THE REGULATIOONF REMEDIES IN …...activities undermined certai ann sourced prerogative o incomsf...
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Caroline HANNA WAY (Baltimore, U.S.A.) D15 THE REGULATION OF REMEDIES IN EIGHTEENTH CENTURY FRANCE The proprietary remedy business was the chief focus of attempts to regulate therapy in eighteenth century France. The trade in such remedies flourished at a time when conventional medicine was limited in its ability to cure and when large segments of the population could not readily obtain medical assistance. Attempts to police the trade ranged from local initiatives by medical corporations and municipal officials to large scale investigations on a country-wide basis by royally supported commissions and societies. This paper will discuss one of the most important of such regulatory attempts, that of the Royal Society of Medicine of Paris, and will aim to show that this society of physicians was not only concerned with policing the trade but also with trying to determine scientifically the therapeutic value of such remedies. This is a point worth exploring for in recent years the emphasis of some historians on the so-called « medicalization » of society has led to a depiction of attempts such as those to regulate therapy as a way of limiting the freedom of choice of individuals seeking assistance and of under- mining their ability to care for themselves, while, at the same time, enhancing the power and prestige of the medical profession. Such accounts often lose sight of the scientific goals of medical men in the second half of the eighteenth century and their authors are also inclined to forget the fact that many of these proprietors of secret remedies were business entrepreneurs whose self interest and aggrandize- ment predominated over their concern for the welfare of their customers. Proprietary remedies were popular in the eighteenth century and their manu- facture and sale could be the basis of a successful business enterprise. Such remedies were generally advocated for particular ailments, such as venereal disease, gout, worms, fever, skin conditions, eye complaints and tooth aches, and they were produced according to a formula kept secret by the proprietor. Certain remedies were known and sold only in a particular town or region, but others, such as Keyser's anti-venereal pills, were sold all over France. A Parisian proprietor, for example, could arrange more widespread distribution for his product by granting provincial agents the right to sell his remedy for a fee (1). Proprietary remedies were widely advertised in journals and news-sheets, as well as by means of street-placards and brochures. Such printed advertising became more common in the eighteenth century as stricter police regulation prevented the sale of remedies in street booths (2). To promote their remedies, proprietors sought endorsements from clients of rank or position, from medical practitioners and from medical corporations. The Paris Faculty of Medicine, as well as provincial faculties and colleges of medicine, were called upon in this regard. From publicity and numerous attestations of their value some remedies acquired a great renown. On occasion the monarch bought the formula of certain 265
Transcript of THE REGULATIOONF REMEDIES IN …...activities undermined certai ann sourced prerogative o incomsf...
C a r o l i n e H A N N A W A Y ( B a l t i m o r e , U . S . A . )
D15
THE REGULATION OF REMEDIES IN EIGHTEENTH CENTURY FRANCE
T h e p r o p r i e t a r y r e m e d y b u s i n e s s w a s t h e c h i e f focus o f a t t e m p t s t o r e g u l a t e t h e r a p y in e i g h t e e n t h c e n t u r y F r a n c e . T h e t r a d e i n s u c h r e m e d i e s f l o u r i s h e d a t a t i m e w h e n c o n v e n t i o n a l m e d i c i n e w a s l i m i t e d i n i t s a b i l i t y t o c u r e a n d w h e n l a r g e s e g m e n t s o f t h e p o p u l a t i o n c o u l d n o t r e a d i l y o b t a i n m e d i c a l a s s i s t a n c e . A t t e m p t s t o p o l i c e t h e t r a d e r a n g e d f r o m l o c a l i n i t i a t i v e s b y m e d i c a l c o r p o r a t i o n s a n d m u n i c i p a l o f f i c i a l s t o l a r g e s c a l e i n v e s t i g a t i o n s o n a c o u n t r y - w i d e b a s i s b y r o y a l l y s u p p o r t e d c o m m i s s i o n s a n d s o c i e t i e s . T h i s p a p e r w i l l d i s c u s s o n e o f t h e