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Points Interview: Pharmaceutical History with Malcolm E. Brown

Today’s post features an interview with Malcolm E. Brown, a retired pharmacist with an interest in pharmaceutical history. Brown recently authored the book Pharmacy Miscellany. Find out more about Brown’s background and research in this interview.

Please tell readers a little bit about yourself

I am a retired pharmacist with an interest in pharmaceutical history. I have BA (Open University), Master's (University of Bradford) and Doctorate (University of East Anglia) degrees in natural and social science research. I have worked in senior positions as a production manager in Big Pharma and in the British National Health Service (NHS) including at the director level. I’ve also worked as a community pharmacist, including dispensing methadone replacements for many people battling addiction. I have tutored over 30 future pharmacists and trained most or all of the sales force of a major international company on selling medicines to the British NHS. I have certified batches of medicine as an EU (or post-Brexit equivalent) Qualified Person. Several licences for human, veterinary and investigational medicinal products have named me. I have audited and advised in several countries. As the keynote speaker at an international multidisciplinary conference at the Hague, I was tasked with helping delegates to think “out of the box”.

I won the premier article award for what is today the Quality Research Association. I have 145 publications including academic papers, pharmaceutical history, journalistic opinion pieces, short stories and a novel. In 2021, I was honoured to be elected as a Fellow of the Royal Pharmaceutical Society (FRPharmS) for distinction in the profession of pharmacy. I am an honorary careers mentor at the University of East Anglia.

I am married to a retired pharmacist. We live in a village in near the Norfolk Broads, UK. We have two children, a general medical practitioner and a science teacher, and grandchildren.

What got you interested in the history of pharmacy and pharmaceuticals?

Pharma history was a compulsory part of first-year study at my School of Pharmacy in 1963.

Background reading about dentists, general practice and hospital medical practitioners, radiographers, nurses, optometrists and community and hospital pharmacists for the Introduction chapter of my Master's thesis in the 1980s further piqued my interest. I discovered that their beliefs, such as the importance of knowledge, patient welfare, ethics and law, were extremely similar. Only towards the end of my research did I realise that what I had thought was novel had been researched by sociologists a generation before. Libraries had been filled with the professionalization endeavours of numerous occupations jostling to better themselves.

My interest shifted to such social scientific perspectives while and since studying sociology at the doctoral level. Before being allowed to start my six-year part-time program, I had to undertake one year’s guided reading, including in history. Through sociological spectacles, my interpretations of history shifted so seismically that it is difficult to overstate. The differences between the perspectives of, on the one hand, natural science and on the other, social science and humanities (such as traditional history), enthrall me.

What motivated you to write this article specifically?

Over just one generation, British community pharmacies (chemists’ shops) stopped selling chemicals used for home chemistry experiments by youngsters and for household DIY. This was so rapid; I had witnessed it and trained to interpret it. To see a custom change before my very eyes, “history in the making”, was too wonderful an opportunity to not record.

Interestingly, the 1843 royal charter of pharmacists’ (then) “Pharmaceutical Society” stated as its first purpose, “advancing Chemistry and Pharmacy”. However, the wording in the 2004 charter of the “Royal Pharmaceutical Society” only stated, “to advance … pharmacy” because, by then, many of the “medicines derive(d) from the biological sciences”. Certainly, there have been well-publicised developments from molecular biology and genetic engineering; the best-known recently are vaccines against COVID-19.

Since ancient times, many medicines came mainly from plants: the Materia medica; part of the natural science of botany. Precise classification and species identification including the Linnean genus and species were crucial. I note that such “old-school” taxonomic “obsessiveness” has been dismissed by natural scientists. For example, the luminary physicist Rutherford (1871 – 1937), divided science into "physics" and "stamp collecting."

Yet in my student days in the 1960s, pharmacognosy (the study of naturally occurring drugs, mainly plants but a few animals such as leeches and minerals like talc) demanded detailed accurate and precise identification. It could be by the naked eye.

For two years, to the left of my bed, pharmacognostical specimens were glued onto cardboard sheets. In one exam, examinees had a short time to troop along ten specimens on a bench and correctly identify each by macroscopic appearance alone. The exam was negatively marked so an incorrect answer meant that your mark was reduced; that discouraged guessing. But, with hindsight, I loved that subject and the crude drugs glow with romantic nostalgia. Those clearest in my memory, sixty years later include Cantharides (beetles), Lobelia, Fennel, Nux vomica, Clove (Penang and Zanzibar), Digitalis purpurea, ginger, Buchu, Cinchona and Atropa belladonna (deadly nightshade). Women around the Mediterranean used to instil drops squeezed from that plant into their eyes; one effect was to dilate their pupils so their eyes looked bigger; The Italian “bella donna”, translates into English as “beautiful woman”.

