The English Apothecaries.
Although the Grocers were the recognised drug dealers of this country, apothecaries who were associated in their Guild were also recognised. Some authorities name Richard Fitznigel as apothecary to Henry II before he was made Bishop of London. But this evidence cannot be trusted. The first definite allusion to an apothecary in England occurs in 1345, when Edward III granted a pension of sixpence a day for life to Coursus de Gangeland, an apothecary of London, in recognition of his services in attending on the king during his illness in Scotland. The record of this grant is found in Rymer’s “Foedera,” which was not published until 1704, but Rymer was historiographer royal, appointed by William III, and his work was a compilation from official archives. An earlier mention of an apothecary is found in the Scottish Exchequer Rolls wherein it appears that on the death of Robert the Bruce, in 1329, payments were made to John the Apothecary, presumably for materials for embalming the king’s body. Dr. J. Mason Good, who wrote a “History of Medicine, so far as it relates to the Profession of the Apothecary,” in 1795, mentions, on the authority of Regner, that J. de Falcand de Luca publicly vended medicines in London in 1357, while Freind (“History of Medicine,” 1725) states that Pierre de Montpellier was appointed Apothecary to Edward III in 1360.
It is clear, therefore, that the apothecary was a familiar professional personage in England five hundred years ago. Conclusive evidence of his practice is given by Chaucer, who, in the Prologue to the “Canterbury Tales” (written in the last quarter of the fourteenth century), describing a “Doctour of Phisike” says—
Ful reddy hadde he his apothecaries
To send him dragges and his lettuaries
For eche of hem made other for to Winne.
The satirical suggestion of the mutual obligations of physicians and apothecaries has been familiar for all these centuries.
It seems certain that in Henry VIII’s reign the apothecaries were doing a considerable amount of medical practice, besides selling drugs. The Act of 1511 incorporating the College of Physicians and giving them the exclusive right to practise physic in London and for seven miles round, was largely used, if not intended, against apothecaries. In 1542, however, an Act was passed which rather modified the severe restrictions of the original statute, and under the new law apothecaries became more aggressive. In Mary’s reign the Physicians again got the legislative advantage, and there is a record in the archives of the College of Physicians (preserved by Dr. Goodall, who wrote “A History of the Proceedings of the College against Empiricks,” in 1684) stating that in Queen Elizabeth’s reign the President and Censors of the College summoned the Wardens of the Grocers’ Company and all the apothecaries of London and the suburbs to appear before them, “and enjoyned them that when they made a dispensation of medicine they should expose their several ingredients (of which they were composed) to open view in their shops for six or eight days that so the physicians passing by might judge of the goodness of them, and prevent their buying or selling any corrupt or decayed medicines.” The grocers and apothecaries do not appear to have raised any objection to this decree. Whether they obeyed it or not is not stated.
Incorporation of the Apothecaries.
The first Charter of Incorporation was granted to the apothecaries by James I in 1606, but this did not separate them from their old foes, the grocers. They continued their efforts, however, and with the aid of friends at Court they obtained a new Charter in 1617, which gave them an entirely independent existence as a City Guild under the title of the Society of the Apothecaries. This is the only London guild which has from its incorporation to the present time admitted only actual apothecaries to its fraternity.
Another peculiarity claimed by one of the Company’s historians (Dr. J. Corfe: “The Apothecary”) is that the Guild of Apothecaries is the only City Company which is called a Society. He believes that this may be attributed to the supposed fact that the corporation was modelled on a similar association founded at Naples in 1540 under the name of Societa Scientifica.
Sir Theodore Mayerne.
The original painting by Rubens, of which the above is a copy, was in the collection of Dr. Mead, and was sold in 1754 for £115. It passed into the possession of the Earl of Bessborough and the Marquis of Lansdowne, and then through the hands of some dealers, and in 1848 was bought by the Royal College of Physicians for £33 12s.
Sir Theodore de Mayerne, the King’s first physician, and Gideon de Laune, pharmacien or apothecary to the Queen, Anne of Denmark, were the supporters of the apothecaries in rescuing them from the control of the grocers. Both of these men deserve honourable mention in the chronicles of British pharmacy. It happens that both were of foreign origin and of the Protestant faith, two of that eminent crowd of immigrants of high principle and distinguished ability who served England so well in the seventeenth century when they found themselves “not wanted” in France.
