Pain and Profits: The History of the Headache and Its Remedies in America

Pain and Profits: The History of the Headache and Its Remedies in America Jan R. McTavish. New Brunswick: Rutgers University Press, 2004. All in My Head: An Epic Quest to Cure an Unrelenting, Totally Unreasonable, and Only Slightly Enlightening Headache Paula Kamen. Cambridge: De Capo Press, 2005 Americans suffer from headaches. In 2005, we find all kinds of messages about "headache remedies" in the mass media from such varied sources as print advertisements, television commercials, advice columns, and newspaper, magazine, and television news stories. Recent newspaper headlines illustrate the conflicting messages that appear: "The Search for the Killer Painkiller"; "Perils of Pain Relief Often Hide in Tiny Type"; "For Pain Management, Doctors Prescribe Caution"; "Patients Press Doctors on Pain Issues"; and "Vioxx. Celebrex. Now Aleve. What's a Patient to Think?" The two books under review, Jan R. McTavish's Pain and Profit and Paula Kamen's All In My Head provide insight into the changing attitudes over time regarding the headache, its treatments, and its sufferers. McTavish, an assistant professor of history at Alcorn State University, introduces her subject through a description Thomas Jefferson gave of one of his infrequent but severe headaches. When he wrote to his relatives that he had "had an attack" his pain was taken seriously by his contemporaries, McTavish argues, because they believed him to be suffering from a "respectable complaint." On the other hand, when John Steinbeck wrote The Wayward Bus in 1948, his "pitiless description" of the character of Mrs. Bernice Pritchard portrayed the woman as someone who used her headache to manipulate others. Commonly held attitudes by the 1950s posited that people who got headaches were self-centered, could not deal with the problems of everyday life, and brought their headaches on themselves. The headache itself had become simply a "disreputable cliche." Throughout her monograph, McTavish is most interested in how the public has largely been left to itself to treat their headaches as she chronicles the rise of the pharmaceutical industry in the United States from the eighteenth century to the present with a particular emphasis on the development of "over-the-counter" headache remedies. The headache "had a small but lively role in helping to establish, shape, and sustain the various jurisdictions and relationships" among the medical professions, the pharmaceutical industry, pharmacists, the local drugstore, and the public. Her well-researched book looks at a variety of sources including professional and trade journal articles, newspaper stories, court cases, government, professional organization and pharmaceutical archives, and secondary materials. While historians of medicine and pharmacy will especially welcome this text, it is also of interest to cultural studies scholars and to a general audience trying to understand common health ailments and their treatments. McTavish first looks at how Americans self-treated headaches in the nineteenth century through such home remedies as prayer and incantations or rest in bed with the application of a water and lavender-dampened cloth on the "place that hurt." Physicians were most interested in exploring the underlying cause of the headache and bringing the body back into balance through prescribing medicines that served a depletion or purging function-bloodletting, emetics, cathartics, or diaphoretics. Alternative practitioners used less heroic treatments but also focused on restoring the body's balance. None of these treatments did much to address the patient's main complaint -their pain. Throughout the nineteenth century as the patent medicine industry grew with virtually no regulation, the drug supply flourished with an increasing number of headache treatments that anyone, pharmacist, doctor, or patient, could easily obtain. Average physicians gained much of their information about drug therapy from commercial advertisements that praised the success and popularity of these ready-made "proprietary" products while medical and pharmacy reformers argued rather that doctors should prescribe "by individual pharmacopeial items," using ingredients in the public domain. …