The British Pharmacopoeia, 1864 to 2014: Medicines, International Standards and the State by Anthony C. Cartwright (review)

Pharmacopoeias have been an important feature of medicine for centuries. They have served to codify pharmaceutical and therapeutic knowledge, provided a mechanism for states to control harmful substances, and acted as a means of regulating trade. Study of the history of pharmacopoeias, as collections of approved medicines and formulas, offers a window into a wide range of issues including the often challenging relationships between medical and pharmaceutical practitioners. The first Edinburgh Pharmacopoeia in 1699 had its origins in disputes between the physicians and the surgeon-apothecaries; and it was the Medical Act of 1858 that gave the General Medical Council powers that included production of a new publication, the British Pharmacopoeia (BP), which would replace the existing Edinburgh, Dublin, and London Pharmacopoeias.

In this book Cartwright illustrates the shifting nature of the BP’s purpose, its contents, and its intended audience, over the 150 years from 1864 to 2014. Its function evolved from a list of suitable drugs and formulations to a compendium of standards for ensuring their quality; by 1968 it had largely completed its transition from a formulary for pharmacists to a book providing analytical standards for the products of industry. But Cartwright also points out that the BP served wider political and economic functions; it was an instrument of empire, and the Cunningham Report of 1999 concluded that it was also an important instrument of development.

The book is divided into three parts with a total of eight chapters, with a chronological account of the history of the BP appearing in part 1. Chapter 1 describes the earlier London, Edinburgh, and Dublin Pharmacopoeias, chapter 2 the early years of the BP from 1864 until 1914, chapter 3 the middle years between 1914 and 1968, and chapter 4 the later years from 1968 until 2014. Part 2 explores the international context of the BP in two chapters, one describing the links between the BP and the European Pharmacopoeia, the second the international harmonization of pharmacopoeias. Cartwright highlights the close links between the staff of the BP and those of the United States Pharmacopoeia, as well as their close connections with staff in Britain’s colonies and dependencies, as the BP Committee worked toward a pharmacopoeia that would be fit for the whole empire.

Part 3 consists of two chapters on change and continuity, the first relating to changes in therapeutics and the second to changes in analytical methods. However, these are largely selective summaries of the secondary literature on the histories of drug discovery and analytical chemistry, and of their inclusion in the BP. The chapter on therapeutics provides brief accounts of the official standardization of twenty-seven drugs or drug classes; that on analytical methods chronicles the inclusion in the BP of a range of such methods. However these are likely to be of interest only to a more specialist audience.

The book is a pharmaceutical regulator’s account of the BP’s history rather than an historian’s. It does however illustrate how the medical domination of pharmacopoeia preparation was slowly eroded, as recognition grew that the expertise of others was needed. With establishment of the BP Commission in 1928 individuals with pharmaceutical and chemical qualifications as well as medical ones were appointed. But only in 1970 did the General Medical Council’s Pharmacopoeia Committee finally demit office, and an independent British Pharmacopoeia Commission was established.

The book ends rather abruptly with no conclusion chapter. Readers are left to reflect for themselves how the history of the BP illustrates the shifting nature of professional boundaries between medicine and pharmacy, how practitioners of chemistry, botany, microbiology, and pharmacology were gradually embraced, and how international developments influenced both its preparation and content. It does however provide a mirror to scientific progress, illustrating the rise in pharmaceutical knowledge over the period. The inclusion of vaccines, sera, and antitoxins follows developments in microbiology, and...