
Karen Bloom Gevirtz explores how medicine has been transformed over the past 500 years – from the sharing of domestic recipes to a full-blown moneymaking industry
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Podcast Host
Welcome to the History Extra Podcast. Fascinating historical conversations from the makers of BBC History Magazine. How did we go from sharing homegrown cures free of charge to buying commercially produced medicine from strangers on the open market? This transition is more complex than you might think, and it's something that Karen Bloom Gewirtz explores in her book the Apothecary's the Hidden History of Medicine and How It Became a Commodity. I spoke to Karen to find out more. Thank you so much for joining me, Karen, to talk about your new book in which you reexamine and I would say in many ways rewrite the history of medicine. So you're challenging this idea of a triumph of modern medicine narrative. I wonder if you could tell us to start us off a bit more about that traditional narrative and why you think it needs challenging.
Karen Bloom Gewirtz
Yes, so it's so familiar to people that it's almost kind of baked into the culture, this idea that we lived in a very dark time when people.
Interviewee
Didn'T know anything and sort of improvised crazy cures and ways of treating illness.
Karen Bloom Gewirtz
And then, ta da, the scientific revolution came along, everything was modernized and boom.
Interviewee
Medicine became useful and effective. Effective.
Karen Bloom Gewirtz
And some versions of the story are.
Interviewee
Much more explicit that medicine was more female, associated all these strange crones in.
Karen Bloom Gewirtz
The woods with warty noses, and then.
Interviewee
All of these well educated smart men came along and fixed everything.
Karen Bloom Gewirtz
And my contention is that that's an.
Interviewee
Excellent myth that was created and perpetrated by the proponents of the scientific revolution, but that in fact, if you look.
Karen Bloom Gewirtz
At the documents of the time and.
Interviewee
You look at the events of the.
Karen Bloom Gewirtz
Time, that story is not borne out.
Interviewee
At all by the facts.
Podcast Host
Why do you think that this idea of medicine going from being the domain of water old crones in the forest to enlightened university educated people who basically solved all our issues, why do you think that that narrative needs reexamining? What do you think was really happening at this time instead?
Karen Bloom Gewirtz
Well, one thing is, as a scholar.
Interviewee
I'm really suspicious of tidy little narratives.
Karen Bloom Gewirtz
So any tidy little narrative, I think needs re examining. In the case of this one in.
Interviewee
Particular, the idea of this triumph is awfully convenient. I'm always interested in the question, who benefits from this story? Well, the scientists and the physicians and so on.
Karen Bloom Gewirtz
I think it bears reexamining for another.
Interviewee
Reason as well, which is that once you start actually looking at the documentation, if you look at what people were.
Karen Bloom Gewirtz
Saying and doing during the 16th, 17th.
Interviewee
And 18th century, but especially the 17th.
Karen Bloom Gewirtz
And 18th centuries, what you find is it's very inconsistent with that narrative.
Interviewee
The first major inconsistency is the idea that proponents of the scientific revolution came up with new medicines because they didn't. If you look at what they were actually making and prescribing, it was exactly.
Karen Bloom Gewirtz
The same as what women were making and distributing. So once you have that coincidence, then the whole narrative begins to fall apart.
Interviewee
If something better didn't come in, then.
Karen Bloom Gewirtz
What really did happen to make people move from getting something at home, from the person they trusted for free, to.
Interviewee
Going outside the home, to a perfect.
Karen Bloom Gewirtz
Stranger for something that they didn't know.
Interviewee
What it was made of and that.
Karen Bloom Gewirtz
They had to pay for.
Podcast Host
I want to ask you a bit more about this transition from what you call in the book domestic medicine to commercial medicine, essentially. Can you tell us a bit more about that? Domestic medicine. So before medicines were widely available on a competitive market, if you were ill and you needed some kind of medicinal help, where might you get that?
Karen Bloom Gewirtz
You got it from the woman in your life, basically. So before the Reformation, in England, you.
Interviewee
Could get it from the church, you could go to the monastery or the convent down the road. And that remained the case in Catholic countries.
Karen Bloom Gewirtz
But in England, what happened was once.
Interviewee
That went away, there was only one place to get medication, and that was.
Karen Bloom Gewirtz
The woman in your life. So it might be mom, it might.
Interviewee
Be your grandmother, or if there wasn't a woman around in your family, it.
Karen Bloom Gewirtz
Might be your employer's wife, your landlord, somebody like that. And she was considered quite reliable.
Interviewee
First of all, most women did not.
Karen Bloom Gewirtz
Have a mortality rate.
Interviewee
That was not something that physicians could say.
