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ABSTRACT
This article focuses on histories of one category of the many new synthetic drugs of the mid-twentieth century, which were variously termed hypnotics, sedatives and tranquillisers. I invoke Obliv(i)on as a metonym for pharmaceutical products now largely forgotten, for the general absence in our historiography of their significance, and for amnesia about the politics of pharmaceutical regulation in South Africa in the 1930s to 1960s. Along with antibiotics and hormones, by 1962, synthetic sedatives and tranquillisers were amongst the most frequently prescribed medical drugs in this country. As in many other countries they came to be amongst the fastest-selling, most desired, and on occasion, most dangerous new drugs of the post-war era. The article identifies a number of registers in which and moments when these sedatives became of pharmacological, professional or public interest, and sketches a chronology of their regulatory politics in South Africa in the mid-twentieth century. While South African markets remained limited, many local pharmacists, manufacturers, importers, and consumers were quick to embrace the therapeutic aspirations and chemical technologies of the time. In turn, they helped to accelerate multiple changes in a fulcrum period of the uneven emergence of ‘pharmaceutical modernity’ in South Africa.
Acknowledgements
My thanks to Thembisa Waetjen for much input to this article, and to Alice Morrison for research assistance: also to Andy Gray, Raymond Pogir, Natie Finkelstein, and Gary Black, for so generously sharing knowledge and archives. All illustrations are used with permission of the publishers of the South African Pharmaceutical Journal.
Note on the contributor
Julie Parle PhD is Honorary Professor of History, currently researching southern African histories of medicines, health and pharmaceutical regulation.
ORCID
Julie Parle http://orcid.org/0000-0002-3894-9567
Notes
1 South African Pharmaceutical Journal (SAPJ), 12, 11 (1959), 6.
2 Sedatives are depressants which slow mental activity and physical functions; tranquillisers are central nervous system-depressant drugs classified as sedative-hypnotics. The latter ‘reduce tension and anxiety and induce calm or induce sleep [ … ] Since these actions can be obtained with other drugs, such as opiates, the distinctive characteristic of sedative-hypnotics is their selective ability to achieve their effects without affecting mood or reducing sensitivity to pain’: AEC Client Education Library, https://www.atlantaequine.com/pages/client_lib_sedvstranq.html; https://www.britannica.com/science/sedative-hypnotic-drug, both accessed 9 April 2019.
3 Influential for this article were A.A. Daemmrich, Pharmacopolitics: Drug Regulation in the United States and Germany (Chapel Hill: University of North Carolina Press, 2005); R. Davenport-Hines, The Pursuit of Oblivion: A Social History of Drugs (London: Phoenix, 2004); A. Tone, The Age of Anxiety: A History of America’s Turbulent Affair with Tranquilizers (New York: Basic Books, 2008); A. Tone ‘Tranquilizers on Trial: Psychopharmacology in the Age of Anxiety’, in A. Tone and E. Siegel Watkins, eds, Medicating Modern America: Prescription Drugs in History (New York: New York University Press, 2007), 156–182; J.A. Greene, F. Condrau, and E. Siegel Watkins, eds, Therapeutic Revolutions: Pharmaceuticals and Social Change in the Twentieth Century (Chicago: University of Chicago Press, 2016).
4 See especially the body of work by Thembisa Waetjen, the most recent being (in this issue) ‘Global Opium Politics in Mozambique and South Africa, c.1880–1930’, and ‘The Politics of Narcotic Medicines in Early Twentieth Century South Africa’, Social History of Medicine, 32, 3 (2019), 586–608.
5 L. Gilbert, ‘Dispensing Doctors and Prescribing Pharmacists: A South African Perspective’, Social Science and Medicine, 46, 1 (1998), 83–95.
