Although people have been using medicinal substances to treat themselves for as far back as there have been people, the pharmacy profession has more recent origins. Nevertheless, its roots can be found over 4000 years ago.
The pharmacy profession can be traced back at least as far as the Sumerian population, living in modern day Iraq. From around 4000 BC, they used medicinal plants such as liquorice, mustard, myrrh, and opium. There were separate people who worked to prepare medicines, as a separate role from diagnosis and treatment which was carried out by medics. These precursors to pharmacists also combined their role with that of a priest. The Sumerians wrote the earliest surviving prescriptions from at least 2700 B.C. – so nearly 5000 years ago.
The Ancient Egyptians had specific preparers of medicine, known as Pastophor. Pharmacy was viewed as a high status branch of medicine, and again, like the Sumerians, these pharmacists were also priests who worked and practised in the temples.
From surviving papyrus scrolls, notably the Ebers Papyrus which dates from 1500 BC, we know that the Egyptians made and used infusions, ointments, lozenges, suppositories, lotions, enemas, and pills. The Ebers Papyrus includes 875 prescriptions and 700 drugs.
Meanwhile, in China in about the same era (2000 BC), a man called Shen Nung wrote the first Pen T’sao or native herbal, which contained descriptions of 365 plant-based drugs.
Stalls and shops selling medicinal goods existed around 1900 B.C. in the town of Sippara on the Euphrates river. However, the earliest recorded shop dealing with sales of medicines in London was opened in 1345.
The Apothecaries – Over the 16th and 17th centuries the art of the apothecary was developing rapidly in Britain as well as on the continent, and with this development there came a desire for the apothecaries or dispensers to form a Guild of their own.
In 1617, King James 1st of England granted the Apothecaries a royal charter which separated them from the Grocers. Naturally the Grocers tried to resist, but the King stood firm as he saw the grocers as merchants having no professional skill, whilst the practice of the apothecary was an art and a mystery. (Skill & Knowledge) These very same words were in use in apprenticeship indentures less than 100 years ago.
The defining moment, after almost 200 years of argument, came with the passing of the Apothecaries Act of 1815. Prior to this, many apothecaries practised medicine, but they weren’t supposed to charge for their advice, only for the drugs they supplied. The physicians weren’t supposed to dispense drugs, but many did and they even brought law suits against apothecaries who exceeded their powers. Surgeons could only prescribe remedies for external ailments and not “physic”, and some of them also dispensed. The outcome of the new Apothecaries Act was a clearer definition of the two streams of practice involving, medicine and pharmacy.
The Evolution of pharmacy and the apothecaries in England
The 1815 Act enabled apothecaries who took a specified course of training with the Worshipful Society of Apothecaries to be licensed as general practitioners with the post nomials L.S.A., and these Licentiates practised in London and the provinces. From 1815 onwards, it was illegal to use the title apothecary without qualifying as a licentiate The establishment of the General Medical Council in 1858, and growth in University training courses for medical students in the later 19th century, reduced the significance of the Society of Apothecaries in the training of general practitioners. Today the General Practitioner is still really the equivalent of an apothecary and the Worshipful Society of Apothecaries of London is an examining and licensing body for doctors. So despite the name, the Worshipful Society of Apothecaries of London was at the very heart of the professional gap between the medical practitioners and dispensing chemists.
Surgeon Apothecary – This term referred to an apothecary who had obtained a diploma at the College of Surgeons, a practice common after 1845.
Some surgeons and physicians also qualified as licentiates of the Society of Apothecaries.
Dispenser – doctors and pharmacists employed non-professionally trained dispensers in institutions such as hospitals, asylums, workhouses, prisons and barracks, and. They were trained assistants who compounded prescriptions under supervision. From 1815 onwards, the Society of Apothecaries offered an assistants’ examination qualifying candidates to compound and dispense drugs under the supervision of an apothecary, pharmacist or doctor.
