Aprovel (hypertension) “Approval is what you get when you get it right”
This image transports the (UK) reader to an exotic location (). Clear blue sky and calm sea denote a high pressure warm front, suggesting hypertension. The pool's edge divides nature and culture; unbroken surface tension signifying containment and control in contrast to the ocean's unbridled force. The man seems to belong to nature, the woman to culture (beauty and the beast?). Legs hooked over the board, he hangs apishly, body massively contracted, even his extremities. This suggests an association between hypertension and inversion: both increase blood pressure in the brain, neither should be maintained for long. The athletic stunt, like the medical condition, seeks attention, which comes as a kiss of approval (or Aprovel).
Aprovel: “Approval is what you get when you get it right”
The woman is also quite taut. Her grip on the pool rim shows she is not lifting herself up but apparently resisting an uplifting force. This is another allusion to surface tension: if you imagine the board dipping into the pool and slowly lifting out, the kissing couple represent a droplet that clings and stretches between board and surface until it breaks. The kiss is a tension, joining and separating two bodies. It marries natural impulse to its acculturated expression, passion and institution, mediating between nature wild and uncontrolled (untreated hypertension) and nature tamed and pacified (medicated). The man personifies hypertension, the woman Aprovel. An explicit association between Aprovel and hypertension is linked to a series of parallel tensions: atmospheric, postural, muscular, surface, sexual. Each is paired with an appropriate response: for hot weather, bathing; for inversion, reversion; for contraction, relaxation; for a perturbed ocean, the swimming pool; for man, woman; for nature, culture; for hypertension, Aprovel. The advert naturalises an association between Aprovel and hypertension by implying their membership of an order of natural couplings. It is a sophisticated version of a generic advertising myth: for indication Y, drug X is the natural choice.
Symbicort (asthma) “Adjustable maintenance therapy. You've got it in one”
Grotesquely distorted into a mnemonic S, Symbicort snake woman embodies an alliterative, sibilant association between Symbicort, snake, sex, and other provocative S-words (symbol, stretch, slither, sensual, slave, suck, etc) (). The image signifies a graduated scale (“Symbicort's maintenance dose can be adjusted up and down”). Aggressive colours repeat the brand name and suggest eroticism. Red cocktail dress and lipstick, long black gloves and shoes, hair swept back and roguishly un-brushed. She is sensuous and monstrous; woman metamorphosing to reptile; a hybrid symbol of disease and sex.
Symbicort: “Adjustable maintenance therapy. You've got it in one”
Evoking Plato's pharmakon, signifying both remedy and poison,16
snake woman signifies therapy and disease; she soothes and constricts. The palm trunk signifies a trachea, she its constricting inflammation—the physiology of asthma. Her feet are rooted in the ground, legs splayed like vine stems (poison ivy?). These further confuse the erotic and pathological. Redness signifies inflammation of lust and immune response. She entwines a phallus, stroking its shaft, head inclined, lips parted—and simultaneously strangles her lover.
The image also invokes the caduceus—snake entwined staff, symbol of Aesculapius, Greco-Roman god of medicine, and carried by Mercury. Linked to the underworld, the snake is a mediator between one way of life and another. The caduceus symbolises medicine as mediator between illness and recovery. The explicit myth is about changing the way we conceive a disease and its treatment. It is underpinned by a more remarkable transformation of woman and snake that can hold the reader's gaze, fascinated by the sight of a sensuous woman and boa constrictor becoming one another.
Taxotere (cancer) “Leading the fight against advanced breast cancer”
An industry award winner in 2001, this example () prompted debate in the BMJ
about what some saw as inappropriate eroticism.17
It is a tableau of Delacroix's Liberty Leading the People
(). Pink silk flags substitute for sabres, muskets, pistols, and tricolour in the original painting to evoke the pink ribbons of the (drug industry sponsored) breast cancer awareness campaign. It implies that commitment and belief are more important than blades and bullets in the fight against breast cancer, a message simplified by removing the naked and dead littering the foreground of original.
Taxotere: “Leading the fight against advanced breast cancer”
Liberty Leading the People by Eugène Delacroix, 1830, in the Musée du Louvre, Paris
A triumphant woman lofts her flag, her fine dress pulled down, revealing her breasts. An armpit, site of lymph nodes involved in metastasis, is exhibited. She is strong and beautiful, but her eroticism is restrained, her nipples toned down, their paleness an attenuated sign of disease. Baring her breasts suggest a political statement about divesting the shame and secrecy associated with breast cancer.
The revolutionary stance echoes positions adopted during clinical examinations. Her impassive face and sideways glance recall the blank expression and posture of one undergoing mammography. An association is made between gazing at art and medical images. Her muscular foot is planted on rock (solid symbol of medical progress), and her expression is dignified in adversity. The inspirational theme is reinforced by a defeated woman kneeling at her feet, drawing strength from Liberty “Leading the fight against advanced breast cancer.” The battle metaphor for cancer has been discussed extensively.18
Treatment for advanced breast cancer can give mothers a few extra months to spend with young children. Beside Liberty a boy, figure of pathos, echoes her posture and waves his small flag. He signifies the hopes of mothers and their children affected by breast cancer and its impact on families. The top-hatted woman (a man in the original painting) is ambiguous, perhaps signifying a male or female partner, but also an institutional revolution, overthrowing outmoded attitudes that some may associate with the ancien régime of a male dominated medical establishment, and an ascendance of feminine values and patient advocacy in cancer care. A hackneyed theme, victory against cancer, but beautifully executed and interwoven with a modern mythology of patient advocacy, both having at least a tenuous foothold in the recent history of the disease. They in turn are associated with a mythology of liberation from oppression, an age of reason and democracy, the French Revolution and the start of the Enlightenment.
Advertising in medical journals provides a privileged channel of communication between the pharmaceutical industry and clinicians
A critical study of imagery employed in drug adverts reveals it to be one the most powerful weapons of drug promotion
Drug advertising uses strong imagery to fabricate mythical associations between medical conditions and branded drugs
Drug advertising manipulates readers' perceptions by subtle appeal to ancient and modern mythological foundations of humanism and Western psychology
Clinicians claiming immunity to drug advertising greatly underestimate some advertising agencies, whose skill they should respect as comparable to their own