Rethinking Georgian Healthcare: The Patent Medicines Industry in England, 1760-1830

Patent medicines were a major constituent of the healthcare of late Georgian England, but their position in the medical market has escaped the attention of scholars. In this thesis, information from advertisements for medicines in runs of provincial newspapers have been combined with contemporary reports and opinions, surviving printed bills, some preserved financial accounts and official documents to provide a systematic and inclusive account of the industry. My argument is that the production, distribution and sale of patent medicines constituted a stable, substantial and largely respectable industry, with only a minority of its participants being irregular practitioners.
The thesis first analyses the status of patent medicines and the imperfect boundary between regular and irregular practice before exploring the functional components of the industry, which include the crucial role of the printed word. The industry employed specific practices from fixed, longstanding, premises, the owners being predominately reputable tradesmen or medical practitioners and the wholesaling being led initially by London booksellers before passing to medicine specialists and chemists. The retail market was national and structured, with the wholesalers organising and paying for much of the publicity. Medicine vending was initially dominated by the newspaper printers and the booksellers, and it was a substantial part of the income of some of them: it was later shared with the druggists. The advertising built up confidence in the medicines by a predominately low-key factual approach and by repetition, and contemporary physicians were aware that this confidence often ensured that the benefits of the medicines were greater than the sum of their pharmaceutical constituents. Thus we can regard the printed word as an essential ingredient of an effective patent medicine.
The findings necessitate a reassessment of the late Georgian medical market with the patent medicines industry positioned as a distinct entity, separate from orthodox and irregular medicine, but overlapping both of them.