“Organoleptic characteristics” using not just sight but also the other four senses known since antiquity were also important. It makes me sad that a generation of aspiring chemists have not been allowed (under health and safety regulations such as fear of carcinogenicity and so on) to smell chemicals like benzene, xylene, carbon disulphide or other volatile materials, (gingerly) sniff phosgene, the chemical weapon of mass destruction used in WW1, or plunge their fingers into a bowlful of mercury.

I have done so and live to tell this tale, but I emphasise that I am not suggesting that you copy; by the standards of today it is probably illegal and deemed dangerous, wherever you are living.

Returning to pharmacognosy, that used microscopy to focus on the “diagnostic features” of hairs, stomata and so on of medicinal herbs. Microscopic analysis rubbed shoulders with the organic pharmaceutical chemistry of the active pharmaceutical ingredients (e.g., Digitalis leaf contains digoxin) and forensic science.

From a completely different angle, knowing that the d- and l- isomers of limonene cause the different smells of oranges and lemons thrills me. Similarly, the variety of forms of chemicals, some astonishingly beautiful such as crystals and for example, dark vibrant blue such as the inorganic copper compound now termed tetraamminecopper(II) sulfate [Cu(NH3)4]SO4·H2O bring me joy. I was never happier when, in a more innocent time, I performed chemical experiments in my home laboratory in the garden shed.

Explain your book in a way that your bartender won’t find boring.

The pharmacy angle is just a platform to explore a far wider range of topics.

For example, our take on what it means to be healthy and ill has changed over the years. For example, the widely accepted aphorism that nasty medicine does you good may originate from the ancient belief that disease is caused by evil demons that had entered the body; such remedies disgusted them so they left. Many snippets may be difficult to find elsewhere. Examples are that some bacteria so thrive on radiation that they may live in atomic plies; the old-fashioned drugs that they are finding it difficult to source in Utah for their lethal injection; that a simple “reversal in algorithm enabled all know chemical agents of mass destruction and several utterly novel ones to be “instantly” discovered.

It offers an “insider view” of what worries the pharmaceutical industry.

It advises on how to thrive in an organisation, and how to cope with change and even redundancy. It is shamelessly autobiographical; it describes my near-death experience and what I learned from it.

Finally, down to earth with a bump, it contains useful but little-known practical guidelines for cleaning just about anything.

Did you uncover anything particularly interesting or surprising during your work on this project?

The official professional periodicals in pharmacy (Pharmaceutical Journal of the Royal Pharmaceutical Society) and chemistry (Chemistry World of the Royal Society of Chemistry) have not reviewed a book for a couple of years. Apparently, nobody reads such reviews.

Wearing social historical spectacles, both of those prestigious royal societies have similar origins as parts of respective professionalization endeavours in mid-Victorian England.

What do you think is the most important takeaway from this book?

Medicines are things and the healing is “crystallised” within the (portable) medicine or pharmaceutical itself. Healing can occur at-a-distance and does not require a face-to-face healer.

That is a strength. But it can have a dark side. Medicines are regularly recalled as faulty. If a medicine maker makes an error, that error is also crystallised-at-a-distance within the empirical medicine itself. Natural science seldom causes an error; human factors applying that science do. Health professionals need extra training in the social and behavioural sciences to increase patient safety.

Is this linked to any other projects?

I continue to be a regular columnist under the strapline “Bottled Brown” for the Industrial Pharmacy Journal.

What else are you working on?

I have been working on a project with a physicist Steve Hubbard PhD, that attempts to combine perspectives from natural and social science on the Thermodynamics of Money. See our talk from a hybrid conference at the University of the Appalachians, USA.

Such collaborations seldom occur. We are delighted that we understand our associated academic paper is to be published in the Philosophical Transactions of the Royal Society. An interest, such as in the history of pharmacy and pharmaceuticals, may lead further than you expected!

Anything else you'd like to share?

First, the range of pharmaceuticals delights me; they include Materia medica such “sterile” maggots removing dead tissue and bacteria, blood fractions and medical gases obtained from the atmosphere by fractional distillation. Note that healing medicines are not only for humans but also for other animals: veterinary.

Secondly, placebos, homeopathic medicaments and nocebos, none of which are, theoretically, likely to contain any active drug within a single dose and even talismans and fetishes are peripheral cases to pharmacy (although commonplace in anthropology) just may yield rich insights.

Thirdly, a topic peripheral, and seldom researched, in one field may be mainstream, and even pedestrian, elementary or outdated knowledge, in another. Collaborating with a widely different discipline is challenging but with mutual respect, has the potential for great reward. Why not have a go?

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