Karen Bloom Gewirtz
There are many jokes about how physicians were far worse than getting sick. The young physician fattens the graveyard, for example.
Interviewee
The cure is worse than the disease.
Karen Bloom Gewirtz
But there wasn't anything equivalent to that for women.
Interviewee
Women were very reliable.
Karen Bloom Gewirtz
They used medications that were organic.
Interviewee
They would grow them in the yard, they would collect them by the riverbank. They would walk along the road and pick up something along the road.
Karen Bloom Gewirtz
And they made it in the kitchen.
Interviewee
According to recipes that had been tested over time, either by themselves, over generations, or by their neighbors.
Karen Bloom Gewirtz
So if it made you sicker or if it killed somebody, they didn't use it anymore. That was pretty basic.
Interviewee
It sounds like common sense. But if you were a physician, you.
Karen Bloom Gewirtz
Were university trained, and you followed medical theory. So the idea was, if it didn't.
Interviewee
Work, you must just not have gotten the dosage right. Or maybe you calculated their horoscope wrong.
Karen Bloom Gewirtz
If it was early enough in the history of medicine so they would keep on using it.
Podcast Host
Much less empirical. Basically, it wasn't going on what you saw. It was going on a strict idea of things. But what were some of the common medicines that people would have been familiar with?
Interviewee
Many of them actually would be family specific or regional specific.
Karen Bloom Gewirtz
So one family might say, swear by my favorite sore throat recipe, actually, which is roasted turnip with sugar, which I.
Interviewee
Know it sounds delicious.
Podcast Host
Have you tried it?
Interviewee
I have not.
Karen Bloom Gewirtz
But I keep thinking, wouldn't that just be great?
Interviewee
Wouldn't you love if that was the great cure for your sore throat? And I can imagine it would be.
Karen Bloom Gewirtz
Very soothing, if nothing else.
Interviewee
So some of the cures were local. You could grow something in one part of England, say, but you couldn't grow it in another. Or one family or neighborhood had a set of traditions that were passed down.
Karen Bloom Gewirtz
And they stayed pretty close. But there were plants that you could always count on turning up. So some of them would be basic garden herbs. We would think of them rosemary, for example, thyme, sage. Some of them are flowers. Marigolds, for example.
Interviewee
Dandelions. Definitely. Science has showed that they really do work as a diuretic.
Karen Bloom Gewirtz
And different kinds of daisies, depending on what was wrong with you.
Interviewee
White roses, red roses.
Karen Bloom Gewirtz
You would also have an approach to medicine which was you took care of.
Interviewee
The body by feeding it proper things also. So you would get herbals, books of.
Karen Bloom Gewirtz
Medicinal plants that would say something like.
Interviewee
Melons do not in and of themselves have great medicinal power. But if you eat melons, they're Quite good for you, and they will preserve the body's health. So it would be in a book of medicinal plants, because it was considered.
Karen Bloom Gewirtz
Good to eat melons, for example.
Interviewee
And you can really tell also how.
Karen Bloom Gewirtz
Imperial agriculture began to work its way into the diet as well. You began to see plants from other places became common. So pharmacists, as we would call them.
Interviewee
Today, or apothecaries and physicians, often made their own medicine, would have their own gardens as well.
Karen Bloom Gewirtz
And those gardens looked, in terms of content, remarkably like your regular garden at home.
Interviewee
There were gardening manuals for women about.
Karen Bloom Gewirtz
How to get the most use out.
Interviewee
Of whatever limited space you have.
Karen Bloom Gewirtz
So there would be recommendations.
Interviewee
Plant your little herbs here between the paving stones and put the delicate ones against the. The wall. Honey also, because honey was a very.
Karen Bloom Gewirtz
Important part of agriculture, women were the.
Interviewee
Beekeepers in the family, so they were responsible for making sure that the bees were healthy. And you'd have a lot of plants.
Karen Bloom Gewirtz
In the garden that were good for.
Interviewee
The bees as well and that were medicinal. So English lavender came in.
Karen Bloom Gewirtz
Poppies were always a big one. Foxglove. So a lot of these do have some kind of medicinal property, and they were just out in the backyard.
Podcast Host
Mm. So you've mentioned that a lot of these methods or ingredients would be passed on orally in terms of the knowledge about them, but they were also, as you've alluded to, included in recipe books. I wonder if you could tell us a bit about some of these recipe books. One that you look at is by Elizabeth Gray, the Countess of Kent.
Karen Bloom Gewirtz
Recipe books begin to appear very late in the realm of Elizabeth I, and that's understandable. Paper becomes more available.
