History of pharmacy in the United States

This article is about the history of pharmacy in the United States. For the development of pharmacy globally, see history of pharmacy.

The history of pharmacy in the United States is the story of a melting pot of new pharmaceutical ideas and innovations drawn from advancements that Europeans shared, Native American medicine and newly discovered medicinal plants in the New World. American pharmacy grew from this fertile mixture, and has impacted U.S. history, and the global course of pharmacy.

A living historian interprets a 19th-century apothecary shop for visitors, Old Salem, North Carolina.

Apothecary—an ancient title that, especially in pre-modern or early modern contexts, indicates a broader set of skills and duties than the core role of dispensing medications, like prescribing remedies and even giving some treatments difficult to self-administer, e.g. enemas—have largely been within the "pharmacist" umbrella in the U.S. since the mid-19th century, when Edward Parrish of the American Pharmaceutical Association successfully proposed that the APhA "consider all the varied pharmaceutical practitioners 'pharmacists'” to better "standardize the field."[1] Unlike in the UK, where pharmacists were separated from apothecaries by Parliament[2] and the pharmacist had effectively eclipsed the ancient apothecary, appellations and professions have been far more fluid and overlapping in the U.S.,[3] especially prior to the regulatory schemes widely adopted in the late 19th century. "Apothecary" still crops up as synonym for pharmacist, along with "druggist," and has yet to fall entirely out of use, with some in the U.S. still calling themselves apothecaries.[4] As the pharmacist increasingly became the distinct discipline and tightly-defined profession it is today, American pharmacists added their own discoveries and innovations, and played a prominent role in the revolution in medical knowledge in the 19th and 20th centuries and the subsequent development of modern medicine.

The history of pharmacy has lagged behind other fields in the history of science and medicine, perhaps because primary sources in the field are sparse.[5] Historical inquiries in this area have been few, and unlike the growing number of programs in the history of medicine, history of pharmacy programs remain few in number in the United States.[6]

Colonial period

Early developments alongside colonization

As soon as Columbus started his explorations of the Americas in the late 15th century, a European effort to find valuable medicinal plants among the flora of the New World to add to the medical canon got underway. Early New World medicines uncovered included guaiacum from the West Indies (for coughs, rheumatism and a wide variety of other uses), sassafras from Florida, copaiba from Brazil, Peru balsam and, most famously, cinchona bark from Peru,[7] also called "Jesuit's bark" in honor of its discoverer, which became the first effective treatment for malaria. The active ingredient of this cinchona bark, quinine, was the primary treatment for malaria well into the 1940s. "About 170 drugs used by the Indians of British North America, and perhaps 50 used by the indigenous people of the Caribbean, Mexico, Central and South America" became important enough in the U.S. (as the practitioners of chemistry and pharmacy eventually catalogued, analyzed and understood them) to merit listing in the United States Pharmacopoeia (est. 1820)[8] or the National Formulary.[9]

In the early 1700s, James Oglethorpe, founder of the Georgia colony, with the financial backing of the Worshipful Society of Apothecaries of London and others, launched an effort to identify and transplant beneficial plant species from the tropical colonies to Savannah, Georgia. Unfortunately for Oglethorpe (and all the Southern colonists) the expedition that marked this first attempt by an organized group of Old World apothecaries to benefit from British North America's potential as a medicine farm never bore fruit. The Caribbean expedition's lead investigator, botanist Robert Miller, was hampered by illness and uncooperative Spanish colonials, and all support from London ceased when Miller died without much success.[10]

Pharmacy in eighteenth century North America

The first "drugstores" in North America "appeared in Boston, New York, and Philadelphia,"[11] with likely proto-drugstores—for example Gysbert van Imbroch ran a "general store" that sold drugs from 1663-1665 in Wildwyck, New Netherland,[12] today's Kingston, New York—preceding the dedicated apothecary shops of the 1700s, and providing a model. Because of that model, and customs that stretch back to the first apothecary shops in the medieval Arab world[4] most drugstores continued selling more general goods, perfumes, cosmetics, and drinks of all sorts alongside medicines, and still do.

Non-British influences

That the Spanish colonials, not the British, were the first in North America to license a pharmacist (in 1769 in New Orleans)[13] and were also the first to regulate pharmacy as a separate profession, points to the importance of non-British colonial governments and, indeed, settlers from mainland Europe throughout North America, in importing and translating the more modern pharmacy methods, standards and ways of organization and regulation—developing in Europe since at least the 1600s—for application in the infant United States.

