Professional Documents
Culture Documents
Pharmacy and
Professionalization in
the British Empire,
1780–1970
Stuart Anderson
Medicine and Biomedical Sciences in Modern
History
Series Editors
Carsten Timmermann, University of Manchester, Manchester, UK
Michael Worboys, University of Manchester, Manchester, UK
The aim of this series is to illuminate the development and impact of
medicine and the biomedical sciences in the modern era. The series was
founded by the late Professor John Pickstone, and its ambitions reflect
his commitment to the integrated study of medicine, science and tech-
nology in their contexts. He repeatedly commented that it was a pity
that the foundation discipline of the field, for which he popularized the
acronym ‘HSTM’ (History of Science, Technology and Medicine) had
been the history of science rather than the history of medicine. His point
was that historians of science had too often focused just on scientific
ideas and institutions, while historians of medicine always had to consider
the understanding, management and meanings of diseases in their socio-
economic, cultural, technological and political contexts. In the event,
most of the books in the series dealt with medicine and the biomedical
sciences, and the changed series title reflects this. However, as the new
editors we share Professor Pickstone’s enthusiasm for the integrated study
of medicine, science and technology, encouraging studies on biomedical
science, translational medicine, clinical practice, disease histories, medical
technologies, medical specialisms and health policies.
The books in this series will present medicine and biomedical science
as crucial features of modern culture, analysing their economic, social and
political aspects, while not neglecting their expert content and context.
Our authors investigate the uses and consequences of technical knowl-
edge, and how it shaped, and was shaped by, particular economic, social
and political structures. In re-launching the Series, we hope to build on
its strengths but extend its geographical range beyond Western Europe
and North America.
Medicine and Biomedical Sciences in Modern History is intended to
supply analysis and stimulate debate. All books are based on searching
historical study of topics which are important, not least because they cut
across conventional academic boundaries. They should appeal not just to
historians, nor just to medical practitioners, scientists and engineers, but
to all who are interested in the place of medicine and biomedical sciences
in modern history.
Pharmacy
and Professionalization
in the British Empire,
1780–1970
Stuart Anderson
Centre for History in Public Health
London School of Hygiene &
Tropical Medicine
London, UK
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer
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For Liz
Preface
vii
viii PREFACE
wishing to carry out more detailed studies. Its shortcomings and limita-
tions are readily acknowledged; there is an over-reliance on a limited range
of secondary sources, and on contemporary professional and trade jour-
nals. A variety of primary sources have been accessed, principally official
documents, circulars, and letters, but little use has been made of social
historical sources such as letters and diaries.
It is hoped that the book will be of interest to medical and impe-
rial historians as well as to historians of pharmacy. Whist I have cited
some important scholarship in imperial and medical history, I have not
attempted to engage extensively with it. Neither have I tackled issues of
gender, exploitation, consumerism, and imperial hegemony in the book,
although I hope it might stimulate and provide a possible framework for
such studies in the future. And whilst the book has little to say about
pharmacy in hospitals and other settings, or about the wholesaling, manu-
facturing, or marketing of pharmaceuticals, I hope it suggests ways in
which pharmaceutical history might better engage with broader historical
and sociological literatures.
It is hoped too that the book might help pharmacy students—along
with pharmacists new and old—across the English-speaking world, to gain
a better understanding of the different ways in which pharmacy evolved
as a profession and what factors have helped shaped it. Despite its limi-
tations, I hope this volume stimulates interest in the history of pharmacy
and empire and provides a basis for further studies.
This book has been ten years in the making. Its origins lie in conversa-
tions with pharmaceutical historians from former British colonies about
the lasting impact of British pharmacy on education and practice in their
countries, and about the role played by British authorities in shaping it.
Since then, I have received many suggestions and a great deal of infor-
mation and advice from friends and colleagues across the world. Some
have visited archives on my behalf, and others have scanned and sent me
documents. I am extremely grateful to them all, some of whom sadly are
no longer with us.
Others have read through drafts of individual chapters and offered
helpful suggestions and corrections. Any remaining errors are mine.
Those to whom special thanks are due include John Bachynsky, Greg
Bond, John Joseph Borg, Tony Cartwright, Patrick Chiu, John Crellin,
John Ferguson, Ellen Grizzle, Greg Haines, Andrew Hersom, Greg
Higby, Peter Homan, Briony Hudson, Augustina Koduah, Geoff Miller,
Harkishan Singh, Thomas Paraidathathu, Ray Pogir, Halil Tekiner, Nina
Thune, and Nick Wood. Thanks also to Lee Williams for help in
producing the maps.
