A DISCOURSE, WHEREIN The Interest of the PATIENT in Reference to PHYSICK and PHYSICIANS is soberly debated.
Many ABUSES of the APOTHECARIES in the Preparing their MEDICINES are detected, and Their Unfitness for Practice Discovered.
Together with The Reasons and Advantages of Physicians preparing their own Medicines.
〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉.
Max. Tyr. Dissert. X.
LONDON, Printed for C. R. MDCLXIX.
IMPRIMATUR,
Sam. Parker, R. Domino ac Domino Gilberto Archi-Episcopo Cantuariensi à Sacris Domesticis.
Ex Edib. Lambeth, Novem. 2. 1668.
IT being usual for Authors in Prefaces to render an account of the occasion which gave Birth to their writings, and to acquaint the Reader with the design or scope of their Discourses, I thought it convenient to continue a custom approved by many Illustrious examples.
Let me therefore give thee to understand, that it is not desire of applause hath engaged me in this Controversie. The care I have taken to conceal my Name will, I suppose, free me from such suspicion; but besides, let me assure thee I am too far from promising my self any addition to my Repute from this scrible, That I do rather apprehend it will lessen my Esteem with many of those excellent Persons, who are now pleased to Honour me with their Friendship: and do expect from me Discourses very different from those I here present thee. Which considerations surely will gain me credit, when I affirm That no Motive besides that of publick
advantage could ever have prevailed upon me, to exchange my darling Studies of Experimental Philosophy, and Physick (most pleasing and profitable imployments) for barren Controversie, which I ever declined. And among all, if I had consulted my own quiet or Interest; I should have avoyded this wherein I have now engaged; which may occasion me much trouble, but cannot possibly bring me any advantage, besides that satisfaction which is alwayes the result of Actions well intended. Which pleasure I must confess will be much heightned, if this endeavour of mine meets with good entertainment and work the desired Effect; which that it may have, I
will particularly address my self to all the Persons concern'd with me in this debate: Who are the People or Patients, and Physicians.
This Discourse is chiefly intended for the First, it being they▪ who are most highly injured by the unwarrantable practices of those we have therein accused; for although many understanding Persons among the People are sufficiently sensible of the abuses we have manifested; and that it is of absolute necessity some reformation be made: yet all are not thus perswaded, for we may daily observe, that many who are less discerning, being deceived by an imaginary good, covet their own ruine; and unless they be given to
understand which is the evil and which the good, by persons in whom they have reason to confide, they must necessarily run much hazard. I have here endeavoured to undeceive them, which I should dispair of, did I only foresee inconveniences a far off (the Vulgar being led by sense, and not by probable conjectures) but since they do now actually labour under many, and those obvious inconveniences, how short soever their sight be, the sense of feeling being no less acute in them, than in others I perswade my self they will readily give their assent to those Truths I have here discovered. Now there are many things whereof most Apothecaries are highly guilty, as carelesness,
Ʋnskilfulness, Vnfaithfulness on the one hand, and Intrusion into the Physicians Imployment (I mean the Practice of Physick) on the other: on all which accounts as I have fully demonstrated, they are exceedingly injurious to the Publick. In order to the prevention of such unpardonable abuses of the People I have made this Proposal, That Physicians prepare and dispence their own Medicines; and at large shewed That the advantages of such a Constitution will be many and great. For it will much abate the charge and expence of Physick, and the Medicines themselves will be more safe and effectual than now they are, interest obliging Physicians
to have their Physick as good as they can contrive or prepare; and certainly such a State of Physick of all other is most desirable, wherein no man having the Interest can have the Power, nor any having the Power can have the Interest to prepare Medicines unfaithfully: wherein bad men shall be made good, and those that are good never be tempted to become dishonest. And in that Constitution of Pharmacy for which we contend, suppose men be never so bad; yet nevertheless their wickedness cannot have any ill influence on Physick, as is manifested at large in this following Discourse: so that
if the sick have regard, either to profit or safety, they will address themselves to those Persons who supply them with the best Remedies, and ••at cheapest Rates.
And as for Physicians, they must necessarily put their affaires into some such Method, as this we have commended; If they have any concern for their Patients, or intend to improve Pharmacy it self. For as it hath been well observed, if we depend only upon that we read in Books, we shall never promote this Art beyond its present limits; and if Physicians in former times had not been knowing in Simples, examined their Vertues, and Tempers, enquired into their Effects, and mixed
them with their own hands, there had been no such Science as Physick. Now according to the Antient Axiom, Ex quibus Constamus, ex iisdem Nutrimur, Those things which gave a being to this Noble faculty must help to make it compleat; towards which as nothing can contribute more than the improvement of Pharmacy: so neither can any thing promote that, more than Physicians taking it into their Management. But besides all this, it is fit that they who exercise themselves in the Practice of Physick, be satisfied their Medicines are good; whereby their Mind will be free, and without any clog: which would add more difficulties and
dangers to a thing by it self hard and dangerous.
These and other Considerations mentioned and insisted on in the following Discourse will I assure my self, perswade all Physicians who have respect to the good and benefit of their Patients, Honour of their mrofession, or own Reputation, to put Pharmacy into other hands, and into better Methods, than those wherein at present it is; Whereby they who now dishonour it (I mean the Apothecaries) will either be reduced to a sense and performance of their Duty, or sufficiently punished. For Notwithstanding that they do now Ʋnanimously resolve with associated endeavours to Oppose all Reformation;
yet I am perswaded that if Physicians take some such courses as those I have mentioned, the event will be the same with that of Mutinies. Where if the Commander be resolute he makes some of the Mutineers exemplary, and threatens others; of fierce, that they were in general, each one out of his particular Fear becomes obedient: So how insolent soever the Apothecaries now are when they see their Punishment neer and certain, not trusting to one another, they will hasten all to Obedience; especially if good encouragement be given to those who return to their Duty, and become Reformadoes.
And now (to hasten to a Conclusion)
if any fancy, we have too rudely attaqued the Apothecaries, let them consider (and then certainly they will excuse us) that what we have done is only in our own defence; for we had never interrupted their quiet, could they have contained themselves within due limits and not invaded our Profession. So that if the Case be stated rightly, it will appear most evident, that we are on the Defensive part, They the Aggressors; and that we cannot justly be blamed, if in our own Defence we offend them: or if being forced, we take violent Courses, whose End yet is not (as may be pretended) Destruction and confusion, but Order and redress.
Nothing now remains but that I Apologize for the defects of the ensuing Discourse. It may be objected, that the Method is not exact, the expression rude, the Style unpolished and abrupt, the parts not closly cemented by handsom and sutable Transitions. All which I readily acknowledge: But withall Desire the Readers to consider that this Book was begun and finished within the space of six or eight dayes at the most; and even then I was not free from diversions of many kinds: so that being penned in so short a time, the subject it self unpleasant, and the writer various•••• distracted, it is scarcely possible 〈◊〉〈◊〉 should be compleat in Method or
Expression. Besides, this Discourse was not calculated for Scholars, but for the Vulgar to whose capacity it is adapted; for if I had intended to instruct the former, I would have taken more time and pains, digested the matter better, disposed it more advantageonsly, and endeavoured to cloath it in more handsome expressions.
I must not here forget to acknowledge, that I have borrowed several passages from the judicious Author of a late excellent Discourse concerning the State of Physick, and the regulation of its Practice. I suppose it will be easily imagined that I could have spoken the same things in other words; but
my respect for that Worthy Person disposes me to believe they will sound better and be more effectual in his own language; although I must crave his pardon for transposing some, and accommodating others to a proposal, he did not then think fit to mention.
For Faults in Printing &c. the Printer must be responsible; and particularly for that formall beginning of the 177. Page, which was never so intended by the Author.
This is all with which I thought fit to acquaint thee, I shall therefore now end with this request. That thou determine nothing in the behalf, or to the prejudice of this
performance, till thou hast impartially examined all that is contained therein; and then if it appear that I have spoken truth, I expect it should be owned and promoted by thee: if I be in any thing mistaken I am content to hear of it, and ready to retract whatsoever is not consonant to Truth and Reason.
IN all Ages, and among all Nations, Health hath obtained the repute of being the greatest among Earthly felicities, in the absence whereof we cannot relish any of those numerous enjoyments which the bountifull Creator hath plentifully bestowed on us; so that the most sublime Antient Philosophers, who
excluded all other External good from being necessary to the well-being of Man, placing happiness onely in those things whereof we cannot be deprived: yet out of them they excepted Health, knowing there was so near a Connexion between the Soul and Body, that this could not be disordered in its Functions, but that would be disturbed in its Operations.
Hence it was, that even among the Wisest, that Science or Art, whereby those Defects we call Diseases were repaired, was always accounted Divine; and the Ministers or Dispensers of this Skill were looked on as the hands of the Gods: and some of them held the first places among their Deified Mortals.
It is well known how great a name Hippocrates obtained, not onely in Greece (which he delivered from a depopulating Plague) but in remote parts; so that the greatest Monarch in the East, and his Vice-Roys, were
suitors to him to free their Country from that devouring Disease, which threatned to exhaust those populous Regions of their Inhabitants: unless the same Person which freed Greece, interposed, whom they esteemed Divine, and descended from the Gods, because so Successfull in such great undertakings.
Neither did the Reputation of Physick die with that excellent Person, but was afterwards in such high account, that the greatest Kings were its chief Professors, and Cherishers; and thought to render themselves more famous (as indeed they did) by finding out the Virtues of some single Plant, or by the contriving of some noble Composition, and leaving their Names entailed on them: than by their acquists of Countries, or enlargement of Empire.
And the Profession of Physick, although neglected by the rude antient Romans; yet with the increase of Civility,
Arts and Sciences, this noble Faculty made a proportionable progress in the esteem of that then judicious people: and it hath ever since been most honoured, and encouraged in the most civilized thriving Nations and Times; Neither was it ever exploded, but where Barbarism or Ignorance prevailed.
So that, when I consider, what reverence hath been paid to this Profession, and the Professors thereof, in all times whereof we have any particular account, I am amazed to find that in this latter Age, wherein it hath received a greater improvement than in two Thousand years before, and daily makes a considerable and sensible progress; that nevertheless it should be by many neglected, by others slighted, and by some even contemned. After a diligent enquiry into the causes of so strange and suddain an alteration, I could not in my opinion so justly ascribe it to Defects in the Profession,
as to those of its Professors. Not that I deny Physick to have its Desiderata, for I believe it is capable of receiving great improvements; But howsoever, all this notwithstanding, it might to this Day have been maintain'd at least in the same degree of honour and esteem which all Ages have justly had for it, if the imprudence of the Real, ignorance and baseness of the pretended, Artists had not interposed. Under the former I comprise the Physicians, under the latter their Dependants the Apothecaries, who I am confident have caused many of the inconveniences, under which the practice of Physick now labours; and will occasion others, if not prevented, whereof Physicians are (not without reason) apprehensive.
Perhaps I shall hardly find credit among superficial observers, when I affirm, that the greatest enemies Physick or Physicians have at present, are the Apothecaries, who should be, and
are thought to be their fast friends; but this Assertion will easily gain belief with more discerning persons, who know that a false Friend is more dangerous than an open Enemy: of which the Italians are sufficiently fensible when they desire to be delivered from their friends, they being always upon their Guard against their professed Adversaries. And indeed it is much more easie for any one, who is acquainted with the thoughts, designs and affairs of him, to whom he pretends friendship, to injure him in his Person, Estate, or blemish his Reputation, than for another who is not privy to his intentions, nor intrusted with the management of his affairs. Hence it is, that Physicians cannot sustain much dammage from common Quacksalvers, or Mountebanks; and that they cannot promise themselves the same security from Apothecaries, will appear so evident in the ensuing discourse, that every unprejudiced Reader
will readily conclude Physicians were either very facile, credulous, or else extremely improvident, when they committed so great a trust to the Apothecaries, in whom they reposed such confidence, that the short-sighted Vulgar were sensible of their danger before they themselves could imagine that, those whom they had so highly obliged, would prove unfaithfull to Physick and Physicians: But now they are forced, though late, to acknowledge, that the great Indulgence they shewed to them, and their notorious abuse of privileges, wherewith had Physicians been circumspect, or suspitious, they had never been acquainted, have occasioned those inconveniences, to which they now endeavour to bring a timely remedy. It is not without a great deal of regret, that they are necessitated to proclaim the Crimes of those whom they have too much, too long countenanced, too often vindicated; and they still retain to much kindness
for them, that if a private opposition could have reclaimed them, the Physicians would never have used so severe and violent a remedy, as is the exposing their unworthy Principles and Practices to the view of the World: but since they are both so mischievous, that to conceal, would be to permit, and allow them; and thereby to betray their Patients, themselves, their Profession and Successors, they are therefore forced to declare how much themselves, their Profession, and the Sick are injured by those vile arts of the Apothecaries, which we shall here display.
It is well known they have great pretences (how fair we shall soon examine) to the practice of Physick; and are now arrived at that degree of confidence (not to say worse) that they are not ashamed to publish this before all men, whom by most unworthy, and illegitimate Artifices, they endeavour to alienate from the Physicians,
and assure to themselves. And besides, they are not more fraudulent in their Practice, than unfaithfull in their preparations, few Physicians having the satisfaction they desire, and it is fit they should receive, that the Medicines they prescribe are prepared after their direction; nothing being more frequent than for the Apothecary to employ bad Druggs, add, substract, or substitute at pleasure one Ingredient instead of another. Now how consistent these Actions are with the ends of their Institution, we desire not to be judges our selves, but appeal to all that have the exercise of Reason; and if after such unpardonable abuses, the Physicians do not desert them, and make better provision for themselves, and their Patients, they would be unworthy of the trust reposed in them, betray their Profession to the scorn of the World, and themselves soon become contemptible.
But yet although the Physicians
might with justice wholly reject the Apothecaries, and are highly censured by many for their forbearance; and though the Apothecaries themselves have little regarded their frequent Admonitions: yet such is the tenderness of those generous persons, that they are determined once more to invite them to entertain a sense of their Duty, and to return to that state from which they are degenerated. Its true we have little hopes of their Reformation, an almost infallible Symptom of incorrigibleness, seeing their scandalous reflections on Physicians in most Companies, their entring into competition with them, nay, sometimes preferring themselves before them; their Associations, not to endeavour the improving their Trade otherwise than by the decay of Physicians, their resolution to stand by each other, and keep the Ground they have got by Treachery, resolving with united Counsels and Purses to withstand any
Reformation the Physicians shall attempt among them. These are their ordinary discourses, and they do not scruple to give them forth, even in the presence of sober Physicians, who cannot certainly be blamed if they do ill resent such unhandsome and so ingratefull a Carriage. But Charity obliges them to endeavour their amendment rather than their inevitable ruin, which they can when they please, effect by dispensing of their own Physick; the conveniences of which will be found so great by the people (as we shall manifest) that they would soon utterly desert the Apothecaries and leave them in solitude to bewail their wretched improvidence; who when they might have had a comfortable and honest subsistence neglected it, that they might obtain a greater: though thereby many lives were hazarded, most of their Benefactors disobliged; and how could they expect that building should be lasting, whose foundation was laid in
blood, and ingratitude. Yet how notorious soever matters of Fact are, least they should pretend innocence, and thence promise themselves impunity, we shall first declare their enormous abuses of Physicians and their Patients. Secondly, lay down certain Propositions, wherewith if they comply, we will oblige our selves yet to retain them. Thirdly, if they refuse to submit to such reasonable terms, we shall acquaint the World with some Methods whereby the Practice of Physick can be more successfully managed by Physicians without the Apothecaries than it can possibly be with them, as they are now constituted.
The grounds of our Complaint against the Apothecaries are these.
That no Physicians can be certain, Medicines are made up according to their prescription. So that after they have taken much pains to inform themselves of the symptoms of the disease, to understand the causes of the
distempers, and have duely deliberated what are likely to prove the most proper remedies; which being judiciously prescribed, they promise themselves that success which usually attends solid Counsel: but after all this trouble, either from the design, Ignorance, Carelessness, or unfaithfulness of the Apothecaries, they are often frustrated, not so much to their own prejudice (which yet is not inconsiderable) as to the Patients, which shall be here demonstrated.
1. Physicians are subject to suffer from the malice or Design of Apothecaries. Now although Charity obliges us to think well of all men, till their actions discover them to be bad; yet such hath been the demeanour of the Apothecaries towards the Physicians, that they have reason to stand upon their guard, and hazard as little with them as they can. For some Apothecaries having been, as they pretend, highly disobliged by Physicians (I
suppose, because for their own advantage, they would not permit them to injure their Patients by bad Physick) what assurance can the Physician have, that they do not meditate revenge; especially since, if they have an opportunity, they can execute it, and be so far from being suspected themselves, that they may make a great advantage of their own miscarriages. (which indeed they often do) As suppose a Physician with whom the Apothecary is disgusted, prescribe a Purge, the Apothecary may make it with Worm-eaten superannuated Druggs, wherewith most of them are well stored; which very probably will not work according to the Physicians promise, and the Patients expectation: the Apothecary may be ready at hand to tell him that this was no ways accommodated to his temper; nay, perhaps he before-hand presages to him, that it will not work sufficiently, (as he may without Conjuring or Astrology)
whereby he obtains the reputation of a person more judicious than the Physician, and makes way for this proposition, That he will prepare a purge for him which shall work more effectually than the former. This perhaps is the same the Physician before prescribed, but assuredly made up of better Druggs; and so the Apothecary at once executes his malice, and effects his design which is to exclude the Physician, and introduce himself. This is, indeed, a supposition, but I fear such as is often practiced; and there are many Physicians who have found it true to their cost: yet these are some of the more Innocent Cheats. I wish we be not often exposed to others of worse consequence, than a slight disgrace of the Physician, and abuse of the Patient. Charity forbids me to suspect worse than I know, but what will not a dishonest mind intent on revenge or gain, scruple? howsoever, I think it behoves Physicians to
take such care, that they and their Patients lye not exposed to the designs of wicked Apothecaries; and that there either are, or may be some such, they have reason at least to fear, and Consequently provide, that they be not injured by them.
2. Another thing Physitians find fault with, in many Apothecaries, is their ignorance in the Latin Tongue, which is of very ill Consequence; for Physicians, for good reasons, not here to be mentioned, have been long accustomed to write those prescripts, they send to the Apothecaries, in Latin: which not being rightly understood, hath often occasioned, not only innocent, but also fatal mistakes. And that a great part of the Apothecaries are very illiterate, is so evident that they themselves dare not deny it. Nay, I have heard them often divert themselves with the mistakes committed by the younger Apothecaries at their Hall; where it is the Custom before they
make an Apprentice (that hath served seven, or eight or nine years) free of their Company, to put him to construe a Doctor's bill, or something in the Dispensatory; which is the only mark of respect they have left for Physicians▪ and if the Probationer escapes this dangerous tryal, he is admitted with great applause. But I do not hear of any, whom they exclude; and they have been highly offended at Physicians, excepting against them: yet many by their own relations, are guilty of gross mistakes; which though they may be pleasant to talk of, yet are sad and serious ones when they come to cost people their lives, or so much as hazard them, which they frequently do. This assertion I could confirm by an innumerable company of instances▪ and there is scarce any Physician, who hath not been troubled with several of them in his Practice. Now if the Masters themselves are subject to these miscarriages, what can we expect from the Servants, who we may
presume are in every respect, their Inferiours. These mistakes are either of one Material for another, or in the Quantities of the Materials; especially, when Physicians write them at length in Latin: for many of the Apothecaries understand the numbers only in figures, so that some of them know little difference between Sexdecem Sexaginta and Sexcenta; And of duodeviginti they will make at least twice twenty. And so for measures, sometimes mistakes proceed from their ignorance in the names of the Materia Medica. Among many other instances of this kind, That most unfortunate one recorded by an eminent Physician, is notorious, Of an Apothecary, who instead of a dose of Mercurius Sublimatus Dulcis, exhibited so much common Sublimate, a mortal poyson; which was scarce ever given inwardly, instead of an innocent Medicine, approved by all Physicians. Sometimes they mistake one operation for another, of
which I could give a large account; but the mentioning of them will be sufficient, since every Physician is able to make a fair Catalogue of them: and there are not many Apothecaries whose Consciences will not at the mention of this, reproach them with the remembrance of many such mistakes, the meanest and most innocent, of which cannot but be a great injury to the Physician, and Patient. The first expects his Medicines should have such Operations as he might promise himself from them, if rightly prepared; the other waits for relief, which in these cases is usually the effect of Counsel, rarely of Chance: or if the miscarriage prove fortunate, which hath sometimes happened, the Patient is no more beholding to the Apothecary, than he was to the Enemy that cured him of an inward Ulcer (under which he had long languished) by a thrust with his Sword. For as that salutary wound would have proved mortal, if it had been in another
place; so these lucky mistakes might be dangerous, if the Apothecary had lighted on another Material: which that he did not employ, cannot be ascribed to his knowledge, Care or Sagacity, whatsoever he may afterward pretend.
3. Another Complaint against the Apothecaries, is, that they are not well acquainted with the Materia Medica; the knowledge whereof is an Essential part of their Profession: but take the words of Druggists who themselves are sometimes mistaken, and differ about the names of several druggs; and which is worse, they trust to Herb-women, who obtrude almost any thing upon the greatest part of them. And that these women do often mistake one thing for another, sometimes ignorantly, otherwhile designedly, is well known to many Physicians▪ who have seen them sell the Apothecaries, herbs, roots, and seeds, under oher names, than those they do really bear.
I do not affirm this of them all, for I am not Ignorant that some Apothecaries are good Herbarists, whose diligence I cannot sufficiently commend; and our industrious Country-men, Parkinson and Johnson, to whom we are beholding for their elaborate Herbals, were Apothecaries: although they have not wrote, especially the former, with that judgment which is requisite, and found in the writings of many Physicians, from whom indeed they derive the greatest part of their knowledge, as they themselves acknowledge. But the generality of Apothecaries are of another humour, they will eat the kernel, but give not themselves the trouble of cracking the shell; take no pains to inform themselves in those things which are absolutely necessary to the faithful discharge of their trust, many among them cannot distinguish between Ingredients, noxious and salutary: so, That we have not Patients daily poysened, is rather
from the care of Herb-women, than Apothecaries. Now Physicians depending almost wholly on such Vegetables as our own Country affords for the cure of Diseases; which if rightly apply'd, are more proper, cheap, fuller of vertue and efficacy, than those that come from remote parts (excepting a few whose vertues are kept pretty entire) and some of them specificall for diseases, which others substituted in their place, may exasperate, though even they also upon another occasion may prove effectual: so that hence proceed many inconveniences. The Patient is not relieved, who perhaps might have been perfectly restored to former health; the Physician who would thereby have acquired repute, is neglected, if not disgraced: and which is worst of all, he distrusts; nay, perhaps wholly rejects remedies, commended in the books of experienced Physicians, or communicated to him by judicious faithful friends,
through the fault of the Apothecary, which might have proved conducive to promote the recovery of many sick people, who after languish all their lives for want of some proper generous Medicine.
4. Most of the Apothecaries trust to several for Compositions, in whom (how charitable soever the Apothecaries may be) Physicians have little reason to confide. There is it seems a great trade driven by many in this City, of selling Medicines by whole-Sale. One makes Treacle, Mithridate or Diascordium, in great quantities; Unguent's Plaisters, and what not: now many of the Apothecaries can buy such Compositions cheaper of these persons, than they can prepare them for, after the prescription of the Colledge in their Dispensatory. This is a good thrifty course, but suppose a dissatisfied Physician (of which not without Cause, there is a great number) suspect, That these Compositions are not
made of sound druggs, and other choice Ingredients; especially since they afford them cheaper than other honest men can make them. And besides, these men for the most part are not Apothecaries, or bred in that trade; but Operators, who casually have taken up this way of living: so that their skill as well as honesty is liable to be questioned. To these Objections the Apothecaries readily answer, That buying their Ingredients at the best hand, and in Quantities, they have them cheaper than those that deal for smaller parcels; and besides they have some peculiar knack in Composition, which saves them much trouble and expense. The first signifies somewhat, yet is not a sufficient answer; but of what kind this latter should be, an honest Apothecary, that surmises no worse of others than he is conscious of in himself, cannot easily imagine. To expend sixpence less in fire in the making two hundred or three hundred pound weight of Plaister,
or Unguent, is not very considerable; so neither is Expediteness or dispatch, which at most cannot save much more in the same quantity: so that what this knack should be, unless leaving cut some of the most costly Ingredients, substituting others in their room, or using only such as are perished and may be procured at easiy rates, I cannot conceive. And that thus it is, I am rather induced to believe, from what I my self have often observed in the Shops of the Apothecaries among other abuses, too many to mention. They ordinarily vend to those that pay a price for the best than can be made, Emplastrum Oxycroceum sine croco; which in down right English, is the Plaister of Saffron, without a grain of that noble Ingredient, from which it derives its name and most of its Vertues: which for the most part they borrow of their corresponding Plaster-mongers. In short, most of the Plaisters and Unguents of the Shop, compared with those that
are made by skilful and honest hands, are so unlike, that they may be easily distinguished by the naked Eye, or some other of the Senses which argues a sufficient difference: but there is a much greater and more sensible in their effects, as hath been often experimented. And I have sometimes heard some curious Chyrurgions grievously complaining of the Shop-trash (they could bestow no better title on it) and professed, that if they used the Unguents and Plaisters of the Apothecaries, their employment would keep pace with their cures, and be as little, as they few; whereas preparing those Medicines they use themselves, their success is conspicuous, and their Patients numerous. If Physicians did in this imitate the Chyrurgions, they would not have occasion to complain so often, as now they do; and that, I fear, not without cause.