Mayerne was a Swiss by birth, but a Frenchman by education and adoption, and had been physician to Henri IV. But he incurred the bitter animosity of the Paris Faculty, led by the fanatic Gui Patin, partly on account of his religious heresy, and partly because he prescribed chemical medicines. By a unanimous vote the Paris College of Physicians resolved in 1603 that he must not be met by any of its members in consultation. He continued, however, to practise in Paris until an English peer whom he had treated took him to London and introduced him to James I, who made him physician to the Queen. Mayerne, however, soon returned to Paris, but in 1611 he settled in London on the invitation of the King, who made him his first physician. He had a great deal to do with the compilation of the first London Pharmacopœia, and is reputed to have introduced calomel and black wash into medical practice. Subsequently he was appointed physician to Charles I and Queen Henriette, but after the execution of the King he retired into private life, and though nominally physician to Charles II he never practised at that Court. He died at Chelsea in 1665.
Gideon de Laune was also a man of considerable influence. Dr. Corfe regards him as almost the founder of the Society of Apothecaries, but Mr. Barrett, who recently wrote a history of that Society, suggests that he could not have been so much thought of by his contemporaries, as he was only elected to the Mastership some years after the Charter had been granted, and then only after a contest. At any rate the apothecaries must have largely owed the Charter to his influence. He lived in Blackfriars and called himself a “Pharmacopœius,” but we also read of him as an importer of drugs, and it is probable that he traded as a merchant. That he was a man of position is evident from the fact that on one occasion he fetched the Queen, Anne of Denmark, from Norway.
Gideon de Laune was born at Rheims in 1565, and was brought to England as a boy by his father, who was a Protestant pastor. A Nonconformist writer of the same surname who got into trouble in the reigns of Charles II and James II, and was befriended by De Foe, referring to Gideon as a relative, says of him that when he died at the age of 97 he had near as many thousands of pounds as he had years; that he had thirty-seven children by one wife; and that his funeral was attended by sixty grandchildren. It has been ascertained, however, that his children only numbered seventeen, and that he died at the age of 94; so that the later De Laune who wrote in 1681 cannot be implicitly relied upon when figures are concerned. Another thing he tells us of Gideon is that “his famous pill is in great request to this day notwithstanding the swarms of pretenders to pill-making.”
The Grocers’ Company warmly resented the secession of the apothecaries who had been their subordinate partners so long, but their formal petition of complaint called forth a cruel snub from the King. Grocers were but merchants, said James, the business of the apothecaries was a mystery; “Wherefore I think it fitting they should be a corporation of themselves.” The grocers, however, got some of their own back a few years later when James demanded a subsidy from the city for the relief of the Palatinate. The grocers and the apothecaries were assessed at £500 between them. Towards this the apothecaries, pleading poverty, offered £20. The grocers ridiculed this offer, and having paid £300 as their share, left their old associates to find the other £200, which they had to do somehow.
About the same time the new corporation vigorously opposed an application for a Charter made by the distillers of London. The grocers supported the distillers, and the apothecaries failed in their opposition. Sir Theodore Mayerne told them that their monopoly of distillation was only intended to extend to the distillation of medicinal spirits and waters. Mr. Barrett quotes from the old records another curious instance of the contest for monopolies which was characteristic of the period. In 1620, one John Woolf Rumbler having obtained from the King a concession of the sole right of making “mercuric sublimate,” applied to the Court of Apothecaries that he might enjoy the same without their contradiction. This “upon advised consideration,” the Court refused to grant. It is not stated whether the will of the King or that of the apothecaries prevailed in the end.
The story of the jealousies which arose between the physicians and the apothecaries is a long and tedious one; innumerable pamphlets were written on both sides of the controversy, and the dispute figures in English literature of the seventeenth and eighteenth centuries. Pope very neatly expressed the views of the physicians in the familiar verse in the “Essay on Criticism” in which, comparing the old critics of Greece who “fanned the poet’s fire, And taught the world with reason to admire,” with those of his own day who
Against the poets their own arms they turned
Sure to hate most the men from whom they learn’d,
illustrated the position by introducing the
Modern pothecaries, taught the art
By doctors’ bills to play the doctors’ part,
Bold in the practice of mistaken rules,
Prescribe, apply, and call their masters fools.
This was written in 1709.
