A Brief History of Pharmacy

Humanity's Search for Wellness

Bob Zebroski

• Publisher: Routledge
• Year: 2015
• ISBN:
  9781317413318
• Edition: 1
• Topic: History
• Subtopic: World History
• Index: History

Pharmacy has become an integral part of our lives. Nearly half of all 300 million Americans take at least one prescription drug daily, accounting for $250 billion per year in sales in the US alone. And this number doesn't even include the over-the-counter medications or health aids that are taken. How did this practice become such an essential part of our lives and our health?

A Brief History of Pharmacy: Humanity's Search for Wellness aims to answer that question. As this short overview of the practice shows, the search for well-being through the ingestion or application of natural products and artificially derived compounds is as old as humanity itself. From the Mesopotamians to the corner drug store, Bob Zebroski describes how treatments were sought, highlights some of the main victories of each time period, and shows how we came to be people who rely on drugs to feel better, to live longer, and look younger. This accessible survey of pharmaceutical history is essential reading for all students of pharmacy.

1 Prehistoric Pharmacy

From Stones and Bones to Weeds and Seeds

Belief begins where science leaves off and ends where science begins.¹

(Rudolf Virchow)

The great astrophysicist Carl Sagan once wrote, “The world is very old and human beings are very young.”² In a passage from The Dragons of Eden entitled “The Cosmic Calendar” Sagan made the complex comprehensible by taking all of history and compressing it into a single year. He placed the 15 billion-year history of the universe in context placing the origin of the universe on January 1, the formation of Earth on September 14, the origin of microbes on October 9, the appearance of dinosaurs on December 24, and the appearance of humans at 10:30 p.m. on December 31. So according to this cosmic calendar, each of us has an astounding 0.16 seconds of life on this planet!

Scientists estimate that the Earth began about 4.6 billion years ago, with the first forms of life appearing as microbes about 4 billion years ago. The first human ancestor Ardipithecus ramidus or “Ardi” appeared about 4.4 million years ago in Eastern Africa, according to the archaeological findings of Dr. Tim White and his team of researchers.³ This means that microbes and some of the diseases they may cause appeared long before humans did. Disease is by far older than humankind.

The great challenge for researchers today who study the Prehistoric Era is the lack of a written record, so we must rely on other types of evidence that fossils and artifacts leave us. Anthropologists add to our understanding of prehistoric people by studying so called “primitive” societies that still exist in remote areas of the world. By observing “primitive” societies anthropologists have a living window into the past. Some religious and/or medical rituals that are still practiced have remained largely unchanged for millennia, such as the pilgrimages made by very ill people high into the lakes of the Andes Mountains in Peru, led by modern day shamans who appear timeless.

Table 1.1 Carl Sagan’s Cosmic Calendar

As early as 80,000 years ago, prehistoric people engraved drawings of plants and plant parts on bones and deer antlers, perhaps as a way of passing down their intimate knowledge of their environment to their descendants. Additional fossil evidence of pharmaceutical knowledge has been found buried in the Shandar Cave in northern Iraq, where humans were buried with clusters of flowers and herbs, including marshmallow, yarrow, and groundsel.⁴ Similarly, about 14,000 years ago, cave artists painted the image of a shaman or medicine man on the walls of the cave Les Trois Freres in Arriege, France.⁵ He/she was depicted wearing the skin of a deer topped by a rack of antlers. Was he or she perhaps the first pharmacist?

One of the most exciting recent discoveries that have changed our thinking about our prehistoric ancestors was the discovery of “Ötzi,” the 5,300-year-old “Iceman” whose remains were recovered frozen in a glacier in the Tyrolean Alps. This find was remarkable for a number of reasons. The Iceman was hunting in the Alps at a high altitude when he was wounded and overcome by a massive snowstorm, which preserved his remains for several millennia. Ötzi carried a utility belt wrapped around his waist that contained pouches of dried mushrooms and fungi that had antibacterial properties. Ötzi also had a number of tattoos on his body that corresponded to acupuncture points, which led researchers to believe that Neolithic people had a much more sophisticated knowledge of the body and of herbs than previously thought.⁶ Apparently, some of our Neolithic ancestors understood acupuncture. This is not surprising, since our Homo sapiens ancestors share the same brain capacity and innate curiosity that we do, but unfortunately did not have the benefit of millions of years of human discovery from which to benefit as we do. One of the important lessons of history is empathy, that is, to place one’s self in the historical circumstances of our ancestors to understand their motives, actions, and accomplishments. It is important to bear in mind that we are here today due in large part to their individual and collective ingenuity, while most other species that have inhabited this planet have long since passed into extinction.

Figure 1.1 Picture of Ötzi—Ötzi (the 5300 year old Iceman) was discovered in the Ötztal Alps on September 19, 1991. Ötzi’s discovery yielded a wealth of information about Neolithic medicine.

Source: © South Tyrol Museum of Archaeology—www.iceman.it.

