Chapter XIV: Medicines From the Metals 376 (4)

Our language indicates to some extent what Pharmacy owes to the Arabs. Alcohol, julep, syrup, sugar, alkermes, are Arabic names; the general employment in medicine of rhubarb, senna, camphor, manna, musk, nutmegs, cloves, bezoar stones, cassia, tamarinds, reached us through them. They first distilled rose water. They first established pharmacies, and from the time of Haroun Al-Raschid there is evidence that the Government controlled the quality and prices of the medicine sold in them. Sabor-Ebn-Sahel, president of the school of Dschondisabour, was the author of the earliest pharmacopœia, which was entitled “Krabadin”; and Hassan-Ali-Ebno-Talmid of Bagdad in the tenth century, and Avicenna (Al-Hussein-Ben-Abdallah-Ebn-Sina) in the eleventh century prepared collections of formulas which were used as pharmacopœias.

It was the Arabs who raised pharmacy to its proper dignity. We do not read of any noted pharmacists among them who were not physicians, but the latter were all keen students of the materia medica, and occupied themselves largely with pharmaceutical studies. But it is evident that there was a distinct profession of pharmacy. We read of Avicenna, for example, taking refuge with an apothecary at Hamdan, and there composing some of his famous works. Elsewhere a quotation from Rhazes gives some indication of the irregular practice of medicine which has prevailed in every country and among all nations; and Sprengel quotes some translated items from various Arabic authors which show that as early as the ninth century the Government sanctioned the book of pharmaceutical formulas, compiled by Sabor-Ebn-Sahel, director of the School of Dschondisabour, already mentioned. His work was frequently imitated in later times. The first London Pharmacopœia was professedly based largely on the Formulary of Mesuë.

There is also evidence that both in civil life and in the army the pharmacists were closely supervised. Their medicines were inspected, and the prices at which they were sold to the public were controlled by law.

The development and progress of medicine and its associated sciences among the Arabs may be very concisely sketched. The flight of Mohammed from Mecca to Medina, the Hejira as it is called, from which the Mohommedan era is dated, corresponds in our chronology with A.D. 622. The prophet died in 632. Contemporary with him lived a priest at Alexandria named Ahrun or Aaron, who compiled from Greek writers thirty books which he called the Pandects of Physic. These were translated into Syriac and Arabic about 683 by a Jew of Bassora named Maserdschawaih-Ebn-Dschaldschal. It is not in existence, and is only known by references to it made by Rhazes. The first allusion to small-pox known to history was contained in these Pandects. Serapion quotes a number of formulas which he says were invented by Ahrun. In 772 Almansor, the Caliph who founded the city of Bagdad, brought thither from Nishabur (Dschondisabour) in Persia, a famous Christian physician named George Baktischwah, who stayed for some time, and at the request of Almansor translated into Arabic certain books on Physic. He then returned to his own land, but his son was afterwards a physician in great favour with the two succeeding Caliphs, Almohdi and Haroun Al-Raschid. Freind states that when the elder Baktischwah returned to Persia Almansor presented him with 10,000 pieces of gold, and that Al-Raschid paid the younger Baktischwah an annual salary of 10,000 drachmas. The last-named ruler also brought to Bagdad the Nestorian Christian, Jahiah-Ebn-Masawaih, who, under the name of Mesuë the Elder, retained a reputation for his formulas even up to the publication of the London Pharmacopœia.

Mesuë is noted for his opposition to the violent purgative medicines which the Greek and Roman physicians had made common, and he had much to do with the popularisation, if not with the introduction of, senna, cassia, tamarinds, sebestens, myrabolans, and jujube. He modified the effects of certain remedies by judicious combinations, as, for example, by giving violet root and lemon juice with scammony. He gave pine bark and decoction of hyssop as emetics, and recommended the pancreas of the hare as a styptic in diarrhœa.

A disciple of Mesuë’s, Ebn-Izak, added greatly to the medical resources of the Arabs by translations of the works of Hippocrates, Galen, Pliny, Paul of Egineta, and other Greek authors.

Abu-Moussah-Dschafar-Al-Soli, commonly called Geber, the equivalent of his middle name, is supposed to have lived in the eighth century. It has already been remarked that the chemical discoveries attributed to this philosopher were probably the achievements of many workers, and were afterwards collected and passed on to posterity as his alone. From him are dated the introduction into science, to be adopted later in medicine, of corrosive sublimate, of red precipitate, of nitric and nitro-muriatic acids, and of nitrate of silver.

These chemical discoveries must have been made within the hundred years from 750 to 850, because Rhazes, who wrote in the latter half of the ninth century, mentions them. Geber has been supposed to have claimed to have discovered the philosopher’s stone, and to have made the universal medicine. But it is not at all certain that he contemplated medicine at all. His language is highly figurative, and probably when he says his gold had cured six lepers he meant only that he had, or thought he had, extracted gold from six baser metals.

Rhazes, whose Europeanised name is the modification of Arrasi, which was the final member of a long series of Eastern patronymics, was of Persian birth, and commenced his studies in that country with music and astronomy. When he was thirty he removed to Bagdad, and it was not until then that he took up the sciences of chemistry and medicine. Subsequently he was made director of the hospital of Bagdad, and his lectures on the medical art were attended by students from many countries. His principal work was entitled Hhawi, which has been translated Continent, apparently because it was supposed to contain all there was to know about medicine. The style of this treatise is that of notes without method, and it is certain that it could not have been written entirely by Rhazes, as authorities are named who did not live until after he had died. The theory is that Rhazes left a quantity of notes of his lectures and cases, and that some of his disciples afterwards published them with additions, but without much editing.

