“Mediciners, like the medicines which they employ, are often useful, though the one were by birth and manners the vilest of humanity, as the others are in many cases extracted from the basest materials. Men may use the assistance of pagans and infidels in their need, and there is reason to think that one cause of their being permitted to remain on earth is that they might minister to the convenience of true Christians.”—The Archbishop of Tyre in Sir Walter Scott’s Talisman.
It would require a very long chapter and would be outside the scope of this work to attempt to trace in any detail the manner in which the ancient wisdom and science of the Greek and Latin authors, which was so marvellously preserved by the iconoclastic Arabs, was transferred, when their passion for study and research began to fail, to European nations. It has been alleged that the Crusades served to bring the attainments of the Eastern Saracens to the knowledge of the West through learning picked up by the physicians and others who accompanied the Christian armies against the Mohammedans.
But there is no evidence and not much probability that Europeans acquired any Eastern science of value through the Crusades. Indirectly medicine ultimately profited greatly by the commerce which these marvellous wars opened up between the East and the West, and the diseases which were spread as the consequence of the intimate association of the unwholesome hordes from all the nations concerned, resulted in the establishment of thousands of hospitals all over Europe. The provision of homes for the sick was far more common among the Mohammedans than among the Christians of that period. Activity of thought was stimulated, and medical science must have shared in the effects of spirit of inquiry. Some historians have supposed that the infusion of astrological superstitions into the teaching and practice of medicine was largely traceable to the communion with the East in these Holy Wars: but this idea is not supported by anything that we know of the Arab doctors. “I have not found the union of astrology with medicine taught by any writer of that nation,” says Sprengel; and his authority is very great. On the other hand the philosophers and theologians of that age were only too eager to seize upon anything mystic, and plenty of materials for their speculations were found in the Greek and Latin manuscripts handed down to them. Superstitions entered into the mental furniture of the age much more directly from Rome and Alexandria than from Bagdad.
That the Arabs of the East could have taught their Christian foes much useful knowledge cannot be doubted. The letter from the Patriarch of Jerusalem to Alfred the Great (see page 131), for example, is proof of the pharmaceutical superiority of the Syrians over the Saxons at that time.
M. Berthelot has shown by abundant evidence in his “History of Alchemy” that the Latin works dealing with chemistry of the thirteenth, fourteenth, and fifteenth centuries which were very numerous in Christendom, were almost exclusively drawn from Arabic sources. Such chemical learning as the Arabs had collected from Greek writers, as well as that which they had added from their own investigations, in this way found its way back to the heirs of the original owners as they may be called.
We read likewise of Constantine the African, who, about the year 1050, came to Salerno after a long residence in the East, and gave to the medical school of that city the translations he had made from Arab authors. But, notwithstanding these evidences of Eastern culture, it is certain that the actual introduction of pharmacy into the Northern European countries is much more largely due to the Spanish Mohammedans. In the Middle Ages poor Arabs and Jews who had studied medicine in the schools of Cordova and Seville tramped through France and Germany, selling their remedies, and teaching many things to the monks and priests who, in spite of repeated papal edicts forbidding them to sell medicines, did in fact cultivate all branches of the art of healing, including many superstitions. The edicts themselves are evidence that they sold their services to those who could afford to pay for them.
The Medical School of Salerno, already mentioned, was the principal link between the later Greek physicians and the teaching institutions which remain with us to this day, as, for instance, the universities of Paris, Naples, Oxford, Padua, Vienna, and others of later fame. The origin of the school of Salerno is unknown, but it was certainly in existence in the ninth century. It was long supposed to have developed from a monastic institution, but it is now generally believed to have been always a secular school. Its historian, Mazza of Naples, 1681, quotes an ancient chronicle which names Rabbi Elinus (a Jew), Pontus (a Greek), Adala (a Saracen), and Salernus (a Roman) as its founders, but there is no evidence of the epoch to which this refers. Although other subjects were taught at Salerno, it became specially noted for its medical school, and in the ninth century it had assumed the title of Civitas Hippocratica. William of Normandy resorted to Salerno prior to his conquest of England, and a dietetic treatise in verse exists dedicated to his son Robert. It has been claimed that the works of Hippocrates and Galen were studied at Salerno from its earliest days, but so far as this was the case it was by the intermediary of Jewish doctors, who themselves derived their knowledge from Arab sources, that these were available. The original texts of the Greek and Latin authors were not in the hands of European scholars till Aldus of Venice began to reproduce them early in the sixteenth century.
The pharmaceutical knowledge to which the famous school attained may be judged by the reputation which attended the Antidotary of Nicolas Prepositus, who was director of the school in the first half of the twelfth century. In this Antidotary are found the absurd formulas pretending to have been invented or used by the Apostle Paul and others. “Sal Sacerdotale quo utebantur sacerdotales tempore Heliae prophetae” is among these. In the course of the next century or two medical students from England, Germany, Italy, and France went to Cordova, Toledo, and Seville, and there wrote translations of the medical works used in those schools. These translations by the end of the thirteenth century were so universally accepted as to eclipse Salerno, which from then began to decline in fame, Bologna, Montpellier, Padua, and Leyden gradually partitioning among themselves its old reputation. But the medical school of Salerno actually existed until 1811, when it was dissolved by a decree of Napoleon I.
