+ Hyphens splitting words across lines have been removed.
+ Original spellings have generally been retained, but the Errata from the Second Edition (at the end), and a mistake in the Errata (!) have been corrected silently. The original text can be found in the HTML version.
+ The Latin epigraph translates as: "They all represent themselves as Doctors—The Uneducated, The Priest, The Nurse, and The Barber, The Apothecary, The Old Woman." ]
Imprimatur, Novemb. 13. 1669. SAM. PARKER.
A SHORT VIEW OF THE FRAUDS, and ABUSES Committed by APOTHECARIES;
As well in Relation to PATIENTS, as PHYSICIANS: AND Of the only Remedy thereof by PHYSICIANS making their own MEDICINES.
BY CHRISTOPHER MERRETT Dr. in Physic, Fellow of the College of Physicians, and of the Royal Society.
——Fingunt se Medicos omnes, Idiota, Sacerdos, Nutrix, & Tonsor, Pharmacopaeus, Anus.
The Second Edition more correct.
LONDON, Printed for James Allestry, Printer to the Royal Society, at the Rose and Crown in St. Paul's Church-Yard, 1670
A Short View of the Frauds and Abuses committed by Apothecaries, as well in Relation to Patients, as Physicians; and of the only remedy thereof by Physicians making their own Medicines.
Doubtless it will seem strange to most men, that after 30 years not unsuccessful practice in this great City, I should now at last forbear sending my Bills to the Apothecaries, knowing that hereby a whole Company of men interested in the World (who by their number, noise, and tricks, may be able to decry any Physician) will become my implacable adversaries, and by their private whispers of untrue tales, will endeavour to their utmost, either to keep me from any new, or shuffle me out of my fixed imployment. But not fearing the utmost their malice can invent, or proclaim; I shall publickly assert what I privately practice, preferring the publick good, and the honour of my profession before my own private profit. And although I have had some experience what their groundless anger can do, when they some years since proclaimed me in their publick Hall their Enemy, for acting the College Interest, and of late for saving my Patients lives and purses, by dispencing gratis my Medicines. Yet I hope no indifferent person, when he knows that I have thus long slighted their weak endeavours, will believe I can now at length have so poor an end as revenge; especially when they shall consider on the one hand, the universal and daily complaints of both Patient and Physician, the great cause they have to do so, and the little hope of a remedy, and on the other, besides that general obligation all men have of doing their Country-men good, and the particular necessity I have of justifying my actions, by leaving the World their judg upon the account I shall here deliver of them. And lastly, that which will leave my Enemies not any objection, I take upon me not only a great trouble, but charge, without any other design then doing mankind good, by endeavouring to restore my profession to its ancient and deserved honours. And had I none of these inducements, I am sure the vulgar excuse of friends importunities may be satisfactory to all persons for my publishing what I here do, when I must acknowledge that many of my Collegues and other Practisers in several parts, upon reading these papers furnished me not only with some bad practices of their own experience, but thereupon enjoyed the publishing of them. So that in these papers I do but speak the common language of all Physicians, and of very many Patients. Neither are all their frauds and abuses here inserted, the rest (perhaps more in number) being reserved to another opportunity. I shall only add by way of preface; that the last year a Book was printed on the same argument, by an inquisitive person, now Dr. in Physic, which might have spared me this labour, but that it was too large for every ones reading, and in some things short. It was his fate to be called by them Fool, Ass, and Simple Fellow, and much worse language, bragging that some of their Boys should answer him. But upon more serious thoughts, the whole Company have suffered it to find the credit it well deserves, without the least reply but that of revilings.
In these ensuing papers, I hope to prove, that these abuses complain'd of by all sorts of persons, arise from this only cause, that Physicians dispence not themselves such Medicines, they use for the relief of their Patients, but commit this work to the Apothecaries, or rather their Servants.
Now the Apothecaries abuses generally relate either to the Medicines, Patients, or Physicians; which three do comprehend all I shall say on this subject.
But the Reader is to take notice, that all here charged on the Apothecaries, is not meant of every single one, but of some, or more of them, and may in a short time in all probability be verified of them all, according as their number, cajoling the ignorant, and bold daring in Physic increase.
But before I descend to particulars, I shall first lay down this Proposition, their own confession, and in their own Language, viz. That they may be the veriest Knaves in England. Because they may put in bad ingredients, and more or less then the composition requires, they may substitute one thing for another; and all this without being detected, and consequently not be punished for such misdemeanors; but more especially in Medicines for private mens uses, wherein they may do what they please without the least discovery of the Patient, and from this general confession of theirs, it clearly follows, that whatsoever deceit, covetous wits can invent, may at least be suspected to be used by them, and whatsoever is here alledged may find easier belief.
And Secondly, Most men wonder, that this Corporation, being but of few years standing, and to the setting up of whose Trade so small a Stock is necessary; should live so high, spend so freely, gain so great Estates, by their return of so little money yearly, which how 'tis done every man may conceive to be effected by the following Artifices.
More particularly, the Frauds by them committed relate either to their falsifying of Medicines, or secondly, to the number of their Bills, and prescriptions, or thirdly, to the prices of them.
First, They use Medicines quite contrary to the prescription, Myrtle-leafs shewed the Censors for Sena, a Binder for a Purger. Mushroms of the Oak, &c. rub'd over with Chalk for Agaric, which Mr. Evelyn in his late publisht Book of Forest Trees, pag. 27. observes, to the great scandal of Physic as he adds; Hemlock-Dropwort Roots for Paeony Roots, Poysons for wholesome remedies; Privet by some, by others Dog-berries, for those of Spina Cervina, no Purgers for a strong one. Sheeps Lungs for Fox Lungs, the Bone of an Oxe Heart for that of a Stags Heart, Damsons for Damasc Prunes, Syrup of Limons, for that of Citrons, Bryony Roots for Mechoacan, &c.
Secondly, They falsify the grand Compositions of the London Dispensatory. It being a common trade with them to buy unsound, and decayed Simples of some Druggists, and to return them back so much of the composition as will pay for the Simples. Secondly, whereas Apothecaries are bound to shew publickly to the Censors of the College, and the Master and Wardens of their Company, Mithridate, Diascordium, Alkermes, &c. Yet for all this some of them privately make a great deal more of the Composition then is shewed, of unsound Drugs, and some without any view at all; others put in the Scrapings that ought to be thrown away; and by these Arts they under-sell, and ruine one another, selling the Composition at a lower rate then good Ingredients cost them; and with these complaints they daily mutiny amongst themselves.
Thirdly, 'Tis very common for them to load Medicines with Honey, and other cheaper ingredients, and to leave out in whole or in part, those of greater value; viz. Saffron in Ruffus Pills, and in Oxycroceum Plaster, which latter, they colour of a saffron colour with Turmeric, Sanders &c. Ambergrise in Alkermes, Diascordium was found by the Censors in their search made only of Honey, and Bole-Armeniac. Which false composition was taken away by the then Master of the Company.
Such Chymists which sell preparations honestly made complain, that few Apothecaries will go to the prices of them. Whence it comes to pass, that most of the preparations found in the Shops are sophisticated, to the great abuse of City and Country. These abuses daily increase since the Censors, discouraged by the multitude of Empirics swarming in every Corner, have omitted their wonted searches, being to their loss of time, and expences out of their own Purses for the publick good only. Now since the Chymical Oyls, by reason of their great prices are most of them adulterated, and very few of them right good, and that nothing hath been published on this matter, and to leave the buyers of them unexcusable, I shall here add briefly, yet sufficiently the ways to discover these Cheats. First for sweet-scented Chymical Oyls, viz. those of Cloves, Cinnamon and Sassaphras. Only drop a little of them into fair water, and that part which is true good will sink under the water, but the adulterated part will swim on the top of it. Some others draw deep tinctures from the said Spices with Spirit of Wine highly rectified, and sell them for the Oyls; but these mix with the water throughout, neither swimming, nor sinking. Others more craftily digest with the said tinctures some of the true Oyls, which compound being put into water, will for a time render it white. Another way of sophisticating is with Oyl of Turpentine mixed in great quantity with that which is adulterated; You may easily discover the Oyl of Turpentine, by setting it on fire, for it yields abundance of ill-scented smoak, with very little savour of the Herb, Flour, or Seed, &c. and soon takes fire. To correct the ill smell of the Turpentine, they digest it with, and distil it off with Spirit of Wine. Those sophisticated with Turpentine, fired in a Silver Spoon colour it, and quickly diffuse themselves upon a Knife, or Paper. The best way to try by firing, is to put a drop or two of these Oyls on the end of a broad pointed Knife, which being first heated, and then thrust into a lighted Candle, presently take fire, and break out into a flame with much dark smoak; but if you will try them in a Spoon, heat it first over a Candle, and then blow the flame of lighted paper, or of a Wax Candle on them. To try the scent, blow out the flame of the good Oyls, and your smell will soon discover the ill scent of the Turpentine from that of the good Oyl. But on the contrary, all Oyls drawn from Plants by distillation hardly flame, and the flame soon goes out, and the smoak gives a full flavour of the Plant it self, whereas those sophisticated as before, differ from the true in both. The same Oyls are also sophisticated with cheap ones drawn from decayed Oringes, and Limons; Your smell on firing will soon discover these mixtures. A third way of sophisticating Chymical Oyls is, by mixing with them such Oyls as are made by expression, which are easily discovered by rubbing them on white paper, which being held and dryed at the fire, the Chymical part soon flyes away, and leaves the paper transparent, looking no otherwise then oyled paper; but pure Chymical Oyls totally fly away, leaving the paper white as 'twas before, and not transparent, and in this way Oyl of sweet Almonds and Spike have a great share. As for Oyls drawn by Retort, they all of them smell so strong of the fire, that neither smell nor tast can well discover any fraud in them. Now for the fixed Salts, most of them are made of the Ashes of Tobacco-stalks, &c. More might be said for the discovery of the Cheats of other Chymical preparations, which shall be reserved to another opportunity, and had Physicians just encouragement, they would spend both their time and moneys on the like discoveries for the publick Utility.