m o s t i m p o r t a n t o f s u c h r e g u l a t o r y a t t e m p t s , t h a t o f t h e R o y a l S o c i e t y o f M e d i c i n e of P a r i s , a n d w i l l a i m t o s h o w t h a t t h i s s o c i e t y of p h y s i c i a n s w a s n o t o n l y c o n c e r n e d w i t h p o l i c i n g t h e t r a d e b u t a l s o w i t h t r y i n g t o d e t e r m i n e s c i e n t i f i c a l l y t h e t h e r a p e u t i c v a l u e of s u c h r e m e d i e s . T h i s i s a p o i n t w o r t h e x p l o r i n g f o r i n r e c e n t y e a r s t h e e m p h a s i s o f s o m e h i s t o r i a n s o n t h e s o - c a l l e d « m e d i c a l i z a t i o n » o f s o c i e t y h a s l e d t o a d e p i c t i o n of a t t e m p t s s u c h a s t h o s e t o r e g u l a t e t h e r a p y a s a w a y o f l i m i t i n g t h e f r e e d o m of c h o i c e of i n d i v i d u a l s s e e k i n g a s s i s t a n c e a n d of u n d e r m i n i n g t h e i r a b i l i t y t o c a r e f o r t h e m s e l v e s , w h i l e , a t t h e s a m e t i m e , e n h a n c i n g t h e p o w e r a n d p r e s t i g e o f t h e m e d i c a l p r o f e s s i o n . S u c h a c c o u n t s o f t e n l o s e s i g h t o f t h e s c i e n t i f i c g o a l s o f m e d i c a l m e n i n t h e s e c o n d h a l f o f t h e e i g h t e e n t h c e n t u r y a n d t h e i r a u t h o r s a r e a l s o i n c l i n e d t o f o r g e t t h e f a c t t h a t m a n y of t h e s e p r o p r i e t o r s o f s e c r e t r e m e d i e s w e r e b u s i n e s s e n t r e p r e n e u r s w h o s e s e l f i n t e r e s t a n d a g g r a n d i z e m e n t p r e d o m i n a t e d o v e r t h e i r c o n c e r n f o r t h e w e l f a r e of t h e i r c u s t o m e r s .
P r o p r i e t a r y r e m e d i e s w e r e p o p u l a r i n t h e e i g h t e e n t h c e n t u r y a n d t h e i r m a n u f a c t u r e a n d s a l e c o u l d b e t h e b a s i s o f a s u c c e s s f u l b u s i n e s s e n t e r p r i s e . S u c h r e m e d i e s w e r e g e n e r a l l y a d v o c a t e d f o r p a r t i c u l a r a i l m e n t s , s u c h a s v e n e r e a l d i s e a s e , g o u t , w o r m s , f e v e r , s k i n c o n d i t i o n s , e y e c o m p l a i n t s a n d t o o t h a c h e s , a n d t h e y w e r e p r o d u c e d a c c o r d i n g t o a f o r m u l a k e p t s e c r e t b y t h e p r o p r i e t o r . C e r t a i n r e m e d i e s w e r e k n o w n a n d s o l d o n l y i n a p a r t i c u l a r t o w n o r r e g i o n , b u t o t h e r s , s u c h a s K e y s e r ' s a n t i - v e n e r e a l p i l l s , w e r e s o l d a l l o v e r F r a n c e . A P a r i s i a n p r o p r i e t o r , f o r e x a m p l e , c o u l d a r r a n g e m o r e w i d e s p r e a d d i s t r i b u t i o n f o r h i s p r o d u c t b y g r a n t i n g p r o v i n c i a l a g e n t s t h e r i g h t t o s e l l h i s r e m e d y f o r a f e e (1).
P r o p r i e t a r y r e m e d i e s w e r e w i d e l y a d v e r t i s e d i n j o u r n a l s a n d n e w s - s h e e t s , a s w e l l a s b y m e a n s o f s t r e e t - p l a c a r d s a n d b r o c h u r e s . S u c h p r i n t e d a d v e r t i s i n g b e c a m e m o r e c o m m o n i n t h e e i g h t e e n t h c e n t u r y a s s t r i c t e r p o l i c e r e g u l a t i o n p r e v e n t e d t h e s a l e o f r e m e d i e s i n s t r e e t b o o t h s ( 2 ) . T o p r o m o t e t h e i r r e m e d i e s , p r o p r i e t o r s s o u g h t e n d o r s e m e n t s f r o m c l i e n t s o f r a n k o r p o s i t i o n , f r o m m e d i c a l p r a c t i t i o n e r s a n d f r o m m e d i c a l c o r p o r a t i o n s . T h e P a r i s F a c u l t y of M e d i c i n e , a s w e l l a s p r o v i n c i a l f a c u l t i e s a n d c o l l e g e s o f m e d i c i n e , w e r e c a l l e d u p o n i n t h i s r e g a r d . F r o m p u b l i c i t y a n d n u m e r o u s a t t e s t a t i o n s o f t h e i r v a l u e s o m e r e m e d i e s a c q u i r e d a g r e a t r e n o w n . O n o c c a s i o n t h e m o n a r c h b o u g h t t h e f o r m u l a o f c e r t a i n
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r e m e d i e s — often those t h a t h a d been successful in cu r ing roya l illness — and s o m e t i m e s publ i shed t h e r e m e d y for t h e benefi t of t he public (3). The possibi l i ty of royal favour served to encou rage r e m e d y propr ie to r s .
