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The British Market for Medicine in the late Nineteenth Century: The Innovative Impact of S M Burroughs & Co

Published online by Cambridge University Press:  26 July 2012

Roy Church
Roy Church
Affiliation:
University of East Anglia, School of History, Norwich NR4 7TJ, UK
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Historians of medicine have tended to be preoccupied primarily with scientific research, the development of therapeutically significant medicines, and ethical business practice. Roy Porter, however, adopted a wider conception. Referring to the eighteenth and early nineteenth century, he redefined the role of “the vile race of quacks” (so described by their own contemporaries) as a manifestation of a burgeoning medical entrepreneurship in an emerging consumer society. He maintained that “Irregular medicine … mobilised the growth of medicine as business”, an aspect of medical history which he believed to have been largely ignored hitherto and one which requires of historians an understanding of the market for pharmaceuticals. Anne Digby has examined the market for medical services during the nineteenth century in an analysis of interactions between doctors and patients at a time when self-dosing was prevalent. However, interactions between medical practitioners and suppliers of medicines in Britain for most of this period remain largely unexplored (with the significant exception of the work by Jonathan Liebenau) and as a result, it will be argued, have been misunderstood.

Type
Articles
Information
Medical History , Volume 49 , Issue 3 , 01 July 2005 , pp. 281 - 298
Copyright
Copyright © The Author(s) 2005. Published by Cambridge University Press

References

The research on which this article is based was funded by the Wellcome Trust as part of a joint project with Dr Tilli Tansey to write the history of Burroughs Wellcome & Co. I am glad to express my gratitude to the Trust, and to others who have helped in various ways in the preparation of this article: Judy Burg, Steve Cherry, Julia Sheppard, Tilli Tansey, and two anonymous referees. None is responsible for the arguments presented here.

Much material used in this article is located in the archives of the Wellcome Foundation held in the Wellcome Library, London. These consist of the personal letter books of Henry Wellcome (WF/E/01/01, WF/E/01/02), of Silas Burroughs (WF/E/02/05/01–02)), his private papers (PP/SMB) and the records of Burroughs Wellcome & Co/ The Wellcome Foundation (WFA). At the time of going to press, most of the material consulted was still being catalogued and was not, therefore, available to the public.

1 John Forbes, ‘On the patronage of quacks and imposters by the upper classes of society’, British and Foreign Medical Review, 1846, 21: 533–40, p. 533.

2 Roy Porter, Quacks: fakers and charlatans in English medicine, Stroud, Tempus, 2000, ch. 2.

3 Roy Porter, ‘Before the fringe: “quackery” and the eighteenth-century medical market’, in R Cooter (ed.), Studies in the history of alternative medicine, Basingstoke, Macmillan, 1988, pp. 1–27, on p. 19.

4 Porter, op. cit., note 2 above, p. 285; Roy Porter and Dorothy Porter, ‘The rise of the English drug industry: the role of Thomas Corbyn’, in Jonathan Liebenau, G J Higby, and E C Stroud (eds), Pill peddlers: essays in the history of the pharmaceutical industry, new series, No. 13, Wisconsin, American Institute for the History of Pharmacy, 1990, pp. 5–28. Elsewhere Roy Porter observed that a “historical study of the roots of the pharmaceutical industry is sorely needed”, op. cit., note 3 above, p. 11.

5 Anne Digby, Making a medical living: doctors and patients in the English market for medicine, 1720–1911, Cambridge University Press, 1994.

6 Jonathan Liebenau, ‘Marketing high technology: educating physicians to use innovative medicines’, in R P Davenport Hines (ed.), Markets and bagmen: studies in the history of marketing and British industrial performance, 1830–1939, Aldershot, Gower, 1986, pp. 82–101. This study grew out of Liebenau's primary research into the history of the American pharmaceutical industry, the subject of Medical science and medical industry: the formation of the American pharmaceutical industry, Basingstoke, Macmillan, 1987.

7 Liebenau, ‘Marketing high technology’, op. cit., note 6 above.

8 Ibid., p. 91.

9 Almost certainly, Burroughs Wellcome & Co became the largest and indisputably the leading pharmaceutical manufacturer in Britain by 1914, the first to establish laboratories employing scientists of the highest calibre, who conducted pure research in addition to contributing to the company's commercial success. For an introduction to the history of BW&Co and a portrayal of the two partners, see Robert Rhodes James, Henry Wellcome, Hodder & Stoughton, 1994.