Interviewee
But also, literacy in the aristocracy is.
Karen Bloom Gewirtz
Extremely highly prized, and literacy moves down into classes below the very elite. So recipe books are the books that women would write the recipes into for anything that they produced for the household.
Interviewee
So it might be a really good recipe for soup, it might be a really good way of pickling plums or candying flowers.
Karen Bloom Gewirtz
And it was also for making ink, shoe polish, soap, and medicine.
Interviewee
So you would find in those pages some books were organized, some books were.
Karen Bloom Gewirtz
Not organized, or they'd followed an organization.
Interviewee
That was very idiosyncratic to whoever kept them.
Karen Bloom Gewirtz
You would find cures for burns right next to the recipe for the roast.
Interviewee
That might have given you the burn in the first place.
Karen Bloom Gewirtz
So one of the very first recipe.
Interviewee
Books that made it into print was.
Karen Bloom Gewirtz
The recipe book of Elizabeth Gray. And she was a really remarkable woman.
Interviewee
She was raised in the court of Elizabeth, the First, she was exquisitely educated. She spoke several languages.
Karen Bloom Gewirtz
She was very interested in the scientific revolution. And Elizabeth Gray had a recipe book, and that made good sense. She was running several households, so she needed to be able to tell her.
Interviewee
Cook how she wanted the peas cooked.
Karen Bloom Gewirtz
Or the turnip smashed or the fish poached.
Interviewee
And she also wanted to be able.
Karen Bloom Gewirtz
To make the heartburn tablets for that.
Interviewee
Extra rich dessert that she had given.
Karen Bloom Gewirtz
Her guests, or the medication for, or jaundice, or for things that she didn't.
Interviewee
Have to worry about, but that other.
Karen Bloom Gewirtz
Women did, like miscarriage, for example. So she had this book, and somewhere along the line, her recipe book got.
Interviewee
Detached from Elizabeth and her estate and.
Karen Bloom Gewirtz
It wound up in somebody else's hands. And he then went ahead and published it.
Interviewee
So it's less interesting who got hold.
Karen Bloom Gewirtz
Of it and how as it is.
Interviewee
That somebody thought publishing Elizabeth Gray's recipe.
Karen Bloom Gewirtz
Book would be a money maker, because.
Interviewee
Women had all of these recipes already.
Karen Bloom Gewirtz
Nobody needed them, but he did.
Interviewee
And this book appears in print.
Karen Bloom Gewirtz
And it's sort of one of the.
Interviewee
Early examples of mansplaining, where a man says, look, women, here's how you cook. As if the women had not known anything about cooking before this.
Karen Bloom Gewirtz
And it sold incredibly well. It sold like hotcakes. It went through 10 editions, which is a lot in less than a decade, if I'm remembering it correctly. And in fact, one of the early.
Interviewee
Printers was a woman, and she inherited.
Karen Bloom Gewirtz
The printing business from her husband, and.
Interviewee
This really made her fortune. So it was the first of what.
Karen Bloom Gewirtz
Became a wave of recipe books coming into print.
Interviewee
And this idea that women really needed.
Karen Bloom Gewirtz
To learn how to do the things that they had actually already been doing. So it created the sense that women.
Interviewee
Didn'T really know what they were doing.
Karen Bloom Gewirtz
Without a man's help.
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Podcast Host
Edu There are a couple of really interesting strands there. One is this kind of commercialization of medical knowledge which will come back to. But the other is this idea that medicine is part of a broader landscape. It's part of what you eat and lifestyle advice and something you alluded to earlier, horoscopes. I wonder if you could tell us a bit about that. And when medical treatment became separated off and segregated into its own category, really.
Karen Bloom Gewirtz
That is one of the important things.
Interviewee
That happened during this transition from domestic into commercial or affordable for profit medication. This idea that medicine and food, for.
Karen Bloom Gewirtz
Example, are totally separate.
Interviewee
That what you put in the body because you're thirsty and what you put.
Karen Bloom Gewirtz
In the body because you have a headache are absolutely different.
Interviewee
And the idea of health and illness.
Karen Bloom Gewirtz
Become divorced, as it were, rather than stages on a continuum.
Interviewee
So illness is the derangement of health.
Karen Bloom Gewirtz
And is a separate state that needs to be addressed as opposed to an.
Interviewee
Experience of being embodied, as it were, and something that you need to manage.
Karen Bloom Gewirtz
By eating properly and so on. So you get a lot of discussion before, say the middle of the 18th century, where people are saying, well, you.
Interviewee
Eat this way to maintain your health.