I cannot dismiss this Subject, before I take notice of an Observation
I have often made and admired at, which is, that the Apothecaries who are very tender of their Priviledges (to give them their due) and who pretend to have a Charter of large extent, should yet nevertheless permit these Unguent and Plaister-sellers to follow that way of traffique; whom yet they are so far from prosecuting and dissallowing, that on the contrary they seem to approve of them by keeping a Correspondence with them, and buying their Commodities. Now what should dispose them to this tenderness and forbearance, of which they are not often guilty, I cannot imagine, unless it be interest? These persons furnishing them with those Compositions at such easy rates, that I have my self over-heard some of them question, Whether they could possibly make them faithfully, since the very Ingredients, would cost as much as the Plaisters, &c. were sold for? Which I confess is to me, a deep Mystery: whether of Iniquity, let others judge.
There is another Custom among Apothecaries, whereof all Physicians do not approve; that is, there are some who make Mithridate, others Treacle, a third Diascordium; perhaps one, all these: another, that noble Preparation, Pulvis è Chelis Cancrorum, commonly known by the name of Gascoign's powder; others Alchermes, Lenitive Electuary, Confectio Hamech; some, Syrups; other, Cordial waters; and they drive a trade of Exchanging with each other, it being to be supposed, that making great Quantities, they can sell cheap: which dealings render their Preparations suspected to the Physitian, who often finds these Medicines to be as bad as they are cheap; and therefore most decline the use of Preparations, if they have not first an assurance that they are made by the Apothecaries themselves, whose word we only have for it. But let us suppose they do really make all the Physick they dispense, yet still the Sceptical Physician will not be satisfied,
having still some scruples remaining▪ which, I fear, will not be easily removed.
5. It is therefore objected by many Physicians, who are somewhat more concerned for the good of their Patients, than the Apothecaries, as yet appear to be▪ That these in the Compounding of Physick employ bad druggs, and use superannuated Medicines which are fit for the dunghill, without any previous Preparation; That if they want any Simple or Composition that is prescribed, they substitute in its place some other, which (in their profound Judgments) they apprehend, approaches nearest thereto. Besides some of them have been found to add to some prescriptions, and substract from others; One or the other, according to the suggestions of a petulant fancy. These are grievous charges, and deserve to pass a severe examen, That if true, some remedy may be found against such unpardonable abuses; or if false, that the innocent
may be acquitted, and the scandal removed. Its commonly said, Vox populi, Vox Dei: So that the Apothecaries being accused by both Physitians and their Patients, it is to be feared they are Criminal. But they will not permit us the Testimonies of Physicians, which they endeavour to render invalid; for being Conscious that they have grosly abused them, they are perswaded these will unanimously condemn them: therefore they are excepted against, as interested persons, and their plea must not be allowed of. If we appeal to events, and tell them of persons that have been, either manifestly injured by bad Physick; when that which was prescribed, if it had been duely prepared, would in all probability have given them great relief: or if we mention others, on whom strong purging, vomiting, or sweating Physick, or such, as if prepared after the Physicians prescript, would have proved such, hath had little or no sensible Operation,
when the same faithfully prepared by other hands, or by the same, the Physician supervising, quickly displayed its nature according to his intention. All these things they ascribe to chance, and pretend that when Physick hath not the desired or promised effect, the Physician to excuse his own defects, lays the blame on Apothecaries, or bad druggs. Since therefore we are excluded from these ways of proof (which yet no indifferent or unconcerned person will deny us) nothing remains, but that we accuse them out of their own mouths. I remember a great Philosopher tells us, that if we would know what actions are vitious, we should enquire of the Vulgar, whose Consciences force them generally to condemn what is bad in others, if they have no concern in the Action; for though they may approve of it in themselves, when they apprehend, it's for their own advantage: yet they will endeavour so to disguise and excuse it, that it may not appear
in its native colour, but pass current under the notion of good, honest, or convenient. This is verified in the Apothecaries. There is no particular person that will acknowledge himself to be in the least faulty, they all faithfully prepare their Medicines; but if we will give credit to what they say of each other, we shall hear the contrary: for if the people urge against them, as well they may, the dearness of their Medicines (which frequently happens) I have often heard them reply, that they were faithfully prepared; and therefore deserved a greater price than those which others vended (its true) cheaper, because they were made with bad druggs, That surely none, who had any respect for their health, would grudge to give a small matter more, for good remedies than the worst would cost them: thus they generally exclaim on each other. And perhaps there are some who apprehend that few of them are
wronged by these mutual Accusations.
But howsoever, either the Apothecaries are an envious, malicious sort of people, to traduce each other in affairs of so great consequence as those wherein the lives or welfare of many thousand men are at stake; or these taccusations are true: either of which being allowed, must necessarily render the Apothecaries unworthy of any great trust▪ at least till they reform their words▪ or actions. But truly I am inclined in this particular to believe what the Apothecaries affirme of each other, it being seconded by common Fame, and the observation of Physicians whose duty and interest obliges them to discover the intrigues of a Profession which hath so immediate a dependence on them▪ as indeed they on it.
It were an endless task to enumerate all the fraudulent tricks, which are used by those▪ Apothecaries who are
not Conscientious; for some I perswade my self there are, who keep strictly to the end of their Institution, the faithful and careful Preparation of Medicines: but I fear these are so few, that they are scarce observed in a croud of men so bad, that to endeavour to render them worse then they are, were to throw Ink in the Face of an Aethiopian. And indeed I cannot say worse of them then barely to relate their practices. I shall not take much notice of their buying bad Druggs, which they apprehend to be good, (and that they are often over-reached seems not impossible to those who have been much conversant with many of them) These being mistakes of Ignorance, and therefore pardonable, so that I do not more blame then pitty them; and if many did not suffer for their unskilfulness I should entertain a pure compassion for them without an alloy of Anger or Animosity. But there remains other manner of miscarriages than
these, to be considered; and they are not innocent mistakes, but designed cheats, and such as not only the all-seeing God, but I hope man also will call them to an account for: such are some of these. A great Copper ••embick at one Distillation (O wonderful accurtation) supplies a whole Shop with simple waters; for it's but flinging into a great quantity of Water in the Stillatory a handful of twenty or thirty sorts of Herbs, as much of the Water being drawn off as is thought sufficient, a due proportion is put into each Glass with its title. Now 'tis well known that most simple distilled Waters have neither sensible smell, nor taste; and differ as to appearance no more from each other than the fixed salts of Plants, though we find both them and these have somewhat (at least a few of them) different effects: So that this cheat is not so easily detected, as an unskilful person would be apt to imagine. But to give our
Apothecary his due, I cannot say he vends any of those Waters, whereof he hath not put a handful into the Still, his Conscience is not so large as to permit him to impose so grosly on his Patients; Nay, perhaps the Vertue of each Herb keeps it self distinct in some portion of Water, without being confounded with its neighbour, as several Chymical Liquors, though never so much shaken, each retires to the station assigned by those various degrees of Gravity and Levity Nature or Art hath bestowed on them; so that the sagacious Apothecary may perhaps restore each Water to its proper Receptacle. But how possible soever this may seem, it doth not appear very probable; and till it can be demonstrated, we shall look upon this as a deceitful Practice, and such as no Physician will dispense with. The same thread runs through many of their other Preparations, as in making Pectoral Syrups, one made up with a handful
of each Ingredient serves for all. Some after that they have extracted the best of the tincture out of Saffron with spirit of Wine, to make the extract and spirit; then they pour more Spirit on the remaining Dreggs, which being strongly expressed, the vinous Spirit is a little tincted: and this is often substituted in the place of that noble Tincture on which Physicians sometimes depend too much, unless they could have it better prepared.
Another just cause of complaint the Physicians have against the Apothecaries, are their old Medicines; For suppose them as faithfully prepared as they can pretend, or we desire: yet length of time will make some changes in them, which are not often improvements. Thus Syrups grow acid, and Waters full of Mother; Electuaries, and Pills dry, and deprived of their most active parts; Powders themselves are not free from this fate, whose vertues in time we find marvelously
diminished. But let the Physicians inculcate this and much more to them, they may with as good success preach to stone-walls; for not a Dram of any Medicine will the Apothecaries part with but for sale: so that they many times sell their Preparations five or six years after they were made; and whether their Medicinal properties are not much impaired, if they have any left, we leave to others to determine. And indeed the Apothecary hath many things in his Shop which are not called for in many moneths, yet these must be vended with the rest. All which when they have lost their Vertues, should they be rejected, it would be much to the prejudice of the Apothecaries; and they have a fundamental Maxim, that no such thing should be allowed of: for 'tis much better that the Patient should suffer somewhat in his Body than the Apothecary in his Estate. And if he injured by the bad Physick he took, perhaps he will have
pitty on him, and the next Prescription shall be faithfully prepared; whereby he makes him abundant recompense for the hurt he received by that which was bad: and he himself makes an advantage of both. Although perhaps, if he had consulted the Patient, he would rather have chosen to keep his Head sound, than have it broken, that a proper Plaster might be applied for the Cure. This is so notorious a Truth that all the World, even their best Friends exclaim against them for it; and till they amend this among many other Peccadilloes, the Physicians desire to be excused that they scruple to employ them.
Another Property they have of substituting one Ingredient for another, which how pernicious a thing it is, unless the Apothecary were equal or superiour to the Doctor in judgment, is very apparent. This is a subject, on which every Physician can expatiate; but I omit it, not that 'tis less material
than the others, but because it is better known: so that here to be particular were as great a Soloecisme as to carry Coals to Castle; for I should acquaint people, especially those who have been conversant with the practice of Physick with nothing, which they were not sensible of long since. I shall therefore wave this discourse and proceed to another complaint against the Apothecaries, which is,
That Apothecaries and their Servants are so Careless, Slovingly, and Slight in preparing of Dispensatory, or prescribed Medicines, that neither Physicians or the Diseased have reason to repose that trust in them which they challenge as their due. As for slovenliness they may I confess plead the old Proverb; that, VVhat the Eye sees not, the Heart rues not. I confess of all the rest it may be best dispensed with, but should Patients but once behold how their Physick was prepared in some Shops, they would so
nauseate it, that perhaps they would undergo much, rather than take the least Dose so ordered. But lest I offend nice queasie Stomachs, I shall dismiss this Subject; and proceed to another, which is the carelesness of Apothecaries and their Apprentices: on which I can never reflect without Fear and Indignation; Indignation to think what numbers have been destroyed and injured by such proceedings; Fear, lest it should be my own misfortune to suffer in my Repute, and in my Patients (for whom every honest Physician is passionately concerned, abstractedly from his own interest) from the rashness or carelesness of some giddy Apprentice or indiscreet Master. That this is not a groundless apprehension many Families can witness; and you can converse with few persons, who are not able to give an account of some such miscarriages. Now although in these cases the Patient is chiefly injured, yet it reflects
also somewhat on the Physicians; if for nothing else, yet that they imploy persons who are so little concerned for that precious Merchandise, the Lives of Men, that they will not be at the expense of a litttle Care, Pains and Trouble to secure them. In vain is it for a Pilot to direct the course of a Ship skilfully, if persons shall make leakes in it under Water; the Wisdom and Care of the Governour will not bring them to their desired Haven: but even He with the Ship will suffer Shipwrack in his reputation, especially if what was transacted in darkness be not discovered; for then it will be supposed that through his unskilfulness it split upon some Rock, struck on some Sand which might have been avoided. Now if Physicians and their Patients will not make provision against such Dangers, they have no reason to complain when they suffer; since it is nothing but what they might easily have remedied.
Now the last complaint of Physicians against the Apothecaries on the account of their Medicines which I shall mention, is their being most of them strangers to Chymistry, which is no inconsiderable part of Pharmacy; whose Preparations at least many of them are of great efficacy and come frequently in use. It's true indeed Phycians were formerly very shy of these Remedies, used them with great caution, and that not without good Reasons; for although the Physicians were satisfied, that being faithfully prepared they were endowed with great Vertue: yet not being at leasure themselves to prepare them, and being earnestly admonished by Helmont and other eminent experienced Spagyrists not to trust to Venal Medicines made by common Operators, who for their private gain scruple not to adulterate, as indeed they ever did, and still do, most of their Medicines; Therefore those that consulted the good and welfare of
their Patients, did rather wholly decline practice with those Sophisticated Medicines than expose their Patients to a manifest hazard. But of late years Chymistry is again come into request, for Physicians curiosity prompting them to prepare some particular Remedies themselves, others were bestowed on them by Persons of Quality who prosecuted Chymistry; only that they might oblige the publick with useful discoveries, especially in Medicine, such as That Honourable Person Mr. Boyle: and some few honest industrious Apothecaries preparing others for them, finding these Medicines of unusual efficacy, they were so far from decrying them (which some falsly object) that they were of frequent use among such whose good fortune it was to meet with these advantages. Others making use of those Preparations they had from unfaithful Apothecaries or Mercenary Chymist, sand finding they had seldom good, frequently
ill effects, they cannot be blamed for desisting from the use of what they found attended with so bad consequences; which how injurious it hath been to the practice of Physick both in reference to the Physician and the Patient, will appear in the sequel of this discourse. Which that it may be more distinct, I shall proceed after this Method, First, Shew what Chymistry is; and that its Medicines are of great efficacy, and safe. Secondly, That very many Chymical Medicines ill prepared, are dangerous, and cannot be safely used. Thirdly, That the Apothecaries are not furnished with such Chymical Medicines as the Physicians can confide in. As to the First, we say that Chymistry is an Art which teaches us how to divide bodyes into several parts; and being seperated, to purifie and again compound them according to the pleasure of the Artist. Indeed according to the vulgar acceptation of the word it is an Art of making Gold and Silver out of
baser Mettals; and that even some who before had the repute of being wise, have entertained such favourable thoughts of it. In this respect I am apt enough to believe, having known many Learned Mens hopes and expectations swelled up to a high pitch by promising experiments or fine-spun speculations, for which they were beholding to the writings of some eminent Alchymists. But supposing this to be an extravagant Notion, and an abuse of Chymistry; yet the Art it self is not therefore to be exploded, It being acknowledged by all Ingenuous unprejudiced Persons that an excellent use may be made thereof, either as it discovers to us the Nature of most Bodies exposed to its Analysis: and in that by its means many Noble Productions may be made, which encrease our Knowledg of Nature and our power over her; so that at this day nothing is in more esteem with the greatest Philosophers then Chymistry. But I shall wave this vse of it, as not pertinent to
our present discourse; and proceed to another, which is the preparing of various Subjects in order to the rendring them Noble Medicines. For in many Bodies which are of great use in Physick, that Vertue which makes them so, consists in few Parts which by Chymical Art may be separated from the useless though greater Portion, and further refined or exalted; and then they do more freely, much sooner, and in less quantity display their salutary effects. Thus we see that a small quantity of a Vegetable Spirit made by Fermentation or of Chymical Essential Oyles, are a Compendium of a great quantity of the Vegetables that afforded them, retaining exactly the genuine Odours and Tasts of their Mother Plants; And a few drops of Spirit of Harts-horn are more effectual than some Ounces of the Horn any other way prepared. We could instance in a thousand other things which I omit designing brevity. There are also among
Minerals, many Subjects which are ennobled with excellent Medicinal Properties; but they are most of them Noxious, unprepared: and the useful part is lockt up or closely united to the bad from which it is not easily freed. Now here Chymistry assists us, for by it we are enabled to separate the Pure from the Impure, the Good from the Bad, that which is of use from the more copious part, which would either have none or ill effects. I will mention but two Minerals which are acknowledged by all, duly prepared, to afford noble Remedies. They are Mercury and Antimony. Mercury admits of various Preparations, and there is not one of these that are commonly known (as for instance those in our own Dispensatory) which faithfully prepared do not answer many intentions of a judicious Physician which could not be any other way satisfied, Such are Mercurius dulcis, Mineral Turbith, the red and other Precipitates; and that not only in Venereal
distempers, for which alone they were formerly in use; but also in many other Chronical diseases; which are sometimes cured by these, after they have baffled many other promising Methods, and Medicines. As for Antimony it is sufficiently known, that scarce any Vomits are prescribed, throughout not only England, but Europe that are not prepared out of this noble Mineral; which ordered after other Methods is an Excellent and safe Purge, working without gripes: and if we proceed after another way we may render Antimony Diaphoretick. As in that which is commonly so called, and in Mineral Bezoara Medicine highly commended by those who in the vogue of the People have went for great Galenists. I might instance in Vitriol, Lead, Tin, Iron, Silver, Many of whose preparations have obtained much Credit in the World: Such are Salt and Sugar of Steel, its astringent and aperitive Crocus, Diaphoreticum
Joviale, Sugar of Lead, Lunar Pills Spirit and Oyle of Vitriol, Ens the Veneris of Mr. Boyle. To these we may add many Preparations of Vegetables and Animals, as the Volatile Spirit, Salt, Oyle and Balsom of Amber, Flowers of Benzoin, the Cremor or Chrystalls of Tartar, its Spirit and Fixt Salts Refines of Jalap, and Scammony, Extracts of Hellebore, Rhubarb, the fixed Salts of Vegetables, Tincture of Saffron, and Castor, with many others, which when duly prepared are used very success fully; and therefore it is great pity every Physician cannot be supplied with such of these Preparations as he hath occasion to use: which he that consults the welfare of his Patients dares not do, unless he either prepares them himselfe, for which few have leasure and conveniences, or receive them from persons in whom he can perfectly confide. For Chymical Remedies though as Innocent or any that are made, if prepared by those who are careful, skilfull and
honest are of more then ordinary vertue and efficacy; Yet if by others of contrary dispositions, Nothing more pernicious: The Consideration whereof unfolds that Riddle which hath puzled so many. Whence it is that some sober and modest Physicians do so highly exalt Chymical Remedies; and at the same time others of candid Tempers as loudly decry them: the one pretending that they are usually attended with good effects: the other confidently pronouncing, that either they have had bad success with them, or that they have proved wholly ineffectual. The difference may be easily reconciled, the one either prepares himself, or supervises the making of his own Medicines; the other trust to Apothecaries, and common Chymists; whom I shall evince in this particular to be as great cheats as are now Extant in the World: and do deserve more severe punishment, than those that pick-pockets or rob on the High way; for by these abuses man
only deprived of a small part of his estate; by those sometimes of life, often of Health which is alwayes by their Medicines extreamly hazarded.
In the Third Place, I come therefore to manifest that we ought not to trust the Apothecaries for Chymical Remedies. There are indeed some few that are very skilful and curious in this kind, whose care and industry deserves encouragement; but these are not many, and are so obscured by the far greater number of those that Act otherwise, that they are scarcely visible. The remainder (if I may so call almost the whole company such, without being guilty of a Soloecism) are not instructed in the very Rudiments of Chymistry: many among them never saw a Chymical glass or furnace, are wholly unacquainted with the very names of the operations; and yet these persons are well provided with all sorts of Chymical Remedies which they buy of the Mercenary Chymists. Whom though otherwise
undisposed to Sophisticate their Remedies, (to which I think them naturally Marvellous prone) they tempt to adulterate by offering them such low prizes, for which indeed they cannot afford them, if Genuine and Right; and have an handsome subsistence out of the gain which certainly their Labour and industry deserves: Yet these cheap prized Medicines are retailed by the Apothecaries at unreasonable rates, at least six times the value they cost them. Now what trust there is to be had in the Venal Chymists will appear by the ensuing account, which I protest is most true and faithful, being free from any other designe than that of having such enormous abuses redressed.
Since Chymistry came into the request it hath been subservient, not only to Medicine, but also to Trades; and hath found employment for many searching busie heads: some of which engage therein only, that they may
gratifie an unbounded Curiosity, by observing an infinite variety of changes in the Subject they expose to the action of Fire, and Solvents, delighting themselves greatly in the contemplation of the Causes of those pretty appearances: Others promise to themselves Golden Mountains, either from the general great work as they style it, or from some particular Lucriferous Experiments. Now they that are intent on any of these, make use of many Materials which are ordinarily vended by a sort of men, whose sole imployment it is to prepare them. And we know by sad experience, that the greatest part of Mankind are not acted by Principles of Reason, Honesty, or Religion, it being Interest which swayes most; few regarding how it fares with the Publick, so that they thrive in their private Concerns. These Operators therefore having ready vent for their Preparations, they contrive the cheapest Methods of preparing
them, not regarding how injurious they are to the Sick, and those that dispense their Medicines; or to those curious Persons who deal in nice Experiments: which differences in the same Materials do often exceedingly vary, these unworthy Selfish People being highly satisfied, if the Substance, they vend, resemble the Genuine in all sensible properties. Now those that are well acquainted with Chymistry, know that most of the ordinary Preparations which are the Grounds or Ingredients of others, may be variously prepared; and yet all of them approach so near unto the true, that the most judicious Eye, Nose, or Palate, cannot distinguish between them.
As for instance, There is no Venal Preparation comes more in use than Sublimate made of Salts and Mercury, whether to make Mercurius Dulcis, Butter of Antimony, in order to Mineral, and Jovial Bezoard••ca, That Precipitate of it, which is abusively called Mercurius
Vitae, or liquid Emetick Remedies; And yet it is too well known that this is often Sophisticated by sublimation with Arsenick: and certainly we cannot expect, that Remedies wherein this is an Ingredient, can be very innocent. There are so many other known Methods of preparing Sublimate amiss; which yet shall be no less fair to sight than the best, that it is to me a greater wonder we have any good, than that we have so much, adulterated by vile Impostors and covetous Operators. Some only Re-sublime common Sublimate twice or thrice, and then vend it for that famed harmless Remedy Mercurius Dulcis, it becoming almost as Insipid as that; which whether it doth exactly emulate in internal as it doth in sensible Properties I leave to Experience to determine. But this is none of the most profitable Succedanea, Therefore many only dissolve the Mercury in Common Aqua Fortis, or other Corrosive Liquors; which abstracted from the Precipitate,
that being sublimed the result is said to be Mercurius Dulcis and sold for such, and it may be so: but yet such Preparations are (not without Reason) liable to suspicion, It not being advisable to permit processes of this nature to be varied at pleasure by any Ignorant, Conceited, Covetous Operator; for although the Medicines may possibly prove more effectual than when prepared after the common Method, yet I fear they are often sufficiently noxious. And this perhaps is the occasion of so many miscarriages in the use of the Shop-Chymical Remedies; which prepared after the usual Method, would have displayed salutary, rather than such pernicious effects. I am unwilling to discover more of these fraudulent tricks, lest I should inform some of them, whom a happy ignorance only hath kept from putting them in execution: yet the Sophistication of the Cremor, or Crystals of Tartar (which come so frequently in use)
with Alom, and the vending common Copperas or English Vitriol for the Salt or Vitriol of Steel are such notorious Cheats that I cannot but mention them. And to pass over the rest, Chymical Essential Oyls which are so often Sophisticated, that I never met with any Venal which was not so abused; and my skilful Friends have often complained to me that they never found, any sincere unmixed Chymical Oyl, in the Shops either of the Druggists, Chymists, or Apothecaries. I remember that formerly I made many of those which were of daily use in Medicine, keeping some parcels by me; that comparing them with the Venal Oyls, I might learn whether I was imposed on. This precaution was thus far useful to me, as it instructed me that unless I would injure my Patient, I ought not to make use of any of these Oyls; unless presented me by my own Laboratory, or by Friends in whom I could absolutely
confide: Those which We, and the Apothecaries, or Druggists borrow of the Chymists enjoying little of the Taste, and less of the Vertues of those Subjects, out of which they are pretended to be Extracted, being usually mixed with a far greater portion of the Oyls of Turpentine, Spike, or rotten decay'd Limons, of which as I and others have observed many of the Chymists make great quantities. Which recals into my mind what once happened to me: Having occasion once to buy a great number of Limons, I enquired of the Merchant how he disposed of those that were rotten, and unsound; who Answered me, that nothing was lost, the Chymists and Apothecaries buying all that refuse Trash which he could not otherwayes vend, to make Oyls and Syrups▪ which did not a little confirm me in my suspicions of their unworthy Practices. And surely such as these I have mentioned, will deter those Physicians that have any respect
for their Patient's Health and own reputation, from trusting to those Remedies of the Shops, which the Apothecaries have of Mercenary Chymists, or Common Operators.
