Apothecary

Apothecary was the early name applied to individuals who prepared and sold substances for medical use. The forerunner of today's pharmacist, the apothecary procured, mixed, and evaluated medications. The role of the apothecary-pharmacist has undergone many changes over the centuries. Once associated with the supernatural and alchemy, the apothecary became a leading health care practitioner whose field of expertise was based on science and who often treated patients directly. Eventually, the traditional apothecary was replaced by pharmacists, as we know them from the local drug store. Today, the pharmacist isprimarily a dispenser of drugs already formulated and manufactured by pharmaceutical companies.

The art of the apothecary, that is mixing compounds according to the specifichealth needs of a patient, goes back to at least to 2200 to 3000 B.C. in ancient China, where the medicinal values of herbs were sought out and investigated. During the latter part of the eighth century, the first apothecaries and apothecary shops appeared in Baghdad. These street market shops sold medicines along with syrups, perfumes, and wines. This approach to pharmacy spread throughout Europe. As greater scientific rigor was applied to medicine, alchemists, who relied on herbs and magic, were replaced by apothecaries, who based their medicines on demonstrable physical effects. During Medieval times, the equivalent of today's apothecary-pharmacist were primarily priests, monks, and medicine men.

In 1606, the Society of Apothecaries of London was created through a charterissued by James I (James VI of Scotland) and was associated with the Guild ofGrocers. In 1617, a new charter came into being establishing an independentApothecary Guild recognized as a distinct group of craftsmen. This charter resulted from England's move toward establishing an official pharmaceutical standard, published as the Pharmacopeiae Londonensis. The granting of charter to the apoethcaries represents the first independently organized group of pharmacists in the western world. The charter made it illegal for anyone other than an apothecary to prepare or sell medicines.

The first American apothecary store appeared in Philadelphia around 1780 andfocused on supplying German immigrants with remedies familiar in their formerhome country. At that time, the apothecary practiced almost like a doctor. In addition to making and prescribing medicines, they made house calls to treat patients and trained apprentices. Many also performed surgery and served asmale midwives during birth. Since there were no regulations regarding drug compounding, the effectiveness of medicines were haphazard and depended on accurate measurements and compounding of the right substances by the individualapothecary. However, the apothecary had many effective substances in his arsenal to treat patients, including chalk for heartburn and calamine for the skin, which are ingredients in some modern medications.

By the turn of the twentieth century, the apothecary as a compounder of medicine who also counseled patients on health, was still the accepted approach topharmacy. The apothecary-pharmacist still compounded approximately 60 percent of all medications dispensed in the 1930s and 1940s. However, after World War II, the growth of commercial drug manufacturers marked a sharp decline inthe need for compounding and the apothecary. In 1951, the Durham-Humphrey amendment to the United States Food, Drug, and Cosmetic Act introduced doctor-prescription only legal status for most medicines, resulting in the developmentof the modern day pharmacist as a dispenser of pre-manufactured drugs. Still, in the 1960s, about 100 apothecaries practiced the United States. These apothecaries differed from the modern drug store in that they focused solely onmedications, including compounding substances for an individual patient's needs.

Throughout the 1970s and the 1980s, the pharmacist as an apothecary became nearly non-existent especially as large chain drug stores took control of the pharmaceutical sales market. However, some community pharmacists continued tocompound their own drugs, primarily salves and ointments, from formulas handed down through generations. Today, the apothecary is making a comeback as theneed for specific doses and customized medications begins to grow again. Each day, thousands of compounded drug dosages are dispensed by pharmacists whoare also compounders or apothecaries. Although most drugs are still dispensedaccording to manufactured dosages, the modern apothecary may adjust dosagesaccording to a doctor's prescription, prepare medications without dyes or preservatives that may cause allergic reactions in some patients, make a medication more palatable for children, and use many other approaches to meet an individual patient's needs.

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