Evolution of Pharmacy Antiquity Middle Ages Modern Europe

Antiquity in Babylon Babylon

jewel of ancient Mesopotamia [cradle of civilization]

earliest known record of practice of the art of the apothecary.

Practitioners of healing in this era (about 2600 B.C.) were priest, pharmacist and physician, all in one.

Medical texts on clay tablets of Mesopotamia (800 tablets) record first the symptoms of illness, the prescription and directions for compounding, then an invocation to the gods. PHARMACY IN ANCIENT

BABYLONIA

Antiquity in China Shen Nung (about 2000 B.C.)

Father of Chinese Pharmaceutics Emperor who started Chinese

Pharmacy sought out and investigated the

medicinal value of several hundred herbs

tested many of them on himself wrote the first Pen T-Sao (The

Botanical Basis of Pharmacy), or native herbal, recording 365 drugs, 11,000 Rx handed down by oral tradition

Still worshiped by native Chinese drug guilds as their patron god

Medicinal plants include podophyllum, rhubarb, ginseng, stramonium, cinnamon bark, and, in the boy's hand, ma huang, or Ephedra.

Pharmaceutical records - clay tablets & long scrolls in 2000BC.

PHARMACY IN ANCIENT CHINA

Antiquity in Egypt Papyrus Ebers (1500 B.C.)

best known and most important pharmaceutical record

21 yard (60 ft) long, contains 700 drug prep of Egyptians [gargles, suppositories, inhalations, poultices, ointments]

a collection of 800 prescriptions, mentioning 700 drugs

might have been dictated to a scribe by a head pharmacist as he directed compounding activities in the drug room

Pharmacy in ancient Egypt was conducted by two or more echelons [higher authority]: gatherers and preparers of drugs "chiefs of fabrication," or head

pharmacists Use of mortars, pestles, hand mills,

sieves & weighing scales

DAYS OF THE PAPYRUS EBERS

Egyptian medicine dates from about 2900 B.C.

Biblical Records

1200 BC Book of Sirach – creation of medicines by

God Genesis – myrrh as astringent, carminative

and protectant Exodus – olibanum (frankinscence)

Taote Ching 500 BC The Way Created by Lao Tzu,

a Taoist philosopher Pharmacy and

medicine were practiced together until Middle Ages

Antiquity in Greece Hippocrates [460 BC] -

rationalization of treatment ( from magical to rational )

Father of Medicine Fundamentals of scientific

method Concept of homeostasis

Theory of humoral pathology Disease as a

disturbance of body’s fluids blood, phlegm, yellow and black bile

Pharmakon –drug as healing remedy

Antiquity in Greece Theophrastus [300 B.C.]

greatest early Greek philosophers and natural scientists

Father of Botany observations and

writings dealing with the medical qualities and peculiarities of herbs are accurate, even in the light of present knowledge

THEOPHRASTUS - FATHER OF BOTANY

Antiquity in Turkey Mithridates VI [about 100

B.C.] King of Pontus Father of Toxicology Studied the art of poisoning

and the art of preventing and counteracting poisoning

used himself as well as his prisoners to test poisons and antidotes

Mithridatum His famed formula of

alleged pan-antidotal powers

popular for over a thousand years

MITHRIDATES VI - THE ROYAL TOXICOLOGIST

Antiquity In the Mediterranean Terra Sigillata (Sealed Earth)

One of the first therapeutic agents to bear a trademarks as a means of identification of source and of gaining customers' confidence

a clay tablet originating on the Mediterranean island of Lemnos before 500 B.C.

One day each year clay was dug from a pit on a Lemnian hillside in the presence of governmental and religious dignitaries Washed, refined, rolled to a

mass of proper thickness formed into pastilles and

impressed with an official seal by priestesses, then sun-dried

The tablets were then widely distributed commercially

TERRA SIGILLATA - AN EARLY "TRADEMARKED" DRUG

Middle Ages Pedanios Dioscorides (first

century A.D.) Father of Pharmacology Botanist/ pharmacologist

De Materia Medica ( 600 plants & 90 minerals)

recorded what he observed, promulgated excellent rules for collection of drugs, their storage and use ( The Herbal)

His texts were considered basic science as late as the sixteenth century.