The Royal Socie ty of Medic ine ' s e n d e a v o u r s to police t he p ropr i e t a ry r e m e d y t r a d e b e g a n in 1778 w h e n it w a s a c c o r d e d th i s responsibi l i ty in i ts L e t t e r s P a t e n t of 29 Agugus t w h i c h set ou t i t s c h a r t e r . At t h e ou t se t t h e Soc ie ty w a s con f ron ted w i t h a n u m b e r of p rob lems . I t h a d to resolve c e r t a i n difficult ies w i t h respec t to t h e o t h e r m e d i c a l g roups w h i c h h a d previous ly b e e n involved w i t h t h e regu la t ion of r e m e d i e s , a n d i t a lso h a d to develop an u n d e r s t a n d i n g of t h e difficult ies i n h e r e n t in a t t e m p t i n g to cont ro l t h e ac t iv i t ies of t h e r e m e d y sel lers t hemse lves . As t h e Socie ty soon found ou t , t h e l a t t e r en ta i l ed no t only a knowledge of med ic ine a n d c h e m i s t r y , bu t a lso of legal i s sues , m e a n s of censorsh ip , a n d of adver t i s ing a n d m a r k e t i n g t echn iques . F u r t h e r m o r e , t h e deve lopmen t of a co-operat ive assoc ia t ion w i t h t h e police w a s necessa ry .
The Society 's e n d e a v o u r s to police t h e r e m e d y t r a d e w e r e no t t h e f i rs t such a t t e m p t s . The need for s o m e con t ro l h a d been recognized in t h e seven teen th c e n t u r y bu t t h e efforts to do so w e r e u n s y s t e m a t i c . In 1728 t h e t r a d e in p ropr i e t a ry r e m e d i e s h a d b e c o m e a s u b j e c t for r egu la t ion by t h e royal a u t h o r i t y a n d l icensing of t he i r sa le r e m a i n e d a p re roga t ive of t he f i rs t phys ic ian of t h e k i n g un t i l 1772. Con t inu ing a t t e m p t s w e r e m a d e t o con t ro l t h e ac t iv i t ies of r e m e d y sel lers , par t i cu la r ly in Pa r i s , by severa l f i rs t phys ic ians to the k ing a n d the i r advisory commis s ions , w h o e x a m i n e d r e q u e s t s for l icenses a t r egu l a r m e e t i n g s , a n d by t h e Pa r i s police w h o t r i ed to m a i n t a i n r eg i s t e r s of r e m e d y p rop r i e to r s a n d to compel the submis s ion of t h e i r r e m e d i e s for e x a m i n a t i o n . These efforts h a d only a l imi ted effect. M a n y r e m e d y sel lers c o n t i n u e d in bus iness w i t h o u t a n y official l i cense or e n d o r s e m e n t , b u t w i t h t h e t ac i t a c c e p t a n c e of local m e d i c a l a u t h o r i t i e s o r local police officials. On occas ion , br ibery he lped i n s u r e t h a t a p rop r i e to r w a s left in peace . Moreover , a t leas t one f irst phys ic ian , J e a n Senac , repor ted ly sold l icences to r e m e d y p ropr i e to r s on h is o w n in i t ia t ive , u n d e r m i n i n g t h e ro le of t h e adv i so ry c o m m i s s i o n a n d inc reas ing h i s o w n i n c o m e (4).