Karen Bloom Gewirtz
Drink this way, moderation, don't have lots of sweet things, don't drink a lot of wine, that sort of thing, because it's important to maintain the fleshly part of who you are. But what happens with medicine, and you can see this in ideas like Descartes.
Interviewee
Idea of the mind, body separation, that.
Karen Bloom Gewirtz
Medicine was really viewed the body very.
Interviewee
Differently, that illness was a state that.
Karen Bloom Gewirtz
Was separate, that was discreet, and that physicians were responsible for.
Interviewee
So you get a real separation there.
Karen Bloom Gewirtz
And we are still, I would argue.
Interviewee
Inheritors of that idea that when we.
Karen Bloom Gewirtz
Talk about lifestyle changes, we're talking about.
Interviewee
Almost the medicalization of diet and exercise as opposed to this is just how you live.
Karen Bloom Gewirtz
For example, we have just an incredible amount of protein bars and protein shakes and things like that that you take to maintain your health.
Interviewee
And it's a medicalization of food.
Karen Bloom Gewirtz
So you can see that in the.
Interviewee
Writing about the body. You can see that in medical books. There's a really horrifying set of surgical lectures from. I think it's the University of Aberdeen at the end of the 18th century.
Karen Bloom Gewirtz
Where surgeon is teaching his class to operate on teething babies gums because his argument is teething.
Interviewee
Babies need their gums slit open so.
Karen Bloom Gewirtz
That the teeth can emerge properly, as.
Interviewee
If human beings teeth had not been emerging perfectly fine for millennia. So there was this idea that what.
Karen Bloom Gewirtz
Was natural and ordinary needed to be manipulated and controlled.
Podcast Host
And just to return to the idea of creating a commercial product, that was medicine. It's a very different thing to have, you know, some plants in the garden that you share, or perhaps you boil them up or whatever, to a pill that is manufactured en masse and sold on the open market. How does that transition happen?
Karen Bloom Gewirtz
There were always quacks. You could always get some person traveling.
Interviewee
From town to town, village to village, or a local person selling it to the local community. This is my fabulous elixir.
Karen Bloom Gewirtz
Drink this and all will be well.
Interviewee
Medication also had many forms from the very beginning.
Karen Bloom Gewirtz
So if you go to a hospital and they talk about administering something through.
Interviewee
A bolus, that was something that women were doing.
Karen Bloom Gewirtz
There were plasters or plasters that were.
Interviewee
Put on the body.
Karen Bloom Gewirtz
Then there was a different kind of.
Interviewee
Plaster that you spread on a piece.
Karen Bloom Gewirtz
Of leather and put on the body. Some things you drank, some things you took with a spoon, some things you licked up. So medication always took a wide variety of forms. What happens is, as medication becomes more.
Interviewee
Commercial, as the market opens up in.
Karen Bloom Gewirtz
The end of the 17th century, there.
Interviewee
Is a period in which anybody can.
Karen Bloom Gewirtz
Sell medication because there's the transition from.
Interviewee
Medication assisting you get at home to, oh, it's normal to go out and.
Karen Bloom Gewirtz
Pay for it, but there isn't the equivalent regulation of it, which is that.
Interviewee
You should really only be getting it.
Karen Bloom Gewirtz
From apothecaries and physicians.
Interviewee
So one way of addressing that was the prescription system. But nevertheless, you still had people who would advertise their wares.
Karen Bloom Gewirtz
So newspapers became full of advertisements for everything.
Interviewee
And you can really get a sense of what was particularly bothersome to a population by reading the advertisements section. So you might have one little advertisement.
Karen Bloom Gewirtz
For something to help with fertility, but.
Interviewee
There'D be a really shocking number of medications for treating what they called venereal.
Karen Bloom Gewirtz
Disease, where there would be plague cures, plague being advertised. So you had more and more and more, as the concept of medication became changed into something as a commodity, you had sort of rush into the market of people who. Who said, well, I've got a great cure.
Interviewee
So in the book, for example, I.
Karen Bloom Gewirtz
Talk about Jane Barker, who persuaded her brother to give her the same training.
Interviewee
And knowledge that he had received going to medical school. And she decided if she knew all the things that he knew, why couldn't she call herself a doctor, even though she'd never been to university? So she went to London and she.
Karen Bloom Gewirtz
Called herself Dr. Barker. She started selling a gout cure, and.
Interviewee
She also wrote prescriptions for people, which.
Karen Bloom Gewirtz
Is illegal at the time. But if the apothecary doesn't know it's a woman, then the apothecary will go ahead and fill it.
