What's inside your medicine cabinet? | Photo by trec_lit, CC. Click on image for license and information.

What story would your medicine cabinet tell about you?

Medicine cabinets are amazing spaces. They can contain a multitude of pills, pastes, syrups, and wrappings that we know we can reach for to manage many types of pain, ailments, and illnesses ourselves. They can provide a window into a persons well-beingreally? youve never peeked after washing your hands?and tell us what works for them. Such forays can give us a basis for making decisions about similar conditions. After all, medicine cabinets house a collection of expertiseall packaged in a way to make them identifiable and trustworthy so that in the absence of a physician, were confident of receiving treatment within the promised parameters of healing.

Between 24-hour pharmacies (1) and Web MD, at any given moment we have access to patented non-prescription, or over-the-counter (OTC), medications, and medical information that we are free to weigh and use at our own discretion. We might take this for granted as we reach for that bottle of antacids or pain relievers or cough syrup, but the establishment of non-prescription patented medication represents a significant movement toward access to standardized health remedies. And as discussions about access to health care rage around us in the United States, OTC medication has become for many a primary means of treating ailments. The standard of care in our medicine cabinets is increasingly for many a measure of health

Packaging a Cure

In the video game Assassins Creed when youre in need of medical attention you have the option of visiting a medical stand and purchasing medicine vials meant to completely cure your ailments, whatever they might be. While no such miracle cure really exists, the medical experience in the game isnt all that far from the reality of health care for much of history. While medical professionals were required to have training, the standard of practice variedparticularly in the 17th-, 18th-, and early 19th-centuries when medical care was dispensed by physicians, doctors, barber-surgeons, and apothecaries.

The advent of the Scientific Revolution and the following Age of Enlightenment saw an explosion of cross pollination between the sciences that allowed doctors to treat illnesses and injuries with greater success. However, during this period and up to the early 19th-century, the odds of a single patient receiving successful treatment from a physician were 50-50 (2). Methods of treatments varied in accordance to superstition, astrology, and religion. For example, the doctrine of signatures maintained that God had provided a natural cure for every illnessas was evidenced by the resemblance some herbs bear to various parts of the body (i.e., liverwort could cure ailments relating to the liver). And ideas about balance were rampant; the prevalence of the theory of humoursthat there were four fluids in the body (black bile, yellow bile, phlegm, and blood) that needed to be in balance for good healthencouraged the practice of bloodletting.

In this context, physicians sought to distinguish themselves by patenting their cures, which meant serving them in specific bottles and with particular labels. The more famous of these include Godfreys Cordial, Dalbys Carminative, Batemans Drops, Turlingtons Balsam of Life, Steers Opodeldoc, British Oil, Daffys Elixir, and Balsam of Honey (2). But patents werent enough to cement these cures as trustworthy in the minds of the purchasing public. But the longstanding success of these medications was also in part due to their reproducibility. They were easily counterfeited, right down to their packagingbut they were chosen to be counterfeited because they worked. So in a sense, they became public property. You wouldnt be too far off in thinking of these early counterfeits as generic brand medications. The public trust in the formulas allowed drove the market for patented (and counterfeited) cures in more rural areas where obtaining medical care was a challenge. These formulas in their tell-tale bottles and wrappings placed medical treatment conveniently within reach of many people.

The Essence of Peppermint: A Case Study

The Essence of Peppermint [pdf] provides a useful case study in considering the factors of success, trust, and counterfeiting in creating a standard of care via patented medication.

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Standards of Healthcare in Your Medicine Cabinet