As evidence of the monopoly of Avicenna in the medical schools of Europe at the beginning of the sixteenth century, and doubtless for a long period previously, the following from the preface to a Latin translation of the works of Paulus Egineta is quoted by Leclerc:—
Avicenna, who is regarded as the Prince and most excellent of all physicians, is read and expounded in all the schools; and the ninth book of Rhazes, physician to the Caliph Almansor, is similarly read and commented on. These are believed to teach the whole art of healing. A few later writers, such as Betruchius, Gatinaria, Guaynerius, and Valescus, are occasionally cited, and now and then Hippocrates, Galen, and Dioscorides are quoted, but all the other Greek writers are unknown. The Latin translations of a few of the books of Galen and Hippocrates which are in use are very corrupt and barbarous, and are only admitted at the pleasure of the Arabian Princes, and this favour is but rarely conceded.
The most notable event in the history of pharmacy after the earlier Crusades was an edict regulating the practice of both medicine and pharmacy issued by Frederick II, the Holy Roman Emperor and King of Sicily. This monarch, probably the ablest ruler in the Middle Ages, who died in 1250, had great esteem for Arab learning. Mohammedans and Jews were encouraged to come to Naples during his reign, and he facilitated by all means in his power the introduction of such innovations as had been acquired from Cordova and Bagdad.
The edict referred to mentions “apotheca,” meaning thereby only the warehouses where prepared medicines were stored. Those who compounded the medicines were termed “confectionarii,” the places or shops where they were sold were called “stationes,” and the persons who supplied them, “stationarii.” It is not quite clear whether the confectionarii and the stationarii were the same persons. Probably they were sometimes, but not necessarily always. Apparently the stationarii were generally the drug importers and dealers, and the confectionarii were the compounders. Both had to be licensed by the Medical School of Salerno; and among the duties imposed upon the physician, one was to inform the authorities if he came to discover that any “confectionarius” had falsified medicines. Longfellow alludes to this provision in the “Golden Legend”—
The physician was strictly forbidden to enter into any arrangement with a druggist whereby he would derive any profit by the sale of medicaments, and he was not permitted himself to conduct a pharmacy. The “confectioners” were required to take an oath to prepare all medicines according to the Antidotary of the Salernian School. Their profits were limited and graduated, less being allowed on those of frequent consumption than on those which they had to keep for more than a year. Pharmacies were only allowed in the principal cities, and in each such city two notable master-apothecaries were appointed to supervise them. The “confectioners” had to make their syrups and electuaries and other compounds in the presence of these two inspectors, and if they were detected in any attempt at fraud their property was subject to confiscation. If one of the inspectors was found to have been a party to the fraud his punishment was death.
“It is well known,” says Beckmann in “Ancient Inventions,” “that almost all political institutions on this side the Alps, and particularly everything that concerned education, were copied from Italian models. These were the only patterns then to be found; and the monks despatched from the papal court saw they could lay no better foundation for the Pontiff’s power and their own aggrandizement than by inducing other States to follow the examples set them in Italy. Medical establishments were formed, therefore, everywhere at first according to the plan of that at Salerno. Particular places for vending medicines were more necessary in other countries than in Italy. The physicians of that period used no other drugs than those recommended by the ancients; and as these had to be procured from the Levant, Greece, Arabia, and India, it was necessary to send thither for them. Besides, herbs, to be confided in, could only be gathered when the sun and planets were in certain constellations, and certificates of their being so were necessary to give them reputation. All this was impossible without a distinct employment, and it was found convenient to suffer dealers in drugs gradually to acquire monopolies. The preparation of medicines was becoming more difficult and expensive. The invention of distillation, sublimation, and other chemical processes necessitated laboratories, furnaces, and costly apparatus; so that it was thought proper that those who devoted themselves to pharmacy should be indemnified by an exclusive trade; and monopolists could be kept under closer inspection so that the danger of their selling improper drugs or poisons was lessened or entirely removed. They were also allowed to deal in sweetmeats and confectionery, which were then great luxuries; and in some places they were required to give presents of these delicacies to the magistrates on certain festivals.”
This extract shows how the German provision of protected pharmacy originated. In many of the chief cities the apothecaries’ shops were established by, and belonged to, the King or Queen, or the municipality. Sometimes, as at Stuttgart, there was a contract between the ruler and the apothecary, the former agreeing to provide a certain quantity of wine, barley, and rye; while the apothecary in return was to supply the Court with its necessary confectionery.
The Reproduction of a Sixteenth Century Pharmacy in the Germanic Museum at Nuremberg.