"Franco-Spanish" Louisiana "more clearly reflected [pharmacy's] development in Continental Europe."[3] Influential milestones achieved in 18th century Louisiana included the February 12th, 1770 edict from the governor in New Orleans, Don Alexandre O'Reilly, delineating the responsibilities and boundaries of medicine, surgery and pharmacy and marking the first legal recognition of pharmacy as a distinct discipline in the territories that would become the United States.[3][13] Though the number of pharmacists licensed under this system in Spanish Louisiana never surpassed the single-digits, O'Reilly's decree and its ethical code for pharmacists set an important precedent future developments would build upon. It also brought on-line an important independent pipeline of licensed druggists, albeit a small pipeline, to add to the scant supply of Old World apothecaries who had immigrated to set up shop in the colonies.

Of the few apothecaries imported from Europe, those of Jesuit training had a long-felt impact in both New Spain and New France; so great was Jesuit involvement in "care of the sick" in their foreign missions, in fact, they sought and received a papal exemption from the ban on clerics serving in medical roles.[14] Two dedicated "pharmacopoles or apothecary brethren" Jesuits are listed under the heading "Missions of North America in New France" in Society of Jesus personnel records for the "Province of France at the End of the Year 1749."[14] Jesuit contributions, especially in translating Native American ethnobotany into medicines for European use, were highly influential as pharmacy developed in North America.[12]

In British North America

Pharmacist Ambrose Hunsberger, in his sweeping introduction covering pharmacy's development in the United States prior to the events discussed in his 1923 article on Prohibition's impact, "The Practice of Pharmacy Under the Volstead Act," described pharmacy before its organization (which he places around 1821) in terms that evoke the snake oil salesmen and medicine shows that hit every town, hamlet and village in the country: "...the disorganized system of hawking medicinal remedies which prevailed throughout our thinly populated country. There was no method of protecting the public from fraud through control or regulation of the sale of adulterated and harmful medicinal products, and the credulous citizenry of the young nation was beguiled by every description of fakir and charlatan into buying their fantastic panaceas."[15] Hunsberger puts the practice of "more or less methodical" pharmacy in Europe "two or three centuries" back, as early as the 16th or 17th centuries, whereas he places the start of organized pharmacy in the United States with the founding of America's first formal college of pharmacy, the Philadelphia College of Pharmacy (PCP), in 1821.[15]

Prior to this, however, the original British colonies retained a much more ad-hoc, improvisational approach to pharmacy, and "there were, as was to be expected in a land so vast and so sparsely settled, virtually no limitations as to where or by whom pharmacy could be practiced."[3] Lines between the professions of pharmacist, wholesale druggist and physician did not yet exist in the way they would later; "their provinces overlapped, and appellations, which often meant little, frequently changed."[3]

An empty bottle of True Daffy's Elixir (center) Dicey and Co.
Dicey and Co.'s True Daffy's Elixir, its 18th century-type embossed medicine bottle seen here (center), was one of the more popular examples of the patent medicines Americans imported from across the Atlantic in the 18th and 19th centuries.

In the colonial and early independence years, necessity demanded a do-it-yourself approach to pharmacy. "Most, if not all, American medical men prepared and dispensed their own medications, since fee bills and custom usually provided fees for the medication and not the visit, unless surgery or delivery was involved."[16] Thus, oftentimes the doctor was the apothecary and the apothecary the doctor, especially among rural "country doctors" who predominated in this era of farmers with "freeholds" thinly dotting the colonies. "Even in the 1760s, when a younger and largely native born cohort of physicians returned from Europe, most of the reputable and even famous among the American medici ran their own pharmaceutical business,"[16] which, for most doctors for the bulk of the 18th century included mostly medications mixed and dispensed by hand, sometimes augmented with a supply of patent medicines imported from the UK or mainland Europe.[17]

In the cities, the foundations of commercial pharmacy were slowly building. By 1721 there were "14 apothecary shops in Boston,"[11] and the first "commissioned pharmaceutical officer in an American army" was the Boston apothecary, Andrew Craigie.[18] A sort of warrior-apothecary, he took part in the Battle of Bunker Hill, June 17, 1775. And "when Congress reorganized the Medical Department of the Army in 1777, Craigie became the first Apothecary General."[18]

