A Short View of the Frauds and Abuses Committed by Apothecaries by Christopher Merrett
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Christopher Merrett >> A Short View of the Frauds and Abuses Committed by Apothecaries
As to the Physicians in general, they endeavour to extirpate them, and
some have been so bold to say, they hope in few years to see never a
Physician in London, and to profess they will scramble with them for
practice. And that this hath been and is their intention, the
following particulars will clearly demonstrate.
First, They have always endeavoured and aimed at the depression and
ruine of the College of Physicians, the only Corporation of that Art
in England, considering rightly, that the depression of the College is
their interest and rise, and that the total subversion of it will make
them absolute Masters in Physic and Physicians their Servants. In
Order hereunto they have constantly, both publickly and privately
opposed the College in whatsoever hath been offered to setle the
liberty of practice on them, their only priviledg and subsistence,
though they have been offered all they could desire for the security
of their Trade, and legal employment, and far beyond whatsoever any
Corporation of Apothecaries in all, or in any forreign part enjoy, yet
nothing would ever content them, but an unlawful, unreasonable,
dangerous, and destructive Usurpation of liberty to some pretended
practice, that thereby they might gain the whole.
Secondly, They have continually traduced the College, and troubled
them in Parliaments, at the Council-Board, &c. to their great charge
and molestation. And for such their great demerits against the
College, the King and his Council, Anno 1639. granted a Quo Warranto
to the Attorney General (the Judges having first heard the whole
matter) to take away their Charter, which doubtless had been effected,
had not the troubles, and long civil War immediately ensued.
Thirdly, And in this present Parliament, how did they endeavour to
prepossess the Members of the House of Commons with strange, and false
prejudices and assertions drawn from irrational, and groundless
suppositions, making us the greatest Tyrants in the World, inferring
ridiculously that a Lady, or Charitable Gentlewoman (for in that
believing Sex they have gain'd a great deal of ground by their
falsities) might not give the Poor a Cordial, &c. without being
questioned by the College; whereas they know in their Consciences,
that the College hath power enough by their first Charter to act as
much in this kind against themselves, and all other persons, as they
desired of this present Parliament; And yet neither Apothecary, or any
other who practised charitably, were ever troubled for so doing. They
pretended also they were abridged wholy from their Trade, and might
not sell a penny-worth of Mithridate, &c. without a Doctors Bill.
Whereas there's not a word in the Charter to that purpose; the sole
intent whereof was to keep them as well as other Mountebanks, from
prescribing (which they call selling) the Physicians only livelyhood.
And as to the bill itself so much railed on by them in
Westminster-Hall, Coffee-Houses, Ale-Houses, &c. 'tis easie to make it
out, that this Charter as proposed gives the Apothecaries more liberty
and freedom of exercising their lawful Trade, then is enjoyed in any
other Nation, where both Corporations are erected, and that it doth in
nothing infringe, or diminish their freedom as Citizens, or their
Charter as Apothecaries; and that our Charter was compiled by some,
and perused and approved by others the most eminent Lawyers in England
for Worth and Place; and yet none of these could find any thing in it
either Illegal, Tyrannical, or unfit to be desired of the Parliament.
