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Long before recorded history, medical practitioners were treating patients with potions, herbs, and incantations. The first written list of prepared medications can be found in an Egyptian papyrus about 1500 BC, and the first recognized pharmacists practiced in the Middle East in the 7th century. Arabian apothecary expertise subsequently influenced medical care in Europe for hundreds of years. Frederick III of Sicily (1-3) officially separated pharmacy from medicine in 1240 and the two groups competed for the drug trade for many years that followed. Since formal training was not available to most, other health practitioners, including barber-surgeons, toothpullers, midwives, and bleeders also entered the marketplace with their curatives.

Theories of Therapy

Paracelcus made great advances in the 16th century when he was the first to use "alchemy", or chemicals in the treatment of disease, though most physicians continued to follow the teachings of Galen, who practiced medicine in the 3rd century. His interest was in maintaining harmony in the human body with disease resulting from an imbalance in the four natural "humors" (see bleeding). Health could only be restored after recreating balance in the system by bleeding or purging, thus the popular use of leeches, diuretics, emetics and cathartics. Many years later, Samuel Hahnemann (1755-1843) advanced another theory for the treatment of disease when he introduced homeopathy. According to him, drugs that caused the original symptoms of a disease could be curative if given in smaller amounts (4,5).

The Drug Trade

Most medications in the United States prior to 1800 came from England and Europe as domestic production was limited to home remedies and Indian "cures" (6). The popularity of imported drugs led to the development of local drug wholesalers. Pharmacy and medicine officially separated in the United States during the Revolutionary War when the first laboratory in the US was established at Carlisle, PA, marking the beginning of the American pharmaceutical industry. Patent medicines, or those with disclosed ingredients, were initially imported to the colonies from England. The first American patent for a medication was awarded to Samuel Lee, Jr. of Windham, Connecticut for "bilious pills," which was a treatment for such complaints as jaundice and dropsy (water retention) - and the industrial race was on! Thomas Dyott of Philadelphia was the first to produce medications distributed nationally while Lydia Pinkham took her vegetable compounds one step further when she aggressively advertised her family remedies (7). Ms. Pinkham's face became the most recognizable face in the United States in the late 19th century. Manufacturers used many forms of advertising including testimonials (8), and beautiful trade cards (9-11). There were, however, some very interesting marketing blunders (12).

1-3) The Early Apothecary Shoppe

These are early prints of apothecary shops, the first a Dutch engraving called Distillatio by Philip Galle, ca 1580, now at the National Library of Medicine. The color fresco shows a typical Italian pharmacy in the 15th century, this one at the Castle of Issogne. La Pharmacie rustique is a Swiss engraving by Barthelemi Hubner in 1775 that shows Michel Schuppach, a local doctor, examining urine (uroscopy) to make a diagnosis.

4-5) Homeopathy Sets

This set is typical of the portable sets available in the 19th century, many of which contained 100 or more medications. Boericke & Tafel produced many sets for pharmacists and physicians, this one nearly complete.

6) Lilly's Herb Chest for Students, 1900

This fabulous chest was made for students of pharmacy and contains 172 natural herbs that were processed into different medications and then sold to doctors and the public.

7) Lydia Pinkham's Vegetable Compound

At one point the most recognizable female face in America, Lydia Pinkham was one of the first to recognize the power of advertising. Her vegetable compound was a home remedy that eventually was sold nationwide well into the 20th century.

8) The Cure of Kidney Failure!

Products that could not claim a scientific basis for their activity relied on testimonials to provide evidence of activity, whether or not there was any reality to the claims made. Look around and you will see the same thing today!

9-11) Trade Cards

Wonderful trade cards were numerous in the 19th century and promoted almost every pharmaceutical product on the market.

12) Bad Luck in Advertising

Sometimes bad luck can't be overcome by spin control. The AIDS antacid was on the market before this terrible epidemic hit; it was quickly recalled.

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3) French Pharmacy, 1775

5) Boericke & Tafel Homeopathy

6) Lily Herb Chest, 1900

7) Lydia Pinkham Herbal

8) Testimonial, 1900

9) Kidney Trade Card

12) Advertising Mistake