Interviewee
So she has a wonderful poem on how good it feels to outsmart the.
Karen Bloom Gewirtz
Apothecary and to be officially a doctor. So there has to be a movement then to restrict the quackery. And you see efforts to create some sort of regulation. So in the book, I talk about two important figures in that effort. One of them is a guy named Joshua Ward, who just built a medication empire. And pretty much what he did was he threw whatever metals that were cheapest at the time, arsenic or mercury or antimony, into a pill, and he would sell it, and it was really super bad for you. And an apothecary named Joseph Cluten tried to persuade people not to buy Ward's pills or his drop or his drinks. He also had an injection, which is horrible to think about. And then there was another person, Joanna.
Interviewee
Stevens, who had a really good cure.
Karen Bloom Gewirtz
For what they called the stone.
Interviewee
So kidney and bladder stones.
Karen Bloom Gewirtz
And the medical community pounced on her as well and tried to make sure that what she was selling was real and accurate.
Interviewee
So, ironically, Cluton proved that Ward was a quack, and Ward stayed in business.
Karen Bloom Gewirtz
And a guy named David Hartley proved.
Interviewee
That Joanna Stevens was not a quack.
Karen Bloom Gewirtz
And they put Joanna Stevens out of business on purpose. But there was a push from the.
Interviewee
End of the 17th century into the 18th century to expand it outward and.
Karen Bloom Gewirtz
To legitimize anybody, including apothecary, selling medication.
Interviewee
That hadn't gone through the physicians and their approval process.
Podcast Host
I'm sure listeners will have noticed in our conversations that the anecdotes you've drawn on, a lot of them are involving women. And that's something that's kind of been rumbling into this conversation, but perhaps we should address it more directly. What did all of this mean for women's involvement in medicine?
Interviewee
It was not good for domestic medicine.
Karen Bloom Gewirtz
Basically, the sea above, warty old crones in the forest. So women, over time, became, I don't.
Interviewee
Want to overstate it, as demonized, but women became a very unreliable source.
Karen Bloom Gewirtz
The publicity, the campaign to promote men and what we would call scientific medicine.
Interviewee
Or modern medicine, part of its success.
Karen Bloom Gewirtz
Depended on persuading people not to depend on women.
Interviewee
So Women were very much the losers in that regard.
Karen Bloom Gewirtz
They became untrustworthy and unreliable and consequently.
Interviewee
Not trusted and not relied upon. So their position culturally, their position in.
Karen Bloom Gewirtz
The family, was greatly eroded. Universities had never admitted women, but once.
Interviewee
Medicine became heavily dependent on officially trained people, either physicians who went through the university process or apothecaries who went through.
Karen Bloom Gewirtz
The guild process, then there was really no room for women at all.
Interviewee
Having said that, there's two things to think about. One is that that sounds like it was men against women, and that is a bit of an oversimplification.
Karen Bloom Gewirtz
It was people who believed in the scientific revolution versus people who thought there.
Interviewee
Was a value for domestic medicine. So we have plenty of evidence that.
Karen Bloom Gewirtz
Women believed in the scientific revolution, that.
Interviewee
They believed that professional medicine, medication was better than their own or was important for augmenting their own knowledge. So we have recipe books over time, beginning to include more and more and.
Karen Bloom Gewirtz
More physicians, prescriptions and apothecary's recipes in women's recipe books.
Interviewee
So we can see that it's not.
Karen Bloom Gewirtz
As simple as men bad, women good. And another thing is that women did have a place in, let's say the out of home or the professional administration of medicine, because women were often allowed to treat the poor because the poor didn't pay. And if you were a physician and you got your living by being paid, treating the poor was really not worth your time. So if you happen to have Mrs.
Interviewee
Smith, who lived in the neighborhood, who.
Karen Bloom Gewirtz
Was happy to give somebody some help.
Interviewee
With an infection in exchange for, say.
Karen Bloom Gewirtz
Some eggs, great Mrs. Smith could have those people. It wasn't worth the time and the bother.
Interviewee
But the minute Mrs. Smith hung up.
Karen Bloom Gewirtz
A shingle for herself and started selling.
Interviewee
Her medication, no, no, no.
Karen Bloom Gewirtz
She had to be pulled up in.
Interviewee
Front of the authorities, chastised, and made to stop. There was another way women could become.
Karen Bloom Gewirtz
Part of the professional administration of medicine.
Interviewee
As well, which was by being licensed by a bishop or an archbishop, and.
Karen Bloom Gewirtz
Very often in a neighborhood that could.
Interviewee
Be a very large neighborhood, say around villages or in a very rural area that was the only person around who.
