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A50694 The accomplisht physician, the honest apothecary, and the skilful chyrurgeon detecting their necessary connexion and dependence on each other : withall a discovery of the frauds of the quacking empirick, the praescribing surgeon, and the practicing apothecary Merret, Christopher, 1614-1695.; Harvey, Gideon, 1640?-1700? 1670 (1670) Wing M1835; ESTC R26201 45,733 105

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Borrage and a Baum Water all very full of Spirits if River Water may be so accounted to these is to be added one Ounce of that miraculous Threacle Water then to be dissolved a Dram of Confectio Alkermes and one Ounce of nauseous Syrup of Gillyflowers this being well shaked in the Viol you shall spy a great quantity of Gold swiming in leaves up and down for which your Conscience would be burdened should you give him less than five shillings for from the meanest Tradesman he expects without the least abatement three and six pence the ordinary and general price of all Cordials though consisting only of two Ounces of Baume Water and half an Ounce of Syrup of Gillyflowers Your Glyster shall be praepared out of two or three handfuls of Mallow leaves and one Ounce of common Fennil seeds boyl'd in water to a pint which strained shall be thickned with the Common Electuary Lenitive Rape Oyle and Brown Sugar and so seasoned with Salt This shall be conveighed into your Guts by the young Doctor his man through an engin he carries commonly about him and makes him smell so wholsom for which piece of service if you praesent your Engeneer below half a Crown he will think himself worse dealt with than those who empty your necessary Closets in the night The Master places to account for the Gut-Medicine though it were no more than water and salt and for the use of his man which he calls Porteridge eight Groats Item for a Stomachick Hepatick Splenetick and a Nephritick Plaister for each half a Crown What the total of this dayes Physick amounts to you may reckon The next afternoon or evening returns the Apothecary himself to give you a visit for should he appear in the morning it would argue he had little to do and finding upon examination you are rather worse than better by reason those Plaisters caused a melting of the gross humours about the Bowels and dissolved them into winds and vapours which fuming to the head occasion a great Headach dulness and drowsiness and part of 'em being dispersed through the Guts and Belly discommode you with a Colick a swelling of your Belly and an universal pain or lassitude in all your Limbs thus you see one day makes work for another however he hath the wit to assure you they are signs of the Operation of yesterdayes means beginning to move and dissolve the humours which successful work is to be promoted by a Cordial Apozem the repetition of a Carminative Glyster another Cordial to take by Spoonfuls and because your sleep hath been interrupted by the unquietness of swelling humours he will endeavour to procure you for this next night a Truce with your Disease by an Hypnotick potion that shall occasion rest Neither will he give you other cause than to imagine him a most careful man and so circumspect that scarce a Symptom shall escape his particular regard and therefore to remove your Headach by retracting the humours or rather as you are like to discern best by attracting humours and vapours he will order his young Mercury to apply a Vesicatory to the nape of your Neck and with a warm hand to besmear your Belly and all your Joints with a good comfortable Oyntment for to appease your pains The Cordial Apozem is a Decoction that shall derive its vertue from two or three unsavory Roots as many Herbs and Seeds with a little Syrup of Gillyflowers for three or four times taking which because you shall not undervalue by having it brought to you all in one Glass you shall have it sent you in so many Viols Draughts for every one of 'em shall be placed three shillings to your account which is five parts more than the whcle stands him in for the Cordial potion as much for the Hypnotick potion the same price for your Carminative Glyster no less and for the Epispastick Plaister a shilling Thus with the increase of your Disease you may perceive the increase of your Bill and therefore it 's no improper observation that the Apothecaries Practice follows the course of the Moon The third day producing an addition of new Symptoms and an augmentation of the old ones the Patient stands in need of new comfort from his Apothecary who tells him that nature begins now to work more strong and therefore all things goes well and never ill but because nature requires all possible assistance from Cordials and small evacuations he must expect the same Cordials over again but with the addition of greater ingredients it may be Magistery of Pearl or Oriental Bezoar in Powder the former being oft times but Mother of Pearl dissolved in distilled Vinegar the latter a cheat the Armenians put upon the Christians by ramming Pebbles down a Goats throat afterwards killing him and extracting the stones before witness out of his Maw which they sell for those rare Bezoars whereof the quantity of fifteen Grains I have known hath been taken by