T h e m o s t se r ious a t t e m p t to police t h e t r a d e m o r e r igorous ly before t h e found ing of t he Socie ty w a s t h a t of t h e Royal Commiss ion of Medic ine es t ab l i shed in 1772. This body w a s b r o a d e r ba sed t h a n prev ious c o m m i s s i o n s , hav ing represen t a t i ve s b o t h f rom t h e roya l househo ld a n d f rom t h e Pa r i s i an m e d i c a l corporat ions a n d inc luded phys ic ians , su rgeons a n d apo theca r i e s (5). However , a s i t w a s i n s t i t u t e d a t a t i m e w h e n no f i rs t phys ic ian t o t h e k ing h a d been appoin ted , it w a s d o m i n a t e d by t h e D e a n of t h e Pa r i s F a c u l t y of Medic ine . Moreover , i t s ac t iv i t ies u n d e r m i n e d c e r t a i n p re roga t ives a n d sou rces of i n c o m e of the f i rs t phys ic ian t o t h e king, m o s t no t ab ly h i s r igh t to c o n t r o l t h e m i n e r a l w a t e r bus iness of F r a n c e . Th i s s i tua t ion w a s no t accep ted by Joseph Lassone w h e n h e w a s appoin ted t h e f irs t phys ic ian in reve r s ion to Louis XVI a n d h e w a s t o b e c o m e t h e P r e s i d e n t of t h e Royal Socie ty of Medic ine . One of t h e s t r a n d s in t h e complex w e b of even t s w h i c h led to t h e founding of t h e Society w a s Lassone ' s des i re t o b r ing t o g e t h e r a g roup of phys ic ians w h i c h could ass i s t h i m in t h e m o r e effective exerc ise of t h e powers of t he first phys ic ian to t h e k ing . His o w n in t e r e s t a n d w o r k in analysis l ed h i m to bel ieve t h a t s u c h a society, w h i c h i n c l u d e d able c h e m i s t s , shou ld rep lace t h e c o m m i s s i o n a n d t a k e over b o t h t h e ch emi ca l a n d cl inical ana lys i s of r e m e d i e s a n d m i n e r a l w a t e r s (6). This w a s ach ieved w i t h t he r e g i s t r a t i o n of t h e Le t t e r s P a t e n t of t h e Royal Socie ty of Medic ine in 1778 a n d t h e Socie ty ' s m e m b e r ship w h i c h inc luded t h e phys ic ian-chemis t s J e a n B u c q u e t , Anto ine F o u r c r o y a n d P i e r r e Macque r s e e m e d su i t ed for t h e t a s k s conf ron t ing it .
The Socie ty ' s p roposed goals in r egu la t ing t h e p ropr i e t a ry r e m e d y t r a d e w e r e set o u t in a n in fo rma t ion bul le t in of n o v e m b e r 1778 w h i c h w a s d i s t r i bu t ed to al l t he m e m b e r s of i ts co r r e spondence n e t w o r k in every pa r t of F r a n c e (7). Wi th th i s publ ica t ion , t h e Society i n s t i t u t e d a ser ies of p r o c e d u r e s w h i c h w a s to fo rm i ts
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s t a n d a r d a p p r o a c h t o t h e e x a m i n a t i o n o f r e m e d i e s d u r i n g t h e n e x t f i f t e e n y e a r s . I n 1781 t h e s e p r o c e d u r e s w e r e f o r m a l i z e d l e g a l l y b y a d e c r e e o f t h e k i n g ' s c o u n c i l ( 8 ) . T h e S o c i e t y ' s g o a l s w e r e t h e i n t r o d u c t i o n of a u n i f o r m l i c e n s i n g s y s t e m f o r r e m e d i e s , a p p l i c a b l e i n a l l o f F r a n c e , a n d t h e u s e of m o r e r e l i a b l e s c i e n t i f i c m e a n s t o t e s t t h e p r o p e r t i e s o f r e m e d i e s . T h e s e m e a s u r e s i t h o p e d w o u l d l e a d t o t h e p r o h i b i t i o n o f a l a r g e n u m b e r o f i n e f f e c t i v e , e x p e n s i v e a n d d a n g e r o u s d r u g s . T o f a c i l i t a t e i t s t a s k o f e x a m i n i n g a n d p o l i c i n g r e m e d i e s , t h e S o c i e t y a n n o u n c e d t h a t a l l p r e v i o u s l y a w a r d e d p a t e n t s a n d p e r m i s s i o n s f o r s a l e w e r e r e v o k e d .
