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The medical marketplace

'Fallacy of the Organic Theory of Doctors, illustrated by Hygeists', lithograph, London, 1843-1846

'Fallacy of the Organic Theory of Doctors, illustrated by Hygeists', lithograph, London, 1843-1846

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Complaints about quacks and charlatans - unregulated practitioners who prey on people's fears or offer ‘panaceas’ for every illness - can be found in the history of every medical tradition. Warnings against unregulated, untrained practitioners partly reflect concern for patients, but possibly doctors’ worries about competition as well. Patients are also consumers and will generally look around to find the medical practitioner or system that suits them best.

Control of medicine

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In medieval Europe public control of medicine varied. In Italy and Germany medical trading was strictly regulated. But in Britain and France there was less control. Generally speaking, small-time specialists offered their medical services with or without a licence. We can discover more about consumer demand by looking at what was supplied. Potions, pills, ointments for the skin and all the raw ingredients for home-made drugs were sold by apothecaries in their shops. Physicians made drugs to order for individual patients. Barber-surgeons specialised in shaving, bloodletting, hair-cutting and tooth extraction, and barbershops sold ointments, perfumes, even drinks and books. Female surgeons, when they were able to practise, treated female patients. There was a lucrative trade in treatment for skin problems and venereal diseases, especially syphilis.

The sale of drugs

In rural areas healers travelled from place to place. Popular empiric healers usually had a single skill, such as bone-setting or urine-casting (‘piss-prophets’). Charms, amulets and astrological predictions were always in demand.

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Many commercial quacks of later centuries continued in the same tradition. Patent medicines were drugs made by individuals. In fact any individual could make up a ‘secret’ recipe and sell it successfully at this time. In Britain in the 1700s big money was made in the mail-order sale of such drugs, without the need for a doctor’s consultation. Quacks such as Joshua Ward promoted his famous pill (a violent purgative) with pamphlets and newspaper advertisements. Samuel Solomon sold his cure-all Balm of Gilead mainly by post, along with his own health advice books. In the 1800s chemists sold patent medicines and other pre-packaged products and later founded ‘chains’ of shops.

Health and leisure

In the 1700s and 1800s there was also a new and highly profitable health and leisure industry. In the 1770s and 1780s the medical theatricals of British sex doctor James Graham, with his electrical Temple of Hymen and Celestial Bed, took place in elegant ‘saloons’ in London and Bath. Growing numbers of health-industry entrepreneurs ran public pools, river baths, spas, hydros and seaside resorts. In the 1800s this market expanded into new health movements. Massive advertising supported a boom in healthy foods and non-alcoholic drinks.

A range of treatments available today

The medical marketplace continues today. A health and wellbeing industry offers a vast array of treatments for preserving health and treating illness. Outside the formally regulated medical profession, practitioners offer treatments from a host of alternative medical systems. The internet is used for medical advice, buying pharmaceuticals and researching therapies. Professional medical associations continue to try and regulate the practice of medicine - and warn patients away from practitioners they regard as quacks.

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Bibliography

R Cooter (ed.), History of Alternative Medicine (London: Macmillan, 1988)

A Corbin, The Lure of the Sea. The Discovery of the Seaside in the Western World, 1750-1840, translation by J Phelps (London: Penguin Books, 1995)

A Digby, Making a Medical Living : Doctors And Patients in the English Market for Medicine, 1720-1911 (Cambridge: Cambridge University Press, 1994)

B Goldacre, Bad Science (London: Harper Collins 2008)

M A Katritzky, Women, Medicine and Theatre 1500-1750: Literary Mountebanks and Performing Quacks (Aldershot: Ashgate, 2008)

M Pelling, Unofficial and Unorthodox Medicine in Western Medicine: An Illustrated History ( London/Irvine: Oxford University Press, 1997)

R Porter and D Porter, In Sickness and in Health: The British Experience 1650-1850 (London: Fourth Estate,1988)

J Whorton, Crusaders for Fitness: the History of American Health Reform (Princeton University Press, 1982)

Glossary:

Syphilis

A sexually transmitted infection resulting in the formation of lesions throughout the body.