Fifthly, Add to the former (though perhaps 'tis an error of ignorance only) that if such Simples are prescribed they know not, they fetch from the Herb-women what they give them, true or false; for many of these Women give to very many Plants false names; Now if the Apothecary be so careful to consult an Herbal, which few have, and fewer know how to make use of, yet they too frequently mistake the thing by reason of several names given to the same thing, or of one name to several things, and many of them consult the common Dictionaries only, which are most erroneous in the names of natural things; insomuch that in my first practice (being curious of these particulars) I have found two or three mistakes in one prescription, a Catalogue of which mistakes, and names ill given, I had collected, but the late fire consumed it, though many of them my memory hath reserved.
Sixthly, Many of the London, and most of the Country-Apothecaries, buy of the whole-sale men, who affirm of one another, especially of such who gain great Estates in short time, that they cannot sell their Medicines honestly made at so low a rate as they do.
Seventhly, I shall need to say little of such distilled waters, as discover themselves neither to smell, nor tast, but shall only recite a known Story of an Apothecary, who chid his man for sending away a Customer that came for Plantan water, telling him there was enough at the Pump.
Eighthly, As for Ointments, and Plasters, they are sold by some at so low a price, viz. 3 d. per l. for Ointments, as I have been informed, that 'tis not possible to make them at, and yet such however falsifyed maintain a trade amongst Country, and low-priced City-Apothecaries, and the Chirurgeons profess they cannot effect their Cures with the Shop-Medicines, and that this is the reason why they make their own Oyls, Oyntments, &c. as the Apothecaries Charter allows them to do; and why may not Physicians think this to be the cause why they sometimes fail in their Cures, as well as Chirurgeons? and also make their own Medicines as well as they, especially since the Apothecary may as easily falsify, and to greater profit in the one, then in the other?
Ninthly, As to their use of bad or decayed Drugs, 'tis so common a practice that I shall need to give but one notorious instance of it, and 'tis this, I having occasion to use some Seeds, sent for them to a Seeds-man, the Messenger desiring to have those of the same Year. The Tradesman knowing him to live with me, asked, if they were for Physical use, he replyed in the affirmative, whereat he presently shewed him others, which were of 6 or 7 years old (as he confessed) affirming them to be as good for that use as the newest, which he sold only for sowing, and that he kept the others, though never so old, for the Apothecaries only, who still asked for them, buying them though 20 years old, not regarding if they were decayed and wholy effete (for no Seed will preserve its vegetative faculty above 7 years much less its Physical) so they could but have them cheap. Besides their pretty knacks (as they call them) of making their Compounds fair to the eye, more vendible, but worse for use, by restoring them to their colour and consistence, that they may pass for good, which perhaps 'tis better to pass over in silence, lest by confuting I should teach the younger Fry, who may better be honestly ignorant of them. Now for their substituting one thing for another, and detracting where they please, I shall add but one Story of an Apothecary, who commanded his man (who told him they had no good Rhabarb in the house) that he should put in double quantity of what they had. Nay I have known one simple of a quite different nature used for a whole composition.
Tenthly, I shall conclude this ungrateful Discourse, with saying that by reason more frauds may be committed by the Apothecaries, then by any other Trade, and by supposition that gain will tempt most men to dishonest actions, especially where they may act undiscovered; I say; that this seems to be the cause why they have two Supervisors set over them more then any Company that I know of, viz. the Censors of the College of Physicians, and the Master and Wardens of their own Company.
The next thing is the inlarging and multiplying their Bills and Medicines.
First, When in Chronical Diseases a Physician is consulted, they go on of their own heads with the same prescription, frequently enough to the Patients great disadvantage, both of health and purse.
Secondly, By giving and intermixing Medicines of their own Phancy, with the Physicians prescriptions, viz. some pleasing Medicine, whereby too often the Physicians intention is quite crost, and the effect made uncertain, and hazardous.
Thirdly, By giving Medicines themselves on small accounts, and such as require only a good ordering, and no more.
Fourthly, By repeating long courses of Physic unadvisedly, and needlesly, when either nothing, or very little is needful to be done.
Fifthly, By creating diseases in easie mens Phansies, and so decoying them into courses of Physic.
Sixthly, Some of them get private and worthless receipts, and sell them at what rate they please; Mr. Delaune by one Pill alone, though not a very safe one, got some thousands of pounds.
Seventhly, If one of them get a private receipt from a Physician called by the inventor his Nostrum, if another Apothecary have occasion to use it, he shall be sure to pay sawce for it.
Eighthly, Another trick is when the Patient is cured, and the Physician therefore hath given over his Visits, then comes the Apothecary and insinuates by his words and passions, either some danger of relapse, or some other present distemper, and repairs to the Physician for a Bill to cure the imaginary disease.
Ninthly, But their principal Art of all is, to cry up, and bring in to Patients such Physicians, who through design must comply with the Apothecaries Interest, and such Practisers they extol and cry up for good Physicians, which some of them call more expresly good Apothecaries Physicians, and such without doubt, the whole Company will endeavour to raise unto a fame and practice. But such as write only for the good of the Patient, and not at all for the benefit of the Apothecary (as all honest men ought to do) they will endeavour to prevent their calling in, or to shuffle them out.
Now this good Apothecaries Physician, they describe by his frequent though needless visits, but especially by the multitude of his Bills, by his visiting twice a day, or oftner (a very careful and painful Doctor) and by still writing new Medicines, when half the former, or perhaps none of them have been taken, making an Apothecaries Shop in the Patients House, planting the Cupboards and Windows with Glasses and Gally-Pots, and not a quarter of the whole made use of. He prescribes a Medicine for every slight complaint, and never goes away from the Patient or the Patient from him, without a Bill, for fear of the Apothecaries grumbling.
And from this burdening the sick with multiplicity of Medicines, too often contrary to, and destructive one of another, it proceeds that in the Small Pox, and Measles, many are afraid to use Physicians, and commit the care of the sick to Nurses, and Old Women, and perhaps sometimes not without cause, for by continual multiplication of Medicines, the humours of the body may be made, or kept in too great a state of fluidity, whence the Flox followeth. Whereas a Medicine or two duly administred, may suffice to bring them well forth, and then there needs no more but good ordering, unless perhaps some accident arise, which may require further care. And here as well as in other Cases, the Patient is to be rectified, who requires the Physicians Visits, and yet dismisseth him without a reward, unless he writes a Bill, whereas it might have been better if nothing at all had been prescribed; and the Physician left to his own judgment; and hence it is that many enlarge their Bills, that the Patient may think he hath enough for his money, whereby the Apothecary is gratified, who ought to commend the Medicines as necessary for the sick person, and singular in themselves, whereas in truth this great farcy proves ungrateful to the tast and stomach; inconvenient to health, by curing one disease, but creating more; and by this means keeping them continually in a way of Physic.
A third abuse of the Apothecaries relates to the prices of their Medicines; first they put what rates they please on their Simples, Compounds, and Receipts, and none are judges of them, but those of their own Trade; insomuch that they gain a 11 d. in the Shilling, if they say true of themselves. Whereas the Colleges of Physicians beyond Sea, yearly set a tax upon the Simples, and Compounds of the Shops. So that the Customer can tell the price of what he hath occasion to use, and not stand at the mercy of the Apothecary to rate them as he lists, and to this purpose they put in print the prices of them every year.
Secondly, Suppose a Physician hath prescribed a Pint of Juleb, &c. to be taken at four several times, some Apothecaries carry not the whole pint at once, but divide it into four parts, and carry but one at a time, and so of other Medicines, and then will charge their Bill for every single Potion, or Draught, as they ought the whole Pint; so that by this Art they gain four times as much for the whole Medicine as in Conscience they ought; and a Juleb, which cost them six pence, will be rated at 10, 12, or more Shillings. But perhaps 'tis fit they should be paid for their created Visits; and for this unnecessary officiousness, persons of great estates may be contented to pay roundly, if they please.
