American Journal of Pharmaceutical Education 2008; 72 (5) Article 123.
BOOK REVIEWS
SZASZ T. The Medicalization of Everyday Life.
Selected Essays. Syracuse NY: Syracuse Univer-
sity Press; 2007. 202 pages, $19.95 (paperback),
ISBN-10: 0-8156-0867-5.
Reviewed By: Michael Montagne, PhD
Massachusetts College of Pharmacy & Health Sciences
The medicalization thesis, the re-labeling or redefining of
a personal or social problem as a medical condition thus
requiring therapeutic intervention, has become the focus
of a number of recent works. In the late 1960s and early
1970s, researchers, mostly social scientists, were studying
issues surrounding social control and a range of human
problems that had come under medical jurisdiction. Three
researchers were at the forefront of this new area of inquiry,
building a career on it: Peter Conrad, Ivan Illich, and Thomas
Szasz. Each tended to focus on certain aspects of medical
care and control: patients’experiences with certain diseases,
the politics of medicine, and the true nature of psychiatry.
The psychiatrist, Thomas Szasz, has written about
medicalization in psychiatry since the 1970s, arguably
even earlier. This collection of previously published
essays, which appear in adapted form, recounts his lifelong
interest in medicalization. These essays are presented in 2
sections: 7 of them are part of the first section, entitled
‘‘Demarcating Disease from Nondisease,’’ and 9 are part
of the second section, entitled ‘‘Disturbing Behavior and
Medicine’s Responses to It.’’ The original publication
dates of these essays range from 1973 to 2006. In both a
preface and introduction, Szasz comments on the term
medicalization and what it means today.
Szasz’s key argument is that social groups seeking to
exercise power and control subvert the diagnostic proc-
ess, resulting in the treatment of non-disease as disease.
He believes, at least in psychiatry, ‘‘that we are not deal-
ing with real, literal diagnoses, diseases, or treatments.
We are dealing with the metaphorical uses of these terms’’
(emphasis his).
The essays herein detail various aspects of his central
thesis: mental illness is not a disease. To the extent that
psychiatry, medicine, and patient advocacy groups have
defined certain behaviors as psychiatric diseases, the med-
ical establishment then forms an alliance with the political
state to gain power over individuals with the purpose of
controlling those behaviors. The ultimate result is a ther-
apeutic state that rules over all human behavior in the
context of biomedical disease to the exclusion of any
individual right or personal freedom. He also differenti-
ates between medicalization from above (coercion) and
1
medicalization from below (choice), reflecting again his
concern for ever diminishing personal freedoms. Accord-
ing to Szasz, ‘‘medicalization is not medicine or science;
it is a semantic social-strategy that benefits some persons
and harms others.’’ The ultimate expression of his thought
is found in the final essay, ‘‘Pharmacracy: The New Des-
potism,’’ originally published in 2001.
There is little support in psychiatry for Szasz’s views.
For that matter, many people become very argumentative,
often hostile, when his viewpoints are brought up for dis-
cussion. While certainly extreme, even in comparison to
other scholars on this topic, his work warrants attention. It
should be read and discussed in context with similar works:
Ivan Illich, Medical Nemesis (1976); Lynn Payer, Disease
Mongers (1992); Ray Moynihan and Alan Cassels, Selling
Sickness (2006); and Peter Conrad’s recent collection of
essays, The Medicalization of Society (2007). Szasz’s book
is best used in graduate courses, specialized seminars, and
by researchers and faculty members wishing to gain a more
thorough understanding of the medicalization thesis.
Use of the medicalization thesis to argue about the
nature of disease and medical treatment in contemporary
society seems to entail a number of interrelated issues.
How do we distinguish or demarcate a disease from a non-
disease? Attendant to that, when is a specific disease’s
diagnostic criteria clear enough and bounded such that
most everyone would agree it is unambiguously a dis-
ease? How then do we explain or help individuals who
present with negative changes in their bodies and minds,
feelings of being not healthy, essentially ‘‘symptoms’’
that suggest what if not a disease? There are many inter-
esting ideas and testable hypotheses floating around in
these works on medicalization. It is time for more serious
attention and focused research on this topic.
