Part 1

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THE APOTHECARY in Eighteenth-Century _WILLIAMSBURG_

Being an Account of his medical and chirurgical Services, as well as of his trade Practices as a Chymist

_Williamsburg Craft Series_

_WILLIAMSBURG_ Published by _Colonial Williamsburg_ MCMXC

_The Apothecary in Eighteenth-Century_ Williamsburg

Of the first 225 men sent over from London to settle at Jamestown in 1607 and 1608, seven were practitioners of medicine—as it was then practiced: Walter Russell, Gent., was a “Doctour of Physicke,” which is to say that he had studied at a university and earned a degree in medicine; Thomas Wotton, Will Wilkinson, and Post Ginnat were listed as surgeons—“chirurgeon” as it then appeared; Thomas Field and John Harford bore the label of apothecaries; and the seventh was “Tho: Cowper the Barber.”

Plainly, the Virginia Company of London, numbering several prominent medical men among its backers, wanted its adventurers to the New World to have the best of medical care. Unfortunately for about four of every five settlers in the first few years at Jamestown, the best was not enough to avert wholesale mortality from sickness, Indian arrows, and “meere famine.” That some of the medical men shared the fate of their patients seems likely in the absence of later information about most of them.

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.”

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.

But the scarcity of physicians, especially in rural areas, left a medical gap that the apothecaries, trained through apprenticeship and many times more numerous, naturally moved to fill. In 1727 English law finally recognized and legalized the fact that for most people the apothecary-surgeon was the only available practitioner of medicine. In turn, the business of purveying drugs and compounding medicines passed from the apothecaries to the wholesale druggists and pharmaceutical chemists.

As it was transferred to America the trade of apothecary—it was neither a craft nor a profession in any strict sense—was probably much like that of the rural apothecary-surgeon of seventeenth-century England. The apothecary still made his living primarily from the provision of drugs and medical preparations; but he also performed amputations, dressed wounds, and subjected his patients to the normal medical treatments of the day.

_ALL THAT THE LAW ALLOWS_

Virginia was the only colony that tried to draw legislative boundaries around the various aspects of medical practice. The effort came in 1736 in the form of “an Act for Regulating the Fees and Accounts of the Practicers of Phisic.” On two grounds the act deserves to be quoted at some length. For one thing, it throws a good light on the state of medical practice at that time. For another, it affords undeniable parallels to some current problems in the cost of medicines and medical care, and to the role of government in serving the interests of the “consumer.”

The first section of the act recited certain abuses, especially of the surgeons and apothecaries:

I. Whereas the practice of phisic in this colony, is most commonly taken up and followed, by surgeons, apothecaries, or such as have only served apprenticeships to those trades, who often prove very unskilful in the art of a phisician; and yet do demand excessive fees, and exact unreasonable prices for the medicines which they administer, and do too often, for the sake of making up long and expensive bills, load their patients with greater quantities thereof, than are necessary or useful, concealing all their compositions, as well to prevent the discovery of their practice, as of the true value of what they administer: which is become a grievance, dangerous and intolerable, as well to the poorer sort of people as others, & doth require the most effectual remedy that the nature of the thing will admit.

The second section then proceeded to emphasize the chief distinction between the apprentice-trained apothecary-surgeons and the university-educated physicians by allowing the latter to charge twice as much for their services as the former could. If the apothecaries and surgeons felt—as well they might have—that the difference in fees was an insult to them, it did not last long. The law was not renewed at the following session of the Assembly; perhaps its backers, the physicians, had seen their patients flock to the lower-priced practicers.

Although Virginia was the only colony to set medical fees by law, the practice of legislative price fixing in other areas of the economy was as common in colonial America as it was in England. In Virginia, to be specific, not only prices and quantities but in some cases even qualities of goods and services offered to the public by tavernkeepers, shoemakers, millers, and ferrymen were regulated by law. The economic philosophy and terminology of _laissez faire_ were among the alien isms imported after 1776. During the colonial years, government rarely hesitated to act in the economic field where the need was felt.

From this particular Virginia law of 1736 it would appear that some if not all medical charges had gotten well out of line—the correct line, of course, being what the people and their elected representatives thought was reasonable:

II. BE it therefore enacted, ...

That from and after the passing of this act, no practicer in phisic, in any action or suit whatsoever, hereafter to be commenced in any court of record in this colony, shall recover, for visiting any sick person, more than the rates hereafter mentioned: that is to say,

Surgeons and apothecaries, who have served an apprenticeship to those trades, shall be allowed,

£ s d For every visit, and prescription, in town, or within 00 5 00 five miles For every mile, above five, and under ten 00 1 00 For a visit, of ten miles 00 10 00 And for every mile, above ten 00 00 06 With an allowance for all ferriages in their journeys. To Surgeons, For a simple fracture, and the cure thereof 02 00 00 For a compound fracture, and the cure thereof 04 00 00

But those persons who have studied phisic in any university, and taken any degree therein, shall be allowed,

For every visit, and prescription, in any town, or within 00 10 00 five miles If above five miles, for every mile more, under ten 00 1 00 For a visit, if not above ten miles 1 00 00 And for every mile, above ten 00 1 00 With an allowance of ferriages, as before.

Lest it appear that all Williamsburg “practicers” made a habit of charging excessive fees, the generous treatment an earlier doctor gave at least one of his patients must be set down. George Hume, a Scottish merchant who came to Virginia about 1722 and soon caught all the prevalent ills, found the place “only good for doctors and ministers who have very good encouragem’nt here.” One of the “common distempers” that afflicted Hume was dysentery, then called the flux. He was laid so low that Dr. John Brown all but despaired of his life. Hume’s gratitude for being cured was doubtless enhanced by the fact—carefully reported to his Scottish relatives—that “ye Dr. took nothing for my druggs.”

The third section of the act, specifying exactly what the “practicer of phisic” should set forth in his bill, bears if least a faint augury of modern food-and-drug labeling legislation:

III. And to the end the true value of the medicines administered by any practicer in phisic, may be better known, and judged of, _Be it further enacted, by the authority aforesaid_, That whenever any pills, bolus, portion, draught, electuary, decoction, or any medicines, in any form whatsoever, shall be administered to any sick person, the person administering the same shall, at the same time, deliver in his bill, expressing every particular thing made up therein; or if the medicine administered, be a simple, or compound, directed in the _dispensatories_, the true name thereof shall be expressed in the same bill, together with the quantities and prices, in both cases. And in failure thereof, such practicer, or any apothecary, making up the prescription of another, shall be nonsuited, in any action or suit hereafter commenced, which shall be grounded upon such bill or bills: Nor shall any book, or account, of any practicer in phisic, or any apothecary, be permitted to be given in evidence, before a court; unless the articles therein contained, be charged according to the directions of this act.

This final section reveals that some differentiation between the branches of the medical profession had already begun in America. The tip-off is the phrase that imposes on “any apothecary making up the prescription of another” the same requirements as on physicians who make up their own prescriptions.

_THE DOCTORS OF WILLIAMSBURG_

If competition tends to keep prices low, fees charged in and around the capital city in the early eighteenth century should have been at the rock bottom level. Governor Gooch in 1729 reported to London that Williamsburg abounded in physicians. The same year young Adam Cunningham gave up his brief effort to establish himself in practice as a doctor:

Williamsburg [he wrote] is but a small Village containing not more than 60 families, at most; and in and about this City are no less than 25 or 30 phisitians, and of that number not above 2 capable of living handsomly. So that I did not think it proper to stay, in a place where so many of my profession are lickely to starve.

Little is known about any of these “phisitians,” not even the names of most. It seems fairly sure, however, that a number were quacks. Gooch had complained in the same letter about the “unskilfulness of practioners in this country” but was gullible enough himself to pay 60 pounds from public funds and give freedom to a Negro slave for the secret of the latter’s alleged cure of venereal diseases. It turned out to be a decoction of roots and barks, which the Governor avowed to be “a certain Remedy here” and sent samples so the College of Physicians could try its effect in England.