6 L.M. Thomas. ‘Skin Lighteners, Black Consumers and Jewish Entrepreneurs in South Africa’, History Workshop Journal, 73, 1 (2012), 259–283 and ‘The Modern Girl and Racial Respectability in 1930s South Africa’, Journal of African History, 47 (2006), 461–490. For South Africa and the USA, white identity, consumerism, capitalism, and aspirations of modernity in the 1960s, see L. Grubbs, ‘“Workshop of a Continent”: American Representations of Whiteness and Modernity in 1960s South Africa’, Diplomatic History, 32, 3 (2008), 405–439; and more recently for the identification of ‘racially politicized consumption’ in South Africa, see D. Posel, ‘Getting Inside the Skin of the Consumer: Race, Market Research and the Consumerist Project in Apartheid South Africa’, Itinerario, 42, 1 (2018), 120–138.
7 J. Parle, R. Hodes and T. Waetjen, ‘Pharmaceuticals and Modern Statecraft in South Africa: The Cases of Opium, Thalidomide and Contraception’, Medical Humanities, 44 (2018), 253–262.
8 For critical reflections on the ‘Golden Age’ (c.1920s–mid-1960s) and Whiggish pharmaceutical histories see A.M. Brandt and M. Gardner, ‘The Golden Age of Medicine?’, R. Cooter and J. Pickstone eds, Medicine in the Twentieth Century (New York: Routledge, 2000), 21–28; Greene, Condrau, and Watkins eds, Therapeutic Revolutions, esp. Introduction, ‘Medicine Made Modern by Medicines’, 1–17.
9 Well explored in K. Flint, Healing Traditions: African Medicine, Cultural Exchange and Competition in South Africa, 1820–1948 (Athens: Ohio University Press, 2008) and C. Burns, ‘Louisa Mvemve: “A Woman’s Advice to the Public on the Cure of Various Diseases”’, Kronos: Journal of Cape History, 23, 1 (1996), 108–134.
10 Author interview with Dr N. Finkelstein (retired pharmacist and pharmacologist), Cape Town, 25 June 2015. Transcript in possession of author. Ativan (Lorazepam) is a benzodiazepine, a treatment for anxiety amongst other conditions and needs. Valium is also a ‘benzodiazepine medicine’ prescribed for agitation, anxiety, and others.
11 ‘Jimsonweed: Scientific name: Datura stramonium (Solanaceae). Alternative common names: Ditch weed; jimson weed; stinkwort (English); gewone stinkblaar; malpitte (Afrikaans); iloqi (isiZulu); lechoe (Sesotho); umhlavuthwa (Xhosa): ‘Invasive species, South Africa’, at http://invasives.org.za/legislation/item/239-common-thorn-apple-datura-stramonium, accessed 18 October 2018.
12 F. López-Muñoz, R. Ucha-Udabe, and C. Alamo, ‘Review Essay: A History of Barbiturates a Century after Their Clinical Introduction’, Neuropsychiatric Disease and Treatment, 1, 4 (2005), 329.
13 L. Gillis, ‘The Historical Development of Psychiatry in South Africa since 1652’, South African Journal of Psychiatry, 18, 3 (2012), 78.
14 López-Muñoz et al., ‘Review Essay’, 338–339.
15 J. Parle, States of Mind: Searching for Mental Health in Natal and Zululand, 1868–1918 (Scottsville: University of KwaZulu-Natal Press, 2007), 185. Veronal was sold by Bayer after 1904 for ‘insomnia and nervous excitability’: The Schering Company sold it as a soluble salt under the name ‘Medinal’.
16 López-Muñoz et al., ‘Review Essay’, 329.
17 S. Berman, ‘Insomnia’, South African Medical Journal (SAMJ), 9, 2 (1935), 40.
18 Government Gazette, 72, 1706, 22 May 1928, ‘South African, Medical, Dental and Pharmacy Act (Number 13) of 1928’, IV Schedule, Division I, 289: ‘Poisons – Divisions One and Two; Fifth V – Habit Forming Drugs. VI Schedule – Laws Repealed’, xli–xlii.
19 Dozens of other poisons were included in Schedule IV, inter alia, Atropine, Belladonna, chloral hydrate, Coca, cocaine; Ergot; Lead; Nux Vomica; Prussic Acid. Schedule V included coca leaves; cocaine; dagga; diamorphine; ecgonine; morphine; opium. Emphasis mine.