Since the founding of the National Health Service in Britain in 1948, trained dispensers have continued to play an important role in dispensing. They still work in pharmacies and hospitals under the supervision of pharmacists (and also in doctor’s dispensaries under the supervision of dispensing doctors). They are now known as pharmacy technicians, and most undertake vocational courses as part of their training.
Barber Surgeon and Surgeon – in 1540 the Barbers Company and Surgeons Guild, both founded in the 14th century, were formally united as the Barber Surgeons Company of London, hence the term barber surgeon. (The Barbers had been practising surgery since the 15th century.) The surgeon’s craft included not only invasive operations and amputations, but also treatment of diseases manifested by external symptoms (e.g. plague and syphilis) with external applications or internal medicines. In 1745, the barbers and surgeons divided, the Surgeons forming the Company of Surgeons. In 1800 they became the Royal College of Surgeons of London, and in 1843 the Royal College of Surgeons of England. However, some individuals calling themselves surgeons were not actually members of a Company or College.
Chemist (Chymist) – although the term chemist is now often used interchangeably with that of pharmacist, references to chemists in historical documents sometimes refer to those involved with the study of the science of pure chemistry rather than pharmacy. In the 16th, 17th and 18th centuries the distinctions between alchemy and medicinal chemistry were somewhat blurred, but by the mid 19th century ‘pure’ scientific chemists had their own Royal Society of Chemistry. The Society was formed in 1841.
The word “Chymist” suggests it origins are Greek, but it is generally accepted that Chemist took over from Chymist as the established spelling around 1790.
Chemist and Druggist a term first used to describe both chemical and drug merchants and practitioners of the emerging profession of pharmacy in the late 18th and 19th century. It is often used in trade directories and census returns. Under the 1868 Pharmacy Act, the term chemist and druggist was used by the Pharmaceutical Society of Great Britain to denote those who had passed its minor examination, thus meeting the minimum requirement to register as a pharmacist (see above). The use of the title chemist and druggist became legally restricted to registered pharmacists only from 1868 onwards.
Commercial chemical and drug merchants not involved with the dispensing or the sale of scheduled poisons were not required to register with the Society, and continued to trade after 1868. Legally they could no longer use the title chemist and druggist. The title master druggist (as in the trade terms master builder, master baker etc.), was occasionally used by both qualified and unqualified chemists and druggists.
Even then, some apothecaries chose to be traders like the chemists and druggists, whilst others turned more to the practice of medicine.
It was the Apothecaries though, who had the higher public profile and so the Chemists and Druggists set about trying to gain a wider public recognition of their value to the nation’s health service.
They realised that many of their number lacked proper qualifications and that there was no organisation that could effectively protect their established interests. This is what led Jacob Bell and his colleagues in 1842 to set up the Pharmaceutical Society of Great Britain and ultimately achieve the passing into law of the first Pharmacy Act in that country in 1852. (See Chapter 4.)
Dentist – The word dentist was first used in Britain in c 1750, although before this there had been many itinerant ‘toothdrawers’ and other individuals such as barbers and blacksmiths offering extraction, while from the seventeenth century onwards more expensive ‘operators on the teeth’ offered extractions and false teeth. From the second half of the 18th century the ‘dentist’, providing a fuller range of dental services, came into being. Many dentists had no medical background; some of those who did were chemists and druggists who provided dental services as a sideline. Consequently, throughout the second half of the 19th century attempts were made to formalise dental training. It was not until 1921, with the passing of the Dentists Act, that more stringent measures, essentially qualification by examination only, were taken to regulate entry to the profession. But even under this Act, pharmacists who already provided dental services were permitted to continue their practice if judged competent to do so. Many of the early chemists in Australia practiced Dentistry in addition to pharmacy, especially in country towns and other remote areas.
Optician – The definition of the term optician is complicated, a general description would be one who tests the eyes and prescribes and dispenses corrective devices for the eye; the phrase ophthalmic optician has often been used, and also means this. Some pharmacists were also opticians. The preferred title of the profession now is optometrist.