Thirdly, When a Physician hath prescribed 20 Pills, some of the Apothecaries will make 30 of them, under pretence the Patient cannot swallow them else; now reckoning each Pill at a certain rate (as they usually do) they gain a third part more then they ought.
Fourthly, To advance the prices, you shall hardly ever see a Bill without Bezoar, or Pearls in it, to make people think them very chargeable; whereas sometimes there is not above a grain or two of these dear ingredients in the prescription, and a few grains of these or Ambergrise doubles or trebles the prices of the Medicines, and are sure never to be omitted in their Bills, besides the guilding of the Pills, and covering their Bolusses, and Electuaries with Gold (which have only an imaginary and no real use in Medicines so used) much inhanseth their prices, and a rich Cordial inserted exceedingly advanceth most of their Bills; or if China or any other dear ingredient be in the receipt 'tis not omitted.
Fifthly, Some Apothecaries offer, and perhaps some Physicians have taken presents to help them to Customers, which must necessarily be squeazed out of their higher-rated Medicines.
Sixthly, I have heard some prudent persons complain of their bringing in their Bills but once in a year, or two; supposing they made them pay Lombards Usury for their forbearance. And through this neglect they sometimes lose their money, and whether they raise other Mens Bills to make up these losses, I affirm not.
Seventhly, Another cause of raising their prices is a necessity of keeping in their Shops such Medicines as are seldom used, or such as must upon necessity decay, and grow useless. Now suppose they throw such away, this reason is good, but you will find a remedy for this hereafter.
To conclude this second Complaint. By reason of the dear Bills of the Apothecaries, many are deterred from going to the Physician, and run to common Mountebanks, and I think this to be the reason (as some disabused persons have confessed to me) why they have so much cryed up the abilities of Apothecaries for practice, because they would save their credit in taking Physic of them. St. Augustine candidly in his Book of Confessions declares, that through covetousness he repeated a course of Physic, without consulting the Physician (who had before cured him of the same disease) to his greater charge, danger of his life, and offence against God.
Having done with the Apothecaries abuses relating chiefly to the Patients Health and Purse, and such as are willfully committed (though all of them reflect on the Physician) I shall now touch on a few neglects, and mistakes proving often very mischievous.
First, They frequently mistake the Physicians directions, which of what dangerous consequence it is, every one can tell.
Secondly, They carry a Medicine appointed for one sick person to another.
Thirdly, They often neglect the sending of Medicines in due time, especially such as have no Servants, or but raw ones, when the Master is out of Town, or upon long visits.
Having now done with the Apothecaries as they relate principally to the sick, I shall in the next place speak of them, as they relate to Physicians, and that either to the profession in general, or to the particular practisers of it.
As to the Physicians in general, they endeavour to extirpate them, and some have been so bold to say, they hope in few years to see never a Physician in London, and to profess they will scramble with them for practice. And that this hath been and is their intention, the following particulars will clearly demonstrate.
First, They have always endeavoured and aimed at the depression and ruine of the College of Physicians, the only Corporation of that Art in England, considering rightly, that the depression of the College is their interest and rise, and that the total subversion of it will make them absolute Masters in Physic and Physicians their Servants. In Order hereunto they have constantly, both publickly and privately opposed the College in whatsoever hath been offered to setle the liberty of practice on them, their only priviledg and subsistence, though they have been offered all they could desire for the security of their Trade, and legal employment, and far beyond whatsoever any Corporation of Apothecaries in all, or in any forreign part enjoy, yet nothing would ever content them, but an unlawful, unreasonable, dangerous, and destructive Usurpation of liberty to some pretended practice, that thereby they might gain the whole.
Secondly, They have continually traduced the College, and troubled them in Parliaments, at the Council-Board, &c. to their great charge and molestation. And for such their great demerits against the College, the King and his Council, Anno 1639. granted a Quo Warranto to the Attorney General (the Judges having first heard the whole matter) to take away their Charter, which doubtless had been effected, had not the troubles, and long civil War immediately ensued.
Thirdly, And in this present Parliament, how did they endeavour to prepossess the Members of the House of Commons with strange, and false prejudices and assertions drawn from irrational, and groundless suppositions, making us the greatest Tyrants in the World, inferring ridiculously that a Lady, or Charitable Gentlewoman (for in that believing Sex they have gain'd a great deal of ground by their falsities) might not give the Poor a Cordial, &c. without being questioned by the College; whereas they know in their Consciences, that the College hath power enough by their first Charter to act as much in this kind against themselves, and all other persons, as they desired of this present Parliament; And yet neither Apothecary, or any other who practised charitably, were ever troubled for so doing. They pretended also they were abridged wholy from their Trade, and might not sell a penny-worth of Mithridate, &c. without a Doctors Bill. Whereas there's not a word in the Charter to that purpose; the sole intent whereof was to keep them as well as other Mountebanks, from prescribing (which they call selling) the Physicians only livelyhood. And as to the bill itself so much railed on by them in Westminster-Hall, Coffee-Houses, Ale-Houses, &c. 'tis easie to make it out, that this Charter as proposed gives the Apothecaries more liberty and freedom of exercising their lawful Trade, then is enjoyed in any other Nation, where both Corporations are erected, and that it doth in nothing infringe, or diminish their freedom as Citizens, or their Charter as Apothecaries; and that our Charter was compiled by some, and perused and approved by others the most eminent Lawyers in England for Worth and Place; and yet none of these could find any thing in it either Illegal, Tyrannical, or unfit to be desired of the Parliament. Nay many mis-informed Members being rightly instructed in the true state of the matter, have acknowledged the justice of it; And was no more then King James by his Letters Patents, dated the 18th of October, in the 15th year of his Reign, granted to the said College; near about the same time the Apothecaries Charter was granted; and being almost nothing else but a supply of what was short in their former Grants, viz. That whereas their Charter granted by King Henry the Eighth, gave power to punish offenders in the practice of Physic; and because there was no power given to summon, nor penalty imposed for the non-appearance of such offenders; therefore by their non-appearance, the said power of the Censors was eluded; for no such offenders would appear before them, and consequently no punishment could be inflicted on them, according to the true meaning of the said Act. Now this Charter so much declaimed against, prayed only a supply of this defect, and also better and more necessary ways and means, without which, such and all other offenders against the lives and healths of his Majesties Subjects could not be discovered; and they had reason not to doubt a grant of the said power, since by the said Charter a power was granted them to imprison offenders, whom the Keepers of the Prisons would not receive, because no command, nor penalty was imposed on them, for not receiving such offenders sent by the Censors (a thing ridiculous to our present Lawyers) however this defect was supplyed by an Act in the first of Queen Mary. Now whereas since the making of the said Acts and Powers, granted to the College, several other Trades, besides the Apothecaries, relating to Physic (being then all Members of the Grocers Company) viz. Druggists, Chymists, Sellers of Strong-Waters and Oyls, have arose distinct from each others, and many abuses have been and are committed in each of them, as they all confess. The said Charter prays for the publick good only (there being the same reason of all) they might have the same power of Surveying them also, as they have of the Apothecaries, which most of the Judicious, and sober of the said Companies, as well in relation to their own private profit, and also the publick, by having all Medicines good, did not oppose, but liked well of. Nay there was nothing in the said Charter, but what was judged good by all or most of the Judges of England, several times convened by Order of the King and his Council, to deliver their opinions concerning some Quaeries, which comprised the main of what was desired and petitioned for by the College, of this present Parliament. But before the Committee could make report to the House, the Parliament was adjourned, whereupon Apothecaries falsly gave out, and made people believe our Charter was taken from us. And in this transaction before the Committee, one Cocket an Apothecary exhibited in the name of the Chymists such a Scandalous Libel, as the Committee would not suffer to be read; drawn as some conceive by the assistance, and countenance, if not contrivance of his Company.
Lastly, The Company of the Apothecaries are bound by their Charter to bring their Servants (before they make them Free) to be examined by the Censors of our College, and to have their approbation of their fitness to exercise their Art, and set up their Trade. Now that they have herein neglected their duty, and consequently may be dis-franchised and lose their Freedoms for this omission, 'tis manifest not only by the vapours of some of them to some members of our Body, that they never underwent this examination; but also by comparing of our Register (wherein are recorded the names of all such as have been examined) with theirs, if they keep any for this purpose. Sure I am, that in two years together, when I was Censor, very few, if any, did appear to their examination, whereas yearly a very great number set up their Trades. Nay since the firing of London not one Apothecaries Servant hath been examined by the Censors, for more then these three Years last past, in which time perhaps no less then 100 have been made free by the Company.