20 See Gilbert, ‘Dispensing Doctors and Prescribing Pharmacists’, 83–95.
21 F.C. Sturrock (chairman), Report of the Select Committee on the Subject of the Proprietary Medicines and Appliances Bill, Select Committee (S.C.) 10–’37 (Cape Town: House of Assembly/Cape Times Ltd, 1937), (hereafter ‘Sturrock Committee’), 30.
22 The committee had based the Bill on Canadian precedents rather than those of Britain or the USA. See Sturrock Committee, 10.
23 A.J. Stals (chairman), Report of the Committee of Enquiry into Advertisements of Proprietary Medicines and Medical Appliances , Union Government (U.G.) 19 –’36, (Cape Town: Government Printer, 1936), 2 (hereafter ‘Stals Committee’). The Stals Committee met during 1935, and its Report was published the following year. Emphasis mine.
24 The ‘Proprietary Medicines and Appliances Bill: To regulate the manufacture, importation, advertising and sale of proprietary medicines and appliances, and the publication of advertisements in which it is represented that certain persons are able to cure or treat human diseases, disorders, defects or deformities’ was read in Parliament on 22 February 1937. Amidopyrine is an analgesic, anti-inflammatory and anti-pyretic. It was later confirmed that it was linked to agranulocytosis, a serious condition caused by low white blood cell count.
25 Sturrock Committee, 46.
26 M.M. Glatt, ‘The Abuse of Barbiturates in the United Kingdom’, https://www.unodc.org/unodc/en/data-and-analysis/bulletin/bulletin_1962-01-01_2_page004.html, accessed 18 October 2018. In the USA the picture was patchy, with restrictions varying across states and jurisdictions. Only in the 1950s did it become a federal requirement that barbiturates be acquired by prescription.
27 R.N. Chopra and G.S. Chopra, ‘Habitual Use of Barbituric Acid Derivatives in India’, Indian Medical Gazette, 70, 4 (1935), 188.
28 Sturrock Committee, 24.
29 ‘The Trades Exhibition’, SAMJ, 11, 20 (1937), 733.
30 Sturrock Committee, 24.
31 Ibid., 24–25.
32 Ibid., 29.
33 Ibid.
34 Ibid., 30.
35 Ibid.
36 Ibid., 33.
37 Ibid., 34.
38 For background to the importance of ‘Dutch medicines’ for South African pharmacopolitics, see Waetjen, ‘The Politics of Narcotic Medicines’.
39 R. Turner, ‘Legislation: Proprietary Medicine’, SAMJ, 29, (1945), 204. In the USA after the 1938 Food and Drug Act, which gave the Food and Drug Administration (FDA) authority over pre-marketing safety, some states did require that barbiturates be issued only on medical prescription and carry a warning label that they were ‘habit-forming’: N. Rasmussen, ‘Controlling “America’s Opium”: Barbiturate Abuse, Pharmaceutical Regulation, and the Politics of Public Health in the Early Post-war United States’, Journal of Policy History, 29, 4 (2017), 543–568.
40 M. Ryan, A History of Organised Pharmacy in South Africa, 1885–1950 (Cape Town: Society for the History of Pharmacy, 1985), 100.
41 One example is the SAPHAR Laboratories, established in 1939. They first produced ethyl chloride and also penicillin ‘before the first stocks arrived from America’: SAPHAR Laboratories, Johannesburg, ‘Development of the South African Pharmaceuticals Industry’, SAMJ, (1949), 41.
42 National Archives Repository, Pretoria (SAB), Department of Trade and Industry (HEN) 125, 6/1/70, No author, ‘[A] Brief History of Pharmaceutical Manufacturing in South Africa’, 19 September, 1961.
43 SAB, Custodian of Enemy Property (BVE,) 810/W27/78/4, Enemy Patents and Trade Marks, 1957–1960, ‘Scherag A.G. Trade Marks’, Scherag (Pty) Limited, Johannesburg to the Custodian of Enemy Property, Pretoria, 14 February 1950.
44 SAB, HEN 125, 6/1/70, ‘A Brief History’, 19 September 1961.
45 Ibid.
46 Ibid.
47 ‘Add to the “Look Appeal” of Your Goods by Packaging in Glass’, advertisement by Consolidated Glass Works Limited, Johannesburg, SAPJ, 16, 6 (1950), 31.
