Enterprise & Society

Although increasing attention has been paid in recent years to the retailing and consumption of medicines and medical instruments across time, the nature of the relationship between medical professionals and medical companies has remained obscure. In particular, the effects on medical advertising of factors such as demand-led innovation and the bureaucratization and regulation of medicine have, until now, remained unclear. Likewise, little attention has focused on medical advertising to the medical profession, rather than to the public, and on the often-delicate ethical issues this could engender. Claire Jones’s excellent new study of medical trade catalogues is therefore both important and timely in exploring the important role of nineteenth-century medical practitioners as both consumers of medical products and agents in the development of instruments of their trade. As Jones argues, medical trade companies and practitioners developed a mutually beneficial relationship, one that balanced the ethical considerations of the profession in not engaging in overt commercial marketing or endorsement in the public domain. As this occurred, medical catalogues became proxy reference texts—a means through which medical knowledge could be disseminated, but also statements of the “professional” nature of medicine.

The book is split into six thematic chapters, each exploring a different aspect of catalogue construction and consumption. Chapter 1 charts the origins and rise of the medical trade catalogue in context of the changing nature of supply, but also discusses the huge rise in practitioner numbers and importance of the institution, creating new opportunities for medical companies. Jones makes a compelling case for the trade catalogue to be understood not only as an information technology in itself, but also as a “discernible tool of business” (p. 31). [End Page 978]

Chapter 2 explores the “physicality” of the catalogue and the variety of different practitioner types to whom medical companies catered. Indeed, the sheer variety illustrates the problems in assuming homogeneity, or speaking of medical catalogues as a uniform group. Medical catalogues differed from pharmaceutical catalogues in form, structure, and audience. The sheer scale of some catalogues (more than 2000 pages, in some cases) highlights the paradox of an occupational group that actively sought to bypass connections with a “trade,” yet relied on extensive trade literature. As Jones highlights, the use of “scientific” language in catalogues was a conscious means to ally medical retail with medical reference and, in many ways, legitimize the profession.

This last point is developed further in the third chapter, which explores the rhetoric of advertising in more detail, but also directly challenges the progress narrative. As is shown, new innovations, from anaesthesia to antisepsis, were promoted using a variety of tropes, from novelty to utility to safety. Interestingly, however, although new instruments were clearly in the foreground of medical trade catalogues, they coexisted with older instruments, suggesting that innovations were not necessarily readily adopted. Indeed, as is shown, many practitioners continued to rely on trusted older designs long after new models became available.

The mechanics of catalogue production are dealt with in Chapter 4, which highlights the conscious attempts made by medical companies to align their catalogues with medical reference literature. Jones raises the important issue of the close relationship between production and readership—a point that chimes with recent discussions about the semiotics of early modern remedy books. To avoid connections with other forms of advertising, catalogues closely resembled medical reference texts, with similar plain bindings and decorations. Catalogues were costly to produce and were highly illustrated, requiring continual updating to reflect new products and designs. Illustrations formed part of the intended didactic function of catalogues, and evidence presented suggests that this was a key consideration for practitioners. Jones’s discussion about the soliciting and use of testimonials highlights the careful negotiation needed to avoid professional censure.

The question of the distribution of medical catalogues is dealt with in Chapter 5, which details the various means used by medical trade companies to create customer bases and disseminate their products. These included postal distribution, advertising new catalogue editions, employing traveling salesmen to promote products, direct marketing through medical register lists, and even the sharing of customer lists across different companies. The numbers of catalogues sent out could be enormous—up to 30,000 per edition by one company—and the marketing costs incurred by companies could be equally large. [End Page 979] An interesting point made here is the dynamic relationship between companies and consumers. Evidence presented suggests that customer lists were regularly updated, with “bad” customers summarily removed.

The final chapter deals with the important issue of consumption and evidence for the readership and reception of trade catalogues. Taking Darnton’s “communication circuit” as its lead, the chapter looks at the ways through which medical practitioners were simultaneously both consumers and authors of trade catalogues. Through testimonials, suggestions and the contribution of their own products for sale, medical practitioners both shaped the nature and structure of catalogues, and fed into the continuum of knowledge contained within them. Here again is shown the delicate balance that needed to be struck between providing professional endorsements and not engaging in overt commercial practice. An extremely useful bibliography of medical catalogues is appended.

This book raises new questions about a range of factors surrounding medical advertising and consumption, and, more broadly, offers a new and innovative lens through which to view the changing nature of the medical profession in the nineteenth century. In so doing, it moves debate about the medical marketplace forward, exposing some of the limitations of the model and offering a genuinely new perspective. Shifting the focus away from the products themselves and, instead, toward the methods of advertising allows us to recover the ethically loaded processes of medical retailing, as well as the challenges facing practitioners as they sought to keep up with the ever-expanding product range. Jones’s book is engaging and lively, is thoroughly researched, and will be an important book for anyone interested in the retail and consumption of medicine through time.