Before our presenting this Charter to the Parliament, they would admit no Arbitrators betwixt our Corporation, and Theirs, not contenting themselves with their Charter lately granted in King James's Reign, and that by the procurement of some of our College for these unthankful persons. For they would not refer themselves (as the Chirurgeons without many words or dispute did) to the most upright, and most knowing Sir Orlando Bridgeman then Lord Chief Justice, and now Lord Keeper, for a clause to be by him drawn, in order to preserve their immunities and Charter; which they refused, fearing belike he would exclude them from the Practice of Physic, which the Law hath already done, and which is all they could doubt of; but the Corporation of Chirurgeons did acquiesce in the clause drawn by the said Lord Chief Justice, and never appeared before the Committee against the said Charter.
Their increasing dis-respect, and undervaluing the College, appears in this, that of late years they place our Censors invited to their new Masters Dinner, at their second Tables whereas always heretofore they were seated at the first Table, next to the Master of the Company.
And to hinder the building of a New College, and the Contribution of the Honorary Fellows thereunto, they tell them that we deceived them in their admission, and never intend the building of a New College, though a large contribution hath been made, and ground purchased in order thereunto by the Members of their Corporation.
And their further design appears in their great triumphing, and rejoycing when any illiterate person hath gained any reputation for a Cure performed, especially where Physicians have been concerned, though the Patients neglect or obstinateness, have been the sole cause of this non-performance, and by their continued detraction from Physicians, and applauding themselves, hoping by the former, that people will think such Mountebanks able to do better Cures then learned Physicians, and then they can easily insinuate themselves superior to such Mountebanks, and consequently to Physicians. By the latter, they seek to depress, and level us to themselves, being conscious they can never rise to that worth and ability, required in a Physician.
Another manifest sign of their endeavour to usurp our Practice is, their absurd calling the sick their Patients, for 'tis most certain that in all reason and language the Physician and Patient only have relation to each other, but not to the Apothecary, who is but a Tradesman, and manual Operator. Now a Tradesman and his Customer, or Chapman, are Relatives each to other, but those Apothecaries who intrude themselves and usurp on our profession, may call their Customers Patients, and that in a true literal sence, when by their ignorance they make them really sufferers under them; and if they deny Apothecary and Patient to be non-sence, they shew themselves pitifully ignorant in the Laws, and Rules of Reason, or else profess themselves Physicians. And the like non-sence they commonly utter by calling Physicians that make their own Medicines, Mountebanks and Quacks, whereas none can be such but those who practise without Lawful Authority, as the Apothecaries, &c. do; and they are not ignorant in this their malice, that the Law of England would punish them roundly for so saying. And were I troublesome or vindicative, I could make some of them examples, but I freely remit the slanders in this kind that are past.
Having done with the main part of the Disease, next follows the Remedy; and the only firm and proper one will appear to be, that Physicians make their own Medicines; the benefit whereof to the publick, the reasonableness of the thing it self, the necessity in relation to the Physician, will be manifest by that which follows.
And First, All that hath been said demonstrates this last proportion.
Secondly, The desire of most persons, and the censure of all wise men, who say we are wanting to our own interest, if we make not use of the remedy in our own hands, performing our Art in all its members, whereof making of Medicines is a chief one.
Thirdly, The common practice, and constant usage of all former and antient Physicians in all other Nations, and in England also (for 'tis easie to say when there was not one Apothecary in this Kingdom) the Laws of our Nation, nay even the Apothecaries Charter allow it, the Language of all Physicians, our College voting it honourable so to do, nay Apothecaries themselves commending it in such Physicians as buy their Medicines of them.
Fourthly, The Kings Physicians have formerly made the Kings Medicines, as 'tis manifest by my Lord Coke, in his 4th. Book of the Institutes, part 4. pag. 251. where he comments on Rot. Pat. 32 H 6. m. 17. He there first recites the Roll it self, wherein are appointed (the King being then sick) 3 Physicians and 2 Chirurgeons, to freely minister and execute Physic about the Kings Person, and there are also recited in general, Medicines external, and internal. And on this Roll Coke among other things infers, that the Physicians may use the aid of those Chirurgeons named in the Warrant, but of no Apothecary, but to prepare and do all things themselves, &c. And the reason of all this is, the precious regard had of the health and safety of the King, who is the head of the Common-wealth. And I am told by one of his present Majesties Physicians, that the King himself affirmed heretofore we are unwise in neglecting our duty herein, and lately of these papers, that 'twas the publick interest so to do.
Fifthly, Chirurgeons (as before) will not trust them to make external Remedies; and the King, and East-India Company commit the making of their Chests for their Fleets to the Chirurgeons.
Sixthly, Have not Ladies and Charitable Gentlewomen their Closets well furnished with various Medicines for the Poors use, and for their own also, when Physicians are called to their houses in the Country? Distillers of Strong-waters, Makers of Plaisters, Confectioners make Medicines bought by the Apothecaries, Ale-Houses sell purging Drinks, and Book-sellers sell Chymical Medicines, and all this without much regret of the Apothecaries. But if a Physician intermix a Medicine with theirs, though the Patients life be saved thereby, what noise, and murmuring, and proclaiming of it the next Market-day to the rest of their Company? to what purpose any one may judg.
Seventhly, Why should not Physicians, being lawfully authorized thereunto, practise with their own Medicines, as well as the Apothecaries with theirs, though against Law, and incurring thereby the penalty of 5l. per Month, which the College never troubled them for, or exacted of them?
Eighthly, Physicians will be necessitated to it for their subsistence and honour, and to preserve their Art from being prostituted to illiterate persons, the Apothecaries becoming now their Competitors.
Ninthly, By this means Physicians will avoid multitudes of inconveniencies, proceeding from writing of Bills, and the Apothecaries Visits.
First The mistakes, and frauds in the Ingredients, especially committed by the great practising Apothecaries, who may, as appears by the following story, be suspected to send, instead of what was prescribed, the remains of his own practice, or else some cast-by Medicines; for else how could it be when a Medicine was prescribed to stand in Infusion or steep a whole night, that it should be brought two hours after the Bill was written, even the very same Evening? Which by accident the Patient confessed, wanting the expected success.
Secondly By this course Physicians avoid the many opprobrious terms cast upon them by Apothecaries:
As First, In saying that if he had not omitted or added something, the Patient might have miscarried; which he may say at pleasure without any contradiction, though doubtless many have been killed by this means.
Secondly, By saying the Bill could never have been made without some alteration of the Apothecary, thereby insinuating the Doctors ignorance in compounding.
Thirdly, In saying the Doctor is not versed in Medicines, because forsooth he varieth not at every Visit, and multiplieth not new Bills for the Apothecaries profit.
Fourthly, In saying they teach Physicians, and help them to, and in their practice. The first and last are vile and foolish Scandals; as to the Second, 'tis true indeed, that younger Apothecaries recommend Physicians to their acquaintance; but 'tis no longer then they have learned enough (as they think) to set up for themselves.
Fifthly, In saying, they knew before-hand what such a Doctor would prescribe, and hence it is they have nick-named some Physicians of no mean practice, by the Medicines they frequently use, which names in respect to the persons, I shall conceal; and of such Physicians, they brag they can prescribe as well as they. But if a Physician advise things unknown to them, or out of the common tract, then they say the Doctor intends to puzzle them.
Sixthly, He will avoid the censure of his Bills, which every pitiful fellow, nay their very Boys will absolve or condemn at pleasure, and that openly too, nay sometimes to the Patient himself, and thereby call in his good Apothecaries Physician. Now what a shame is it, that a Physicians credit and livelihood, should stand at the mercy of such pitiful ignorant, and self-ended Souls? I have heard one of them say of the now most Eminent Practiser in London, that his Boy could write as good a Method as he, and that he understood the practice of Physic as well as any Physician in London except 2, or 3, though the same person was soon made to confess, he neither knew the Disease, Cause, nor Cure of a Pleurisy, pretended to be throughly understood by him.
Thirdly, He will avoid the trouble put upon him after he hath writ his Bill, by the Apothecaries ignorance in not understanding it, who to be informed came to the Doctor heretofore, with their Hats off, but now send their Boys, who soon put theirs on. Such respect do they give Physicians, when they come to them as to their Masters to teach them.
Fourthly, He will avoid the impertinent Visits of the Apothecaries, and non-sensical, troublesome, and discouraging, frightful discourses to the Patient, of whom no man can expect more then the Common Proverb gives to Praters, and impertinent Speakers, That they talk like Apothecaries.
Fifthly He will avoid the mischiefs from their Visits, who by their shrugs, signs, or words, may diminish the Physicians reputation, and good opinion, whether in his skill, or Medicines, whereby good Medicines are neglected and the expectation of a good success upon the use of them taken away, or at least causing an averseness to them; which actings do exceedingly prejudice the Patient, in reference to his Cure.
Sixthly, He will avoid this inconvenience, that some Apothecaries have attributed the Cure to some of their intermixed Medicines, or alteration of the Doctors Bill.
