Negotiating the (Global) Medical

Marketplace Case Study: ‘Quackery’,

Contestation and Consumer Choice in London

Kill or CureWeek 10

Canaletto, ‘The Thames and the City’, 1746-7

London: ‘Great Wen’ or ‘Metropolis of Empire’

London: ‘a great, wicked, unweildy [sic] overgrown Town … where nothing dwells but Absurdities, Abuses, Accidents, Accusations, Admirations, Adventures, Adversities, Advertisements, Adulteries, Affidavits, Affectations, Affirmations, Afflictions, Affronts, Aggravations, Agitations, Agonies, Airs, Alarms, Ailments, Allurements, Alterations, Ambitions, … Anathemas, Animosities, Anxieties, Appointments, Apprehensions, Assemblies, Assessments, Assurances, Assignations, Attainders, Audacities, Aversions, &c.’

Hell upon earth (London: Roberts, 1729)

Wilhelm ten Rhyne,

Dissertation de Arthritide; Mantissa

Schematica de Acupunctura,

LONDON: Royal Society,

1683

Experimenting Elites

“The talk of this Cure ran about The Hague, and

made the conversation in other places...”

Sir William Temple, 1680

“Dere mi - you Angloise - you no believe in galvanism - be gar two-dree shock more make you young again.” c 1790s-

1810s

‘All Sciences a fasting Monsieur knows…’ Samuel Johnson, 1738

Global medicines and (Im)Patient-Consumers

Engelbert Kaempfer, A History of Japan, 1728

I suppose my readers will be pleas’d to practice according to the Chinese mode, as well as to adorn their houses with their curious manufactures, and to use their diet of Thea.” Sir John Floyer, 1707

Lorenz Heister, A General System of Surgery, 1743

The revealing tale of Mr. B.

Orthodox Doctor, Heterodox Innovator

John Elliotson 1791-1868• Cambridge graduate,

University College Hospital physician

• Among the first to take up Laennec’s new stethoscope, and to improve it

• Also one of the first men in London to give up his breeches in favour of the new-fangled trouser…

Elliotson’s innovations: successes

and scandals

Building a medical ‘alternative’: Homeopathy

lands in London• 1832 First

dispensaries: London and Bristol

• 1844 First professional association

• 1843-4 First journal

• 1849 First hospital

Building a medical ‘alternative’: Homeopathy

takes hold• 1859 LHH moves to

Great Ormond Street• By the 1860s,

homeopaths boasted 4 medical societies, 2 quarterly and 3 monthly journals , at least 5 hospitals, and 59 dispensaries in Britain

• 1866 LHH had treated 59,138 patients

Homeopathy, consumers and the ‘regular’

physician: the case of Mr. Kingdon

So why London?• A centre of government,

population and wealthThus a locus of:• medical care• medical education• medical and other publishing,

– and a magnet for knowledge, expertise, elites, and those who lived by serving them.

Still Global, Still

‘Alternative’?

‘For generations the Chinese have regarded several species of ginseng as possessing the greatest value in the treatment of diseases; …their great faith in this drug amounts to idolatry. Many of their … claims… are groundless and ridiculous… However, we must admit that this race of people eat more food liable to cause indigestion and still enjoy better digestion than any other race on the face of the globe.”

‘If snakes’ blood and crocodiles’ teeth

produced cures, he would use them.’

‘Report of the BMA Annual Clinical Meeting’ BMJ, 1968

Global medicine goes (back?) upmarket

And mass-market…

• Marketed in 100 countries;

• Largest single market: USA

• Marketed in the UK in association with Boots (and sold by many others)