Karen Bloom Gewirtz
Could do whatever they needed to do.
Interviewee
So a woman could be not an official physician, but she could be a.
Karen Bloom Gewirtz
Surgeon, she could be a midwife.
Interviewee
Sometimes very small rural towns would hire.
Karen Bloom Gewirtz
Women to take care of the poor, because otherwise there was too great a.
Interviewee
Strain on the town resources, the neighborhood resources.
Karen Bloom Gewirtz
And so women were allowed to do that.
Interviewee
So it wasn't an all or nothing proposition.
Karen Bloom Gewirtz
But there's not a lot of status.
Interviewee
And there's certainly Not a lot of money in treating the poor. And if you can't go to medical.
Karen Bloom Gewirtz
School, you can't do any better than that.
Interviewee
So they were still really shut out quite a lot.
Podcast Host
Now, I'm going to jump us forward a couple of centuries because this is what you do in your book, and you look at the impact of all of this stuff that happened in the 17th and 18th centuries, on the 20th and even 21st centuries. I wonder if you could tell us about a couple of the parallels that you found or the influences, maybe giving us some examples of particular drugs that you draw on in that section.
Interviewee
So one of the things that I found as I was writing this book was I kept wanting to write in the chapter, and this is exactly what we see today. And so after writing dozens of pages that drew those connections, I thought, well.
Karen Bloom Gewirtz
Maybe I would just actually take a section of the book and point that out, because we are very much the inheritors of that transition.
Interviewee
But there are still some places where.
Karen Bloom Gewirtz
You can see not domestic medicine itself, and I would never advocate any of those cures over, say, antibiotics or sterilized.
Interviewee
Instruments, but we can see ways in which the ethos or the values of domestic medicine are still with us.
Karen Bloom Gewirtz
One of the things that I thought.
Interviewee
Was absolutely fascinating was iodized salt. Iodized salt is not glamorous, but iodized.
Karen Bloom Gewirtz
Salt continues today to save thousands of.
Interviewee
Lives and also to.
Karen Bloom Gewirtz
To promote the national health of countries around the world. Everywhere it's regular, plain old salt that.
Interviewee
Has been chemically manipulated so that some iodine is attached to the salt molecules. And iodine is vital for the development of the fetus and utero. It's vital for the development of the brain. It's vital for the regulation of the endocrine system, hormones.
Karen Bloom Gewirtz
So iodine is really, really important, but.
Interviewee
You can't get it naturally from a.
Karen Bloom Gewirtz
Lot of places, seaweed and shellfish, pretty much.
Interviewee
So to deal with the problems of widespread iodine deficiency, which affected not just individuals and not just birth rates, but.
Karen Bloom Gewirtz
Also, by the time you got towards.
Interviewee
World War I, the ability of a country to field a competent army, which was really a very pressing issue.
Karen Bloom Gewirtz
In 1917, 1918, scientists began working on finding a way to get iodine into the population.
Interviewee
And initially physicians thought, well, we'll give them a special drink or we'll give.
Karen Bloom Gewirtz
People a shot, because that's the idea.
Interviewee
In medicine, right, that it's a special substance.
Karen Bloom Gewirtz
And it took public health people, nutrition.
Interviewee
Nutritionists, pediatricians, to realize that actually you.
Karen Bloom Gewirtz
Could just eat it and I love this story because it breaks down the barrier that had been erected between food and medicine. It recombines those things. I think it's a glorious story that the simplest solution is the one where you go back to thinking in a much earlier way, and the most effective solution is one where you do that.
Interviewee
We were just talking about quacks also, and the idea of regulation of medication is incredibly important.
Karen Bloom Gewirtz
So one of the stories that I.
Interviewee
Tell in the book is the story.
Karen Bloom Gewirtz
Of thalidomide, that corporate interests were so invested in making profit from thalidomide, which.
Interviewee
They were marketing as a morning sickness.
Karen Bloom Gewirtz
Drug, that they really didn't conduct the tests. And it wasn't until scientists in the uk, and I believe it was Germany, and a regulator in the United States put their feet down and said there.
Interviewee
Is lots of evidence to show that it's very harmful. And so the idea that it's science's.
Karen Bloom Gewirtz
Responsibility to everyone to protect everyone is just, I think it's a marvelous, wonderful idea that is in direct conflict with.
Interviewee
The idea that science has an investment.
Karen Bloom Gewirtz
Also in profit and private property, which was part of what drove the problems with thalidomide to begin with.
Podcast Host
And another case that touches on a similar thread is that of insulin and the idea that medicine should be for everyone and not just purely for profit. I wonder if you could tell us about that.