Beckmann gives much minute information concerning the establishment of apothecaries’ shops in the chief cities of Germany.[1] He mentions a conjecture that there was a pharmacy at Augsburg in the thirteenth and fourteenth centuries, but exact dates begin with the fifteenth century. There was a female apothecary established at Augsburg in 1445, and the city paid her a salary. At Stuttgart, in 1458, Count Ulric authorised one Glatz to open a pharmacy. There was one existing at Frankfort in 1472. The police regulations of Basle in 1440 mention the public physician and his duty, adding that “what costly things people may wish to have from the apothecary’s shop they must pay for.” The magistrates of Berlin, in 1488, granted to one Hans Zebender a free house, a certain provision of rye, no taxes, and the assurance that no other apothecary should reside in the city. But the Elector Joachim granted a new patent to another apothecary in 1499. At Halle there was only one apothecary. In that year the Archbishop, with the confirmation of the Chapter, granted to his physician, von Wyke, the privilege of opening another, but gave at the same time the assurance that no more should be permitted in the city “to eternity.”
In France apothecaries were in business as such certainly before 1250. A charter of the church of Cahors, dated 1178, describes the retail shopkeepers of the town as “apothecarii,” the term being used evidently as “boutiquiers” is now, and signifying nothing more than shopkeepers. The meaning, however, soon became restricted to dealers in drugs and spices. In the middle of the next century John of Garlande alludes to “appotecarii,” who sold confections and electuaries, roots and herbs, ginger, pepper, cumin, and other spices, wax, sugar, and licorice. Officially, however, these tradesmen were classed at that time among the “espiciers.” The two guilds, indeed, continued in formal association until 1777, but royal ordinances of 1484 and 1514 clearly established the distinction between them. Even in 1271 the Faculty of Medicine of Paris forbade “herborists and apothecaries” to practise medicine. Special responsibilities, duties, and privileges were expressly provided for the apothecaries, and in the ordinance of 1514 it is specifically declared that though the apothecary is always a grocer, the grocer is not necessarily an apothecary. (“Qui est espicier n’est pas apothicaire, et qui est apothicaire est espicier.”)
In the fourteenth century the apothecaries of Paris were required to subscribe to a formal oath before they were permitted to practise. They swore to live and die in the Christian faith, to speak no evil of their teachers or masters, to do all in their power for the honour, glory, ornament, and majesty of medicine, to give no remedy or purge without the authority of a physician, to supply no drugs to procure abortion, to prepare exactly physicians’ prescriptions, neither adding, subtracting, nor substituting anything without the express permission of the physician, to avoid the practices of charlatans as they would the plague, and to keep no bad or old drug in their stocks. An ordinance of 1359 provides that no one shall be granted the title of master-apothecary unless he can show that he can read recipes.
The edict of 1484, issued during the minority of Charles VIII, sets forth that, “We, of our certain science, especial grace, full power, and royal authority, do say, declare, statuate, and ordain” the curriculum to be observed by those who desire to learn the trade of an apothecary. A four years’ apprenticeship was essential, and the aspirant had to dispense prescriptions, recognise drugs, and prepare “chefs d’œuvres” in wax and confectionery in the presence of appointed master-apothecaries. Latin was added to the examination in 1536, and ten years’ experience after the apprenticeship was also insisted upon ultimately before the candidate could be admitted as a master-apothecary. One of the ordinances of the sixteenth century gave to the apothecaries the monopoly in the manufacture and sale of gingerbread.
These edicts all related particularly to the apothecaries of Paris. There were similar ones in the provinces, with some peculiarities. At Dijon, for example, it was provided that no apothecary could receive a legacy from one of his clients. En revanche he had the first claim on the estate of a deceased debtor for the payment of his account.
In 1629 the Hotel de Ville of Paris granted to the apothecaries of that city a banner and blazon, the latter, which I do not venture to translate, being thus described:—“Couppé d’azur et d’or, et sur l’or deux nefs de gueulle flottantes aux bannieres de France, accompagnés de deux estoiles a cinq poincts de gueulle avec la devise 'Lances et pondera servant,’ et telles qu’elles sont cy-dessous empreinctes.”
In 1682, under Louis XV, after the Brinvilliers panic, the poison register was introduced, and regulations were framed forbidding apothecaries to sell any arsenic, sublimate, or drug reputed to be a poison except to persons known to them, and who signed the register stating what use they intended to make of their purchase. Earlier in the same reign the practice of pharmacy was strictly forbidden to persons professing the reformed religion.
The last of the royal edicts applying to pharmacy was issued in 1777 by Louis XVI, and, as already stated, this was the authority which finally separated the apothecaries from the grocers. Then came the Revolution, and in 1791 all restrictions on trades or professions, including pharmacy, were abolished. Some accidents having occurred, the Assembly passed an ordinance on April 14, 1791, declaring that the old laws, statutes, and regulations governing the teaching and practice of pharmacy should remain in force until a new code should be framed. This did not appear until April, 1803, under Napoleon’s Consulate, and the law, which is still in force, is to this day cited in legal proceedings as the law of Germinal, year XI.