Nay many mis-informed Members being rightly instructed in the true
state of the matter, have acknowledged the justice of it; And was no
more then King James by his Letters Patents, dated the 18th of
October, in the 15th year of his Reign, granted to the said College;
near about the same time the Apothecaries Charter was granted; and
being almost nothing else but a supply of what was short in their
former Grants, viz. That whereas their Charter granted by King Henry
the Eighth, gave power to punish offenders in the practice of Physic;
and because there was no power given to summon, nor penalty imposed
for the non-appearance of such offenders; therefore by their
non-appearance, the said power of the Censors was eluded; for no such
offenders would appear before them, and consequently no punishment
could be inflicted on them, according to the true meaning of the said
Act. Now this Charter so much declaimed against, prayed only a supply
of this defect, and also better and more necessary ways and means,
without which, such and all other offenders against the lives and
healths of his Majesties Subjects could not be discovered; and they
had reason not to doubt a grant of the said power, since by the said
Charter a power was granted them to imprison offenders, whom the
Keepers of the Prisons would not receive, because no command, nor
penalty was imposed on them, for not receiving such offenders sent by
the Censors (a thing ridiculous to our present Lawyers) however this
defect was supplyed by an Act in the first of Queen Mary. Now whereas
since the making of the said Acts and Powers, granted to the College,
several other Trades, besides the Apothecaries, relating to Physic
(being then all Members of the Grocers Company) viz. Druggists,
Chymists, Sellers of Strong-Waters and Oyls, have arose distinct from
each others, and many abuses have been and are committed in each of
them, as they all confess. The said Charter prays for the publick good
only (there being the same reason of all) they might have the same
power of Surveying them also, as they have of the Apothecaries, which
most of the Judicious, and sober of the said Companies, as well in
relation to their own private profit, and also the publick, by having
all Medicines good, did not oppose, but liked well of. Nay there was
nothing in the said Charter, but what was judged good by all or most
of the Judges of England, several times convened by Order of the King
and his Council, to deliver their opinions concerning some Quaeries,
which comprised the main of what was desired and petitioned for by the
College, of this present Parliament. But before the Committee could
make report to the House, the Parliament was adjourned, whereupon
Apothecaries falsly gave out, and made people believe our Charter was
taken from us. And in this transaction before the Committee, one
Cocket an Apothecary exhibited in the name of the Chymists such a
Scandalous Libel, as the Committee would not suffer to be read; drawn
as some conceive by the assistance, and countenance, if not
contrivance of his Company.
Lastly, The Company of the Apothecaries are bound by their Charter to
bring their Servants (before they make them Free) to be examined by
the Censors of our College, and to have their approbation of their
fitness to exercise their Art, and set up their Trade. Now that they
have herein neglected their duty, and consequently may be
dis-franchised and lose their Freedoms for this omission, 'tis
manifest not only by the vapours of some of them to some members of
our Body, that they never underwent this examination; but also by
comparing of our Register (wherein are recorded the names of all such
as have been examined) with theirs, if they keep any for this purpose.
Sure I am, that in two years together, when I was Censor, very few, if
any, did appear to their examination, whereas yearly a very great
number set up their Trades. Nay since the firing of London not one
Apothecaries Servant hath been examined by the Censors, for more then
these three Years last past, in which time perhaps no less then 100
have been made free by the Company.
Before our presenting this Charter to the Parliament, they would admit
no Arbitrators betwixt our Corporation, and Theirs, not contenting
themselves with their Charter lately granted in King James's Reign,
and that by the procurement of some of our College for these
unthankful persons. For they would not refer themselves (as the
Chirurgeons without many words or dispute did) to the most upright,
and most knowing Sir Orlando Bridgeman then Lord Chief Justice, and
now Lord Keeper, for a clause to be by him drawn, in order to preserve
their immunities and Charter; which they refused, fearing belike he
would exclude them from the Practice of Physic, which the Law hath
already done, and which is all they could doubt of; but the
Corporation of Chirurgeons did acquiesce in the clause drawn by the
said Lord Chief Justice, and never appeared before the Committee
against the said Charter.
Their increasing dis-respect, and undervaluing the College, appears in
this, that of late years they place our Censors invited to their new
Masters Dinner, at their second Tables whereas always heretofore they
were seated at the first Table, next to the Master of the Company.
And to hinder the building of a New College, and the Contribution of
the Honorary Fellows thereunto, they tell them that we deceived them
in their admission, and never intend the building of a New College,
though a large contribution hath been made, and ground purchased in
order thereunto by the Members of their Corporation.
And their further design appears in their great triumphing, and
rejoycing when any illiterate person hath gained any reputation for a
Cure performed, especially where Physicians have been concerned,
though the Patients neglect or obstinateness, have been the sole cause
of this non-performance, and by their continued detraction from
Physicians, and applauding themselves, hoping by the former, that
people will think such Mountebanks able to do better Cures then
learned Physicians, and then they can easily insinuate themselves
superior to such Mountebanks, and consequently to Physicians. By the
latter, they seek to depress, and level us to themselves, being
conscious they can never rise to that worth and ability, required in a
Physician.