Among the methods of treatment for which Rhazes is responsible may be mentioned that of phthisis, with milk and sugar; of high fever, with cold water; of weakness of the stomach and of the digestive organs, with cold water and buttermilk; and he advises sufferers from melancholia to play chess. He states that fever is not itself a disease, but an effort of nature to cast out a disease. He was particularly careful in the use of purgatives, which he said were apt to occasion irritation of the intestinal canal, and in dysentery he relied usually on fruits, rice, and farinaceous food, though in severe cases he ordered quicklime, arsenic, and opium. In Freind’s History of Medicine (1727) a translation of some comments of Rhazes on the impostors of his day shows better than the citations already given how just and, it may be said, modern were the ideas of this practitioner of more than a thousand years ago. It may be added that Freind is not very complimentary to Rhazes generally. I append an abbreviation of this interesting notice of the quackery of the ninth century.

There are so many little arts used by mountebanks and
pretenders to physic that an entire treatise, had I mind to
write one, would not contain them. Their impudence is equal to
their guilt in tormenting persons in their last hours. Some
of them profess to cure the falling sickness (epilepsy) by
making an issue at the back of the head in form of a cross,
and pretending to take something out of the opening which
they held all the time in their hands. Others give out that
they will draw snakes out of their patients’ noses; this they
seem to do by putting an iron probe up the nostril until the
blood comes. Then they draw out an artificial worm, made of
liver. Other tricks are to remove white specks from the eye,
to draw water from the ear, worms from the teeth, stones from
the bladder, or phlegm from various parts of the body, always
having concealed the substance in their hands which they
pretend to extract. Another performance is to collect the evil
humours of the body into one place by rubbing that part with
winter cherries until they cause an inflammation. Then they
apply some oil to heal the place. Some assure their patients
they have swallowed glass. To prove this they tickle the
throat with a feather to induce vomiting, when some particles
of glass are ejected which were put there by the feather. No
wise man ought to trust his life in their hands, nor take any
of their medicines which have proved fatal to many.

Rhazes writes of aqua vitæ, but it is now accepted that he only means a kind of wine. The distillation of wine was not practised till a century after him. Mercury in the form of ointment and corrosive sublimate were applied by him externally, the latter for itch; yellow and red arsenic and sulphates of iron and copper were also among his external remedies. Borax (which he called tenker), saltpetre, red coral, various precious stones, and oil of ants, are included among the internal remedies which he advises.

As represented on the diploma of the Pharmaceutical Society.]

The Arab author who acquired by far the greatest fame in Western lands, and who, indeed, shared with Galen the unquestioning obedience of myriads of medical practitioners throughout Europe until Paracelsus shook his authority five hundred years after his death, was Al-Hussein-Abou-Ali-Ben-Abdallah-Ebn-Sina, which picturesque name loses its Eastern atmosphere in the transmutation of its two concluding phrases into Avicenna. This famous man was born at Bokhara in 980; at twelve years of age he knew the Koran by heart; at sixteen he was a skilful physician; at eighteen he operated on the Caliph Nuhh with such brilliant success that his fame was established. In the course of a varied life he was at one time a Vizier, and soon afterwards in prison for being concerned in some sedition. He escaped from prison and lived for a long time concealed in the house of a friendly apothecary, where he wrote a large part of his voluminous “Canon.” He spent the later years of his life at Ispahan, where he was in great favour with the Caliph Ola-Oddaula, and he died at Hamdan in 1038 in the fifty-eighth year of his age. He had led an irregular life, and it was said of him that all his philosophy failed to make him moral, and all his knowledge of medicine left him unable to take care of his own health.

Competent critics who have studied the medical teaching of Avicenna have not been able to discover wherein its merits have justified the high esteem to which it attained. The explanation appears to be that what Avicenna lacked in originality he made up in method. The main body of his “Canon” is a judicious selection from the Greek and Latin physicians, and from Rhazes and other of his Arabic predecessors. He wrote a great deal on drugs and remedies, but it has been found impossible to identify many of the substances of his Materia Medica, as in many cases the names he gives evidently do not apply to those given by Serapion, Rhazes, and other writers. He often prescribed camphor, and alluded to several different kinds; a solution of manna was a favourite medicine with him; he regarded corrosive sublimate as the most deadly of all poisons, but used it externally; iron he had three names for, probably different compounds; he had great faith in gold, silver, and precious stones; it was probably he who introduced the silvering and gilding of pills, but his object was not to make them more pleasant to take, but to add to their medicinal effect.

Serapion the younger, and Mesuë the younger, who both lived soon after the time of Avicenna, were principally writers on Materia Medica, from whose works later authors borrowed freely.

The subsequent Arab authorities of particular note came from among the Western Saracens. Albucasis of Cordova, Avenzoar of Seville, and Averrhoes of Cordova, who are all believed to have flourished in the twelfth century, were the most celebrated. Albucasis was a great surgeon and describes the operations of his period with wonderful clearness and intelligence. Avenzoar was a physician who interested himself largely in pharmacy. He was reputed to have lived to the age of 135 and to have accumulated experience from his 20th year to the day of his death. Averrhoes knew Avenzoar personally, but was younger. He was a philosopher and somewhat of a freethinker who interested himself in medical matters. We are naturally more concerned with Avenzoar than with the others.

