The history of pharmacy and medication

Pharmacy is derived from the Greek word pharmakeia, meaning “use of drugs, medicines, potions, or spells; poisoning, witchcraft; remedy, cure.”

The practice of pharmacy has been around for thousands of years, and healing with medicinal plants is as old as mankind itself. There is evidence that Neanderthals used pain-killers and antibiotics to self-medicate as early as 49,000 years ago.

From the dawn of civilization to modern times, healing properties of medicinal plants have been identified, noted and conveyed to successive generations.

Many modern medications are derived from plants: 

Aspirin is derived from the willow tree (Salix alba)

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Quinine, which treats malaria, from the cinchona (Chincona calisaya)

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Morphine and codeine from the poppy (Papaver somniferum)

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Digoxin, which treats heart conditions, from foxglove (Digitalis lanata)

digitalis_lanata_1L0058212 Bottle of digoxin tablets, 'Tabloid' brand, London, England,

The Apothecary

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The apothecary’s study of herbal and chemical ingredients was a precursor to the modern sciences of chemistry and pharmacology. The profession dates back thousands of years back to ancient Mesopotamia.

An apothecary is a medical professional who formulates and dispenses material medica to physicians, surgeons and patients. The term materia medica was used from the time of the Roman Empire until the 20th century, but has now been replaced by the term pharmacology.

The modern pharmacist has taken over the role of the apothecary, although in some languages the word “apothecary” is still used to designate a pharmacist or pharmacy (e.g. pharmacist is translated to “apotheker” in German and Dutch).

A Timeline of the Evolution of Pharmacy

China

 

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A picture of Shennong bencao jing, a classic work on plants and their uses

2700 BC: The Chinese “Shen-nung Pen-tsao Ching” is a compendium of medicinal plants that was written by the Emperor Shen Nung (or Shennong), who is credited as the founder of Chinese herbal medicine. The book describes 365 medications, which include dried parts of medicinal plants, many of which are still used today.

Ancient Sumerians

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Sumerian cuneiform medical clay tablet

2600 BC: The oldest known prescriptions are recorded on Sumerian cuneiform clay tablets. The Sumerians also cultivated opium poppies as early as 3400 BC, although opium poppy seeds have also been found in much older Neolithic sites.

Ancient Egypt

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Ebers Papyrus

1500 BC: The Ancient Egyptians are notorious for their advanced chemical and pharmacological knowledge. The Ebers Papyrus is one of the oldest preserved medical documents. It has over 700 plant species and drugs used for therapy.

India

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Page from the Sushruta Samhita

1000-500 BC: The Sushruta Samhita is one of the foundational texts of Ayurveda, or Indian traditional medicine. The surviving text contains descriptions of 1,120 illnesses, 700 medicinal plants, including safety, efficacy, dosage and benefit.

Ancient Greece

 

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Engraving of Hippocrates by Peter Paul Rubens 

 

460- 370 BC: Hippocrates, known as the Father of Medicine, founded a school of medicine that focused on treating the causes of disease rather than just its symptoms. The works of Hippocrates contain 300 medicinal plants classified by physiological action.

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375 BC- 295 BC: Diocles of Carystus is one of the best-known early pharmacists of ancient Greece. He is a member of the rhizotomoi, a branch of medical experts on the use medicinal plants. He is considered to be the source for all Greek pharmacotherapeutic treatises between the time of Theophrastus and Dioscorides. 

 

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De Historia Plantarium by Theophrastus

 

371-287 BC: Theophrastus was a disciple of Aristotle and is considered the Father of Botany. His books “De Causis Plantarium” and “De Historia Plantarium” were the first attempts to organize and classify plants in Greece. These books provided physicians with a rough taxonomy and detailed information on 500 medicinal plants and herbal concoctions. 

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De Materia Medica by Pedanius Dioscorides

77 AD: De Materia Medica is written by Pedanius Dioscorides, Greek physician, pharmacologist and botanist, who is considered the Father of Pharmacognosy (branch of knowledge concerned with medicinal drugs obtained from plants or other natural sources).

