Part 3

How very few go through this Course of Improvement, we too readily discover, and may be reproved by the first beginning of the Practice among the Ancients, where we find the Method then in use, to train up Youth to the Profession, was to place them Apprentices with able Physicians, who adjudged it necessary to take their Beginning from Surgery, the Subject whereof being external Diseases, as Wounds, Swellings, Members out of joint, and others that were visible, proved more facile and easy to their inmate Capacities, and wherein they might suddenly become serviceable to their Masters, in easing them of the Trouble of dressing and cleansing stinking Ulcers, and applying Ointments and Plaisters, a nauseous Employ, which they ever endeavour'd to abandon to their Scholars with what Expedition possible: This as it was the easiest, so it was the first, and ancientest Part of Physick, and from which those that exercised it were anciently not called Surgeons, but Physicians, tho' they attempted no other Diseases but what were external; according to which Sense _AEsculapius_ the first Physician, or Inventor of Physick, and his Sons _Podalyrius_ and _Machaon_, are by History asserted to have undertaken only those that wanted external Help; internal Diseases being in those Days unknown, and by Temperance in their Diet, wholly debarr'd; and if accidentally an internal Distemper did surprize them, they apply'd a general Remedy (having no other) of poisoning or killing themselves with a Dagger or Sword, thereby chusing rather to die once, and finish their Misery, than to survive the Objects of Peoples Pity, or to endure the Shocks of Death by every Pain or Languor, especially since the sage Judgment of that Age did esteem it a signal Virtue to despise and scorn the vain World, by hurrying out of it in a Fury, a Maxim most of the Philosophers were very eminent in observing; and was likewise extended to Children that brought any Diseases external or internal with them into the World, their Cure being perform'd immediately by strangling, or drowning them; neither was this Art of external Physick of short Continuance; _Pliny_ writing that Six hundred Years after the building of _Rome_, the _Romans_ entertain'd Chyrurgical Physicians from _Peloponesus_: Idleness and Gluttony at last exchang'd their Ease into a Disease, which soon put them into a Necessity of experimenting such Remedies as might re-establish them into that healthful Condition, which Exercise in War, and Temperance in Diet had for so many Ages preserved their Ancestors in.

Upon a competent Improvement of their Scholars in this external Practice of Physick, and their deserving Deportment, they thought them worthy of giving them Entrance into their Closets, to be instructed in such Matters as the most retir'd Places of their Cabinets contained; which were their Remedies and Medicines, and the Manner of preparing them: And then bending his Endeavours to arrive to the Art of discerning the Disease by its Signs, and making Observations upon the Prognosticks, all critical and preternatural Changes: The Dose, Constitution, and all other Circumstances of giving the Medicines which he did gradually accomplish, by his sedulous Attendance on his Master, and his practical Discourses and Lectures from him on every Patient he visited: Lastly, upon his Attainment to a Degree of Perfection in the Art, discovered by his Master by his private Examination, all the Physicians and Commonalty of the Place were summoned to be present at the taking of his Oath in the publick Physick-School, which served in lieu of making Free to Practise, or taking his Degree; the Form of which, as remarkable as it is ancient, the Oath was as followeth.

"I Swear by [1]_Apollo_ the Physician, and [2]_AEsculapius_, and by [3]_Hygea_, and [3]_Panacea_, and I do call to witness all the Gods, and likewise all the Goddesses, that according to my Power and Judgment I will entirely keep this Oath and this Covenant; That I will esteem this Master that taught me this Art, give him his Diet, and with a thankful Spirit, impart to him whatever he wants; and those that are born of him I will esteem them as my Male Brethren, and teach them this Art, if they will learn it, without Hire or Agreement; I will make Partakers of the Teaching, Hearing, and of all the whole Discipline, my own and my Master's Sons, and the rest of the Disciples, if they were bound before by Writing, and were obliged by the Physicians Oath, no other besides; I will, according to my Capacity and Judgment, prescribe a Manner of Diet suitable to the Sick, free from all Hurt or Injury; neither will I, through any bodies Intercession, offer Poison to any, neither will I give Counsel to any such Thing; neither will I give a Woman a Pessary to destroy her Conception: Moreover, I will exercise my Art, and lead the rest of my Life chastly and holily; neither will I cut those that are troubled with the Stone, but give them over to Artists that profess this Art; and whatever Houses I shall come into, I will enter for the Benefit of the Sick; and I will abstain from doing any voluntary Injury, from all Corruption, and chiefly from that which is venereal, whether I should happen to have in Cure the Bodies either of Women or of Men, or of free-born Men or Servants; and whatever I shall chance to see or hear in curing, or to know in the common Life of Men; if it be better not to utter it, I will conceal, and keep by me as Secrets: That as I entirely keep and do not confound this Oath, it may happen to me to enjoy my Life and my Art happily, and celebrate my Glory among all Men to all Perpetuity; but if transgressing and forswearing, that the contrary may happen."