Seventhly, He will avoid that incivility of such of them, who in the Physicians presence, will feel the Pulse, judg of the Urine, discourse the Cause, Nature, what the Disease is, and what will be the issue of it, propose Medicines, nay sometimes endeavour to advise with the Physician, to contradict and dispute with him, to compare and set himself above the Physician; and to say truth, these odious and intolerable Comparisons and intrusions daily complained of by my Collegues, were a great cause of my departing from them.
Eighthly, He will avoid those Scandals they have opportunity to raise, that such a Physician is Covetous, Proud, Negligent, and minds not his practice, and the like without the least ground, and are frequently by such Artifices, the Cause of introducing another Physician, knowing that thereby more Bills will come to their File, and many times the former Medicines be layed aside, and in this shuffling in and out of Physicians, they have commonly a great share.
Ninthly, Apothecaries being now Competitors with Physicians for practice, and down-right Enemies to such as make their own Medicines; why should not we suspect them of this false Play, by telling the Patient the Doctors Medicine will not work (which he knows well enough how to effect) and then to tell him he will prepare him one of his own that will work, when perhaps that he calls his own preparation, was nothing but what the Doctor had prescribed before; and by this Artifice to advance himself above the Physician.
Another mischief in sending Bills to the Apothecaries is, that though the Apothecaries be honest (and who can tell which of them is so?) yet the Servants neglect, or ignorance (to whom they commit the whole care of dispensing, and are intruth the Apothecaries (and not their Masters) may mar all in their Masters absence, who is visiting abroad, or at his recreations.
And now I have done with the unpleasant talk of raking into the faults of the Apothecaries, and with discoursing how Physicians may save themselves from their devices, I shall next shew the advantages that will come to the Patient, the Physician, and people, by this way of remedy proposed.
As for the Patients, they may hereby save most of the great charges of Apothecaries Bills, which in long Cases amount to very great sums in a year, although the Physician hath received very few Fees; the Physician may so order his business as to take his Fee for his Visits only, and at home such competent Fees for his advice alone, as are usually given, and in both Cases take nothing for his Medicines, and so save the Patient the whole charge of the Apothecaries Bill, which very seldom comes short, and for the most part manifoldly exceeds the Physicians Fees. And this he may very well do by making fewer, less chargable, more effectual, and durable Medicines then the Shops afford, and suffer nothing in the non-use, or decay of his Medicines; because he need make no more then will serve his own practice: and I must here profess, that which I intended not to have published, that this is the course I have generally taken, for the four Months last past, since I made my own Medicines, but that some Apothecaries have given out most falsly, that I have sent in Bills to Patients for money; but to convince such of their wonted lying, I do hereby oblige my self to give 100 pound to any of them that shall produce such a Bill. Secondly, This way will not clog the Patient with more Medicines then are needful, nor will omit anything may conduce to his recovery, for if he fails in either, 'tis to his prejudice, either in spending more Medicines which cost him money, or in not performing his Cure, which loseth his practice.
But I do not propose this course of mine as a general rule to all Physicians, but leave this to every mans private judgment; Neither do I hereby bind my self to the same practice, because some few Cases may fall out (though to an equal advantage to the Patient) may perswade me to the contrary. For I find some persons of that perswasion, as to think they have not given satisfaction, unless they have payed for the Medicines; but to such persons, I have always allowed them to give me what they pleased themselves, for the cure only, to the full satisfaction of both parties. Though I will not deny but some persons out of gratitude for their Cure, have rewarded me beyond this proposal. Some of my acquaintance have desired me to be more plain in this last Paragraph, especially in that part of it where I say I do not bind my self to the said practice; and to declare more fully the Cases that may perswade me to the contrary; which are these and such as these. First Where Patients of their own free offers will contract with the Physician, or have formerly too meanly rewarded him for his Cure, in both which the Statutes of our College allow a contract to be made with Patients. Another case is, if a Physician be consulted once, and for his Fee hath given Medicines gratis, if the Patient frequently send for his Medicines without the least reward at all. Or if the Patient living far in the Country, having (as before) once consulted the Physician, as in the last case, and shall for weeks, nay months, send for the same Medicines. Or if the Patients friend shall recommend a Medicine to another friend of his unknown to the Physician; and where he gives no Counsel, if a Physician in the Country shall desire some of his Medicines, which are all the cases that occur at present; I say in some of these, the Physician must needs be payed for his Medicines; but in other, 'tis rational he should be payed for his advice, as he desireth new Medicines, which charge will be far short also of the Apothecaries Medicines, whether repeated or prescribed upon new advice.
Now the great charge of Apothecaries Bills, and nauseousness of their Medicines, appears to be the cause why long habitual diseases, as the Kings Evil, Falling-Sickness, Convulsions, Melancholies, and Winds in the Bowels, Gouts, &c. become seldom relieved, though they may with a constant, facile way, be perfectly cured, where neither the great charge, nor unpleasantness of Medicines, deterr them from a continued necessary use of Remedies. And for the same reasons many will be kept from relapses, who being tired out with taking variety of Medicines, give over before the tone and strength of their parts is restored, which is necessary to be done in all long Diseases.
He may so contrive his Medicines, first, That they may be taken in small quantity, and be made more grateful to the tast, and stomach, and perform more then those of the Apothecaries, commonly slovenly made, and of themselves Fulsom, Nauseous, and Sluggish. Secondly, His Medicines made for particular persons, may last Weeks, Months, nay Years, whereas the Apothecaries Drinks, especially in the Summer time, must be renewed once, or twice every day, to the excessive charge of the Patient.
That his Medicines may be fewer, is evident in Physicians that practise in the Country, who ride far to Patients, and carry in their Mans Cloak-bag, Medicines enough, not only for the person he is sent to, but also for most other persons, and Cases he meets with in his Travels, and therefore his Closet needs contain but few, yet noble and generous Medicines, and such as may serve him upon all occasions, supplying what's defective from the Fields or Gardens. He may avoid all pompous, useless, chargable Medicines of the Shops, and substitute in their place, cheaper, and more conducible to health; He may very well lay aside the precious Stones, Saphir, Emerals, &c. the high priced Magistrals of Coral, and Pearl, made worse by their preparations, or rather destroyed thereby in their Virtue, as also Unicorns Horn; and Bezoar, all which are now rarely used alone, but in the received Compositions; He may also spare the charges of leaf-gold, for guilding Pots, Glasses, Pills, Electuaries, Boles, &c. which serves only to raise the Bill.
He may teach the Patients facile and easie Remedies, as to make a Clyster, apply Blisters, or Medicines to the feet, where they are needful, &c. and in many Cases may cure by well ordering his Patient only, without any Remedies at all, or but very few; being free to act for the Patients Health, without the grumbling of the Apothecary; and many other ways he may daily meet with, very advantageous to the Patient.
He will have little use of Conserves, Syrups, Lohocks, &c. a greater part whereof Sugar makes up, which doth more hurt to most persons, then the other ingredients do good.
As for Infusions and Decoctions, he will find by experiment, how much liquor, or Menstruum will suffice to extract the full vertue of the ingredients, and what are helps, or hinderances thereunto, and thereby neither suffer loss in the quantity, or quality of them.
He will discover the inefficacy of many of the Syrups and other Medicines in the Shops, made of such ingredients, the qualities whereof, what with boiling, what with the great quantity of Sugar necessary to keep them, are either made useless or opposite to the ends they are proposed for. Especially in such Plants, Seeds, and Flowers, which consist of fine volatil parts, and even in drying and pounding, or the least boiling exhale and evaporate, and therefore in the common way of ordering them, lose their whole vertue or most of their efficacy, and alter in their properties. From which by several methods known to some Physicians, very generous and singular Medicines may be produced.
He need not use so large Compositions consisting of such confused and contrary ingredients, and will find good reason to lay aside those unintelligible and unreasonable Compositions of Mithridate, and Treacle, and the so much magnified Treacle-water, and will substitute better in their places, of smaller charge, and less trouble; and this all Physicians I have conversed with, and the College it self, by their Book published for the common good, in the year before the Plague, and all those Physicians in this City, who make or intend to make their own Medicines, do confess.