De Materia Medica forms the basis for knowledge of medicines for the next 1,500 years and is considered one of the most influential herbal books in history. It is the first extensive pharmacopeia, which includes about a thousand natural product drugs (mostly plant-based), 4,740 medicinal usages for drugs, and 360 medical properties (such as antiseptic, anti-inflammatory, stimulant).

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A page from Historia naturalis by Pliny the Elder

23-79 AD: Pliny the Elder, who travelled throughout Germany and Spain, wrote about approximately 1000 medicinal plants in his book Historia naturalis. Pliny’s and Dioscorides’ works incorporated all knowledge of medicinal plants at the time.

Middle Ages and Islamic Golden Age

The knowledge of the classical medicine was nearly lost in Western Europe during the Middle Ages. In Europe, the skills of healing, cultivation of medicinal plants, and preparation of drugs is moved to monasteries.

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Folio from an Arabic manuscript of Dioscorides, De Materia Medica, 1229

Many classic works of antiquity that might otherwise have been lost were translated into Arabic and Persian to be preserved, systematized and further developed. They integrated concepts of the ancient Greek, Roman, Persian as well as the ancient Indian traditions of Ayurveda. European physicians regained this knowledge when they became familiar with Islamic medical authors in the 12th century.

754 AD: The first drugstores are established in the ancient city of Baghdad during the Islamic Golden Age. By the 9th century, these pharmacies were state-regulated.

Europe

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Pharmacy at Santa Maria Novella in Florence

1100-1200s: Apothecaries begin to appear in Europe. In 1221, the oldest known pharmacy is set up in Florence, Italy. In 1240, the Roman Emperor Frederic II issued a decree that the physician’s and the apothecary’s professions were separated

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Doctor and pharmacist, illustration (1505)

1500-1600s: The demand for compound drugs is increasing. Each medication is custom-made from raw ingredients to suit an individual patient’s needs.

New World and Canada

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Louis Hébert, the first european apothecary in the New World

1605: Louis Hébert, a Parisian apothecary, travels to the new world and establishes the first Canadian apothecary in New France’s first settlement, the Habitation, at Port Royal (Nova Scotia, Canada). There, Hébert cultivated native plants, cared for the health of local pioneers and learned about medicinal plants from the indigenous Micmac tribe. When the Habitation was destroyed by the English in 1613, Hébert returned to his Parisian apothecary shop. In 1617, he returned to Quebec City, where he was the first to establish farming in Canada.

1831: Law passed in Canada prohibiting pharmacists from visiting patients and prescribing medicine, which is reserved for doctors. As they can no longer visit patients nor prescribe medications, pharmacists begin to feel the need to organize their profession.

1875: Pharmacy Acts are passed in the provinces of Quebec and Ontario to regulate the practice of pharmacy. This includes issuing the licences to practise pharmacy and supervising its members. These Acts served as models for the rest of Canada; each province later passed similar legislation.

1907: The Canadian Pharmaceutical Association is founded. Previously, there was no permanent national pharmacy organization.

1963: The Pharmacy Examining Board of Canada is formed to establish academic qualifications to participating provincial licensing bodies. All provinces require that pharmacists obtain a baccalaureate degree in pharmacy in order to be licensed.

The Community Pharmacy

Before the advent of mass production of medication by drug companies in the mid 20th century, each medication was custom-made from raw ingredients to suit an individual patient’s needs. Pharmacists used the mortar and pestle for centuries to make custom medications, which is why it is now the industry symbol of today’s pharmacists.

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Mortar and pestle used by compounding pharmacists
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The symbol of the discipline of pharmacy

Compounding pharmacies evolved into what we know today as community pharmacies, which provide a range of pharmaceutical services to a specific community. Today’s pharmacists dispense a vast array of complex medications, and must comply with federal regulations on handling, quality, safety and efficacy. Therefore, most medications are prepared in industry laboratories and are obtained by the pharmacist in finished form. The community pharmacist advises patients regarding drug interactions, toxicities, side effects, allergic reactions and other adverse effects.

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Community pharmacy in 1910 (with soda fountain)
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Modern community pharmacy
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