The history of the optician’s craft in Britain begins with the incorporation of the Company of Spectacle Makers of London in 1629, and it is interesting to note that the Company of Spectacle Makers is a tenant of the Worshipful Society of Apothecaries today.
The Company exerted qualitative control over all London spectacle makers. However from the late 18th century onwards its influence declined, and by the late 19th it had very little control. During the 19th century, many traders offered optical services as part of their business, but most had received no formal training and were essentially dealers constructing spectacles from ready made lenses. Even up to the start of World War I, testing eyes and fitting glasses was also a sideline for many pharmaceutical chemists in Australia.
Pharmaceutical Chemist – The term ‘pharmacy’ was in widespread use in Europe, with various spellings, from the late classical period. ‘Pharmaceutical’ was used in England by the 17th century and the Oxford Dictionary cites a reference to ‘good pharmaceuticall, botanik and chymicall institutions’ made in 1648. More common usage of the term ‘pharmaceutical chemist’, however, dates from the 18th century, often referring to advocates of the French school of chemical based therapeutics. By the mid 19th century, when it was adopted by the new Pharmaceutical Society of Great Britain, the term ‘pharmaceutical chemist’ was being more widely applied to those interested in organic chemistry and in the skilled compounding of drugs of all descriptions.
Physician – The College of Physicians was founded in 1518. The College’s Charter allowed for the practice of all branches of medicine, but the physician came to be primarily concerned with medical diagnosis and the prescribing of medicines, which were then dispensed by the apothecary. Physicians could also oversee and advise surgeons, and prescribe for internal disease within this context. Physicians were the elite of the medical profession, and the prestigious Fellowship of the College was open only to those who were graduates of Oxford and Cambridge. Physicians usually treated patients of considerable social status and financial means. The College’s new constitution of 1862 first contained the first official inclusion of the word Royal in its title. However, the title Royal College of Physicians had been intermittently applied to the College since the drafting of a new but unconfirmed Charter during the reign of Charles II, and the title was in general usage by the late 18th century.
Some key dates in pharmacy history
|1820|| ||The alkaloid quinine was first extracted from the bark of cinchona trees by two French chemists, Pierre Joseph Pelletier and Joseph Biename Caventou.|
Diamorphine or Heroin was first synthesised from morphine.
|1883|| ||First edition of The Extra Pharmacopoeia published, edited by William Martindale and Dr Wynn Westcott.|
|1899|| ||Aspirin, was launched by the German company.|
Salvarsan, the first 'magic bullet' drug, effective against syphilis was discovered by Paul Ehrlich and Dr Sahachiro Hata.
|1915|| ||Medicine stamp duty was doubled as a wartime fundraiser.|
The Venereal Disease Act prohibited the advertising of medicines for VD and selling
mixtures containing scheduled substances. It introduced the concept of 'prescription only' medicines.
The Dangerous Drugs Act regulated the import and sale of potential 'drugs of addiction',
including the derivatives of opium, cocaine and cannabis so widely used in proprietary remedies.
|1928|| ||Penicillin discovered by Alexander Fleming.|
The Food and Drugs Act prohibited the adulteration and mislabelling of drugs.
|1939|| ||The Cancer Act restricted the advertisement of products claiming to treat cancer.|
Under the Finance (No. 2) Act purchase tax was imposed on a range of goods including most drugs and medicines.
The Pharmacy and Medicines Act repealed the old medicine stamp duty. It forbade the general advertisement of products claiming to treat a number of specific illnesses including Bright's disease, cataract epilepsy and TB, or to be effective in procuring an abortion. For the first time manufacturers were required to list the active ingredients of products on their packaging.
The National Health Service made prescription medicine available to all. Until the introduction, in the 1950s, and subsequent hefty increasing of prescription charges, proprietary medicines were no longer seen as a cheap alternative to seeing the doctor.
|1961|| ||Ibuprofen was first synthesised by a team at the Boots Pure Drug Company in December.|
|1964|| ||Introduction of Adverse Drug Reaction 'yellow card' scheme in response to the thalidomide tragedy of 1961.|