Another manifest sign of their endeavour to usurp our Practice is,
their absurd calling the sick their Patients, for 'tis most certain
that in all reason and language the Physician and Patient only have
relation to each other, but not to the Apothecary, who is but a
Tradesman, and manual Operator. Now a Tradesman and his Customer, or
Chapman, are Relatives each to other, but those Apothecaries who
intrude themselves and usurp on our profession, may call their
Customers Patients, and that in a true literal sence, when by their
ignorance they make them really sufferers under them; and if they deny
Apothecary and Patient to be non-sence, they shew themselves pitifully
ignorant in the Laws, and Rules of Reason, or else profess themselves
Physicians. And the like non-sence they commonly utter by calling
Physicians that make their own Medicines, Mountebanks and Quacks,
whereas none can be such but those who practise without Lawful
Authority, as the Apothecaries, &c. do; and they are not ignorant in
this their malice, that the Law of England would punish them roundly
for so saying. And were I troublesome or vindicative, I could make
some of them examples, but I freely remit the slanders in this kind
that are past.
Having done with the main part of the Disease, next follows the
Remedy; and the only firm and proper one will appear to be, that
Physicians make their own Medicines; the benefit whereof to the
publick, the reasonableness of the thing it self, the necessity in
relation to the Physician, will be manifest by that which follows.
And First, All that hath been said demonstrates this last proportion.
Secondly, The desire of most persons, and the censure of all wise men,
who say we are wanting to our own interest, if we make not use of the
remedy in our own hands, performing our Art in all its members,
whereof making of Medicines is a chief one.
Thirdly, The common practice, and constant usage of all former and
antient Physicians in all other Nations, and in England also (for 'tis
easie to say when there was not one Apothecary in this Kingdom) the
Laws of our Nation, nay even the Apothecaries Charter allow it, the
Language of all Physicians, our College voting it honourable so to do,
nay Apothecaries themselves commending it in such Physicians as buy
their Medicines of them.
Fourthly, The Kings Physicians have formerly made the Kings Medicines,
as 'tis manifest by my Lord Coke, in his 4th. Book of the Institutes,
part 4. pag. 251. where he comments on Rot. Pat. 32 H 6. m. 17. He
there first recites the Roll it self, wherein are appointed (the King
being then sick) 3 Physicians and 2 Chirurgeons, to freely minister
and execute Physic about the Kings Person, and there are also recited
in general, Medicines external, and internal. And on this Roll Coke
among other things infers, that the Physicians may use the aid of
those Chirurgeons named in the Warrant, but of no Apothecary, but to
prepare and do all things themselves, &c. And the reason of all this
is, the precious regard had of the health and safety of the King, who
is the head of the Common-wealth. And I am told by one of his present
Majesties Physicians, that the King himself affirmed heretofore we are
unwise in neglecting our duty herein, and lately of these papers, that
'twas the publick interest so to do.
Fifthly, Chirurgeons (as before) will not trust them to make external
Remedies; and the King, and East-India Company commit the making of
their Chests for their Fleets to the Chirurgeons.
Sixthly, Have not Ladies and Charitable Gentlewomen their Closets well
furnished with various Medicines for the Poors use, and for their own
also, when Physicians are called to their houses in the Country?
Distillers of Strong-waters, Makers of Plaisters, Confectioners make
Medicines bought by the Apothecaries, Ale-Houses sell purging Drinks,
and Book-sellers sell Chymical Medicines, and all this without much
regret of the Apothecaries. But if a Physician intermix a Medicine
with theirs, though the Patients life be saved thereby, what noise,
and murmuring, and proclaiming of it the next Market-day to the rest
of their Company? to what purpose any one may judg.
Seventhly, Why should not Physicians, being lawfully authorized
thereunto, practise with their own Medicines, as well as the
Apothecaries with theirs, though against Law, and incurring thereby
the penalty of 5l. per Month, which the College never troubled them
for, or exacted of them?
Eighthly, Physicians will be necessitated to it for their subsistence
and honour, and to preserve their Art from being prostituted to
illiterate persons, the Apothecaries becoming now their Competitors.
Ninthly, By this means Physicians will avoid multitudes of
inconveniencies, proceeding from writing of Bills, and the
Apothecaries Visits.
First The mistakes, and frauds in the Ingredients, especially
committed by the great practising Apothecaries, who may, as appears by
the following story, be suspected to send, instead of what was
prescribed, the remains of his own practice, or else some cast-by
Medicines; for else how could it be when a Medicine was prescribed to
stand in Infusion or steep a whole night, that it should be brought
two hours after the Bill was written, even the very same Evening?