But suppose these Chymical vulgar Medicines are prepared with the greatest care and honesty, there are besides them, many noble Remedies, which do as much exceed them, as they, the common Syrups, or Electuaries; such are those which great Chymists call the lesser Arcana, The greater being it seems no less then their renowned Elixir, the Universal Medicine, and the Alkahest or great Solvent which they affirm many have actually possessed. How true this latter assertion is makes not for our purpose: But as for what concerns the former, I my selfe can affirm it. These generous Remedies have been hitherto industriously concealed by their Possessors from the Apothecaries and common Chymists, knowing that they would make a preposterous use of them; but
should Physicians put themselves in a Method that they can have any Chymical Preparation, which shall be discovered to them, faithfully and skilfully prepared, they would soon be divulged: which would be much to the benefit both of the Physician and Patient, they being more sure and sudden in their Operation than any other whatsoever, and are of much greater extent, one single Remedy often curing many diseases that have any affinity with each other. Such are the Essences of Plants made by the union of their Volatile Spirits, Essential Oyles, and fixed Salts, Volatile Salt, or Spirit of Tartar, Tincture of Corals, Essences of Pearles, and Crabs Eyes, Basilius Valentinus's Tincture of Antimony, his Mineral Bezoar, Tinctura Lilii, Helmont's Elixir Proprietatatis, his Laudanum, his Aroph, the Volatile Spirit of Vitriol, the Anodine Sulphur of Vitriol, its Essential Oyle the Tincture of Gold: &c. All which I have seen, and can witness
that they have had extraordinary effects: And there are many such or better in the hands of discreet Persons, who are nothing so reserved and invidious as the generality of Chymists (how deservedly I know not) are taxed to be. For I have heard several of them, persons of great note and honour, profess their readiness to communicate what they know in this kind, to any Society of sober, Industrious Physicians that would oblige themselves to use, as they see occasion in their Practice, such noble Remedies as they will direct them to prepare. Now is it reasonable Physicians should neglect these advantages of improving their faculty, only to gratify an ingrateful, idle, careless generation, by whom they and their Patients are so highly injured that no Persons who have any sense of Honour or Honesty can further trust them, till they give sufficient testimony of their Reformation: which what it is, shall be anon mentioned. Another Remedy may be applyed, and
which perhaps were most advisable, that is, for Physicians to prepare their own Physick, whether Chymical or what is commonly called Galenical: but of this more hereafter.
Another thing the Physicians deservedly blame in the Apothecaries, is their enhauncing the Prizes of Medicines so much above what they might in Reason expect; about which the Physician doth not so much concern himself, because it hath a bad influence on him: as on the account of his Patient; though certainly if Apothecaries were more modest in the Prizing their Physick, the Patient could be more liberal to the Physician. Whereas on the contrary the Apothecary holds them at such unreasonable rates that in most courses of Physick, he gains more then his Master, how deservedly let others determine; though in my Opinion were their pay proportionated to their care and honesty, I doubt they would gain little besides shame and reproaches. But the Apothecaries Bills must be
paid without abatement; otherwise there shall be more clamour than if twenty Physicians went unpaid: but with how much regret they are discharged, almost every Physician can witness, most of them being daily troubled by their Patients with complaints of their Apothecary, which it is not in their power to redress. Now several things contribute to, or are the occasional Causes of this universall Grievance: The Number, Pride, or Covetousness of the Apothecaries; and that prizes are not set on their Medicines.
For Apothecaries, the Physicians procuring it being reduced into a company were at first few; and therefore having full employment could afford their Medicines at moderate prizes: but being since that time increased to a great number, each person bringing up two, three or more, That imployment which was before in a few hands became more dispersed; so that a very
small portion thereof falls to the share of some; and indeed very few of them, have more than they can manage.
Now the Sick must maintain all these, for although there be no occasion for a Sixth-part; Yet they must all live handsomly, as those that account themselves Physicians Fellows: to supply which Expense they have no other way than to exalt the prizes of their Medicines; and stil the less they are employ'd the higher they must prize them: otherwise they could not possibly subsist, unless they become Physicians and Prescribe as well as prepare, to which practices they are not only propense but are initiated in them, as we shall see in the sequel of this Discourse.
Now would it not be much better, if it were with us as in some parts of Germany? Where the Magistrates of many Cities, and I think Territories, agree upon a certain number of Apothecaries, so many as they can apprehend are necessary, all the rest being excluded;
and must either seek other seats, or be content for a small Salary to work under those that are allowed. The number of the Apothecaries thus limited, is beneficial to themselves in that they never want imployment; and to the Patient, who for the same reason hath his Physick at cheaper rates. I hope so manifest an advantage will invite us to imitate them which would not only be a great ease to the Patient; but also should be desired by the Apothecaries themselves if they consulted their own Interest. For if the future increase of their number bear any proportion to what is already added therto since they were Constituted a Company, the Physician need not oppose them, they must necessarily fall of themselves; unless they meet with some Extraordinary support which cannot be at Present foreseen nay scarcely imagined: but they are so intent on their private gain that I do them an injury in proposing to them the good of the Publick
or of their Company, especially when it will diminish their present profit. Therefore, since here is so little 〈◊〉〈◊〉 that they will reform themselves, others must take upon them that troublesome and ingratefull task; and next to the Magistrate I know not who are more capable of this than the Physicians: as will be seen when we come to the Remedies which shall be proposed in order to the prevention of this and other inconveniences, of which they are the Causes
Another bad Property the Apothecaries have, is their Insinuating many things to the prejudice of an Honest Physician among their Patients; to whom the Apothecary endears himself by the frequent access he hath to them, and some little pieces of Officiousness, as applying of Blisters Leeches, Plasters, or some such trivial business, which might be as well performed by any Nurse that is used to attend Sick people: so that a Physician,
whose Name and Interest is not very considerable, is in a great measure at their Mercy; which is such, that he may rest assured if he be a stranger to the Patient▪ or have not so great an Interest in him as the Apothecary, and if this have no immediate dependance on him, that if he be never so little distasted, he will employ all his Skill and Interest to ruine him in the Opinion of his Patient, and Introduce Himselfe or another Physician that shall be more compliant in his stead. Now one thing which touches an Apothecary to the Quick, is Detracting, as they call it, from the goodness of their Medicines (although how speaking truth should be Detraction, I understand not) against which no exception must be made, though the Patients Lives lye at stake; Another cause of their displeasure is, if they are reproved for setting immoderate Prizes on their Medicines: or which amounts to the same thing (I
mean the lessning of their Gain) if the Physician prescribes a few Medicines; and those either commonly known to be cheap, and especially if he gives the Patients Directions to make their own Physick, as if it be the Decoction or Infusion of a Simple or two: or if he cures them by a Regular Diet. For by this means, little Profit coming to the Apothecary, you cannot blame him that he thinks himself highly injured, or affronted, and seeks to be Revenged on that unworthy Physician, who prefers the Good of the Patient before the Benefit of the Apothecary. Whereupon he suggests to the Patient, that this Physician is a Man of mean Parts, of moderate Knowledge, of little Repute; that the Things he prescribed are very Slight, and altogether unlikely to effect what the Physician designes; that if he would be advised by him, some other Physician should be consulted, which yet is not very frequent: for
they do most of them redeem Opportunities, of imposing themselves on the Patient, who certainly makes a goodly exchange when he parts with a Sober, Judicious Physician for a Confident, Daring, Empty, Bragadocio Apothecary.
This Consideration brings to my remembrance another particular, which is the last complaint we shall make of Apothecaries; and that is their taking on them the Practice of Physick, Quis Credet haec? It will seem hardly Credible to Sober, Judicious people that have not observed the course of the World: and I confess it amazes me when I behold a Company of such Ignorant persons, dare at so great an Undertaking. I wonder, First, how they had the Confidence to attempt it; and having made so fair an Essay, that they did not Clandestinely manage those unwarrantable Practices, creep into Corners and Oblige to Secrecie: But to
commit all this in the face of the Sun, when Challenged, be so far from Excusing and Retracting that they should publiquely avow, acknowledge, and Glory in their shame, is a piece of Insolence that I could never have imagined a Society of men should ever have been guilty of. That a private man should so far degenerate, is no unusual thing; but this is the first Rank of men that ever in England did generally revolt from their Masters, and greatest Benefactors; and they are indeed so rare an example, that they deserve to be Registred in the black Catalogue, if not of Perfidious, yet at least of Ingrateful Persons, from whence without some general Repentance and Reformation, their names will never be Cancelled.
But amongst all these Prodigies nothing doth more excite my Admiration, than the consideration tht anay Persons dare confide in them, for whence can it be imagined they should derive
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this Skill, to which they are such high pretenders, That especially the more antient among them, boldly affirm they have many advantages over young unexperienced Physicians, and stand on even ground with the elder. Did ever those Physicians that were a means of constituting them a Company, and procuring for them such Priviledges, suspect that in the same Century, some of their own Profession should be forced to take Pen in Hand and determine the Controversie, whether They or the Apothecaries are more fit for the Practice of Physick? One would think this should be like those common Notions which are said to be Imprinted in the Minds of all men, As that the Whole is more than the Part, &c. so methinks every Man that is asked of the Question in hand, who understands what Physicians, and what Apothecaries commonly are, should as easily determin which is fitted for, and which ought to be excluded from
Practice, as to tell us that One and Two makes three; or that if we add equal parts to equal they are still equal. But lest we should be thought to Assume rather then Prove, or it be Objected that we are Precarious in our assertions, we shall give this Question a fair debate; and then we shall manifest the unworthy Artifices that Apothecaries use to depretiate and exclude the Physicians, to introduce, and ingratiate themselves.
As for what refers to the first, Apothecaries have this to plead for themselves.
That it is unreasonable to deny them the liberty of Practicing, who understand the Symptoms, and Cures of Diseases; if not as well as some Physicians, yet better then many, at least than the young and unexperienced. They have been present at the Death, and Recovery of many Patients; and therefore have had Opportunity to observe the course of the Distempers, and procedures of
Physicians: That they have kept exact Diaries of these Transactions, What Medicines the Physician prescribed; especially if they proved succesful: That they want nothing of a Doctor but the bare title: That they are not destitute of this, amongst the people, the most competent Judges; who if they were not satisfied with their Abilities and Success, surely they would not salute them by that Name, which is conferred by the Universities, rather upon those who have read Books than cured Diseases.
Not to answer to these frivolous allegations, that on the account of some of these pretensions old Wives, or Nurses, and others, Farriers and Smiths, may pretend to the Name or Thing they are so ambitious of: Nor to tell them which is most certainly true, That the knowledge they derive from Doctors Prescripts is very uncertain, and fallacious: it being absolutely
impossible for the best Physician to calculate a Medicine that shall be proper for all that are, or shall be subject to any one Disease; unless he were Possessor of the Universal Remedy, So great in the variety of Complexions, so many are the complications of Distempers, and so infinite are the variations of Circumstances: all which the Judicious Physician attends to, and which few Apothecaries are capable of Comprehending. The former being commonly men of more smart, piercing, natural Parts; and their Brains farther refined, purged from Prejudices, and well furnished with excellent, clear, and distinct Conceptions of things, for which they are beholding to an excellent Education: so that notwithstanding I have heard several of the Apothecaries confidently, (not to say impudently) affirm they were so throughly acquainted with such mens Practice, naming some eminent Physicians, that if they knew
the Case, they would lay a Wager they did exactly Predict before they took Pen in Hand what they would Prescribe; when to my knowledge there is not so much difference between a shallow River and the profoundest Sea, as between these empty, light Fellows and those Grave admired Physicians, whose depths such light Shittle-Cocks, Cork and Feathers, are so unlike to sound, that it is not without much difficulty that they are made to penetrate the very Superficies. In short, to compare them with sober, judicious Physicians, is as preposterous, as to parallel the faint glimmering of an expiring Candle with the beauty and luster of the Sun in its Noon-day Glory. But we shall more clearly and distinctly perceive the vast difference between them, by comparing them both with the Idea of Medicine; and see which is the more likely to have it imprinted in their Minds, and display it in their Actions.
The design of the Physician, ought to be the preservation of Health and cure of Diseases. The Preservation of Health is best effected by a regular Diet, and the due use of those things which are called Non-naturals; to which may be added some small matter of Physick when there is a slight propension to a disease rather than a Disease formed. Now in this Part certainly the Physician is more understanding than the Apothecary, being bred a Philosopher; and must therefore probably (or he is much to blame) understand more of the Nature and properties of Meats and Drinks, of Air, Sleeping and Waking, Exercises, and Passions of the Mind, than the Apothecary who never addicted himself to these enquiries. Then as for the Cure of Diseases, it seems highly probable that they who are best acquainted with the Causes and Symptomes of Diseases, will apply Medicines more properly than others that cannot so well distinguish
although possessed of the same Remedies. But we will wave this, although it would be very proper for our present purpose; and examine which are best furnished with Methods and Medicines in order to the Cure of Diseases.
Diseases are removed, either by Method, Specificks, Arcana, chiefly Chymical; or by a Practice mixed of Two or more of these. That Cure by Method which doth not interfere with the other by specificks, is when by Vertue of Medicines that have a Sensible Operation, such are Vomits, Purges, Salivating, Sweating, Diuretick, vesicating, Cordial Anodyne and Narcotick Remedies, (with the helps of Phlebotomy &c.) used in such a Method as the Physician apprehends most proper, the Diseases are removed. And that most Distempers might be Radically or Perfectly Cured by these judiciously prescribed without either specificks or Chymical Arcana, I am so far from
Doubting that I could name some excellent Physicians, who have eminently signalized themselves only by Method. But then these (and indeed whosoever insists in this way must be such) were Men of most quick apprehensions Solid Judgements, knew when, what, how much, and in what order to prescribe, a little mistake hazarding the Patients Life in acute Distempers, either in over, or under doing; and how fit a Hairbrained, Careless or Ignorant Apothecarie is for this Practice, is easily discerned.
As for Specificks by which we mean such Simples as being appropriated to a Disease, cure without any sensible Operation; probably by changing the ill texture of the Morbous matter into another more innocent and less incongruous with those parts which before were extreamly disaffected thereby. Now the great question is, how Physicians come by the knowledge of these admirable Properties.
Surely they have it not by natural Instinct, much less can any pretend to Divine inspiration. I am not ignorant that some talk of a Medicina Adepta, but the boldest and most talkative Apothecary I ever yet met with, had not the slightest Pretensions to it; and no wonder for till they leave off their fraudulent unworthy Practices, of all men I know in the world, they have the least Reason to expect revelations in this kind, supposing there were such. Well then, since there are no other means besides, Physicians must derive this knowledge from Communication, either of living or dead Physicians; or from their own Experience and Observations, and indeed I believe they are not a little beholding to the writings of those that preceded them: wherein yet this Knowledge is so scattered, that great Labour, Industry and Sagacity must be imployed before any Physician can arrive to an ability of Curing most Distempers by means of Specificks. Now that the
Apothecaries are like to be Possessors of this Treasure, will appear very improbable, If we consider that they do not trouble themselves to search any other Records than they themselves have made of Physicians, Prescripts; and besides they are great Enemies of Cures by Specificks, because that notwithstanding they personate the Doctors: yet their gain comes in by the Trade of an Apothecary, which this way of Cure doth much impair. And therefore by their good-will they would neither allow of it in others, nor practice it themselves if they were able; from which they are so remote, that al the Physicians in England, can hardly beat it into most of their heads, that any thing should effect a Cure without Evacuating sensibly the Material Cause of the Disease: and therefore they deal chiefly in Purges, Vomits, &c. And how judiciously they manage these instruments, we shall hereafter make inquirie.
A third course whereby Diseases are said to be cured, are Chymical Arcana: Such were the Mercurius Diaphoreticus of Helmont and Paracelfus, the Ignis or Sulphur Veneris, the highly exalted Tincture of Gold, the Mineral Laudanum of Paracelsus, and other great Medicines which those renowned Chymists, B. Valentinus, R. Lully, R. Bacon, Paracelsus, Helmont and Others were said to have had in their Possession; and to have used with incredible Success. These noble Remedies curing without any Evacuation (besides ordinary Diseases) those that had then the Repute of being incurable: such were the Gout; Dropsie, Stone, Leprosie, and other formidable Distempers. It is not my intention at present to spend time in inquiring after the truth of this Tradition, whether these Persons were actually possessed of these Remedies, and whether by their means they effected such great Cures: Or whether such Medicines may be procured. I shall only insist on this that
if any of them can be obtained by Labour, Skill, and Industry, the Physicians are much more like to be possessed of them than Apothecaries, triffling Chymists, or mean Operators. Many of them having been long conversant with Chymical Operations, and having ••ot spared for any expence of Money, Time, or Trouble, are now so throughly acquainted with the Principles of that Art; and have rendred Nature so familiar, that they design few things which they do not effect: and I can say from my own Knowledge that the Productions of their Furnaces, have been as considerable as of any sort of Men whatsoever that do publickly appear in the World. So that if there be any thing in Chymistry useful and noble, what should hinder their bidding fair for the possession thereof? Besides, there are many Antient, and Younger Physicians who dayly ingage in these Enquiries; and the whole Colledge of Physicians is so concerned for the promoting
this usefull part or appennage of Medicine, that they do intend publickly to promote it by associated endeavours. And notwithstanding what hath been said to the contrary, I am Confident there is not a Society of men in Europe more considerable; not only for that knowledge which we owe to Books, for their insight into Philosophy, Skill in Anatomy, and all Natural History which is allowed by most: but even for an intimate acquaintance with Chymistry, which though some have denyed them, yet how unjustly the World will be soon (if it be not already) convinced.
Now it remains that we discourse of the Fourth and last way of Practice, which we said was composed of those already mentioned, and indeed this is the most frequent; for, although I know there are some few, who confine themselves to that which I call strict Method, others to Cure by Specificks, a Third sort who only use Chymical
Medicines, which they are pleased to dignifie with the glorious Title of Arcana (although I fear they are far from being so) and perhaps there may be some Persons in the World, who have those that are really such; yet I have observed that the generality of sober judicious Physicians, compose out of all these a Practice which pertakes somewhat of every one: yet so, that Medicines which have a sensible Operation, Specificks and Chymical Remedies, have all a subserviency to Method, that is, they observe a certain order in the use of all these, which is so advantageous, that inverted or transposed, they have not the same effect. Thus perhaps first they premise some general evacuations, whereby the Body being freed from impurities, the Stomach after strengthned with digestives, the Vital Spirits invigorated by Cordials or a Regular Diet▪ Specificks then easily perfect the Cure, which perhaps would be
compleat neither without them, nor with them only, without the mentioned helps. Now he that hath but half an Eye must necessarily discern, that much of judgment, much of contrivance is requisite in these Cases; and indeed so much, that it is well known many (and I hope that it may be affirmed of most) Physicians, make a History of the Patients condition, or Case: and then after due Consideration of all circumstances, determine to proceed after a certain Method from which they do not recede without great occasion given them, as the intervening of some accidents, which Humane, Wisdom, and Care, could neither soresee, nor prevent. Now how Apothecaries, or indeed any others that have not a solid Judgment, quick Apprehension, and fixed indefatigable Mind, can sustain so much labour be capacitated for so great undertakings I cannot imagine. And they that know them did never suspect
they would give themselves so much trouble to obtain what they can purchase at a cheaper rate. For they design not so much the doing good, as that the People should entertain an opinion that they do it, which is no hard matter to arrive at, being in this like Machiavel's Politician (though in other things silly enough) who is to make a profession of Vertue and Piety; but not to be really so, for many things will be swallowed that are proposed under the pretence of Vertue and Piety, by unwary, well-meaning People, who are not apt to suspect others because free from Designs themselves: whereas a strict profession of Religion and Vertue will hinder the Politician from doing many things which might prove highly advantageous to him. The Parallel is easie and obvious. Besides, as it is easie to obtain an Opinion of Vertue or Piety, but to be really and truly Vertuous, requires much Sweat and great diligence; so it
is with Learning, nothing being more easie then to impose on the incautious, credulous Vulgar, who believes he knows most, who makes the largest profession. And at this the Apothecaries are excellent; good success so rarely anticipating their promises, that I scarcely ever heard such a thing happen'd; but how devoid they are of solid Knowledge, how free from Care, and empty of Skill, or whatsoever is requisite for the making good their pretences, is so well known to them that dive into the depth of their silly intrigues: and they are so numerous, that it is needless to repeat what is imprinted on so many memories.
But we shall now proceed to enumerate and descant on the particulars, wherein the Physician seems to have some advantages over the Apothecacaries, and indeed all other whom Nature and a good Education have not fitted for so great an employment.
1. It seems very probable that Diseases will be better cured by them that are acquainted with the Frame and Fabrick of Man in his sound Constitution, with the Nature and Properties of the Humors and Ferments in the Body, that understand (which they chiefly do by Analogy from what they have observed without Man) how these are depraved and perverted, What was the Occasion, or Instrument. Whereby certainly they may neerly conjecture what is most fit to oppose the cause of these Irregularities, and to remove their Effects. This is no new Notion, it having been the perswasion of former, and later Ages, That the Physician is to begin where the Philosopher ends; And that the Physicians have made great advantages of Experiments and Observations, is most evident from their own confession: but chiefly manifested in many of those Noble productions of their Brains, which will perpetuate
their Names, and oblige all Mankind that shall succeed them. Of how great use was that admirable Invention of Harvie's concerning the Blood's Circulation? and, What great advantages may we derive from the Inventions of Pecquet, Glisson, Ent, Wharton, Bartholine, Willis, Needham, Lower, and other excellent Anatomists? Some have gained to themselves immortal Renown by their voluminous, yet judicious Histories of Plants, Animals, and Minerals; and indeed Natural History, and Philosophy have been scarcely cultivated by any besides Physicians: who were so considerable that the deservedly admired Des-Cartes, not long before his death, was deeply engaged in the study of Anatomy, Chymistry, and other appendices of Medicine; designing all his Philosophical toyl, only for the good and benefit of Man; intending to imploy his later time in the investigation of the Nature of Diseases, and
their Cures. Neither did a high Birth, and Quality, an Excellent Education, a plentiful Estate, and great Reputation, dispose that Noble Experimental Philosopher Mr. Boyle to think himself above the Profession of Physick; which cannot be questioned, after he hath given so publique a testimony, as the accepting a degree therein, freely proffered him by one of the most Famous Universities in Europe: whose expectations he hath not deceived, having ever since applied himself to improve that noble Faculty, with such success, that notwithstanding what some few in their mistaken Zeal urge to the contrary, it is well known that most acknowledge themselves highly obliged to him for what he hath already published; and wait not without some Impatience for what he hath promised in the same kind. And how great advantages a Physician skilled in Philosophy hath over others, He hath so clearly, and copiously evinced
in many parts of those excellent Discourses concerning the usefulness of Experimental Philosophy, (to which I refer the Reader) that he hath saved me a Labour of saying more on that Subject, which would be only a Recapitulation of what he hath there at large delivered, and which will be better understood in his own words; and probably make a deeper impression than any thing I can add. So that now nothing remains for me to do, but to draw this Corollary, That till Apothecaries become better Philosophers its very probable that there will be better Physicians: but to proceed.
