Piracy_ The Intellectual Property Wars from Gutenberg to Gates - Adrian Johns [64]
The conflict between Grew and the Moults thus exploited strains that had rent the medical world for generations. Those strains penetrated every aspect of medicine: the identity of drugs, the content of medical knowledge, the nature of discovery and invention, the proprieties of authorship, and the social structure of the entire medical enterprise. Grew knew that he was venturing onto controversial terrain. He may not have recognized just how riven it was, and how far his project would venture onto its most treacherous ground.
A MEDICAL MARKETPLACE
As Grew tried to use his patent to extend the authority of a physician into the province of the apothecaries and druggists, these broad and deep conflicts were approaching their climax. The College of Physicians attempted to recover some authority after the 1688 revolution, while the Society ofApothecaries fought back by, among other things, threatening to reveal the vacuity of the College's presumptions by a pirate printing of its "illogical and unjust" statutes. That it would threaten an action of this kind in search of respectability speaks volumes. At the same time, the apothecaries brought before Parliament what sounds an arcane matter, but was in fact of great significance. The obligation to serve in parish offices was one incumbent on all guilds and companies except the College of Physicians, and the exemption marked out the physicians as a profession rather than a craft. The apothecaries now sought the same privilege. Were they to prevail, they could infer that they too were no mere artisans. And therefore they could engage directly with patients, formulating their own medicaments. To the physicians' shock, the bill passed, and passed quickly. The existing structure of medicine seemed to hang in the balance.60
The College reacted as best it could. Conscious as they were of the widespread perception that theywere expensive, self-interested, and monopolistic, the physicians resolved to tackle the apothecaries head-on. They opened their own dispensary to provide medicines for the poor. The College also took the internally controversial step of translating and publishing its own statutes, again in order to preempt the apothecaries' plans. And it took the fateful decision to prosecute an apothecary named William Rose for practicing physic. The case was an involved one, but the College won at King's Bench. Rose appealed to the House of Lords, however, where his lawyers represented the prosecution as a strategy of physicians intent on "monopolizing the whole business of physic." The Lords, dominated by Whig convictions against monopolies, took Rose's side and ruled against the College.61 The result was widely taken to mark the end of a regime. From now on, the old tripartite structure persisted only as an empty shell. A radically entrepreneurial medical marketplace that had long burgeoned in practice was now legitimated. 62
In the marketplace that ensued, formal distinctions between authoritative and heterodox medicine retreated into invisibility. Patients, as customers, saw nothing questionable in sampling the recommendations of a range of practitioners and opting for the most congenial or most convincing. A vast range of nostrums and "patent medicines" tempted them -many, or so the physicians claimed, pirated from the pharmacopoeia with the addition of some more or less cosmetic ingredient to mask the theft. Or patients might simply self-medicate, following