Pain and Profits: The History of the Headache and Its Remedies in America

Abstract

Pain and Profits is an accessible social history of headache that aims to answer the question of why headache treatment remains in popular hands. It is also a highly readable history of jurisdictional disputes among the pharmaceutical industry, dispensing druggists, and clinical practitioners that is suitable for undergraduate courses. Bringing the history of drug supply (and demand) to bear upon the history of headache, Jan R. McTavish interweaves the history of commerce with the history of medicine. She uses patient accounts of this most everyday complaint to supplement those of the trade press, which portray ongoing professional disputes over prescription, distribution, advertising, and marketing but largely ignore sufferers. The book is also a history of intellectual property and direct-to-consumer pharmaceutical advertising, a much-contested policy blamed for everything from the com-modification of medicine to its democratization. This book reminds us that both are far from new phenomena. At times the book falls prey to the very trivialization of the headache it protests; it is sometimes more anecdotal and engaging than substantive. The final chapter on headache research is somewhat unsatisfying. McTavish is at her best when she recounts how aspirin became inextricably linked to the headache, given that it was not so introduced or marketed by either Bayer or Sterling Drug, the American company that bought the property at auction when it was confiscated by the U.S. Office of the Alien Property Custodian at the outset of World War I. McTavish ultimately settles upon “laypeople” as responsible for keeping headaches within the realm of self-medication, yet she acknowledges gaps both in the credibility of the laity and in physicians' sympathy toward them (p. 172). The people are attributed great sway, yet their outlines are but vaguely delineated. There is little attempt to specify populations and thus the public is represented as a somewhat homogenous and stubborn actor.