It is evident from the books left by Avenzoar, whose full name was Abdel-Malek-Abou-Merwan-Ebn-Zohr, that in his time the practices of medicine, surgery, and pharmacy were quite distinct in Spain, and he apologises to the higher branch of the profession for his interest in those practices which were usually left to their servants. But he states that from his youth he took delight in studying how to make syrups and electuaries, and a strong desire to know the operation of medicines and how to combine them and to extract their virtues. He writes about poisons and antidotes; has a chapter on the oil alquimesci, which Freind renders oil of eggs, and Sprengel calls oil of dates. Avenzoar says his father brought it from the East, and that it was a marvellous lithontryptic. He tells how mastic corrects scammony, and sweet almonds colocynth. He is the earliest writer to refer to the medicinal virtues of the bezoar stones. He gives a different account of the origin of these stones from that of other authors. The best, he says, comes from the East and is got from the eyes of stags. The stags eat serpents to make them strong, and at once to prevent any injury their instinct impels them to run into streams and stand in the water up to their necks. They do not drink any water. If they did they would die immediately; but standing in the stream gradually reduces the force of the poison, and then a liquor exudes by the eyelids which coagulates and forms a stone which may grow to the size of a chestnut, which ultimately falls off. According to another Arab author, Abdalanarack, the bezoar stone acquired such a celebrity in Spain that a palace in Cordova was given in exchange for one.

Moses Maimonides, the most famous Jewish scholar and theologian of the middle ages, must be mentioned among the exponents of Arab pharmacy. He was born at Cordova in 1139, and studied medicine under Averrhoes, but when he was twenty-five the then Mohammedan ruler of Spain required him to be converted or quit the kingdom. Maimonides therefore went to Cairo, and became physician to Saladin, the well-known hero of Crusade wars, who was then Sultan of Egypt. Among his duties he had to superintend the preparation of theriaca and mithridatium for the Court. The drugs for these compounds, Maimonides says, had to be brought from the East and the West at great expenditure of time and money. Consequently, “the illustrious Kadi Fakhil,” (who was apparently one of Saladin’s ministers), “whose days may God prolong, ordered the most humble of his servants in 595 (A.D. 1198) to compose a treatise, small, and showing what ought to be done immediately for a person bitten by a venomous animal.” The treatise which Maimonides composed, in obedience to this order, he called “Fakhiliteh.” This small popular manual reflects in general the pharmacy of Spain and is of no particular interest. The author considers that for all kinds of poisons and venoms the most efficacious antidote is an emerald, laid on the stomach or held in the mouth; and he notes the virtues of theriaca, mithridatium, and of bezoar. But the Kadi was thinking of poor people, and therefore more ordinary remedies were also named. A pigeon killed and cut in two pieces might be applied to painful wounds, but if this was not available warm vinegar with flour and olive oil might be substituted. Vomiting must be excited, and to destroy the virus a mixture of asafœtida, sulphur, salt, onions, mint, orange-pips, and the excrement of pigeons, ducks, or goats, compounded with honey and taken in wine, was recommended. The wisdom of Rhazes, of Avenzoar, and of other great authorities was also drawn from.

VII

FROM THE ARABS TO THE EUROPEANS

“Mediciners, like the medicines which they employ, are often
useful, though the one were by birth and manners the vilest
of humanity, as the others are in many cases extracted from
the basest materials. Men may use the assistance of pagans and
infidels in their need, and there is reason to think that one
cause of their being permitted to remain on earth is that they
might minister to the convenience of true Christians.”--The
Archbishop of Tyre in Sir Walter Scott’s _Talisman_.

It would require a very long chapter and would be outside the scope of this work to attempt to trace in any detail the manner in which the ancient wisdom and science of the Greek and Latin authors, which was so marvellously preserved by the iconoclastic Arabs, was transferred, when their passion for study and research began to fail, to European nations. It has been alleged that the Crusades served to bring the attainments of the Eastern Saracens to the knowledge of the West through learning picked up by the physicians and others who accompanied the Christian armies against the Mohammedans.

But there is no evidence and not much probability that Europeans acquired any Eastern science of value through the Crusades. Indirectly medicine ultimately profited greatly by the commerce which these marvellous wars opened up between the East and the West, and the diseases which were spread as the consequence of the intimate association of the unwholesome hordes from all the nations concerned, resulted in the establishment of thousands of hospitals all over Europe. The provision of homes for the sick was far more common among the Mohammedans than among the Christians of that period. Activity of thought was stimulated, and medical science must have shared in the effects of spirit of inquiry. Some historians have supposed that the infusion of astrological superstitions into the teaching and practice of medicine was largely traceable to the communion with the East in these Holy Wars: but this idea is not supported by anything that we know of the Arab doctors. “I have not found the union of astrology with medicine taught by any writer of that nation,” says Sprengel; and his authority is very great. On the other hand the philosophers and theologians of that age were only too eager to seize upon anything mystic, and plenty of materials for their speculations were found in the Greek and Latin manuscripts handed down to them. Superstitions entered into the mental furniture of the age much more directly from Rome and Alexandria than from Bagdad.

That the Arabs of the East could have taught their Christian foes much useful knowledge cannot be doubted. The letter from the Patriarch of Jerusalem to Alfred the Great (see page 131), for example, is proof of the pharmaceutical superiority of the Syrians over the Saxons at that time.

M. Berthelot has shown by abundant evidence in his “History of Alchemy” that the Latin works dealing with chemistry of the thirteenth, fourteenth, and fifteenth centuries which were very numerous in Christendom, were almost exclusively drawn from Arabic sources. Such chemical learning as the Arabs had collected from Greek writers, as well as that which they had added from their own investigations, in this way found its way back to the heirs of the original owners as they may be called.

