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four-month course of lectures, came back the next year to hear Ihe same lectures a second time, then look a nominal examination and received iheir degree. At Harvard, for example, Ihe examination consisted of five minutes of oral questioning by each of the nine faculty membei-s. Approval from five of the nine was sufficient to pass.

Since few people wish to leave earth more quickly than necessary, self-medication was Ihe sensible alternative. And between 1859 and 1903 ihe patent medicine industry, which catered lo the needs of the self-medicators, increased its sales tweniyfold. American medicine simply treaded water during most of this period. Europe accepted Ihe germ theory of disease in Ihe 1860s; Ihe American profession remained unconvinced until the eauly 1890s. But acceptance of the germ theory released long dormant energies, and by 1900, dozens of medical research laboratories had been established. The medical profession became inlelleclually respectable. And egotistical: doctors took the position that illness could properly be treated only by qualified physicians. Undei-standably, ihey forgot thai illness had managed lo gel along without them for a very long lime.

Now thai a monopoly on healing had become in iheir eyes a necessary as well as a desirable goal, doctors had lo convince the public lhal self-medication was undesirable and unhealthy. Americans, however, were quile fond of their opium, morphine, heroin, cocaine and alcohol-based patent medicines. Bui the American medical profession had a powerful ally: "Do we not recognize," said a speaker at the 1893 convention of the American Pharmaceuiical Association, "That this [patent medicine) industry is one of our greatest enemies, and that there are millions of dollars worth sold all over the country, thus diverting money which rightly belongs lo the retail drug trade in the way of prescriptions and regular drugs?" The speaker recognized his long-term interests but most of his colleagues were chained to ihe here and now, which, simply stated, was that the patent medicines accounted for a substantial part of any pharmacist's income. The doctoi-s faced a similar problem in attempting to discourage people from using patent medicines. Their own medical journals received Ihe greater pari of their income directly from patent medicine advertising.

Unable to mount effective frontal assaults on the enemy, doctors and pharmacists had to content themselves with guerrilla actions-pointing out the dangers of self-medicalion and the risk of becoming addicted lo your favorite no si rum. But this was like an embezzler accusing a slick-up

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