I am grateful to the staff at several archives in both Britain and over-
seas for their help and support. Particular thanks are due to those at the
British Library, The National Archives, The Wellcome Library, the Royal
College of Physicians, and the Archives of the Society of Apothecaries in
London. Staff at the Royal Pharmaceutical Society in London, especially
xi
xii ACKNOWLEDGEMENTS
Jane Trodd and Karen Horn from the Library and Catherine Walker from
the Museum, are due a special mention, as is Sophie Clapp, Curator of
the Walgreens Boots Alliance Archive in Nottingham.
I am extremely grateful to the peer reviewers for many helpful
comments and suggestions, and to the Series Editors for their encour-
agement and support. Thanks are also due to the team at Palgrave,
particularly Lucy Kidwell, Redhu Ruthroyoni, and John Justin Thomyyar,
for efficiently seeing through the editing and production processes for
the book. I would also like to thank my colleagues at the Centre for
History in Public Health at the London School of Hygiene and Tropical
Medicine, particularly Virginia Berridge, Martin Gorsky, John Manton,
Susanne McGregor, and Alex Mold, for their continuing support and
encouragement.
My greatest debt, however, is to my wife Liz who accompanied me
on many trips and who has been unfailing in her support throughout the
process of research and writing. The book is dedicated to her.
Stuart Anderson
Contents
xiii
xiv CONTENTS
Index 371
About the Author
xix
Abbreviations
xxi
xxii ABBREVIATIONS
xxiii
xxiv LIST OF FIGURES
Fig. 6.1 Map of the West African Division of the British Empire,
1914 158
Fig. 6.2 Richard Zacheus Bailey (1829–1911), ‘father’ of Nigerian
pharmacy (Courtesy of Pharmaceutical Society of Nigeria) 162
Fig. 7.1 Map of the South African Division of the British Empire,
1914 188
Fig. 7.2 Golden Mortar Dispensary, Johannesburg, 1886
(Courtesy of Pharmaceutical Society of South Africa) 192
Fig. 8.1 Map of the Indian division of the British Empire, 1914 218
Fig. 8.2 Treacher & Co. Pharmacy, Bombay, 1894 (Courtesy
of Wellcome Collection) 226
Fig. 9.1 Map of the Eastern Division of the British Empire, 1914 250
Fig. 9.2 Penang Dispensary, 1890 (Courtesy of National Archives
of Malaysia) 258
Fig. 10.1 Map of the Australian colonies of the British Empire, 1914 282
Fig. 10.2 Bray’s Hill End Dispensary, 1872 (Courtesy
of Holtermann Collection, Mitchell Library) 287
Fig. 10.3 John Souter, chemist and druggist, Home Rule, New
South Wales, 1872 (Courtesy of Holtermann Collection,
Mitchell Library) 288
Fig. 11.1 Map of New Zealand, Fiji and Samoa, 1914 312
Fig. 11.2 Tyerman Chemist and Druggist Store, Wanganui, North
Island (Courtesy of Alexander Turnbull Library, National
Library of New Zealand) 315
Fig. 11.3 John Turnbull, Chemist, Thursday Island, 1897
(Courtesy of John Oxley Library, State Library
of Queensland) 334
Fig. 12.1 The Imperial Dispensary: a pharmacist making
up a prescription for a kangaroo, representing
Chamberlain’s advocacy of the Commonwealth
of Australia, 1900 (Courtesy of Wellcome Collection) 364
List of Tables
xxv
CHAPTER 1
Table 1.1 Divisions of the British Empire referred to in the British Pharma-
copoeia 1914
Division Colonies
Fig. 1.1 Map of British Empire, 1920s (Ashley Jackson, The British Empire: A Very Short Introduction. Reproduced
with permission of the Licensor through PLSclear)
1 PHARMACY AND THE BRITISH EMPIRE 5
empire’; the context in terms of the forces shaping local cultural encoun-
ters; religion, particularly differences in worship of people of the East or
West; and the intersection between culture and politics, including issues
of power and authority.
Interaction occurred at the boundaries between British pharmacy and
indigenous pharmacy, with each adopting remedies from the other’s
culture; each was changed by the other. By British pharmacy I mean
pharmacy as it was practised in Britain at the time, within the frame-
work of ‘western medicine’, although this term is contested. In relation to
the French in Vietnam, Laurence Monnais notes that the medical system
emanating from Europe is variously described as ‘modern’, ‘scientific’,
‘western’, or ‘European’. She uses the more neutral term ‘biomedicine’,
to avoid making claims about the ‘geographical origins, epistemological
universality or temporal status’ of the relationship between medicine and
biological sciences.14 Yet in the early nineteenth century British phar-
macy still reflected many of the ‘pre-biomedical’ principles of Galen and
Paracelsus, with extensive use of purgatives and emetics. In many ways it
was little more biomedical than the indigenous pharmacy it encountered.