We read likewise of Constantine the African, who, about the year 1050, came to Salerno after a long residence in the East, and gave to the medical school of that city the translations he had made from Arab authors. But, notwithstanding these evidences of Eastern culture, it is certain that the actual introduction of pharmacy into the Northern European countries is much more largely due to the Spanish Mohammedans. In the Middle Ages poor Arabs and Jews who had studied medicine in the schools of Cordova and Seville tramped through France and Germany, selling their remedies, and teaching many things to the monks and priests who, in spite of repeated papal edicts forbidding them to sell medicines, did in fact cultivate all branches of the art of healing, including many superstitions. The edicts themselves are evidence that they sold their services to those who could afford to pay for them.

The Medical School of Salerno, already mentioned, was the principal link between the later Greek physicians and the teaching institutions which remain with us to this day, as, for instance, the universities of Paris, Naples, Oxford, Padua, Vienna, and others of later fame. The origin of the school of Salerno is unknown, but it was certainly in existence in the ninth century. It was long supposed to have developed from a monastic institution, but it is now generally believed to have been always a secular school. Its historian, Mazza of Naples, 1681, quotes an ancient chronicle which names Rabbi Elinus (a Jew), Pontus (a Greek), Adala (a Saracen), and Salernus (a Roman) as its founders, but there is no evidence of the epoch to which this refers. Although other subjects were taught at Salerno, it became specially noted for its medical school, and in the ninth century it had assumed the title of Civitas Hippocratica. William of Normandy resorted to Salerno prior to his conquest of England, and a dietetic treatise in verse exists dedicated to his son Robert. It has been claimed that the works of Hippocrates and Galen were studied at Salerno from its earliest days, but so far as this was the case it was by the intermediary of Jewish doctors, who themselves derived their knowledge from Arab sources, that these were available. The original texts of the Greek and Latin authors were not in the hands of European scholars till Aldus of Venice began to reproduce them early in the sixteenth century.

The pharmaceutical knowledge to which the famous school attained may be judged by the reputation which attended the Antidotary of Nicolas Prepositus, who was director of the school in the first half of the twelfth century. In this Antidotary are found the absurd formulas pretending to have been invented or used by the Apostle Paul and others. “Sal Sacerdotale quo utebantur sacerdotales tempore Heliae prophetae” is among these. In the course of the next century or two medical students from England, Germany, Italy, and France went to Cordova, Toledo, and Seville, and there wrote translations of the medical works used in those schools. These translations by the end of the thirteenth century were so universally accepted as to eclipse Salerno, which from then began to decline in fame, Bologna, Montpellier, Padua, and Leyden gradually partitioning among themselves its old reputation. But the medical school of Salerno actually existed until 1811, when it was dissolved by a decree of Napoleon I.

As evidence of the monopoly of Avicenna in the medical schools of Europe at the beginning of the sixteenth century, and doubtless for a long period previously, the following from the preface to a Latin translation of the works of Paulus Egineta is quoted by Leclerc:--

Avicenna, who is regarded as the Prince and most excellent of
all physicians, is read and expounded in all the schools; and
the ninth book of Rhazes, physician to the Caliph Almansor,
is similarly read and commented on. These are believed to
teach the whole art of healing. A few later writers, such
as Betruchius, Gatinaria, Guaynerius, and Valescus, are
occasionally cited, and now and then Hippocrates, Galen,
and Dioscorides are quoted, but all the other Greek writers
are unknown. The Latin translations of a few of the books
of Galen and Hippocrates which are in use are very corrupt
and barbarous, and are only admitted at the pleasure of the
Arabian Princes, and this favour is but rarely conceded.

The most notable event in the history of pharmacy after the earlier Crusades was an edict regulating the practice of both medicine and pharmacy issued by Frederick II, the Holy Roman Emperor and King of Sicily. This monarch, probably the ablest ruler in the Middle Ages, who died in 1250, had great esteem for Arab learning. Mohammedans and Jews were encouraged to come to Naples during his reign, and he facilitated by all means in his power the introduction of such innovations as had been acquired from Cordova and Bagdad.

The edict referred to mentions “apotheca,” meaning thereby only the warehouses where prepared medicines were stored. Those who compounded the medicines were termed “confectionarii,” the places or shops where they were sold were called “stationes,” and the persons who supplied them, “stationarii.” It is not quite clear whether the confectionarii and the stationarii were the same persons. Probably they were sometimes, but not necessarily always. Apparently the stationarii were generally the drug importers and dealers, and the confectionarii were the compounders. Both had to be licensed by the Medical School of Salerno; and among the duties imposed upon the physician, one was to inform the authorities if he came to discover that any “confectionarius” had falsified medicines. Longfellow alludes to this provision in the “Golden Legend”--

To report if any confectionarius
Mingles his drugs with matters various.

The physician was strictly forbidden to enter into any arrangement with a druggist whereby he would derive any profit by the sale of medicaments, and he was not permitted himself to conduct a pharmacy. The “confectioners” were required to take an oath to prepare all medicines according to the Antidotary of the Salernian School. Their profits were limited and graduated, less being allowed on those of frequent consumption than on those which they had to keep for more than a year. Pharmacies were only allowed in the principal cities, and in each such city two notable master-apothecaries were appointed to supervise them. The “confectioners” had to make their syrups and electuaries and other compounds in the presence of these two inspectors, and if they were detected in any attempt at fraud their property was subject to confiscation. If one of the inspectors was found to have been a party to the fraud his punishment was death.

