Medical theories and practices at the beginning of the seventeenth century were largely those that had prevailed since the time of Galen, a Greek physician who died about two centuries after Christ. According to Galen, the four elements of Aristotelian science—fire, water, air, and earth—comprised the four major humors of the human body: blood, phlegm, yellow bile, and black bile. Blood was held to be moist and warm, phlegm was moist and cool, yellow bile dry and warm, and black bile dry and cold.
Sickness, in the theory of Galen, was caused by one or more of these humors becoming impure or out of place or out of balance. Treatment thus consisted of removing or diminishing the offending humor by purging, bleeding, vomiting, blistering, urinating, sweating, or salivating; on the other hand, a deficient humor was to be restored by diet and drugs. Galen classed drugs according to their warm, cold, moist, or dry qualities. For instance, pepper was a heating drug, good for chills, while cucumber was a cool one, to be given in case of fever.
Galenism had been subjected to attack in the sixteenth century by Paracelsus and Vesalius, but its appeal was logical and remained strong in seventeenth-century England. (In fact, some survivals can be found in twentieth-century folk medicine.) Dr. Lawrence Bohun (or Boone), who came over in 1610 and returned to England in 1611, spent some of the year investigating medicinal sources in Virginia. He discovered a white clay—and shipped some to England—that he claimed could absorb and expel poisons from the body. Among vegetable remedies, Bohun experimented with sassafras and found “Galbanum mechoacon, otherwise called rubarbum alum, to be of service in cold moist bodies, for the purginge of fleame [phlegm] and superfluous matter.”
WHAT IS AN APOTHECARY?
Already it will be evident that the practice of medicine in seventeenth-century England, and hence in the first American colonies, was not neatly confined to the licensed graduates of accredited medical schools. Quite the contrary. In fact, Henry VIII had complained that all kinds of ignorant people got into the act, including “Smiths, Weavers, and Women.”
In the upper half of this woodcut from The Expert Doctor’s Dispensary, published in London in 1657, a learned physician is shown conducting a urinalysis. He simply holds the flask of liquid to the light for visual examination. Below, a customer presents what appears to be a written prescription to be filled by the apothecary.
Two centuries of legal and parliamentary pulling and hauling, plus the consequence of some natural developments, left the situation in England somewhat stabilized—but not necessarily logical. The barbers, chartered as a guild in 1462 and authorized to practice surgery, included both barbers and surgeons in growing disharmony until they were formally divorced in 1745.
The apothecaries—the word originally meant shopkeeper—joined the guild of grocers at one time but shortly broke away to form their own guild in 1617. Meantime, the physicians, organized in the College of Physicians, obtained the right to keep watch on the apothecaries.
Physicians, who had to have as much as 14 years training and four degrees from Oxford or Cambridge, were naturally not abundant. Being learned men, they would not stoop to the indignity of such menial work as performing surgical operations or compounding medicines. The former was the province of the surgeon or barber-surgeon, the latter was the specialty of the apothecary.