The latest book by Stuart Anderson of the London School of Hygiene & Tropical Medicine (LSHTM) is the tenth volume in McGill-Queen’s University Press’ Intoxicating Histories series, edited by Virginia Berridge (LSHTM) and Erika Dyck (University of Saskatchewan). Anderson’s work on the history of medicines in the British Empire closely aligns with the series’ aim to provide historical perspectives on how psychoactive substances have been ‘consumed, created, traded, and regulated’ worldwide.
Anderson’s analysis centres on the notion of pharmacopoeia, a term whose polysemy has generated confusion that the author seeks to clarify. The book develops a precise historical exploration of the term by focusing on the metropole and colonies of the British Empire over three and a half centuries. Here, ‘pharmacopoeia’ refers to published treatises whose purpose was to catalogue and validate the use of remedies involved in healthcare practices under a given jurisdiction, potentially including information on the preparation, dosages, and uses of these remedies. Over time, such pharmacopoeias served various functions, including protecting the public, appropriating ‘traditional’ remedies for trade, asserting national identity, controlling costs, and facilitating the taxation of medicines, for example. The subtitle’s phrasing, ‘making medicines official’, may seem to suggest a linear progression from informal to official, yet a far more intricate story unfolds before the reader. At the book’s centre is the tortuous fate of the project – never truly realised – to produce a single official pharmacopoeia that would be accepted and used throughout the British Empire. The chronology is thus punctuated by the work of committees, both in Britain and its colonies, engaged in the task of creating pharmacopoeias that would encapsulate pharmaceutical practice within the Empire in both an encyclopaedic and normative way. Communication between these committees, sometimes through large intercontinental consultations, reveals an imperial arena in medicine that, while intended to converge towards the metropole, enabled some form of medical arbitration on a global scale as early as the nineteenth century.
As Anderson demonstrates, the quest for a unified pharmacopoeia across the British Empire was characterised by repeated failures, achieving partial actualisation at best. Yet the interest of this process’s history is that it exposes imperial tensions and fault lines. Anderson meticulously traces how the formulation of pharmacopoeias was entangled with conflicts between regulatory ambitions and a plurality of healthcare practices, or concerns about the purity of pharmaceutical products, for instance. He also highlights the often-divergent paths taken by the metropole and various colonies regarding remedies. Within the metropole itself, tensions were evident between Scotland, Ireland, and England, each of which developed its own pharmacopoeia during the nineteenth century. Additionally, Anderson explores the friction between physicians and apothecaries or pharmacists, who contested each other’s expertise and legitimacy.
One notable strength of this study is how it evidences the flow of pharmaceutical practices both between the metropole and the colonies and among the colonies themselves, as illustrated by useful tables (e.g. pp. 90, 92, and 149). This extensive overview provides insights into the workings of what was perhaps the largest medical empire in history, characterised by constant historical change and multidirectional influences – British pharmacopoeias did include remedies from the colonies, with some British practitioners praising them (e.g. p. 168), though some of these remedies were later excluded from formal pharmacopoeias.
The ten-chapter structure makes an overarching point about the distinctiveness of the British Empire in pharmaceutical matters compared with other European colonial empires. Anderson begins by clarifying the multiple meanings of ‘pharmacopoeia’ (Chapter 1), then examines the diverse ways pharmacopoeias have been utilised for drug regulation (Chapter 2), before contrasting the British imperial approach to drugs with those of the Spanish, Portuguese, Dutch, French, German, Danish, Italian, and Belgian empires (Chapter 3). The book then proceeds chronologically, detailing the struggles and ultimate failure to craft a uniform pharmacopoeia across England, Scotland, and Ireland (Chapter 4), the early production of pharmacopoeias in British colonies (Chapter 5); and the emergence, along with the twists and turns, of the idea of a single pharmacopoeia for the entire empire (Chapters 6–9). The concluding chapter reflects on the British pharmacopoeia through decolonisation to the present day, noting that ‘[t]he [British Pharmacopoeia] continues to be used in over one hundred countries, about a quarter of which were once part of the British Empire’ (p. 256). If a lesson becomes apparent from this exploration of the British pharmaceutical world, it may be that practice-driven pharmacopoeias are more likely to be effective than those imposed from the top down. Unlike their counterparts, Anderson concludes, the ‘British authorities chose to develop an imperial pharmacopoeia rather than to impose a metropolitan one; they chose to consult and engage with colonial practitioners rather than leaving it in the hands of metropolitan physicians; and doctors alone would be responsible for its compilation, although they would seek the advice of pharmacists and chemists’ (p. 246).
In line with its goal of clarifying the use of ‘pharmacopoeia’ in different disciplines, the book is primarily grounded in the relevant secondary literature and published sources, while also referencing archival materials from the British Library, the National Archives at Kew, the Royal College of Physicians of Edinburgh, the Tamil Nadu Archives in Madras, and the National Archives of India in New Delhi. In the absence of a bibliography, these sources can be identified in the abundant endnotes. Perhaps reflecting the state of scholarship and archival resources, as well as the dynamics of pharmacopoeia-making within the British Empire, India, and, to a lesser extent, the dominions of Australia, New Zealand, and Canada are more prominently featured in the book than other British colonies. The treatment of Canada is notably precise, drawing distinctions between provincial and federal levels. This book provides a solid foundation for research on pharmacy in empires, an area of imperial medicine and health with significant potential for further exploration, enhancing the importance of Stuart Anderson’s work.