“It is well known,” says Beckmann in “Ancient Inventions,”
“that almost all political institutions on this side the Alps,
and particularly everything that concerned education, were
copied from Italian models. These were the only patterns then
to be found; and the monks despatched from the papal court
saw they could lay no better foundation for the Pontiff’s
power and their own aggrandizement than by inducing other
States to follow the examples set them in Italy. Medical
establishments were formed, therefore, everywhere at first
according to the plan of that at Salerno. Particular places
for vending medicines were more necessary in other countries
than in Italy. The physicians of that period used no other
drugs than those recommended by the ancients; and as these had
to be procured from the Levant, Greece, Arabia, and India,
it was necessary to send thither for them. Besides, herbs,
to be confided in, could only be gathered when the sun and
planets were in certain constellations, and certificates of
their being so were necessary to give them reputation. All
this was impossible without a distinct employment, and it
was found convenient to suffer dealers in drugs gradually to
acquire monopolies. The preparation of medicines was becoming
more difficult and expensive. The invention of distillation,
sublimation, and other chemical processes necessitated
laboratories, furnaces, and costly apparatus; so that it was
thought proper that those who devoted themselves to pharmacy
should be indemnified by an exclusive trade; and monopolists
could be kept under closer inspection so that the danger
of their selling improper drugs or poisons was lessened or
entirely removed. They were also allowed to deal in sweetmeats
and confectionery, which were then great luxuries; and in some
places they were required to give presents of these delicacies
to the magistrates on certain festivals.”

This extract shows how the German provision of protected pharmacy originated. In many of the chief cities the apothecaries’ shops were established by, and belonged to, the King or Queen, or the municipality. Sometimes, as at Stuttgart, there was a contract between the ruler and the apothecary, the former agreeing to provide a certain quantity of wine, barley, and rye; while the apothecary in return was to supply the Court with its necessary confectionery.

Beckmann gives much minute information concerning the establishment of apothecaries’ shops in the chief cities of Germany.[1] He mentions a conjecture that there was a pharmacy at Augsburg in the thirteenth and fourteenth centuries, but exact dates begin with the fifteenth century. There was a female apothecary established at Augsburg in 1445, and the city paid her a salary. At Stuttgart, in 1458, Count Ulric authorised one Glatz to open a pharmacy. There was one existing at Frankfort in 1472. The police regulations of Basle in 1440 mention the public physician and his duty, adding that “what costly things people may wish to have from the apothecary’s shop they must pay for.” The magistrates of Berlin, in 1488, granted to one Hans Zebender a free house, a certain provision of rye, no taxes, and the assurance that no other apothecary should reside in the city. But the Elector Joachim granted a new patent to another apothecary in 1499. At Halle there was only one apothecary. In that year the Archbishop, with the confirmation of the Chapter, granted to his physician, von Wyke, the privilege of opening another, but gave at the same time the assurance that no more should be permitted in the city “to eternity.”

In France apothecaries were in business as such certainly before 1250. A charter of the church of Cahors, dated 1178, describes the retail shopkeepers of the town as “apothecarii,” the term being used evidently as “boutiquiers” is now, and signifying nothing more than shopkeepers. The meaning, however, soon became restricted to dealers in drugs and spices. In the middle of the next century John of Garlande alludes to “appotecarii,” who sold confections and electuaries, roots and herbs, ginger, pepper, cumin, and other spices, wax, sugar, and licorice. Officially, however, these tradesmen were classed at that time among the “espiciers.” The two guilds, indeed, continued in formal association until 1777, but royal ordinances of 1484 and 1514 clearly established the distinction between them. Even in 1271 the Faculty of Medicine of Paris forbade “herborists and apothecaries” to practise medicine. Special responsibilities, duties, and privileges were expressly provided for the apothecaries, and in the ordinance of 1514 it is specifically declared that though the apothecary is always a grocer, the grocer is not necessarily an apothecary. (“Qui est espicier n’est pas apothicaire, et qui est apothicaire est espicier.”)

In the fourteenth century the apothecaries of Paris were required to subscribe to a formal oath before they were permitted to practise. They swore to live and die in the Christian faith, to speak no evil of their teachers or masters, to do all in their power for the honour, glory, ornament, and majesty of medicine, to give no remedy or purge without the authority of a physician, to supply no drugs to procure abortion, to prepare exactly physicians’ prescriptions, neither adding, subtracting, nor substituting anything without the express permission of the physician, to avoid the practices of charlatans as they would the plague, and to keep no bad or old drug in their stocks. An ordinance of 1359 provides that no one shall be granted the title of master-apothecary unless he can show that he can read recipes.

The edict of 1484, issued during the minority of Charles VIII, sets forth that, “We, of our certain science, especial grace, full power, and royal authority, do say, declare, statuate, and ordain” the curriculum to be observed by those who desire to learn the trade of an apothecary. A four years’ apprenticeship was essential, and the aspirant had to dispense prescriptions, recognise drugs, and prepare “chefs d’œuvres” in wax and confectionery in the presence of appointed master-apothecaries. Latin was added to the examination in 1536, and ten years’ experience after the apprenticeship was also insisted upon ultimately before the candidate could be admitted as a master-apothecary. One of the ordinances of the sixteenth century gave to the apothecaries the monopoly in the manufacture and sale of gingerbread.

These edicts all related particularly to the apothecaries of Paris. There were similar ones in the provinces, with some peculiarities. At Dijon, for example, it was provided that no apothecary could receive a legacy from one of his clients. _En revanche_ he had the first claim on the estate of a deceased debtor for the payment of his account.

In 1629 the Hotel de Ville of Paris granted to the apothecaries of that city a banner and blazon, the latter, which I do not venture to translate, being thus described:--“Couppé d’azur et d’or, et sur l’or deux nefs de gueulle flottantes aux bannieres de France, accompagnés de deux estoiles a cinq poincts de gueulle avec la devise ‘Lances et pondera servant,’ et telles qu’elles sont cy-dessous empreinctes.”