Interviewee
Yes. Synthetic insulin was developed to replace natural insulin in the body for people with diabetes.
Karen Bloom Gewirtz
And without insulin, basically eventually you die.
Interviewee
Especially for children who get it very young.
Karen Bloom Gewirtz
The mortality rate in the beginning of the 20th century was just spectacular. So scientists developed a synthetic insulin and.
Interviewee
The idea was, this is for everybody, it is a human good.
Karen Bloom Gewirtz
And as a human good, like sunshine, fresh air, clean water, it should be for everybody.
Interviewee
And what unsurprisingly happened was that somebody has to make it. And non profit institutions like universities just simply didn't have the capacity to mass produce it. So it became corporate. And once it becomes corporate, it becomes.
Karen Bloom Gewirtz
A mechanism for making profit. Right? It becomes a commodity.
Interviewee
And so the price, price of insulin.
Karen Bloom Gewirtz
Went up and up and up over time.
Interviewee
And also it became private property, as opposed to public property.
Karen Bloom Gewirtz
So in the United States, what happened was the privatization of insulin became a source of mortality.
Interviewee
People couldn't afford the cost of insulin.
Karen Bloom Gewirtz
And so they were rationing their insulin, which is a life threatening practice, simply.
Interviewee
Because they couldn't afford to buy enough for themselves.
Karen Bloom Gewirtz
And finally what happened just a few years ago, in fact, was public health advocates persuaded the federal legal system in the United States to start suing companies for price gouging. Essentially what happened was that Congress authorized.
Interviewee
The federal government to negotiate medication prices, among them insulin.
Karen Bloom Gewirtz
And the American government secured an agreement to cap the price of insulin.
Interviewee
And this was considered a tremendous triumph. But unfortunately, what gets lost in the.
Karen Bloom Gewirtz
Story is the fact that the agreement to work with the federal government was.
Interviewee
Also driven by competition that some of.
Karen Bloom Gewirtz
The, what we call the big box stores, the big stores like Walmart, were beginning to produce their own much cheaper form of insulin. And it was in the pharmaceutical company's.
Interviewee
Interest to strike this deal.
Karen Bloom Gewirtz
So the irony of having created a.
Interviewee
Medication that could save lives and that was in fact, incredibly cheap to produce.
Karen Bloom Gewirtz
Insulin is something like a dollar a dose to produce, and it was selling.
Interviewee
For hundreds of dollars is great if you're a corporation, because that's what a commodity is supposed to do, but it's terrible if you're a sick person, because that's not what medication is supposed to do.
Karen Bloom Gewirtz
So negotiating that difference between commodity and medication, that I think is where any kind of crisis is going to have to go, Based on what I know of the history of it. If we're going to expand access to medication, and that's something that we have yet to completely deal with on a international level, Thinking about what it means to have these things as commodities and.
Podcast Host
The historical setting can really offer a different perspective on some big current issues. To end. Karen, I wonder if we could leave listeners with a bit more of a esoteric, silly note. You have some amazing cures and unexpected cures in this book from history that you talk about, one of which is viper wine. I wonder if you could tell us what was viper wine.
Interviewee
Viper wine is, unfortunately, exactly what it sounds like.
Karen Bloom Gewirtz
It is distilled eau de viper.
Interviewee
So the way you make viper wine is you take a whole bunch of.
Karen Bloom Gewirtz
Vipers, you shove them in a cask of wine, so the wine is pre made, you bung up the hole, and then you just wait and you wait for the vipers to drown, which happens fairly quickly.
Interviewee
You then wait for them to disintegrate.
Karen Bloom Gewirtz
Into the wine, which takes some weeks.
Interviewee
And then you wait for it all to sort of ferment, and then you drink it.
Karen Bloom Gewirtz
And viper wine has been around for millennia.
Interviewee
The Greeks were drinking it, and it was thought to have all sorts of marvelous properties.
Karen Bloom Gewirtz
It was supposed to be good for.
Interviewee
Skin conditions like leprosy. It was supposed to be good for curing paralysis. It was also supposed to be good.
Karen Bloom Gewirtz
For what they called the animal spirits. So if you couldn't quite get your.
Interviewee
Body to respond to the lust that you were feeling.
Karen Bloom Gewirtz
Yeah.
Interviewee
A little glass of viper wine would set you up properly. And it was also considered a bit.
Karen Bloom Gewirtz
Of a health drink. So there was a period in the.
Interviewee
Middle of the 17th century when fashionable ladies took a glass of viper wine. And there is some discussion about whether people strained the wine before they drank it or they just poured it right.