In this book I use ‘western’ in favour of ‘biomedical’ to better reflect
contemporary usage.
The ‘elite’ physicians did not engage in pharmacy; it was the job of
the apothecaries to dispense their prescriptions. But other medical prac-
titioners such as ships’ surgeons did. It was the court ruling to allow
apothecaries to practise as general medical practitioners (Chapter 2) that
set pharmacy in Britain on a different course to that in Europe. In
Europe, the apothecary quickly evolved into the pharmacist; in Britain
the apothecary or surgeon-apothecary evolved into a hybrid medical and
pharmaceutical practitioner, creating space for the emergence of chemists
and druggists who often had little or no training. By mid-nineteenth
century a variety of such practitioners had found their way to the colonies.
When the PSGB was founded in 1841, its leaders were in no doubt
that they were part of the medical profession. Jacob Bell referred in
1842 to ‘the position which pharmacy occupies or ought to occupy as
a branch of the medical profession’.36 Four of the nine Bills introduced
for the regulation of the medical profession in the years between 1840
and 1850 included chemists and druggists as part of the profession. In
fact, the status of the leading chemists and druggists within their local
communities was far higher than that of the general practitioners. It was
the 1852 Pharmacy Act which effectively made the exclusion of phar-
macists from the medical profession inevitable, as it provided the legal
basis for the registration of pharmaceutical chemists; and it was the 1858
Medical Act that drew an inalienable line between those practitioners who
were medically qualified and those who were not. It established the legal
and institutional boundaries of the medical profession37 ; pharmaceutical
chemists had their own register and were no longer a branch of medicine,
but completely outside it.
Without the 1852 Act, the 1859 Medical Register might well have
been published in four sections rather than three, one of which would
have contained the names of the pharmaceutical chemists.38 Yet to
suppose that by 1858 pharmacy in Britain had become an autonomous
‘profession’ separate from medicine would be inaccurate. The PSGB
represented only a small proportion of those engaged in pharmacy. Alter-
native bodies emerged which presented it with an existential threat.
Doctors made renewed attempts to take control of pharmacy. The absence
of a curriculum meant that educational standards were variable, and
‘crammer schools’ emerged to prepare people for the PSGB’s exami-
nations by second-guessing questions. Most of these issues were only
resolved by the early twentieth century. The professionalization of phar-
macy across the Empire was thus taking place at the same time as it was
1 PHARMACY AND THE BRITISH EMPIRE 11
in Britain rather than following it, and in some respects it was ahead. An
understanding of pharmacy in the Empire requires an awareness of the
situation in Britain at the time, and this is described in Chapter 2.
Professionalizing Occupations
Autonomy from medicine, the conflict between dispensing doctors and
prescribing pharmacists, the tension between pharmacy as trade and phar-
macy as profession, the focus on product rather than patient, and the
level of training and education needed to fulfil the role; these issues are
at the heart of the story of pharmacy and empire, and what links them
all is professionalization. Professions have been the subject of extensive
and frequently contentious interpretations in sociological and historical
circles for many years. The questions they address are fundamental ones;
Why do professions form? What is their relationship with the state and
other professions? How can the power, authority, and reach of profes-
sions be understood? Yet the answers invariably produce more confusion
and complexity. The term ‘professionalization’ is a hotly contested one,
with sociologists tending to a more fixed or standard characterization,
and historians usually insisting on a relative and changing one. Such argu-
ments are of little help when considering processes of professionalization
over time and space.
It is not the purpose of this book to engage with these debates. Rather,
it is to look at change over time, and what it meant to be in a ‘profes-
sion’ and to be ‘professional’ in very different countries in relation to a
single occupation. It is nevertheless necessary to consider definitions that
have been proposed for both a ‘profession’ and ‘professionalization’, to
examine theories put forward to explain them, and to review previous
studies of pharmacy professionalization. Many definitions of a profession
have been proposed over the years, but a widely accepted one, proposed
by Julia Evans, is that ‘a profession is a service occupation that is based
on extensive technical knowledge, and assists clients in dealing with risk in
daily life’.45 Alan Rushton defines professionalization as ‘the process over
time that results in ‘professional’ status for an accomplished occupational
in society’.46 Yet pharmacy fits uncomfortably in most such definitions
because of its link with a commodity, medicines. The professionalization
1 PHARMACY AND THE BRITISH EMPIRE 15
body of knowledge that is shared by all members of the group. The key
to professionalization is education.