DIOSCORIDES - A SCIENTIST LOOKS AT DRUGS

On the Art of Healing, most famous writing

practiced and taught both Pharmacy and Medicine in Rome

First Pharmacist/Botanist associated with galenicals

(tinctures, fluidextracts, syrups, ointments) A class of pharmaceuticals

compounded by mechanical means

originator of the formula for a cold cream, essentially similar to that known today

Many procedures Galen originated have their counterparts in today's modern compounding laboratories

Compilations: Antidotaria – similar to dispensatories Receptaria – more modest

formularies

GALEN - EXPERIMENTER IN DRUG COMPOUNDING

Galen (130-200 A.D.)

Damian and Cosmas Damian, the apothecary, and

Cosmas, the physician Twin brothers of Arabian

descent, and devout Christians offered the solace of religion as

well as the benefit of their knowledge to the sick who visited them

Their twin careers were cut short in the year 303 by martyrdom

For centuries their tomb in the Syrian city of Cyprus was a shrine. Churches were built in their honor in Rome and other cities

After canonization, they became the patron saints of Pharmacy and Medicine, and many miracles were attributed to them.

DAMIAN AND COSMAS - PHARMACY'S PATRON

SAINTS

Monastic Pharmacy Pharmacomedical services - lay practitioners

and clerics Monasteries

remained to be the centers of intellectual life Where remnants of the Western knowledge of

Pharmacy and Medicine were preserved (fifth to twelfth centuries)

Monks Collected and cultivated medicinal plants Distilled aromatic and cordial flowers prepared herbs according to the art of the

apothecary for the benefit of the sick and injured

Herb gardens such as the ones used by monks may still be found in monasteries in many countries.

Famous manuscripts: De Viribus Herbarum (Herbs Used by

the People) – Abbot Odo in France Causae et Curae – Abbess Hildegard in

Germany

Arabs separated the arts of apothecary and

physician [Italy, Spain, France] first privately owned drug stores -

established in Baghdad late in the eighth century

preserved much of the Greco-Roman wisdom and added to it

developed syrups, confections, conserves, distilled waters and alcoholic liquids

Own treatises – influential and authoritative in Europe when translated into Latin

More refined and elegant way of administering drugs

THE FIRST APOTHECARY SHOPS

When the Moslems swept across Africa, Spain and southern France, they carried with them a new pattern of Pharmacy which western Europe soon assimilated.

Avicenna Ibn Sina (about 980-1037 A.D.) called Avicenna by the

Western world “Persian Galen” Among the brilliant contributors

to the sciences of Pharmacy and Medicine during the Arabian era

Pharmacist, poet, physician, philosopher and diplomat

His pharmaceutical teachings were accepted as authority in the West until the 17th century; and still are dominant influences in the Orient.

AVICENNA - THE "PERSIAN GALEN"

EDICT of 1231 Magna Carta of Pharmacy Public pharmacies began to

appear in the 17th century 12th century – public

pharmacies [Italy & France] Some still remained under

church control. Pharmacy was separated from

Medicine [about 1240 A.D] in Sicily and southern Italy

Frederick II of Hohenstaufen Emperor of Germany first European edict completely

separating the responsibilities of pharmacists from those of Medicine, and prescribing regulations for their professional practice

SEPARATION OF PHARMACY AND MEDICINE

Middle Ages to Modern Europe Magna Carta (document acknowledging rights)

of the Pharmacy profession [1240] Made Pharmacy an independent branch of public

welfare service Limited of number of pharmacies Fixed prices of remedies Required official supervision to pharmaceutical

practice Made the use of a prescribed formulary (fixed

formula for a certain drug) compulsory Evolution of individual standards and

responsibilities in urban centers like Italy, Spain, France

10th-15th Centuries Moses Ben Maimon (1135-1204)

Maimonides Spanish Rabbi, whose prayer was written in many

scrolls given during graduation Published glossary of drug terms and manual of

poisons

Paracelsus – revolutionized pharmacy Philippus Aureolus Theophrastus Bombast von Hohenheim Superiority over Celsus, herbalist “Luther of Medicine” Introduced medically active “quintessences” (pure and concentrated

essence of a substance) from natural resources Transformed pharmacy from botanical science to chemical

science He replaced 4 body fluids to 3 chemical constituents

namely: Sulfur – combustibility Mercury – liquidity Salt - stability

Disease was a chemical abnormality to be treated with chemicals

10th-15th Centuries

Modern Europe In the British Isles, trade in

drugs and spices was monopolized by the Guild of Grocers, which had jurisdiction over the apothecaries.

Upon persuasion by the philosopher-politician, Francis Bacon, King James I granted a charter in 1617 which formed a separate company known as the "Master, Wardens and Society of the Art and Mystery of the Apothecaries of the City of London" over vigorous protests of the grocers. This was the first organization of pharmacists in the Anglo-Saxon world.

THE SOCIETY OF APOTHECARIES OF LONDON

Modern Professional Societies Replaced guild [self-governed] Opened schools of pharmacy or encouraged institutions to do so Modified the rules by which one was allowed to practice pharmacy to

prolonged apprenticeship (4-8 yrs) Obligatory examinations were given [Germany] – 1725

West European Pharmacy Matured during the 17th century Put up organized activities and a periodical literature Standardized proliferating formulas of varying compositions, which lead

to creation of official pharmacopoeia Dispensatorium Pharmacopolarum –official book of drug

standards in Cologne, Florence, Rome Ricettario Florentino – 1st Official Pharmacopeia of European world Lititz Pharmacopeia – hospital formulary used during revolutionary war

in Pennsylvania

USP 1820 in Philadephia by USP Convention Goal : to select official drugs and set up

standards for identity, purity and assay methods

Members: Physicians (1820), Pharmacists (1850)

Charles Rice – 1st pharmacist to be the chairman; USP VI

Italy Cradle of professional pharmacy The ff were established in Italy

1st prof European apothecary shop 1st post antique antidotary 1st pharmacopeia 1st real botanical garden

Nuovo Receptario, originally written in Italian, was published and became the legal standard for the city-state in 1498 the result of collaboration of the Guild

of Apothecaries and the Medical Society - one of the earliest manifestations of constructive interprofessional relations

The professional groups received official advice and guidance from the powerful Dominican monk, Savonarola, who, at the time, was the political leader in Florence.

THE FIRST OFFICIAL PHARMACOPOEIA

Modern Age (18th century) William Withering – digitalis, digoxin Karl Scheele – arsenic, chlorine, glycerin,

organic acids Edward Jenner – eradication of small pox

French Pharmacist Bernard Courtois – iodine in algae, bromine

(sea water) Joseph Caventou & Pierre Pelletier– quinine,

caffeine Pierre Robiquet – codeine Henri Moissan – flourine by electrolytic

methods

German Pharmacists Frederick Serturner – morphine Johannes Buchner – salicin from willow bark,

nicotine from tobacco; aspirin and nicotinic acid production

Rudolf Brandes & Philipp Geiger– hyoscyamine and atropine

20th Century Scientists Paul Ehrlich – chemoTx, Arsphenamine –

syphilis Frederick Banting & Charles Best – insulin Gerhardt Domagk – Prontosil (Sulfa drug), for

hemolytic streptococci Alexander Fleming – penicillin Selman Waksman – streptomycin Jonas Salk – injectable vaccine for polio Albert Sabin – oral vaccine for polio