How medicine became a moneymaker

Summary

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"

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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.

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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.

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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.

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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.

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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.

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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.

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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.”

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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.

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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

Learn More:
Unlock full access to articles and resources at HistoryExtra.com.

Transcript

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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.