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"

1. Introduction

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.

2. Challenging the Traditional Narrative

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.

• Quote:
  Karen Bloom Gewirtz (02:01): “It's almost kind of baked into the culture, this idea that we lived in a very dark time… and then, ta da, the scientific revolution came along, everything was modernized and boom. Medicine became useful and effective.”

She asserts that this narrative simplifies history and overlooks the complexities and continuities in medical practices across eras.

3. Domestic Medicine vs. Commercial Medicine

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.

• Quote:
  Karen Bloom Gewirtz (05:17): “You got it from the woman in your life… it might be mom, it might be your grandmother… they used medications that were organic, grown in the yard or collected locally.”

As medicine transitioned to a commercial enterprise, people began purchasing medicines from strangers, often without understanding their composition or efficacy.

4. The Role of Women in Historical Medicine

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.

• Quote:
  Karen Bloom Gewirtz (23:33): “Women became untrustworthy and unreliable… their position culturally, their position in the family, was greatly eroded.”

Despite their foundational role, women were excluded from formal medical institutions, which reinforced the dominance of male physicians and apothecaries.

5. Recipe Books and Knowledge Transmission

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.

• Quote:
  Karen Bloom Gewirtz (10:35): “Elizabeth Gray had a recipe book… running several households, she needed to tell her cook how she wanted things done and also make medications like heartburn tablets.”

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.

6. Commercialization and Regulation of 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.

• Quote:
  Karen Bloom Gewirtz (19:39): “As medication becomes more commercial, you have rush into the market of people who said, well, I've got a great cure.”

The establishment of prescription systems and licensing sought to curb the spread of ineffective or dangerous treatments, further distancing medicine from its domestic roots.

7. Quackery and Regulation Efforts

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.

• Quote:
  Karen Bloom Gewirtz (21:03): “Jane Barker persuaded her brother… to call herself a doctor and started selling a gout cure despite it being illegal.”

These efforts to enforce medical standards were often met with resistance and highlighted the tension between profit motives and public health.

8. Impact on Women

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.

• Quote:
  Karen Bloom Gewirtz (23:48): “Women were very much the losers in that regard. They became untrustworthy and unreliable… universities had never admitted women.”

However, Karen notes that women did find niches, such as treating the poor, albeit with low status and limited recognition.

9. Modern Parallels and Lessons

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.

  • Quote:
    Karen Bloom Gewirtz (28:08): “Iodized salt continues today to save thousands of lives… it's a mechanism for making profit, but terrible for sick individuals who need it.”

• Thalidomide and Insulin:
  She discusses the Thalidomide tragedy and the privatization of insulin, underscoring the ongoing struggle to balance profit with public health.

  • Quote:
    Karen Bloom Gewirtz (30:38): “Thalidomide… was marketed as a morning sickness drug without proper testing… insulin's privatization led to unaffordable prices, making it a life-threatening practice.”

10. Historical Cures and Anecdotes

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.

  • Quote:
    Karen Bloom Gewirtz (35:34): “Viper wine is... distilled eau de viper. You take vipers, shove them in a cask of wine, and let them disintegrate.”

These examples underscore the diverse and often extreme measures taken in historical medicine, highlighting the contrast with modern standards.

11. Conclusion

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.

• Final Quote:
  Karen Bloom Gewirtz (34:37): “Negotiating the difference between commodity and medication is where any kind of crisis is going to have to go… expanding access to medication requires rethinking these historical transitions.”

Produced by: Daniel Kramer Arden

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