In 1682, under Louis XV, after the Brinvilliers panic, the poison register was introduced, and regulations were framed forbidding apothecaries to sell any arsenic, sublimate, or drug reputed to be a poison except to persons known to them, and who signed the register stating what use they intended to make of their purchase. Earlier in the same reign the practice of pharmacy was strictly forbidden to persons professing the reformed religion.

The last of the royal edicts applying to pharmacy was issued in 1777 by Louis XVI, and, as already stated, this was the authority which finally separated the apothecaries from the grocers. Then came the Revolution, and in 1791 all restrictions on trades or professions, including pharmacy, were abolished. Some accidents having occurred, the Assembly passed an ordinance on April 14, 1791, declaring that the old laws, statutes, and regulations governing the teaching and practice of pharmacy should remain in force until a new code should be framed. This did not appear until April, 1803, under Napoleon’s Consulate, and the law, which is still in force, is to this day cited in legal proceedings as the law of Germinal, year XI.

VIII

PHARMACY IN GREAT BRITAIN.

For none but a clever dialectician
Can hope to become a great physician:
That has been settled long ago.
Logic makes an important part
Of the mystery of the healing art;
For without it how could you hope to show
That nobody knows so much as you know.
--LONGFELLOW: “Golden Legend.”

BRITISH PHARMACY IN SAXON ENGLAND.

The condition of medicine and pharmacy in Saxon times has been carefully portrayed in three volumes published, in 1864, under the authority of the Master of the Rolls at the expense of the Treasury. These were edited by the Rev. Oswald Cockayne, M.A., and appeared under the title of “Leechdoms, Wortcunning, and Starcraft.” Many old documents were translated and explained, and from these the ideas of medicine in these islands a thousand years ago were made manifest.

Mr. Cockayne gave at length a Saxon Herbarium, written, he supposed, about the year 1000, and professing to be a translation from Apuleius, a Roman physician of the second century, with additions from Dioscorides, and some from native science. A few specimens will suffice to show the character of the herb treatment in England before the Conquest.

CRESS, WATERCRESS (Nasturtium officinale).

1. This wort is not sown, but it is produced of itself in wylls (springs), and in brooks, also it is written that in some lands it will grow against walls.

2. In the case that a man’s hair fall off take juice of the wort which one nameth nasturtium, and by another name cress; put it on the nose; the hair shall wax (grow).

3. For sore of head, that is for scurf and for itch, take seed of this same wort and goose grease. Pound together. It draws from the head the whiteness of the scurf.

4. For soreness of the body (the Latin word is ad cruditatem, indigestion) take this same wort nasturtium, and pennyroyal; seethe them in water, give to drink; then amendest thou the soreness of the body, and the evil departs.

5. Against swellings, take this same wort, and pound it with oil; lay over the swellings; then take leaves of the same wort, and lay them thereto.

6. Against warts, take this same wort and yeast, pound together, lay thereto, they be soon taken away.

MAYTHE (Anthemis nobilis).

For sore of eyes, let a man take ere the upgoing of the sun, the wort which is called Chamaimelon, and by another name Maythe, and when a man taketh it let him say that he will take it against white specks, and against soreness of the eyes; let him next take the ooze, and smear the eyes therewith.

POPPY (Papaver somniferum).

1. For sore of eyes, that is what we denominate blearedness, take the ooze of this wort, which the Greeks name Makona and the Romans Papaver album, and the Engles call white poppy, or the stalk with the fruit; lay it to the eyes.

2. For sore of temples or of the head, take ooze of this same wort, pound with vinegar, and lay upon the sore; it alleviates the sore.

3. For sleeplessness, take ooze of this same wort, smear the man with it, and soon thou sendest the sleep on him.

* * * * *

Many of the herbs named in the Herbarium were employed for other purposes than those for which they were used in later practice. Comfrey is recommended for one “bursten within.” It was to be roasted in hot ashes and mixed with honey; then to be taken fasting. But nothing is said of its bone-setting property. Mullein, subsequently famous as a pectoral medicine, is recommended in the Herbarium as an external application in gout, and to carry about to prevent the attacks of wild beasts. Dill is prescribed as a remedy against local itching; fennel in cough and sore bladder; and madder for broken legs, which it would cure in three days.

To prevent sea-sickness the traveller had to smear himself with a mixture of pennyroyal and wormwood in oil and vinegar. Peony laid over a lunatic would soon cause him to upheave himself whole; and vervain or verbena if carried on the person would ensure a man from being barked at by dogs.

A PROFESSED TRANSLATION.

The next document presented is the Medicina de Quadrupedibus of Sextus Placitus, an unknown personage, who adds to the interest of his narrative by pretending that “a king of the Egyptians, Idpartus he was highten,” sent this treatise to the Emperor Octavius Cæsar, “for,” he said, “I wist thee worthy of this.” Probably this manuscript was not a translation at all; if it was, the pretended authors were almost certainly fictitious. Most of the instructions here given relate to the medicinal uses of animals. The idea that foxes’ lungs will strengthen ours is hardly dead yet. Here it is in this old Saxon document:--

“For oppressive hard drawn breathing, a fox’s lung sodden and put into sweetened wine, and administered, is wonderfully healthy.”

The fox had many other uses. Foxes’ grease would heal many kinds of sores. His sinews soaked in honey would cure a sore throat; his “naturam” wrapped round the head would banish headache; his “coillon” rubbed on warts would break them up and remove them; and dimness of sight could be relieved by his gall mingled with honey. The worst recipe is:

For disease of joints. Take a living fox and seethe him till the bones alone are left. Let the man go down therein frequently, and into another bath. Let him do so very oft. Wonderfully it healeth.

