Perspectives in Biology and Medicine

Perspectives in Biology and Medicine 45.3 (2002) 470-472

Book Review

Pharmacopoeias and Related Literature in Britain and America, 1618-1847

Pharmacopoeias and Related Literature in Britain and America, 1618-1847. By David L. Cowen. Brookfield, VT: Ashgate, 2001. Pp. viii + 296, $105.95.

Thirteen articles, written by David Cowen between 1951 and 1987 and originally published separately in a number of journals, appear together for the first time. Several of them are entirely bibliographic, meant to document the existence of publications on the subject. Cowen, a historian of pharmacy, decided to reprint them because—in his opinion—historians have paid too little attention to therapeutics and treatments with drugs, a central concern of practicing physicians through the ages. Indeed, the historiography on this subject has taken diverse paths of inquiry that must be combined before fruitful insights can be gained. Physicians and pharmacists look narrowly at old remedies, trying to find out what actually worked from a pharmacological point of view. They are usually quite disappointed about what they find and thus become quite dismissive of historical medicine as placebo. Historians of science check the impact of the scientific revolution and the advent of modern chemistry on medicine and pharmacy, often with meager results. Finally, social historians examine the implications of drug prescribing for both patients and physicians, and the role it played in the construction of their relationship but often fail to recognize the symbolic meanings of such interactions.

Cowen's papers range widely in size and subject, from Enlightenment Edinburgh medicine to Pennsylvania Dutch folklore healing, Colonial veterinary tracts to the New York Hospital drug reference book. Nevertheless, the collection retains a certain thematic unity: the need to compile, classify, and explain the action of substances believed to possess a favorable medicinal action. Today, the term pharmacopoeia is given to a number of publications, including the official and complete drug listings of the U.S. Pharmacopoeia (1997) and more abridged, "lab-coat pocket" works listing selected preparations and their optimal dosage. There are also works separating prescription from over-the-counter preparations, generic and brand-name drugs, and even [End Page 470] formularies that list the powers of medicinal plants and their potential poisonous side effects. Beginning in the late 17th century, however, the vast number of animal, plant, and mineral materials believed to contain healing qualities was collected and arranged, then published, resulting in erudite Latin editions prepared under the sponsorship of elite medical organizations located in some of the most important cities of Europe.

Several of Cowen's articles draw attention to the Royal College of Physicians of Edinburgh, which sponsored its first official pharmacopoeia in 1683. He insightfully explains that such a task was conceived as a weapon in the contemporary professional struggles between physicians, apothecaries, and surgeons. By virtue of their charter and statute, elite medical corporations wished to assert their traditional control over apothecaries as they began to separate from their fellow surgeons. At the same time, such colleges were determined to set boundaries in the medical marketplace between the therapeutic armamentarium of educated physicians and the large groups of unorthodox healers with their own claims for cures. In sanctioning a list of preparations, the Royal College of Physicians of Edinburgh placed its own stamp of approval on items that lent legitimacy to the practicing medical man. This is revealed in the rhetoric employed during the creation of such pharmacopoeias, where complaints about the older remedies were expressed in code words such as "superstition," when referring to persisting folk remedies, "credulity," when referring to the power of authority, and "established custom," when referring to tradition. Cowen then walks the reader through successive editions of this work, with their gradual elimination of numerous compounds touted as "rational cleansing"—although many of the exclusions were simply the result of empirical clinical experiences that revealed the compounds' inefficacy. For its part, chemical nomenclature invaded the classifications. By the early 19th century, the range of what was considered materia medica had dwindled considerably, in part through the elimination of household...