Between those Bounds of Secresy, Veneration, Honesty and Gratitude, the Art was for many hundred Years maintained; for in the Time of _Galen_, and many Ages after him, Medicines for their greater Secresie were used to be prepared and composed by Physicians, as you may read, _Libr. de Virt. Centaur._ where is observable, their Men were wont to carry their Physick ready prepar'd in Boxes after them, which they themselves, according to the Exigency, did dispense. This Custom was continued until Wars ceasing, People began to be as intent upon the Propagation of Mankind, as the Cruelty of the former martial Ages had been upon its Destruction; where the World growing numerous, and through Idelness and want of those Diversions of their military Employ, addicting themselves to Gluttony, Drunkenness, and Whoredom, did contract so great a Number of all inward Diseases, that their Multiplicity imposed a Necessity upon Physicians (being unable to attend them all as formerly) to dismember their Act into three Parts, whereof two were servile, Chirurgery and Pharmacy; and the other imperial and applicative or methodical.

The servile Part being now committed to such as are now called Surgeons and Apothecaries, the former were employed in applying external Medicines to external Diseases; the latter in preparing all ordinary internal and external Medicines, according to the Prescription and Directions of the Physicians, whose Servants were ordered to fetch the prescrib'd Medicines at the Apothecaries, and thence to convey them to their Patients; by which Means the Apothecary was kept in Ignorance: As to the Application and Use of the said Medicines, not being suffered to be acquainted with the Patients or their Diseases, to prevent their Insinuation into their Acquaintance, which otherwise might endanger the diverting the said Patients to other Physicians, or at least their presuming themselves to venture at their Distempers. Neither were the Physicians Servants in the least Probability of undermining or imitating their Masters in the Practice, not knowing their Medicines or Prescriptions. Besides all this, those Remedies from which the chief Efficacy and Operation against the Disease was expected, still remain'd secret with the Physicians, who thought it no Trouble to prepare them with their own Hands. Thus you may remark the Physician's necessary Jealousy of their Underlings, and their small Pains prov'd the sole Means of impropriating their Art to themselves: And yet by the Advantage of their Chirurgeons and Apothecaries, were capacitated to visit and cure ten times greater Numbers of Sick than before; which in a short Time improved their Fame and Estate to a vast Treasure, whence it was well rhimed,

----_dat Galenus Opes, dat Justinianus Honores_.

But at length, their Honour and vast Riches in the Eye of Apothecaries and Surgeons, proved Seeds sown in their Minds, that budded into Ambition of becoming Masters, and into Covetousness of Equality, and shareing with them in their Wealth; both which they thought themselves capable of aspiring to by an Emperical Skill the Neglect and Sloath of their Masters had given them occasion to attain, since they did not begin to scruple to make them Porters of their Medicines to their Patients, to intrust them with the Preparation of their greatest Secrets. This Trust they soon betray'd, for having insinuated into a familiar Acquaintance with their Masters Patients, it was a Task not difficult to perswade them, that those that had made and dispensed the Medicines, were as able to apply them to the like Distempers, as they that had prescrib'd them, who had either forgot, or were wholly ignorant how to prepare them; so that now they were as good as arrived to a Copartnership with their Masters in Reputation and Title, the best being call'd Doctors alike, and there being no other Difference between them, than that the Master Doctor comes at the Heells of his Man Doctor, to take in Hand the Work which he or his Brother Doctor (the Chirurgeon) had either spoiled, or could not farther go on with; a very fine Case the Art of Physick and its Professors are reduc'd to, and that not only of late Days, but of almost Seven hundred Years, for before that time Apothecaries had scarce a Being, only there were those they call'd _Seplasiarij_ from their selling of Ointments on the Market of _Capua_, call'd _Seplasia_, _Armatarij_, and _Speciarij_, or such as sold Drugs and Spices; tho' I confess Apothecaries may offer a just Objection in pretending to a far greater Antiquity, since the Original and Necessity of their Employ was deriv'd from the _Egyptian_ Bird _Isis_, spouting Water into its Breech for a Glyster: But 'tis no Matter, the Doctor must truckle to this powerful Engineer, he must conform to the Manner of the Age; and were I to enumerate the many Abuses that are practised by this lower Profession, I mean the Generality of them, you would be more careful in making Choice of your Apothecary, or making a better Choice in having least to do with them; and how dangerous is their Ignorance in the _Latin_ Tongue, which is of very ill Consequence, as their Prescriptions sent 'em by the Physicians are writ in _Latin_, and which not being rightly understood, hath often occasioned not only innocent but fatal Mistakes. _Homine semi docto quid iniquius?_ and that a great Part of the Apothecaries are very illiterate! is so evident, that they themselves dare not deny it; among many Instances of this Kind, that most unfortunate one recorded by an eminent Physician is notorious, who instead of a Dose of _Mercurius sublimatus dulcis_, exhibited so much common Sublimate, a mortal Poison, which was scarce ever given inwardly, instead of an innocent Medicine approved by all Physicians. Yet those worthy Sons of Bombast must disgust your Palate with the Relation of the nauseous and choaking Terms, their Ends of _Latin_ and stifling Phrases, driving to confound and amaze the simple Vulgar. An Instance of this Kind may afford you some little Diversion: A practical Apothecary coming to see his Customer, a Cobler, that lay indisposed of the Cholick, observed him to crack a Fart (for so it is express'd in the Original) upon which, said the Apothecary, Sir, that's nothing but the Tonitruation of Flatuosities in your Intestines; this was no sooner out of his Mouth, but the Cobler crack'd another, and reply'd to his Doctor, Sir, that is nothing but your Hobgoblin Notes thundring Wind out of my Guts; which literal Return of his Terms of Art in plain _English_, though by chance, obliged the Apothecary to this Expression; I beg your Pardon, Sir, I suppose you have study'd the Art of Physick as well as my self, and want not my Help: So away went Doctor Pestle, imagining the Cobler to be as great a Master in the Faculty as himself.