T h e e x a m i n a t i o n a n d t e s t i n g p r o c e d u r e s w e r e a s f o l l o w s . P r o p r i e t o r s o f r e m e d i e s s u b m i t t e d a c e r t a i n q u a n t i t y o f t h e i r p r e p a r a t i o n w i t h a w r i t t e n s t a t e m e n t o f i t s v i r t u e s a n d t h e c i r c u m s t a n c e s i n w h i c h i t s h o u l d b e u s e d . A s e a l e d c o p y o f t h e r e c i p e a n d d e t a i l s o f i t s p r e p a r a t i o n h a d a l s o t o b e s u b m i t t e d , a r e q u i r e m e n t p r o t e s t e d b y m a n y r e m e d y s e l l e r s . T o p r o t e c t t h e p r o p r i e t o r s ' i n t e r e s t s t h i s l a t t e r i n f o r m a t i o n w a s k e p t c o n f i d e n t i a l a n d w a s o n l y m a d e k n o w n t o t h e c o m m i s s i o n e r s c h a r g e d w i t h e x a m i n i n g t h e r e m e d y . T h e p r o p r i e t o r p r e p a r e d h i s r e m e d y i n t h e p r e s e n c e o f t h e c o m m i s s i o n e r s , s o t h a t t h e y c o u l d v e r i f y t h e i n g r e d i e n t s a n d p r o c e s s o f m a n u f a c t u r e , a n d a t t e m p t e d t o j u s t i f y h i s c l a i m s f o r i t s m e r i t s . A f t e r a s c e r t a i n i n g t h a t t h e r e m e d y w a s ] n o t a l r e a d y i n c l u d e d i n t h e p h a r m a c o p e i a s , a p r o c e d u r e d e s i g n e d t o p r e v e n t a p r o p r i e t o r f r o m p r o f i t i n g a t t h e p u b l i c ' s e x p e n s e f r o m a p r e p a r a t i o n a l r e a d y i n t h e p u b l i c d o m a i n , t h e c o m m i s s i o n e r s d r e w u p t h e i r r e p o r t w h i c h w a s p r e s e n t e d a t o n e of t h e S o c i e t y ' s r e g u l a r m e e t / n g s . T h e g r o u p a s a w h o l e t h e n p a s s e d j u d g m e n t o n t h e r e m e d y .
I n c e r t a i n i n s t a n c e s , a f t e r t h i s i n i t i a l a n a l y s i s , t h e S o c i e t y p r o p o s e d f u r t h e r t r i a l s f o r a r e m e d y i n c l u d i n g c l i n i c a l t e s t i n g o n p a t i e n t s i n h o s p i t a l s . T h i s w a s a n o t h e r r e a s o n w h y t h e c o m m i s s i o n e r s n e e d e d t o k n o w t h e i n g r e d i e n t s o f t h e r e m e d y , t o a v o i d a n y d a n g e r t o t h e p a r t i c i p a n t s i n s u c h t e s t s . T o s u b s t a n t i a t e f u r t h e r t h e e v i d e n c e o b t a i n e d , t h e S o c i e t y a l s o s o u g h t t h e t e s t i m o n y o f m e d i c a l p r a c t i t i o n e r s w h o h a d u s e d a r e m e d y w i t h s u c c e s s o n p a t i e n t s w h o s e i d e n t i t y w a s u n k n o w n t o t h e r e m e d y p r o p r i e t o r . A f t e r a l l t e s t s w e r e c o m p l e t e d , t h r e e o u t c o m e s w e r e p o s s i b l e : 1) t h e s a l e o f t h e r e m e d y m i g h t b e p r o h i b i t e d o n t h e g r o u n d s t h a t i t Was n o t n e w , t h a t i t w a s n o t e f f e c t i v e , o r t h a t i t s u s e w a s d a n g e r o u s ; 2 ) t h e r e m e d y m i g h t b e c l a s s i f i e d a s h a v i n g s o m e t h e r a p e u t i c m e r i t a n d i t s p r o p r i e t o r a c c o r d e d a s i m p l e p e r m i s s i o n a l l o w i n g i t t o b e s o l d ; o r 3) t h e r e m e d y m i g h t r e c e i v e a p o s i t i v e e n d o r s e m e n t a s a n a d d i t i o n t o t h e p h a r m a c o p e i a a n d b e r e c o m m e n d e d f o r a p a t e n t . T h e l a t t e r o u t c o m e w a s t h e l e a s t l i k e l y . F e l i x V i c q d'Azyr , the] p e r p e t u a l s e c r e t a r y , c l a i m e d t h a t o n l y f o u r t i m e s d i d t h e S o c i e t y r e c o m m e n d a r e m e d y f o r a p a t e n t f r o m t h e k i n g . A n d of t h e 442 r e m e d i e s e x a m i n e d b e t w e e n O c t o b e r 1780 a n d J u l y 1789, M a u r i c e G e n t y f o u n d t h a t o n l y 100 r e c e i v e d s i m p l e p e r m i s s i o n s f o r s a l e w h i l s t 342 w e r e p r o h i b i t e d (9 ) .
