Another mischief in sending Bills to the Apothecaries is, that though the Apothecaries be honest (and who can tell which of them is so?) yet the Servants neglect, or ignorance (to whom they commit the whole care of dispensing, and are intruth the Apothecaries (and not their Masters) may mar all in their Masters absence, who is visiting abroad, or at his recreations.
And now I have done with the unpleasant talk of raking into the faults of the Apothecaries, and with discoursing how Physicians may save themselves from their devices, I shall next shew the advantages that will come to the Patient, the Physician, and people, by this way of remedy proposed.
As for the Patients, they may hereby save most of the great charges of Apothecaries Bills, which in long Cases amount to very great sums in a year, although the Physician hath received very few Fees; the Physician may so order his business as to take his Fee for his Visits only, and at home such competent Fees for his advice alone, as are usually given, and in both Cases take nothing for his Medicines, and so save the Patient the whole charge of the Apothecaries Bill, which very seldom comes short, and for the most part manifoldly exceeds the Physicians Fees. And this he may very well do by making fewer, less chargable, more effectual, and durable Medicines then the Shops afford, and suffer nothing in the non-use, or decay of his Medicines; because he need make no more then will serve his own practice: and I must here profess, that which I intended not to have published, that this is the course I have generally taken, for the four Months last past, since I made my own Medicines, but that some Apothecaries have given out most falsly, that I have sent in Bills to Patients for money; but to convince such of their wonted lying, I do hereby oblige my self to give 100 pound to any of them that shall produce such a Bill. Secondly, This way will not clog the Patient with more Medicines then are needful, nor will omit anything may conduce to his recovery, for if he fails in either, 'tis to his prejudice, either in spending more Medicines which cost him money, or in not performing his Cure, which loseth his practice.
But I do not propose this course of mine as a general rule to all Physicians, but leave this to every mans private judgment; Neither do I hereby bind my self to the same practice, because some few Cases may fall out (though to an equal advantage to the Patient) may perswade me to the contrary. For I find some persons of that perswasion, as to think they have not given satisfaction, unless they have payed for the Medicines; but to such persons, I have always allowed them to give me what they pleased themselves, for the cure only, to the full satisfaction of both parties. Though I will not deny but some persons out of gratitude for their Cure, have rewarded me beyond this proposal. Some of my acquaintance have desired me to be more plain in this last Paragraph, especially in that part of it where I say I do not bind my self to the said practice; and to declare more fully the Cases that may perswade me to the contrary; which are these and such as these. First Where Patients of their own free offers will contract with the Physician, or have formerly too meanly rewarded him for his Cure, in both which the Statutes of our College allow a contract to be made with Patients. Another case is, if a Physician be consulted once, and for his Fee hath given Medicines gratis, if the Patient frequently send for his Medicines without the least reward at all. Or if the Patient living far in the Country, having (as before) once consulted the Physician, as in the last case, and shall for weeks, nay months, send for the same Medicines. Or if the Patients friend shall recommend a Medicine to another friend of his unknown to the Physician; and where he gives no Counsel, if a Physician in the Country shall desire some of his Medicines, which are all the cases that occur at present; I say in some of these, the Physician must needs be payed for his Medicines; but in other, 'tis rational he should be payed for his advice, as he desireth new Medicines, which charge will be far short also of the Apothecaries Medicines, whether repeated or prescribed upon new advice.
Now the great charge of Apothecaries Bills, and nauseousness of their Medicines, appears to be the cause why long habitual diseases, as the Kings Evil, Falling-Sickness, Convulsions, Melancholies, and Winds in the Bowels, Gouts, &c. become seldom relieved, though they may with a constant, facile way, be perfectly cured, where neither the great charge, nor unpleasantness of Medicines, deterr them from a continued necessary use of Remedies. And for the same reasons many will be kept from relapses, who being tired out with taking variety of Medicines, give over before the tone and strength of their parts is restored, which is necessary to be done in all long Diseases.
He may so contrive his Medicines, first, That they may be taken in small quantity, and be made more grateful to the tast, and stomach, and perform more then those of the Apothecaries, commonly slovenly made, and of themselves Fulsom, Nauseous, and Sluggish. Secondly, His Medicines made for particular persons, may last Weeks, Months, nay Years, whereas the Apothecaries Drinks, especially in the Summer time, must be renewed once, or twice every day, to the excessive charge of the Patient.
That his Medicines may be fewer, is evident in Physicians that practise in the Country, who ride far to Patients, and carry in their Mans Cloak-bag, Medicines enough, not only for the person he is sent to, but also for most other persons, and Cases he meets with in his Travels, and therefore his Closet needs contain but few, yet noble and generous Medicines, and such as may serve him upon all occasions, supplying what's defective from the Fields or Gardens. He may avoid all pompous, useless, chargable Medicines of the Shops, and substitute in their place, cheaper, and more conducible to health; He may very well lay aside the precious Stones, Saphir, Emerals, &c. the high priced Magistrals of Coral, and Pearl, made worse by their preparations, or rather destroyed thereby in their Virtue, as also Unicorns Horn; and Bezoar, all which are now rarely used alone, but in the received Compositions; He may also spare the charges of leaf-gold, for guilding Pots, Glasses, Pills, Electuaries, Boles, &c. which serves only to raise the Bill.
He may teach the Patients facile and easie Remedies, as to make a Clyster, apply Blisters, or Medicines to the feet, where they are needful, &c. and in many Cases may cure by well ordering his Patient only, without any Remedies at all, or but very few; being free to act for the Patients Health, without the grumbling of the Apothecary; and many other ways he may daily meet with, very advantageous to the Patient.
He will have little use of Conserves, Syrups, Lohocks, &c. a greater part whereof Sugar makes up, which doth more hurt to most persons, then the other ingredients do good.
As for Infusions and Decoctions, he will find by experiment, how much liquor, or Menstruum will suffice to extract the full vertue of the ingredients, and what are helps, or hinderances thereunto, and thereby neither suffer loss in the quantity, or quality of them.