Tax, Medicines and the Law: From Quackery to Pharmacy by Chantal Stebbings (review)

From 1783 to 1941, proprietary medicines in Britain were subject to Stamp Duty. Dues of several pence per bottle or box were paid to the government via the manufacturer, with payment proven by a stamp that was glued to the container. This long-running tax was a minor contribution to the state’s expanding needs, supplying just 1 percent of total stamp duty yield by 1807, but proved remarkably durable, still quietly and productively raising more than one million pounds a year by the 1920s. It was also, as Chantal Stebbings argues, a remarkably bad tax from a legal and administrative perspective: bad in how it was written, and—consequently—bad in the implementation. Indeed, the commissioners responsible for the Stamp Duty were pushed to act unconstitutionally to interpret the law in a way that broadly fitted a changing medical and economic landscape, but trampled over the actual wording of the statute.

Stebbings’s study traces the administrative and medical history of this tax from its genesis in the fiscal nightmare of the late eighteenth century, in which ministers were rapidly innovating to extract revenues from as rich an array of sources as they could (this was the era of taxes on windows, wigs and dogs) to its demise in the 1940s, when the task of defining a tax that could accommodate the competing interests of retail chemists, large retailers such as Woolworths, tax authorities, and medical opinion finally became impossible. The central problems of the tax lay in the trickiness of defining a proprietary medicine—the tax was never intended to fall on treatments produced and supplied on a doctor’s prescription—and identifying who benefited from an exemption for “known, admitted and approved” medicines. That no satisfactory solution to these challenges was achieved underlines clearly the ambiguous place that proprietary medicines and their producers had within health care. Ambiguity is the enemy of fiscal bureaucracy, however, and the consequence was a series of illegal administrative adjustments and refinements that were largely decided in the private meeting rooms of the revenue authorities.

The close reading of the social and political life of a tax that Stebbings presents here will surely make an important contribution to the history of law. Her close reading of the administrative implementation of the tax is particularly impressive, and I for one was left with a surprising amount of respect for the care and thought the civil servants involved paid to the equity and social consequences of their actions. Based on a single case, it is hard to judge quite how representative or exceptional this kind of administrative reinterpretation was, or how troubling it was in practice.

I was left less convinced by some of the arguments set out for the history of medicine, however. For her account of proprietary medicines, Stebbings leans heavily on the views of contemporary critics of the trade. These are loud and compelling, to be sure, but they steamroller over the variety of proprietary medicines and obscure their close relationship to orthodox medicine. The durability of many of the most popular medicines, and their frequent indistinguishability from prescribed remedies, means that we should not accept the argument that they are all hoaxes on the ignorant and thus just objects for eradication from the marketplace. Yet this is often the subtext, even the text, of the analysis presented here. The implications of the tax for the professionalization of chemists and druggists, the regulation of pharmacy, and the development of analytical chemistry seem relatively limited—and here Stebbings deserves credit for acknowledging that her topic did not necessarily make the biggest waves. Nonetheless, there is much of importance in her study for historians interested in understanding the development of pharmacy, branding and marketing of drugs, and changing political attitudes to medical and pharmaceutical regulation.