Professionalization models have their limitations. In a recent study
of professions in four Canadian provinces, Tracey Adams tested several
key sociological theories of professionalization. She found that no single
approach fitted the complex stories of professional creation, and suggested
a hybrid approach, although even then with qualifications.53 Such
approaches may add to the debate, but they offer little in the way of
practical tools to compare processes of professionalization across diverse
geographical regions and extended timescales.
Professionalizing Pharmacy
Because professionalization is itself an historical process it offers a conve-
nient model by which to track developments in pharmacy across several
centuries and in different parts of the world. However, whether pharmacy
ever fully completed the process, emerging as a fully-fledged profession in
its own right, has been debated for many years. In 1968 Denzin and
Mettlin described pharmacy as an example of ‘incomplete professional-
ization’.54 According to these authors, pharmacy did not possess the
characteristic traits of a profession as defined by Good.55 It had failed
to recruit altruistic people, exercise adequate control over the sale and
manufacture of drugs, develop a unique body of scientific knowledge, or
maintain occupation unity. But this analysis has been challenged by other
sociologists; Dingwall and Wilson, for example, argue that when these
features are examined in relation to both medicine and law, doctors and
lawyers are no more ‘professional’ than pharmacists.56
Others such as Birembaum have argued that, in the second half of the
twentieth century, pharmacy went through a process of reprofessionaliza-
tion as a result of changes in the economic and technological environment
in which pharmacists worked.57 He argued that an elite group of pharma-
cists in a position to practise a more clinical form of pharmacy—clinical
pharmacy—engaged in an attempt to establish a new identity for phar-
macy, the process he described as ‘reprofessionalization’. But this critique
has been criticized by other sociologists; Holloway, Jewson, and Mason
concluded that ‘if professionalization is a dynamic, conditional, interac-
tive process born of group struggle, the concept of reprofessionalization
is redundant’.58
1 PHARMACY AND THE BRITISH EMPIRE 17
in the Gold Coast (Ghana); it—like the Ordinances passed in many other
colonies—was based on the British Pharmacy and Poisons Act of 1868.
Having strengthened its legal foundation through this Act, which also
established restricted titles and created a dual profession of chemists and
druggists and pharmaceutical chemists, the PSGB extended its influence
throughout the Empire. The pharmaceutical historian Leslie Matthews
noted in 1962;
for thirty years or so after passage of the Pharmacy Act in 1868, the Society
was engaged in consolidating its position as the body responsible for raising
the educational standards of the pharmacists, extending its influence in
Great Britain, in the Dominions and the Colonies, and in supporting every
endeavour to advance pharmacy in the interest of the public.69
1908, and the PGB finally published its Terms of Reciprocity Agree-
ment in 1913 (Chapter 12). An imperial pharmaceutical qualification was
proposed in 1929, although nothing came of it.71
The PSGB was however as much concerned with the imperialization
of medicines as with imperialization pharmacy. Work on ‘imperializing’
the BP had begun soon after publication of the third edition in 1885.
The 1898 edition contained many items originating from the colonies,
but it did not include many that were in regular use in the colonies
themselves. In 1900 an Indian and Colonial Addendum to the BP was
published to fill the gap, although further amendments were needed for
India, and a Government of India edition appeared in 1901. But by 1899
John Attfield, the BP’s editor, was able to report to the Pharmacopoeia
Committee of the General Medical Council (GMC) that ‘fifty-three of the
seventy British Administrations of India and the Colonies, without excep-
tion, concur in supporting the broad principle of imperialization of the
great national book of medicines’.72 However, the PSGB considered that
many items useful in pharmacy were omitted from the BP, and its Council
resolved to prepare a volume which would ‘make available in one volume
accurate information respecting all drugs and medicines in common use
throughout the Empire’. In 1907 it published the British Pharmaceutical
Codex, describing it as ‘an Imperial Dispensatory for the use of medical
practitioners and pharmacists’.73 Empire also became a popular theme
in advertisements for medicines, reflecting the pervasiveness of imperial
imagery (Fig. 1.2).
In Britain, the development of pharmacy was to be heavily shaped by
the testing of the wording of laws in the courts. The 1880 case leading
to the rise of company chemists was the first of many, most of which were
initiated by the PSGB. In most cases the outcomes were not what the
founders of the PSGB either expected or anticipated. Yet it was a pattern
that was to be repeated in many parts of the Empire.
Pharmacists in the colonies followed events in Britain with great
interest. But being the first to seek legislation in certain areas meant that
inevitably mistakes were made. Yet too often lessons were not learnt from
mistakes made in Britain, often with serious consequences in the colonies.
22 S. ANDERSON