T h e R o y a l S o c i e t y of M e d i c i n e ' s e f f o r t s t o r e g u l a t e t h e p r o p r i e t a r y r e m e d y t r a d e p r o v e d t i m e c o n s u m i n g a n d f r u s t r a t i n g i n m a n y r e s p e c t s . T o u n d e r s t a n d w h y t h i s w a s t h e c a s e , i t h a s t o b e k e p t i n m i n d t h a t t h e S o c i e t y w a s a t t e m p t i n g t o c o n t r o l a s i g n i f i c a n t r e t a i l t r a d e a n d t h a t m o s t p r o p r i e t o r s w e r e n o t o p e r a t i n g f r o m c h a r i t a b l e m o t i v e s b u t i n t h e h o p e s o f d e v e l o p i n g a s u c c e s s f u l b u s i n e s s e n t e r p r i s e . M o r e o v e r , a n u m b e r of t h e m w e r e s h o p i s t i c a t e d e n t r e p r e n e u r s w i t h i n f l u e n t i a l p r o t e c t o r s w h o w e r e w e l l v e r s e d in s u b v e r t i n g a t t e m p t s t o c o n t r o l t h e a d v e r t i s i n g a n d m a r k e t i n g of t h e i r p r o d u c t s a n d k n e w h o w t o c a p i t a l i z e o n a n y e n d o r s e m e n t o f t h e i r r e m e d i e s .
T h r e e o r f o u r e x a m p l e s o f t h e S o c i e t y ' s d e a l i n g s w i t h w e l l - k n o w n p r o p r i e t a r y r e m e d y s e l l e r s w i l l s e r v e t o i l l u s t r a t e t h e n a t u r e a n d r a n g e of t h e p r o b l e m s i t e n c o u n t e r e d . I n O c t o b e r 1779 t h e S o c i e t y a p p r o v e d t h e s a l e o f t h e m e r c u r i a l p i l l s o f B e l l o s t e , f i r s t i n v e n t e d b y a s u r g e o n of t h a t naf t i e i n 1680, w h i c h h a d b e e n t h e f o u n d a t i o n o f a f a m i l y b u s i n e s s a n d w h i c h h a d p r e v i o u s l y r e c e i v e d i n 1758 a t h i r t y - y e a r r o y a l p r i v i l e g e . T h e S o c i e t y f e l t t h a t l o n g c l i n i c a l e x p e r i e n c e h a d s h o w n
267
t he pi l l s ' va lue as blood depura t ives , pu rga t ives a n d in t h e t r e a t m e n t of ex te rna l sk in condi t ions . They w e r e di f ferent f rom o t h e r m e r c u r i a l pills l i s ted in t h e p h a r m a c o p e i a s a n d chemica l ana lys i s showed t h a t they w e r e wel l m a d e a n d con ta ined no u n c o m b i n e d m e r c u r y par t i c les . The Socie ty env is ioned t h a t s u c h approva ls for sa le a s i t g r a n t e d t h e Bel los te family w o u l d las t fo r t h r e e yea rs a f te r wh ich , to m a i n t a i n con t ro l of qual i ty of i ng red i en t s a n d m a n u f a c t u r e , r e -examina t ion of t h e r e m e d y wou ld be r equ i r ed . B u t in th i s case , Socie ty endorsem e n t led t h e k ing to acco rd the p rop r i e to r s a n o t h e r th i r ty -year roya l pr ivi lege in J a n u a r y 1781, u n d e r c u t t i n g t h e Socie ty ' s goal of c o n t i n u e d m o n i t o r i n g even for approved r e m e d i e s (10).
A n o t h e r r e m e d y w h o s e sale w a s au tho r i zed in 1780 by t h e Socie ty w a s J a c q u e t ' s a n t i m o n i a l p r e p a r a t i o n for va r i ous sk in aff l ict ions w h i c h h a d previous ly been e n d o r s e d by t h e Pa r i s F a c u l t y of Medic ine in 1762. Th i s ac t ion b y t h e Socie ty led t h e Min i s t e r of t h e Navy to inc lude i t a m o n g s t t h e m e d i c a m e n t s t h a t w e r e suppl ied on all nava l ships a n d it w a s a lso o r d e r e d for t h e i r m e d i c i n e c h e s t s b y t h e Di rec to r s of t h e E a s t I n d i a C o m p a n y (11). S u c h i n c r e a s e d popu la r i t j ' a n d sa les of a r e m e d y a f te r Soc ie ty approval w e r e l a t e r to be a focus for c r i t i c i sm of t h e Society 's r egu la to ry ac t iv i t ies . T h e Society 's efforts to d i m i n i s h t h e n u m b e r of p rop r i e t a ry r e m e d i e s h a d a s a corol lary t h e effect of giving m u c h g r e a t e r recognit ion to those w h o s e sale w a s au tho r i zed a n d g r e a t e r prof i t s for t h e i r o w n e r s . I n t h e case of t h e f a m o u s Rob Laffecteur , an an t i -venerea l r e m e d y w h o s e chief m e r i t s w e r e i ts al l vege tab le i ng red i en t s a n d i t s supposed lack of m e r c u r y , t h e five-year p rocess of inves t iga t ion , w h i c h inc luded t h r e e se t s of c l inical t r i a l s a n d involved t h e Socie ty ' s o w n c h e m i s t s in p roduc ing t h e rob for t hemse lves , gave t h e r e m e d y fa r g r e a t e r r e n o w n t h a t i t o t h e r w i s e w o u l d h a v e en joyed a n d he lped i n s u r e i t s successful sa le wel l i n t o t h e n i n e t e e n t h c e n t u r y (12).