The apothecaries strengthened their position as medical practitioners in the public esteem by remaining at their posts during the Great Plague in London in 1665 when most of the physicians fled from the stricken city. Between this date and the end of the seventeenth century the quarrel between the two sections of the profession constantly grew in bitterness. Some of the allegations of extortion made against the apothecaries are almost incredible. In Dr. Goodall’s “Historical Account of the Proceedings of the Royal College of Physicians against Empiricks and Unlicensed Practisers” (1684), it is reported that George Buller who gave the college some trouble in 1633 had charged 30s. each for 25 pills; £37 10s. for the boxful. Three were given to a Mrs. Style for a sore leg, and she died the same night. A Dr. Tenant prosecuted by the college in James I’s reign “was so impudent and unconscionable in the rating of his medicines that he charged £6 for one pill and the same for an apozeme.”
Dr. R. Pitt, F.R.S., in “Crafts and Frauds of Physic Exposed,” 1703 (a book written expressly to defend the establishment of dispensaries by the Physicians), states that apothecaries had been known to make £150 out of a single case, and that in a recent instance (which had apparently come before the law courts) the apothecary had made £320. In every bill of £100 Dr. Pitt says the charges were £90 more than the shop prices for the medicine.
In Jacob Bell’s “Historical Sketch of the Progress of Pharmacy in Great Britain” an apothecary’s bill for medicines for one day, supplied to a Mr. Dalby of Ludgate Hill, is quoted from a pamphlet called “The Wisdom of the Nation is Foolishness.” It is as follows:
An Emulsion, 4s. 6d. A Mucilage, 3s. 4d. Gelly of Hartshorn, 4s. Plaster to dress Blister, 1s. An Emollient Glister, 2s. 6d. An ivory pipe, armed 1s. A Cordial Bolus, 2s. 6d. The same again, 2s. 6d. A cordial draught, 2s. 4d. The same again, 2s. 4d. Another bolus, 2s. 6d. Another draught, 2s. 4d. A glass of cordial spirits, 3s. 6d. Blistering plaster to the arm, 5s. The same to the wrists, 5s. Two boluses again, 5s. Two draughts again, 4s. 8d. Another emulsion, 4s. 6d. Another pearl julep, 4s. 6d.
Mr. Dalby’s bill for five days came to £17 2s. 10d., and this was declared to be not an isolated case but illustrative of the practice of apothecaries when attending patients of the higher classes.
Contest between the Physicians and Apothecaries.
In 1687 the College of Physicians adopted a resolution binding all Fellows, Candidates, and Licentiates of the College to give advice gratis to their neighbouring sick poor when desired within the city of London or seven miles round. But in view of the gross extortions of the apothecaries it was asked, What was the use of the physicians’ charity if the cost of compounding the medicines was to be prohibitory? The apothecaries, of course, denied that the examples of their charges which were quoted were at all general, and probably they were not. It was not to the interest of the apothecaries to destroy free prescribing. Indeed a proposal was made to the physicians on behalf of a numerous body of London apothecaries to accept a tariff for medicines dispensed for the poor to be fixed by the physicians themselves.
The relations of the two bodies had become, however, so strained that arrangement was no longer possible. The apothecaries had in fact obtained the upper hand. They treated many cases themselves, and calling in the physician was largely within their discretion. At this time (about 1700) the ordinary fee paid to a physician was 10s. University graduates expected more, but they too, in the majority of cases, were only too glad to take the half sovereign, and it was alleged that they would sometimes pay the apothecary who called them a percentage off this.
Such was the condition of affairs when in 1696 an influential section of the physicians, fifty-three of them, associated themselves in the establishment of Dispensaries, where medicines should be compounded and supplied to the poor at cost price. The fifty-three subscribed ten pounds each, and Dispensaries were opened at the College premises in Warwick Lane, in St. Martin’s Lane, and St. Peter’s Alley, Cornhill.
Needless to say, the war now waxed fiercer than ever. The physicians were divided among themselves, and the anti-dispensarians refused to meet the dispensarians in consultation. The apothecaries naturally recommended the anti-dispensarians to their patients, and consequently it was only the independent ones who could afford to maintain the struggle. Scurrilous pamphlets were written on both sides, and one long poem, Garth’s Dispensary, which was less venomous than most of the literature on the subject, but which as a poem had no merits which could justify the reputation it attained, complicated the struggle from the physicians’ point of view. Johnson says that in addition to its intrinsic merit it “co-operated with passions and prejudices then prevalent.” His sympathies are indicated by his remark that “it was on the side of charity against the intrigues of interest, and of regular learning against licentious usurpation of medical authority.” One line in the book (the last in the passage quoted below) has attained currency in the English language. Expressing satirically the complaints of the apothecaries, Garth says:
Our manufactures now the doctors sell,
And their intrinsic value meanly tell;
Nay, they discover too (their spite is such)
That health, than crowns more valued, costs not much;
Whilst we must shape our conduct by these rules,
To cheat as tradesmen or to fail as fools.