48 ‘Display and Recommend “Zephrol Cough Syrup”’, advertisement by May & Baker Ltd, Port Elizabeth, SAPJ, 16, 6 (1950), 39.
49 E.H. Burrows, ‘Alcohol-barbiturate Synergism’, SAMJ, 27, 47 (1953), 1058.
50 Ibid., 1057.
51 Ibid.
52 Ibid., 1059.
53 G.L.N Daniel, ‘Poisons by Telephone’, SAMJ, 26, 29 (1952), 603.
54 ‘Tablets to Aid Mothers’, The Barrier Miner (Broken Hill, New South Wales), 15 August 1950, 2, https://trove.nla.gov.au/newspaper/article/49588175, accessed 15 August 2018.
55 ‘Habit-forming and Potentially Harmful Drugs: A Guide to Medical Practitioners’, SAMJ, 28, 48 (1954), 1024.
56 A. Kramer, ‘“Potentially Harmful Drugs”, from President’s Address to the Annual General Meeting of the Pharmaceutical Society of South Africa’, 1 April 1959, Supplement to SAPJ, 25, 9 (1959), 10.
57 Davenport-Hines, The Pursuit of Oblivion, 269–270.
58 D.W. Goyns, Pharmacy in the Transvaal, 1894–1994 (Johannesburg: Pharmaceutical Society of South Africa, Southern Transvaal Branch, 1995), 70.
59 Ibid.
60 The Amendment Act was an omnibus one; inter alia it sought to extend police powers with regards to cannabis; extended flexible sanction for doctors who were themselves drug addicts; and was most concerned with the registration of medical specialists.
61 Republic of South Africa, House of Assembly Debates (hereafter Hansard), 2, 26 February 1962, column 1592.
62 U.G. 40/1951, ‘Report of the Committee to Enquire into the Training of Chemists and Druggists in South Africa’ (Pretoria: Government Printer, 1951), also known as the ‘Bremer Commission’.
63 Hansard, 84, 10 March 1954, cols 1871–1878.
64 The Stals Committee’s recommendations bear the imprint of legislation (including veterinarian) from Britain, the USA, Canada and elsewhere. For the history of drugs regulation in Canada, see M. Herder, ‘Denaturalizing Transparency in Drug Regulation’, McGill Journal of Law and Health, S57, 8, 2 (2015).
65 Hansard, 84, 10 March 1954, col. 2270.
66 Davenport-Hines, The Pursuit of Oblivion, 269–270.
67 Ibid., 270.
68 Goyns, Pharmacy in the Transvaal, 70.
69 South African Pharmacy Board Circular, ‘Habit-Forming and Potentially Harmful Drugs. A Guide to Medical Practitioners. Potentially Harmful Drugs: Sixth Schedule’, SAMJ, 26, 48 (1954), 1025.
70 Ibid.
71 Kramer, ‘“Potentially Harmful Drugs”, from President’s Address’, 10.
72 SAB, Department of Health (GES), 1820, 58/30G, 842/58/60, ‘Medical and Dental Pharmacy Act, 13 1928, “Sale of Poisons, Patented and Proprietary and Dutch medicines by General Dealers”, 1959–1960’. From The Director, The PN Barrett Company Pty Ltd, PO Box 694, Cape Town to Secretary for Health, date 4 December 1958. The conclusion of the correspondence is unknown.
73 SAB, GES 1820, 58/30G, 842/58/60, ‘ Barrett Company Pty Ltd, to Secretary for Health’, 4 December 1958.
74 ‘Packet - Drug, Relaxa-tabs (Carbromal and Bromvaletone), H.W. Woods Pty Ltd., Huntingdale, Victoria, circa 1960’, Museums Victoria's Collection, Medicine and Health, at https://collections.museumvictoria.com.au/items/1208459; and H.W. Woods Pty Ltd, ‘Helping Australians Sleep Better’, at https://hwwoods.com.au/, both accessed 18 October 2018.
