History of Pharmacy and Drug Making
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Transcript of History of Pharmacy and Drug Making
PHARMACY FROM THE ANCIENT
WORLD TO 1100 AD
PHARMACY IN THE MEDIEVAL
WORLD
2012.04.24.
BPOP1.; Lecture 23. & 24.
History
History of:
Medicine
Pharmacy
People who use them
Different in each country
But it is partly similar history worldwide
1. Natural substances used by primitive man
2. Specialized individuals in communities
3. Early civilizations: physician-pharmacist Historical evolution connected with medicine
4. Developed civilizations: separation of professions Pharmacists
Physicians
Why do we need to talk about this?
History as heritage History of pharmacy = history of a profession Contribution of pharmacy to civilization.
Who became pharmacists and why?
What activities did they carry out?
What skills did they need to perform their duties?
Philosophy of the pharmacist’s role in society
Ways of thinking as a pharmacist
Narrative history Story of the past, appearance of pharmacy in different times
Great names, interesting stories
Lessons of history Medical literature
Policy making, disease control
Sources of history in pharmacy
Where can one find material about the history of pharmacy?
1. Publications: books and journals
2. Archives, letters
3. Prescription books
4. Oral history
5. Pharmacy illustrations (images) in
1. Books
2. Art
3. Photographs
4. Equipments and machines in industry
6. Pharmacy artefacts: early pestels and mortars, antiques
Products of pharmacists - nomenclature
Products are described by many names Drugs
Medicines
Pharmaceuticals
Therapeutic drugs
Drug Nowdays can be referred to illicit substances
Earlier it was used for active ingredients
Medicine Product in a finished form (like Panadol tablet)
Pharmaceutical Broader meaning including active ingredients, products,
vaccines, etc.
Interchangable?
Do they mean the same?
Pharmacy from the ancient world to 1100 AD
Pharmacy from the ancient world
Development of human species and civilizations
Prehistoric men: Hunter-gatherer - Food producer
Early civilizations in Babylonia, Egypt, China… 4000 B.C.
Discovery of tools, writing/symbols
Specialization
Disease, illness and accidents needed treatment
Selected specialists treated symptoms
Plants and minerals in nature (early folk medicine)
food-poison-drug?
Called „doctor”, „wise woman”, „medicine man”, „priest”
Mixture of: instinct + magic + confusion
Practiced „pharmaco-magic”
Later – instinct and magic changed to Empiricism (not science jet)
Careful observation, systematic observations, Trial and error method
Causes of illnesses were mostly unknown
Due to supernatural causes, evil or sins
Mesopotamian civilisations, 3000 BC – 539 BC
First urban civilisation around 4000 BC
Tigris and Euphrates rivers
Babylon (2200-1300 BC)
Babylonian – Assyrian medicine
Used plant drugs, wound washing, wines, oinments
Manufactured soap, vinegar, plant extracts
King Hammurabi (1795-1750 BC)
Hammurabi’s code regulated medical and surgical practice
Apothecaries: Separation of „diagnosis and treatment” from „preparation of medicines”
Mesopotomian drug formulas were not quantitative
Apothecary = perfumer Preparation of volatile oils and unguents
king Assur-Bani-Pal (668-627 BC)
Library in Ninive
Clay tablets: 800 fragments contain information on Babylonian medical treatments
Egyptian civilisations, 3000 BC – 1200 BC
Nile valley
Well documented history on:
tombs, ceramic and papyrus
Formulation of medicines
Wine, beer and honey as vehicles for liquid medicines
Honey for incorporation of solids in pills
Waxes for oinments
Papyrus Ebers (1500 BC) ~ 20mx30cm Medical-pharmaceutical „dissertation” ~ 4m
875 prescriptions, 700 drugs (plant, animal, mineral)
21 methods against coughing, 18 skin disorders, etc…
Dosage forms
Infusions , Decoctions, Pills, Suppositories
Recipes were stated quantitatevly
Use of: mortars, handmills, sieves and balances
Pastophor: preparer of medicines (separated from physicians)
Imhotep (2635 – 2595 BC)
Egyptian polymath, chancellor to the pharaoh and high priest, architect - Pyramid of Djoser
probably acoauthor of Edwin Smith papyrus
Anatomical observations and cures
Greeks identified him with Asklepios
God of medicine and healing
The rod of Asclepius, a snake-entwined staff, remains a symbol of medicine today.
twisting the worm around a stick may have inspired the symbol in case of dracunculiasis
Egyptian civilisations, 3000 BC – 1200 BC
Greek civilisations, 1250 BC – 285 BC
Crete – Bronze Age culture
Script for writing was developed
Iron melting
Greek empire
Mesopotamian and Egyptian culture had great influence
on Greek culture
Early philosophers’ theories
Heraclitus of Ephesus: all things were composed of two types of
opposites - wet/dry and hot/cold controlled by Logos
Empedocles: eveything is made up of four elements – fire, air,
water and earth
Greek civilisations, 1250 BC – 285 BC
Hippocrates (460-377 BC)
Hippocratean Corpus (collection of Ancient Greek medical works)
Theory of four liquid humours (humoralpathology) Blood
Phlegm
Yellow bile
Black bile
Disease was the result of excess of one of
these liquid humours, and the
treatment is to eliminate it from the body
Main principles for the practice medicine
Hippocratic Oath, primum nil nocere!