There are scores of cures from parts of animals, some of them very disgusting. A few more specimens of decent ones must suffice.

For oversleeping, a hare’s brain in wine is given for a drink. Wonderfully it amendeth.

To get sleep a goat’s horn laid under the head turneth waking into sleep.

For sleep lay a wolf’s head under the pillow; the unhealthy shall sleep.

Let those who suffer apparitions eat lion’s flesh; they will not after that suffer any apparition.

For any fracture, take a hound’s brain laid upon wool and bind upon the broken place for fourteen days; then will it be firmly amended, and there shall be a need for a firmer binding up.

If thou frequently smearest and touchest children’s gums with bitches’ milk, the teeth wax without sore.

VARIOUS LEECHDOMS.

Some “Fly-Leaf Leechdoms” of unknown authorship follow. In these information concerning the four humours is given, hot and cold, moist and dry remedies are distinguished, and we are told of the forty-five dies caniculares “in which no leech can properly give aid to any sick man.” It is carefully noted that the same disorder may occur from different causes, and quite scientifically the practitioner is advised to vary his treatment accordingly. Thus, for example, dealing with “host” (cough) we are told that “it hath a manifold access, as the spittles are various. Whilom it cometh of immoderate heat, whilom of immoderate cold, whilom of immoderate dryness.” The remedies must depend on the causes of the complaint. The “tokens” of “a diseased maw” of “a half head’s ache” (megrims) and of other distempers are set forth with graphic simplicity, and often sensible advice as to diet and medicine is given. But not infrequently the remedy may not be an easily procurable one. For instance “If one drink a creeping thing in water, let him cut open a sheep instantly and drink the sheep’s blood hot”; and “if a man will eat rind which cometh out of Paradise no venom will damage him.” The writer considerately adds that such rind is “hard gotten.”

The following is apparently adapted from Alexander of Tralles, or some other of the later classical authors.

“Against gout and against the wristdrop; take the wort hermodactylus, by another name titulosa, that is in our own language the great crow leek; take this leek’s heads and dry them thoroughly, and take thereof by weight of two and a half pennies, and pyrethrum and Roman rinds, and cummin, and a fourth part of laurel berries, and of the other worts, of by weight of a halfpenny, and six pepper corns, unweighed, and grind all to dust, and add wine two egg-shells full; this is a true leechcraft. Give it to the man to drink till that he be hole.”

A few other recipes in the Leechbooks may be quoted:--

For headache take a vessel full of leaves of green rue, and a spoonful of mustard seed, rub together, add the white of an egg, a spoonful, that the salve may be thick. Smear with a feather on the side which is not sore.

For ache of half the head (megrim) take the red nettle of one stalk, bruise it, mingle with vinegar and the white of an egg, put all together, anoint therewith.

For mistiness of the eyes take juice of fennel and of rose and of rue, and of dumbledores’ honey; (the dumbledore is apis bombinatrix); and kid’s gall, mixed together. Smear the eyes with this. Again, take live periwinkles burnt to ashes; and let him mix the ashes with dumbledores’ honey.

For sore and ache of ears take juice of henbane, make it lukewarm, and then drip it on the ear; then the sore stilleth. Or, take garlic and onion and goose fat, melt them together, squeeze them on the ear. Or, take emmets’ eggs, crush them, squeeze them on the ear.

For the upper tooth ache:--Take leaves of withewind (convolvulus), wring them on the nose. For the nether tooth ache, slit with the tenaculum till they bleed.

For coughs, mugwort, marrubium, yarrow, red nettle, and other herbs are recommended generally boiled in ale, sometimes in milk.

Pock disease (small-pox) is dealt with, but not very seriously. It is of interest because the classical writers do not mention it. The Arab Rhazes wrote a treatise on it about A.D. 923. A few herb drinks are prescribed in the Leechbooks, and to prevent the pitting “one must delve away each pock with a thorn, then drip wine or alder drink within them, then they will not be seen.”

Against lice:--One pennyweight of quicksilver and two of old butter.

Against itch:--Take ship tar, and ivy tar, and oil, rub together, add a third part of salt; smear with that.

In case a man should overdrink himself, let him drink betony in water before his other drink.

For mickle travelling over land, lest he tire, let him take mugwort to him in hand or put it in his shoe, lest he should weary, and when he will pluck it, before the upgoing of the sun, let him say these words, “I will take thee, artemisia, lest I be weary on the way.” Sign it with the sign of the cross when thou pullest it up.

HELIAS TO ALFRED.

In one of the Leechbooks translated by Mr. Cockayne is found a letter on medicines from Helias, Patriarch of Jerusalem, to King Alfred the Great. Mr. Cockayne believes it to be authentic. There was a patriarch of that name at Jerusalem contemporary with Alfred, and the medicines he recommends are such as were obtainable in the Syrian drug shops at that date. It is to be presumed that the information was given in reply to a request for some recipes from the king. Helias recommends scammony, ammoniacum, gum dragon, aloes, galbanum, balsam, petroleum, triacle, and alabaster. Of petroleum he writes:--

“It is good to drink simple for inward tenderness, and to smear on outwardly on a winter’s day, since it hath very much heat; hence one shall drink it in winter; and it is good if for anyone his speech faileth, then let him take it; and make the mark of Christ under his tongue, and swallow a little of it. Also if a man become out of his wits, then let him take part of it, and make Christ’s mark on every limb, except the cross on the forehead, that shall be of balsam, and the other on the top of his head.”