10Med. Press Circular, 3 Aug. 1881.

11Chem. Drug., 28 Jan. 1888, 32: 104–6.

12 C H Feinstein, ‘A new look at the cost of living, 1870–1914’, in James Foreman-Peck (ed.), New perspectives on the late Victorian economy: essays in quantitative economic history 1860–1914, Cambridge University Press, 1991, pp. 151–79.

13 Stanley Chapman, Jesse Boot of Boots the chemists, London, Hodder & Stoughton, 1974, p. 26.

14 Ibid.

15 Hilary Marland, ‘The medical activities of mid-nineteenth-century chemists and druggists, with special reference to Wakefield and Huddersfield’, Med. Hist., 1987, 31: 415–39; S W F Holloway, ‘The orthodox fringe: the origins of the Royal Pharmaceutical Society of Great Britain’, in W F Bynum and R Porter (eds), Medical fringe and medical orthodoxy, 1750–1850, London, Croom Helm, 1988, pp. 129–35; S F W Holloway, ‘Cutting remarks: reflections on the origins of the Proprietary Trade Association’, Pharm. J., 1996, 256: 198–9.

16 Marland, op. cit., note 15 above, pp. 418–39. See also A McAuley Brownfield-Pope, ‘From chemist shop to community pharmacy: wide study of retailing chemists and druggists, c.1880–1960’, PhD thesis, University of East Anglia, 2003, chaps. 1–3.

17 In 1808, a Nottingham chemist sold more than 200lbs of opium and 600 pints of Godfrey's Cordial to the local poor. Roy Porter, ‘Death and the doctors in Georgian England’, in R Houlbrooke (ed.), Death, ritual and bereavement, London, Routledge, 1989, p. 93. Bile beans were advertised as applicable to 38 ailments and Beecham's pills to 31. Thomas Richards, The commodity culture of Victorian Britain: advertising and spectacle, 1851–1914, London, Verso, 1991, p. 180. Sales of patent medicines are estimated to have risen from £0.5m in the mid nineteenth century to £4m by 1900. Chapman, op. cit., note 13 above, pp. 22–3.

18 Anne Digby, The evolution of British general practice, 1850–1948, Oxford University Press, 1999, p. 101.

19 Irvine Loudon, ‘Medical practitioners, 1750–1850, and the period of medical reform’, in Andrew Wear (ed.), Medicine in society, Cambridge University Press, 1992, pp. 219–47, on p. 241.

20 Lindsay Granshaw, ‘The rise of the modern hospital in Britain’, in Wear (ed.), op. cit., note 19 above, pp. 197–218, on pp. 205–9.

21 S W F Holloway, Royal Pharmaceutical Society of Great Britain: a political and social history, London, Pharmaceutical Press, 1991, pp. 240–61.

22 Christopher Lawrence, ‘Incommunicable knowledge: science, technology, and the clinical art in Britain, 1850–1914’, J. Contemp. Hist., 1985, 20: 504–12; Michael Worboys, Spreading germs: disease theories and medical practice in Britain, 1865–1900, Cambridge University Press, 2000, pp. 284–9.

23 John Harley Warner, ‘The idea of science in English medicine: the “decline of science” and the rhetoric of reform, 1815–1845’, in Roger French and Andrew Wear (eds), British medicine in an age of reform, London, Routledge, 1991, pp. 136–64, on pp. 154–7.

24 Christopher Lawrence, Medicine in the making of modern Britain, 1700–1920, London, Routledge, 1994, pp. 38, 72.

25 Porter, op. cit., note 3 above, p. 4; idem, op. cit., note 2 above, pp. 204, 206.

26 Holloway, ‘The orthodox fringe’, op. cit., note 15 above, p. 154.

27 E M Tansey, ‘Pills, profits, and propriety: the early pharmaceutical industry in Britain’, Pharm. Hist., 1995, 25: 3–9, p. 3; see also Roy Porter, Health for sale: quackery in England 1660–1850, Manchester University Press, 1989.

28 Worboys, op. cit., note 22 above, pp. 284–9.

29 Lawrence, op. cit., note 24 above, pp. 75–8.

30Chem. Drug., 15 Feb. 1879, 21: 63.

