Chapter I: Front Matter

THE
APOTHECARY
in Eighteenth-Century
_WILLIAMSBURG_

Being an Account of his medical and chirurgical Services, as well as
of his trade Practices as a Chymist

_Williamsburg Craft Series_

_WILLIAMSBURG_
Published by _Colonial Williamsburg_
MCMXC

_The Apothecary
in Eighteenth-Century_ Williamsburg

Of the first 225 men sent over from London to settle at Jamestown in 1607 and 1608, seven were practitioners of medicine—as it was then practiced: Walter Russell, Gent., was a “Doctour of Physicke,” which is to say that he had studied at a university and earned a degree in medicine; Thomas Wotton, Will Wilkinson, and Post Ginnat were listed as surgeons—“chirurgeon” as it then appeared; Thomas Field and John Harford bore the label of apothecaries; and the seventh was “Tho: Cowper the Barber.”

Plainly, the Virginia Company of London, numbering several prominent medical men among its backers, wanted its adventurers to the New World to have the best of medical care. Unfortunately for about four of every five settlers in the first few years at Jamestown, the best was not enough to avert wholesale mortality from sickness, Indian arrows, and “meere famine.” That some of the medical men shared the fate of their patients seems likely in the absence of later information about most of them.

Medical theories and practices at the beginning of the seventeenth century were largely those that had prevailed since the time of Galen, a Greek physician who died about two centuries after Christ. According to Galen, the four elements of Aristotelian science—fire, water, air, and earth—comprised the four major humors of the human body: blood, phlegm, yellow bile, and black bile. Blood was held to be moist and warm, phlegm was moist and cool, yellow bile dry and warm, and black bile dry and cold.

Sickness, in the theory of Galen, was caused by one or more of these humors becoming impure or out of place or out of balance. Treatment thus consisted of removing or diminishing the offending humor by purging, bleeding, vomiting, blistering, urinating, sweating, or salivating; on the other hand, a deficient humor was to be restored by diet and drugs. Galen classed drugs according to their warm, cold, moist, or dry qualities. For instance, pepper was a heating drug, good for chills, while cucumber was a cool one, to be given in case of fever.

Galenism had been subjected to attack in the sixteenth century by Paracelsus and Vesalius, but its appeal was logical and remained strong in seventeenth-century England. (In fact, some survivals can be found in twentieth-century folk medicine.) Dr. Lawrence Bohun (or Boone), who came over in 1610 and returned to England in 1611, spent some of the year investigating medicinal sources in Virginia. He discovered a white clay—and shipped some to England—that he claimed could absorb and expel poisons from the body. Among vegetable remedies, Bohun experimented with sassafras and found “_Galbanum mechoacon_, otherwise called _rubarbum alum_, to be of service in cold moist bodies, for the purginge of fleame [phlegm] and superfluous matter.”

_WHAT IS AN APOTHECARY?_

Already it will be evident that the practice of medicine in seventeenth-century England, and hence in the first American colonies, was not neatly confined to the licensed graduates of accredited medical schools. Quite the contrary. In fact, Henry VIII had complained that all kinds of ignorant people got into the act, including “Smiths, Weavers, and Women.”

Two centuries of legal and parliamentary pulling and hauling, plus the consequence of some natural developments, left the situation in England somewhat stabilized—but not necessarily logical. The barbers, chartered as a guild in 1462 and authorized to practice surgery, included both barbers and surgeons in growing disharmony until they were formally divorced in 1745.

The apothecaries—the word originally meant shopkeeper—joined the guild of grocers at one time but shortly broke away to form their own guild in 1617. Meantime, the physicians, organized in the College of Physicians, obtained the right to keep watch on the apothecaries.

Physicians, who had to have as much as 14 years training and four degrees from Oxford or Cambridge, were naturally not abundant. Being learned men, they would not stoop to the indignity of such menial work as performing surgical operations or compounding medicines. The former was the province of the surgeon or barber-surgeon, the latter was the specialty of the apothecary.

But the scarcity of physicians, especially in rural areas, left a medical gap that the apothecaries, trained through apprenticeship and many times more numerous, naturally moved to fill. In 1727 English law finally recognized and legalized the fact that for most people the apothecary-surgeon was the only available practitioner of medicine. In turn, the business of purveying drugs and compounding medicines passed from the apothecaries to the wholesale druggists and pharmaceutical chemists.

As it was transferred to America the trade of apothecary—it was neither a craft nor a profession in any strict sense—was probably much like that of the rural apothecary-surgeon of seventeenth-century England. The apothecary still made his living primarily from the provision of drugs and medical preparations; but he also performed amputations, dressed wounds, and subjected his patients to the normal medical treatments of the day.

_ALL THAT THE LAW ALLOWS_

Virginia was the only colony that tried to draw legislative boundaries around the various aspects of medical practice. The effort came in 1736 in the form of “an Act for Regulating the Fees and Accounts of the Practicers of Phisic.” On two grounds the act deserves to be quoted at some length. For one thing, it throws a good light on the state of medical practice at that time. For another, it affords undeniable parallels to some current problems in the cost of medicines and medical care, and to the role of government in serving the interests of the “consumer.”

The first section of the act recited certain abuses, especially of the surgeons and apothecaries:

I. Whereas the practice of phisic in this colony, is most commonly
taken up and followed, by surgeons, apothecaries, or such as have only
served apprenticeships to those trades, who often prove very unskilful
in the art of a phisician; and yet do demand excessive fees, and exact
unreasonable prices for the medicines which they administer, and do
too often, for the sake of making up long and expensive bills, load
their patients with greater quantities thereof, than are necessary or
useful, concealing all their compositions, as well to prevent the
discovery of their practice, as of the true value of what they
administer: which is become a grievance, dangerous and intolerable, as
well to the poorer sort of people as others, & doth require the most
effectual remedy that the nature of the thing will admit.

The second section then proceeded to emphasize the chief distinction between the apprentice-trained apothecary-surgeons and the university-educated physicians by allowing the latter to charge twice as much for their services as the former could. If the apothecaries and surgeons felt—as well they might have—that the difference in fees was an insult to them, it did not last long. The law was not renewed at the following session of the Assembly; perhaps its backers, the physicians, had seen their patients flock to the lower-priced practicers.

Although Virginia was the only colony to set medical fees by law, the practice of legislative price fixing in other areas of the economy was as common in colonial America as it was in England. In Virginia, to be specific, not only prices and quantities but in some cases even qualities of goods and services offered to the public by tavernkeepers, shoemakers, millers, and ferrymen were regulated by law. The economic philosophy and terminology of _laissez faire_ were among the alien isms imported after 1776. During the colonial years, government rarely hesitated to act in the economic field where the need was felt.

From this particular Virginia law of 1736 it would appear that some if not all medical charges had gotten well out of line—the correct line, of course, being what the people and their elected representatives thought was reasonable: