The Ancient Era through the Middle Ages

Over the last hundred years, pharmaceuticals (both prescription and non-prescription medicines) have changed our world so dramatically that the average person in the U.S. is now expected to live to nearly 80 years old. That’s thirty years more than people lived just a century ago! But the practice of pharmacy as a profession has existed since the earliest records in history. Some aspects of pharmacy are completely different from earlier times while other things haven’t changed very much, even after thousands of years.

Take ancient Babylonia (which we now know as Iraq) circa 2,600 B.C E., for instance. At that time, experts in the art of healing were essentially priests, pharmacists and physicians all rolled into one. The Babylonians created detailed disease descriptions – written on clay tablets – that listed symptoms of the illness, the appropriate treatment, directions for making the prescribed medications, as well as religious blessings to accompany the treatment. Blessings were considered a very important part of the cure, as medicines were thought only to work in conjunction with the healer’s blessing. Babylonians had the earliest known form of prescriptions.

In ancient China and India, people looked to nature for their medications, and still do to this day. One of the plants they used was the poppy, which has anesthetic or numbing properties. We have the ancient world to thank for modern anesthetics, which are used in surgery, dental procedures, and for pain management. Another example is the herb ginger, which was used to help with digestion and upset stomachs. If anyone has ever told you to drink a ginger ale to settle your stomach, you can thank ancient Chinese and Indian medicine.

Almost 4,000 years ago, Egyptians were creating pills, ointments, lozenges and lotions to treat various ailments. Herbs were ground with mortars and pestles which could crush substances into powders or pastes, dissolved into liquids or even combined with flavored syrups to improve the taste (not unlike the cherry cough syrup of today). And those mortars and pestles? For many years, they were an iconic symbol of pharmacy, even though today mortars and pestles are largely used for cooking.

Taking the ancient art and science of healing one step further was Galen, who was born in Rome around 310 A.D. Galen actually tested the drugs of his time for strength and effectiveness, and then developed mathematical equations to figure out proper dosing. To this day, dose management – calculating the right amounts of a medication for a given patient and condition – is one of the key responsibilities of a pharmacist. While physicians usually prescribe the dosage, the pharmacist is the person who actually dispenses the medication. In addition, the pharmacist plays an important role in communicating to a patient about the drug dosage and how the drug should be taken (with or without food, how many times a day and so on).

Several centuries later, in 1023, a famous Persian doctor named Avicenna published the Canon of Medicine, a medical science guide which took him over ten years to write. The Canon of Medicine was translated into Latin in the mid-1100s and remained the standard “textbook” for medicine from that point on and throughout the Middle Ages, listing medicinal plants and what they treated, naming 760 drugs, instructing how to make medical treatments (compounds), and even providing a guide for minor surgeries.

By the mid-13th century, the roles of physician and apothecary (from the Old French word “apotecaire,” which meant shopkeeper) were separated from doctors and others in the science of healing. In fact, King Frederick II, one of the most powerful Holy Roman Emperors of the Middle Ages, issued an edict for the first time in Europe completely and officially separating the professions of physicians and pharmacists, and issuing professional regulations for both. This led to the creation of apothecaries, or stores where medicines were sold.

Given that lives depended on getting the right drugs in the right amounts, there was a need for some legal guidelines for the profession. By the end of the Middle Ages, pharmacists had clearly defined professional roles as well as clearly defined rules to follow. In fact, the first official pharmacopeia – or encyclopedia of pharmaceuticals – was published in Florence in 1498.

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