31 Ibid., 14 June 1879, p. 5. Burroughs wrote to the editor of the Medical Times and Gazette, enclosing a sample product submitted for examination, testing, and a report in the journal. He expressed the wish that the report should include a reference to the favourable opinion on the company's products by Dr Roberts when addressing a meeting of the Lancashire and Cheshire branch of the BMA. WF/E/02/05/02, 25 July 1879.

32Medical Times and Gazette, 10 Oct. 1879. See also footnote 34 below.

33 On Silas Burroughs's life, see G MacDonald, One hundred years: Wellcome: in pursuit of excellence, London, Wellcome Foundation, 1980; John Davies, ‘Silas Burroughs, Part 1: The early years from Medina to medicines’, Wellcome Journal, Feb. 1991: 10–11; Rhodes James, op. cit., note 9 above, chs 3–5.

34 University of the Sciences in Philadelphia, College of Pharmacy Box, manila envelope and S M Burroughs, ‘Inaugural Essay’, 1877. There is some uncertainty regarding both the date when Burroughs joined the Wyeths and the duration of his studies. I am grateful to Julia Sheppard for this information.

35 Tom Mahoney, The merchants of life: an account of the American pharmaceutical industry, New York, Harper, 1959, p. 31.

36 Davies, op. cit., note 33 above, pp. 10–11.

37 However, his weaknesses were shortly to frustrate Henry Wellcome, too. WF/E/03/01/01, p. 32, H Wellcome to S M Burroughs, between 23 Jan. and 16 Feb. 1882.

38 WFA, Acc82/1 Box 15, J Wyeth to S M Burroughs, 13 April 1881.

39 WF/E/02/05/01, S M Burroughs to J Wyeth, 22 Oct. 1878.

40 WFA, PB110, Medical formulae of new and improved chemical preparations, 1881, p. 35. The list and accompanying text refer to several products supplied before 1880.

41Chem. Drug., 27 July 1895, 47: 91.

42 WF/E/02/05/02, S M Burroughs to Romford Chemical Co, 6 Nov. 1879.

43 S M Burroughs to Chem. Drug., 28 May 1892, 40: 785.

44 WF/E/02/05/01, S M Burroughs's letters to Middlesex, St Mary's, and Paddington hospitals, 10, 12, 19 July 1878.

45 WF/E/02/05/02, S M Burroughs to Lennox Browne, 17 Oct. 1879.

46 Ibid., Order, 23 Sept. 1879.

47 S M Burroughs to Lowe & Co, 6 May 1879, quoted in Rhodes James, op. cit. note 9 above, p. 75, note 31.

48 WFA, Acc82/1 Box 15, J Wyeth to S M Burroughs, 13 Apr. 1881.

49Chem. Drug., 15 Dec. 1885, 27: 97.

50 WF/M/GB/08/01, clippings of BW&Co ads from Br. med. J., Book 1, 1880.

51Chem. Drug., 15 March 1879, 21: 63.

52 WFA, Acc82/1 Box 15, J Wyeth to S M Burroughs, 13 Apr. 1881.

53 WFA, Acc82/1 Box 15, J Wyeth to H Wellcome, 9 July 1880; WF/E/02/05/01, S M Burroughs to J Wyeth, 22 Oct. 1878.

54 WF/E/02/05/01, S M Burroughs to J Wyeth, 13, 19 Aug. 1878.

55 WF/E/02/05/01, draft advertisement for the Lancet, 29 Sept. 1879. The “pharmaceutical preparation” was to alleviate bronchial irritation and hoarseness. It was advertised as especially convenient for singers and public speakers, including clerics. The appliance referred to was probably the Silas Burroughs Ammonia Inhaler, described in a quotation from the Lancet as “an ingenious and convenient device”, which was claimed to remove catarrh and render the patient “less susceptible to the weather”. WFA, PB110, Medical formulae, op. cit., note 40 above, p. 39.

56 WF/E/02/05/01, S M Burroughs to C Stanley Churton, 9 Oct. 1878.

57 WF/E/02/05/01, draft advertisement, 29 Sept. 1879.

58 WF/E/02/05/02, S M Burroughs to L W Warner & Co., NY, 18 March 1879.

59 Ibid., S M Burroughs to J & H Smith, 15 Oct. 1879.

60 Ibid., S M Burroughs to Heander & Riches, 20 March, 1879.

61 Ibid., S M Burroughs to Ash & Son, 3 Sept. 1879.

62 Ibid., S M Burroughs to J Wyeth, 8 May 1879.

63 Davies, op. cit., note 33 above, p.13.

64 Annual sales of between £4,000 and £5,000 were described as “very large.” WF/E/02/05/01, S M Burroughs to J Wyeth, 11 July, 15 Aug. 1878.