Important early American "apothecary shops" include the one in colonial Fredericksburg run by later-brigadier general in the Continental Army, Hugh Mercer,[19] (the building is now a museum, and has been "scientifically dated" to 1771 or 1772[20]). And the Marshall Apothecary (established 1729, open for 96 years)[21] in Philadelphia, which was a manufacturer of medicines as well as a retailer, and served as an important supplier throughout the Revolutionary War.[11][21] Advertisements from the period indicate "that there were drugstores in virtually all American cities by the end of the eighteenth century."[3]

Economic historian Bernice Hamilton describes the 1700s as having "completely transformed" all "the medical professions," explaining that "advances in medical education and science," the emergence of a robust middle class, "as well as the growth of 'a professional feeling'" had greatly changed the socio-economic order by the end of the 18th century.[22] Thanks to the ruling in the Rose Case back in London, apothecaries began 1705 as fully accredited medical professionals who could write prescriptions.[2] Hamilton notes "…the apothecaries, once mere tradesmen and the 'servants of the physician,' had become practicing doctors," treating patients directly.[22] These trends spread to the colonies, and though apothecaries never organized into a legally distinct and guilded profession in North America, the rural hinterlands mirrored the prevalence of the apothecary in Britain, where "in more remote locales, the apothecary 'was usually the only doctor.'"[23]

The pharmacopoeia, which simply lists useful drugs—or sometimes more importantly, drops questionable substances from the canon—"came fully into its own in the early modern age",[24] encompassing roughly the span of history covering the 1500s up until the French Revolutions in the late 1700s. But pharmacopoeias mainly offered some basics and compounding instructions.

An engraving depicting an 18th-century chemical laboratory, from William Lewis' later work Commercium Philosophico-Technicum (mid-1760s)

Not until the first dispensatories were there books disseminating more comprehensive information on pharmaceuticals: guidance on uses for drugs, how and in what situations to employ them, experience with best practices, etc. "This kind of book, the dispensatory, became something of a British specialty in the late seventeenth and eighteenth century."[25] These dispensatories, chief among them William Lewis' The New Dispensatory, which debuted in 1753 and was regarded as "the first truly scientific work on pharmacy in the English language,"[26] along with a later (1786) book intended as "'an improvement' on Lewis," the Edinburgh New Dispensatory,[26] were undoubtedly formative for pharmacy in British North America. The New Dispensatory and Edinburgh New Dispensatory were printed in many editions and numerous languages within their lifespans (1753-1830) including six printings for American use between them.[27]'

The nineteenth century: American pharmacy emerges

The 19th century (1800s) birthed "pharmacy as we know it."[3] And again, pharmacy's development in mainland Europe continued to fuel its growth in the young American republic.

The Philadelphia College of Pharmacy and the birth of organized American pharmacy

The Philadelphia College of Pharmacy (PCP), modeled—at least in concept—after the Collége de pharmacie in Paris,[28] was aided by European talent in its early, formative years. Elias Durand, who had served as "pharmacien of the Grand Army of Napoleon I," set up shop in Philadelphia in 1825, and "...in connection with the Philadelphia College of Pharmacy, immediately exerted a strong foreign influence on American pharmacy."[28] According to William Procter, Jr., Durand "directly and indirectly had much to do with the introduction of scientific pharmacy into Philadelphia."[28] Without teaching at the college, Durand still had a big impact by spreading new findings about medicinal plants, making "medicinal chemicals" never before created in the U.S., by training apprentices, like Augustine Duhamel, who went on to make important contributions and publish in the college journal,[28] and by serving as a role model for foundational figures like Procter.[29]

Hunsberger cites the founding of the Philadelphia College of Pharmacy (PCP) as "the first step forward in the development of a system of pharmaceutical practice in the United States,"[15] with the 1821 "meeting of apothecaries...held in Carpenters' Hall" (where the Declaration of Independence had been signed) to set up the first formal college of pharmacy and first pharmacists' association (the Philadelphia College of Pharmacy) in North America[30] the seminal founding event.[15] On March 13, 1821, "Sixty-eight pharmacists signed the Constitution of the first pharmaceutical association in the United States,"[31] with the symbolism of the Carpenters' Hall backdrop undeniable: American pharmacy would have a constitution, following in the footsteps of the founding fathers and their constitutional framework. The PCP constitution included a strict code of ethics that would expel anyone from the college who "adulterated" medications or knowingly sold "articles of that character," and provided for a "committee of inspection" to verify the purity, safety and effectiveness of medicines, and a "committee of equity" to arbitrate disputes between member pharmacists.[28] The college, which was founded as an association to advance the discipline of pharmacy not just a university, quickly became a game-changer: in 1824 they published "carefully determined formulas" for the fabrication of (formerly) "secret-formula" patent medicines previously imported from the UK, an essential step toward self-sufficient pharmaceutical manufacturing in the U.S.[28]

The Philadelphia College of Pharmacy also aided the rise of the American Pharmaceutical Association (APhA), which formed at a founding convention congregated in the Hall of the College, October 6 to 8, 1852.[32] Daniel B. Smith, who had long been the PCP's president—ultimately from 1829 to 1854—was elected the APhA's first president at the founding convention, and William Procter, Jr. the first secretary.[32][33]

The "Father of American Pharmacy"

William Procter, Jr., who graduated from, then taught at the Philadelphia College of Pharmacy for 20 years, went on to exert so much influence over the formative years of professional pharmacy that he's now widely considered the "Father of American Pharmacy."[29][30][34] Procter successfully argued for the establishment of a chair of Pharmacy for pharmacist-professors at the PCP in 1844,[29] then wrote "the first American pharmacy textbook," which came to be known as Mohr, Redwood, and Procter's Practical Pharmacy (1849). The book was not commercially successful, but became a model for subsequent "works of long-lived popularity: Edward Parrish's An Introduction to Practical Pharmacy (1855-1884), and Joseph P. Remington's Practice of Pharmacy (1888-1995 [19th ed.])".[29] Procter also led the American Journal of Pharmacy for 22 years, served 30 years on the U.S.P. Revision Committee, where he did much to improve the U.S. Pharmacopeia,[34] and following five years as the American Pharmaceutical Association's corresponding secretary,[29] he became the APhA's president, leading delegations of American pharmacists in conferences with their counterparts offshore. At the Second International Congress of Pharmacy in Paris, France, August 21 to 24, 1867, Procter argued forcefully against the "compulsory limitation of pharmacies" (capping their number in a given city or province) under consideration, telling the assembled delegates that, in the U.S., "there is not the slightest obstacle toward a multiplication of drug stores save that a lack of success" and that the American public is "a forceful agent of reform"[35] to keep unscrupulous operators in check. Procter's declaration was later seen as a defining statement of "the American Way of Pharmacy."[35]

Pharmacy schools and professional organizations spread

Other major cities on the Eastern Seaboard followed Philadelphia's lead, establishing university training programs, professional associations and colleges of pharmacy that acted as professional associations like the PCP. New York City was among the quickest to follow suit with the New York College of Pharmacy, established 1829.[36]

As this 1851 notice from the New York Daily Times exemplifies, pharmacy schools (here the New York College of Pharmacy) often were acting as professional associations, or at least promoted pharmacist education and the distinct profession of pharmacist with a guild-like zeal, with this article advertising training for "those who desire to qualify themselves thoroughly as Apothecaries" while calling out "inferior druggists" and cautioning that "community ought not to be indifferent" to the character and motives of druggists who "stand aloof from the College."[37] Note the use of the term "druggists" to denote medication providers who are not trained pharmacists, while the term "apothecary" is still used as positive synonym.

Pharmacy and the Industrial Revolution

With the rise of mechanization and mass production, new modes of medication-delivery, among them the tablet (1884),[38] the enteric-coated pill (1884)[39] and the gelatin capsule (first produced on a large scale in 1875 by Parke, Davis & Company, Detroit)[38] became practicable. By 1900, most pharmacies stocked the shelves, partially or predominantly, with medicines prefabricated en masse by the growing pharmaceutical industry instead of custom-produced by individual pharmacisti, and the traditional role of the scientifically trained pharmacist to produce medicines increasingly eroded. This shift worried many, raising concerns of quality control, professional irrelevance and more. William Procter lamented that, "If the pharmacist becomes a mere dispenser of medicines, 'he relapses into a simple shopkeeper.'”[40]

