Gendered Drugs and Medicine: Historical and Socio-cultural Perspectives ed. by Teresa Ortiz-Goméz, María Jesús Santesmases (review)

Editor-contributors Teresa Ortiz-Goméz and María Jesús Santesmases have melded papers from two international conferences into an informative anthology on gender, medical practice, and drugs. Though the contents range from women’s roles in penicillin manufacture to the search for “pink Viagra,” the book’s primary concerns are contraceptives and psychoactive substances.

Excepting Ilana Löwy’s work on spermicide development and Carrie Eisert’s on Dialpak-type dispensers (a product of Yankee ingenuity), the chapters on contraception track Western European developments. As in North America, the introduction of estrogen-based contraceptives provoked an ideological crossfire. Socially conservative physicians and laymen objected, as did feminist critics like Alice Schwarzer, who feared that the pill would aggravate sexual exploitation. Advocates and manufacturers had to tread carefully. Ulrike Thoms reprints a Schering AG advertisement showing a demure young mother, accompanied by a newborn and a toddler, pleading with an older male physician, “Two children so shortly after each other were simply too much for me” (p. 156). The answer, coos the ad copy, is Anovlar 21. What responsible practitioner could deny such a reasonable request?

In Spain, where natalist views were particularly strong and where Franco’s government banned contraceptive ads, Schering and its competitors marketed the new drugs as “anti-ovulatories,” useful for treating irregular or painful menstruation. Though the pills and their euphemisms remained controversial, Pharma had its foot in the Spanish door. It swung open in the late 1970s, when the democratic transition and pent-up demand for family-planning resources from women and female physicians transformed the Spanish market.

Of the three chapters on psychoactive substance use, one, by Jesper Vaczy Kragh, takes a comparative tack. Several scholars, myself included, have reported that the majority of nineteenth-century U.S. “opium eaters” and morphine addicts were female. Not until the early twentieth century did some authorities report male majorities. Reviewing Danish archival sources and nineteenth-century continental medical literature, Kragh finds otherwise for Europe. There women were always in the minority. European morphine addicts were mostly overworked, middle-aged male doctors who injected themselves. If doctors’ wives and nurses also figured prominently, they never constituted a majority.

It follows that either there was something different about the United States or, as Kragh tentatively suggests, “the proportion of [U.S.] female morphinists has been overemphasized” (p. 192). I think the first hypothesis likelier. Several American studies indicated female majorities. They drew on reasonably large surveys of physicians and pharmacists, who knew the identities of institutionalized as well as noninstitutionalized addicts. They were consistent, placing the female percentage in the 60 to 70 percent range in the 1870s and 1880s. The easy availability of narcotized home remedies and patent medicines put ailing women at risk, as did fierce competition among often poorly trained physicians. The higher proportion of female morphine and medicinal-opium addicts in the United States, together with the higher overall rate of iatrogenic addiction, seems another sign of the relatively backward state of nineteenth-century American medicine.

Denmark did resemble the United States in one important respect. When narcotic addiction finally gravitated from isolated professionals to an underworld subculture, the government cracked down, enacting punitive legislation in 1955. Alexandre Marchant shows that France followed suit with its own drug war in 1970, after LSD, marijuana, and heroin caught on with the young, especially those involved in the counterculture. While most narcotic users were male, sensational stories of strung-out jeunes femmes, “old and dying” (p. 204) in their twenties, had the greatest impact on public opinion.

Would French tabloid readers have reacted similarly to middle-aged prostitute-addicts? Though the book highlights gender, Marchant and other contributors ultimately make a case for the demographic complexity of pharmacological politics. When drugs threaten the health, morality, or class status of the young, they...