65 WF/E/02/05/02, S M Burroughs to J Wyeth, 26 Oct. 1878.

66 WFA, Acc82/1 Box 15, J Wyeth to S M Burroughs, 13 April 1881; WFA, PB110, Medical formulae, op. cit., note 40 above.

67Chem. Drug., 15 March 1879, 21: 63.

68 Rhodes James claimed that Kepler Malt Extract was the first British product to be added to the Silas Burroughs line, but the association with Nubian Blacking Co preceded this. Rhodes James, op. cit., note 9 above, p. 77. WF/E/02/05/01, T Y Kelly to S M Burroughs, 16 Sept. 1878; WFA, Acc99/6/7, Memorandum of Association, Jan., 1881, which refers to the original agreement including Silas Burroughs in December 1878. Evidence of selling Kepler occurs in March 1879. WF/E/02/05/02, S M Burroughs to Alfred Lewis, 4 March 1879.

69 WF/E/02/05/01, T Y Kelly to S M Burroughs, 16 Sept. 1878; 3 Sept. 1879.

70 WFA, Acc85/16, Trade Marks, Silas Burroughs & Co. The substance was later found to contain fluorine, a poisonous or deleterious ingredient. This verdict appeared in Journal of American Medicine, 1939, 113 (1): 78.

71 WFA, Acc85/16, Trade Marks, Silas Burroughs & Co.

72 WF/E/02/05/02, S M Burroughs to London Manufacturing Co. NY, 18 March 1879, p. 95: “[request substitute] ‘keep in a cool place’ for ‘keep on ice’ as ice is not plentiful here in summer”; 23 Sept. 1879; 7 May 1879. S M Burroughs to Wans & Son, 2 May, 22 Sept. 23 Sept. 1879.

73 WFA, Acc99/6/7, Memorandum of Association. 20 Oct. 1879.

74 Ibid.

75 WFA, Acc99/6/7, Memorandum of Association, 22 Oct. 1879.

76 WFA, Acc99/6/7, P Lockwood to BW&Co. 22 Oct. 1879, 9 April 1881.

77 WF/E/02/05/01, S M Burroughs to J Wyeth, 11 July 1878.

78 Geoffrey Tweedale, At the sign of the plough: 275 years of Allen & Hanburys and the British pharmaceutical industry, 1715–1990, London, John Murray, 1990, pp. 78–9.

79 WFA, Acc99/6/7, P Lockwood to J Wyeth, 28 Aug. 1879.

80 WFA, Acc82/1, Box 21: Chem. Drug., 15 Feb. 1879, 21: 13; 15 July 1879, 21: 23.

81 F Peckel Möller, Cod-liver oil and chemistry, London and Christiana, P Möller, 1895, pp. v–vi, lvi–lvii.

82 H A Phillips, ‘Winter time is Kepler time’, Foundation News, 2 (Oct. 1952), pp. 6–8.

83Commissioner of Patents Journal, 11 Dec. 1877, p.1391.

84 WFA, Acc82/1 Box 21, Chem. Drug., 15 July 1879, 21: 23.

85 WF/E/02/05/02, S M Burroughs to Alfred Lewis, 4 March 1879.

86Chem. Drug., 15 Feb., 1879, 21: 63. The formulae provided for 3 pints of spirit to 4 gallons of malt, 3 pints glycerine, and 1 gallon cod liver oil. Alcohol was substituted for spirit in export orders.

87 WF/E/02/05/02, S M Burroughs to Hayes & Co, 13 March 1879.

88 Ibid., S M Burroughs to editor Medical Times and Gazette, 2 May 1879.

89 Ibid.

90 This estimate is based on one month's sales figures quoted by Rhodes James, op. cit., note 9 above, p. 75. No other data have been found.

91 WF/E/02/05/02, S M Burroughs to editor Medical Times and Gazette, 2 May 1879; WFA, Acc99/6/7, KMEC balance sheets.

92 Rhodes James, op. cit., note 9 above, pp. 61–4, 78–81.

93 Ibid., p. 86. WFA, Acc89/72/01–4, A W J Haggis, ‘The life and work of Sir Henry Wellcome’ (unpublished typescript, 1942), p. 83, quoting S M Burroughs to H Wellcome, 7 Feb. 1880.

