Before the Dawn of History

From beginnings as remote and as simple as these came the proud profession of Pharmacy. Its development parallels that of humankind itself. Ancient peoples learned from instinct, for observation of birds and beasts. Cool water, a leaf, dirt, or mud were their first soothing application. By trial, they learned which served them best. Eventually, they applied this knowledge for the benefit of others. The wise man or woman of the tribe, whose knowledge of the healing properties of herbs and plant had either been gathered from experience or handed down by word of mouth from progenitors, was called on to attend the sick or wounded and prepare the remedy. It was from the methods of preparing the substances thus employed for the treatment of an injury or a disease that the art of the apothecary originated. Recorded history as it pertains to the art of the apothecary takes us back forty to fortyfive centuries. Though the cavepeople's methods were crude, many of today's medicines sprin g from sources as simple and elementary as those which were within reach of early humans.

Pharmacy in Ancient Babylon

Babylon, jewel of ancient Mesopotamia, often called the cradle of civilization, provides the earliest known record of practice of the art of the apothecary. Medical treatment was similar to treatments found in the Egyptian papyrus but their documents, written in cuneiform, date from an earlier period than those found in Egypt. Some practitioners of healing of this era (ca. 2600 B.C.) were priest, pharmacist, and physician, all in one. Also there were separate priest-physicians who treated some diseases with religious incantations and psychosomatic remedies whereas there were some secular physicians who employed drugs and what we would call rational therapies. Medical texts on clay tablets record first the symptoms of illness, the prescription and directions for compounding, then an invocation to the gods. Among the drug substances which they used were oils of cedar (Cedrus spp.) and cypress (Cupressus sempervirens), myrrh (Commiphora spp.), licorice (Glycyrrhiza glabra), honey , poppy juice (Papaver somniferum), nutgalls -- all of which are still in use. Early Babylonian science of drugs, their preparation and combination, spread far from the Tigris and Euphrates basins, and influenced Pharmacy's beginnings for many centuries.

Pharmacy in Ancient China

Chinese Pharmacy, according to legend, stems from Shen Nong (ca. 2000 B. C.), emperor who sought out and investigated the medicinal value of several hundred herbs. Also known as the Blazing Emperor, he is reputed to have tested many of them on himself, and to have written the first Ben Cao, or native herbal, recording 365 drugs. Still worshipped by native Chinese drug guilds as their patron god, Shen Nong conceivably examined many herbs, barks, and roots brought in from the fields, swamps, and woods that are still recognized in Chinese Pharmacy today. Among the herbal drugs Shen Nong is reputed to have discovered is Ma Huang, or Ephedra (Ephedra sinica). In the background is the "Ba Gua," a mathematical design symbolizing creation and life. Medicinal plants include rhubarb (Rheum spp.), ginseng (Panax ginseng), cassia bark (Cinnamomum cassia), and, in the boy's hand, Ma Huang. Shen Nong is a symbol of belief in empirical knowledge, which has been so characteristic an aspect of China's pharmaceutical practice through the ages.

Days of the Papyrus Ebers

Though Egyptian medicine dates from about 2900 B.C., the best known and most important pharmaceutical recorded is the "Papyrus Ebers" (1500 B.C.), a collection of 800 prescriptions, mentioning 700 (mostly plant) drugs. Formulas for gargles, snuffs, inhalations, suppositories, fumigations, enemas, poultices, decoctions, infusions, pills, troches, lotions, ointments, and plasters are included with beer, milk, wine, and honey as common vehicles for most of the compounded drugs. Pharmacy in ancient Egypt was conducted by two or more echelons: gatherers and preparer of drugs, and "chiefs of fabrication," or head pharmacists; a special room in the temple, the asi-t, was provided for the head pharmacist's work. They are thought to have worked in the "House of Life" or a medical training center. In addition, it appears that there were individuals known as "conservators of drugs," responsible for proper storage of medicinal substances. In a setting such as this, the Papyrus Ebers might h ave been dictated to a scribe by a head pharmacist as he directed compounding activities in the drug room.