a Child of a year old that lay ill of the Small Pox without the least effect of sweat or any expulsion through the Pores And besides the repetition of a Glyster and the renewing of your Plaisters for the profit of your Physician you must be perswaded to accept of a comforting Electuary for the Stomach to promote digestion of a Collution to wash the slime and filth from your Tongue and to secure your Gums from the Scurvy of a Melilot Plaister to apply to the Blister was drawn the night before of some Spirits of Salt to drop into your Beer at Meals of three Pills of Ruffi to be swallowed down that night and three next morning which possibly may pleasure you with three Stools but are to be computed as 2 Doses each at a Shilling the Spirit of Salt a Crown the Ounce for the Stomach Electuary as much for the Glyster as before for your Cordial in relation to the Pearl and Bezoar their weight in Gold which is two pence a Grain the greatest cheat of my whole discourse for dressing of your Blister a shilling for the Plaister as formerly Here I praesume that candour in you as not to believe me so disingenious as to take the advantage of Apothecaries in producing any other than the best methods of their practice and that which savours the least of their frauds for in comparison with others though these are very palpable in regard there is not a valuable consideration respected or a proportionable Quid pro Quo they are such as may be judged passable yet when you are to reflect upon the total that shall arrise out the Arithmetical progression of charge of a fortnights Physick modestly computed at fifteen Shillings a day without the inclusion of what you please to praesent him for his care trouble and attendance I will not harbour so ill an opinion of him or give so rigid a censure as your self shall upon the following Oration your Glysterpipe-Doctor delivers to you with a Melancholy accent
end rid their Shops of two thirds of their decayed Compositions and rotten Simples which at their seasons they are obliged to praepare a fresh and keep them ready for your use if unhappily your Disease should require any of 'em whence it appears the greatest justice you should be charged for Medicines that are purposely so praepared and reserved for you though never praescribed in the higher Rates and Prices of such you at any time have occasion for Thirdly An Apothecary being obliged to repair to a Physicians Covenant Apothecary to purchase his Phantastical Nostrum at the unreasonable rate he is pleased to value it at doth not a little inflame the reckoning Fourthly The unskilful Physician praescribing an Ounce of Pearl in a Cordial Emulsion puts the Patients Purse into a Disease and gives him but little ease Moreover to praescribe Bees praepared in the Winter or four or five Ounces of Peach Kernels in the Spring or to ordain a restorative Electuary out of Parats tongues and Hawks livers as a most egregious Physician of our Town did is an argument you need not to stair if your Bill amounts to pounds sterling And when your glorious Physician hath markt you down an Apozem of a yard and half long I would not have you dispute with your Apothecary for demanding more than what 's usual for one that contains but a simple or two which possibly shall operate more effectually and the Physician will know more certainly which of the Simples did the feat whereas in a great composition it 's impossible to determinate which of 'em contributed most to the Cure § These defects and abuses in the practice of Physick in relation to their prices chiefly depend on the great bulk of the London Dispensatory being overburdned with at least two thirds though considering the time it was framed in might well have vyed with any of its cotemporaries for excellent and select Compositions But the experience of our so wonderfully improved age declares most methods of Physick can more commodiously be performed with a less than one third of its Contents To what purpose so many scores of Syrups which upon their unavoidable fermentation through the heat of the Summer undergo a dissipation of the imbibed or infused vertues of Simples differing afterwards in nothing from nauseous Molasses so great a number of distilled Waters seems rather intended for pomp than the absolute necessity of such Phlegmatick and insiped Liquors as most of 'em are Aqua Gilberti and Cordialis frigida Saxoniae are through the addition of Coral Pearl Bezoar and precious Stones considerably advanced in price but not the least particle in vertue accusing the Inventors of a defect in experimental knowledge which would have discovered to them there had been nothing so Volatil or Salin in those forementioned Stones and Pearl that such weak Menstruums were capable of extracting And he that revises the Composition of Confectio Hamech will conclude it a very senseless one for being render'd so adstrictive by that great proportion of Myrobalaas Mithridate and Threacle if ever they had been causes of those great effects former ages adscribed to them would certainly be promoted to higher vertues were they corrected by the substracting many of their poysonous and hurtful ingredients Neither could I ever give my self a satisfactory reason why those ancient and pure Empirical Compositions