The Paleolithic Era

The Prehistoric Era is customarily divided into two periods: the Paleolithic or Old Stone Age, and the Neolithic or New Stone Age. Life in Paleolithic societies, where people lived in caves and survived by hunting and gathering food, dates back to about 40,000 BCE. Paleolithic people lived in low-density populations in small clans or tribes of less than 100 people and moved from place to place in search of food. Human life at this time was precarious, uncertain, and relatively brief in duration. Any disease or injury might well have meant death for those afflicted. Until 1800 CE the overall life expectancy was about 25 years with some notable exceptions such as during Roman times. This average has been adversely affected by extraordinarily high infant mortality rates for this time period.

Despite leading lives governed by necessity, Paleolithic people used their instincts as well as simple trial and error to learn how to cope with their environment. For example, when someone is stung by a bee, a natural reaction is to rub the afflicted area with something cool and grainy such as mud, which brings relief from the pain and also has the potential to help remove the source of the pain, the bee’s stinger. Further, people observed what animals ingested and also learned by trial and error what was helpful in healing and what was not. Over time, individuals in a tribe emerged who had special talents for healing others, known as “shamans,” “witch doctors,” or “medicine men.” The term “shaman” derives from the Siberian language meaning “one who knows.”⁷ Thus, the role of the learned and trusted healer in the person of the shaman evolved over time into the modern physician, pharmacist, nurse, and other health care professionals.

Paleolithic people explained the world around them in supernatural or religious terms. In fact, from Paleolithic times through the Renaissance Era, cultures and civilizations would explain illness in sacred or religious language. It would not be until well into the Early Modern Era when pharmacy and medicine would be framed in secular or scientific language. Shamans developed theories of illness based on supernatural causation. Causes of illness might include a person who broke a tribal taboo, dishonored a god, or had a spell cast against them by another shaman. In order to heal the afflicted person, the shaman enlisted the whole tribe in the healing process, and the patient became a symbol of this conflict between illness and health. The patient would “confess” (today we use the term “present”) their symptoms to the shaman and the shaman would assess the problem and offer a cure. Even with all of our modern technology, 75 percent of all primary diagnoses derive from the patient’s presentation of symptoms.⁸ It is important to note that the shaman treated the “whole” patient. The mind, body, and spirit were treated as one entity and not compartmentalized as they often are in modern health care.

The goal of the shaman was to cast out the “evil” or purify the patient by means of both oral and manual rites. Oral rites were symbolic and palliative in nature and included chants, incantations, and dances. By contrast, manual rites were physical actions performed on the patient by the shaman and included, performing a rudimentary surgical procedure, sucking out poison from a wound, or administering herbs for a patient to smell or swallow. Indeed, administering herbs or potions might well have been the first form of drug therapy. Depending on the severity of the illness or local custom the shaman might administer an especially harsh potion. Dreckapotheke is a term derived from medieval German slang used to describe an especially disgusting concoction or fumigation used by shamans to ward off evil.⁹ Even in Paleolithic times, people respected the power of medications to fight disease and saw the need for them to be strictly controlled and administered by a relatively learned and trusted individual. The shaman’s cauldron became a symbol of magic, mystery, and transformative power that still lingers in modern memory in the symbol most closely associated wit...

Table of contents

• Cover Page
• A Brief History of Pharmacy
• Title
• Copyright
• Dedication
• Contents
• List of Figures
• List of Tables
• Introduction: The Essentials of Pharmacy
• 1 Prehistoric Pharmacy: From Stones and Bones to Weeds and Seeds
• 2 Ancient Pharmacy in the River Civilizations of Mesopotamia and Egypt
• 3 Pharmacy and Medicine in the River Civilizations of the East: Ancient India and China
• 4 Pharmacy in Ancient Greece and Rome
• 5 Medieval Pharmacy in the West: Pharmacy in an Age of Faith (Dogma and Authority)
• 6 Medieval Arab and Islamic Pharmacy
• 7 Pharmacy During the European Renaissance and Early Modern Era
• 8 Eighteenth- and Early Nineteenth-Century Pharmacy: From Apothecary to Chemist to Pharmacist
• 9 Colonial and Early American Pharmacy
• 10 The Era of Alternative and Patent Medicine
• 11 American Pharmacy Organizes and Promotes a New Vision for the Practice of Pharmacy
• 12 Learning How to Learn—From Apprenticeship to the Doctor of Pharmacy (Pharm.D.): The Struggle for Professional Recognition
• 13 The Origin and Growth of the Pharmaceutical Industry: From Terra Sigillata to Viagra
• 14 The Emergence of an American Institution: From the Corner Pharmacy to the Chain Drugstore, to the Big Box Department Store Pharmacy
• 15 The Impact of Federal Legislation on the Practice of Pharmacy
• 16 Hospital Pharmacy and the Rise of Clinical Pharmacy in the United States
• Index