P roh ib i t ion of a r e m e d y f rom sale d id no t a lways achieve t h e des i r ed resu l t e i the r . T h e Socie ty d id n o t ripprove F a y n a r d ' s p o w d e r in 1779 w h i c h t h e p rop r i e to r c l a i m e d could s t e m t h e h e m o r r h a g i n g of a r t e r i e s cu t in acc iden t s a n d a m p u t a t i o n v
I t h a d c o n d u c t e d a t h o r o u g h e x a m i n a t i o n us ing a n i m a l s in t h e t e s t s a n d found t h a t compres s ion by a b a n d a g e w a s t h e cause of a n y an t i -hemor rhag i c effect d e m o n s t r a t e d in t h e t r ia l s , n o t F a y n a r d ' s powder , a n d t ha t , moreove r , o t h e r s typ t ic subs t ances a l r eady k n o w n w e r e of m o r e va lue . F a y n a r d ' s a t t e m p t t o inf luence t h e c o m m i s s i o n e r s ' r e p o r t by r e s o r t i n g t o b r ibe ry — a t a c t i c t r i e d by m a n y p rop r i e to r s — w a s a l so r e g a r d e d w i t h d is favour . Unfo r tuna t e ly for t h e Socie ty in t h i s i n s t ance , i t s scientif ic j u d g m e n t w e n t aga ins t t h e e n d o r s e m e n t F a y n a r d h a d a l r e a d y o b t a i n e d f rom t h e inf luent ia l Min i s t e r of Fore ign Affairs, t h e C o m t e de Vergennes , before t rave l l ing t o F r a n c e f rom London 1 w h e r e h e h a d b e e n successful ly sell ing h is r e m e d y . F a y n a r d k n e w h o w to exploit s u c h connect ions a n d a l so p roved h imsel f a m a s t e r a t m a n i p u l a t i n g t h e avai lable m e a n s of adve r t i s i ng w h i c h t h e Socie ty t r i ed t o censor . Difficulties abou t th is r e m e d y , w h o s e use b e c a m e widesp read , con t i nued for a n u m b e r of y ea r s (13).
S u c h p rob lems t h e n as p a t r o n a g e a n d t h e abi l i ty s h o w n by p ropr i e to r s t o u s e every aspec t of t h e inves t iga t ion of t he i r r e m e d i e s t o t h e i r o w n a d v a n t a g e c r e a t e d difficult ies for t h e Socie ty in achiev ing i t s goals . Prov is ions t h a t s e e m e d a d e q u a t e on pape r w e r e no t a lways easy t o enforce in p rac t i ce . I n Pa r i s co-operat ion w i t h t h e police r e s u l t e d in m a n y p ropr i e to r s be ing compel led to s u b m i t t he i r r e m e d i e s for e x a m i n a t i o n bu t t he i r n u m b e r s m a d e it possible for m a n y to avoid any invest igat ion . F o r t h e c o u n t r y s i d e t h e Socie ty could only adv i se i ts c o r r e s p o n d e n t s of w h i c h r e m e d i e s w e r e approved a n d w h i c h b a n n e d a n d hope t h a t local p r ac t i t i one r s w o u l d do t h e i r b e s t to e n s u r e t h a t t h e sa le of p roh ib i t ed r e m e d i e s w a s not a l lowed.
