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Filled with pills or potions, the bulky pharmacist’s bag will come for us all

For many men, the first regular prescription can be a shocking sign of increasing vulnerability

Men tend to come to pills quite late in life. For our first 50 or 60 years, what has a chemist’s shop meant to us? Toothpaste, shampoo, Calpol when the kids were small (or even, in our own impossibly distant youth, an attractive drawer marked “Liquorice”). Certainly, we’ve been aware of another kind of man in the queue – a shakier-looking or more breathless-sounding man, perhaps leaning on a stick or sitting on a chair opposite the pharmacy counter where an assistant in a white coat is about to deliver him a bulky paper bag with words such as: “Here you are, Mr Mackenzie, that’ll last you ’til next month.” But what were such men to us, who wanted only Euthymol? Then suddenly one day we are … not that other kind of man, not exactly, not yet, but certainly more aware that becoming that other kind of man isn’t so impossible.

A bulky paper bag with a prescription form attached awaits us. The pills have begun. To women, a regime of pills may be no big deal in a life that may have been governed since the age of 16 by the contraceptive pill; and women, to risk a generalisation, are less alarmist about medicine. But to many men, pills are a sign of vulnerability – sometimes the first sign. Cholesterol, hypertension, type-two diabetes: our 50-year-old selves were hardly aware of the prospect of them. And now 10 and more years later they come marching towards us with their little warning banners about heart attacks, a risk to be moderated by an unending commitment to pills.

The Wellcome Gallery at the British Museum has an exhibit that tries to dramatise the size of this commitment. Inside a 13-metre-long display case are stretched two lengths of fabric, each length incorporating tiny pockets of nylon filament containing a capsule or pill. One length shows the estimated average number of drugs prescribed to men in Britain over their lifetime, while the other length does the same for women. So far as one can tell, the number is roughly the same in each case: 14,000 individual pieces. But while the representative woman in the display is alive and still taking her prescription aged 82, her representative male partner has died aged 76 of a stroke, having taken as many pills in the last 10 years of his life as he did in his first 66. One morning this week, as I soberly read these details, a party of French schoolchildren swept past the exhibit in high spirits – was this some art by the famous Monsieur ‘Irst? – as unaware as children should be of what chemicals lie in store for them.

It might be as well to see the display as art, rather than as an accurate guide to contemporary life, because it dates from 2003 and Britain’s consumption of medicines hasn’t stopped climbing since. Between 2000 and 2010, the number of prescriptions, excluding those issued by hospitals, rose by 70% in England, with most of the increase attributed to drugs that can prevent heart disease. Some studies suggest that as many as one in three people aged over 40 take statins, which are intended to lower cholesterol, while prescriptions of all kinds issued to people over 60 almost doubled in the decade up to 2007, from 22 to 42 items per year per head.

Almost all of these comprise what we think of as pills, with only the scientifically discerning or religious distinguishing the capsule as a separate kind of dosage form (the casing, made from animal gelatine, can present a problem for orthodox Hindus, Muslims and Jews). Pills were at one time simply one delivery system among many. Tinctures, pastilles, lozenges, emulsions, ointments, cachets, inhalations, injections, plasters, enemas, bougies, suppositories: pills may not have supplanted all of them (the suppository tunnels on in France), but they began to dominate medicine in the first half of the last century when potent new drugs meant that dosages needed to be much more accurate. The answer, in fact, wasn’t the pill – pills were spherical, artisanal objects mixed by mortar and pestle, whose active ingredients were protected behind layers of varnish and sugar. The answer was a new kind of tablet, produced under compression from powder, that had began to pour from the rotary presses of pharmaceutical factories in Europe and North America. The difference between pills and tablets had never been made clear to the public, however, and was muddled forever when the contraceptive tablet became known as The Pill.

The Wellcome Library, with its remarkable medical collection, is an appropriate place to untangle this history, because its founders, the pharmaceutical company Burroughs Wellcome, took a lead in compressed tablet production in Britain in the 1880s. Seeking a “fancy” and meaningless word as a trademark for the product, they hit on “tabloid”. The word became a rage. Burroughs Wellcome extended it from tablets to many other products – The Tabloid Hypodermic, The Tabloid Laxative Fruit Pastille – and considered the possibility of Tabloid Tea, which would have used the same compression technique to manufacture the late Victorian equivalent of the tea bag. Any suspected infringement of copyright was vigorously pursued. In 1904 an American newspaper advertised Dr Conway’s Bust Tabloids (‘Enlarge your bust ladies, four to ten inches … at trifling cost’), but Burroughs Wellcome were quickly on the case and Dr Conway’s products were never heard of again.

And then, after all this zealous regard, the company lost interest in its trademark, allowing later generations to think of it as a dubious kind of compressed newspaper. Many stranger names came out of the Victorian age and lived longer. Oxo, of course, and Bovril and Virol, but also Bile Beans, Singleton’s Golden Eye Ointment, Carter’s Little Liver Pills and Dr William’s Pink Pills for Pale People. Patent and proprietary medicines were among the earliest brands – some dated back to the 17th century – and effective advertising was usually the key to their success. Pink Pills for Pale People, originally a Canadian product, swept Britain in the 1890s after a campaign in which 5m pamphlets were distributed and ads taken out in 200 weekly newspapers. Pink Pills promised to cure anaemia, bronchitis, sciatica, St Vitus’ Dance and the condition known starkly as Decline. They promised less as the years went on, but survived in the darker corners of pharmacies into the 1970s.

My pills are almost certainly more efficacious, but boast about it much less. A legal wariness, possibly. Every week I count them into their daily compartments. A blue and white capsule, a yellow and white capsule, a couple of vitamin supplements, four small white pills of the same kind, a slightly larger white pill of a different kind, and only on Mondays a torpedo-shaped pill which demands that the taker stays upright for half an hour after swallowing, as though it might fall out otherwise. Touch wood, some of these pills can be given up soon, though not all of them will be. There are conditions that need, in that business-like word, to be “managed”. © 2012 Guardian News and Media Limited or its affiliated companies. All rights reserved. | Use of this content is subject to our Terms & Conditions | More Feeds