Pharmacies, Apothecaries, and Such

As a fresh legal arrival in America from communism, the requests I kept getting from my relatives left behind, besides the blue jeans everyone loved, was medicine, medicine that was non-existent in pharmacies or in very short supply in the socialist republic ruled by the inept Communist Party that had no idea how to run an economy and if they did, they did not care that people suffered and died needlessly.

For some reason, the extended family thought that I could walk into a U.S. pharmacy and purchase whatever I wanted, without a doctor’s visit, and without a prescription for a valid, demonstrable ailment. A refusal to deliver their requests put me on a do not contact because she is not going to deliver list. I had no money, no resources, and no prescriptions.

Looking at the history of pharmaceuticals and the places where medicinal drugs were made, the apothecary, it is self-evident that there was a definitive split between apothecaries and doctors – their distinct roles were to mortar and pestle a potion/compound upon the request of the doctors.

The Holy Roman Emperor, Fredrick II, who was neither holy, nor Roman, nor an Emperor, but king of Sicily, promulgated in 1231 the Constitution of Melfi which determined that doctors were not to prepare remedies for disease, only prescribe them.

Based on surviving painting, murals, and wood carvings of apothecaries (“storehouse” in Greek) in medieval Europe, they looked very much like the apothecary in Colonial Williamsburg, Virginia. Potions, ointments, plants, and liquids were stored in ceramic jars on shelves around the store and a counter circled the shelves. Amulets, candles, and sponges were hanging from hooks.

What exactly did apothecaries think had curative powers in medieval times? Precious and semi-precious stones like agate were thought to cure eye problems; mineral water which is still believed today to have curative powers; products from animals (quite a big trade still exists in China today of different animal parts, some which result in the cruel slaughter of endangered species, often just to harvest their fins, tusks, or other organs); products from humans such as nails, urine, blood; spices; and a large variety of dried plants and mushrooms.

Because convents, monasteries, and abbeys were places of learning, could afford to purchase expensive hand-illustrated and written one of a kind books, and had special gardens called herbularius dedicated to medicinal plants called simples, they received the pilgrims and the poor who were offered hospitality within the abbey, in a wing called hospitals; the monks often treated their sores, ailments, and diseases for the duration of their stays. The monks were the teachers, the herbalists, the apothecaries, the doctors of first resort, and spiritual guides.

A pharmacopoeia, De Materia Medica, by the Greek physician Dioscorides, was found in monasteries in the medieval west as well as in the Arab world. A pharmacopoeia was a compendium published as an authority for standards of strength, purity, and quality of therapeutic drugs. It described how each drug, potion, poultice was formulated, their chemical properties, quantities, and preparation methods so that the resulting product would be ‘standard’ every time.  Today we have the U.S. Pharmacopoeia (USP), the European Pharmacopoeia (EP), and the British Pharmacopoeia (BP).

There is a fresco from an apothecary in northwestern Italy in the 15^th century; ceramic vessels with medicinal ingredients are lining the shelves and a precision scale/balance is present, as well as a mortar and pestle.

There is reference to an apothecary in Camadoli, east of Florence, in 1048. In the same town, a monk called Romuald founded a Benedictine group that ran a hospital for the poor.

In 1221 a Dominican convent was built in Florence next to Basilica of Santa Maria Novella which ran the precursor of the modern drugstore. “Apothecaries were obligated to label the bottles, indicating when the remedy was prepared.”

On the bell tower of Florence Cathedral there is a 14^th century panel carved by Nino Pisano, panel which represents medicine with apothecary jars.

In 1281Paris the Faculty of Medicine forbade apothecaries “to visit the sick or dispense any medicine without a prescription from a physician.” It is not known for sure how knowledgeable physicians of that time were about drugs and their efficacy in the treatment of disease. In modern times, it is fair to say that pharmacists know more about drugs than doctors do.

The rise of professional guilds further regulated the activities of apothecaries. For example, in 1353 the king’s statutes regulated by law the Guild of Spice Merchants-Apothecaries in Paris. One could not practice mixing potions “if he did not  know how to read prescriptions or had no one who knew how to do so.”

Apothecaries could not sell poisonous and dangerous medicines, bottles had to be labeled with the year and month of preparation, and products had to be sold “at a loyal, fair, and moderate price.” Perhaps modern medicine could learn a thing or two from such modest inclinations, following the medieval price regulation.

To ensure compliance, “a master of apothecaries with two physicians from the dean of the Faculty of Medicine inspected each apothecary at least twice a year” to make sure the substances within the shop were good. (Nat Geo 2025)

Women were not allowed to be apothecaries, they were only relegated to midwifery. Women were skilled in medicine and healing but were not accepted in Europe as they were accepted in the New World of 1682.

According to Nat Geo, there is record of a prescription in 1462 for the King Henry IV of Castile by the Spanish apothecary Fernando Lopez de Aguilar, for stomach water at a cost of 48 maravedis. The liquid contains chamomile flower 2 oz, roses 2 oz, violets 2 oz, and King’s crown (Pyrenean saxifrage) 2 oz. (Nat Geo, July/August 2025)

With such a long history of apothecary science and art, will modern pharmacists survive technology and AI?