But here Apothecaries open wide, and cry out that the Physicians are great Cheats, and envious persons, for continuing such flat Medicines, and not recommending to the World, or rather their Shops, our greater secrets. The answer is easie, that the Medicines in our Pharmacopaea, are the best of any other Pharmacopaea in the World, both for their goodness, and well preparing of them, whether they be Chymical, or Galenical; and therefore the same scandal will ly on all Pharmacopaea's whatsoever. Secondly, I say that within these few last experimental years, the practical part of Physic hath been much improved (as well as Anatomy) especially by such as have put their hands to work; and therefore till such improvement, this could not be well amended. Furthermore, in making new Dispensatories, a full content must be had, and 'twere not fit to move where the motion were not like to take place, for though private men invent new ways of compounding and preparing, and using their own invented Medicines, yet 'twill require a long time to make them publickly known, and brought into common use, and till that be done 'tis not possible to have them brought into a common Dispensatory; besides, no man would make a motion for such a reformation, unless he were well furnished with specificks, and then 'twill be required of him to expose them to the whole World, which how incongruous it will be, every man may easily conceive; hereto add, that the Apothecaries think themselves able enough by this present Dispensatory, to out-beard Physicians, and do publickly profess (as hath been said) that they understand the practice of Physic well as they; how much more would they have said so, if they had been made Masters of these secrets? And here I shall admonish those of my own Faculty, who have devoted their Studies, Labours, and Purses, for the improvement of their Art, to consider, that as natural things have their bounds and limits, and that there is no new Creation of them, and besides, that these things have their bounds also of improvement, beyond which 'tis impossible for man to go; and that by a good method and industry, that end may be attained; (though at present I must confess, no Art is more capable of enlargement then ours:) I say let all consider, and they will find, what a vast encouragement they have to improve their knowledg so far, that they shall not only be able to leave mankind destitute of no remedy Nature did ever produce; but also restore and setle those Honours ignorant men would usurp, upon the Learned Professors of this Science, and I see no reason why Physicians should communicate their secrets to such persons, who will make use of them, to the ruine of the Inventors, which is indeed a failer of trust, for when a Physician writes his Bill, he trusts the Apothecary only with making the Medicine for a particular occasion, and not to make use of it as his own when be pleaseth for his own profit, and the Inventor have no further benefit by it, then perhaps one single advantage.
Lastly, When Dispensatories were first made, the Apothecaries were really Physicians Servants, and wholy at their command, not in the least intrenching on their business, and the rates of Medicines were reasonable; which superiority over them still continues only in their prescriptions, the forms whereof are always commanding to take this and that, and to mix them, &c. but within these few last years they have set up for themselves, and advanced the rates beyond all reason; and to be sure, the more we teach them by our Books, the more they will trangress in both.
He may receive encouragement from what he discovers, that is more then ordinarily useful, whereas by writing Bills, he soon communicates to the ignorant and lazy, who will neither spend time nor money to advance the Art, but while the one is at work to his great charge, lots of time, much pains and trouble, the others seek by petty tricks and Arts to gain a name, and profit from the industrious. Nay some Mountebanks have been set up by purchasing receipts of the Apothecary or his Servants. And one of them told me, he set up a Quack by selling and commending to him a Medicine he had long kept in his Shop and could not otherwise put off, and that by degrees he made him a famous practiser among the ignorant and poor people. An Act quite contrary to the interest of the Company.
Hence also will arise an emulation amongst Physicians, who shall exceed each other in noble remedies, and from thence a full and happy improvement of whatsoever God hath created for the recovery of mans health impaired; for from the Physician alone the advancement of Physic is to be expected. How many simples of unknown properties have been brought into use, to the great comfort of the sick? and many more may be, as also many preparations, both simple and compound, both in the Galenical, and Chymical practice, and by this means the Art will be advanced to its just dignity, now much diminished, dishonoured, and near to be lost by the intrusion of ignorant persons.
Greater respect will be given to such Physicians, as being the immediate instruments of life and health, who will derive unto themselves that which is now given to the Apothecaries, which proceeds chiefly from fear lest they should do the Patient hurt; and so their honour will be doubled, which every Physician looks principally at; but the Apothecary being not so far concerned, looks chiefly at his own profit, and regards not the Patients charge. For the greater the Patients charge, the greater must needs be the Apothecaries gain; whereas on the contrary, 'tis the Physicians Interest to cure the Patient with the greatest ease.
He may proceed on safely and securely in his well experienced Medicines, having before him not only what he hath prescribed for the same Patient, but for all others in the like Case, and thereby keep in memory what he would have forgot, if his Bill had remained on the Apothecaries File; viz. the Medicines and their success. By means whereof Physicians do not advance their knowledg so far as they might; for how is it possible they should remember the particulars of their Bills writ some days before? and therefore know not how to proceed so well. But the Apothecaries having before them the whole series of Medicines, brag they can do more then the Physicians, and by this means insinuate the same opinion into people.
The Physician will be consulted in the beginning of Diseases, to the safety and little expence of the Patient, who will not go first to the Apothecary, who practiseth on him till the Case is desperate, and then calls in a Physician when 'tis too late; and if he dyes, the Physician must carry away the disgrace alone; but if he recover, the Apothecary if he be so minded, by some trick will share with him in the honour: and by this resort of people to the Apothecaries in beginning of Diseases; we meet with few Cases of easie Cure, but are chiefly made use of in dangerous Diseases, or those of short period, or such as are accompanyed with great pains and torments, to our great and continual anxiety.
The Physicians experience hereby as 'tis surer, so 'twill be greater.
He will make use of no Medicines but the choicest, and when they are in their full vigour, and such as are durable, and after once or twice Tryal of them, will seldom fail in his expected success; which cannot be certainly had without some tryal. For though a man buy the choicest ingredients, viz. Sena, which may appear to the Senses very good, yet he cannot positively say, how well, nor yet what quantity of it will work, till he hath made use of it. But afterwards he may confidently apply the whole parcel he hath bought to his purpose. The like may be instanced in a crop of Wheat or Barley, which the skillfullest Husband-man cannot tell how they will yield for Bread, or Malt, till he hath used them. Now how is it possible that a Physician can with any certainty make use of several Shops, since there is so great difference in the ingredients? and 'tis certain the same Medicine made by several Apothecaries, shall differ much in colour, smell, and tast, and consequently effect too; which cannot proceed from any other cause then the difference of the ingredients themselves, or by omitting some ingredients, or by substituting one thing for another; or by distinct ways of preparing them. The same also may be said of Compositions, much more of Chymical Medicines so much sophisticated, and of so much danger and hazard, if not well prepared, which he cannot discover till he hath seen the effect of them, unless it be such as he makes himself, nor those neither till he hath made some tryal of them.
He will much inlarge Materia Medica, Chymistry and Pharmacy, and discover the grounds of them, and wherein the efficacy of remedies lyes, and thereby lay open a whole Ocean for new discoveries, and by the by observe many useful products and Phenomena of Nature, to the great improvement of his Art, and sound Natural Philosophy, which are not taken notice of by Apothecaries, and their Servants; for all which they have neither will nor skill.
As to the improvement of Medicines, this may be added, by the experimenting Physician, that in distill'd waters he will consider and find which of them will afford any virtue, which only phlegm equivalent but to Conduit-water, which of them will keep long, and in perfection, which soon or in what time decay, and spend them accordingly, and in compound distill'd waters, will find cause to lay aside many simples as nothing conducing, or rather weakning the efficacy of the Medicine designed; whereby much charge and trouble will be spared, and better compositions be made.
He will gain and keep to himself Patients, who have diseases they are unwilling should be known by Apothecaries and their Boys, and all such as have a mind to turn over their File.
The Patient will have better opinion of the Medicines, and confidence in the use or them, and the Physician more satisfied in his Conscience, and better assured of the success.
He will gain reputation to his Art, by restoring it to its first institution and practice, by the Founders and Heroes of Physic.
By constantly practised Medicines he will find out a better method of Cure, and may hereby arrive at the true causes of diseases.
He will observe what Medicines by precipitation or other ways, alter, destroy, or weaken one another, whereby of good ingredients singly used, a bad Composition may be made, and therefore fail in the success expected. Many more things might be here added, which a skillful observer, and versed in the way to make experiments (no easie matter) will daily find, and at present I do not so much as give hints of them, but shall hereafter, as occasion and opportunity require.
He will have more scope to be charitable to the poor, and more civil and obliging to his friends, by curing them gratis, or at small charges.
He need not trouble himself with ways of concealing the use of his Medicines, by setting down no directions in his Bill, but giving them to the Patient, which the Apothecary soon learns; nor with giving some of his own Medicines at a pinch, which if they succeed not, to be sure the Apothecaries will cry down in all places, but will conceal all eminently good successes, as disadvantageous to themselves; nor by placing their Arcana's in the Shops of those Apothecaries they commonly make use of; nor by recommending their Patients to such Apothecaries they intrust their secrets with. For then great complaints are made that the Physicians carry away their Customers, and take away their livelyhood, affirming they are willing to fetch them from the prescribing Doctors Apothecaries. To which I answer, that they do fetch them, but perhaps not always; since I have heard them often say, these secrets were but the Medicines of the London Dispensatory disguised under new names, to the discredit of the Physicians that prescribed them. And I well remember some of them have neglected to fetch from my house, not far from their own, some of my preparations, though they had them gratis, for the fetching; whereby the Patients have suffered, and thought I neglected them, 'till they were rectified by another Visit. Nay one of them told me, he had rather dy with his own Shop-Medicines, then be cured with my Magistrals: much more would he have said of Patients, manifestly preferring his own profit before their lives; a most Unchristian saying!
One singular advantage such a Physician will have, that the slanders of the Apothecaries will appear to be malicious, as being raised against such as act contrary to their profit.