Which by accident the Patient confessed, wanting the expected success.
Secondly By this course Physicians avoid the many opprobrious terms
cast upon them by Apothecaries:
As First, In saying that if he had not omitted or added something, the
Patient might have miscarried; which he may say at pleasure without
any contradiction, though doubtless many have been killed by this
means.
Secondly, By saying the Bill could never have been made without some
alteration of the Apothecary, thereby insinuating the Doctors
ignorance in compounding.
Thirdly, In saying the Doctor is not versed in Medicines, because
forsooth he varieth not at every Visit, and multiplieth not new Bills
for the Apothecaries profit.
Fourthly, In saying they teach Physicians, and help them to, and in
their practice. The first and last are vile and foolish Scandals; as
to the Second, 'tis true indeed, that younger Apothecaries recommend
Physicians to their acquaintance; but 'tis no longer then they have
learned enough (as they think) to set up for themselves.
Fifthly, In saying, they knew before-hand what such a Doctor would
prescribe, and hence it is they have nick-named some Physicians of no
mean practice, by the Medicines they frequently use, which names in
respect to the persons, I shall conceal; and of such Physicians, they
brag they can prescribe as well as they. But if a Physician advise
things unknown to them, or out of the common tract, then they say the
Doctor intends to puzzle them.
Sixthly, He will avoid the censure of his Bills, which every pitiful
fellow, nay their very Boys will absolve or condemn at pleasure, and
that openly too, nay sometimes to the Patient himself, and thereby
call in his good Apothecaries Physician. Now what a shame is it, that
a Physicians credit and livelihood, should stand at the mercy of such
pitiful ignorant, and self-ended Souls? I have heard one of them say
of the now most Eminent Practiser in London, that his Boy could write
as good a Method as he, and that he understood the practice of Physic
as well as any Physician in London except 2, or 3, though the same
person was soon made to confess, he neither knew the Disease, Cause,
nor Cure of a Pleurisy, pretended to be throughly understood by him.
Thirdly, He will avoid the trouble put upon him after he hath writ his
Bill, by the Apothecaries ignorance in not understanding it, who to be
informed came to the Doctor heretofore, with their Hats off, but now
send their Boys, who soon put theirs on. Such respect do they give
Physicians, when they come to them as to their Masters to teach them.
Fourthly, He will avoid the impertinent Visits of the Apothecaries,
and non-sensical, troublesome, and discouraging, frightful discourses
to the Patient, of whom no man can expect more then the Common Proverb
gives to Praters, and impertinent Speakers, That they talk like
Apothecaries.
Fifthly He will avoid the mischiefs from their Visits, who by their
shrugs, signs, or words, may diminish the Physicians reputation, and
good opinion, whether in his skill, or Medicines, whereby good
Medicines are neglected and the expectation of a good success upon the
use of them taken away, or at least causing an averseness to them;
which actings do exceedingly prejudice the Patient, in reference to
his Cure.
Sixthly, He will avoid this inconvenience, that some Apothecaries have
attributed the Cure to some of their intermixed Medicines, or
alteration of the Doctors Bill.
Seventhly, He will avoid that incivility of such of them, who in the
Physicians presence, will feel the Pulse, judg of the Urine, discourse
the Cause, Nature, what the Disease is, and what will be the issue of
it, propose Medicines, nay sometimes endeavour to advise with the
Physician, to contradict and dispute with him, to compare and set
himself above the Physician; and to say truth, these odious and
intolerable Comparisons and intrusions daily complained of by my
Collegues, were a great cause of my departing from them.
Eighthly, He will avoid those Scandals they have opportunity to raise,
that such a Physician is Covetous, Proud, Negligent, and minds not his
practice, and the like without the least ground, and are frequently by
such Artifices, the Cause of introducing another Physician, knowing
that thereby more Bills will come to their File, and many times the
former Medicines be layed aside, and in this shuffling in and out of
Physicians, they have commonly a great share.
Ninthly, Apothecaries being now Competitors with Physicians for
practice, and down-right Enemies to such as make their own Medicines;
why should not we suspect them of this false Play, by telling the
Patient the Doctors Medicine will not work (which he knows well enough
how to effect) and then to tell him he will prepare him one of his own
that will work, when perhaps that he calls his own preparation, was
nothing but what the Doctor had prescribed before; and by this
Artifice to advance himself above the Physician.
