PHARMACY FROM THE ANCIENT

WORLD TO 1100 AD

PHARMACY IN THE MEDIEVAL

WORLD
2012.04.24.
BPOP1.; Lecture 23. & 24.

History

History of:
Medicine
Pharmacy
People who use them

Different in each country

But it is partly similar history worldwide
1.
2.

3.

Natural substances used by primitive man

Specialized individuals in communities
Early civilizations: physician-pharmacist

4.

Historical evolution connected with medicine

Developed civilizations: separation of professions

Pharmacists
Physicians

Why do we need to talk about this?

History as heritage

History of pharmacy = history of a profession

Contribution of pharmacy to civilization.

Who became pharmacists and why?
What activities did they carry out?
What skills did they need to perform their duties?

Philosophy of the pharmacists role in society

Ways of thinking as a pharmacist

Narrative history

Story of the past, appearance of pharmacy in different times

Great names, interesting stories

Lessons of history

Medical literature
Policy making, disease control

Sources of history in pharmacy

Where can one find material about the history of

pharmacy?
Publications: books and journals
Archives, letters
Prescription books
Oral history
Pharmacy illustrations (images) in

1.

2.
3.

4.
5.
1.
2.
3.
4.

6.

Books
Art
Photographs
Equipments and machines in industry

Pharmacy artefacts: early pestels and mortars, antiques

Products of pharmacists - nomenclature

Products are described by many names

Drugs
Medicines
Pharmaceuticals
Therapeutic drugs

Interchangable?
Do they mean the same?

Drug
Nowdays can be referred to illicit substances
Earlier it was used for active ingredients

Medicine

Product in a finished form (like Panadol tablet)

Pharmaceutical

Broader meaning including active ingredients, products,

vaccines, etc.

Pharmacy from the ancient world to 1100 AD

Pharmacy from the ancient world

Development of human species and civilizations

Prehistoric men: Hunter-gatherer - Food producer

Early civilizations in Babylonia, Egypt, China 4000 B.C.

Disease, illness and accidents needed treatment

Selected specialists treated symptoms

Plants and minerals in nature (early folk medicine)

food-poison-drug?

Called doctor, wise woman, medicine man, priest

Mixture of: instinct + magic + confusion

Practiced pharmaco-magic
Later instinct and magic changed to Empiricism (not science jet)

Discovery of tools, writing/symbols

Specialization

Careful observation, systematic observations, Trial and error method

Causes of illnesses were mostly unknown

Due to supernatural causes, evil or sins

Mesopotamian civilisations, 3000 BC 539 BC

First urban civilisation around 4000 BC

Tigris and Euphrates rivers
Babylon (2200-1300 BC)

Babylonian Assyrian medicine

King Hammurabi (1795-1750 BC)

Hammurabis code regulated medical and surgical practice

Apothecaries: Separation of diagnosis and treatment from preparation of
medicines

Mesopotomian drug formulas were not quantitative

Apothecary = perfumer

Used plant drugs, wound washing, wines, oinments

Manufactured soap, vinegar, plant extracts

Preparation of volatile oils and unguents

king Assur-Bani-Pal (668-627 BC)

Library in Ninive
Clay tablets: 800 fragments contain information on Babylonian medical
treatments

Egyptian civilisations, 3000 BC 1200 BC

Nile valley
Well documented history on:

Formulation of medicines

tombs, ceramic and papyrus

Wine, beer and honey as vehicles for liquid medicines
Honey for incorporation of solids in pills
Waxes for oinments

Papyrus Ebers (1500 BC) ~ 20mx30cm

Dosage forms

Medical-pharmaceutical dissertation ~ 4m
875 prescriptions, 700 drugs (plant, animal, mineral)
21 methods against coughing, 18 skin disorders, etc

Infusions , Decoctions, Pills, Suppositories

Recipes were stated quantitatevly

Use of: mortars, handmills, sieves and balances
Pastophor: preparer of medicines (separated from physicians)

Egyptian civilisations, 3000 BC 1200 BC

Imhotep (2635 2595 BC)

Egyptian

polymath, chancellor to the pharaoh

and high priest, architect - Pyramid of Djoser
probably acoauthor of Edwin Smith papyrus
Anatomical

observations and cures

Greeks identified him with Asklepios

God

of medicine and healing

The rod of Asclepius, a snake-entwined staff,
remains a symbol of medicine today.
twisting

the worm around a stick may have inspired

the symbol in case of dracunculiasis

Greek civilisations, 1250 BC 285 BC

Crete Bronze Age culture

Script for writing was developed
Iron melting

Greek empire
Mesopotamian and Egyptian culture had great influence
on Greek culture
Early philosophers theories
Heraclitus of Ephesus: all things were composed of two types of
opposites - wet/dry and hot/cold controlled by Logos
Empedocles: eveything is made up of four elements fire, air,
water and earth

Greek civilisations, 1250 BC 285 BC

Hippocrates (460-377 BC)

Hippocratean Corpus (collection of Ancient Greek
medical works)
Theory of four liquid humours (humoralpathology)

Blood
Phlegm
Yellow bile
Black bile

Disease was the result of excess of one of

these liquid humours, and the
treatment is to eliminate it from the body

Main principles for the practice medicine

Hippocratic Oath, primum nil nocere!
Precise anamnesis (observation) of the patient

Greek civilisations, 1250 BC 285 BC

Aristotle (384-322 BC)

Classification

of animals to genera and species

Polymath: botany, physics, anatomy,
physiology, mathematics

Theophrastus (372-287 BC)

Established

the discipline of botany

Attacking the thoory of four elements
Stressing
Empirical

approach
Experimental evidence

Roman civilisations, 275 BC 476 AD

Expansion of the Roman epire

Overruning two literate nations: Greeks and
Hebrews
Advances in engineering (sewage disposal systems,
aquaducts), law and govrenment

Adoptation of greek medicine

Disseminating medical knowledge in the empire
Celsus (20-50 AD)
Medical practioneer, encyclopaedist
Translated and edited other peoples work
De Medicina (8 books)

250 drugs, 100 surgical procedures

Roman civilisations, 275 BC 476 AD

Dioscorides (50-100 AD)

Greek physician, pharmacologist and
botanist
Surgeon of the emperors army
De Materia Medica ("Regarding Medical
Materials")

List of materials of animal, plant and mineral

origin
"precursor to all modern pharmacopeias
It remained in use until about 1600 BC
It was circulated in Latin, Greek, and Arabic

For every illness there is a specific plant

remedy

Roman civilisations, 275 BC 476 AD

Galen (129-199 AD)

Physician and surgeon of gladiators
Experiments: dissected animals
Developed the humoral pathology scheme

Combining earlier theories like Hippocratic

theory and the four temperaments of man
All illness is the result of imbalance between Four bodily fluids affect human
these elements
personality and behaviors

Apotheca = storeroom for drugs

Galenicals = creams and ointments

1. sanguine (pleasure-seeking
and sociable)
2. choleric (ambitious and
leader-like)
3. melancholic (introverted
and thoughtful)
4. phlegmatic (relaxed and
quiet)

Arabian civilisations, 400 AD 1100 AD

Arab empire
Greek and Roman works were translated to
Arabic
Apothecary shops appeared (850 AD)
Separation

of medicine from pharmacy

Precise education
High code of ethics
Wide range of medicines

Movement of scholars from Persia

Religious

oppression
To the west: Italy, France

Arabian civilisations, 400 AD 1100 AD

Rhazes (865-925 AD)
(Mohammad-e Zakari-ye Rzi)

the

Persian Galen
Physician at Baghdads great hospital
Writer, chemist and teacher
Well equiped laboratory
Book of Medicine
Encyclopedia

derived from Greek, Arabic, Persian

and Indian sources

Use

of pills
differentiated smallpox from measles

Arabian civilisations, 400 AD 1100 AD

Avicenna (980-1037 AD) (Ibn Sina)

Studied medicine at age 15
writing on philosophy, astronomy, alchemy, geology,
psychology, Islamic theology, logic, mathematics
Canon of Medicine (al-Qanum)

Containing teachings from Hippocrates, Galen and

Aristotle
5 books, 760 drugs and their antidotes
Translated to Latin
text-book in the universities of
medieval Europe

Silvering of pills

By the end of th 11th century

Basic conditions for the development of a separate

profession were available:
Natural

materials for medical use have been identified

Encyclopedias and writing was available to pass on
knowledge
Technologies for processing of raw materials have been
developed
First steps toward separation of professions have been
taken

Science, culture and art evolved simultaneously

polymaths

Developments of and the opposition to science

and experimental medicine in Europe

Advances of the Mesopotamian, Egyptian, Greek and Roman

cultures resulted in:

Development of botany, biology, philosophy

Medical theories
Experimental knowledge
Encyclopedias

Drugs and medications

Animal, Plant and Mineral substances

Formation of physician and drug manufacturer specialisation

Rise of the Christian religion

Churches enforced obedience to dogma

Natural philosophy was forbidden
Works of Hippocrates, Galen and Dioscorides were preserved in
libraries of Christian monks
Dark Ages (735-1150 AD)

Pharmacy in the medieval world

From 1100 to 1617 AD

Medieval world

Constant wars
Frequent epidemics, infectious diseases

Majority of people lived a short life

Crusades (1095 and 1291)

Black Death (Yersinia pestis)

estimated to have killed 3060 % of Europe's population,
reducing world population by 100 million

series of religious expeditionary wars

Impact of the crusades

Spice and drug trade, commercial centers, weight and measure,

coins for trading
Adaptation of new ideas:

Separation of pharmacy from medicine

Compounding drugs in large scale
Government officer inspection of shops run by pharmacists, herbalists

Medical schools

Developments in Europe

Centers of learning in Italy, Spain, France created

Medical school of Salerno (Scuola Medica

Salernitana) - 1077

Medical schools

first medieval medical school

Meeting of different culture: Greek-Latin medical tradition
merging with the Arab and Jewish medical traditions