By this means Physicians will unite against the common Enemy, will contribute mutual assistance, and communicate more freely to one another their practice and remedies; and also the frauds and unlawful practices of the Apothecaries, will conceal the counsels, and act whatsoever may tend to the advance of their Art; and Patients also will discover the Apothecaries censures, and practices against the Physicians and their prescriptions.
Hereby that great interest will decay Apothecaries have in Families for their petty officiousnesses (which Physicians not to displease them have put them upon) these will be taught Nurses, and the assistants, and which are by some of these as well, certainly more diligently performed then by the Apothecaries.
Hereby the filii Artis, or younger Physicians, will sooner come into a better and more setled practice, and not be beholden to Apothecaries to bring them Patients wherewith they often upbraid them, and glory amongst themselves and to other persons, that they introduced such and such a Physician.
Hereby Chirurgeons will be restored to some of their employment now usurped by the Apothecaries, as leting of blood, applying Leeches, Plasters, Cupping-Glasses, Syringing and Salivation, wraping up bodies in Cere-Cloaths, &c. which indeed do more properly belong to them then to the Apothecaries; hereby also haply many occasions of quarrel betwixt Physicians and the Apothecaries will cease, each party acting according to his own way.
By this means Pseudochymists, and other Mountebanks mouths and revilings will be stopped, only exclaiming for this, that Physicians make not their own Medicines. But since the publication of these papers I am informed that the said Pseudochymists and Mountebanks rail against me, this Book, and the way propounded, as much as the Apothecaries, though before equal Enemies each to others. So that they have fulfilled the Proverb, of like to like. And no wonder since hereby their Kingdom of darkness is brought to light, and they are obliged to oppose it, as the Copper-Smiths were to revile St. Paul for speaking against the Idol of Diana of the Ephesians, whereby their trade was lost.
And as for the reasonableness of it, that the Physician ought to support himself by all lawful ways and means, and to have praeeminence above those ignorant persons that incroach upon his profession, 'tis confessed by all that have considered the great charge, study, and labour, before he can arrive at any benefit from it; for he must take the chargeable degrees of Batchellor, and Master of Arts, Batchellor of Physic, and after 14 years standing, the degree of Doctor; besides his bare expences for his maintenance in the University, Charges in Anatomies, knowledg of natural things; Travels abroad, Chymistry, and Experiments; his Library, Habit, his more free way of living in a suitable house, and Attendants, greater Taxes, &c. insomuch that a Doctor of Physic spends more before he comes to practise, then will set up perhaps a dozen Apothecaries in a way of livelihood; and besides, great sums of money before he can put himself in a fitting Equipage: whereas on the contrary, many young men before their time of Apprenticeship is out, provide well for themselves by Quacking; and certainly the Study of Physic, and consequently the knowledge of Nature, must bid farewel to the Universities, if Shops be permitted to make practisers, for such the people will soon create Doctors, which title the Apothecary takes upon him, though he understand not the reason of the name, to the great shame of the Universities, and Faculty, when ignorant people shall give, and they challenge the same title for nothing, attained by the Physician at a great rate and long study, the vulgar taking Practiser and Doctor to signifie the same thing. And which no persons of knowledg and education do, and perhaps most other persons give them in way of Jeering.
From the handsom support of Physicians these benefits will accrue to the publick, that thereby the honour all Nations yield to the English Physicians will be kept up, who in the late times, when the reputation of the Nation was well neer forfeited abroad, the Physicians then in being, most whereof are now living, and Members of the College, maintained the credit, for learning and value, of this Kingdom, and since his Majesties happy return, some of them have kept up the honour of the Faculty; which manifestly appears by the great esteem Foreigners have of their Books, by often printing them, and translating into Latin what hath been published in English, though they are no where so depressed as in England.
A second benefit to the publick is, that men of competent Estates will breed up their Sons in the Art of Physic, giving them such education as is necessary, and will not vouchsafe to place them out to Apothecaries, though now adays want of learning and degrees are adjudged as needful a qualification for the exercise of Physic, as formerly 'twas for Preaching, and the Shops fit to supply both.
I will conclude this part of my discourse with this observation; that the Laws of England in all their Acts of Parliament, have granted the practice of Physic to Physicians and them alone, and in no clause thereof put in any restraint at all upon them, but every where, either new priviledges, or a confirmation of the old, have been granted, by the said powers. Whereas on the contrary, the Law supposeth cheats in the Apothecaries Shops, and therefore impowers our Censors to destroy and burn what they find bad and corrupt.
The next thing to be treated of, shall be the ways of Apothecaries creeping into practice, and their unfitness thereunto. As to the first, heretofore when they were Members of the Company of Grocers, and dispersed in place, as well as in counsel, they then were wholy subordinate to the Physicians, only keeping in their Shops, and faithfully making the prescriptions they received from the Physicians, and when made, sending them to the Patient by their men (as they still continue to do in Foreign Countries) and not committing the preparation to raw Boys, or Apprentices, which is the true interest of the Patient they should do here likewise. But in process of time, Physicians in acute diseases having taught them somewhat, sent them to visit their Patients, to give them the best account they could of the estate of their health, and effect of their Medicines. And of later years some Physicians took them along with them in their Visits, whereby they acquired a little smattering of diseases, by which means, and their continual officiousness, they insinuated themselves into Families, and by applying (right or wrong) the terms of Art they had learned from the Physicians, they made people believe they had acquired some skill in the Art, and afterwards began to venture a little at practice, and but until these 10 years last past kept themselves within some bounds and limits; but since that time have daily more and more incroached upon our Profession, being assisted by a greater familiarity of conversation with younger Physicians. And in the Plague time they took upon them the whole Practice of Physic, which ever since they have continued, being much helped also therein by the dispersing of Physicians into places unknown to their Patients, by the Fire, but above all by the burning of the College, by means whereof their Government and view of their Shops have been omitted, insomuch that now they are past all restraint, having insinuated and (as they think) rooted themselves by the aforesaid Artifices, so that there remains now no other real remedy but that proposed.
Now here I shall take occasion in a short digression, to discourse briefly the reason, why in all Ages there have been so many pretenders to Physic, and why some of them have got reputation in the World. One hath been mentioned before, viz. the great charges sick men are put to, caused by the separation of the Physician from the Apothecary. But the principal reason is, the want of knowledge in most persons, both of the materials used, and the grounds for which they are applyed. Insomuch that there are but few that can judg, and distinguish rightly of either, and no wonder therefore that in their reasonings they commit more absurd mistakes, or Paralogisms then in any other Art whatsoever, and censure Physicians by the success alone. Which my Lord Verulam accounts the great unhappiness both of the States-man and the Physician, both being alike censured by those that know not the bottom and rise of their Actions and Counsels. For how can any man in either make a sound Judgment without a full knowledge of the business it self; and of all the circumstances thereunto belonging; nor in Physic without the concurrent knowledg of the sick mans habit, disease, cause, remedies, and many other particulars necessary to make a clear judgment upon the success? Yet notwithstanding, many will censure and grumble at the actions of the States-men, though their proceedings have been never so wise, and prudent, and oft-times from muttering and whispering, fall to down-right distast, and mutiny against their Superiors. So that the good success, in State-affairs, of rash and imprudent undertakers, have been extolled and preferred before the wary, and prudent management, and guidance of the soberest and wisest States-men. The same likewise happens between the bold Empiric, and learnedst Physician. But in this way of censuring, the States-man hath this advantage above the Physician, that 'tis possible he may meet with a series of Business so circumstantiated, as seldom or never to miscarry, especially having a greater power over subordinate persons then Physicians have. But the irreversible statute of Heaven forbids us to expect a constant recovery of our Patients, for 'tis appointed, that all men must die. 'Tis sufficient therefore for us, to employ those remedies God hath given to the Sons of men, to the utmost vertue the Creator hath endowed them withal: since his eternal decree hath limited their efficacy from making man immortal. Now since (if men judg by the success alone) it cannot be otherwise, but that the most learned Physician, and most sottish Empiric must be thought equal in skill, by those that are not able to make a right judgment and difference betwixt them on other principles. Hence it comes to pass, that where some ignorant person hath cured accidentally a slight disease, and a Physician hath a Patient dye of an irrecoverable Case, here the Empiric shall be applauded, and the Physician decryed. Nay many will say the disease is the same in both, whereas we daily see most gross mistakes in such opinions, when the Cases differ totally in their Nature, agreeing in one sign only common to both the Cases proposed, nay to many other also. Furthermore, if a Patient dy under an Empirics hand, the friends willingly conceal their Names, lest some discredit should befal them for using such worthless practisers; but if under the hands of a known Physician he shall be sure to be named, and sometimes his attendance falsly fathered on him, when Mountebanks only have been employed: but to besure if an Empiric hath first been made use of, and afterwards an able Physician called in (when all opportunity of doing good was past) and the Patient dy, the Mountebank hath never been mentioned, but the Physician perhaps condemned though he hath done whatsoever could have been thought on, rational in that Case.
