Changes in pharmaceutical market and "fake drug" problem in the Qing period.

Since ancient times, fake drugs have been on the market in Chinese society. However, during the Ming-Qing Dynasty, this problem intensified as the size of the pharmaceutical market grew, the collection and distribution structure of pharmaceutical products became increasingly complex, and the phenomenon of separation between the prescription and distribution of drugs advanced. Additionally, the government did not manage the manufacturing or quality of drugs and there was no law or institution designed to solve the problem of fake drugs. Furthermore, social opinion also criticized the widespread problem of fake drugs, and patients and doctors had to rely on various pharmacognostic books and medical knowledge to find reliable drugs in the drug market. Meanwhile, as merchants participated and invested commercial capital in the pharmaceutical industry, large reputable pharmacies began to emerge in large cities and produced drugs. With the commercialization of the pharmaceutical market, the public gained interest in drugs and consumed drugs produced by these pharmacies. Moreover, there were frequent problems in the market as fake drugs imitating popular drugs were distributed and the names of famous pharmacies were stolen. Although fake drugs were a universal social problem, the Qing government was reluctant to strictly control them tried to solve this issue by enforcing banning and punishment through local governments. Prominent pharmacies filed several lawsuits against the government over the theft of fake drugs and drug names. They also advertised the legitimacy and authenticity of drugstore to the public and customers. Doctors and merchants responded to the problem of fake drugs by following occupational morality, developing drug discrimination, cracking down on organizational discipline, filing complaints with government offices, and advertising their authenticity. However, the fake medicines did not easily disappear despite such a response, as there was no state control or legislation. Evidently, the pharmaceutical market was already highly commercialized and its structure were complex. Moreover, the financial benefits of fake drugs, competition in the pharmaceutical market, and public demand for drugs with similar effects at low prices also affected the popularity of fake drugs. Hence, the distribution of fake medicine in the Qing society can be seen as a phenomenon of separation between the prescription and distribution of drugs, commercialization and consumption of drugs, and competition on the medical market.