2. It is not unlikely that they who in their cures attend to the Age, Sex, strength of the Patient, time of the Year, their Constitution or Complexion, Antipathies or Aversions, Diseases preceding in them or their Parents, and the present Complication of Diseases (for they are not frequently
solitary) that they, I say, who attend to those Circumstances, should be more succesful in their Cures than those that have little regard of them; for whatsoever the Apothecaries think, the Physicians are of the mind that all these are material, if not necessary to the Cure of Diseases. And although the Apothecary not hearing the Physician enquire after all those particulars, himself also neglects them; Yet nevertheless the Physician considers them, having such a habit that he doth it intuitively rather than discursively, especially if he were formerly with the Patient: but the Apothecary looks on this as work of Supererogation, and thinks 'tis only to please and humour the Sick, and perswade them of their care. But that this surmise is grounded rather on Ignorance than Sagacity we shall now manifest. To avoid Prolixity I shall instance only in one particular, and that is the Complication of Diseases; about which the Physician
is (not without just cause) marvellously solicitous. And indeed this is so nice a Speculation, that it sometimes almost puzzles the most perspicacious Physicians; and is far out of the Apothecarie's Ken, who yet presumes he can see into a Milstone as far as another man, and so he may: but in this case it is with the Physician and Apothecary, as 'tis said to be with two persons diversly qualified looking into a Magical Glass; where the one sees a great variety of objects, and the other nothing but a transparent Glass, and will not believe but what the other sees is by the help of Imagination's Spectacles; which objection, how true soever it may be in that case, is not in this. Or, (to make a comparison less liable to be censured) It is with Apothecaries and Physicians as with two Persons that contemplate the Galaxy, or milky way, the one with his naked Eye, the other by the assistance of a Telescope; That
to the former seems only a confused white cloud, which to him who veiws it through his Tube appears to be a great company of Stars: which he perceives little less distinctly, than he doth by his Unarmed Eye, those that are most conspicuous among that innumerable Company, wherewith the Heavens aremost gloriously bespangled. But that I may render this more manifest, I will descend to particulars, and shew first that there is frequently if not usually a Complication of Distempers in the Diseased. Secondly, That the Apothecaries are not often sensible thereof.
It hath been judiciously observed by Piso, Bontius and others that in Brasile, &c. where their way of living is most simple, the Temper of their Air constant, their exercise much, and their hereditary Distempers few; That their Diseases also are few, and short, for the most part simple (being scarcely ever complicated) seldom dangerous, the
Crisis certain and visible, so that they rarely dye, except of Accident, or old age: wheras on the contrary, in these Northern Regions our Diseases are many and various, Crisis uncertain, and oft-times scarcely sensible; and which I chiefly aim at, Diseases are variously complicated. And indeed how can it possibly be otherwise when we are generally very irregular in our Diet; so that I know not whether we are more injured by the great quantities, or ill Qualities of the food we live on: When we sometimes too much indulge our selves in sleep, at other times allow our selves too little, and that at unseasonable times, when we lead for the most part sedentary lives, exercising either too little, or immoderately; not to say how intemperate some are in their Passions, and insatiate in their Lusts: besides the Air in which we breath is as uncertain as the Winds that blow which suddenly changes from heat to
cold, moisture to dryness; and on the contrary, cannot but leave ill Impressions behind them, to which we may add Hereditary Distempers. For what is more frequent than for weakly diseased Parents to be further tormented by seeing their Children labour under the same Infirmities; which are either rivitted into the Principles of their Constitution, or sucked in with their milk: from which dispositions they are hardly, if ever freed. Now any one of all these is sufficient to change the nature of a Disease, which in their absence would have appeared in a much different form: So that there being in most of those who are surprized with any distemper especially Acute a previous, ill Diathesis, or Constitution of the Blood, a depraved ferment in the Stomach, and these very various, we must apply our selves after different methods to cure Diseases, which spring from different causes. Thus for instance in Feavers,
Agues, and many other Distempers, it is not sufficient to remove their occasional Cause, and to allay the inordinate commotion of the Blood; but he that will approve himself a true Physician must (in a great measure at least) free the Patient from that ill habit of Body, which exasperated the former Distemper, and disposes still to the same, or worse. For when the Blood is depauperated or the spirits oppressed by more numerous Saline, or Earthy parts, on every light occasion the whole Body is disordered; and indeed the great skill of a Physician is seen in the cure of Chronical Diseases, which is too far out of an Apothecaries reach: that although I have made strict enquiry, I solemnly profess, I never heard of any one cured by them. If then they are unable to cure Chronical Diseases, which are those that chiefly reign in England; and if they are absolutely unfit to deal with any acute Distempers where
there is any Complication, Why are they allowed to practice Physick? With which if they must be conversant, let them addict themselves to the cutting of Corns, and drawing of Teeth, which do resemble the cure of Diseases; and that may perhaps in some measure gratifie their petulant Fancy at a cheaper rate by spoiling a part, than hazarding the whole, which is now their daily practice.
3. It is no inconsiderable part of a Physician's Office, to know when nothing is to be done, but the whole matter committed to Nature, the Physician supervising, and taking care to correct all Nature's aberrations; and if there be occasion, to give her some little assistance. For Diseases seize on many in whom Nature is so strong that after some conflicts the Aggressor is expelled without any assistance from Physick, according to the Aphorism of Hippocrates: Naturae sunt morborum Medicatrices. Whereas should a Physician
in these cases administer any active Medicines, or make use of other pretended helps (suppose Phlebotomy) unless by his great Sagacity, or the obviousness of the Distempers cause, he applyes a Remedy very sutable (for which there is yet little occasion) We cannot imagine otherwise, than that Nature being weakened by evacuations, or diverted from her usual Methods by Medicines; which if not appropriated, will rather disorder or debilitate than bring relief, in the interim the distempers will proceed by insensible, degrees and at length may become so powerful, that Nature with the help of the most generous Remedies cannot prevail: where if She had not been unseasonably weakened or diverted She would have obtained an easy Victory.
As for Example there is a well-known Disease, wherewith Children are as frequently afflicted, as by Agues or the Rickets; which soone deprives
the poore Infants of their colour; makes them lose their appetite; they sleep little, and that unquietly; they will be exceeding Thirsty, Froward or Peevish, and seem to have greivous sick or fainting fits: and after they have long laboured under this distemper, they have usually great swellings or hardness of the Belly, and are so emaciated that they seem not much unlike to little Skeletons; and yet notwithstanding all these threatning Symptoms I have seldome, if ever, known Children miscarry who were forbidden the use of Physick till freed from most of them (for they vanish of themselves) and then gently purged for a few dayes successively, they not only recovered their former health but have often given me occasion to dispute with my self, whether they were not rather better than worse for the distemper thus managed. Whereas on the contrary others that have been disordered and weakened by evacuations, Cordials, or
fuges, appointed by the Apothecaries or other unskilfull practicioners, (who are very ready to prescribe and Impose Physick on these occasions) although to appearance they are freed from their troublesome companion; yet withall soon after, many exchange this life for a better: and those that survive, are usually weakly, more subject to Rickets, Convulsions, and other Distempers, than those in whom the Disease was permitted quietly to take its course without interruption. The same hath also been observed in elder Persons labouring under Quartain Agues. Neither is it without a great deal of trouble that Physicians observe so many miscary of acute simple Feavers, who committing themselves to the care of Apothecaries, and rather unskilful pretenders to Medicine, often receive dispatches out of this World, by Food, or Physick preposterously administered, rather than from their Distemper; which will appear evident to
them who consider that a Feaver is usually Natures Instrument, or an Ebullition of the Blood, caused by the Vital Principle, in order to the expelling of some substance mixt with the Blood, or other Humors in the Body: whose presence perverts Natures regular actions, and thereupon is opposed by those active parts, through whose mediation She performes her operations. Now in most of those conflicts Nature would be victorious, subdue or expel her intestine Enemy; if She were recruited sparingly with the liquid part of Her ordinary and daily supply: and be not diverted by gross Food, whose digestion while the Spirits attend the Morbous matter, exceeding the remainder in quantity or energy, may gain great advantages, either by vitiating the Organs, or by reducing the Humors to their own Nature by a depraved Ferment; and the Stomach wanting Spirits copious enough to assist it in digesting
the Food, dismisses it crude: or being it self disaffected, imparts thereto some noxious qualities, which are again communicated to the Blood, whose impurities it thereby encreases, extreamly hazarding, and sometimes over-powring the Principle of Life. The same happens by Medicines unsutable to the Distemper, or unseasonably exhibited; as if in the height of a Feaver one should advise to hot Medicines, whereby more Fuel is added to the Fire, and the Disease rendered more formidable and difficult of cure than ever: or if in the declination of the same Distemper, when the Patient should be supported by Cordials, and relieved by Opiates, whereby the Crisis, or separation of the peccant matter is most certainly and easily affected; if instead of these refrigerating Medicines, Juleps, Clysters, or other Coolers which weaken the Blood, depress the Spirits, and disable Nature for her intended
separation, whereby the Distemper runs into a Diuturnity, and if Life chance to be secured for the present, howsoever the Patient continues weak: and without great regularity, or exact observation of Diet, Exercise, and the other Non-Naturals, will become subiect to some Chronical Distempers, whether Consumption, Scorbute, Dropsie, Jaundice, Scyrrhus, Tumors, or Ulcers, which frequently succeed acute diseases, ill managed, and are seldome perfectly removed; at least not by the Apothecaries, who were the occasion of these, and are daily of many other Miscarriages, when they are consulted about Persons who would recover without the use of any, or with the help of little Physick. But as it is above their skill to know what Persons are thus affected, so it is contrary to their Interest to manage them aright; and therefore they neither can, nor will do
it. That they cannot, the faithful Character or Description we have given of them will render sufficiently probable; That they will not, may be easily believed, if we consider that this way of proceeding would diminish their Profit, which they do by no means approve, but will rather charitably obtrude store of Physick on all their Patients: and that sometimes so much to their prejudice, that they had better hire them at a dearer rate to be less officious.
4. Oftentimes persons seem to labour under several Diseases, when as really the whole Tragedy is acted by the same peccant matter, which is either translated from one part to another; and affecting them after different manners, the Symptoms are various and their Denominations different: or from differences in Age, Sex, previous habit of body, Complexion or Constitution, Strength of the Patient,
Season of the year, and other circumstances. Matter which hath the same Nature and Properties, may diversly affect the Persons thus discriminated; also according to Quantity and Degrees in the same Qualities it may diversly affect the body: and thereby occasion different Symptoms, which to the Unwary or Unskilful seem distinct Diseases, when as it is but one and the same matter variously displaying it self; and which may be removed or otherwise disposed of by one and the same Method or Medicine.
Thus for instance a great number of Diseases are caused by the redundance of Acidities, which acid noxious juyce being mortified, all those troublesome effects of its presence cease. Many Diseases there are which proceed from the obstruction of some part, such are Apoplexy's, Lethargy's, Carus, Catalepsia, Gutta Serena, Palsy's,
&c. Now those Methods and Medicines which will cure the most obstinate and dangerous of these, will seldom fail to remove the rest. The same happens in Convulsions, Epilepsy, Madness, Hysterical and Hypochondriacal Passions, Vertiginous Affections, and Melancholy, &c. We also daily observe that many violent Fluxes, wherein the blood or other humours have the same cause and cure, all which proceed mostly from sharpness, thinness, or heat of the blood, are removed by Medicines answering the Indications of cooling, dulcifying or incrassating. Some of the Diseases thus cured, are immoderate Fluxes in Women, spitting and vomiting of blood, Periodical, or other copious Evacuations thereof at the Nose, Haemorrhoids, with the Urine, or by Stool in the Flux, commonly called Hepaticas, and Dysenteries; to which we may add several sorts of Diarrhea's, fluor albus, incontinentia
Urinae, much Spitting, Weeping, Coryza, and Rheumes, of divers kinds. Further, most simple, continued and intermittent Feavours have very nearly the same way of Cure; although the Body seems diversly affected by them: an evident Argument that their causes are little different. We might instance in Colical, and Iliack pains, and many other torments in the Stomach and Bowels, which seem to have their rise from the same Causes, and have almost the same Cure; Nay to proceed still higher, What Analogy doth there seem to be between the Palsie and the Colick? yet this often degenerates into that which also many other Diseases do; whereof I could give a large account: but shall refer it to a more convenient Opportunity. We might proceed to shew how great an affinity, there is between many outward affections in their Causes and Cures: But because the care of
such Diseases is denied by some to belong to Physicians; and because the Apothecaries do scarcely ever intermeddle with the Chyrurgeons imployment (which yet it is much less intricate then the Physicians) I shall pass over this Ponsideration.
Thus we have given a superficial account of those opportunities judicious Physicians have to discriminate themselves from ignorant pretenders, by their discerning with great Celerity, and Sagacity, how to act where all these are allwayes grievously perplexed, and often perfectly confounded; as is manifest in their wayes of proceeding, which are usually so ridiculous and Irrational that they would give intelligent Physicians a full and pleasant Divertisement, if they could Indulge themselves therein: which they can by no means do, where their Errours and Miscarriages are so far from Innocent, that they do often
exceedingly hazard, and sometimes occasion the Misery, or Destruction of the unhappy credulous Patient. Which sad accidents dispose those generous Physicians, they neglected, rather to Pitty and Compassion than to disport themselves, or look with Malicious Smiles on misfortunes; which they in some measure deserved, for being guilty of so egregious a piece of folly, as committing themselves to Ignorant, and Unskilful Practiciooners, altogether unfit for so great a trust. And indeed it will excite Admiration in any judicious Person to observe what a Wild-Goose-Chase they go in most of the Cases we lately mentioned: sometimes applying a Remedy they have learned is proper for the Head-ach, then another for the Tooth, Stomach, or Heart-ach, Gripes, Flux, heats in the Head, and burning in the habit of the Body, Vartigo Asthma, and other semblances
of Distempers which one and the same matter will often occasion. Now the Sagacious Physician soon detests this Cheat, and immediately by a stroke or two at the root, intercepts the depraved Nourishment; so that all the other ill effects cease with the removal of their cause: whereas should he only attend to every particular symptome as the less discerning do, there would be no end, either of Physick or the Disease, which, 'tis very probable will receive a great aggravation by so many improper Remedies. For Physick is, or ought to be active; and if not appropriated to the distemper, it must necessarily work an effect contrary to that for which it was designed, so that if it do not abate of the Disease, 'tis more than likely to exasperate it, if it do not strengthen Nature actually, or consequentially; I mean by removing Impediments, it will certainly weaken Her.
AND if this be so great a truth as Physitians have hitherto generally esteemed it to be, then he that is acquainted with the Nature of Aliments, and the Process of Nutrition, will probably cure Diseases with greater certainty and less trouble to the Patient, than him that is utterly ignorant of both these: And who is more like to be a Possessor of this knowledge, than a judicious learned Physitian? For,
1. He understands the Nature of Aliments, whether Animal or Vegetable; he knows that such among them as are most temperate, and have no sensible Operation are more agreeable to the body, and nourish more than others which abound with active parts, whose Purging Vomitive,
Sweating, Diuretick, or other Qualities, render them unfit for Nutrition. As also, that most, if not all things that are used for food, although they be not active in so high a degree as others which come commonly in use for Medicine, that yet they often cause great alterations in the body, according to the quantity, quality, right, or unsutable application thereof; and find that the Cause and Cure of many, if not most Diseases, have their dependance on a good and regular, or a bad inordinate Diet. But this will be made more evident by descending to particulars. I think nothing can be more plain and evident, than that Onions, Shalutes, Horse-radish, Capers, Olives, Broom-buds, Pepper, Cinnamon, Nutmegs, Salt, Sugar, Butter, Vinegar, Wine, and Oyl, are active alterative substances; and yet they are often taken alone, or variously compounded to make savory picquant Sauces which are supposed to promote
digestion by rendring the food more grateful, and by strengthning the ferment of the stomach. But besides these there are many Vegetables which come frequently in use among all people, and in some Countres with Bread, Cheese, and Milk are almost their only food, such are Melons, Pompions, Cucumbers, as also Turneps, Carrots, Parsnips, Skirrets, Radishes, Pease, Beans, Artichocks, and other Thistles, Asparagus, Hop-tops, Cabbages, Coleworts, Cauleflowers, Comfry, Lettuce, Purslain, Parsly, Sage, Leeks, &c. (not to mention various kinds of fruits) These are either boyled, or eaten crude; alone, or variously compounded according to pleasure, being rendred more grateful, or as is thought wholesome, by the addition of Butter, Vineger, Pepper, or other of the mentioned active substances. I shall not insist on the great difference that there is in substance and qualities, between Flesh
and Fish, the variety of both being unimaginable; especially if we consider the various wayes of preparing them for food, and the additaments that are used to render them more agreeable to the Palate: Concerning which Physitians have wrote intire Volumns. Now the body partaking of the nature of the Aliments (which I suppose no one will deny, or if they should, I could demonstrate it by unquestionable experiments and observations) They having such various qualities, and there being so great a variety in the complexions and constitutions of men, it will necessarily follow, that some of those Aliments may be contrary to a good sound constitution of body; & if a person indulge himself much in the use of them, his health will by degrees be impaired, and a bad texture or disposition of blood superinduced, which would have been prevented: and if recent, easily removed by sutable nourishment,
especially if this regular good Diet be long continued.
Now the Physitian being better than any other person acquainted with the properties of most things that are commonly eaten, and with the temper of his Patient, can teach him what to eat, and which to avoid; what will prove beneficial to him, which are hurtful. Besides, he gives him some general Rules in reference to Diet, yet not so strict and severe, but that they may be easily without any trouble or inconvenience observed. These Rules may respect men either in a Healthful, Neutral, or Diseased state.
1. For a man in Health, the Physitian prescribes him not any set time or hours whercin he should take his repasts, only that he should not eat another plentiful meal, till what he eat before be well digested, and passed out of his stomach. Then for the Quality of his food, that it be such as
is most agreeable to his constitution and imployment; a gross food being most sutable to those that are of a strong robust, a more fine and delicate to such as have a more spare and weakly complexion: he allows them also such food as being long accustomed to, they find agreeable to them, there being Idiosyncracies or peculiarities in some men, whereby some food agrees well with them, which would be noxious to others seemingly of the same constitution. As for Quantity, that they should eat only so much as abates, not gluts their appetite; and after which they find themselves rather more than less lightsome than they were before eating: That its better to eat little and often, than much and at once; that as near as they can, they keep to an equality for substance, not quantity, making allowances for meats that have little nourishment, as substracting from what are very nutritive, as Swines flesh, &c. And
if they live temperately, to exceed once or twice in a month in eating and drinking their ordinary stint, which is found to promote perspiration the great preserver of health, and enables the stomach to bear any accidental overcharge, there being few persons that can at all times command their Appetites; and such a surplusage is dangerous to those that have long observed exactly a regular Diet, not varying the quantity of their food. Then lastly for Order, he advises that they should not eat immediately after any great exercise of body or mind, and that they avoid all those things which hinder the concoction or distribution of the nourishment, and use whatsoever promotes it. Some such general rules as these observed (abating hereditary and contagious Diseases which yet are in a great measure prevented by an orderly Diet, and are less dangerous when we lapse into them) will keep them
in perfect health: For then the food will be readily converted into good chyle, which conveyed into the veins, the blood not being overcharged with quantity, and the food being before well prepared and opened by the ferment of the stomach, becomes upon reiterated circulations, a most noble generous liquor, and in its passage through the brain a pure unmixed spirit will be sublimed or seperated from it, free from preternatural acidities which cause many Diseases.
This subtle and sincere Liquor or Spirit supplies the Nerves and Muscles with what is necessary for Animal Actions, the Lungs, Stomach, Spleen, and other Viscera, And the parts destined for the Propagation of the Species with so much as is necessary to keep them in a due Tone and enable them to perform all these actions for which they were instituted. The rest of the blood visiting
the most extream parts of the body, and others retired from sight, where percolated through Parenchymous fibrous or bony substances, it leaves with each part what is Congruous to it: And so long as this course is continued without interruption, health also will be uninterrupted.
Whereas on the contrary high Compounded nourishment, whose quantity and substance is often varied, especially if it be more then the Stomach can well digest, must by a Mechanical necessity cause Diseases. For if the quantity be greater then the ferment of the Stomach can dissolve the Chyle will enter the Blood Crude, and being more then that is used to assimilate at once, and not well opened by a previous digestion, it by insensible degrees depraves the best constitution, for then the blood supplies the Brain, Nerves, Viscera, and Musculous parts with unsutable Spirits, and nourishment which affecting them after an
unusual manner, pain or somewhat worse, is in time the result of this bad or irregular Diet. Then for the quality of the food if it abound too much with Oyly and Spirituous parts, it puts the blood into that great commotion or Ebullition we stile a Fever, if with cold Crude juyces as Melons, Cucumbers or Cherries, it sometimes extinguishes the Native-heat, and if the sick escape they are usually stigmatized by blotches or eruptions all over their bodies or in some particular parts, whereat the Morbous matter is excluded. Lastly, if Salt be predominant in the nourishment it causes various Maladies, especially of the Genus nervosum often occasions strange disorders in the whole mass of blood and sometimes Corrodes the External parts which it deforms and and tortures in Ulcers, Fistula's, Cancers and other painful, loathsome and formidable Diseases. All which might have been prevented, and if timely
care had been taken, cured by a sutable and orderly Diet. For an ill Crasis or Constitution of the blood doth not always, presently, display it self in such bad Syptoms as to deserve the denomination of a disease, this by Physitians is called a Neutral-state which may be first Checkt, and then redressed by Diet. For although if we will examine things strictly there is no middle between sickness and health, yet because it is so hard to find a Standard for either of them; therefore Physitians have agreed on this third, as an expedient the better to express their thoughts: so that we apprehend a man is in perfect health who is free from pain or any Indisposition, performs in his own and the Physitians opinion all Animal and Natural Actions as well as if he were in perfect health, we account a Neutral state to be a slight propension to a disease, when the ferment of the Stomach begins to be perverted, the blood somewhat
depraved, and yet no very ill Symptom appears, No function of the body is much hindered or interrupted at least not very sensibly; As when by too strict and severe a diet the body begins to be Emaciated, the Nerves disaffected, or when by drinking to freely the body is inclining to a fever, dropsie or Consumption, to the same or other diseases, by eating frequently too much, or such food as suits not with the Stomachical Ferment being to it hard of Digestion, or meat endowed with any other ill quality: by frequent excesses crudities being accumulated which if they increase will display pernicious effects; But if timely discerned may be conquered without the help of Physick. As to avoid Repetition I shall manifest under the next head.
But suppose that a Disease is sensibly formed: Let us examine then what Diet can contribute to the Cure, Moderation, or Palliation of the Distemper.
To avoid prolixity, I shall mention only some general wayes of Cure by Diet, on which any understanding person may expatiate in his mind.
It's so well known that many Indispositions are cured by Fasting or a spare Diet, that I need only mention it. Others are cured by a Diet axact for the quantity of food which hath laudible qualities, for what is taken being no more then can be well overcome and dislolved by the stomach, this conveyed into the blood soon renders it more spirituous, whereby what is crude is either digested, or carryed off in perspiration; so that Nature being duely▪ fed with a constant supply of good spirits, the bad texture of the blood is soon exchanged for one more innocent. Thus Consumptions and other Chronical Distempers have been frequently cured. Many diseases are overcome by a Diet contrary to the peccant matter; as
Hecticks by a Milk Diet; Fevers by Ptisans; some Consumptions by Snails, and other glutinous substances; Hot Diseases by moist cold, Cold and moist by a hot and drying Diet. Some Diseases are alwayes moderated and often cured by substracting from the liquid part of the nourishment, as Catarrhs; others by allowing it more plentifully, as in that dreadful Disease called by Physitians Cholera Morbus, wherein if the Patient take great quantities of Posset-drink, or thin weak Chicken-broath, those affrightful symptoms of Vomiting and Looseness soon cease, the liquor dilating that corrosive saline matter, which pricking the coats of the stomach, and intestines, caused those violent workings upwards and downwards. And this is a remedy so certain that I never yet observed it to fail, and others who have had longer time and more opportunities to make Observations than my self, and particularly he whom I take
to be the first inventor of this easily parable effectual Remedy, do unanimously affirme, That it hath scarcely ever frustrated their Expectations; and yet we know that many miscarry of this distemper, even where the pretended generous Remedies of the Chymists, and best methods of those whom they style Galenists have been imployed.