Theophrastus -- Father of Botany

Theophrastus (ca. 300 B.C.), among the greatest early Greek philosophers and natural scientists, is called "the father of botany" due to the completeness of his work. He most definitely and systematically fought the superstitious ideas and dogmatism rife in his time, replacing them in his writings on botanical and other subjects with his own observations and logical inferences. Thus scientific observers began to take the place of, or to question the infallibility of, the school of philosophers whose utterances were based upon purely speculative or theoretical musings. His observations and writings dealing with the medical qualities and peculiarities of herbs are unusually accurate, even in the light of present knowledge. In his History of Plants he deals especially with the medical qualities and peculiarities of herbs. He also knew of and made use of the ability to change the character of plants by cultivation, transforming, for instance, wild mint (menthrastrum) to tame mint (m entha). He lectured to informal groups of students who walked about with him, learning of nature by observing her treasures firsthand. He immortalized himself to Pharmacy for having put the sciences of pharmacology and pharmacognosy on a rational basis. In his hand in the picture he holds a branch of belladonna (Atropa belledonna). Behind him are pomegranate blooms, senna, and manuscript scrolls. Slabs of ivory, coated with colored beeswax, served students as "slates." Writing was cut into the surface with a stylus.

The Royal Toxicologist -- Mithridates VI

Mithridates VI, King of Pontus (ca. 100 B.C.), though he battled Rome for a lifetime, found time to make not only the art of poisoning, but also the art of preventing and counteracting poisoning, subjects of intensive study. The science of toxicology had in Mithridates one of its early promoters. Unhesitatingly, he used himself as well as his prisoners as "guinea pigs" on which to test poisons and antidotes. A formula for "Mithridatum," his famed formula of alleged pan-antidotal powers, alleged to have been found by the Roman general Pompey among the possessions of Mithridates, gradually gained a reputation as an antidote against all kind of poisons, and later as a cure-all. Whether the reputation was true or not, it remained great. The most important modification made was during the first century A.D. by the physician to the Roman Emperor, Nero Andromachus, who added vipers and increased the portion of opium (Papaver somniferum). It was this form that was approved by Galen (1 30-200 A.D) and became the model of the class of compounds known as theriac in later pharmaceutical literature. This formula was popular for over a thousand years. Behind Mithridates in the picture are rhizotomists, offering fresh, flowering aconite (Aconitum apellus), ginger (Zingiber officinale), and gentian (Gentiana lutea). At lower right is a crater -- a two-piece forerunner of the champagne bucket.

Terra Sigillata -- An Early "Trademarked" Drug

People learned early of the prestigious advantage of trademarks as a means of identification of source and of gaining customers' confidence. One of the first therapeutic agents to bear such a mark was Terra Sigillata (Sealed Earth), 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, and rolled to a mass of proper thickness, the clay was formed into pastilles and impressed with an official seal by priestesses, then sun-dried. The tablets were then widely distributed commercially. From a modern point of view, the ingredients (silica, aluminum, chalk, magnesia, and traces of oxide of iron), indicate that this clay might be expected to act as an adsorbent. In the early days, and even up to the early nineteenth century, Terra Sigillata was used as an antidote for poisons as well as in the treatment of dysenteries, int ernal ulcers, hemorrhages, gonorrhea, pestilential fevers, complaints of the kidneys, and eye infections. The most striking feature of this drug, however, was the way in which it was marketed, and the method of identifying it and warranting its origin from a definite source. The great demand for Terra Sigillata and the good business that the sale of these troches brought caused people in almost every country in Europe to look for similar earths. This trademarking to protect the rights of seller and buyer today has behind it the sanction and approval of some 2,500 years of man's experience in world commerce.

Galen and Drug Compounding

Of the men of ancient times whose names are known and revered in both the professions of pharmacy and medicine, Galen (130-200 A.D.), a top-flight scientist in his day, undoubtedly, is the foremost. He practiced and taught both pharmacy and medicine in Rome; his principles of preparing and compounding medicines ruled in the Western world for 1,500 years. He is remembered for his extremely complex prescriptions, sometimes containing dozens of ingredients. He prepared his medicaments himself, and his treatises dealing with the preparation and use of drugs contain a profusion of formulas. Formulas of this type make up the class of pharmaceuticals compounded by mechanical means -- galenicals. His formulas indicate a most intelligent use of opium, hyoscyamus, hellebore, grape juice, wine, and cold compresses. To further his knowledge of the action of drugs, and to assure more dependable and accurate results form his treatments, Galen developed many methods for mixing, extracting, ref ining, and combining drugs. These ideas carried over into the late eighteenth century, and have their counterparts today in compounding, both at the retail pharmacy and in the large manufacturing laboratory.

He was a pillar of medicine; the first important pillar in the millennium of Greek domination of the medical world. Physician to the emperor as well as commoners in the Roman empire, he traveled extensively, lectured widely, and wrote prolifically. Among his many and varied publications are no less than 30 books touching on pharmacy. The great Greek was a shrewd observer who gained much experience through experimentation. His theories were not called into question until the more realistic approaches of the sixteenth, seventeenth, and eighteenth centuries. He was the originator of the formula for a cold cream essentially similar to that known today.