75 SAB, GES 1820, 58/30G, 842/58/60, ‘Barrett Company Pty Ltd, to Secretary for Health’, 4 December 1958.
76 For a detailed discussion of which drugs should be classified as ‘PHD’, see A. Kramer, ‘ Potentially Harmful Drugs: A Review of the Revised Sixth Schedule’, SAPJ, 25, 12 (1959), 36–38.
77 See, for example, Editorial, ‘Dangerous Habits’, SAPJ, 29, 2 (1963), 13–15; and ‘Notice by the Pharmaceutical Society of South Africa’, ‘P.H.D. Prescriptions’, Supplement to the SAPJ, 29, September 1963, no page number.
78 Editorial, ‘Outer Fringe’, SAPJ, 27, 8, (1961), 11–12.
79 S.L Speaker, ‘From “Happiness Pills” to “National Nightmare”: Changing Cultural Assessment of Minor Tranquilizers in America, 1955–1980’, Journal of the History of Medicine and Allied Sciences, 52, 3 (1997), 339. This article also does not look at the use of the ‘major tranquillisers’ used in severe psychiatric illnesses.
80 Tone, ‘Tranquilizers on Trial’, 157.
81 Equanil (Meprobamate) Wyeth, ‘New Preparations and Appliances’, SAMJ, 30, 21 (1956), 500.
82 Editorial, ‘The Ataractic Drugs (Tranquilizers)’, SAMJ, 31, 8, (1957), 161–162.
83 V.J. Kinross-Wright, ‘New Horizons in the Chemotherapy of Mental Disease’, SAMJ, 31, 46 (1957), 1167.
84 Ibid., 1168.
85 Ibid.
86 Ibid.
87 See ‘Oblivon Elixir’, ‘Three tubes of “Oblivon” capsules, Britain, 1953–67’, and ‘Canister of Oblivon C tablets from Savory and Moor’, The Science Museum Group, Collections, ‘Materia Medica & Pharmacology, 1960–1980’, ‘Materia Medica & Pharmacology, 1953–1967’ and ‘Materia Medica & Pharmacology, 1951–1970’, at http://collection.sciencemuseum.org.uk/search?q=Oblivon, accessed 22 October 2018. Thanks to Jeremy Martens for pointing me to this website.
88 Davenport-Hines, The Pursuit of Oblivion, 260.
89 Ibid.
90 Advertisement for ‘Noludar - the safe sedative-hypnotic’, Roche Products (Pty) Ltd, Johannesburg, SAPJ, 27, 7 (1961), ii.
91 Advertisement for ‘Dormwell - hypnotic sedative is safe’, Smith & Nephew Ltd, SAMJ, 35, 3 (1961), 184’ and see S. M. Klausen and J. Parle, ‘“Are We Going to Stand By and Let These Children Come into the World”? The Impact of the “Thalidomide Disaster” in South Africa, 1960–1977’, Journal of Southern African Studies, 41, 4 (2015), 739.
92 Advertisement for ‘Miltown’, Lederle Laboratories, Sole distributors, Alex Lipworth Ltd, Johannesburg, SAPJ, 27, 5 (1961), 11.
93 Advertisement ‘Tranquilex is Here’, SAPJ, 28, 1 (1961), 7. No information about the drug’s manufacturers or its chemical composition appear in the advertisement.
94 In Grubbs, ‘Workshop of a Continent’, 422–424, medicines and drugs (legal or illicit) are not mentioned as available items of and preferences for American goods in South Africa (as were Playboy magazine, Coca-Cola, and Eskimo Pie ice-creams, for example), but pharmaceuticals advertisements complement the arguments made in his article about consumer culture, race, gender, and consumption by white elites.
95 Tone, The Age of Anxiety, ch. 1, e-book location 2067. This is clearly a subject for detailed research. A search through popular magazines including Sarie Marais, Huisgenoot, and Fair Lady for the late 1950s through to the mid-1960s does not reveal medicines for nervousness, anxiety, or fatigue being exclusively aimed at women. Nor did international pharmaceutical companies place advertisements in these publications.