whereof Mesues was so diligent a Collector were recommended by those learned Physicians to their Apothecaries without reducing their Empirical and senseless multitude of ingredients to a less and more rational number in the Compositions of Species Confect Liber Pulvis Bezoard Magistr Diarrhod Abbat and of many others Likewise the Chymical praeparations described in the latter end of the said Pharmapoea are as mean as they are defective Antimonium Diaphoreticum is not so much fixt but oft moves Vomits the like effect may be imputed to their Bezoardicum Minerale Their Mercurius vitae proves for the most part Convulsive towards the latter part of the operation their Oleum Vitrioli too corrosive and not at all volatil their Turbith Mineral is as churlish as it is a crude and barren praeparation The body of the Chalybs praep not being sufficiently opened by distill'd Vinegar doth not answer the Physicians expectation in obstinate obstructions Their Magisterium Coral and Perlar. differ little from chalk in powder or lime well washt In fine nothing is more worthy of the consideration of those so eminently Accomplisht Physicians of the College than the reformation of their Pharmacopoea the correcting of its Compositions in retrenching the number of the ingredients and reducing the body of the whole into a far less number of Simple Waters Syrups Electuaries Powders Compound Purgatives Oyntments and Plaisters whereby they will singularly pleasure Honest Apothecaries in detracting so considerably from that needless and almost endless pains and trouble the praesent Dispensatory injoyns and save them the labour of running to one another to borrow Medicines and lastly since by this small determinate number of Simples and Compounds little or nothing will remain to be flung away at the years end they may afford their Medicines two thirds cheaper and yet be no less Gainers and for this the publick will in gratitude become their aequal Debtors with Apothecaries § To this praeceding Catalogue of clamourous abuses of Practising Apothecaries I will annex such others as the immoderate thirst of lucre and the sweet ease of laziness do tempt them to and therefore if in the praeparation of prolix compositions as of Syr. Arthem Syr. Chamaepit Mithridate and others they omit half a score Simples or more and supply the defect of 'em by a double proportion of others you may judg they intend nothing but the contracting their business and the humouring their inclination to idleness And if in the Species of Diamoschu they omit the Mosck in Pulv. e Chel Cancror the Bezoar in Pulv. Cardiac Magistr the Ambergrise and Leaf Gold in Pulv. Bez. Mag. the Unicorns horn and the Pearl you may imagine they design a double profit the one by saving those dear Ingredients and the other by charging the said Medicines at as high a rate to the Patients Bill as if they had been added in their full proportion Secondly At the Druggists there being two sorts of all Drugs the one good sound and dear the other though of the same kind course almost rotten and very cheap we may be jealous that those who aim at an Aldermanship by a quick step do for the most part make use of the latter sort of Drugs in all their Compositions and in the praeparations of the praescripts of Physicians whose Bills its most certain are by some Apothecaries unfaithfully dispensed by adding a less quantity of the Ingredients or such as will prove ineffectual on design either to protract the course of Physick or to defame the Physician Thirdly the humour of a Tradesman to play the Gentleman is too visible in many Apothecaries who pass
their time either Physician like in visiting Patients or rendring themselves to the recreations of the times wherein they are plentifully supported by the revenue of their Shop which their men manage according to the idleness and negligence Servants are all addicted to in the absence of their Masters whence supposing a praescription to be erroneously or dangerously praepared and the Patient upon the taking of it surprized with urgent symptoms or yeild to his last fate it shall not be divulged to you the man that made up the Medicine was a raw Apprentice or had been drinking Drunk whil'st the Master was breathing his Nag in Hide-Park in all which transaction it 's the Physician that must father the ill success § Were you here to pass your sentiment on the praemisses you would conclude I had spoken for and against the Apothecaries which how far I seem to have written for them it 's time I should resolve you First in answer to what I objected seemingly on the behalf of the reasonableness of their Practice Our most perfect English Law imposes death upon those who exact money though out of a necessity for a Livelyhood from any by threatning their lives if so what can we suppose a greater argument against Apothecaries that exact great Sums in their long Bills for Medicines which beyond threatning have artificially taken away their lives for it 's observable our Law is so intent in the praeserving of the life of every though the meanest of the Kings Subjects that if a proof be pursued that the untimely death of any person was caused by an error in Physick administred by one that had no legal warrant for it the crime is severely punish'd with