Dioscorides -- A Scientist Looks at Drugs

In the evolution of all successful and enduring systems of knowledge there comes a time when the observations of many people, or the intensive studies of one person, transcend from the level of trade of vocation to that of a science. The Greek physician, Pedanios Dioscorides (first century A.D.), contributed mightily to such a transition in pharmacy. In order to study materia medica, Dioscorides accompanied the Roman armies throughout the known world. He recorded what he observed, promulgated excellent rules for the collection of herbs, their storage, and use. His texts were considered basic science as late as the sixteenth century. Of a keenly scientific turn of mind, he recorded what he observed, as he observed it, without compromise with or deference to the persistent myths and wrong guesses of the day. The highly critical Galen (130-200 A.D.) stated, "In my opinion, he is one among the various authors who has presented the most perfect discussion of the drugs." Many authors consider him to be the most important representative of the science of herbal drugs in antiquity, the greatest of all the men concerned, and a genuine natural scientist who observed and examined the reports conveyed to him. He described the herbs exactly and arranged his descriptions methodically, becoming the accepted teacher of pharmacognosy.

Monastic Pharmacy

During the Middle Ages remnants of the Western knowledge of pharmacy and medicine were preserved in the monasteries (fifth to twelfth centuries). These sciences are known to have been taught as early as the seventh, eighth, and ninth centuries in cloisters in England, Ireland, France, Switzerland, and Germany. The first attempt at systematizing this endeavor was made by Marcus Aurelius Cassiodorus (490-585), Chancellor to the Ostrogothic King Theodoric and his successors at Ravenna. The materia medica of the monastic apothecary was mainly drawn from the vegetable kingdom. At first, the neighboring woods and fields furnished most of the herbs and simple remedies. The monks gathered such herbs and simples in the field, or raised them in their own herb gardens. These they prepared according to the art of the apothecary for the benefit of the sick and injured. Gardens such as these still may be found in monasteries in many countries. To the monk-apothecaries, who linked healing of the soul with healing of the body, who preserved the records of the past and carried forward the light of learning and investigation, pharmacy indeed owes much.

The First Apothecary Shops

The Arabs separated the arts of apothecary and physician, establishing in Baghdad late in the eighth century the first privately owned drug stores. Destruction of many libraries and schools, which had begun in the conflicts between the Romans and the Christians, and was later carried on by invading Vandals, Longobardi, Visigoths, and Ostrogoths, had reduced Western knowledge of the sciences largely to that remnant preserved and kept alive in the seclusion of the monasteries. The Arabs preserved much of the Greco-Roman wisdom, added to it, developing with the aid of their natural resources syrups, confections, conserves, distilled waters, and alcoholic liquids. Persian, Indian, and Chinese herbs unknown to the Greco-Roman world, such as camphor, cassia, cloves, cubeb, musk, nutmeg, rhubarb, sandal-wood, senna, and tamarind, were described in the treatises of authors writing in Arabic; and in crude form or in preparations compounded therefrom, filled the shelves and drawers of th e newly established apothecary shops. Sugar cane grew in the areas occupied by the Arabs, and sugar was produced at a reasonable price, giving rise to a number of new types of pharmaceutical preparations requiring the skill of the experts: syrups of all kinds, confections, and conserves. Distillations of aromatic waters and alcoholic preparations became almost a monopoly of the Arabian pharmacists. In the picture the apothecary is examining logs of sandalwood offered by a traveling merchant, while children indulge their taste for sweets with stalks of sugar cane. 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 -- the "Persian Galen"

Among the brilliant contributors to the sciences of Pharmacy and Medicine during the Arabian era was one genius who seems to stand for his time -- the Persian, Ibn Sina (ca. 980-1037 A.D.), called Avicenna by the Western world. Pharmacist, physician, poet, philosopher, and diplomat, Avicenna was an intellectual giant, a companion of Persian princes and rulers. He wrote in Arabic, often while secluded in the home of an apothecary friend. During his 58 years, he traveled extensively, studying, teaching and writing about 200 books and treatises while administering for the state as a Vizier. It was his main medical work, his Canon Medicinae, which can be regarded as "the final codification of all Greco-Arabic medicine." A large part of this Canon, so important to Pharmacy, was written after his escape from political imprisonment. In this, he paid much attention to the right ways of preparing drugs. His pharmaceutical teachings were accepted as authoritative in the West until the 17 th century; they still are dominant influences in Asia, where reliance on traditional "energetics" concepts precede Galen.

Louis Hébert, Apothecary To New France (Canada)

Nowhere is the intrepid spirit of self-sacrifice and service to fellow humans which has marked the lives of many pharmaceutical pioneers better exemplified than in the life of Louis Hébert -- first pharmacist in Canada, and probably the first to practice his profession on the North American continent.

