bull. Hist. Med., 1993, 10: 49–66.

⁶⁵ ‘Who is to blame?’, Can. pharm. J., 1900, 33: 494.

⁶⁶ ‘Drug habits’, Can. pharm. J., 1903, 37: 63.

⁶⁷ ‘The sale of narcotics’, Can. pharm. J., 1905, 38: 450.

⁶⁸ ‘Unwise sales’, Can. Druggist, 1899, 11: 153.

⁶⁹ Extracted from Merck's Report in Can. pharm. J., 1899, 31: 478.

⁷⁰ ‘The sale of narcotics’, Can. pharm. J., 1903, 37: 451.

⁷¹ ‘Drug habits’, Can. pharm. J., 1903, 37: 63.

⁷² Editorial, ‘Prescribed repetition and its dangers’, Dominion Medical Monthly, 1903, 20: 289–90.

⁷³ Reprinted from Calif. State J. Med. in Can. pharm. J., 1904, 37: 496–7.

⁷⁴ Editorial, ‘Proprietary medicines’, Montreal med. J., 1894, 22: 866.

⁷⁵ Ibid., p. 867.

⁷⁶ In July 1904, the Can. pharm. J. commented upon a libel case launched against the Ladies Home Journal by the R V Pierce Medical Company. In an examination of the patent medicine trade, the editor of the Ladies Home Journal had alluded to the existence of opiates in one of Pierce's products. After the Pierce Company threatened court action, the Ladies Home Journal printed a retraction, noting that its original article had drawn upon studies of the products from twenty-five years earlier. A new chemical investigation demonstrated that the formula for the medicine had changed, and it contained no opiates. See Can. pharm. J., 1904, 37: 568.

⁷⁷ Editorial, ‘Proprietary preparations’, Montreal med. J., 1903, 22: 359–62.

⁷⁸ Editorial, ‘Patent medicines’, Can. pharm. J., 1906, 39: 358–9.

⁷⁹ ‘Proposal to place patent medicines under dominion government control’, Can. pharm. J., 1893, 27: 31.

⁸⁰ ‘Vigilance required on the part of the pharmacist’, Can. pharm. J., 1900, 33: 447.

⁸¹ Editorial, ‘No parliament made pharmacists’, Can. pharm. J., 1907, 40: 359–60.

⁸² Other provincial legislatures had also attempted to deal with the sale of patent medicines, a fact that the Minister of Inland Revenue noted in 1908 when he alluded to “widespread public opinion that legislation of some kind is necessary”. Debates of the House of Commons, 15 June 1908, p. 10551. I am using Quebec and Ontario as comparative case studies.

⁸³ ‘Quebec Pharmacy Act, 1885’, Can. pharm. J. 1885, 19: 7–11.

⁸⁴Statutes of Quebec, 1890, Cap XLVI, pp. 88–94.

⁸⁵ ‘Proposed legislation to restrict the sale of patent medicines in Quebec’, Can. pharm. J., 1892, 25: 114.

⁸⁶ ‘Patent medicines and the Pharmacy Act’, Can. pharm. J., 1892, 25: 114.

⁸⁷Can. pharm. J., 1893, 26: 161–2. On Elliot, see ‘Elliot, Robert Watt’, Dictionary of Canadian Biography, vol. 13, University of Toronto Press, 1966, pp. 321–2.

⁸⁸ Paris Green was also called Schweinfurt Green, and was the subject of a number of investigations into its poisonous nature. Prior to the 1871 Pharmacy Act, commentators had registered their concerns over the availability of Paris Green, which apparently had on occasion been used for suicides and homicides.

⁸⁹ Province of Ontario, Bills, 1894, Bill 137.

⁹⁰ ‘The press and the Quebec Pharmacy Act’, Can. pharm. J., 1899, 32: 306–7.

⁹¹Journals of the Legislature of Quebec, 1897–98, Bill 78, 8 Dec., 14 Dec., 22 Dec., 30 Dec., 7 Jan., 12 Jan., 13 Jan., 14 Jan.; Journals of the Legislature of Quebec, 1899.

⁹² See, for example, Editorial, ‘Stimulants and narcotics in proprietary medicines’, Canada Lancet, 1902, 34: 55; Editorial, ‘Secret proprietary medicines’, Canada Lancet, 1886, 18: 343; editorial, ‘The growth of quackery’, Canada Lancet, 1904, 36: 1147.

⁹³ W H Moorehouse, ‘Presidential address’, Canada Lancet, 1903, 36: 10.

⁹⁴ Editorial, ‘Proprietary medicines’, Canada Lancet, 1906, 39 9: 841–3.

⁹⁵ ‘Vancouver Medical Association on patent medicines’, Canada Lancet, 1906, 41: 750.

⁹⁶ ‘Probable legislation regulating patent medicines’, Can. pharm. J., 1906, 39: 354–5. This argument was repeated often. See ‘Proposal to place patent medicines under dominion government control’, Can. pharm. J., 1893, 27: 31; ‘Patent medicines’, Can. pharm. J., 1906, 39: 358–9; A E DuBerger, ‘Return to an order of the House of Commons, dated April 23, 1906, for a copy of the Report of A E DuBerger, on the Drug and Proprietary Medicine Trade of Canada’, Sessional Papers of the House of Commons, No. 125, Ottawa, 1906, pp. 22–3.

⁹⁷ Duberger, op. cit., note 96 above; some of the details of the formation of the 1908 legislation are in Murray, op. cit., note 64 above, pp. 72–87.

⁹⁸ DuBerger, op. cit., note 96 above.

⁹⁹Debates of the House of Commons, 21 Feb. 1907, p. 3464.

¹⁰⁰Debates of the House of Commons, 11 March 1907, p. 4441.

¹⁰¹Debates of the Senate, 17 July 1908, p. 1670.

¹⁰² Ibid., p. 1667.

¹⁰³ Ibid.