Most of Gooch’s abundant physicians almost certainly made up their own prescriptions. From 1622 at Jamestown until 1731 in Williamsburg no mention of an apothecary in Virginia has been found in historical records. In the latter year, however, there were four shops purveying drugs and compounding medicines in Williamsburg. The proprietors of two were doctors—Dr. George Gilmer and Dr. Kenneth McKenzie; the other two were druggists or “chymists”—Thomas Wharton and Thomas Goodwin.

Goodwin did not remain independent long. After about two years he joined Dr. Robert Davidson, mayor of Williamsburg, in a partnership that was itself dissolved in two years by the death of Dr. Davidson. Thomas Wharton, on the other hand, kept shop in Williamsburg for some eleven years. He had arrived in Virginia about 1703 as an indentured servant to a Dr. Richard Wright and had acquired by the time of his death in 1746 not only a pharmaceutical business, but the title of “Doctor.” He willed his drugs, medicines, and shop utensils to Dr. McKenzie.

_SHOPKEEPER EXTRAORDINARY_

The fourth named practicer, George Gilmer, Sr., deserves extended attention. He comes as close as any one person to being a typical Williamsburg apothecary-surgeon-physician of his time, though his extramedical career was far from typical.

Born in Edinburgh in 1700, Gilmer studied medicine there, then practiced with one of London’s leading doctors, whose daughter he married. Possibly the death of his young wife moved him to ship for America; at the age of 31 he arrived in Virginia to practice medicine and manage the affairs of a land company. He married again and must have prospered, because in four years’ time he was able to purchase for £155 three choice lots near the Governor’s Palace in Williamsburg.

These three lots, on which the rambling St. George Tucker House has stood since 1788, were described in 1735 as “the Lotts and Land whereon the Bowling Green formerly was, the Dwelling House and Kitchen of William Levingston and the House call’d the Play House.” The last, of course, was the first theater in the English colonies, and Gilmer later sold it to the mayor and aldermen of Williamsburg to be used as a city hall and courthouse. It was a particularly convenient arrangement for one of the aldermen who was to become mayor himself a year later, none other than Dr. George Gilmer.

Gilmer’s career as an apothecary-surgeon-physician was not without its ups and downs. Soon after buying the property on Palace Green, he was giving away samples of rattlesnake root on behalf of Dr. John Tennent, who maintained it would cure pleurisy, the gout, rheumatism, and mad-dog bites.

At the same time the _Virginia Gazette_, Williamsburg’s new weekly, carried the news that “on _Monday_ Morning last, dy’d, at Mr. _Geo. Gilmer’s_, in this City, Mrs. _Susanna Skaife_, ... and was decently interr’d on _Wensday_. And, on _Thursday_ Morning also dy’d, the Rev. Mr. _John Skaife_, her Husband, after a tedious Indisposition.” It would appear that at least Mrs. Skaife was a bed patient in Dr. Gilmer’s home; this was a usual way of caring for serious illnesses before the day of hospitals.

Soon thereafter, Gilmer found it necessary to insert the following advertisement in the _Virginia Gazette_:

Williamsburg _May_ 26, 1737.

_There being a Report industriously spread about the Country, of _George Gilmer’s_ Death, by some well-meaning People, and of his being so much in Debt, that nothing from _England_ would be sent him this Year, _if alive_._

_To obviate such scandalous and groundless _Reports_, I take this Opportunity to acquaint all my Friends, that I can now, better than ever, supply them with all manner of Chymical and Galenical Medicines, truly and faithfully prepared, and at as cheap Rates as can be had from _England_. Also Double-refin’d, Single refin’d, and Lump Sugars, Cinnamon, Cloves, Mace, Nutmegs, _Bateman’s_ Drops, _Squire’s_ Elixir, _Anderson’s_ Pills, Sweet Oil, _&c._ at reasonable Rates; at my Old Shop, near the _Governor’s_._

George Gilmer

Nine years later Gilmer was so much alive and active as to be mayor of the city, the owner of a new four-wheeled chaise, and once more a bridegroom. On the death of his second wife, Gilmer had promptly married his next-door neighbor. The third Mrs. Gilmer was Harrison Blair, daughter of Dr. Archibald Blair and sister of the Hon. John Blair of the governor’s council. The apothecary’s star was rising.

