classic drug ad de jour

On this page I will periodically share items from my collection of historical pharmaceutical ads, with commentary to illuminate their implications for the drug industry's activities, along with doctors and patients and illnesses of the past.  These advertisements all come from medical journals and were aimed strictly at health professionals in the days when advertising prescription medicines directly to the public was forbidden (as it still is, everywhere but the USA and NZ).  It is essential to bear in mind that they speak to the doctor in language meant to tap in to his experience and prescribing habits.
Advertising like this, especially the full page ads that I collect, was routinely removed from medical journals when they were bound by libraries.  Thus, these images are not a widely available resource for historians of medicine -- a pity due to their enormous value as evidence.

This splashy 2-page colour ad for Merck's Diuril, in the 12 July 1958 issue of JAMA, construes PMS as a problem of bloating, and therefore the prescription diuretic as a remedy, deliberately confusing 'tension' as a mental state with hypertension.   The drug did -- as historian Jeremy Greene has argued -- become a huge success as a blood-pressure-lowering medication for even the mildest hypertension, on the rationale that people with elevated blood pressure are at risk for heart disease.  While, as Greene says, Diuril is early example of treating numbers and risk rather than actual illness, this ad shows that there was more to its blockbuster status.  Merck also marketed it for an even broader indication that hypertension, in that all women were potential consumers for thirty years of their lives for perhaps a week every month -- a use for which its efficacy rationale was even less justified than heart disease prevention. 

So we can plainly see that 'disease mongering' by big pharma, and the 'diagnostic creep' it causes are hardly new phenomena.  In fact they were worse in the 1950s, before the FDA gained regulatory authority over drug efficacy in 1962.  Indeed the 1950s give us  a glimpse of what will happen soon if, as many conservative idealogues and Republican lawmakers urge, the 1962 laws should be repealed so that pharmaceutical firms can market any drug for any condition once minimal toxicity testing has been conducted.  They doctors, they say, can decide what the drugs are good for, even though drug firms won't have to conduct any controlled studies to see what patients they actually help.  This logic ignores the fact that any chemical that exerts biological effects strong enough to affect disease processes has effects strong enough to cause harm when given the wrong patients.
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