The patriarch had strong faith in Theriaca, and the directions he gives for its administration are minute, and would be explicit if he had only explained how much he meant by “a little bit.”

“Theriaca,” he says, “is a good drink for all inward tenderness, and the man who so behaves himself as is here said, he may much help himself. On the day on which he will drink Triacle he shall fast until midday, and not let wind blow on him that day; then let him go to the bath, let him sit there till he sweat; then let him take a cup, put a little warm water in it, then let him take a little bit of the triacle, and mingle with the water, and drain through some thin raiment, then drink it, and let him then go to his bed and wrap himself up warm, and so lie till he sweat well; then let him arise and sit up and clothe himself, and then take his meat at noon (three hours after midday), and protect himself earnestly against the wind that day; then I believe to God it will help the man much.”

EARLY ENGLISH MEDICAL PRACTICE.

In the thirteenth century Roger Bacon, the great man of science, wrote on medicine, alchemy, magic, and astrology, as well as most other sciences. He believed that a universal remedy was attainable, and urged Pope Clement IV to give his powerful aid to its discovery. Nothing particular remains of his medical studies.

Gilbert Anglicanus, who was a contemporary of Bacon, and wrote a Compendium of Medicine, a tedious collection of the most fantastic theories of disease, was more advanced in pharmacy than in the treatment of disease. He describes at considerable length the manner of extinguishing mercury to make an ointment, recommending particularly the addition of some mustard seed to facilitate the process. He gives particulars of the preparation of the oil of tartar per deliquium, and proposes a solution of acetate of ammonia in anticipation of Mindererus four hundred years later. Gilbert’s formula is thus expressed:--

“Conteratur sal armoniacum minutim, et superinfundatur frequenter et paullatim acetum, et cooperiatur et moveatur, ut evanescet sal.”

Ant’s eggs, oil of scorpions, and lion’s flesh is his prescription for apoplexy, but he does not explain how the last ingredient was to be obtained in England. Several of his formulas are quoted in the first London Pharmacopœia. For the expulsion of calculi he prescribes the blood of a young goat which has been fed on diuretic herbs such as persil and saxifrage.

Chaucer, whose writings belong to the latter half of the fourteenth century, has left on record a graphic picture of the “Doctour of Phisike” of his day, and the old poet is as gently sarcastic about his pilgrim’s “science” as a writer of five hundred years later might have been. “He was grounded in astronomy,” we are told, and--

Well could he fortune the ascendant
Of his images for his patient
He knew the cause of every malady
Were it of cold, or hot, or moist, or dry,
And where engendered and of what humour.
He was a very perfect practisour.

His library was a wonderful one considering the rarity of books at that time.

Well knew he the olde Esculapius
And Dioscorides, and eek Rufus
Old Ypocras, Haly, and Galien,
Serapyon, Razis, and Avicen,
Averrois, Damascien, and Constantyn,
Bernard, and Gatesden, and Gilbertyn.

The doctor was careful about his food, “his study was but little on the Bible,” he dressed well, but was inclined to save in his expenses.

He kept that he won in the pestilence.
For gold in phisike is a cordialle
There fore he loved gold in special.

The original of Chaucer’s “Doctour of Phisike” has been sometimes supposed to have been the well-known John of Gaddesden, physician to Edward II, Professor of Medicine at Merton College, Oxford, a Prebendary of the Church, and the author of “Rosa Anglicana.” This work, although full of absurdities and crude ideas of medicine and pharmacy, became the popular medical treatise in England, was translated into several European languages, and reprinted many times in this country during the two hundred years which followed its first appearance. The author named it the Rose, he says, because, as the rose has five sepals, his book is divided into five parts; and as the rose excels all other flowers, so his book is superior to all other treatises on medicine. It was probably published between 1310 and 1320.

John of Gaddesden’s work well illustrates the pharmacy of the period, for he was great on drugs. He taught that aqua vitæ (brandy) was a polychrest, or complete remedy; that swines’ excrement was a sovereign cure for hæmorrhage; that a sponge steeped in a mixture of vinegar, roses, wormwood, and rain-water, and laid on the stomach, would check vomiting and purging; that toothache and other pains might be cured by saying a Paternoster and an Ave for the souls of the father and mother of St. Phillip; a boar’s bladder, taken when full of urine and dried in an oven, is recommended as a cure for epilepsy; a wine of fennel and parsley for blindness; and a mixture of whatever herbs came into his mind--for example, “apium, petroselinum, endive, scolopendron, chicory, liver-wort, scariola, lettuce, maidenhair, plantain, ivory shavings, sandal wood, violets, and vinegar”--is ordered as a digestive drink. Add to such senseless recipes as these a number of equally unintelligent charms, and a fair idea of the condition of medical science in England in the fourteenth century is obtained. It does not compare at all favourably with the condition to which the Arabs in Spain had elevated the art two and three hundred years before.

Bernard of Gordon, who wrote from Montpellier, but is believed to have been a Scotchman, was the author of the “Lilium Medicinæ,” published about 1307 or 1309. The work was known to John of Gaddesden, for he quotes from it. Perhaps he had it in his mind when he observed that the rose excels all other flowers. Mainly it was a compilation from Arabic writers with the addition of many scholastic subtleties and astrological reveries. It is noticeable in this author and in John of Gaddesden how careful both are to distinguish between the treatment of the rich and the poor. The latter, for example, states that dropsy can be cured by spikenard, but he advises practitioners never to give this costly medicine without first receiving pay for it. Gordon recommends for a poor person’s cough that he should be ordered to hold his breath frequently during the day for as long as possible, and if that does not cure he is to breathe fire.