But to proceed: Another way of curing Diseases by Diet, and the last I shall mention, is with some sorts of food, which by a hidden or specifical property cure Diseases. Our instances shall be only in the Vegetable Kingdom, whose Simples are numerous, and they differ from each other in many sensible properties, as Taste, Smell, Figure, Colour, and their internal qualities are far more numerous; and between them also there are great differences and contrarieties. Some are of a hot, others cooling, moist, or dry Nature; some are saline,
others oyly, &c. And most of them have several of these properties in some degree, all which may be suted to the removal of whatsoever is contrary to, and less powerful than themselves: now Diseases, if simple, are only an excess in one quality or other, which an appropriate nutritive simple judiciously applyed, if the quantity be sufficient, and especially if often reiterated, doth usually redress. To make this more cleer, I will give one or two obvious examples of the same disorders caused and cured by different Vegetables. It's well known, that Parsly eaten in a small quantity is apt to exasperate diseases of the Eye, and there are other Plants which prove more healing than that is hurtful, witness Eybright: And it hath been observed that even Turneps render the sight more acute, cure moderate Inflammations, and are commended by Physitians to be of frequent use while persons are under cure for the
Gutta Serena, Recent Cataracts, & other diseases incident to that tender part. But this will appear most evidently in the Sea Scorbute which is contracted usually by a bad Diet, salt meats, and nastiness; sometimes extremity of heat or cold combining to exasperate it. 'Tis hardly to be imagined how deplorable a condition those persons that are highly afflicted with this distemper seem to be in, being to appearance absolutely incurable by the most generous Medicines, helped with the advice of the greatest Physitians; yet such slight things as the juice of Limons, Fresh meat, but especially plenty of green Herbs presently dispell all these horrid threatning Symptomes, and that so suddenly that they seem to be cured by a Charm, those who were not able to stir a limb, were exercised with many grievous Maladies, in a week recovering perfectly their former health; which perhaps long courses of Physick would
never have restored to them in a much longer space. And we find, that not only the Sea Scorbute, but that also wch. is on land contracted by eating salt meats, is more certainly and suddenly cured by a convenient diet, then by Physick. And an Eminent Physitian in this city assured me, that most ill habits of body occasioned by feeding much on salt meats, are soon cured by eating daily for a few weeks a good Quantity of almost any edible green herbs. And another no less considerable, who hath great dealing with Seamen, protested seriously to me, that he cures all those among them that are Scorbutically affected, only with young pease, ordred all manner of ways; eaten crude, boiled with, or without their shells, whose juice is to be plentifully mix'd with their broth; that this Remedy never failed him, nor the Seamen of cure: and this sometimes after the disease had eluded many very promising Methods and Medicines.
We have hitherto treated of Meats, which Physitians, as I have shewed, can render medicinal. I now proceed to mention, Drinks, which are no less, nay more capable of being improved, by being impregnated with the virtues of Simples Animal, Vegetable, and Mineral, or their Preparations, and not become considerably distastful to the Palate, or nauseous to the Stomach. There are myriads of such prescripts in the books of Authors. I shall only mention that method which is of general use in order to the extricating the virtues of Simples or Compositions, which is this: The ingredients are to be hung in fermenting liquors, whether Wine, Ale, Beer, or Cider, &c. and that their medicating properties are extracted by this method, dayly experience doth attest, many who either will not, or cannot use other Physick, being recovered by ingredients thus prepared. For the fermenting liquors being
in a brisk motion, and abounding with active parts chiefly spirituous, insinuate themselves into the most private recesses of the Simples or other materials, give motion enough to their active parts to loosen them from the more gross, and drive them into the liquor, and these freed, associate with their deliverers to unloose the rest. And that the Crasis, or chief parts and properties of Simples are by this method obtained, is evidenced by the effects and tasts of the drinks exactly emulating those of the materials which were thus fermented. As for what refers to Cures effected by these means, I dare boldly affirm, That there is scarcely any Chronical Disease, that is cured by the Shop Medicines, which may not be cured with more certainty, ease, and pleasure, by Drinks thus ordered, joyned with a regular Diet.
Thus have we shewed of how great advantage a convenient Diet is in order
to the cure of Diseases. I have spoken more largly to this particular, not that I design to learn Physicians any new notion, they having many of them better digested thoughts on this subject, then these which are the Product of two hours Meditation; But I mention these things partly on the account of the Vulgar, that they may have other apprehensions of understanding Physicians, then they have hitherto entertained; as also that I might learn the Apothecaries to know themselves, and their own insufficiency; or if they will not acknowledge it, to expose them so nakedly to others, that, unless they will shut their eyes, they cannot but behold unpardonable weakness and great defects in most of those confident blind Bayards, the Quacking Apothecaries; who before I have dismissed them, will appear lean and scrannel, though now they seem plump and juycy. I shall therefore
proceed to polish the mirror: wherein if impartial Spectators do view and compare them with Learned honest Physicians, they will find without any delusive Catoptrical trick, no less difference between them, then there is betwixt admired beauty, and hated deformity.
Therefore lastly, A Physitian will appear to be Superior to other pretenders, if we reflect on those many advantages he hath, whereof they are wholly destitute. He is accounted to to enjoy a great Piviledge, who hath been Educated by an Eminent Practicioner of Physick, who hath been free in his communications to him; and this is by the Vulgar accounted sufficient to constitute a person, who hath been in such circumstances an able Physitian: And the best plea the Apothecaries have, is, that they have collected the Practice of some worthy Physitian for most Diseases; now there is no Physitian but injoys the
benefit of the writings of many hundred excellent persons, that were eminent in the same faculty before him: These have faithfully communicated their experiements and observations of the causes and symptoms of diseases, and of their cures; what methods and Medicines they found most beneficial, what things are injurious and to be avoided: And there are others who have left us their writings concerning the virtues of most Simple and Compounded Medicines, in what cases they have been found effectual; and many (which is perhaps the most profitable way of writing) have left us intire books of Medical Observations, to which Physitians, who have a Scheme of them in their memories have recourse in difficult cases, and by Analogy know how to proceed, as do the Lawyers, on other occasions.
Now let us suppose with some that Physick is altogether Empyrical, being rather a Mass of Experiments then a
Science perfectly formed & established on sound unquestionable verities (wch is the most plausible plea Apothecaries or other pretenders can use) yet still it must needs follow, that he ought to be esteemed most able and sufficient, who is furnished with most and best experiments, either from his own observation, or by reading of books which afford him the experiments of all the rest of the world, and can best conclude and argue from the Analogy, Correspondence, and Harmony, they have one to another. So that a studied Physitian must, in all consideration of reason, have far the advantage of any other.
Indeed it hath been objected by some that the diseases of one country & age are so vastly different from those of others, that what is profitable to those thar live in one age, or to the inhabitants of one Country is not so to another. Which is not only a great mistake as I have else where demonstrated, but
of bad consequence, leading us to the neglect of the writings of many Excellent Persons, from which we do dayly derive great assistance: For although I will not deny but that there may be some uncertainty, and the Analogy may not be altogether so exact, as we could desire; yet it is no otherwise then the variation of the Needle, touched by the Load-stone; which although it doth not always directly point to the Poles, but in some places considerably varies, so that the most skilful Mariners cannot certainly, though they can neerly determine where, and in what degree of Longitude they are; yet it is such a help that they cannot without great hazard ingage in long and dangerous voyages without it; and by it's direction, if no other ill accidents intervene, they usually arrive at the desired ports, though very remote from the place whence they set forth. So a Physitian by the help of his own and others observations,
for which he makes allowance, or abatements, as he sees occasion, Pilots most of his Patients almost, as surely as if his course were chalked out for him or directed by a line; So that patients, who venture themselves in dangerous cases with Physitians and Apothecaries, do it only with this difference, the one (as it were) Imbarks for a long Voyage in a Leaking Skiff, with an Ignorant Pilot without Sayls, Compass, and other due Provisions, the other in a stanch fair Ship, well Riggid, provided with a skilful Pilot, good Compasses, and all other requisites for Navigation: And which is like to make the most short and fortunate Voyage, which is most secure from storms, foundring, or holding uncertain courses, is, I suppose easily determined? 'Tis true we read of some, that in a little Boat set out from New-England, and made a quick and safe Voyage to Ireland; and of others, who no better accommodated
Sailed from the Bermudas to Virginia; yet these Accidents are not frequent, and if they are registered, it is under the notion of extarordinary events. And besides none of these were so mad as to have neglected any helps they could have procured, it not being choice but necessity, that put them on such strange adventures, and to run so great a risque to escape dangers, which they could not otherways avoid. But this is not the case of any that are sick, there being choice of means, so that for a man advisedly to hazard that, which is so precious and valuable as life, by committing himself to the care of ignorant unskilful Empericks, when he might in a great measure secure it by consulting a sober Learned Physitian, is to put an affront upon his reason, or to disesteem his life; but certainly there are not many, who after so fair a warning given them, will expose themselves to dangers, which they may so easily avoid. I will therefore now proceed,
in compliance with my promise, to give an account of some of those numberless unworthy practises, the Apothecaries are manifestly guilty of, in Order to the disgracing Physitians, and insinuating or confirming a good opinion of themselves.
They will often commend to persons as preventive Physick, a gentle Purge, and at night a little Dose of Diascordium, Mithridate, Treacle or somewhat else, in so small a quantity that it shall not disorder them; so that their Patient, for so they call them, finding that he hath received no prejudice by this Physick, and the purge possibly working kindly, (of which they among the Physitians prescriptions may have enough) apprehends that he may be somewhat better, and so begins to have some confidence in the Apothecary; who doth not loose any hold he hath got. For soon after the Patient perhaps hath occasion for a Physitian, himself or some of his family being ill: If it be for any distemper they
were formerly subject to, for which the Apothecary hath any of the Doctors Prescriptions; he then suggests that there is no necessity he should give himself the charge of sending for a Physitian who would prescribe the same things he ordered formerly, which prescriptions he hath by him, and is ready to make up for them; although now, as I shewed before, the case may be so altered by complication or otherwise, which the Physitian would presently have discovered, that this, which did once give Relief, may be either highly prejudicial or ineffectual. Thus they do ordinarily obtrude themselves and their Medicines on the sick especially if the disease be frequent and obvious, as the Measles, Small-pox, Fever, Scurvey; and some among them soar so high as the Venereal Lues: For they have seen persons often under courses for these diseases, and, having the prescripts still on the File, they know no reason why they should not cure them, as
well as the Doctor: They therefore tell them that it is a great expence to gratifie the Physitian, and pay the Apothecaries Bill, which in these courses they assure them, will amount to much (as indeed they do by their ordering) that they are throughly acquainted with the Physitians Method: which as I have already shewed, is a gross mistake and high presumption. But I cannot dismiss, without a further Check this frivolous pretence of the Apothecary, that because he hath most of those Medicines which the Physitian otdinarily imploys, therefore he ought to be allowed in the practice of Physick, it being a way of Argumentation not much unlike that, some silly fellow might make, who seeing a Lutinist play well to admiration, is there upon desirous to please himself, and gratifie the Company with the like Musick: But upon tryal although he have the same Instrument, as many Fingers as the Musitian, & the Notes prickt down before him; yet can produce no other
harmony, then what is the result of discord: And would he not render himself yet more ridiculous, should he perswade himself his Musick is not inferiour to that of the Excellent Artist, and becomes highly difpleased with the Company, because they do not bestow on him the same applause they gave to the person, he vainly endeavours to imitate? There being requisite to the best performance of Musick, not only a hand & instruments, but also an exact knowledge of the Rules of that Art, and frequent Exercise. So that for any to promise themselves the Art or habit without the use of the right means, which conduce to it's attainment, is the highest folly, and hath as little foundation in reason as an Attempt (according to our Common homely Proverb) to make a Velvet Purse of a Sowes ear, or any other unsuitable matter.
But to leave this, and proceed in the account of our Quacking Apothecaries,
who by some such Artifices as we mentioned having scrued themselves into families, that they take especial care of them according to their mean ability, I am willing to admit, their interest, obliging them so to do, and you may be sure, they ply them with store of Physick; wch how fatal it proves to those that have the Measles or Small-pox, is too well known. But if by good fortune the Patient escape, then they sufficiently Celebrate themselves in all Companies, rendring the case somewhat more dangerous & difficult, then really it was: whereby they make way for their Introduction into other families. But if (as is most likely) by their ill management, the Patients lapse into a dangerous condition, so soon as they are sensible thereof, they immediately advise them to send for a Doctor, who is oftentimes so Civil as not to animadvert on what hath been done amiss. If they recover, then he endeavours to perswade them, that the
Physician proceeded in the very same course he intended to have followed; and that it was only for their satisfaction he was desirous to have the Physician advised with. But if the person dies before the Physician was sent for, he cryes out with a wide mouth on malignity, which is for the most part no other then the effect of his ill management; yet being dead he sparingly suggests that he fears the Physician took not a right course; and wishes that he himself had proceeded after his own method, which for any thing he knew might have recovered him: which suggestion taking with the humour of the people, who are very prone to accuse the last medicines of any strange Symptomes which are often Fore-runners of death, the treacherous Apothecary makes a great advantage of his own miscarriages. Which double dealing having been detected by some Physicians, hath so highly displeased them that they have
often been ready to take up a firm resolution never to take care of any Patients who had before been managed by Apothecaries; and had actually performed it, did they not apprehend it would be a breach of Christian charity to punish people so severely for imprudent actions extorted from them by an others over-bearing perswasions and confidence. These are some of those many artifices the Apothecaries employ, I speak not at randome what they may do, but what they have often actually done, many of which have fallen under my owne observation, others I have received from the Patients or Physicians themselves, on whom they have thus imposed. Now I appeal to the whole Nation, whether such great mischiefs and inconveniences as these I have already enumerated, ought not to be redressed; and that we may not think they are beyond the reach of any remedy, I shall now proceed to the mention
of those proposals the Physicians make to the Apothecaries: with which if they comply, they will save themselves from ruine, which otherwise is at their heels. I have also thought fit to let the world know that we can subsist without them, and that probably much better then with them; I mean more to our own and the Patients satisfaction or security, as in it's due place shall be made manifest.
Notwithstanding that Physicians and their Patients have been so highly injured by Apothecaries, that they might with the greatest justice utterly reject them; and although the nature of their crimes seem to be such, that they cannot safely keep any further correspondence with them: yet this is so far from being the design of the Physicians, that if any expedient can be excogitated (and such they apprehend they have found out) which may prove a fair ground for an accommodation, they are willing to
forgive and forget all former miscarriages, and give them such encouragement as reasonable and honest persons can desire. Now all that the Physicians expect of them, is that they keep in their own Station, and endeavour to answer the end of their institution. That is, First they shall give the Physicians sufficient security and assurance, that they will carefully and faithfully prepare their medicines; And secondly, that this shall be their sole imployment, they no more intruding themselves into the Physicians, which is the practice of Physick. If these be not reasonable requests, let the Apothecaries themselves propose such as are, which the Physicians are ready to receive. Now that the Physicians can be satisfied with nothing less, if they have regard, either to their own credit and subsistence, or the welfare of the Patient, is easily evinced by a recapitulation of what was said before. For if it be true which I think was demonstrated,
That many Apothecaries are not well acquainted with the Materia medica, and liable to be imposed on by Herb-women, Druggists, and others; If they trust to those for Medicines, that prepare them unfaithfully as 'tis manifest they do; If they themselves use bad drugs in their compositions and vent medicines which have lost most if not all their Medicinal vertue; Or if they are fraudulent in their compositions, leaving out frequently the chief Ingredients; If they substitute, add, and subtract at pleasure; Are negligent, slovenly, and superficial in their compositions, subject to mistakes, either from their own or Apprentices ignorance of the Latine tongue; and besides utterly unacquainted with Chymistry, a most material if not necessary part of Pharmacy; and instead of those noble Remedies, imploy such as they have from unfaithful persons, who ordinarily adulterate and sophisticate
them. If all these may be affirmed (as they may most certainly be) of most Apothecaries, would not Physitians expose themselves and their Profession to the scorn of the world, and might not their Patients deservedly load them with reproaches, should they still make use of their Medicines? And further, if the Apothecaries be absolutely unfit for the practice of Physick, why are they allowed in it? And that they are, was proved from the nature of Diseases, and those several wayes whereby they admit of cure. Where we shewed, that the Apothecaries are Masters neither of the cure by Method, Specificks, Arcana, or any other compounded of these; That they understand not Physiology, and are not capable of attending to all those circumstances, which ought to be duely considered by a true Physician; That they understand not when Nature is to be left, to manage things after her own conduct: but on the contrary,
that they disturbe her orderly motions, and distract her in most regular Operations; That they are not acquainted with cure of Diseases, or preservation of health by Diet; That they ordinarily mistake simple Diseases for complicated, and these for such as are simple; That they are not furnished with those helps which are of great use to the Physician, such are the observations of the Ancients concerning the rise, symptoms, progress and cure of Diseases; and therefore deserve not the denomination of Physicians, nor can without extream prejudice to the publick, be permitted to follow the practice of Physick till they are better qualified for it. I hope then after such a Manifesto of grievances, the Physicians may either endeavour their reformation, or desert them; and entertain such as will be more faithful to themselves, and to their Patients. But they are very unwilling, though highly provoked, to
be an occasion of the ruin of so many as will upon their deserting them, be exposed to miserable exigencies; they will not therefore promote their downfal, till they deserve it by rejecting verbally or implicitly the succeeding modest proposals. It will therefore be expected:
That they do faithfully and carefully prepare all the Medicines they send out of their Shops, not trusting to whole-sale either Apothecaries or other Medicine-mongers; That all the Drugs they use shall be viewed and approved of by one or more Physicians before they enter Compositions, as also the Drugs that are of dayly use; That once in three months a solemn Scrutiny be made by Physicians, deputed for that purpose, of all their Drugs and Compositions: who shall be impowred immediately to cause to be destroyed all such as are found unfit for use. We also require, That they either themselves prepare
their Chymical remedies, or give the Physicians such assurances, that they are faithfully and skilfully made as shall satisfie them; And that care be taken for the future, that no Apothecary entertain any for an Apprentice that is not competently skilled in Latin tongue; and that they be first examined and approved by such Apothecaries as the Physicians shall depute. Further, Physicians observing the great inconveniencies which have ensued on Apothecaries having access to the Patients, which is not allowed of in many Countries, do also think it unreasonable that Apothecaries here should take that liberty, which for reasons mentioned is thought fit should be denyed them; especially having found upon due deliberation, that there is no need of them out of their Shops, where they are to look to the Composition of their Medicines: which in their absence often suffer through ignorance of their
young Apprentices, whatsoever is commonly performed by them among Patients, being otherwayes easily effected. Further, That they contract their number, or at least take care for the future, that it be not increased. And lastly, that such prizes be set on Medicines by Physicians as they shall think fit, who will take care that the Apothecaries have reasonable gain; That these be Printed, as in the Amsterdam and other Pharmacopoeia's, so no person can be cheated.
The Substance of what I have here delivered, is comprized in the last proposition mentioned, and insisted on by the Judicious Writer of that rational discourse concerning the state of Physick, in these words, or to this effect.
That Physitians send bills to be made up by Apothecaries, as now they are; provided only that the Time and Manner of using them, be not set down nor the name of the Patient, That it be not
sent by the Patient, but by their own servants; That it be returned to the Physitians again with the Physick it self, to be filed up by them or entred into a book with the Patients name and the time: the Physick so made and provided by the Physitians order to be fetcht at their own houses (as it is now at the Apothecaries shops) or from thence sent home by their own servants to the Patient. And because we cannot safely trust to Apothecaries for Chymical Remedies, they usually buying them of common Chymists or Operators, It is desired that the Colledge would erect a publick Laboratory, where all Chymical Medicines fit to be used, shall be well and faithfully made upon the Faith and Authority of the Colledge; and that they shall expressly appoint those, whose Physick they shall think fit to buy, to provide all their Chymical Preparations from thence; nor to permit the use of any other Chymical Preparations to any of their number, except he himself
make and prepare them, or have them from such Apothecaries as the Colledge being satisfied with their abilities and honesty shall approve of. And lastly, That the Colledge of Physicians (who herein will be soon imitated by others) Enact, That none of their number send bills to, or buy Physick of, any Apothecary who takes on him the practice of Physick, till they are fully satisfied he is sensible of the injury done to them, and cease to do the like for the future.
Now how severe and unjust soever these Limitations may seem to the Apothecaries, yet in reality this is but a fair and moderate course between them and Physicians; for it hinders not the Apothecaries making and selling of Physick to any that shall please to buy of them: which thing only belongs to their Trade. To visit the Patient, feel his Pulse, and consider his Urine, discourse of the state of the Disease, and prescribe proper
Remedies for it, is the business and care of the Physician: So that by this method the Interest of both will be preserved, and all causes of jealousie between the Physicians and them will for ever cease. The Physicians practice and profession will be so absolutely and intirely secured to himself, that the Apothecary cannot invade it; for he will never see a Physicians bill (from which they alwayes take direction) nor the Patient himself, and so be utterly ignorant of that case for which the Physick was prepared and used; nor will he hear the Physicians reason and discourse of the due times and manner of Administring it, or explain the nature and cause of the distemper, nor have occasions of officious intervening between the Physician and Patient, nor dispence the Physick with praise of his own great care and pains in preparing it as he is wont to do, all this the Physician obtains by only concealing
his bills (the writing of a bill being as it were the Mystery of his trade) in which therefore he doth nothing, but what is held reasonable among all men.
Besides, This will insensibly lessen that exorbitant number of Apothecaries, which makes the trade scarce a competent subsistence. For as things are now, while the Master or their Servants, are imployed by the Physitian to visit his Patients, and carry Physick about, they will be under a necessity of taking several Apprentices; else they cannot perform such attendances abroad, and the business of their shop too: and this hath made so vast in increase of the trade within few years, as has rendred it but a mean way of livelihood 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: and, which is of much greater consequence, Physick will be better prepared, for the Apothecaries will be more in their shops, and not leave things to raw, negligent Servants, as is now often done; they not being sent about by Physitians to their Patients, or with Physick, no•• engaged in any Quacking practice of their own, will have more leisure to attend making good Medicines, which is their proper business.
This in short, is the Summary of what we expect from them; and if it be not granted us, nothing remains, but that Physitians take Pharmacy into their own hands, supervise the making of their own Medicines, and dispense them themselves. And we have reason to apprehend that Physitians will be put on a necessity of acting thus, it being highly improbable, that the generality of Apothecaries should be reduced to a sense and practice of their duty, having been so
long accustomed to such bad courses. For Custom, we know, is a second nature, and where bad, they are not easily subdued by those that heartily desire and design it, how much less by Immoral men who if they amend, 'tis from a principle of fear; and therefore they will redeem every opportunity of infranchising themselves and getting loose from a restraint so troublesome, and contrary to their inclinations. Besides, how unwilling will they be to moderate their gain, lessen their number, which must necessarily be done, unless we will allow the mentioned Inconveniencies, which cannot otherwise admit of a remedy. Besides, 'tis natural for some to be ambitious of practice, not only as it is gainful, but because it adds to their credit and repute, conciliates them more respect, than people think ordinarily due to simple Apothecaries; and therefore to part with their imployment in this kind, will not be without
unspeakable regret and vexation. And besides, supposing, which is yet very improbable, that they should promise to keep within due limits, reform abuses, what other security can they give us besides their bare word or promise, which is so much the more unlikely to be valid; because, as I before intimated, it is not free but extorted: and 'tis absolutely impossible for any besides their own consciences to detect all their fraudulent practices. For though Physicians see and allow of their Ingredients, behold them mixed, what should hinder them, if any of the old Ferment remain, from increasing the quantity with bad Materials? And indeed, neither Laws of God nor Man, good Instructions, excellent Examples, or strict Observance of their actions, can hinder those that are ill disposed from acting that secretly, which sinister respects keeps them from doing in publick. Therefore such a constitution of Pharmacy
is desirable, where bad men shall be made good and faithful, rather that where those that are innocent meet with daily temptations to be dishonest.