He was still, of course, a shopkeeper. His “Old Shop near the Governor’s” stood at the very edge of Palace Green, a frame building of about 20 feet square. Every year or so he advertised the arrival from England of a shipment of drugs, medicines, spices, and groceries—to be sold at the shop, wholesale or retail, and at reasonable rates.

Archaeological excavations on the site of the first theater, and extending north of it onto the adjacent Brush-Everard House property, yielded quantities of Dr. Gilmer’s domestic and pharmaceutical rubbish. The latter included delftware ointment pots and drug jars, glass medicine phials and fragments of carboys, bottles for Pyrmont mineral water, a brass pestle, and, inexplicably, a human jaw. Just how, or if, that related to Gilmer’s shop remains open to conjecture, but it is evident from the quantity of pharmaceutical artifacts recovered that Dr. Gilmer’s business was as extensive as his 1737 advertisement claimed.

Indeed, Gilmer was no ordinary shopkeeper. His social status—doubtless bolstered by that of his wife’s family—was great enough that he could be among the first to entertain the newly appointed Governor Dinwiddie. One suspects that either the ambitious Dr. Gilmer or his well-born wife decided that his house on Palace Street fell short of such prestigious demands. Six months after the dinner for Dinwiddie, the apothecary was having his dining room wainscoted, with a marble fireplace, a mirror over the mantel, and a cabinet to contain the set of new china his wife had ordered from London.

About the same time Dr. Gilmer, who gave himself perhaps facetiously the title of “colonel,” became part owner of the Raleigh Tavern. The deed by which he and Colonel Chiswell bought the famous inn for £700 testified that he had gained that ultimate accolade of social and economic status in colonial Virginia, the designation “Geo Gilmer Gent.”

In the letters he wrote to London, Gilmer seems to refer to himself not as a doctor or surgeon, but as an apothecary, and his name in public documents as well as in private records most often appears not as Dr. Gilmer but as Mr. Gilmer. He was doubtless prouder of being known as a gentleman and a colonel; the title of doctor was often held in poor esteem. William Byrd II wrote in 1706 that “here be some men indeed that are call’d Doctors: but they are generally discarded Surgeons of Ships, that know nothing above the very common Remedys.” As late as 1783 Dr. Johann Schoepf, writing of his travels through the former colonies, asserted that “in America every man who drives the curing trade is known without distinction as Doctor, as elsewhere every person who makes verses is a poet—so there are both black doctors and brown, and quacks in abundance.”

_THE EDUCATION OF AN APOTHECARY_

Apprenticeship was the usual form of training for all colonial occupations, with the possible exception of the ministry at one end of the scale and ordinary farming at the other. Medicine was not an exception; practitioners normally took apprentices for the same reasons that cabinetmakers or blacksmiths did. The beginning apprentice performed the unskilled and some of the semiskilled duties of the establishment, learning as he did so. As he acquired knowledge, he could give the doctor more and more assistance in his practice.

The doctor generally undertook, if there was a formal indenture, to teach the apprentice the “art and mystery of physic, surgery, and pharmacy,” or words to that effect. Sometimes, however, he agreed to teach only the art of the apothecary. In either event, the apprentice was taught to compound medicines as directed by his master, to search the woods for medicinal plants, and probably to keep books and collect fees. Even an apprentice apothecary might in time be called on to assist—or perhaps even take over—such routine treatments as bleeding. Most likely he also had to spend his evenings reading whatever medical or pharmaceutical works the doctor had on hand—from Hippocrates to the latest edition of the _Edinburgh Pharmacopoeia_.