Secret, owned, Georgian medicines were normally known as patent medicines, though few had a current patent. Up to 1830, just 117 medicines had been patented, whilst over 1,300 were listed for taxation as ‘patent medicines’. What were the benefits of patenting? Did medicine patenting affect consumer perception, and how was this used as a marketing tool? What were the boundaries of medical patenting? Patents for therapeutic preparations provided an apparent government guarantee on the source and composition of widely available products, while the patenting of medical devices seems to have been used to grant a temporary monopoly for the inventor's benefit.

The origins of contemporary exclusion of surgical methods from patenting lie in the complexities of managing credit claims in operative surgery, recognized in the nineteenth century. While surgical methods were not deemed patentable, surgeons were nevertheless embedded within patent culture. In an atmosphere of heightened awareness about the importance of ‘inventors’, how surgeons should be recognized and rewarded for their inventions was an important question. I examine an episode during the 1840s which seemed to concretize the inapplicability of patents to surgical practice, before looking at alternatives to patenting, used by surgeons to gain social and financial credit for inventions.

The attitudes of physicians and drug manufacturers in the US toward patenting pharmaceuticals changed dramatically from the mid-nineteenth century to the mid-twentieth. Formerly, physicians and reputable manufacturers argued that pharmaceutical patents prioritized profit over the advancement of medical science. Reputable manufactures refused to patent their goods and most physicians shunned patented products. However, moving into the early twentieth century, physicians and drug manufacturers grew increasingly comfortable with the idea of pharmaceutical patents. In 1912, for example, the American Medical Association dropped the prohibition on physicians holding medical patents. Shifts in wider patenting cultures therefore transformed the ethical sensibilities of physicians.

From the late nineteenth century onwards there emerged an increasingly diverse response to escalating patenting activity. Inventors were generally supportive of legislation that made patenting more accessible, while others, especially manufacturers, saw patenting culture as an impediment. The medical profession claimed that patenting represented ‘a barrier to medical treatment’ and was thus detrimental to the nation's health, yet, as I argue, the profession's development of strict codes of conduct forbidding practitioners from patenting resulted in rebellion from some members, who increasingly sought protection for their inventions. Such polarized opinions within the medical trade continue to affect current medical practice today.

Despite its prominent position in today's medical research, popular culture and everyday life, cancer's history is relatively unwritten. Compared to the other great ‘plagues’ – cholera, tuberculosis or tropical fevers, to name but a scant handful – cancer has few dedicated pages in the general surveys, and its specialists have largely failed to convince the broader community of medical historians – or indeed historians of anything at all – that histories of the disease can tell us fundamental things about the science and practice of medicine, both past and present. Moreover, cancer has a remarkably stable profile over time, at least in terms of its definition, language and terminology – a detail that only makes the disease's absence from historical literature more surprising.