Pharmacy in Its Infancy.—All through the Hippocratic period and during the years when Alexandria was at the height of its prosperity as the great centre of medical activity, it was customary for the physicians to prepare their own drugs. The same is true of the best physicians belonging to the Augustan period; they were not willing to put their trust in the drugs which had been prepared in the shops where such things were usually sold.
In the second century of the present era Galen gave the definition that a remedial drug, or “Pharmakon,” was something which, when taken into the living body, produces an alteration in its component tissues or organs, whereas foods or nutrient elements simply cause an increase of the parts. He attached great importance to such characteristics as purity, freshness, care in handling, etc. It was his custom to prepare with his own hands the different combinations of simple remedial agents which he administered to his patients, and he kept these combinations, as well as the simple drugs of the more costly kinds, carefully stored in locked wooden boxes in a room which was devoted to this special purpose and which was termed the “Apotheke.” Originally, therefore, the “apothecary” was simply the person who had charge of this room in which the drugs and spices were carefully “placed to one side” (ἀπό, τίθημι) for safe keeping. At a later period, when the caretaker became also the compounder of drugs, another word of a more comprehensive significance—that of “pharmacist”—gradually supplanted the term apothecary.
There is another word, “antidote,” which has very materially changed its significance during the lapse of centuries. Galen, for example, employed this word as a synonym of pharmakon—a simple remedial agent, and medical writers continued using the term in this sense during the following thirteen or fourteen centuries. The word commonly employed, by mediaeval physicians, to signify “pharmacopoeia,” was “antidotarium.” In modern times the word “antidote” signifies only an agent which neutralizes a poison.
Galen took a very great interest in everything relating to the subject of drugs, and sometimes made long journeys for the purpose of securing certain plants or roots which he was unable to procure near home or which he was very anxious to obtain in a more perfect condition than was possible when they were purchased from the regular dealers. “Simple remedies,” he declared, “are pure and unadulterated, and produce effects in only one direction. It is the business of pharmacology to combine drugs in such a manner—according to their elementary qualities of heat, cold, moistness and dryness—as shall render them effective in combating or overcoming the conditions which exist in the different diseases.” Galen’s interest in pharmacology materially aided the advance of medical science in other ways. He systematized the existing knowledge of materia medica and infused some measure of orderliness into the therapeutics of his day. The success of his efforts in this direction did not become manifest until after he had been dead about fifty years; but, if his ideas were slow in meeting with general acceptance, they took such deep root in the minds of physicians that to-day in Persia Galen’s system of therapeutics is the only one generally received as authoritative. Although the facts do not warrant our making the same statement with regard to Western and Southern Europe, it is nevertheless true that our dispensatories still continue to honor the memory of this great physician by bestowing the name of “Galenical Preparations” on a large group of pharmaceutical combinations.
It is scarcely possible to state with any degree of positiveness at what date pharmacists, in the modern sense of the term, came to be recognized as constituting a separate and honorable class in every well-organized community. It is known, however, that in Syria and Persia, during the eighth and ninth centuries of the present era, not a few of the leading physicians were the sons of apothecaries. Honein, for example, of whose career I furnished a brief sketch in Chapter XIX., was the son of an apothecary; and the careful manner in which he was educated during his youth justifies the belief that his father must have been a man of some cultivation and not at all like the general average of that class of men of whom Galen speaks so disparagingly. But even at that early period there certainly were individuals who were skilled in the pharmaceutic art, for Berendes (op. cit.) tells us that Dioscorides (circa 100 A. D.) describes minutely the manner of preparing “Oisypum.” Oisypum is identical with the modern “Lanolin” or “Lanolinum,” and is a pure fat of wool. Mention is made of the preparation by four different authors of medical treatises during the following sixteen centuries—viz., by Aëtius in the sixth, by Paulus Aegineta in the seventh, by Nicolaus Myrepsus in the thirteenth, and by Valerius Cordus in the seventeenth. Subsequently to the latter date no further mention of the preparation is to be found in any of the pharmacopoeias except the French Codex of the year 1758, in which it is classed among the simple remedies under the title of “Oesipe.” Finally Liebreich, toward the end of the nineteenth century, brought the preparation once more into favor under the name of “lanolin.” The fact that it remained in complete oblivion for such very long periods of time is easily explained by the statement which Berendes makes: “It was a troublesome ointment to manufacture, and consequently the apothecaries disliked it and resorted to all sorts of falsifications.”
With the advance of the Arab Renaissance pharmacy gradually became a regular established occupation in every fairly large city in the East. It is known, for example, that the first public apothecary shop in the city of Bagdad was established during the eighth century of the present era under the caliphate of Almansur; and about the same time, probably a little earlier, there existed at Djondisabour a similar pharmacy in connection with the school and hospital of the Bakhtichou family. The training of an apothecary in those days was probably the same as that of the physician. Originally pharmacists were called “Szandalani,” probably because they dealt largely in sandal wood.
The materia medica furnished by the Arab physician Rhazes in the different works which he has written, is unusually rich in simple elements, the majority of which are always drugs of a rather mild action; Greece, Persia, Syria, East India and Egypt were the sources from which they were derived. Beside the simple elements, Rhazes mentions a number of composite preparations of drugs. As not a few of the latter required very careful manipulation, it may safely be inferred that the Arabian apothecaries of the ninth century had already acquired considerable skill and experience in their special field of work.
At Salerno, during the first half of the twelfth century, pharmacy began to assume a position of considerable importance. The work which was prepared by Nicolaus Praepositus, and which was known as an “Antidotarium,” furnished quite full information with regard to the characters and therapeutic uses of nearly 150 different drugs. According to Berendes this work served for several centuries as the basis of later pharmacopoeias. One of its notable features is the importance which the author attaches to the duty of weighing very carefully each of the drugs that enter into the composition of a given preparation, of gathering certain vegetable products at the right season, and of paying strict attention to their quality and to the manner of preserving them.
In 1140 A. D., Roger, King of Naples and Sicily, promulgated a law which defined what should be the proper relations between physicians and apothecaries; and about one hundred years later (1241 A. D.) Frederick II. amplified and gave greater precision to this law, thus establishing what was practically an Institute of Apothecaries. The following provisions constitute the essential features of the law:—
1. The physician and the apothecary shall have no business interests in common.