This will be accomplished by Physicians taking it into their own hands; for then suppose them as bad as malice, or the Apothecaries can render them, how little sense soever they retain of their duty, that of interest will strongly oblige them to have good Medicines. Machiavel somewhere prudently advises, That if you would understand what mens designs or intentions are, learn what will conduce most to promote their interest; and that they will chiefly aime at, although to the unwary Spectator, they may seem to look another way, and act another part then they intend. There are but two cases where this Maxim is rendred invalid. The one is, when men are over-awed with such a sense of Religion, as will not allow them to
practice what they apprehend would be highly for their temporal advantage: but this is so far from hindering the Physitian, that it is or ought to be the greatest incouragement he can meet with, the applauses and acquittances he will daily receive from his own conscience, proving an abundant recompense for the unusual trouble he will meet with in compounding and dispensing his own Remedies. The other occasion of invalidating the fore-quoted Maxime, is, when men mistake their interest and do not see it; which here is morally impossible for a Physitian's credit, and consequently his profit depending on the goodness and success of his Remedies, the better his Medicines are, the greater will be his gain, the higher his repute: Whereas the Apothecary, let his Medicines be never so bad, runs little hazard, the Physitian only being usually blamed if they cause people to miscarry; especially if the Apothecary
can confidently affirm, that his Materials were choice, carefully and skilfully prepared, which they are never backward to do: adding, sometimes such insinuations as have a tendency to disparage the Physitian, and introduce themselves, as was before intimated. Therefore now we proceed to shew that Physitians can manage Pharmacy. Secondly, That if they proceed in such Methods as we shall mention, or some other analogous great conveniencies, and advantages to the Physician, and Patient; nay, even to the publick, will be the result of such Procedures.
The Proposals that we make, are, That either every Physitian prepare and dispense his own Physick; or that they enter into Associations: either of which will be of great advantage to the publick. Nothing can in my opinion be objected against the first, unless the Physitian himself pretend that it will be too great a trouble, and divert
him too much from his other imployment, of visiting and advising the Sick, or consulting in private with his Books, Reason, and Experience, (as every honest Physitian doth) in order to the Recovery and Relief of his Patients. Now to him that considers things attentively, this can be urged only by such Physitians as have a full imployment, which will afford them to keep in their own houses; or to have near them persons skilful in Pharmacy, whose only business it should be to provide such Medicines, whether Compound or Simple, as they shall have occasion to use in their practice, the Physitians directing and supervising them. So that supposing the Apothecary skilful, there will be little reason to fear miscarriages; for the Apothecary will have no temptation to be unfaithful, because it will not benefit him, his gains not being contingent (as now) depending on the quantity of Physick he sells, his salary
being we suppose fixt and certain. But rather on the contrary it is his interest to have the Physick as good as he can make it; for the greater success the Physitian hath, the more will be his imployment: and consequently he will be the better able to gratifie the Apothecary for his care and trouble in preparing the Medicine he imployes so successfully. But suppose the Apothecary should have bad designs (which yet he can never have so long as he is in his wits) he will want opportunities to effect them; himself, and his Medicines being almost continually under the Physitians inspection, who allows no bad drugs admittance into his Operatory, and may if he please, see them mix'd and duly prepared.
But Physitians will be freed from much of this trouble, if they take the advice of that late judicious Writer we have already cited, which is, That the most eminent among them
entertain in their houses persons of three or four years standing in either of our Universities, who are to be received in the capacity, not of Servants, but of young Students, Friends, or vertuous Companions, to be instructed in their worthy Profession; and brought up in the exercises of Anatomy, knowledge of Herbs, mixing and compounding of Medicines, (the drudgery resting on Servants) and visiting the sick under their direction: who when they are a little advanced, and studied in this Art, may be appointed by the Physitian to observe Patients in his absence, and give him an account of their cases; by which means he will be ignorant of nothing material, although he be not there himself. They may also visit their Laboratories, and look after the Preparations of those Medicines the Physitians prescribe; which as it will much ease the antient, so it will be of great advantage to the young Physitian,
who while he imployes his industry in such services as these for the elder gains (besides what is learnt from Books and Authors) his long experience sees his Patients, hears him discourse of their several Cases, considers the Medicines provided for them, and observes their several effects: All which advantages are now given away in vain to Apothecaries, to whom the practice of Physick does not belong. And if this has been the course that all mankinde has ever taken to raise and propagate practical arts, and trades of daily use in humane life, why should it not be used in Physick, which is a practical Art of much greater consequence? especially if we consider how dangerous the errours of this Profession are, and how necessary a practical education is for any man that intends the exercise of it. And though some through pride or weakness disgrace this method as Mechanical; yet without doubt there are many ingenious
young men in England, who would be very glad, and take it for a great honour to be thus received by some of the Grandees and great Practitioners: and their Friends think them well and honourably imployed.
But (to proceed in our discourse, which was interrupted by this seasonable Digression) because young Physitians, and such as have little imployment cannot allow an Apothecary maintenance out of their small gain; it being therefore proposed, That Physitians enter into Societies or Combinations, (which indeed they do naturally, and many such there are now in this City) more or fewer in a company, according as they have greater or less imployment: That these provide a place which shall be the publick Laboratory, for the preparing of all Physick, Chymical and Galenical. That they also procure one or more skilled in the Operations of both faculties; these to have, either the profit
profit of all the Medicines that shall be prepared: or to have a certain salary or allowance from the Physitians, yet to proceed to register Bills, and receive money, as if they were concerned only for themselves. So many Physitians frequenting the Laboratory, will be a double advantage; for if they meet with any new and extraordinary way of preparing any sort of Medicines, they will readily communicate it for the benefit of the Society: and so many supervising Drugs and Operations, it will be almost impossible to erre, and difficult to cheat, if the Operator should have such a design, which would be the highest folly and madness in him who makes no benefit thereof, but is rather to his prejudice; as it will be also eminently of the Physitians, who therefore will not connive at, much less incourage, any Practices of that nature.
But to be more particular, the
Reasons and Advantages of these proposals are very many, and of great Consideration.
For first, if this course be taken, It will free the Physician from much Anxiety and Hazard, from which, he cannot plead exemption (if an observing considerative person) while he depends on the honesty, care, and skill of an Apothecary, in whom perhaps he hath little reason to confide, upon some or all of those accounts, I have already mentioned: Whereas now in this Constitution of Pharmacy, the Physitian will be satisfied his Medicines are good; and that he cannot be injured by the malice or designe of unworthy, miscarriages or mistakes of Ignorant or Careless Apothecaries.
2. This will also free the Patient from fears, jealousies, and dangers; to which, they will be subject so long as the Physitian shall repose so great a part of their trust in persons, who
do seldome faithfully discharge what is committed to their care. How great a satisfaction will it be to them, for Physitians to put their affairs in such a Method, that all the Physick is prescribed, be prepared exactly after the Physitians direction? and That it will be very unlikely they should suffer from any of those mistakes and miscarriages, which have heretofore often happened? For the Patient knowing it is the Physitians interest to take care that his Medicines be prepared aright; that they are immediately under his inspection; that the Operators have no bias clapt upon them, which should make them run aside, will throughly acquiesce in all that shall be done: which quietness, composure, and satisfaction, will promote the Cure, according to that of Galen, Plures sanat, cui plures fidunt. There is greatest success where people have most confidence. Which in this case is far from presumption;
For I see no reason, why they may not promise to themselves, and expect better success from Medicines, that are contrived with skill, and are prepared with the greatest care; than from such as are carelesly and slightly made, or which is worse, Adulterated. Which brings to my mind a third Advantage.
3. If this course be taken, it will render Physick more successful. For Medicines will be better prepared, than now they are, the Physician taking care himself to have nothing but what is good; which he could not so well do, when it was made up out of his sight. Besides, He is under a necessity of taking greater care to have all he uses very good, and most exactly prepared; for no man can now lay any miscarriage on the neglect or ignorance of an Apothecary. It rests altogether on himself, and he becomes responsible for it.
Further, the Profession of Physick
will be exercised with greater success, if Physitians prepare and dispense their own Medicines, than now it is; because then, all sorts of men would apply themselves immediately to the Physitian, whereby he will have opportunities of seeing the disease in its first rise, which gives him a mighty advantage, for the true understanding and cure of it. Whereas now it is the unhappiness of the Physitian (and indeed chiefly of the Patient) that he is never almost sent for, till things are brought to extremity, and all opportunities of curing neer lost; Whereas if the Disease had been encountred in the first rise of it, with powerful and convenient Medicaments, the Patient had been again restored to health: whose life it may be must now answer for the first omission. Besides, that the Disease if met in the beginning, is often carried off with a little matter; which neglected, requires a long and troublesome
course: Not to insist on this, that more coming than formerly to the Physitian, enlarges his business, and experience. Neither is it a mean convenience, that Physitians will have no temptations, to recede from experimented Methods and Medicines, which I fear now they sometimes do, especially if they are easie, or obvious, lest they should bring themselves into contempt with Apothecaries, and discover their practice; so as they might use it to their prejudice, which is now frequently done. Neither need they adde more Ingredients than are necessary, or those that are of great price, and little efficacy to serve dishonourable Interests. And preparing themselves the Physick they give, will help them better to remember what had a good effect, and which had not, ot failed; and how to accomodate themselves to the same persons at other times.
4. This will mightily abate the
charge and expense of Physick, the Physitians being contented with such moderate prices for their Medicines, as will discharge what they expend for Drugs in their Laboratories, among Servants and Operators; so that if at the years end their receipts for Medicines amount to so much as they have expended on them, it is all they promise themselves, or expect from others. For the Physitian will not, as the Apothecary now doth, depend upon the gain of the Physick he sells to such as come to him; but as he did before upon the Fees which he receives from persons of condition and ability, when he is sent for out of his own house: for the trouble of selling his own Physick, he takes upon him only to advance the publick Interest, satisfie himself more in his own Profession, minister to the necessities of the poor, and consult the greater security of all. Now the charge of Pharmacy (upon a modest compute) if
this course be taken, will not arise to a sixth part of what is now paid towards it; for we can buy Druggs as cheap as any retail, Apothecaries, and every Physitian or Association of them, knowing what Compositions they shall chiefly have occasion for, such only are prepared, and so much of them, as they conjecture may be sufficient, till they have an opportunity again to make them, which shall always be when the Ingredients are fullest of vertue and vigour. By which means they will avoid that great loss of Medicines which is frequent in an honest Apothecaries shop, where many Compositions are made, that are not used six times in a year; may perhaps not once in six years, as I have heard many of them seriously protest: which must necessarily occasion great losses, unless they are kept till they have opportunities to vend them, as most of them do, although they retain nothing of the Medicine, they once were, besides
the Name. So that in this case the Apothecary is inevitably exposed either to be a looser, or become dishonest, This is to the prejudice of the patient, the other of himself, who must endeavour to repair his losses, by inhauncing the prizes of those that remain; which doth also obliquely reflect on the patient, although of the two 'tis more excusable, and both of them are avoided, by the expedient we have proposed; Where the Medicines will be assuredly good, the Physitians interest obliging him to look to that, and withal afforded cheap, I mean at the same prizes they cost him; Physitians being abundantly requited for their care and pains in seeing to the preparing their own Medicines by the success they will have, and by it's necessary Concomitant, a full Imployment. But suppose a Physitian should sell his Physick to the meaner sort of people, who give him nothing for his advice, as
dear as the Apothecary now doth, it is still a great benefit to them, they having advice and Physick too for the same rate they paid for Physick alone.
5. The leaving off the common way of sending Patients to the Apothecaries, will be a great case to the publike; especially to the poorer sort of people, to whom now the Physitian will have a fair advantage of being charitable, and exceedingly helpful as he will be: either if he let them have their Physick at the same price it cost him, bestow it on them freely or (which I suppose will be most usual) teach them how to prepare it themselves. For it's well known that Physitians who are Masters of method, and well acquainted with the Medicinal properties of simples, do often effect great cures, by means, which to an injudicious Person will seem slight or trivial. And indeed if we seriously consider things, we cannot but conclude that nature hath made perhaps
no less plentiful provision of remedies for the poor than for the rich, that Diseases may be cured in the absence of Aurum potabile and costly Elixirs; without Magisterial Syrups, Apozems or other chargeable Compositions. We have I perswade my self Medicines at our doors▪ or neer us; we need only gather, and slightly prepare them, and certainly 'tis no great labour or trouble to make an Infusion or Decoction, to express the juyce, or dry the herb▪ and employ the powder: and yet these easie and obvious Preparations are oftentimes (perhaps usually) no less effectual then those which are more elaborate. Now of how great advantage is it to the poor to be adopted Apothecaries by the Physitian; and instructed how to make their own physick, which costs them nothing but a little labour? These otherwise by reason of poverty must commit all to Nature, whereby they are often exposed to a manifest
hazard; and many die who if they had seasonably consulted the Physitian might have been rescued with some common familiar remedy. Besides we shall frequently have opportunities of obliging the poor in another way; For Physitians having for their patients many Ladies, Gentlewomen and other Persons of Consideration or Qualitys, whose charitable inclinations dispose them not only to feed and clothe the poor, but also to supply them with Physick, if they knew what was proper for their Diseases, now a Physitian knowing what Distempers are most frequent in his neighbourhood, can instruct them what provision they should make in Order to their Cure, of Drugs, Simple distilled Waters, Syrups, Conserves, Spirituous or Cordial-waters; and those much better then any which are made in the Apothecaries shops. For I should suppress truth, if I did not acknowledge
to the honour of that Curious Sex, that all those preparations they themselves make, are much superior to any the Apothecaries can produce. Now what I have mentioned, is not a meer supposition, or a thing desirable; but is daily practiced by many tender, sweet-natur'd Creatures: and if all Physitians improve the Interest they have in Wealthy, Generous Patients, I perswade my self it will become a general Practice. Which if it should, as these gallant persons will be commended by all men, and beloved by those towards whom they exercise this beneficial Charity; so without doubt these Actions will be acceptable to God, and have their reward in this life, and in that which is to come.
6. This will be of high advantage to Physitians, and those Patients of theirs that live in the Country, where multitudes miscarry, (and many even among the Gentry,) either under bad
or for want of good Physick. For the Country Apothecaries not having certain vent for their Medicines, and few among them being well skilled in their Composition, to avoid charge and trouble, buy such things▪ as they have most frequently occasion for, of London Apothecaries who sell Medicines cheaper than the others can make them; and well they may, they being either the refuse of their Shops, or fraudulently compounded, I mean, made either with old or perished Drugs: or else they leave out the most costly, which are often the most effectual and active Ingredients. Now Physitians in the Country comporting with the common way of sending prescripts to the Apothecary, especially those that concern persons of Quality; Which Physick, what effects it is like to have, I leave to others to conjecture; for my own part I will not affirm, That any are dispatched by it (though we have little reason to believe
bad Physick can have good effects) but of this I am most certain, that it lets many die (which is little better) whom probably it would have restored, had it been such as the Physitian presumes the Apothecary is furnished with. And but that it is contrary to my nature, and the design of this Discourse, to divulge any thing which might be a reproach to particular persons, I could name several gallant Gentlemen, exceedingly beloved in their Countries, wherein they were very useful; who miscarried, as is verily thought (by those that are competent Judges) between the neglect and baseness of the Country and City Apothecaries. Whereas, when it shall be once declared by the Colledge of Physitians, That it shall be accounted to disgrace for any to prepare their own Physick; this will be the most pleasing News that can come to Physitians who live remote from great Cities, and have hitherto abstained from that practice,
only to maintain their reputation, the Apothecaries and their adherents, endeavouring to blast the repute of those that provide, and give their Medicines themselves; branding them, in all Companies, with the ignominious Titles of Empirick, and Mountebanck: which injurious design often takes effect among those half-witted people, that are greater admirers of Formality, than Realities. But the Colledge having published such a Declaration, as I have mentioned, Physitians will receive greater encouragement from discerning persons, who certainly will be best satisfied with their Physick, when they have it from the Physitian himself, which surely will be as good as he can contrive or ••••ke; otherwise he will ruine his Patient, his Reputation, and indeed himself by the loss of his livelyhood, and subsistence: for now if the sick miscarry, from any defects in the Physick, the Physitian only can be blamed,
it proceeding from his ignorance, or neglect, that he provided not better. Besides, in many parts of England, there are no Apothecaries, or the people are so poor, that the expense of Physick is intolerable to them; and therefore the Physitian cannot help them, if he prescribe only Shop-Medicines.
Now, Is it not a great shame, that Physicians should not be able to teach the poor, how to provide themselves with sutable Remedies? especially in the Country where Nature hath open so rich and large a shop, stored with all those materials Physitians can have occasion for, who want only the knowledge of their virtues, or how to prepare them: with both which they will better acquaint themse••••es, when they leave off the Apothecaries, and take Pharmacy into their own hands, which brings to my mind, those other Advantages that will attend such a state of Physick.
7. Physitians preparing their own Medicines, and giving or selling them to the poor, without expecting any thing for advice, is a great advantage to the Publick, as it overthrows the practice of persons that are ignorant of the Art of Physick, who now take on them to Administer it, to the great prejudice and dammage of the people; especially the meaner sort, who now the charge of advice is taken away, and that of Physick lessened, will much more willingly address themselves to sober intelligent Physitians, than to Apothecaries, and other Quacks or Mountebanks.
8. This improvement of Physick will be of great advantage to Philosophy.
First, Because thereby the practice of Physick being taken from those who have hitherto usurped it, and intirely secured to sober, learned Physitians, will afford them somewhat more than an handsome subsistance;
which of all persons living, they are most capable of improving, and most ready to imploy in Physiological Researches. This overplus will enable them to be much conversant with Anatomical experiments, not only about Man, but other Animals; that by comparing their structures, they may attain to the knowledge of the true and natural uses of each part: they will also busie themselves more about the investigation of the nature and properties of Simples, and be more frequent in the practice of their composition; and some it's probable will engage deeply in Chymistry, a most noble Invention, which seems equally calculated for the benefit of Medicine, and Advantage of Philosophy.
But Secondly, Pharmacy being in the hands of Physitians, will give them many and great opportunities of advancing the Knowledge of Nature; Because (as a Learned person hath judiciously
observed) Physitians will then be frequently invited to take notice of many excellent Phaenomena, for the use and service of Philosophy, which now pass unregarded in the hands of Apothecaries and their Servants.
Besides, that by observing the several mutations which happen in the Preparation of Medicines, as well Simple as Compound, they will be assisted to consider what effects may happen upon their mixture with the blood or other juyces of the body; and give a great light to the Reasons of all the Appearances of Health and Sickness.
But above all other parts of Pharmacy, Chymistry will most transcendently manifest its usefulness, in reference to the improvement of Philosophy; which it doth most signally promote, by discovering the nature and properties of those Subjects, which are exposed to its Operations: as it gives us a great insight into the
nature of those simple affections of Bodies, we call Qualities, The knowledge whereof is the basis of a solid natural Philosophy; as it acquaints us with the constitutive Principles of most Bodies, whether Vegetable, Animal, or Mineral; informes us what are the great Principles or Springs of action in the production, preservation, and destruction, or dissolution of all Concretes. In a word, there is no part of Natural Philosophy, which it doth' not highly illustrate and enrich, with many noble experiments and observations which would pass unheeded by common, incurious Chymists or Operators: But will be highly improved by judicious, observing Physicians, in Order to the increasing our knowledge of Nature, and our Power over her, which are the main intentions of Philosophy.
9. Physitians taking Pharmacy into their own hand, will be a profitable means of improving it. For first, it
may be a means of inlarging the extent of the Materia Medica; and therein chiefly our knowledge of their Specifical Virtues. For then, there will be a more immediate converse between Physitians, Druggists, and Merchants; which will be an occasion of bringing into use many excellent Drugs we know nothing of, but what we read in Authors: by whose directions, Physitians can give them advice where they may be procured; how to discriminate the good from the bad, the Genuine from such as are Spurious, and Sophisticated; they can also inform the Merchants or Druggists how to preserve many of them, which for want of a little care or skill, loose most of their virtues, before they arrive at these parts. And as to what belongs to the Specifick properties of Simples, It is generally acknowledged, that of late they have been too much neglected. Now this is the only way to retrieve and improve that
knowledge, which will, I am perswaded, be greatly enlarged by some new ways of Analyzing Vegetables lately invented; and which will be suddenly communicated. From which we may derive fair conjectures, not only what their Constitutive Principles are, and what proportion of each Principle is in every Concrete; but some other hints will be given by some, of these Methods of Operating on them, which will not meanly conduce to discover their hidden properties: of which I must say no more at present. Whereas it's well known that the Apothecaries have very little of Curiosity, being rarely tempted to make any experiment, out of the Road of our Dispensatory: So that Pharmacy may degenerate, as it doth daily, every one striving to make Medicines cheaper, but few being concerned to have them better than others. Now Physitians, as they are more judicious; and understand the
grounds of Pharmacy much better than the Apothecaries, as may appear by some of their accurate writings on this subject; and may be seen in their ordinary prescriptions; many whereof are as exact, and the Ingredients no less Judiciously dispos'd, than in those processes we find in Pharmacopoeas. They are also acquainted with many excellent Chymical and Galenical Preparations which have been either Invented, or published, since our Dispensatory was last revised; and most know better Methods of preparing many of those Medicines that come frequently in use, as of simple distilled Waters, Syrups, Spirits, Extracts, Tinctures, Magisteries, as also of several Elaborate Preparations which may be made in less time, and with less expense then they now are, some Ingredients being superfluous, adding nothing but trouble, and expense to the goodness of the Preparation. Farther it
being, as I have shewed, the Interest of every Physitian to have his Medicines well made, there will arise a generous emulation between Combinations, who shall exceed in that kind, which will put them on contrivance and Experiments. The result whereof must necessarily be of Publique advantage; for somewhat amiss in former preparations will daily be discovered and corrected, instead of which, additions and improvements may be made: so that probably in a few years, Pharmacy will be very different from what it now is, and greater success will attend better Medicines, Which will heighten the honour of that Noble profession which seems now to languish for want of some such Remedy; add to the repute of Physitians; and be highly beneficial to the Patient, whose diseases will be cured more certainly, speedily, with greater security, and more pleasure (if there is any in courses of Physick.)
