Prescribed: Writing, Filling, Using, and Abusing the Prescription in Modern America edited by Jeremy A. Greene and Elizabeth Siegel Watkins (review)

The latter half of the twentieth century witnessed a dramatic transformation in how American society understood, used, and regulated medicinal drugs. Prescribed brings together ten influential historians of medicine to take a novel approach to the subject of pharmaceutical history. Rather than focusing exclusively on the drugs themselves, this anthology places the prescription necessary to procure these medications at the heart of the story. As a collective, the authors expertly demonstrate that what might seem like a small slip of paper is in fact a powerful symbol representing the boundary between professionals and laypeople, a protective mechanism for consumers, a tool for tracking physicians’ behavior, and a “site for examining the ebb and flow of public trust in the cures we consume and the professional, commercial, and regulatory frameworks that support them” (103). In their quest to illuminate the historical importance of the prescription in post-WWII America, the authors succeed brilliantly.

The volume’s great strength is the way in which individual chapters cohere to tell a broader story. The contributors and editors have done a marvelous job linking each chapter thematically, and the connections are easily discerned by the reader. The essays by Houck, Munro Prescott, and Siegel Watkins, for example, demonstrate how the prescription has been maintained, challenged, and changed from the perspective of gender history. These chapters go well beyond the trope of frustrated feminists and patriarchal physicians to illustrate the complex ways in which women (and men) strove to alter the accessibility and content of prescriptions. The chapters by Podolsky, Fairman, and Tobbell, meanwhile, highlight the battles over professional rights and autonomy in handling prescriptions. These debates occurred not only between professional medical groups (physicians, pharmacists, and nurse practitioners) but also involved governmental regulatory bodies and pharmaceutical companies. Again, these authors emphasize that we should avoid looking at these groups as monolithic entities and instead consider each as a site of internal discord and discussion over the issue of prescribing power. Elsewhere, Rasmussen, Meldrum, and Herzberg all make contributions which reveal the problematization of the prescription in instances where social judgments on the value or dangers of particular drugs (barbiturates, opioid painkillers, and Quaaludes respectively) cast doubt upon the prescribing physicians and consumers. These chapters reveal the myriad strategies employed by governmental agencies to control and limit prescriptions at both the organizational and individual level. Finally, Greene examines the “afterlife” of the prescription by following the paper trail, quite literally. He highlights the harvesting and utilization of filled prescription slips by data companies, pharmaceutical producers, government agencies, and researchers of medicine, providing an appropriate bookend to the volume’s earlier entries.

Although there are few reasons to criticize the book, it could perhaps have been strengthened by the addition of a concluding chapter. The editors have done well to fuse a collection of narratives into a tight, overarching whole, but the end comes rather abruptly. Such a chapter might have been used to link the American story with the broader international history of the prescription. Although many of the volume’s central events are uniquely American (such as the Harrison Act, the Kefauver-Harris Amendment, and the creation of the U.S. Drug Enforcement Administration), the book’s wider themes, which situate the prescription as a focal point in battles over professional identities and medical authority, are part of the broader history of pharmaceuticals and medicine.

This criticism, however, is a very minor point. The book’s clear prose recommends its use in the classroom; it also does an excellent job of introducing and contextualizing major themes, events, and figures in pharmaceutical history. At the same time, it would very likely interest researchers from allied fields such as medical anthropology, sociology, and medicine since most of the major debates discussed within the volume have continued to the present day. On the whole...