The Apothecaries Win.
Notwithstanding the sympathy of Dr. Johnson, Pope, and many other famous contemporaries, the quarrel ended in the comparative triumph of the apothecaries.
The physicians, though reluctant to enforce what they believed to be their statutory powers, were goaded into law, and at last brought an action against a London apothecary named William Rose, who they alleged had infringed the Act passed in the reign of Henry VIII. Rose had attended a butcher in St. Martin’s-in-the-Fields named Seale, and had administered “proper medicines” to him. He had no licence from the Faculty, and in his treatment of Seale had not acted under the direction of any physician. He had neither taken nor demanded any fee for his advice.
Those were the facts found by the jury who first heard the case. The College claimed a penalty of five pounds per month for the period during which Rose had thus practised. The Charter granted to the physicians in the tenth year of Henry VIII, and confirmed by an Act of Parliament passed in the fourteenth and fifteenth year of that reign, contained a clause forbidding any person not admitted by the College to practise the faculty of medicine in London or within seven miles thereof under a penalty of one hundred solidi for every month during which he should thus infringe the law.
The jury having found the facts already quoted, referred to the Court of Queen’s Bench the legal question whether the acts performed constituted the practice of medicine within the meaning of the Act. The case was argued three times in the Court of Queen’s Bench—(so it is stated in the report of the proceedings in the House of Lords),—and ultimately the judges decided unanimously in favour of the contention of the College. Thereupon, on behalf of Rose a writ of error was moved for in the House of Lords demanding a reversal of the judgment. The counsel who argued the appeal were S. Dodd for Rose, and F. Brown for the College. The case was heard on the 15th of March, 1703.
In support of the appeal it was argued that if the judgment were allowed to stand it would ruin not only Rose but all other apothecaries. That the Act was a very old one, and that the constant usage and practice ought to be taken into account. That if this judgment were right the apothecary would not dare to sell a few lozenges or a little electuary to any person asking for a remedy for a cold, or in other common cases where a medicine had a known and certain effect. That to give a monopoly in the treatment of disease to physicians would have most mischievous consequences; both rich and poor would be seriously taxed, and in the case of sudden accidents or illnesses in the night when apothecaries were so frequently sent for, the danger of not permitting them to supply the necessary medicine might often be most serious.
To these contentions the counsel for the College replied that by several orders physicians had bound themselves to attend the poor free, either at their own offices, or, if sent for, at the patient’s house. That out of consideration for the poor they had gone further by establishing Dispensaries where the medicines they prescribed could be obtained at not more than one-third of the price which the apothecaries had been in the habit of charging. That in sudden emergencies an apothecary or anyone else was justified in doing his best to relieve his neighbours, but that in London, at least, a skilled physician was as available as an apothecary, and that this emergency argument ought not to be used to permit apothecaries to undertake all sorts of serious diseases at their leisure. That there was nothing to prevent apothecaries selling whatever medicines they were asked for, but that to permit them to treat cases however slight involved both danger and expense, because a mistake made at the beginning of a distemper might lead to a long illness, and in any case the apothecary would charge for much more medicine than was necessary.
After hearing the arguments “it was ordered and adjudged that the judgment given in the Court of Queen’s Bench be reversed.”
The Apothecaries and the Chemists and Druggists.
From this period the apothecaries became recognised medical practitioners, the Society granted medical diplomas, and a hundred years later (1815) they obtained an Act which gave them powers against other persons similar to those which the physicians thought they possessed against them. Persons not qualified by them were forbidden to “act or practise as apothecaries” under a penalty of £20; and the courts have held that to practise as an apothecary is to judge of internal disease by symptoms, and to supply medicine to cure that disease. The chemists and druggists who had largely succeeded to the old business of the apothecaries opposed this provision, and the apothecaries, to buy off their opposition, offered to insert a clause in their Act which would allow all persons who should at that time or thereafter carry on that business to do so “as fully and amply to all intents and purposes as they might have done in case this Act had not been made.” The chemists were not content with this provision, and drafted another which defined their business as consisting in the “buying, preparing, compounding, dispensing and vending drugs, and medicinal compounds, wholesale and retail.” The apothecaries accepted this alteration, and subsequently obtained penalties from chemists who had prescribed remedies for customers. Such prescribing would have been legal if the druggists had accepted the provision proposed by the apothecaries; but they had limited themselves out of it. In the actions which the Society of Apothecaries have brought against chemists the apothecaries have often reproduced with scrupulous fidelity the arguments used against themselves by the physicians in Rose’s case.