Young Parisian Apothecary Louis Hébert answered the call of the New World in 1605, when he helped de Monts and Champlain build New France's first settlement, the Habitation, at Port Royal (Nova Scotia). Hébert looked after the health of the pioneers, cultivated native drug plants, and supervised the gardens. At the waterfront, he examined specimens of drug plants offered by friendly Micmac Indians. These included Eupatorium (Boneset), Verbascum (Mullein), Arum (Jack-in-the-Pulpit), and Hydrastis (Golden Seal). When the Habitation was destroyed by the English in 1613, he returned to his Parisian apothecary shop. The lure of Canada was strong, however, and in 1617, he and his family returned with Champlain to Quebec where Hébert's "green thumb" gained him lasting fame as the first successful farmer in what is now Canada. He provided free medical attention to the settlers and employees of the Association of Merchants, but was enjoined from entering into trade either with natives or colonists -- so his days in an apothecary shop were ended.

The First Official Pharmacopeia

Medieval Italy owed its economic blossoming mainly to the circumstance that the wares of the Orient had to pass through Italian hands before they reached other European countries. It was particularly Florence, Genoa, and Venice which dominated the European trade in oriental herbs and spices. The confusion of different views and varying interpretation on compounding drugs brought about demands for some standard that would warrant uniformity in kind and strength of drugs prescribed by physicians and dispensed by pharmacists. The idea of a pharmacopeia with official status to be followed by all apothecaries originated in Florence. The Nuovo Receptario, originally written in Italian, was published and became the legal standard for the city-state in 1498. It was 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 guidanc e from the powerful Dominican monk, Savonarola (seated, foreground), who, at the time, was the political leader in Florence. The content of the Nuovo Receptario was based entirely on the Greco-Arabic drug therapy of the time. Some 50 years were to elapse before the example of Florence was followed and official pharmacopeias began to appear in other political jurisdictions.

Sertürner -- First of the Alkaloid Chemists

Swedish pharmacist Carl W. Scheele paved the way for isolating organic plant acids; but it remained for a young German apothecary, Friedrich Wilhelm Adam Sertürner, hardly having finished his five years of apprenticeship, to probe opium's secrets, to give the world opium's chief narcotic principle, morphine; and to recognize and prove the importance of a new class of organic substances: alkaloids. His first announcements challenged, Sertürner in 1816 conducted a new series of bold, startling experiments in his apothecary shop in Einbeck, including a series of physiologic tests on himself and three young friends. Recognition and fame followed. Relocating in an apothecary shop in Hameln, Sertürner continued organic chemical experimentation and discovery throughout his life. His greatest tribute, however, lives in today's highly developed field of alkaloidal chemistry, for which he laid the basis.

Caventou, Pelletier, and Quinine

Taking their cue from Sertürner's alkaloidal experiments, two young French pharmacists, Pierre-Joseph Pelletier (1788 - ) and Joseph-Bienaimé Caventou (1795-), isolated emetine from ipecac root (Cephaelisip ecacuanha) in 1817; strychnine and brucine from nux vomica (Strychnos nux vomica, ignatia bean) in 1818. Then in their laboratory in the back of a Parisian apothecary shop, they tackled the problem that had baffled scientists for decades -- wresting the secrets of the Peruvian barks that were so useful against malaria. In 1820 Caventou and Pelletier announced the methods for separation of quinine and cinchonine from the cinchona barks (Cinchona spp.); prepared pure salts, had them tested clinically, and set up manufacturing facilities. Many other discoveries came from their pharmacy-laboratory, and high honors were accorded them. But in making known his methods of preparation of quinine, and especially of its sulfate, Pelletier refused, for the sake of humankind, to exploit this discovery as a monopoly. The research activities of this pair of pharmacists did not stop with their success with quinine. They went on, as a team, individually and in collaboration with others, to make further discoveries; but it is for quinine that they are best remembered.