Unt i l 1790 t h e Society con t i nued to hope t h a t m o r e r igo rous a n d b i n d i n g legis la t ion in con junc t ion w i t h t h o r o u g h inves t iga t ion a n d t e s t i ng w o u l d lead t o a b e t t e r police of p rop r i e t a ry r e m e d i e s .However , by t h e t i m e Vicq d'Azyr pres e n t e d h i s New Plan for the Constitution* of Medicine in France t o t h e Na t iona l
268
Assembly in November 1790, the Society had had a change of heart. The solution proposed in this discussion to the problem of regulating the remedy trade was not to grant any more patents or permissions at all. Instead it recommended that new remedies with therapeutic potential should be tested at the government's request and the recipe of those which proved efficacious should be bought by the government and thereby brought into the public domain (14). This new approach was no more realizable than other earlier ideas but perhaps reflects the Society's frustration over its attempts to regulate the proprietary remedy trade.
NOTES
* Research for this paper was supported in part by a grant from the National Library of Medicine (1 ROI LM 2497) whose assistance is gratefully acknowledged.
1. See works on the history of pharmacy such as Albert Couvreur, La Pharmacie et la thérapeutique au XVIIIe siècle vues à ravers le Journal Encyclopédique de Pierre Rousseau à Bouillon (Paris, Vigot, 1953), 2 : 484-520.
2. Léon MacAuliffe, « La réclame médicale au xv i i r siècle (Documents des Archives de la Seine)», France Médicale, 1901. 48: 73-75: Mauricje Bouvet, «Histoire sommaire du remède secret », Rev. Hist. Pharm., 1957, 154 : 190-13.
3. Alfred Franklin. La Vie privée d'autrefois : Les médicaments (Paris, 1891), pp. 207-237 ; Couvreur, La Pharmacie, 2 : 489-94.
4. Maurice Bouvet, « Les Commissions de contrôle des sDécialités pharmaceutiques au XVIII E siècle », Bull. Soc. Hist. Pharm., 1922, 3 : 88-94 ; Paul Delaunay, Le Monde médical parisien au XVIIIe siècle (Paris, Jules Rousset, 1905), pp. 298-330.
5. Déclaration du Roi, portant établissement d'une Commission royale de médecine pour l'examen des remèdes particuliers et la distribution des eaux minérales (Paris, 1772) ; Bouvet. «Les commissions de contrôle», pp. 119-22; Delaunay, Le Monde médical, pp. 134-135. 301-6.
6. Félix Vicq d'Azyr, Eloge de M. de Lassone, lu le premier Septembre 1789, dans la séance publique de la Société Royale de Médecine (Paris, 1789), pp. 25-30 ; Marie Jean Antoine Nicolas Caritat. marquis de Condorcet, « Eloge de M. de Lassone », Hist Acad. Roy. Sciences, 1788 : 28-30.
7. Avis au public, sur l'examen des remèdes pour lesquels on demande des permissions ou brevets (Paris, 1778). See also Pierre Julien, « La Société Royale de Médecine de PParis et les essais de remèdes contre maladies et épidémies dang le dernier auart du x v m e siècle », in Acta Congressus Internationalis Historiae Pharmaciae Pragae MCMLXXI (Stuttgart, 1972), Band 38, po. 173-182.
8. Arrêt du conseil d'Etat du Roi. concernant les remèdes pour la distribution desquels on demanderait des Lettres Patentes, Brevets ou Permissions, du 5 mai 1781.
9. Maurice Genty. « La Société royale de Médecine et les remèdes secrets avant la Révolution», Progrès Médical, suppl. illustré, 1937: 18.
10. Arch. S.R.M-, Carton 96. See also Maurice Bouvpt, « Les pilules de Belloste », Bull. Sciences Pharmacol., 1928. .?5 : 246-259, 296-312.
11. Bernard Jacquet, Histoire abrégée de l'antimoine et particulièrement de sa préparation (Paris, 1784Ï. P D . 195-201 : Couvreur. La Pharmacie, 2: 504.
12. Arch S.R.M., Carton 96 ; Pierre Boyveau-Laffecteur, Traité des maladies vénériennes, anciennes, récentes, occultes et méthode de leur guérison par le rob Anti-Syphilitique (Paris, 1807), pp. 179-201 ; Maurice Bouvet, «Un remède secret du x v m e siècle: Le rob Boyveau-Laffecteur». Bull. Soc. Hist. Pharm., 1923, 264-722. '
13. Arch. S.R.M., Carton 99. 14. Félix Vicq d'Azir, Nouveau plan de Constitution de la Médecine en France in
A. de Beauchamo, éd.. Enquêtes et Documents relatifs] à l'enseignement supérieur (Paris, 1888), vol. 28, Médecine et pharmacie, pp. 106-113. See aJso Louis Faligot, La Question des remèdes secrets sous la Révolution et l'Empire (Paris and Toulouse, Editions Occitania, 1924).
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