96 See e.g., advertisement for Amitron (SAPHAR Laboratories, Johannesburg), SAPJ, 20, 2 (1954), 15.
97 J. Parle and L. Wimmelbücker, ‘These are the Medicines that “Make” Monsters’, Social History of Medicine, https://doi.org/10.1093/shm/hkz011, Online Advance article published 5 March 2019, accessed 16 August 2019.
98 W. Leigh, ‘Correspondence to the Editor: Thalidomide’, SAMJ, 36, 44 (1962), 928.
99 ‘PILL-LLS’, Rand Daily Mail, 9 August 1962, 8.
100 Ibid.
101 H.W. Snyman, ‘The High Cost of Medical Services: A Summary’, SAMJ, 38, 10 (1964), 195.
102 See J.A. Greene and S.H. Podolsky, ‘Reform, Regulation, and Pharmaceuticals: The Kefauver–Harris Amendments at 50’, New England Journal of Medicine, 367, 16 (2012), 1481–1483.
103 H.W. Snyman (chairman), Report of the Commission of Enquiry into [the] High Cost of Medical Services and Medicines, R.P. 59/1962 (Pretoria: Government Printer, 1962), 119. Hereafter, ‘Snyman Commission’.
104 Snyman Commission, 108.
105 Ibid., 116.
106 Ibid., Annexure 25: ‘Multiplicity of Preparations’, 224.
107 Ibid., 116.
108 Ibid., 60.
109 Ibid., 60–61.
110 Ibid., 61.
111 Editorial, South African Journal of Obstetrics and Gynaecology, 11, 1 (1973), 1.
112 Finkelstein interview.
113 Ibid.
114 Sarah Jensen, ‘The Tragic Fallout of the “Black Bombs”’, Fair Lady, 9 August 1967.
115 Ibid.
116 ‘What Cure for Drug Hysteria?’, Management (Johannesburg: Adcock-Ingram [Chemists] Group Ltd, 1973), 36.
117 W.J. Steenkamp (chairman), Commission of Inquiry into the Pharmaceutical Industry, RP 38/1978 (Pretoria: Government Printer, 1978), ‘Table 3.3. Competitors in the Therapeutic Submarket’, 9 (known as ‘Steenkamp Commission’).
118 Steenkamp Commission, ‘Code List A: Leading Pharmaceutical Products’, 76.
119 Steenkamp Commission, ‘Code List B: Active Ingredients – Top 100 Products’, 77.
120 The term was used at the time: see Steenkamp Commission, 3.
121 I. Truter, ‘Prescribing of Meprobamate-containing Analgesics in South Africa’, South African Family Practice, 58, 6 (2016), 207–212.
122 Grubbs, ‘Workshop of a Continent’, 407.
123 Statsinform (Pty) Ltd, A Survey of the Pharmaceutical Trade and Industry in South Africa, 2 (Johannesburg: Netherlands Bank of South Africa Ltd, 1969), 16.
124 R.S. Summers, ‘Training the Bantu [sic] in Pharmacy’, SAPJ, 35, 7 (1969), 13 and 22.
125 It was, for example, with the support of white apartheid era law-makers, representing their white constituents, that in the same year that the Pharmacy Act (no. 53) of 1974 cemented separation of the regulation of the medical and the pharmaceutical professions, homeopathy and naturopathy (each epistemologically distinct from pharmacology) were formally recognised under the ‘Homeopaths, Naturopaths, Osteopaths and Herbalists Act (no. 52) of 1974’. For dissension on the ‘scientific’ basis of homeopathy and naturopathy, see Hansard, 53, 13 September 1974, 2913–2935. For a broad outline of pharmaceutical politics in the 1960s and 1970s, see Goyns, Pharmacy in the Transvaal, 70–94.
126 The state was an important purchaser of the major tranquillisers, with black psychiatric patients usually recipients of the cheaper, less well-tested drugs. See T. Jones, Psychiatry, Mental Institutions and the Mad in Apartheid South Africa (New York: Routledge, 2014 [2012]), 166–167.
127 Steenkamp Commission, 60.
128 ‘Medigesic: The safe, traditional, defence against pain…’, advertisement by Nattermann South Africa (Pty) Ltd, SAPJ, 46–47, 12 (1980), 373.