Another Complaint against the Apothecaries is, That they are not well acquainted with the _Materia Medica_; the Knowledge of which is an essential Part of their Profession, but must take the Words of Druggists, who themselves are sometimes mistaken, and differ about the Names of several Drugs; and which is worse, their trusting to Herb-women, who obtrude almost any thing upon the greatest Part of them; and that those Women do often mistake one Thing for another, sometimes ignorantly, sometimes designedly, is well known to many Physicians, who have seen them sell the Apothecaries Herbs, Roots and Seeds, under other Names than those they do really bear, for many among them cannot distinguish between Ingredients noxious and salutary: So that we have not Patients daily poisoned is rather from the Care of Herb-women than Apothecaries. Another just Cause of Complaint against the Apothecaries are, their old Medicines; for suppose them as faithfully prepared as they can pretend or we desire, yet Length of Time will make some Changes in them, which are not often Improvements: The Syrups grow acid, and Waters full of Mother, Electuaries and Pills dry and deprived of their most active Parts, Powders themselves are not free from this Fate, whose Virtues in Time we find marvelously diminished. But were they to be told of this, you may with as good Success preach to a Wall, for not a Dram of any other Medicine will the Apothecaries part with but for Sale: So that many times they sell their Preparations five or six Years after they were made, and whether their Medicinal Properties are not much impaired, if they have any left, we leave to others to determine. And indeed the Apothecary has many Things in his Shop which are not called for in many Months, yet these must be vended with the rest; all which, when they have lost their Virtues, should they be rejected, it would be much to their Prejudice, and they have a fundamental Practice that no such Thing should be allow'd of: For 'tis much better the Patient should suffer somewhat in his Body than the Apothecary in his Estate; and if he has injured by his bad Physick, perhaps he will take Pity of him, and the next Prescription shall be better prepared; whereby he makes him abundance of Recompence for the Hurt he receiv'd by that which was bad: And he himself makes an Advantage of both, although perhaps if he had consulted the Patient, he would rather have chosen to keep his Head sound than have it broken, that a proper Plaister might be applied for the Cure. This is so notorious a Truth, that all the World, even their best Friends, exclaim against them for it, and 'till they amend this among many other Peccadillo's, it behoves the Patient to take care how seldom he employs them. Another, that the Apothecaries and their Servants are so careless, slovingly and slight in preparing of dispensatory, or prescribed Medicines, that neither the Physicians, or the Diseased, have Reason to repose that Trust in them which they challeng'd as their Due. As for Slovenliness, they may, I confess, plead the old Proverb, _That what the Eyes see not, the Heart rues not_. Indeed of all the rest it may be dispensed with; but should Patients but once behold how their Physick was prepared in some Shops, they would nauseate it: But least I should offend some nice Stomachs, I shall dismiss this Subject, and proceed to another, which is the Carelessness of Apothecaries and their Apprentices; on which I can never reflect without Fear and Indignation, to think what Numbers have been destroy'd and injur'd by such Proceedings: That this is not a groundless Apprehension many Families can witness, and you can converse with few Persons who are not able to give an Account of some such Miscarriages.

