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A70658 A letter concerning the present state of physick, and the regulation of the practice of it in this kingdom written to a doctor here in London. T. M.; Merret, Christopher, 1614-1695. 1665 (1665) Wing M81C; ESTC R32085 26,204 65

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these are changed and altered by the mixture of several things together they will be much more able to preserve in memory what is proper and useful for every Distemper then by reading their names in Books onely and so direct better and with greater ease and certainty Likewise by understanding the true wayes of mixture and being acquainted with the tastes and scents of things a great many errors will be avoided and Physick be render'd much more pleasant and palateable Finally a great many excellent Experiments will be drawn from it for the use of Philosophical speculations Now in the present Method of your Bills either the Physician depends wholly upon the memory of what he has read in Books which Galen greatly condemns and then we shall never hope to promote this Art beyond its present limits although 't is well known there are so great treasures of powerful and active Medicines yet undiscovered Besides if we do not exactly remember the very proportions and measures of every thing in every Medicine which is impossible we cannot reasonably hope well from it because as my Lord Bacon observes the Experiment was made in such quantities only which when we alter considering the nature of things à priori are altogether unknown to us we know not what we do And though Physicians commonly endeavour to provide themselves rather of the general materia medica then of particular Receipts yet if we duely weigh the strange alterations that happen upon the blending several things together and the unexpected results of quite different qualities the unpleasing scent and taste they acquire many times especially if their proportions are not precisely just we shall not think it strange that so wise a man as that great Person was blam'd this last and uncertain way And as to the common proportions and quantities by which Physicians govern themselves in the usual forms of Medicines they vary so much according to the several natures of things that whoever is not well acquainted with the things themselves shall never be able as Galen notes to direct as he ought to do And none will doubt but any Physician could make a better Apozem Potion Julep or the like by measuring the Proportions of each ingredient by his taste and scent then by writing a Bill from the unexact proportions of Authors especially if he be not very well acquainted with the things he prescribes In a word neither these proportions themselves nor their Books had ever been at all if Physicians had not in former times been knowing in all Simples examined their vertues and tempers enquir'd into their effects and mixt them with their own hands 17. Lastly if any still think this way too troublesome and are unwilling to excuse a little trouble for so many great conveniences both to themselves and their whole Profession there remains yet another expedient for them which they may make use of without doing prejudice to those we are contented to enter into the course already propos'd They may if they please have an Apothecary of their own and send their Bills to be made up by him as now they are provided only 1. That the time and manner of using it be not set down nor 2. The name of the Patient 3. That it be not sent by the Patient but by their own Servants 4. That it be returned to the Physicians again with the Physick it self to be fil'd up by them with the Patients name added or entred into a Book as was said before and the Physick so made and provided by the Physicians order to be fetch'd at their own houses as it is now at the Apothecaries Shops or from thence sent home by their own Servants to the Patient Now if we consider how this way respects the Apothecaries 't is evidently a fair and moderate course between them and the Physicians not taking away nor lessening any of the priviledges and immunities granted to them by their Charter or which they claim and enjoy as Freemen of this City or other Cities and Corporations For it hinders not their making and selling of Physick to any that please to buy of them which thing only belongs to their Trade To visit the Patient feel his Pulse consider his Vrine discourse of the state of the Disease and prescribe proper Remedies for it is the business and care of the Physician So that I dare presume no Apothecary who is content to live on his own Trade without invading the Profession of another and I doubt not but the greatest number and ablest men among them are such will think ill of it but rather be pleased to see that for the future all causes of jealousie and suspicion between Physicians and them will for ever cease the interests of both be preserv'd and the practice of Mountebanks and Quacks brought to nothing 2. It will very much conduce to the profit and advantage of the Apothecary For now the people finding encouragement to address themselves to the Physicians who before to decline the charge and expence of a Doctors advice went only to the Mountebank who made and gave all his Physick himself It must needs come to pass that the Apothecaries must provide and vend much greater quantities then they could before And thus all that which went away to Quacks and other ignorant pretenders be brought into the hands of the industrious and careful Apothecary 3. It will insensibly lessen that exorbitant number of Apothecaries which makes the Trade burdensome to it self and scarce a competent subsistence for a man after he has spent a good sum of money and seven years or more in an Apprenticeship to understand it For as things are now while the Masters or their Servants are employed by the Physician to visit his Patients and carry Physick about if an Apothecary have great business he will be under a necessity of taking several Apprentices else he cannot perform such attendances abroad and the business of the Shop too And this has made so vast an encrease of the Trade within a few years as has rendred it but a mean way of livelyhood to a great many and very dangerous to the sick Now as their number will by little and little grow less so the Trade will become better and they who are of it both for skill and estate much more considerable To come now and consider how much more this way is for the common good and welfare of the people and in general of all men First it mightily abates the charge and expence of Physick and this is the only reason why so many persons not of the poorer sort only but even some others of a better condition daily put themselves into the hands of Mountebanks and other ignorant persons to the great prejudice of the lives and health of men Also many Poor of this City and other places to the high dishonour of Religion perish for want of necessary help whilst on the one hand they are terrified by the Physicians Fee and