a Rope § But since the condition of inferiour Tradesmen and Servants will not admit of great expences in Physicians fees besides large prices for Medicines the Honourable College of Physicians would singularly acquit their duty to the publick in praeventing their rash inconsiderate humour of running to Mountebanks Empiricks or practising Apothecaries for cheapness so seeming by appointing every three or four years one or two Junior Physicians in every Ward whose visiting Fee they should be obliged by Oath shall not exceed a shilling and their Chamber Fee six pence by which means many lives might be praeserved the young Physician gain considerably enough by the frequency of Patients and the multitude of Visits and very much improve his experience Likewise there ought a Pharmacopoea Pauperum to be annex'd to the other which consisting in cheap few and effectual Medicines and praepared by two or three Apothecaries authorized for that purpose in every respective Ward and every Medicine reasonably rated by the Physician at the end of his praescription it would certainly praevent the ruine of many mean Families in case of a great Sickness which oft cannot stand them in less than twenty or thirty pounds at the rate Physick is practised now § Physicians of late have made some sputter about the dishonesty stubborness and incapacity of Apothecaries in their Trade but seeking redress among incompetent Judges the vulgar mistook their case and so must begin again The Carrier in the Fable complaining to Iupiter his Ass was sullen and wo'd not go the way he wo'd have him Iupiter return'd no other answer than that he had given him hands implying he might make use of 'em in taking the Ass by the Haltar and driving him on with a Battoon The Moral applyed to this affair can give no offence since Fables never created exceptions So then the College of Physicians having the means in their own hands which their Charter and several acts of Parliament had conferred on them may without much difficulty arrive to the end of their design by summoning the chief of their Corporation before them and offering whether they will accept of an Oath to be taken every seven years or oftner to put them in mind of their duty in this form or any other they shall think fit They shall swear they will praepare the Medicines and Compositions of their Dispensatory faithfully without altering or substituting Quid pro Quo or omitting or adding any Simples which they engage shall be the sound and good and that they will praepare and dispense the praescriptions of Physicians exactly without the least alteration omission or addition without cavilling deriding or reviling any thing therein contain'd That they shall not sell their Medicines at higher prices than the College shall think fit to tax or rate them That they shall not praesume to give a Vomit or Purge without a Bill from a Legal Physician That they shall not give a Patient more than one Cordial or Glyster on an urgent occasion which may satisfie the Patients impatiency until a Physician be sent for provided alwayes that this shall not extend to hinder them from selling Mithridate Threacle Simple Waters Syrups or any thing else a Customer will buy of ' em That they shall not feel Pulses examine Patients puzzle or fright them to cause them to send for another That they shall dispense Laudanum Mercurius vitae and some other weighty Medicines with their own hands That they shall give Physicians a due respect and honour oppose the frauds and insinuations of Empiricks and Practising Apothecaries That they shall not keep any Medicine in their Shops longer than the College praescribes a time for their continuing good and sound That they shall not sell Sublimate Praecipitate Arsenick or any other sort of quick poyson to any inferiour or unknown Customer That they shall conceal the Diseases of Patients or whatever other secrets are committed to them in the Cure That they shall likewise keep secret such praescripts of the Physicians as they shall enjoyn them to That they shall not publickly or privately advise or sell any Medicine that may occasion Women to miscarriages or kill their Conception That they shall discover the frauds and errors committed by Practising Apothecaries if suspected to have caused the untimely death of any That they shall not let Blood dress Ulcers or invade any part of the Skilful Chyrurgeons employ Besides what else is convenient to be added An Oath being no more than necessary in a Trade where frauds and abuses are so practicable I am confident no Honest Apothecary can or will refuse it since containing no particular that cuts off from the priviledge or full extent of his Trade Those whom the honesty of their intentions shall perswade their submission to these rules may be distinguish'd from others by being called College Apothecaries to whom it 's likewise most just the Physicians shall ingage upon the reputation of their Profession not to praepare any Medicines but such as are very difficult requiring art and care and whereon the weight and principal efficacy of Curing great Diseases doth depend but that they shall send these also to be dispensed by them and consequently shall leave off praescribing of Nostrums that were used to be praepared by their Covenant