94 For a detailed account of the origins of the partnership based on Wellcome's correspondence, see Rhodes James, op. cit., note 9 above, ch. 3.

95 S M Burroughs to H Wellcome, Aug. 1879, quoted in Haggis, op. cit., note 93 above, p. 80.

96 S M Burroughs to H Wellcome, 20 Oct. 1879, and early 1880, quoted in Haggis, ibid., p. 81.

97 Rhodes James, op. cit., note 9 above, pp. 89–90.

98 WF/M/GB/32/1, Records of travellers' calls upon chemists and druggists at home and abroad, 1881–5, book 1.

99 WFA, Acc87/33/69, ‘Instructions to Travellers’.

100 WFA, Acc87/33/2, S M Burroughs to H Wellcome, 19 Jan. 1882.

101 Digby, op. cit., note 5 above, p. 100.

102 Ibid., p. 99.

103 WF/M/GB/32/2, ‘Records of travellers' calls upon medical men at home & abroad, 1881–7’, book 2, 26 Feb. 1883, 15 March 1883.

104 E M Tansey and Rosemary C E Milligan, ‘The early history of Wellcome research laboratories, 1894–1914’, Wellcome Institute symposium on the History of the Pharmaceutical Industry, Jan. 1987; E M Tansey, ‘The Wellcome physiological research laboratories, 1894–1904: the Home Office, pharmaceutical firms, and animal experiments’, Med. Hist., 1989, 33: 1–41.

105 WFA, Acc82/1 Box 13, ‘Talk’ 21/7/1893.

106 These exiguous comparisons were dictated by the limited availability of data on pharmaceutical firms, the exception being Tweedale, op. cit., note 78 above, pp. 115, 118; WFA Acc 96/45, BW&Co, Sales Book 2, p. 1. Boots and Beechams were altogether larger enterprises, but before 1911 these were essentially patent and proprietary medicine manufacturers, while Boots' extensive retail organization renders comparison even more irrelevant. Among manufacturers of ethical pharmaceuticals, BW&Co was almost certainly the largest.

107 WFA, Acc82/1 Box 07, Proceedings of the convention of home representatives, 1907, Curry, 71.

108 Tweedale, op. cit., note 78 above, pp. 98, 103–4, 134–5.

109 Wellcome Library, London, Lister Archives, SA/Lis/I. 11fb, Lloyd Wood (Toronto) to Allen & Hanburys (London), 22 May 1905.

110 Judy Slinn, A history of May & Baker, Cambridge, Hobsons, 1984, p. 57.

111 R P T Davenport-Hines and Judy Slinn, Glaxo: a history to 1962, Cambridge University Press, 1962, pp. 38, 43–4.

112 Ibid., p. 96.

113 Edgar Jones, The business of medicine: the extraordinary history of Glaxo, London, Profile Books, 2001, p. 52.

114 Jonathan Liebenau, ‘Corporate structure and research and development’, in Jonathan Liebenau (ed.), The challenge of new technology: innovation in British business, Aldershot, Gower, 1988, p. 35.

115 Worboys, op. cit., note 22 above, pp. 284–9.

116 Lawrence, op. cit., note 22 above, pp. 504–12.

117 Worboys, op. cit., note 22 above, pp. 288–9.

118 Liebenau, ‘Marketing high technology’, note 6 above, pp. 82–101.

119 Tansey and Milligan, op. cit., note 104 above; Tansey, op. cit., note 104 above; idem, op. cit., note 27 above, pp. 3–9; Rhodes James, op. cit., note 9 above.

120 ‘The “detail man” was introduced by Wellcome’; Liebenau, op. cit., note 6 above, p. 91.

121 Tansey, op. cit., note 27 above, pp. 3–9.

122 Rhodes James, op. cit., note 9 above, pp. 77–8.

123 Ibid., p. 78.

124 A business acquaintance referred to “initial trade and national prejudice” because of the novel character of his business and the unconventional methods he adopted. “Burroughs made his own road and it has become a highway”, Chem. Drug., 9 Feb. 1895, 46: 213. The marketing innovations introduced by Silas Burroughs were not, of course, the only ones affecting the growth in sales and profits between 1880 and 1900 when the introduction of the Tabloid brand, a supporting policy of litigation in its defence, and the implementation of a resale price maintenance policy were associated with Wellcome.