And here, since I have taken the liberty to reflect (a little unhandsomely, it may seem to some) on our own Dispensatory, I am forced to make a digression. The substance whereof is, that 'tis not my Opinion only; but the perswasion of most Physitians who are but indifferently acquainted with those Methods of preparing Medicines, which are of recent invention, That our Dispensatory is so far from being arrived at the highest degree of perfection, that on the contrary it is most manifestly, and in many respects very defective, abounding with pompous Prescriptions, some whereof seldom, if ever, come in use; And many Compound Remedies have been recently invented or divulged, which are of greater efficacy and larger extent than the best our Dispensatory can boast of. Besides in many of the Prescriptions that are of frequent use, there are superfluous Ingredients, which add indeed to the trouble and charge
we are at in compounding them; but little to the vertues of the Medicines, which would be better displayed, if they were omitted, the Preparations being rather clog'd than improved by them. And besides, Modern Industry, and Invention, hath found our better Manuals or Methods of Compounding Medicines, whereby the Ingredients are better opened, more exactly mixed, and in some more highly depurated; I mean, where the Active parts are freed from those gross useless portions of their bodies, which hindred them from exerting their salutary properties. And there are many Natural, Genuine, easie Methods of preparing Simples, especially Vegetable, whereby their whole Crasis is preserved intire, their vertues being rather heightned, then in the least impaired; which taken in a small Dose are more effectual than whole pounds of the Vulgar waters, Syrups or Electuaries. And as they
are not ingrateful to the palate; So neither doth the Stomach Nauseate them. And they have this further priviledge, that in some years their vertue doth not sensibly decay, not are they subject to corruption, as the shop-Preparations; and yet neither Honey, Sugar nor any Saccharine substance is imployed to preserve them, their own simplicity or their being exactly freed from gross unsutable parts, which are usually the occasional causes of fermentation and putrefaction, rendering them less liable to these destructive operations. Besides it hath been the complaint of Physitians for many ages, that Flowers which seem to be made up of the most fine and active parts of the whole Vegetable, and are probably enobled with Extraordinary vertues, do, in most of the Operations they are exposed to, loose those subtile portions of matter, from which we might promise our selves great effects. And I
confess it seems highly probable to me, that flowers are the Compendium of the whole plant, and possess more of their Medical vertues in a little room, than is contained in a far greater quantity of leaves, stalk, root, or fruit; and the wise contriver of the Universe seems to have destined them chiefly for Medicine. I shall not here mention those reasons and experiments which inspire me with this perswasion; only this I dare affirm, that they afford more Noble Medicines, if truly prepared, than any other part of the Vegetable: at least so far as I have made tryal. Now the shops employ the flowers, either dried, and then a great part of the Volatile active parts are exhaled, which being after decocted leave behind them a scarce sensible impression of their prefence; Or else they are beat up with Sugar into Conserves, which doth, as I could manifest at large, almost wholly change the properties of
these otherwise Active substances: The same happens also in Syrups and all other preparations, where Sugar is imployed. For although many perswade themselves that Sugar is a most Innocent thing, keeping Simples and their parts from putrefaction; and that it doth not make the least change in the Vegetables, it is imployed to preserve: yet by their leave I do assert that it is highly questionable, whether simples mixed therewith do not loose many of those Properties, with which by nature they were endowed, Sugar being an Active body, a sweet Salt (for so it may be styled without a Soloecisme, I having often made a Salt sweeter then Sugar of Ingredients either very Acid, or exceeding Fiery) and is a potent Menstruum or dissolver of bodies. And though Metals are commonly reputed indestructible, it being well known that they are recovered from
all ordinary Solvents, the same Metals without any alterations that they were when first exposed to their Actions; for notwithstanding that they are sometimes disguised, appearing in the form of Volatile Salts, lovely Crystals, or are brought over in the form of an Oyl swiming on water (both which I have had my self from them) nevertheless after all these Operations, the Metals are easily reduced into the same for weight, colour and other properties: and yet the Calces of these seemingly indestructible bodies, by a slight manual with Sugar over a Kitchin fire are so strangely altered, that none of the ordinary ways of Reduction will recover them their Metalline form. And so mild an Ingredient of Medicines as Honey, only by Distillation is made, as Corrosive and pernicious as any Aqua fortis made with Salt-Peter and Vitriol, dissolving Metals
much after the same manner. If then Sugar and Honey may, and do probably often superinduce another Texture, and other qualities than they found in Vegetables, destroying the former, it were advisable, that besides these Preparations we used others, at least on extraordinary occasions; wherein the vertues of the simples are preserved more intire: and wherein much is concentred in a little room. I will not deny but there is more trouble in making the latter, than the former; but extraordinary success will be an abundant recompense for the expence of time and trouble, the charge being rather inferiour, or at least but equal to what the vulgar Shop-Medicines now cost: a small Dose of those being likely to prove more effectuall then a great Quantity of these. And as for Flowers which occasioned this digression by a most facile
and natural method without any additament, or so much as the help of Culinary fire, they may be converted into Liquors exceedingly Spirituous; and which may be kept without loss of vertue many years. But of this the world will shortly, I suppose, have a more particular account; and therefore I shall let it pass without any further Illustration.
ut if it be enquired, What Preparations of Vegetables they are, which are pretended to retain the whole Crasis and Vertues of the Vegetables intire?B
I answer, The Essences made by Distillation, per descensum, in the Sun, which by other easie Operations, are further purified and exalted: the Essential Salts of Vegetables, I mean not the vulgar, but such as have the exact tast and smell of the Vegetables that afforded them, whose active parts are most evidently united in the
Crystalline Salts, as appears by the effects; as also from this, that if the Capious faeces be Distilled, they yield only an insipid Phlegm, and a very small portion of gross faeculent Empyreumatical Oyl: and afterwards the Caput Mortuum calcined never so long, yields no fixed Salt, which is in another form in the Essential, united with the active Principles of Spirit and Oyl, as appears upon Distillation. But besides these, the Essences of Vegetables made by the union of their pungent vinous Spirits, essential Oyles, and highly depurate fixed Salts, which by iterated Cohobations become a similar Liquor, wherein the Principles are inseparably united, are noble Remedies; and though I do not affirm, that they retain all the Specifical properties of their Vegetables: yet I perswade my self, that if they want any, this defect is abundantly supplyed by the acquest of new, which perhaps in many cases are much superiour to
what we could expect from the crude plant, most exactly appropriated. And that in a word I may manifest, how great alterations may be made on Vegetables by slight means, I will mention one Method more of dealing with them; whereby without any other additament than what they may receive from the Air, the leaves of all Vegetables being duly fermented and distilled, yield copiously a Liquour which rectified, is not to be distinguished from Spirit of Blood, Soot, Harts-horn, or other urinous Spirits or Salts: and mixed with highly dephlegmed Spirit of wine, they concoagulate into the Offa alba. And though some herbs, as Wormwood, Carduus Benedictus, Mugwort, &c. yield it more plentifully then others; yet all yield so much that a large Retort filled only with common Grass thus ordered, gives at least a pint of this subtile, volatile Spirit: which if often rectified, appeares in a Saline form, and is as
penetrating and fugitive, as the Salt of fermented Urine. As for the Caput mortuum, in vain do you expect a fixt Salt in it; That being made such by the action of the Fire; it being volatile not fixed in the Vegetable, as this natural way of Analysis evinces. I have by me an intire discourse on this subject; wherein there is a great variety (I had almost said infinity) of experiments and observations. And sometimes I am apt to flatter my self into a belief, that this is the true, genuine, and universal way of extricating the component Principles of Vegetables; and that it will give us a greater insight into their nature, than any thing which hath been hitherto made publick. Besides, there appear during these Operations many things, which will prove highly instructive to those that Philosophize on other Subjects. But to return into the way from which we were diverted, I affirm.
That, Physitians preparing and dispensing their own Medicines will be of great advantage to the Publike, as it confirms the health of the weak, and rescues many from diseases, who would otherwise faint under them, This addition to the number of the living, and increase of their strength, being of no mean importance, the honour and prosperity of a Nation consisting in a multitude of sound minds animating healthful bodies; whereby they are rendred fit for the Arts of War and Peace. And therefore, we may presume that publick persons, whether the most supreme or subordinate Magistrates, will be so far from opposing such a reformation as this we design; that they will give us all the encouragement and assistance we can desire. And questionless, if there be any Impediments or Obstacles, which Physitians themselves cannot remove, as I hope there are not many, they have reason to rest assured; that
our Great and Wise Counsel will in such cases interpose their Authority, which will extirpate whatsoever opposes it self to so just and advantageous designs. For where any thing is of publick advantage, what should hinder its proposers from expecting publick Countenance? It being well known, that in all well founded Constitutions where there is a union of interests, there will be united Counsels and Endeavours. And we may farther encourage our selves from hence, that they who are so tender of every mans propriety, that they account every invasion thereof, an injury done to themselves, will not deny their assistance to Physitians, whose propriety also is strangely invaded, the Usurpers now being almost ready to plead Prescription. And besides, we suppose that they who are so much concerned to keep every man in quiet possession of his own estate, will not be wanting to those who would endeavour
to render them more secure of their lives; which are of somewhat greater value. And that the lives of many are frequently indangered by ignorant, bold, daring Apothecaries and Empiricks, hath been made sufficiently manifest.
But besides all this, If Physick be really, as is pretended, a useful Science, the Publick ought to take care it do not degenerate; and that its worthy Professors be not discouraged, or deprived of an honourable subsistance. For it hath been ever observed, That where any Art receives greatest encouragement, there it usually arises to its highest perfection; and where its much slighted, there it soonest declines: The Artists either leaving those places, or applying themselves to the study and exercise of more profitable imployments. This will be exactly the case of Physick, which whilest it is established in that degree of Honour and Esteem it
may justly challenge, and the Professors thereof are liberally rewarded, and duly respected: this countenance will exceedingly heighten their Industry, and put them on Actions which may manifest to the World, that they do, in some measure, deserve the favour it shews them. So that some will cultivate the Anatomy both of the body and its humours, endeavour to acquaint themselves and the World with the admirable Fabrick and use of those parts whereof Man is composed, and the nature of those humours which produce such admirable effects as are dayly observed. They will never cease till they have investigated the nature of the stomach's ferment, a Menstruum so universal, that there is scarcely any Animal Vegetable, nay, even Mineral substances, which can elude its dissolving property, they being all by it reduced into a seemingly homogeneous milky liquor; they will then enquire how this comes to
be tincted with a noble purple dye, which they find it puts on soon after its admission into the bloud, and how that nourishes all parts, leaving with each what is suitable to its nature, and then returns again for fresh supplies, running this round without intermission till death puts a period to its Course. They will further examine the frame of the Lungs, the nature and properties of that air whereby they are dilated, its use in reference to respiration, and whence it is that we cannot subsist a minute without it. They will also more attentively consider the nature of the Nervous liquor, and that truly admirable effect thereof, Muscular motion; where small chords, by means of a little spirituous Juyce, helped with an advantageous situation, perform actions which would appear stupendous if they were not common: And are a Subject which hath hitherto sufficiently exercised the greatest Wits later or former Ages
ever produced: But nothing will more deserve their attentive consideration than the propagation of the Species, in which process there is not a greater or more pleasant variety than obscurity: The one serves to excite Desire, the other to heighten Industry; and there is no Physician, who hath any spark of Curiosity, or sense of his Duty, and sufficient Encouragement, but will endeavour to acquaint himself with these great Processes of Nature; I mean, the preparation of the food, its Distribution, Respiration, Muscular motion, and Generation: To which we may add, the exclusion of what is useless or burdensome. And then he can be no longer a stranger to her regular actings, and knows what are most likely to continue them such without interruption. But before this excellent Person we would here characterize, I mean, a true Physitian, attains to this knowledge he is at the expense of much money, time, and
trouble; for howsoever Providence might deal with the Protoplast, the wisest of Kings, or others in former Ages, and whatsoever some now pretend to the contrary, we cannot find that this Skill comes by inspiration, but is the result of innumerable Experiments and Observations. One dissection of a dead man is not sufficient to inform him of his frame, doth not learn him the use or function of each part; he converses with many other Animals living or dead, whereon he makes numerous experiments, which by Analogy and Induction he aptly applies to Man. Neither doth his learned toyl here end, this is but the Praeludium and most pleasant part thereof. He is forced therefore to consider the body of Man, not only as an Engine of curious and admirable contrivance, of unmatchable workmanship, wherein nothing besides beauty and order appears: But also as a Machine, which consisting of many
parts, and having great variety of motions, is often out of order, seldom long performing them all with the greatest exactness, but sometimes gives the skilful Artist an opportunity to manifest that he knows much of its nature and contrivance, by redressing what was amiss, and some waies supplying its defects. It is needless to mention those many diseases Man is subject to, there being no person that understands himself, and others, who hath not a Scheme of them in his memory; and yet, although the Anomalies mans body is subject to are so numerous, and many among them appear exceedingly formidable to most Spectators; they may be all removed by the skill of a Judicious Physitian. But how great is his care, how unspeakable his trouble, before he attain to the knowledge of the Symptomes and cure of Diseases? How often is his mind upon a Rack, and he frequently perhaps too anxiously solicitous for
his afflicted neighbour? He makes it his business to enquire into all those helps Nature or Art can afford him, which may prove conducive to promote their recovery; he many waies examines Simples, and uses all means to extort from them a Confession of their nature, deliberates whether he should imploy them in their simplicity, slightly, or more elaborately prepared; and when he hath determined, administers them with all due Circumstances. Now, surely to inform himself of the Medicinal properties of Simples, to know how skilfully to mix, compound, and sutably apply them, as it is no mean Art, so neither is it an easie labour, or an ordinary trouble, whether he derive his knowledge from those that have preceeded him in the same Faculty, or from his own personal observations. And if Physitians, who are of so clear Judgments, so unparallel'd for Industry, have no more respect or consideration
than mean, empty, shallow pretenders, we have reason to fear that hereafter persons of great Abilities and liberal Education will scorn to look towards a Faculty which, though noble and honourable in its own nature, is so low and mean in the esteem of the World▪ that every person who hath the confidence to affirm he is a Physitian, although perfectly ignorant of the Rudiments of Physick, shall yet have no less countenance from the Publick, than those gallant persons, who after a long courtship have rendered nature familiar, are acquainted with the causes and cure of diseases, and who have so well deserved of Mankind, that I cannot but marshal them next to those Divine Persons, who also, as these, are often slighted and neglected, although of them the World is not worthy.
But it is now fit I should leave these idle melancholy speculations, and presage better things of the Publick, and
to sober learned Physitians. For I perswade my self, I may promise them from Authority encouragement, and assistance proportionable to their care and success; both which will be more conspicuous, if they prepare their own Medicines: which I most passionately commend to their Consideration. And that this Proposition may meet with a kind Reception, and be more readily entertained, I will endeavour to return satisfactory replies to to whatsoever can be objected against it, by either Apothecaries or Physitians: For the most Noble designs have ever met with great opposition, and sometimes a proposal, which was made with a sincere intention of Publike benefit, hath occasioned the ruine or been otherwise prejudicial to the propounders; which would happen in this Case, supposing the Event of affairs did depend on the will of Apothecaries. But howsoever if they are resolute, and determine unanimously
to oppose all reformation, (which is sufficiently probable) they, and most of those that are tied to their Interests by alliances, will endeavour to possess the people wheresoever they come, with an Opinion of the injustice, and unreasonableness of the Physitians cause, and as plausibly as they can maintain their own pretensions; whereby they may possess many with prejudices against a most honest and Honourable design, who would otherwise have promoted it: For hearing the plea, but of one party which, if they proceed at the usual Rate, will be well stuffed with falsities, denying many matters of fact, which are notoriously scandalous, and producing things in their own behalf, which almost every Physitian can easily disprove. So that those persons, whom they shall thus abuse, apprehending they are engaged in a good cause, may unawares oppose Truth and Equity, contrary to their Intention;
which they had never done, but through misinformation. Besides the Apothecaries may urge (where they have not confidence to deny truths as visible as the Sun) that these designs of Reforming them are indeed fine spun Speculations, but can no ways be reduced to Practice; That if the hedge be once broken, and the Apothecaries discountenanced, it will occasion greater inconveniences then those, for which the Physitians design a remedy.
The Inconveniences are some such as these,
First, It will be an Act of great cruelty, advisedly to design the Ruine of so many Persons, who have most of them families to make Provision for. Besides that it will be a great injury to the Publike.
To this we answer, that the Physitians design no mans ruine, their intentions are Innocent, Rational, and such as will approve themselves to all
the world; And I suppose they are so far from deserving blame for Endeavouring to reform abuses, which have crep't into their Faculty, that, on the Contrary among wise people, they will meet with great Commendation and Encouragement: And for the Apothecaries to oppose them, because their credit by such proceedings will be Eclipsed, and their dishonest gain diminished, is, (pardon the Comparison) like Demetrius and the Silver Smith's opposing the Apostle, because, if the people hearkned to his wholsome Counsels, their Trade would fall to decay; a worthy way of Argumentation, and such as is in the mouth, only of selfish persons, who are more eager on their Private gain, then the Publike good. And the Apothecaries being so little concerned for that, I admire with what confidence they can expect the Publike should be so deeply engaged with them in a Quarrel
against those who are it's best friends, and fall out with the Apothecaries, only because they are enemies to the Publike; as most certainly they are if the least part of that be true we have affirmed of them which whether it be, let the world first examine, and after determine. So that if the mentioned plea of the Apothecaries pass for legitimate and valid, what sort or profession of men is there so base, and vile, which may not use the same Argument? Coyners, Robbers, Cutpurses, Sophisticaters of wine, who all pretend necessity of acting as they do, that otherwise they cannot subsist, but the Law is so far from approving of such idle pretences, that it deservedly, orders severe punishments, for such as shall by fraud or force deprive men of their Propreity. And shall we animadvert with so great severity on those that take away unjustly an inconsiderable portion of a mans Estate, without which he
can well subsist, and at the same time take no notice of him, that shall deprive men of health, and sometimes life? This were like fishing with that strange net, which keeps little fish and dismisses the greater: There is no reason we should punish offenders for slight faults, and find excuses and evasions for such as are guilty of greater crimes. In short
where the continuance of a few disorderly persons in any place, employment, or Publike capacity, is inconsistent with the good and Welfare of the Community, it is so far from injustice, and cruelty to reject them, that it were both, should we do otherwise,which is the very case of the Apothecaries, if their Medicines and practices be so dangerous, as we have reported them. But to be more particular in our reply, because some deceit may be concealed in universals; First, I say if it be so great cruelty to ruine many men in
their Estates, how much greater is it to expose as many, not once in an age, but every year, to a manifest hazard of loss of health, or life which are so much more considerable, that the Estates and wealth of all the Apothecaries put into the balance against the life of the meanest person in these Nations, the latter will surely Preponderate. Therefore when we are in such straits, that of two inconveniences we can avoid but one, none but an Imprudent or mad person will make choice of the greatest: But this is not our present Case. For all such Apothecaries, as are found to be upright and honest, shall be well provided for; and the remainder may addict themselves to other professions: If they pretend unskilfulness, no one will regard that frivolous allegation, who observes their frequent intrusions into the Practise of Physick. For wch, by what hath been said▪ they appear more unfit, then for any Mechanical
or other imployment; to the knowledge of whose Mysteries and Intricacies they may certainly much sooner arrive, then of so profound a Science as Physick. But to put a Period to this Reply the Apothecaries may consider, that there are in this famous City, and many other parts of England a great number of Ingenious Persons, whose ill fortune it was to addict themselves to the study of Physick, (for the event plainly shews it was their unhappiness) these after great expense of Money, after long and intense Study, being become well Qualify'd for the Practice thereof, cannot have a subsistence, the Apothecaries having more in their own hands then would be a sufficient maintenance for some hundred such persons, who are under so great discouragements, through the Coveteousness and Injustice of the Apothecaries, as none can imagine, besides those that converse with them.
Now to retort the Apothecaries argument upon themselves with advantage, we say, that it is a high piece of Cruelty and Injustice for the Apothecaries to deprive so many Learned, Ingenious Persons of a means to subsist. And I make full account that the Practice which is in the Apothecaries hand is as much their due, as an inheritance, which is held from the right owner by the Artifice of some usurper, and to take the Practice out of their hands, and turn it into the right Channel, deserves no more blame, than he that shall restore an inheritance long withheld to the true owners; For since but one can possess it, 'tis fit surely, that he to whom of right it appertains should enjoy it, rather than any other, how urgent soever his wants may be, how great his necessities. Thus all Circumstances duly weighed, it appears evident that the inconveniences, some few persons will deservedly labour
under, is not comparable to the advantages the Publike will receive from their Seclusion or Reformation.
Another thing the Apothecaries plead in their own behalf against the Physitians, is, that they are like Aesop's Dog in the Manger (for such an irreverent Expression I heard one use) who could not eat Hay himself, and yet would not permit the Ox to feed thereon. So the Physitians will neither take care of the poor themselves, nor permit the Apothecaries so to do, who are chiefly Conversant among them, advising and assisting those who would meet with little other help, they not being able to gratifie Physitians; who are (as one of their worthy Authors says) like Balaam's Ass they cannot speak till they see an Angel. These being neglected (as they would perswade the world) by Physitians, have recourse to them; and they it seems being prevailed on (Tender Hearts!) by sentiments of pity, let
them have such Medicines as they think most apposite to their distemper.
Whosoever reads this plausible story which the Apothecaries set off with greater advantage than their Advocate can, will look on the Physitians as churlish Levites, passing by their distressed brother, not vouchsafing him a single regard; who there lies in misery and danger till he is rescued from both, by such as vaunt themselves to be so many Charitable Samaritans: But how well that title becomes them, and how grosly and palpably they have calumniated the Physitians, will appear by the ensuing Discourse. First, suppose the Physitians should say to them (wch yet they neither do nor ever will) we cannot but approve of your charity, although we do not intend to imitate it; therefore we give you free permission to concern your selves as much as you please for the poor, we allow you to advise, and give them Physick, either freely:
or to afford it at such prises as you may be no gainers, so neither loosers. This and a greater liberty we will allow you, so that you tamper not with the rich, to whom we will give better advice and greater assistance than any they can receive from you. Can any man think, understands who the Genius of the Apothecary, that such Language will be very agreeable to him? No, the Contrary is well known, they make it more their business than the tending of their Shop is, to insinuate themselves into the most wealthy families, and find this Imployment more beneficial then their observance of Physitians.
But let us imagine, that our Apothecaries Shop is like an Hospital, to which there is great resort of poor distressed people, all which he supplies with sutable remedies (we will suppose the best) but upon what terms? Truly on such as are very beneficial to himself. For, not a dose of any
thing goes out of the Shop, which is not twice paid for; I mean is sold for double the value or price, for which they might afford it, and yet be gainers. So that by this time we see the Charity of the Apothecary is not so Conspicuous, as his Collusion in gratifying of others at their own expence. And that what I have said, are no Fictions will be attested by great numbers of Physitians, whose repute was never yet stained by unhandsome practices; and are so far from being such covetous, uncharitable persons as they represent them, that they have on the contrary often given their advice freely, refused money when it was offered them, if they knew or suspected the condition of the person to be very mean. And it's well known, that scarce any Physitian exacts mony of his Patient, what comes, is free gift, not extorted; whereas the Apothecarie will be paid by the poor immediately: and he alwaies gains
more of them by his Physick, than the Physitian hath ever for his advice. Nay I am well acquainted with several Physicians, who pay their Apothecaries every year out of their own Purses, for a large Catalogue of Medicines they cause to be bestowed freely on poor Patients. I fear the Apothecaries cannot produce many such Examples of persons in their own faculty. And besides, there is a great company of Physitians, of whose number I own my self to be (and I am confident many others, with whom I am not acquainted, have the same intentions) who have solemnly obliged themselves to go at all times to all Patients, poor as well as rich, whensoever they are called; and if they are in a necessitous condition, to give them their advice freely: only they will be called by the Patients or their friends, not by the Apothecaries, who will endeavour to give them much unnecessary trouble, and
put them to as many Inconveniences as they can, that they may make a benefit of their well-grounded refusals. If any person be taken Apoplectical with Convulsions of any kind, violent pains, or any other dangerous disease or Symptome, we will not at midnight decline giving them visits, although they dwell with poverty it self; But it's unreasonable a Physitian should be called out of his Bed on trivial occasions, and endanger himself to do that, which without any danger to the Patient, might be deferred till morning. To invite a Physitian to visit them at unseasonable times upon the aking of a tooth or corn, a slight pain or lask of the belly, or to cure diseases which are extant only in a depraved Fancy, is a most unreasonable request, and such as the Apothecaries themselves will not comply with. And indeed Physitians have been ever more ready (If I flatter them not, which I would not willingly)
to Visit and Advise the poor, where it has been only a deed of charity, and abstracted from interest, than the Apothecaries.
Another Objection I have heard some Apothecaries make against Physitians dispensing their own Physick, and deserting them, is, That the publick cannot with safety allow thereof; for then Physitians might prescribe their Patients poyson instead of salutary Physick: and all this without any danger to themselves, if they have any command of their Tongues and Consciences. That this is prevented by sending Bills to the Apothecaries, which besides is a great convenience to the Physitians; for should they be suspected upon some horrid Symptomes or ill Accidents attending the Physick they prescribe (which the Apothecaries well know sometimes happens, rather from their own carelessness, unfaithfulness or Ignorance, then the Physitians as I have shewed) these surmises are presently
quelled by the Physitians, appealing to his Bills on the File, which on Examination being found to contain nothing of that kind, for which he is suspected, he is without any more ado acquitted.
This Objection is so fraught with malice, and design, that I cannot consider it without some Indignation. This is the first time that ever I heard Physitians were in danger of turning Poysoners; and I do not remember that ever any were suspected for that fowl crime, although it's well known the Apothecaries have not escaped so well. But howsoever this is a most frivolous Objection on many accounts, for first, If Physitians were so wicked, as this Objection supposes some of them to be, that they should design the destruction of that life, they ought to preserve, Is any man so sensless as to think they could not meet with Apothecaries, as ill minded as themselves? Yes, I
dare say ten for one, besides, Is it not very apparent that all people lie now more at the mercy of Apothecaries and their Apprentices or Operators, then (supposing the design we have proposed take effect) they can ever at the Physitians? For although we send Bills to the Apothecary we can have no assurance, they are made up according to our Prescription, but the Master or Servants may add what they please, without any but their Consciences, being able to detect them. Therefore since they are so malicious as to start so unworthy an Objection, we might retort it upon themselves, and argue; since Physitians and their Patients are in danger of being poysoned by every Apothecary or their Apprentices, Were it not much better that Physitians should supervise those that make their Physick, whereby they may prevent this danger? And since the trust must be reposed in some, whether doth not
the Physitian more deserve it; than the Apothecary and his Apprentices?
But we will not insist on this, For I hope that all English men have so strange an Antipathy against this horrid Crime, that I am perswaded there are few amongst the worst of them would be guilty of it, although to save their own lives; and therefore we will acquit the Apothecaries, and others from suspicion of a crime, of which should they entertain the least favourable thought, they would deserve to be excluded from humane Society. But these vices I hope have not passed the Alps, and I wish they may ever keep within those bounds; and that they will never pass the Seas to us, so as to become Epidemical, my mind doth strongly presage.