The Dispensaries established by the physicians were not long maintained, but apparently they provided the material of the modern chemist and druggist. “We have reason to believe,” writes Jacob Bell in his Historical Sketch of the Progress of Pharmacy in Great Britain, “that the Assistants employed and instructed by the Physicians at these institutions became dispensing chemists on their own account; and that some of the apothecaries who found their craft in danger followed the example, from which source we may date the origin of the chemists and druggists.”
In the course of the eighteenth century chemists and druggists had to a large extent replaced apothecaries as keepers of shops where medicines were sold and dispensed, and even when the businesses were owned by apothecaries, they usually styled themselves chemists and druggists. In the year 1841 an attempt was made to get a Bill through Parliament which would have made it penal to recommend any medicine for the sake of gain. The Bill was introduced by a Mr. Hawes, and the chemists and druggists of London opposed it with such vigour that it was ultimately withdrawn. In order to be prepared against future attacks the victorious chemists and druggists then formed the Pharmaceutical Society of Great Britain, which was incorporated by Royal Charter in 1842. An Act protecting the title of pharmaceutical chemist was passed in 1852, and in 1868 another Act, requiring all future chemists and druggists to pass examinations and be registered, and restricting to them the sale of poisons, became law.
IX
MAGIC AND MEDICINE
“Amulets and things to be borne about I find prescribed, taxed by some, approved by others. Look for them in Mizaldus, Porta, Albertus, etc. A ring made with the hoof of an ass’s right forefoot, carried about, etc. I say, with Renodeus, they are not altogether to be rejected. Piony doth help epilepsies. Pretious stones most diseases. A wolf’s dung carried about helps the cholick. A spider an ague, etc. Such medicines are to be exploded that consist of words, characters, spells, and charms, which can do no good at all, but out of a strong conceit, as Pomponatious proves, or the devil’s policy, that is the first founder and teacher of them.”
Burton: “Anatomy of Melancholy.”
Charms, enchantments, amulets, incantations, talismans, phylacteries, and all the armoury of witchcraft and magic have been intimately mixed up with pharmacy and medicine in all countries and in all ages. The degradation of the Greek term pharmakeia from its original meaning of the art of preparing medicine to sorcery and poisoning is evidence of the prevalence of debasing superstitions in the practice of medicine among the cultivated Greeks. Hermes the Egyptian, Zoroaster the Persian, and Solomon the Hebrew were famous among the early practitioners and teachers of magic. These names served to conjure with. Those who bore them were probably wise men above the average who were above such tricks as were attributed to them. But it suited the purpose or the business of those who made their living out of the superstitions of the people to pretend to trace their practices to universally revered heroes of a dim past.
Not that the whole of the magical rites associated with the art of healing were based on conscious fraud. The beliefs of savage or untutored races in demons which cause diseases is natural, it may almost be said reasonable. What more natural when they see one of their tribe seized with an epileptic fit than to assume the presence of an invisible foe? Or if a contagious plague or small-pox or fever attacks their village, is it not an inevitable conclusion that angry spirits have attacked the tribe, perhaps for some unknown offence? From such a basis the idea of sacrifice to the avenging fiend follows obviously. In some parts of China if a person accidentally kicks a stone and soon afterwards falls ill the relatives go to that stone and offer fruit, wine, or other treasures, and it may be that the patient recovers. In that case the efficacy of the treatment is demonstrated, and only those who do not desire to believe will question it; if the patient should die the proof is not less conclusive of the demon’s malignity.
In some primitive peoples, among the New Zealand natives, for example, it is believed that a separate demon exists for each distinct disease; one for ague, one for epilepsy, one for toothache, and so forth. This too, seems reasonable. Each of those demons has something which will please or frighten him. So amulets, talismans, charms come into use. The North American Indians, however, generally attribute all disease to one evil spirit only. Consequently, their treatment of all complaints is the same.