France: Montpellier
Spain: Cordova

Developments regarding pharmacy

Distillation
Stressing the value of chemistry

First formal separation of pharmacy from

medicine in Europe - 1231

Idea of separation introduced by the Arabs into Sicily

Edict(=regulation) of Frederik II of Hohenstaufen (1231)

Emperor of Germany and king of Sicily

Created clear distinction between the responsibilities of
physicians and those of apothecaries
Laid down regulations for their professional practice

Particular skills and responsibilities were required

Druggist confectionarii
Apothecary -stationarii

Avoid the expliotation of the sick

Government supervision of pharmacy, controlled prices
Had to stock certain drugs
Can not store them for more than 1 year

This idea spread across Europe

Basel Switzerland: Apothecaries Oath (1271)

no physician shall own an apothecarys business

The Guilds

Traders were organising themselves into craft and

merchant guilds (like Guild-Merchant, wool traders)
For the interest of its members
Exluding strangers

Pharmacy was also a trading activity at that time

Decree of King Edward III. (1363)

Every craftsmen had to enrolled in a guild = registration

Traders of drugs and spices

Were guild members
Had pharmaceutical knowledge

Medieval hospitals

Pharmacy was also practiced in hospitals

Hospitals
Early

Roman military hospitals

Later also for travelers (guesthouse and therapy)
Special institutions outside cities
Leper

houses (Mycobacteriom leprae)

Pets houses (Yersinia pestis)

Respective roles of physicians and apothecaries

Pharmacists (apothecaries) were practicing
In

retail premises (shops)

Public institutions (hospitals)

Benedictine Abbey and Monastery in Pcsvrad

Founded in 1015 AD
Pharmacy
Garden for herbs

Sources of medical knowledge

Medical universities from 14th century in Europe

Slow spreading of knowledge = no printed books

Herbals

Monks hand copied and translated manuscripts, painted

illustrations

Medical literature about medicines, drugs, plants

Sources of information on preparing medicines
De Materia Medica by Dioscorides (100)

Woodcuts
Printed books

De Viribus Herbarium by Macer Floridus (1477)

Development of pharmacopoeias

Herbals were often diferent in content and

inconsistent

Plants were difficult to identify

Need for standardisation and official publications

Nuovo Receptario (1498)
Florence Italy
Published by the Guild of Apothecaries and the
Medical Society

London Pharmacopoeia (1618)

Standards for the whole country
Contained salts, chemicals and metals

Renaissance

Paracelsus (1493-1541)
German-Swiss physician, botanist, alchemist,
astrologer
Philippus Aureolus Theophrastus Bombastus von
Hohenhe
"Paracelsus is meaning "equal to or greater than
Celsus"

Questioned works of Avicenna and Galen

publicly burned traditional medical books

Belief in chemical and mineral remedies

mercury, lead, sulphur

Medical use of opium pills and tincture

New dosage forms: extracts and tinctures
only the dose determined if a substance was
poisonous or not

Foundation of the Society of Apothecaries

Sale of medicines was a business for long time

Apothecaries were members of the Grocers

Company

King James I (Charter of 1617)

The Worshipful Society of the Art and Mystery of
the Apothecaries
Complete independence for apothecaries just like
for physicians
Important landmark of the profession of pharmacy

7 years training with a master apothecary

Oral examination: Preparation, dispensing, handling and
compounding of medicines

PHARMACY IN THE
MODERN WORLD
FROM 1600
UNTIL THE XX. CENTURY
PREPARATION FOR FINAL TEST
2012.05.02.
BPOP1.; Lecture 25. & 26.

Europe and England in the 1600s

Growth of population
Different living conditions
Rich:

large houses separated

Poor: terrible conditions
Streets

covered in sewege, rats

Spread of diseases and plagues

Smallpox,

dysentery, typhus, tubercolosis

High infant mortality

Medical practice in the 1600 and 1700

Largely based on system of Hippocrates and Galen

Treatments included

Disease is caused by the bodys four humours

Physicians examined which humour is in excess
Bleeding
Pugratives
Diaphoretics (promoting sweating)

Medical service providers:

Physicians healing, expensive, only for the rich

Apothecary dispensing/preparing medicines according to prescription

Also gave advice on treatment (no charge) middle class, poor

Traveling salesman
Family, Religious ministers, Wise woman poor people

Prayers
Medical plants

Pharmaceutical practice in the 1700

Development of printed formularies and pharmacopoeias

Growing understanding of medicines

New drugs in pharmacopoeias

Rejecting principles of humoral pathology

Ferrous sulphate, Benzoic acid

Apothecaries became legitimised practioneers of

medicine
formation of the Pharmaceutical Society of Great
Britain- 1841
Register of pharmacists,

Rise of welfare and national insurance

Development of Friendly societies

People join together for a common financial or social purpose

Working people pay small amount of money regularly

Societies pay for medical service in time of need

Rise of welfare in the XX. century

Public education
Old age pension
Unemployment pay and sick pay
National insurance and health service

More dispensing according to prescriptions

Administrative duties (doctors prescriptions, insurance companies)
Standardisation of common remedies, no secret medicines accepted