Add to the former reasons, the bold and confident brags, and promises of Empirics, that they have cured worse diseases, and will in few hours free them from their maladies, especially where sober Physicians have pronounced doubtfully of the event. No wonder that these pleasing promises to persons in danger and distress bring them into employment even with a rejection of the former sober Physician.
Besides, a foolish opinion prevails with some ignorant persons, that they will deal only with such as will undertake the Cure, (that is) contract with them for a sum of money, one half whereof to be payed in hand, and the other the Cure being done, and so are usually cheated of one half of their money; and such people will have nothing to do with such Physicians as will not undertake them in this sence.
Another Stratagem is, to give strange and hard names to their Medicines, such as are Pilulae radiis Solis extractae, and in English is no more then Pills dryed to that consistence by the Sun-Beams, which ignorant people have thought were made of the Sun Beams. Others commend their Extract of the Soul of the Heathen Gods. One sets up with a receipt received from Van Helmonts own hands; Another hath received from a Jew the shining of Moses Face; nay I have heard a Pseudochymist blasphemously brag, he saw in the making of a grand Elixir, the Quintessence of the Trinity in Unity, and infinite other pitiful captivations of silly people, to be seen on every Gate and Post of this City; such as are the Spirit of the Salt of the World, Panchymagogon, and other ten-footed Greek names, and some other Mongrel non-sensical ones compounded of several Languages; promising certain, speedy, and concealed Cure of incurable Diseases.
And no less ridiculous and absurd to considering persons are, their cantings of themselves, wherewith they no less befool, amuse, and beguile the people; as that by long prayer, and seeking of God, they have had many secrets revealed to them from Heaven. Another by long Travels through Hungary, Poland, &c. hath attained great secrets from Kings and Emperours. Another a Gentleman lately come from Oxford, or Cambridg, Cures the Pox, Running of the Reins, &c. in Capital Letters, at all which what sober man cannot but laugh? Yet such as these are inducements to many to resort to them; moreover some of them are Astrologers, Physiognomers, Fortunetellers, Professors of Palmistry and such other vain Arts; much applauded by the weaker sort of people.
Besides, the former they have their Emissaries, Scouts, and Setters up and down, to cry up the skill And feigned Cures done by them, Nurses, Good-fellows, Midwives, &c. to make up the cry and full noise.
Now it being natural to most people to admire what they understand not, and for Admiration to infer Love, and Love Praise, and Praise the use especially of such things as are set off with high and lofty expressions, it necessarily follows that such persons will cry up, and make use of, those that by these means captivate their understandings, especially their credits being ingaged also; but above all, if they proceed from meaner persons, of whom they are most credulous, having in suspition wiser men, believing the former are not able, and that the wiser are able; and therefore will deceive them. All which appears in some with us cryed up above any Physician that ever was in England, though for pitiful, dangerous, nay sometimes mortal Medicines, whereby great sums of money have been gained in a short time; I shall instance first in Lockyers Pills made of Antimony, discovered to be so by some of my Collegues, and my self, at the first selling of them. A Medicine as ill made as any of that Mineral, and no Physician though meanly versed in Chymistry, but could have excelled it. Yet so great a Vogue this Pill had for some time, that infinite people resorted to him, and purchased them for their lives, both for themselves, and Families, and (as I have heard) for their posterities too. Though a common Chimney in a little time would have made enough of it to have served the whole Nation for some years to come, and that at very small charges. But Experience, the Tutor of too many, hath in a short time brought these Pills into a dis-use, if not a total Oblivion, even amongst the vulgar.
A second cryed up Medicine was Mathews's Pills, made of Opium (to which the virtue of the whole Composition must be attributed) of white Hellebor Roots, and Oyl of Turpentine, whereto some add Salt of Tartar, which will puzzle the most knowing Naturalist to declare why these should be thus jumbled together; unless to obscure the Opium. 'Tis indeed a very cunning Composition, for by giving rest and ease it may easily decoy people into the use of them, though by long taking of them, diseases become far more uncurable then they are in their own Nature.
A third Universal Medicine was Hughes's Powder, sold by him at 10 s. the Grain, and 3 l. 10 s. the Dose, made doubtless of Gold and Quicksilver. The tast and weight of it manifestly discover the former to be an ingredient into it, and the effect, viz. Salivation proves the latter to be part of the compound. Besides I have made of these two dissolved, and digested in their peculiar Menstruums, in no long space of time, a Medicine that had the same effect with his, and in the same Dose, and having a View of his Cabinet left after his Death, containing a large quantity of the said Powder (being all he left behind him) there was found crude Gold, and Quicksilver in the same Cabinet. Now these three Notorious Universal Medicines were put to sale by most ignorant persons. Add hereunto the forementioned Mr. De-laun's Pill, whereof I shall say nothing, being mentioned under the Name of the Pilule ex duobus, in the London Dispensitory, though some make them of the Extract of Coloquintida. The last of any Fame with us, were Dr. Goddard's Drops, a good Medicine, but not so universal, and superlative as he would have made the World believe, and was nothing else but what some Physicians many years since enjoyed. I well remember that in the late troubles, a Person then in great Authority, having cryed up this above all the Medicines in the World, a round wager was offered, that the Doctor should not distinguish his own from two others that should be brought him, both which were but Spirit of Harts-horn. But the wager would not be accepted of. Furthermore, that this Medicine of his was Spirit of Harts-horn, some relations plainly argue; One whereof was the following.
A certain person in Norfolk having sent for as much as came to a 11 l. and dying upon the 2d. dose of it, and by accident most part of the remainder being spilt; there comes in a friend to the House, of some skill, who supposing it to be Spirit of Harts-horn, told the Widow he would endeavour to gain back the money for her. And thereupon went to a Chymist, and bought as much of the said Spirit, as would make up the quantity purchased of Dr. Goddard, who after Tryal of it by smell, and tast, acknowledged it to be his, and honestly payed back the sum 'twas first sold for; which I think few of the Mountebanks do. Sure I am that a Quack sold 21 Pills for 20 l. whereof the Patient took 4 at two doses, to the great hazard of his life, who then repairing to me for my advice, I by Tryal of one of them found them to be Mercurial, and wished him to return them back, but the Quack would not give him 10 s. for the 16 remaining.
The inference and sum of what hath been said, is to shew briefly by what Artifices people are deceived in their Healths, and Purses, and how easily the ignorant are couzened, and such practices used, that Physicians, men of honesty and repute, would be ashamed to own, and must by using them in a short time be ruined and discredited. And such Cheats as these, the College of Physicians are bound by the Laws of the Land to decry, and punish (though by so doing it hath often incurred the censure and clamor of the vulgar) Besides the Statute of the 14th. and 15th. of Henry the Eighth injoyns us to it, declaring that 'tis good for the Common-wealth of this Realm, and therefore expedient, and necessary to provide that no person of the College of Physicians (for all practisers then were of the said body) be suffered to exercise, and practise Physic, but only those persons that be profound, sad, and discreet, groundly learned, and deeply studyed in Physic. Now certain it is, that none of the said body did or dare use any of the forementioned frauds and deceits, but will constantly indeavour (since 'tis impossible but there will be Cheatees; (according to the old Proverb, Populus vult decipi, The People will be deceived) to abridge the number of the Cheaters, who answer to the former part of the Proverb, Decipiatur, Let them be couzened.
I shall end this discourse by returning from my digression to the Apothecaries, who may and do use some of the tricks before-mentioned, and shall here briefly recite some great advantages they have, and make use of above Physicians. One is, that they live in this City 7 or 8 years as Apprentices, as also by their retail Trade, and by living in open Shops, by frequent converse with their fellow Citizens, whether in Commerce or Offices, by many friendly and Neighbourly mutual kindnesses and actions, wherein they spend their whole lives, and are never diverted by studies, and ingenuity from their proposed way of gain, by all which means they get into a fixed familiarity and good opinion with their Neighbours, and a large acquaintance in the World. Now for their skill, besides what hath been before-mentioned, and common to them with the Mountebank, viz. Vapouring and braging of their skill, and decrying Physicians, by talking above the Capacity of those they converse with, who therefore take all they say to be authentick, though never so absurd, and trivial, and many times to set off themselves they will venture to speak Latine commonly as false as the matter, although some of them at Coffee-Houses, and in other mixt Companies, by venturing so boldly have been met with and baffled, and made to depart thence with shame and discredit enough, which their friends and acquaintance take little notice of. Add hereunto their exposing to view their Compositions of Treacle, Mithridate, Diascordium and Alkermes, which all their friends, and neighbours one time or another must see; (being set off by some very curiously) and seeing cannot but admire the great charge, art, and labour of the Apothecary, and perhaps hear his learned Lecture upon them, whereby they imply their great skill, knowledg in the virtues of these ingredients, and consequently an ability to practise with them; all which are below the dignity of a Physician; and therefore a long time is necessary for him to gain acquaintance, wanting the fore-mentioned opportunities the Apothecaries enjoy. Lastly, Their painted Pots and Glasses, with false Titles on them, more win the vulgar then a Physicians Library of far greater value.