Precise anamnesis (observation) of the patient
Greek civilisations, 1250 BC – 285 BC
Aristotle (384-322 BC)
Classification of animals to genera and species
Polymath: botany, physics, anatomy,
physiology, mathematics
Theophrastus (372-287 BC)
Established the discipline of botany
Attacking the thoory of four elements
Stressing
Empirical approach
Experimental evidence
Roman civilisations, 275 BC – 476 AD
Expansion of the Roman epire
Overruning two literate nations: Greeks and Hebrews
Advances in engineering (sewage disposal systems, aquaducts), law and govrenment
Adoptation of greek medicine
Disseminating medical knowledge in the empire
Celsus (20-50 AD)
Medical practioneer, encyclopaedist
Translated and edited other people’s work
De Medicina (8 books)
250 drugs, 100 surgical procedures
Roman civilisations, 275 BC – 476 AD
Dioscorides (50-100 AD)
Greek physician, pharmacologist and botanist
Surgeon of the emperor’s army
De Materia Medica ("Regarding Medical Materials")
List of materials of animal, plant and mineral origin
"precursor” to all modern pharmacopeias
It remained in use until about 1600 BC
It was circulated in Latin, Greek, and Arabic
For every illness there is a specific plant remedy
Roman civilisations, 275 BC – 476 AD
Galen (129-199 AD)
Physician and surgeon of gladiators
Experiments: dissected animals
Developed the humoral pathology scheme
Combining earlier theories like Hippocratic theory and the four temperaments of man
All illness is the result of imbalance between these elements
Apotheca = storeroom for drugs
Galenicals = creams and ointments
Four bodily fluids affect human
personality and behaviors
1. sanguine (pleasure-seeking
and sociable)
2. choleric (ambitious and
leader-like)
3. melancholic (introverted
and thoughtful)
4. phlegmatic (relaxed and
quiet)
Arabian civilisations, 400 AD – 1100 AD
Arab empire
Greek and Roman works were translated to Arabic
Apothecary shops appeared (850 AD)
Separation of medicine from pharmacy
Precise education
High code of ethics
Wide range of medicines
Movement of scholars from Persia
Religious oppression
To the west: Italy, France
Arabian civilisations, 400 AD – 1100 AD
Rhazes (865-925 AD)
(Mohammad-e Zakariā-ye Rāzi)
the „Persian Galen”
Physician at Baghdad’s great hospital
Writer, chemist and teacher
Well equiped laboratory
Book of Medicine
Encyclopedia derived from Greek, Arabic, Persian and Indian sources
Use of „pills”
differentiated smallpox from measles
Arabian civilisations, 400 AD – 1100 AD
Avicenna (980-1037 AD) (Ibn Sina)
Studied medicine at age 15
writing on philosophy, astronomy, alchemy, geology,
psychology, Islamic theology, logic, mathematics
Canon of Medicine (al-Qanum)
Containing teachings from Hippocrates, Galen and
Aristotle
5 books, 760 drugs and their antidotes
Translated to Latin
text-book in the universities of
medieval Europe
Silvering of pills
By the end of th 11th century
Basic conditions for the development of a separate profession were available:
Natural materials for medical use have been identified
Encyclopedias and writing was available to pass on knowledge
Technologies for processing of raw materials have been developed
First steps toward separation of professions have been taken
Science, culture and art evolved simultaneously
polymaths
Developments of… and the opposition to science
and experimental medicine in Europe
Advances of the Mesopotamian, Egyptian, Greek and Roman cultures resulted in:
Development of botany, biology, philosophy…
Medical theories
Experimental knowledge
Encyclopedias
Drugs and medications
Animal, Plant and Mineral substances
Formation of physician and drug manufacturer specialisation
Rise of the Christian religion
Churches enforced obedience to dogma
Natural philosophy was forbidden
Works of Hippocrates, Galen and Dioscorides were preserved in libraries of Christian monks
Dark Ages (735-1150 AD)
From 1100 to 1617 AD
Pharmacy in the medieval world
Medieval world
Constant wars
Frequent epidemics, infectious diseases
Black Death (Yersinia pestis)
estimated to have killed 30–60 % of Europe's population, reducing world population by 100 million
Majority of people lived a short life
Crusades (1095 and 1291)
series of religious expeditionary wars
Impact of the crusades
Spice and drug trade, commercial centers, weight and measure, coins for trading
Adaptation of new ideas:
Separation of pharmacy from medicine
Compounding drugs in large scale
Government officer inspection of shops run by pharmacists, herbalists
Medical schools
Developments in Europe
Centers of learning in Italy, Spain, France created
Medical school of Salerno (Scuola Medica Salernitana) - 1077
first medieval medical school
Meeting of different culture: Greek-Latin medical tradition merging with the Arab and Jewish medical traditions
Medical schools
France: Montpellier
Spain: Cordova
Developments regarding pharmacy
Distillation
Stressing the value of chemistry
First formal separation of pharmacy from
medicine in Europe - 1231
Idea of separation introduced by the Arabs into Sicily
Edict(=regulation) of Frederik II of Hohenstaufen (1231)