But yet nevertheless, that no ground may remain for suspicion we shall send Bills or Prescriptions to our Laboratories, as duly as we now do to the Apothecaries, which necessity will
oblige us to, many being concerned together; otherwise instead of that order, and Conveniency we promise our selves, we shall have discord and confusion: but I shall relinquish so nauseous and ingrateful a Subject, Whereunto Physitians might have returned the same answer the Lacedaemonian did to him that asked, What was the punishment among them for Parricides? viz. That they could not imagine any person should arrive to so high a pitch of wickedness, as to be guilty of so enormous a crime; therefore they had made no Provision against it.
Another thing they are ready to Object to us, is, That if Physitians reject the Apothecaries, let them Contrive their business never so prudently, Medicines will be more unskilfully prepared, than whilest they Imployed them.
To which we Answer, That the Contrary will happen; for Physitians
will imploy, as I shewed before, such sober industrious Apothecaries, as are willing to be engaged by them, to which shall be associated, ingenious Operators: all these Combining, certainly Medicines will be better prepared, than they have been hitherto; for Physitians the Inventours of Pharmacy have ever since been the great improvers thereof, and not the Apothecaries: Among the Ancients Mesue, among the Moderns Renodoeus, Schroder, Zuelfer, Quercetan and Others. Besides, its well known that most Physitians are Masters of some Excellent Compositions, which are not extant in our Dispensatory, with which only the Apothecaries are acquainted; and many of them there are, have found out better general Methods of Distilling Waters, making Syrups, Electuaries, and other forms of Medicines than are commonly known: which if this design succeed, they will put in Practice highly to
their own, and the Patients advantage. And indeed there are few Physitians, but would prescribe (if they knew where to have it) Physick more pleasant, less Nauseous for quantity, and Quality, than any is in the Apothecaries Shops. So that we see this Objection returns upon them to their prejudice.
And indeed, if we impartially examine things, it will readily appear, that many Physitians have greater skill in Pharmacy, or the ways of Compounding and Preparing Medicines than any Apothecaries. For if no Persons are so well acquainted with the Nature, and Vertues of Simples, or with the ways of finding them out as Physitians, which is acknowledged by all; It will thence follow, that they in all probability must know best, how to prepare Simples, how to dispose them to Operate with the greatest advantage, which are most Effectual
with, and what without Elaborate Preparations; whereby the Vertues of many Simples are often destroyed not improved. And in Compositions they know the true Methods of mixing things together, that some may not annihilate the force of others▪ and so become altogether ineffectual.
But if it be further Objected by Apothecaries, That the Materia Medicais so copious, Compositions so numerous, that it will be an unspeakable trouble to Physitians to provide the one, and see to the Preparing of the other.
To this we Answer, That a good Method with little trouble, will dispatch much business, which in a hurry and confusion, will require a far longer time, greater expence, more labour; and perhaps at last be more perfunctorily, and slightly performed then the other. But further its sufficiently known that few Physitians, use a tenth part of what is in the shops; & perhaps if they made their own Medicines
they would find a convenience in a farther contraction of their practice; I mean confining themselves to fewer compositions, making amends for the number in the goodness and extent of those they use, and they can at any time supply the want of a Composition▪ (which yet will seldom happen) with Simples which as I have already manifested, would be so far from an inconvenience, that it would be a priviledge to Physitian and Patient, and conduce greatly to the encrease of our knowledge of the Specifical properties of concretes; wherein I fear we are very defective. And every Physitian knowing what Medicines he shall usually employ, may have them only made, which perhaps are different from those made in other Combinations, where he enjoys a double benefit; making fewer Medicines, he hath the more time to prepare them, and is likely to take care they be such as they ought to be:
and making only such as he is sure he shall have occasion for to dispence, thereby having little loss in their Medicines they can afford them cheaper; whereas the Apothecaries who make all the Dispensatory Medicines, loose many, (they being never called for) and are put on the temptation of selling others, when they are old, ineffectual, and have lost their sanative properties.
Another thing the Apothecary Objects against the Physitians new Model, is, That the Patients will suffer, they not having made Provision of Persons, that are acquainted with many Operations, about sick people which the Apothecaries perform with great skill and facility; such are the administring of Clysters, applying Leeches, Vesicatories, Plasters, Pigeons, Cupping-Glasses, tending them whilst under salivation, making fomentations,&c. and that otherwise they are very helpful to, & officious about the diseased.
To this we answer, That most of these litle pieces of Officiousness, whereby Apothecaries do so much endear themselves to Patients (of which favour, we have seen, they make no good use) are either such, as may be altogether as well performed by nurses or others that attend the sick, by the Apothecaries of our Laboratories, or others we shall breed up to these easily learned Operations; which have nothing of difficulty, but that a child of ten years old by the Physitians directions shall accurately perform: looking to people under Salivation only excepted; whom the Apothecaries for the most part less understand how to manage, than many whom the Physitians having instructed shall depute for that service▪ but to proceed.
The Apothecaries may further object,That neither Physitians nor Patients have much reason on their side, when they find fault with the dearness of their
Medicines; which if the Physitians upon Complaint find too high prized, the Apothecaries do make such abatements as they think just and fit.
This will be a fair pretence, although I never heard it urged by any of them, neither do I believe they will trust to the Physitians arbitration; but on the contrary I know several have flatly refused it. But supposing they should all agree, let us examine whether this will give much relief to the abused Patient. For, first the English are known to have so generous a humour, especially the richer sort; that they will rather pay the whole bill without deduction, especially if the sum be not considerably great, rather than give the Physitian the trouble of enquiring into this affair, which is indeed unreasonable, especially if such complaints were frequent: and nothing more certain, than that if all who were abused, should appeal to the Physitian, he
would hear daily as many complaints of Apothecaries, as he now doth of Diseases. And that an endeavor to relieve the Plaintiffe would give the Physitian sufficient diversions from more serious employments, will appear, if we consider that Apothecaries bring in their bills but once every year, when all circumstances are forgot; which gives them a fair opportunity of adding to the true number and heightning the prices of Medicines, the Physitian not remembring what he prescribed so long before. Neither is it to be imagined that a Physitian will, or indeed can have leisure to examine twenty or thirty bills, and set down the true value of the prescriptions, not to urge how unfit an imployment it is for the Professors of so noble a science as Medicine, to decide such controversies. Besides that there would be no end of this trouble, some of the original bills being lost, only the common title of a Cordial or Purge
being registred with their prices in the book. So that it will be impossible to make an Estimate of the value of Compositions, whose Ingredients we do not know.
The last Objection we shall think worthy an answer, is made by such Apothecaries, as will not acknowledge (which we have so largely proved) their unfitness for the practice of Physick. All they have to plead is, That surely people would not trust their lives with them, were they not satisfyed with their abilities and success. That Physitians indeed, may be better vers'd in the Theory; but that they are as well acquainted with the Experimental, Practick part, which is the most material.
To this I answer, first, Let them prove that any person who is not Master of the greatest Chymical Arcana (for that somewhat may be done by them extraordinary, though exhibited by illiterate, unskilful persons, I dare
not absolutely deny) can successfully exercise Physick; and yet have none of those Qualifications, I have before enumerated: Some of which seem not only conducive, but necessary, to the right administration of Physick. And for the vulgar to entertain a marvellous good opinion of many, who little deserve it, hath been observed by wise men in all ages; and hath of later years been confirmed by many almost incredible Examples. I shall instance only in some of recent memory: although I might without exhausting the store, in many hundred. It's well known that a pretended Chymist who calls himself Lockier, hath gained by a Pill many thousand pounds; which yet is one of the vilest and most contemptible among all the Mineral Preparations, I ever yet knew tryed in Medicine. The Ingredients being certain proportions (it's needless to mention, though I have often made it) of Antimony, Saltpeter, common
sea-Salt and Charcoal; whereof more may be made in one Laboratory, by two men in twenty four hours, than I believe he hath ever disposed of in the space of a year: and is so dangerous a Medicine that no honest person skill'd in Chymistry, who is acquainted with it's Composition, durst venture to exhibit it. It's true the gums and sugar wherewith the yellow powder is made up, do add considerably to it's bulk; but the chief and only active Ingredient is taken in so small a dose, that I know few things which can poyson in so little a quantity and this hath been fatal to many, who never spake after it had begun it's operation, and others did long repent their use of so rough a Medicine. I could give the world a large Catalogue of its mischievous effects: But I think they are generally satisfyed in that point; which is the reason that it is now disused. But formerly what crouding, what enquiring was there
after it, and how highly did they extol it whose good fortune it was not to be prejudiced thereby? Now if this were so admirable a remedy, why is it not so still? wherefore lies it neglected, if so effectual as was once pretended? But it seems long experience hath given the generality of people such proof of it's noxious qualities, that thereupon, they have desisted from it's use, and learned a lesson of abstinence, which some have offered to teach them at a cheaper rate. But the wit of the vulgar is most of it bought, and many of them cannot avoid any other inconveniences, than those they have suffered by.
Thus Time the Mistress of truths, often discovers many of great importance, and the vulgar, though not so quick-sighted to discern dangers at a distance; yet they can feel pressures when they labour under them: and having cast their burden, will never again admit of it unless so disguised,
that it appears different from what it was before. And thus my mind presages it will be with the Apothecaries, if their Ruin or Reformation do not anticipate it; for this encroachment of theirs on the Physitians Profession, is of no long standing. So that people are not yet well aware of what they suffer by them, but time and some more Experiments will open their Eyes; then the tide will turn, and that same water which carried them so merrily down the stream, will return them to the place from whence they set forth; and it's well if they be dealt so favourably withal.
But further, That we are not to take our measures of things from the opinions, and perswasions of the vulgar, will be yet more Conspicuous, if we consider, how many resort to be basest pretenders to Physick, that ever yet appeared; which may serve to abate the Pride, and Confidence of Apothecaries, who urge this is an
Argument of their own worth. There is scarce a Pissing-place about the City, where many Bills are not fastned; among which the most Modestly Penn'd, promise great matters. One undertakes a long Catalogue of diseases, and among them (can any be blamed for laughing thereat) of those that are incurable. Another performs wonderful cures by vertue of Medicines extracted out of the souls of the heathen Gods (by which I suppose he means Tinctures of Metals which he never saw) Many cure by direction from the Stars: Some by Phisnomy and Palmistry can foretell events; and I wonder none undertake to make the Heavens more propitious, for if they should I suppose there are many credulous enough to believe them. And how likely are most of these people, who make such large promises to perform them, when they are not instructed in the Rudiments of any Single Art or Science, being most of
them mean, Ignorant Mechanicks; who not being ingenious or industrious enough to subsist by the calling in which they were brought up, engage in another, the meaning of whose name they scarcely understand, and whose first Principles they are utterly unacquainted with: and yet the world flows in a pace to them they shrowding themselves from the discovery of the Ignorant, under the Covert of pretended Secrets, which are usually some ridiculous, sordid Preparations, whose effects if they have any good cannot possibly be made out unless we have recourse to the imagination of him that takes it. And if either they or the Apothecaries brag of any particular success; We may answer them, as he in Lucian did the Priest; who shewing him the offerings of those that had invoked Neptune, when they were in danger of Shipwrack, boasted of the Power of his God which was manifested by
the number of his Donaria, but how shall we know replyed he, how many notwithstanding they invoked thy God, have nevertheless suffered Shipwrack, which he suspected to be far the greater number. I wish the Application were not so easie as I fear it is. Thus we see that popular approbation is not sufficient to authorise Practicioners of Physick, even by the Apothecaries own Concession; who in all Companies do most bitterly inveigh against these pretenders, and disswade all people from consulting them: which whither they do from a sense of their duty or Interest is soon determined. I shall therefore take my leave of them, with this request that they would Exchange the Motto of their Arms for another, which will better sure with their actions. It is this Eadem probamus, eadem reprehendimus; for the Quacking Apothecary can plead little in his own
behalf, which the Mountebanks will not make use of in their defence: and urge few things against those Quacksalvers, their profest enemies, which these, if they have so much Latine may not again retort on them, in the saying of the Poet;
—Mutato nomine de te Fabula narratur.—
Now having displayed at large though not at full the injuries Medicine it self, the Physitians, and most sick people do dayly receive from the unwarrantable Practices of Apothecaries, nothing remains, but that I add a Proviso, which I have had in my Eye all along this Discourse. I would not therefore have any apprehend that, what I have said against the Apothecaries, is intended against them all, being affirmed only of the greater number; for it would be the highest injustice to Comprehend them all in the Character I have given of their unworthy associates: whose actions the Physitians
do not dissallow of, or declaim against more, than some among themselves. I dare not, I say, accuse them all of dishonest practices, there being several on whom there is impressed so true a Sense of their duty to God, and their Neighbours, that they are not capable of actions which will so highly dishonour their Christian Profession, or injure their neighbour. Others there are, whose skill in Pharmacy, and Chymistry, secure Physitians from those fears they would be otherwise Subject to, from their unskilfulness or ignorance, in one or the other. And here I must necessarily acknowledge, that I have met with some Apothecaries that for knowledge in Chymical affairs, have been much Superior to professed Chymists; and of all that I have hitherto met with, I account them the most faithful and industrious: and which may seem strange, they do prepare Galenical Physick, better
than most others, who have no other imployment; and therefore of all others in a New Constitution of affairs, they will deserve the greatest incouragement, as being most likely to be serviceable, and faithful to the Profession of Physick, and Physitians. Who are so far from designing any thing which will be to the prejudice of such honest skilful Apothecaries (who are all sufficiently known to some Physitian or other) that on the Contrary they intend them more good than they can in the present way, promise to themselves; and will make such provision for them that they shall never have cause to complain, or occasion given to betray, as the greatest part of their Company have done so Noble a Profession as that of Physick, Or such generous friends and great Benefactors as they will find the Physitians to be, so long as they keep in those due limits which shall with their
own consent be Prescribed them.
But here I foresee, some Objections may be made, by Physitians themselves, against the Design of preparing their own Medicines; which although they are weak, and of little import, and deserve not to be named after the mention of those many reasons, and high advantages, wherewith that proposal is attended; yet we shall give them a fair debate, and so put a Period to this Discourse.
It may be pretended by some that are guilty of delicacy, sloath, or ignorance; and by others, who are either proud, or imprudently Zealous, for their own honour, and that of their Noble Profession; That it is below a Physitian to make his own Medicines, or give himself the trouble of supervising those whom he shall appoint to prepare them.
To this I Answer, That I would gladly learn, whether they are Galenists or Chymists that object this;
not the latter certainly, for then they desert the Principles of their great Masters, Paracelsus, and Helmont, who do Anathematize all those that trust to Mercenary Chymists for their Medicines. And as for those who are the followers of the deservedly admired Hippocrates, or Galen, I wonder with what confidence any among them can scruple, as beneath them, those Offices wherein their great Dictators were so much Exercised. Hippocrates hath left recorded in many of his Writings, the care and pains he took to provide Simples, preserve, and prepare them for Medicinal uses; not only dispensing them himself, but making them in his own Operatory. And Galen visited many parts of Asia, which were renowned for famous Remedies; as Palestine for it's Noble Balsome, Lemnos, for it's Earth, and Cyprus for it's Minerals, bringing away quantities of them; Exposing
himself to great hazards, labour, and expense, only that he might furnish himself with the genuine Simples, and provide against the Cheats and abuses of Impostors. He had also a Repository where his Medicines were always, either under his Eye, or in his hand. He himself made Treacle, and never gave any Medicine of which he had not first tasted or smelt. Now could these great Persons give themselves so much trouble, and publickly acknowledge it, as apprehending it would rather enhance than derogate from the Esteem the world had justly for them? And shall their pretended admirers, and followers plead exemption from such imployments, because dignified with some empty Title? For so indeed it is, where not accompanied with reall intrinse call merit, although it conciliates more Respect and Esteem
to those Gallant Persons, who Honour their Titles and Dignities, by a diligent pursuance of those Noble Ends, on whose account they were conferred on them; not neglecting any means which may make their Profession more Effectuall for those great ends of preserving life and restoring health: Which if any Neglect, it is not their Formalities will gain them Repute, or enable them to Cure Diseases. They must therefore in this imitate those great Physitians, they do so highly Magnifie in their Discourses, who did not refer to Apothecaries the Preparing of Medicines, but made it their own care; neither did they think it too mean, or below them to do with their own hands, most of those things which are now accounted (by those, who in their own and the worlds Opinion are much beneath
them) the Ministery of Inferiour Persons.
I have by this time, I hope, returned satisfactory Answers to all those Objections I can foresee Apothecaries, or others, will make against Physitians preparing their own Medicines; which is a Proposal more free from Exceptions than any I have hitherto met with. But let us suppose that it is attended with some slight inconveniences; yet since there is a necessity of a change, in the opinion of all honest judicious Persons, I know no expedient like this I have offered, which in my opinion promises so well, that although through difference of opinions among Physitians and Patients, it may prove a difficult taske to introduce such a change as this we plead for, many perhaps not understanding the good of it: yet I am very confident,
that having once made tryal, both Physitians and Patients will generally agree, not to quit, upon any slight, frivolous pretences, what both one and the other find experimentally to be highly advantageous. I would therefore perswade them to deal with this Proposition, as they do when a fair new Suit of Clothes is brought them; which they put on, knowing, that though it be not exactly fit at first, it will either fit it's self to the body in wearing, or thereby more plainly shew wherein it may be mended. But if I flatter not my self and the world (which I do not if I know my self, or understand the things I have been debating) not only few or no difficulties, and inconveniences will accompany the mentioned Proposition; but on the contrary, as I have fully demonstrated, many and great advantages: whether we have respect
to the Patient or Physitian. And indeed, what can be more desirable to either, than to have Pharmacy put in such hands, and in such a method, that none having the Interest can have the Power, nor any having the Power, can have the Interest to prepare Medicines unfaithfully? Therefore if Physitians regard the Honour of Medicine, or good of the Diseased, they will not neglect the means which answer these noble ends. And as it has been well observed in Government, That the safety of a Kingdom, or Common-wealth consists not wholly in a Prince that Governs wisely, while he lives; but in one that so orders it, that he dying, it can preserve it self: So the safety of the People (in reference to health) being cast upon Physitians, it is not sufficient that they are honest men, addicted to all the good ends of their Profession, unless they be also skilled
and careful to put their affairs in such a method, that these ends may be certainly attained to, not only by themselves, but also by others that shall succeed them. Which will most infallibly happen, if it become the custom and fashion for Physitians to look after the preparing of their own Medicines; for then the common interest will oblige all Physitians to have them as good as they can contrive or make them. And let their Servants, Apothecaries, or Operators, be never so bad or wicked; although I will not say, if this course be observed it will make them good: yet it is attended with the great convenience of being sufficient to prevent any influence their wickedness can have on Physick, It being highly improbable that they should Sophisticate or Adulterate Medicines, when they make no benefit thereof. And besides, it will be almost impossible
to effect such designs, should they be so mischievously disposed; for they would be soon discovered, and for the future prevented.
Nothing therefore remains, but that I address my discourse to the Physitians; And certainly I need not use many more words to engage them in a design which Duty and Interest (the most perswasive and powerful Arguments in the World) must necessarily oblige them to promote. That it is our duty to reform such enormous abuses as those we have mentioned, I suppose no one will question; and that it is also no less our Interest, the Arguments I have produced, will render to those that are free from prejudices, sufficiently probable: so that as I am most certain, no honest persons who will allow themselves the liberty of reflection can be ignorant of their Duty, so
neither can they mistake their Interest. It is true indeed, the Apothecaries give forth in most Companies, that they are not at all apprehensive of any danger from the designs of such Physitians, as shall endeavour their reformation, who they pretend are but few, and those inconsiderable persons; that the greater number, and they the most eminent Physitians, have their Interest so interwoven with the Apothecaries, that they cannot be separated from them, and will never desert them: but repute all such persons their own enemies, who shall attaque the Apothecaries, and all injuries that are done to these, as intended against themselves. All which is a meer fiction, of their own devising, to deter Physitians, from engaging against so great a number, so potent a faction, as they would perswade the world they are. But how gross and palpable a cheat this is, will
then appear, when all honest, industrious Physitians shall unanimously agree to confute them; and I dare assure the world, that this will most certainly and suddenly be effected, unless there happen the most unlikely change in the humours, intentions, and resolutions of men that was ever yet known: And for the Apothecaries to expect such an alteraon, were to promise to themselves little less then impossibilities. Besides, Suppose any Physitians should stand Neuter, or appear publickly concerned for them, they will be such as will rather discredit their cause, than add to it any honour or repute▪ for they that stand Neuters in this quarrel, or vindicate the Apothecaries must either be such who look on the profession of Physick, as a meer cheat, a craft, rather than an art or Science, who believe, that as much is performed by those that are
reputed the meanest Physitians, as by any other; the difference arising only hence, that some being more prudent and fortunate than the rest, obtain a repute proportionable to their pretended success, affable obliging demeanour, or cunning management of the People, working more upon the humours of their minds, than on those of their bodies. And if there be any thus minded, I do not wonder that their Zeal should not transport them too far against the Apothecaries; for if Physick doth so little influence diseases, what matter is it whether the Medicine be made up of bad or good Drugs? Whether it be recent, or of a longer standing? Whether made up of the same or different Ingredients from what were prescribed? Neither will a person thus perswaded, apprehend he is in conscience obliged to reform these abuses, which as I have shewed, are frequent among
Apothecaries; Nor can he have the least pretence against their exercising the practice of Physick. For if all cure alike, and so little good be done by the Professors of that Faculty, then why may not the Apothecaries be allowed as well as any others? So that these, should they oppose them on an account of interest, their consciences rather reproaching than encouraging them, they cannot with any confidence accuse the Apothecaries for actions, which if they be faults, they themselves are guilty of the same; and if they be not, the same Principle which acquits them, must also free the other. These probably, if there are any such, will stand Neuters, and not much concern themselves in a quarrel de Lanâ caprinâ.
But perhaps there are some of another humour, who make great advantages of the Apothecaries in
wayes I could mention; which for many reasons, I forbear to manifest. Now if there be any Physitians of this latter sort, who shall endeavour to uphold the Apothecaries, notwithstanding they do not relinquish their former ill courses, only because they make some benefit of them; whosoever, I say, they are that have such sordid Spirits, so unworthy the Name they bear, the noble Science they make profession of, and the great Trust reposed in them; that for a little gain, shall betray their Profession to scorn, and their Patients to most manifest hazards, These dishonest and unfaithful persons will have so good espial kept on them, that all their prudence shall not secure them from having their sordid actions displaied in genuine colours: which will render them so odious and despicable, that most will desert them, and apply themselves to those worthy Physitians
who are so far from countenancing the Apothecaries in their fraudulent courses, that they had rather give themselves the trouble of preparing their own Physick, than expose the Sick to manifold inconveniences: as they do who compromise with the Apothecaries in their unworthy practices, and share with them their dishonest gain.
FINIS.PAge 10. line 14. read being, p. 15. l. 23. dele not, p. 16. l. 1. dele such, p. 21. l. 19. for of r. in, p. 23. l. 15. add another, l. 19. dele for, p. 29. l. 1. dele still, p. 30. l. 24. for such r. so, p. 40. l. 4. r. Newcastle, l. 24. dele but, p. 46 l. 4. dele the period, p. 50. l. 2. r. the Ens Veteris, p. 51. l. 1. r. and are, p. 53. l. 20. dele the, p. 61. l. 12. r. that seem not to have any affinity, p. 65. l. 24. dele can, p. 72. l. 18. for in r. on, p. 108. l. 7. for Pffections r. Affections, p. 110. l. 7. for Ponsideration r. Consideration, l. 14. dele all, p. 112. l. 3. r. detects, p. 190. l. 16. r. dilating, p. 193. l. 25. dele long, p. 209. l. 6. for dyes before r. dyes, although before, p. 216. l. 14. dele shall, p. 218. l. 19. after Physick, add and its regulation, p. 233. l. 13. for it being r. it is, p. 254. l. 24 for profitable r. probable, p. 255. l. 5. for converse r. commerce, p. 226 l. 5. dele and, p. 267. l. 3. r. Copious, p. 273. l. 7. dele in some measure, p. 291. l. 8. r. who understands.
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