use of the common and more modern way of sending Bills to Apothecaries Shops but instead of that To buy their Physick of the said Apothecaries more or less as their practice shall requi●e Together with express order That no Physick should be given to any Patient without setting it first down in such manner and form as was accustomed before in the Bills sent to Apothecaries with the Patients name Year of our Lord and day of the Moneth and every such Bill to be fil'd up and kept by the Physician And the Physick so bought to be dispensed at home to the Patient by the Physician himself or his Servant or some young Student educated under him for that and all other things appertaining to his Art at reasonable rates The Physician not to demand or expect any other payment but for his Physick only unless he be sent for out of his own House and then to be paid his accustomed Fee according to the Ability of the Patient Yet this not to prejudice any other Physician of the Colledge who would take on him the Trouble and Charge of preparing all his Physick himself which was the use of the Ancients The reasons of this Proposition and the advantages it brings are very many and of great consideration 1. It appoaches as near to the genuine and true Method of Hippocrates Galen and other great Masters of Physick as the present constitution of things will admit And though your Self very well know what they did this way yet give me leave to put you in minde of some passages of Hippocrates and Galen to this effect for which I was lately beholding to Dr. our worthy friend He first acquainted me with the Letter of Hippocrates to an Herbarist his acquaintance to provide him things for the Cure of Democritus where he demands only Simples as Juyces and Tears of Plants which he orders to be sent in Glass Vessels and Leavs Roots and Flowers which he bids him put up in earthen Pots well clos'd he directs him to the time of gathering them and the place which was not difficult for him to do who was so well knowing of their Natures since he tells us how often he visited his Gardens and contemplated with wonder that Mysterious place the Earth which brings forth 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Animals Plants Food Medicine and Riches And these Simples so bought and received were by himself to be prepared and compounded as occasion should require I need not describe to you the Physicians Shop out of the same Author who has a whole Treatise of it I shall content my self with a passage out of his Book 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 The conversation and manners of a Physician which evidently shows how that Physicians of that time did not onely dispense their own Medicines themselves but make them too in Shops of their own by Hippocrates called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 His words are these A Phycsiian sayes he ought to have his Shop or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 provided with plenty of all necessary things as Lint Rowlers Splints all sorts of Chirurgical Instruments also of Medicines as for Wounds for the Eyes c. alwayes ready prepar'd Let there be likewise sayes he in readiness at all times another small Cabinet as it were of such things as may serve for occasions of going far from home have also ready all sorts of Plaisters Potions purging Medicines so contriv'd that they may keep some considerable time and likewise such as may be had and used while they are fresh The advantage of this will be very great for when you come to a Patient you will be more ready and certain what to do having all things prepar'd by you for your occasions Which is indeed a most excellent reason to perswade this course and much better then the hasty and praecipitate way of writing Bills And for Galen the same worthy Person has inform'd me There are so many things in him to this effect that it would be too great a vanity for me to tell you how he travell'd to Cyprus to enquire the nature of Mettals see Pompholyx Cadmia Diphryges Vitriol and brought home such quantity with him as might serve him all his life how he visited Palestine for its rich Balsom and the Bitumen found there or how curious he was at Lemnos to see the Terra Lemnia there he went likewise to Crete Alexandria and several other places for the same end and most earnestly conjures all who design'd themselves to this Study to do as he did and provide against the frauds and abuses of Impostors notwithstanding the great expence necessary for such an undertaking And a little after complains of a sort of men who contented themselves to know Simples out of Books Because sayes he the knowledge of sensible things can never be acquir'd but by frequent inspection and often repeated views I need not adde that he had a Repository which he call'd his 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 from whence the name of Apothecary came where he tells us his Medicines were alwayes under his Eye or in his hand To acquaint you that he made the Emperours Treacle with his own hands or dress'd the wounded Gladiators himself nor ever gave any Medicine of which he had not first tasted and smelt nay made experiment of it he sayes upon his own person and how he was hated by the Roman Physicians for using Simples and plain Medicines would from me to you be extreamly impertinent who know all this so much better then I. I shall content my self for the present to rectifie a mistake of some who think that there was a trade of men in Galens time such as our Apothecaries now are but this proceeds from want of understanding the ancient sense of the word Pharmacopola which in those times signifi'd not an Apothecary but such a person as we now call a Mountebank one who sold Physick in Markets Fairs and other places of publick Concourse And these were ever reputed at Rome among the basest and meanest men of the Town and were obnoxious to the common Laws made against Rogues and Vagabonds as Pliny has noted And if there were nothing else we might take their Character from Horace Ambubaiarum Collegia Pharmacopolae Mendici Mimi Balatrones hoc genus omne Moestum ac sollicitum est Cantoris morte Tigelli And out of Max. Tyrius We shall find sayes he that there is no kinde of good thing but some evil will endeavour to counterfeit it so a Sycophant will imitate an Orator a Sophister a Philosopher 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 And a Quack will pretend himself a Physician And for the Word Apothecary in Scripture 't is so well known that word means only sellers of rich Oyntments Perfumes Balsoms 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and such other Cosmeticks as were in use in those Countreys which sort of men were after by the Greeks call'd 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and among the Romans from the place