Emperor of Germany and king of Sicily
Created clear distinction between the responsibilities of physicians and those of apothecaries
Laid down regulations for their professional practice
Particular skills and responsibilities were required Druggist – confectionarii
Apothecary -stationarii
Avoid the expliotation of the sick
Government supervision of pharmacy, controlled prices
Had to stock certain drugs
Can not store them for more than 1 year
This idea spread across Europe
Basel – Switzerland: Apothecaries Oath (1271)
„no physician shall own an apothecary’s business”
The Guilds
Traders were organising themselves into craft and
merchant guilds (like Guild-Merchant, wool traders)
For the interest of its members
Exluding strangers
Pharmacy was also a trading activity at that time
Decree of King Edward III. (1363)
Every craftsmen had to enrolled in a guild = registration
Traders of drugs and spices
Were guild members
Had pharmaceutical knowledge
Medieval hospitals
Pharmacy was also practiced in hospitals
Hospitals
Early Roman military hospitals
Later also for travelers (guesthouse and therapy)
Special institutions outside cities
Leper houses (Mycobacteriom leprae)
Pets houses (Yersinia pestis)
Respective roles of physicians and apothecaries
Pharmacists (apothecaries) were practicing
In retail premises (shops)
Public institutions (hospitals)
Benedictine Abbey and Monastery in Pécsvárad
Founded in – 1015 AD
•Pharmacy
•Garden for herbs
Sources of medical knowledge
Medical universities from 14th century in Europe
Slow spreading of knowledge = no printed books
Monks hand copied and translated manuscripts, painted illustrations
Herbals
Medical literature about medicines, drugs, plants
Sources of information on preparing medicines
De Materia Medica by Dioscorides (100)
Woodcuts
Printed books
De Viribus Herbarium by Macer Floridus (1477)
Development of pharmacopoeias
Herbals were often diferent in content and
inconsistent
Plants were difficult to identify
Need for standardisation and official publications
Nuovo Receptario (1498)
Florence – Italy
Published by the Guild of Apothecaries and the
Medical Society
London Pharmacopoeia (1618)
Standards for the whole country
Contained salts, chemicals and metals
Renaissance
Paracelsus (1493-1541) German-Swiss physician, botanist, alchemist,
astrologer
Philippus Aureolus Theophrastus Bombastus von Hohenhe
"Paracelsus” is meaning "equal to or greater than Celsus" Questioned works of Avicenna and Galen
publicly burned traditional medical books
Belief in chemical and mineral remedies mercury, lead, sulphur
Medical use of opium pills and tincture
New dosage forms: extracts and tinctures
„only the dose determined if a substance was poisonous or not”
Foundation of the Society of Apothecaries
Sale of medicines was a business for long time
Apothecaries were members of the Grocers’
Company
King James I (Charter of 1617)
„The Worshipful Society of the Art and Mystery of
the Apothecaries”
Complete independence for apothecaries just like
for physicians
Important landmark of the profession of pharmacy
7 years training with a master apothecary
Oral examination: Preparation, dispensing, handling and
compounding of medicines
PHARMACY IN THE
MODERN WORLD
FROM 1600’ –
UNTIL THE XX. CENTURY
PREPARATION FOR FINAL TEST
2012.05.02.
BPOP1.; Lecture 25. & 26.
Europe and England in the 1600’s
Growth of population
Different living conditions
Rich: large houses separated
Poor: terrible conditions
Streets covered in sewege, rats
Spread of diseases and plagues
Smallpox, dysentery, typhus, tubercolosis
High infant mortality
Medical practice in the 1600’ and 1700’
Largely based on system of Hippocrates and Galen
Disease is caused by the body’s four humours
Physicians examined which humour is in excess
Treatments included
Bleeding
Pugratives
Diaphoretics (promoting sweating)
Medical service providers:
Physicians – healing, expensive, only for the rich
Apothecary – dispensing/preparing medicines according to prescription
Also gave advice on treatment (no charge) middle class, poor
Traveling salesman
Family, Religious ministers, Wise woman – poor people
Prayers
Medical plants
Pharmaceutical practice in the 1700’
Development of printed formularies and pharmacopoeias
Growing understanding of medicines
Rejecting principles of humoral pathology
New drugs in pharmacopoeias
Ferrous sulphate, Benzoic acid
Apothecaries became legitimised practioneers of
medicine
formation of the Pharmaceutical Society of Great
Britain- 1841
Register of pharmacists,
Rise of welfare and national insurance
Development of Friendly societies
People join together for a common financial or social purpose
Working people pay small amount of money regularly
Societies pay for medical service in time of need
Rise of welfare in the XX. century
Public education
Old age pension
Unemployment pay and sick pay
National insurance and health service
More dispensing according to prescriptions
Administrative duties (doctors prescriptions, insurance companies)
Standardisation of common remedies, no „secret medicines” accepted