Karen Bloom Gewirtz
Out with all the little bits of viper, the skin that hadn't dissolved or.
Interviewee
The little bones of the little fangs.
Karen Bloom Gewirtz
Or whatever that is. And I also have to say, any.
Interviewee
Given cask of wine required dozens of vipers.
Karen Bloom Gewirtz
So this is not good. If you're one of the only species of viper in the uk, you really.
Interviewee
Don'T want to be one of those poor little guys.
Karen Bloom Gewirtz
But also, vipers were sort of cultivated to ensure that you had a supply of vipers to make viper wine.
Podcast Host
That was Karen Blum Gebert, the author of the Apothecary's Wife the Hidden History of Medicine and How It Became a Commodity. Thanks for listening. This podcast was produced by Daniel Kramer Arden.
History Extra Podcast: "How Medicine Became a Moneymaker" – Detailed Summary
Release Date: January 30, 2025
Host: Immediate Media
Guest: Karen Bloom Gewirtz, Author of "The Apothecary's Wife: The Hidden History of Medicine and How It Became a Commodity"
The episode delves into the transformation of medicine from a domestic, community-based practice to a commercialized industry. Karen Bloom Gewirtz, the author of The Apothecary's Wife, challenges the conventional "triumph of modern medicine" narrative, offering a nuanced exploration of this pivotal shift in medical history.
Karen begins by questioning the ingrained belief that pre-modern medicine was primitive and ineffective, dominated by "crones in the woods," and that the scientific revolution ushered in a new era of effective medical practices.
She asserts that this narrative simplifies history and overlooks the complexities and continuities in medical practices across eras.
Karen explores the concept of domestic medicine, where medical knowledge and remedies were passed down orally within families and communities. Before the commercialization of medicine, individuals relied on trusted family members, typically women, for healthcare.
As medicine transitioned to a commercial enterprise, people began purchasing medicines from strangers, often without understanding their composition or efficacy.
Historically, women were the primary caregivers and healers within families, utilizing herbal remedies and traditional practices. Karen argues that the rise of commercial medicine systematically marginalized women's roles in healthcare.
Despite their foundational role, women were excluded from formal medical institutions, which reinforced the dominance of male physicians and apothecaries.
With the advent of printed recipe books in the Elizabethan era, medical knowledge began to be documented rather than solely transmitted orally. Elizabeth Gray, the Countess of Kent, is highlighted as a pivotal figure whose recipe book was published, inadvertently undermining women's traditional knowledge and positioning.
The publication of such recipe books commodified domestic knowledge, making it accessible to a broader market and diminishing the exclusive role of women in household medicine.
As medicine became commercially viable, the market saw a surge in unregulated and often harmful remedies. Karen discusses how the lack of regulation led to the proliferation of quackery and the eventual push for formal medical standards.
The establishment of prescription systems and licensing sought to curb the spread of ineffective or dangerous treatments, further distancing medicine from its domestic roots.
Karen recounts instances of medical fraud and the subsequent regulatory responses. Jane Barker’s attempt to market a gout cure despite lacking formal credentials exemplifies the challenges in maintaining medical integrity.
These efforts to enforce medical standards were often met with resistance and highlighted the tension between profit motives and public health.
The commercialization of medicine had profound implications for women, stripping them of their roles as primary healers and relegating them to marginalized positions within the medical landscape.
However, Karen notes that women did find niches, such as treating the poor, albeit with low status and limited recognition.
Karen draws connections between historical shifts in medicine and contemporary issues, illustrating how the legacy of commercialized medicine persists today.
Iodized Salt:
Karen highlights iodized salt as a modern example of integrating medical knowledge into everyday life, blurring the lines between food and medicine.
Thalidomide and Insulin:
She discusses the Thalidomide tragedy and the privatization of insulin, underscoring the ongoing struggle to balance profit with public health.
To illustrate the eclectic nature of past medical practices, Karen shares anecdotes of unusual remedies, such as viper wine.
Viper Wine:
A concoction involving vipers steeped in wine, believed to cure various ailments from skin conditions to hormonal imbalances.
These examples underscore the diverse and often extreme measures taken in historical medicine, highlighting the contrast with modern standards.
Karen Bloom Gewirtz's exploration unveils the intricate evolution of medicine from a trusted domestic practice to a lucrative commercial industry. Her work emphasizes the importance of understanding this history to navigate contemporary medical challenges, advocating for a balance between accessibility, regulation, and the preservation of valuable traditional knowledge.
Produced by: Daniel Kramer Arden
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