The Shakers and Medicinal Herbs

The most unique of American sectarian ventures into drug plant cultivation, and by far the most important, was undertaken by the Shakers. Begun about 1799, and commercially important by 1830, the medicinal herb industry flourished, hit its peak in the 1860s, then waned at the close of the century. The medicinal herb industry was a natural outgrowth of the Shakers' early interest in gardening and agriculture, necessary to the self-sufficiently of their communities. The "physics garden" at New Lebanon, New York by 1850 occupied about 50 acres, given over chiefly to cultivation of henbane (Hyoscyamus niger), belladonna (Atropa belladona L.), dandelion (Taraxacum officinale G. H. Weber ex Wigg.), aconite (Aconitum carmichaelii Debx.), poppy (Papaver sommiferum L.), lettuce (Lactuca sativa), sage (Salvia officinalis L.), summer savory (Satureja hortensis L.), marjoram (Origanum majorum L.), dock (Rumex crispus L.), burdock (Arctium lappa L.), valerian (Valeriana officinalis L.), and horehound (Marrubium vulgare). Extract of taraxacum was an important product. Nearly 200 varieties of indigenous plants were collected, and 30 or 40 varieties were brought from the South, West, and Europe. The Shakers gathered or cultivated 248 varieties; dried, chopped, and pressed them into "bricks"; wrapped, labeled, and sold them to pharmacists and physicians the world over. Tons of solid and fluid extracts also were produced. The Shaker label was recognized for reliability and quality for more than a century.

Henry Hurd Rusby -- Wresting the Jungle's Secrets

Expeditions in search of new medicinal plants probably are as old as Pharmacy. Scientific adventurers, such as Henry Hurd Rusby (1855-1940), opened vast new horizons for the advancement of Pharmacy and Medicine late in the nineteenth century. Sent by Parke, Davis & Company in 1884 to Peru for supplies of coca leaves, Dr. Rusby crossed the Andes and journeyed down the Amazon to the Atlantic amid incredible hardships. He returned with 45,000 botanical specimens. Among them were many new drug plants, including cocillana bark, pharmaceutical preparations of which are still important to medicine. Dr. Rusby later became Dean of the College of Pharmacy of Columbia University.

The Artist -- The Concept

Robert Thom, painter and illustrator, spent nearly 20 years in collaboration with writer George A. Bender and the American Institute of the History of Pharmacy in researching and developing the two series, Great Moments in Pharmacy, and Great Moments in Medicine. He estimated that he and Dr. Bender traveled nearly a half-million miles in seeking information and rechecking paintings and stories for the 85 subjects in the pharmacy and medicine series.

For example, when researching in the Oriental Institute (University of Chicago) for production of the painting on the beginning of Chinese pharmacy, it was suggested by an advisor that the pair consult with a Dr. Eliza Veith, recently arrived from Germany, who was knowledgeable on early Chinese medicine. The advisor did not know where she lived, but sent them to a building where they might find her, since she had a class scheduled that afternoon.

According to Dr. Bender, "Since historical research is much like doing detective work, Thom and I set about the task locating a good-looking German blonde on a campus populated by thousands of students and faculty. At the appointed hour, we entered the building, and its elevator. A lady approximating the description given us also entered. She got off at the right floor, and entered the fight room. As the class had not yet started, Thom entered and asked her if she would good enough to step out into the hall. She came -- her eyes round with fear. `How did you find me?' was her first question. It took a couple of minutes to reassure her that this was not a Gestapo operation, and that all we wanted was to make an appointment to consult with her at a convenient time."

When Thom contacted a prominent rug merchant in Detroit for possible backgrounds for the painting of Avicenna, they were stuck with his resemblance to the portraits furnished by the Iranian Embassy, so he became Thom's model in costume for reference photos for the painting.

"One day I discussed my dream project with Bob," said Bender. "In a way characteristic to him, Bob took off for Chicago and the Field Museum, which had a series of dioramas of mankind, beginning with the cave period. A few weeks later, Thom came in with the caveman painting -- the first one in the history of pharmacy series. We took the caveman painting and our outlines to the APhA [American Pharmaceutical Association] Convention in 1949. There, at a private dinner Thom and I unveiled our painting and our ideas. From that meeting came sufficient encouragement for us to continue our efforts. Little did we realize that it would be two years before the first story and picture would be reproduced!"

The original material is devoid of binomials and footnotes since, according to Bender, "It was our aim to tell our story through the eyes of as many people as possible -- not to try to hide it behind folds of style. I was not writing for historians, but for the broadest possible reading audience."

Robert Thom and his wife Nelli, while visiting their two sons, were killed in an automobile accident in southern Michigan during the Christmas holidays in 1980.

Professor George Bender, author of the original text, was a pharmacist, editor, advertising executive, author, and teacher. Historical work had been a major interest for him since the late 1940s, culminating in the two volumes, Great Moments in Pharmacy and Great Moments in Medicine. This work earned for him the 1976 Edward Kremers Award of the American Institute of the History of Pharmacy. After presumably retiring to Arizona, he launched into academic work at the University of Arizona, as Professor (teaching the history of pharmacy) and as Administrative Aide to the Dean of the College of Pharmacy from 1970 to 1974. He died at eighty, in September 1985.

Article copyright American Botanical Council.