Another mischief in sending Bills to the Apothecaries is, that though
the Apothecaries be honest (and who can tell which of them is so?) yet
the Servants neglect, or ignorance (to whom they commit the whole care
of dispensing, and are intruth the Apothecaries (and not their
Masters) may mar all in their Masters absence, who is visiting abroad,
or at his recreations.
And now I have done with the unpleasant talk of raking into the faults
of the Apothecaries, and with discoursing how Physicians may save
themselves from their devices, I shall next shew the advantages that
will come to the Patient, the Physician, and people, by this way of
remedy proposed.
As for the Patients, they may hereby save most of the great charges of
Apothecaries Bills, which in long Cases amount to very great sums in a
year, although the Physician hath received very few Fees; the
Physician may so order his business as to take his Fee for his Visits
only, and at home such competent Fees for his advice alone, as are
usually given, and in both Cases take nothing for his Medicines, and
so save the Patient the whole charge of the Apothecaries Bill, which
very seldom comes short, and for the most part manifoldly exceeds the
Physicians Fees. And this he may very well do by making fewer, less
chargable, more effectual, and durable Medicines then the Shops
afford, and suffer nothing in the non-use, or decay of his Medicines;
because he need make no more then will serve his own practice: and I
must here profess, that which I intended not to have published, that
this is the course I have generally taken, for the four Months last
past, since I made my own Medicines, but that some Apothecaries have
given out most falsly, that I have sent in Bills to Patients for
money; but to convince such of their wonted lying, I do hereby oblige
my self to give 100 pound to any of them that shall produce such a
Bill. Secondly, This way will not clog the Patient with more Medicines
then are needful, nor will omit anything may conduce to his recovery,
for if he fails in either, 'tis to his prejudice, either in spending
more Medicines which cost him money, or in not performing his Cure,
which loseth his practice.
But I do not propose this course of mine as a general rule to all
Physicians, but leave this to every mans private judgment; Neither do
I hereby bind my self to the same practice, because some few Cases may
fall out (though to an equal advantage to the Patient) may perswade me
to the contrary. For I find some persons of that perswasion, as to
think they have not given satisfaction, unless they have payed for the
Medicines; but to such persons, I have always allowed them to give me
what they pleased themselves, for the cure only, to the full
satisfaction of both parties. Though I will not deny but some persons
out of gratitude for their Cure, have rewarded me beyond this
proposal. Some of my acquaintance have desired me to be more plain in
this last Paragraph, especially in that part of it where I say I do
not bind my self to the said practice; and to declare more fully the
Cases that may perswade me to the contrary; which are these and such
as these. First Where Patients of their own free offers will contract
with the Physician, or have formerly too meanly rewarded him for his
Cure, in both which the Statutes of our College allow a contract to be
made with Patients. Another case is, if a Physician be consulted once,
and for his Fee hath given Medicines gratis, if the Patient frequently
send for his Medicines without the least reward at all. Or if the
Patient living far in the Country, having (as before) once consulted
the Physician, as in the last case, and shall for weeks, nay months,
send for the same Medicines. Or if the Patients friend shall recommend
a Medicine to another friend of his unknown to the Physician; and
where he gives no Counsel, if a Physician in the Country shall desire
some of his Medicines, which are all the cases that occur at present;
I say in some of these, the Physician must needs be payed for his
Medicines; but in other, 'tis rational he should be payed for his
advice, as he desireth new Medicines, which charge will be far short
also of the Apothecaries Medicines, whether repeated or prescribed
upon new advice.
Now the great charge of Apothecaries Bills, and nauseousness of their
Medicines, appears to be the cause why long habitual diseases, as the
Kings Evil, Falling-Sickness, Convulsions, Melancholies, and Winds in
the Bowels, Gouts, &c. become seldom relieved, though they may with a
constant, facile way, be perfectly cured, where neither the great
charge, nor unpleasantness of Medicines, deterr them from a continued
necessary use of Remedies. And for the same reasons many will be kept
from relapses, who being tired out with taking variety of Medicines,
give over before the tone and strength of their parts is restored,
which is necessary to be done in all long Diseases.