Corresponding Author: Michael Montagne, PhD, Senior
Associate Dean, Massachusetts College of Pharmacy & Health
Sciences, Boston. Tel: 1-617-732-2995. E-mail:
michael.montagne@mcphs.edu
Christopher A. Langley and Dawn Belcher.
FASTtrack: Pharmaceutical Compounding and
Dispensing. London, United Kingdom Pharma-
ceutical Press; 2008. 214 pp, $29.95 (softcover),
ISBN 978-0-85369-700-8.
Reviewed By: Deborah Lester Strong, PharmD
College of Pharmacy, University of Georgia
Pharmaceutical Compounding and Dispensing is 1 of 5
study guides in the FASTtrack series. In the introduction
to the FASTtrack series, the authors describe the series as
 American Journal of Pharmaceutical Education 2008; 72 (5) Article 123.
revision guidelines designed for use in conjunction with
textbooks and reference books as an aid to guide under-
graduate pharmacy students through their examinations.
They also state the books’ usefulness to preregistration
trainees preparing for the Royal Pharmaceutical Society
of Great Britain’s (RPSGB’s). Pharmaceutical Com-
pounding and Dispensing is a well-written study guide
to extemporaneous pharmaceutical compounding and
dispensing following the British National Formulary
and British Pharmacopoeia guidelines.
This book is a well organized comprehensive review
of extemporaneous pharmaceutical compounding and
dispensing written by British educators. Chapter 1 out-
lines the layout of the text, general principles of labeling,
pharmaceutical packaging, and standards for extempora-
neous dispensing. Chapters 2 through 8 are dedicated to
the extemporaneous preparation of key dosage forms.
Each chapter begins with an overview and introduction
of each product type, followed by methods of preparation,
worked examples and self-assessment exercises. Chap-
ters 2 through 5 cover the preparation of solutions, sus-
pensions, emulsions, and creams, respectively. The
preparation of ointments, pastes, and gels are covered in
Chapter 6. Chapter 7 guides you through the compound-
ing of suppositories and pessaries. The final chapter cov-
ers the preparation of powders and capsules. Embedded in
each chapter are shaded boxes. The boxes are used to
emphasize chapter objectives, patient and prescription
information, important tips, and key points. The use of
these boxes throughout the book is a beneficial tool. Self-
assessment exercises are found at the end of each chapter.
Assessments include multiple-choice questions (MCQs),
case studies, sample essay questions, and worked exam-
ples. Answers to self-assessment exercises are provided in
a separate section following Chapter 8. Appendices 1
through 3 provide a glossary of terms used in formula-
tions, formulas, and abbreviations commonly used in
pharmacy.
Overall this book is an excellent review of extem-
poraneous compounding and dispensing following the
British National Formulary. The book addresses prod-
uct preparation and use, safety calculations, dispensing
containers, labeling, discard dates, and patient informa-
tion concerning an extemporaneously prepared dosage
form under one condensed cover. The inclusion of self-
assessment exercises and answers is a beneficial tool
not found in other books covering extemporaneous com-
pounding and dispensing. However, I would not recom-
mend this book as a study guide for undergraduate
pharmacy students preparing for examinations following
the United States Pharmacopeia, National Formulary
(USP-NF) guidelines. The authors themselves state in
Chapter 1 that in all the worked examples and the infor-
mation provided in the text has been fully referenced,
wherever possible, using British Pharmacopoeia
(2004, London: TSO), British National Formulary, 51st
edition (2006, London: BMJ Publishing Group and RPS
Publishing), Martindale, The Extra Pharmacopoeia,
33rd edition (London: Royal Pharmaceutical Society).
Several formulas contain products that are not approved
for use by the Food and Drug Administration (FDA) and
greatly limit its usefulness as a study guide for those pre-
paring for examinations following the USP-NF guidelines.
This book would be a useful addition to the resource
and reference library of pharmacy educators and practic-
ing pharmacists seeking a review of extemporaneous
pharmaceutical compounding and dispensing.
Corresponding Author: Deborah Lester Strong, PharmD,
Clinical Assistant Professor, College of Pharmacy, University
of Georgia, Athens. Tel: 706-542-7306. E-mail:
dstrong@rx.uga.edu