Another thing of great Blame with the Apothecaries is, their enhancing the Prices of Medicines so much above what they might in Reason expect; about which the Physician must no ways concern himself, because it has a bad Influence on him, as on the Account of his Patient; though certainly, if the Apothecaries were more modest in the prising of their Physick, the Patient would be more liberal to the Physician: Whereas on the contrary, the Apothecary holds them at such unreasonable Rates, that in most Courses of Physick he gains more than the Doctor, how deservedly let others determine, though in my Opinion, were their Pay proportion'd to their Care and Honesty, I doubt they would gain little besides Shame and Reproaches: But their Bills must be paid without Abatement; and with how much Regret they are discharg'd, I shall refer it to those who have suffered by them. Now several Things contribute to, or are the occasional Causes of this Universal Grievance. The Physician's Silence, and the Number, Pride, or Covetousness of the Apothecaries, and that Prices are not set upon their Medicines: the Apothecaries being reduc'd into a Company, were at first few; and therefore having full Employment, could afford their Medicines at moderate Prices; but being since that time increased to a great Number, each Person bringing up two or three, or more, that Imployment which was before in a few Hands, became more dispers'd, so that very small Portion thereof falls to the Share of some, and indeed very few of them have more than they can manage. Now the Sick must maintain all these, for although there be no occasion for a sixth Part, yet they must all live handsomely; to supply which Expence, they have no other Way than to exalt the Prices of their Medicines, and still the less they are employ'd, the higher they must prize them, otherwise they could not possibly subsist, unless they became Physicians, and prescribe as well as prepare; to which Practices they are not only propense, but more arrogantly assume, which is no less fatal to their Patients, than by the impudent Prescription of your common Quacksalver, Emperic, or Mountebank.

Now would it not be much better, if it were with us as in some Parts of _Europe_, where the Magistrates of many Cities agree upon a certain Number of Apothecaries, so many as they can apprehend are necessary, all the rest are excluded, and must either seek other Seats, or be content for a small Salary to work under those that are allow'd; their Apothecaries not being permitted to multiply by Apprentices, but one out of the Shop is by the publick Authority appointed to succeed in the Employment. _Hamburgh_ has but one, _Stockholm_ and _Copenhagen_ four or Five, _Paris_ (which rivals _London_ in its Inhabitants) has but one or two and fifty; they are from the due Regard to the Safety of the People exempted from Offices, either troublesome or profitable, that they may always be inspecting the Preparations, or compounding of the Doses, to prevent the deadly Consequences of sophisticated Medicines, or the fatal Errors of one Composition for another, not easily to be distinguished: They are not permitted to visit the Sick, that they may not be wanting from the Duties of the Shop, or be tempted to gratify themselves as they please for the Trouble, by introducing the Custom of taking too often of the Bolus and Cordials. The Physicians Fees are settled according to the various Conditions and Abilities of the Patient; 'tis not allow'd them to make any Advantage by the arbitrary Rates of Physick, when prepared by themselves, that the Patient and the Bill may not be too much inflam'd by a Profit on that side, not easily to be limited or confined. I would not be suspected to design any Prejudice to the careful and industrious Apothecary, (if such there be) his Business requires the greatest Diligence and Fidelity in selecting the Drugs, and preparing them faithfully according to the Appointment of the Faculty, and in making up the Doses with that just Regard to the Life of the Sick, that all Suspicion of the least Mistake may be prevented, in the Weight and Measure, or the Number of Drops, _&c._ But when the Apothecary deserts his Station, is always abroad, and leaves the compounding Part to his unexperienc'd Apprentice, who cannot avoid sometimes infusing one thing for another, by which Errors many are known to have lost their Lives; when 'tis known that the Prescripts are made up of Medicines bought by Wholesale of the Chymist, and not made up by the Apothecary himself, as is too much the present Practice, and consequently can't be known to be made of all, and best Ingredients, but are suspected, because bought at low Prices; you will doubt whether the Character of an Apothecary can be given to this new, and till lately unknown Employment: When he neglects the Business of his Trade, neither prepares himself the Compositions, nor forms the Doses for them, to be deliver'd at the most urgent Occasions, but daringly undertakes to advise in all Distempers, he becomes an Emperic, and invades a Profession which he cannot be supposed to understand.