The Dr. Wilson Foskett Home and Drugstore, opened c. 1897 and now a registered National Historic Place in Idaho County, Idaho, shows how pharmaceutical businesses run by a doctor in conjunction with their medical practice, a ubiquitous feature of medicine in 1700s North America, persisted in more rural areas during the 19th century, sometimes even into the 20th century
At the "London Chemists" drugstore at Eighth Avenue and 23rd Street in Manhattan, many foods and medicines are advertised, including Ex-lax. Photo taken following the gangland killing of Mad Dog Coll, who was using the drugstore phone booth, February 8th, 1932.
"Soda jerks" dispensing Coca-Cola at Fleeman's Pharmacy, Atlanta, Georgia, circa 1948. This photo documents the first-ever installation of this model of "Boat Motor"-styled Coca-Cola dispenser.

Footnotes

  1. ↑ "A Brief History of Pharmacy". St. Louis College of Pharmacy. Retrieved 16 February 2014.
  2. 1 2 "History of Pharmacy". Royal Pharmaceutical Society. Retrieved 16 February 2014.
  3. 1 2 3 4 5 6 7 Cowen 1990, p. 110
  4. 1 2 Kelly 2006, p. 4
  5. ↑ Swann 2009, p. 126
  6. ↑ "Marvin Samson Center for the History of Pharmacy | University of the Sciences". University of the Sciences. Retrieved 5 March 2014.
  7. ↑ Kremers and Sonnedecker 1986, p. 146
  8. ↑ "Mission & History - U.S. Pharmacopeial Convention". Retrieved January 20, 2014.
  9. ↑ Kremers and Sonnedecker 1986, p. 147
  10. ↑ Kremers and Sonnedecker 1986, pp. 147–148
  11. 1 2 3 Kelly 2006, p. 5
  12. 1 2 Kremers and Sonnedecker 1986, p. 151
  13. 1 2 Kremers and Sonnedecker 1986, p. 149
  14. 1 2 Welie, Jos V. M. (2003). "Ignatius of Loyola on Medical Education. Or: Should Today's Jesuits Continue to Run Health Sciences Schools?". Early Science and Medicine. Brill. 8 (1): 38–39. JSTOR 4130497.
  15. 1 2 3 4 Hunsberger 1923, p. 179
  16. 1 2 Wilson, Renate; Savacool, Woodrow (2001). "The theory and practice of pharmacy in Pennsylvania: Observations on two colonial country doctors". Pennsylvania History. 68 (1): 35. JSTOR 27774311.
  17. ↑ Wilson and Savacool 2001, p. 40
  18. 1 2 WSU History of Pharmacy & Scene 22
  19. ↑ Kremers and Sonnedecker 1986, p. 393
  20. ↑ "Historic Buildings in the Fredericksburg Area". Simply Fredericksburg. Retrieved 4 February 2014.
  21. 1 2 WSU History of Pharmacy & Scene 19
  22. 1 2 Hamilton, Bernice (1951). "The Medical Professions in the Eighteenth Century". The Economic History Review, New Series. Blackwell Publishing, Economic History Society. 4 (2): 141. JSTOR 2599120.
  23. ↑ Hamilton 1951, p. 160
  24. ↑ Cowen 1990, p. 91
  25. ↑ Cowen 1990, p. 100
  26. 1 2 Cowen 1990, p. 101
  27. ↑ Cowen 1990, p. 102
  28. 1 2 3 4 5 6 Kremers and Sonnedecker 1986, p. 192
  29. 1 2 3 4 5 Higby, Gregory J. "Procter, William, Jr.". American National Biography Online. Oxford Index. Retrieved 17 February 2014.
  30. 1 2 Kelly 2006, p. 6
  31. ↑ WSU History of Pharmacy & Scene 25
  32. 1 2 WSU History of Pharmacy & Scene 27
  33. ↑ Western Druggist 1899, p. 222
  34. 1 2 WSU History of Pharmacy & Scene 29
  35. 1 2 WSU History of Pharmacy & Scene 28
  36. ↑ The New York Observer Year Book. Sidney E. Morse, Jr. & Company. 1873. p. 171.
  37. ↑ "College of Pharmacy". New York Daily Times. New York, NY. 5 November 1851. p. 2. Archived from the original on February 23, 2014. Retrieved 23 February 2014.
  38. 1 2 Cowen 1990, p. 165
  39. ↑ Cowen 1990, p. 166
  40. ↑ Swann 2009, p. 133

See also

References

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