Praxis medicorum antiqua & nova the ancient and modern practice of physick examined, stated, and compared, the preparation and custody of medicines as it was the primitive custom with the princes and great patrons of physick asserted and proved to be the proper charge and grand duty and every physician successively, the new mode of prescribing and filing recipe's with apothecaries manifested an imprudent invention and pernicious innovation, demonstrated from the treble damage and disadvantages that arise thence to physician, patient and the medical science : with enforcing arguments for a return and general conformity to the primitive practice ... / by E. Maynwaring.

The Ancient and Modern Practice of PHYSICK, Examined, Stated, and Compared.

IT cannot be expected in this small Volume that the whole matter in difference, between the Ancient and modern Professors in the medicall Science, should be controverted and stated. But that which I aim at, and pitch upon at present to traverse, relates chiefly to the management and mode of Practice: therein to let you understand how differently the affair of Phy∣sick is carried on now of later times, from what it was in former Ages, and from the beginning; lay∣ing down and assigning the benefits and advan∣tages that accrue by the one; as also the prejudice and damages that arise by the other, necessarily depending thereon, and unavoidable.

These are the two cardinal points, to which this present Discourse is directed, and principally looks at: Yet in the current of this debate, some things else will fall in parergos, which we shall animadvert on, as remarkable and to be noted, but not insist thereon at this time. And in ma∣naging this Disceptation, I must recite and revive some of my own Writings (scattered in several

Tracts) that are extant relating to this subject, which I cannot well pass by, but insert in their due places as valid arguments not to be smothered and forgotten, but to be preserved in memory so long as the cause in hand remains disputable.

I must confess, the current of Practice runs strongly against me, by the multitude of Professors that are fixed in the contrary course; whose gene∣ral custom and perseverance therein is strongly perswasive to * 1.1 inconsiderate, unwary heads, that it is undoubtedly the right way, the most learned, and most advantagious mode of Practice: notwith∣standing so great a party appears against me, I am not thereby daunted to oppose their male-Practice, though supported by the authority and countenance of learned men well reputed, exercising therein. And in the designing and carrying on of this un∣dertaking, I would not be misunderstood and deemed a malevolent detractor, or emulator to any person or party herein concerned; but incited to it by the merits of the cause, and through a just zeal to do a publick service for the sick and infirm, and to promote the honor and improvement of this Science I do profess, and now plead for, being at present captivated and ensnared by an abusive Cu∣stom, intollerably injurious and destructive.

I shall not longer detain you with an Apologeti∣cal premise, but lead you into the substantial matter indicated and promised in the front of this Work. And first I will present to your view and consideration, the model and form of the Primitive Practice, wherein Physick had its first Being, and also increased to a considerable growth, by the

sole industry of the Professors, without substitutes or subordinate men, to divide and share with them in their business. After this I shall relate to you the unhappy change and subversion of this lauda∣bly industrious institution, for the late mode of Pen Practice, and filing Bills with Apothecaries, generally imitated and followed at this day.

In the Infancy of Physick, and during its growth to a considerable improvement; the learn∣ed Professors thereof, were so careful in their Im∣ployment, and industrious to advance their Know∣ledge, that nothing appertaining to the whole bu∣siness of this Art; but passed through their own hands, and was managed under their own eye; being privy and present to all concernments; and a faithful Guide in the conduct of the whole Work: not refusing the gathering of Simples, readily to know, and rightly to distinguish them; examining of Drugs, and proving their virtues; dissecting bo∣dies, to view the admirable systeme and frame of man; and to understand the oeconomy or govern∣ment of Nature therein: preparing and compound∣ing their own Medicines diligently, to gain a sound and true knowledge in Pharmacy, and to be expert in Medicines, and their various prepara∣tions: and all this with their own hands; and what not? to be truly informed, and ascertained in their Art; and not to depend upon hearsay, or fallacious reports of others, and the insufficiency of such testimonies: deeming it also not fit to ma∣nage so grand an Affair, of which the World was big in expectation, and that so nearly concerns the life of man, by proxyes and substitutes; but by

their own proper labour and inspection; not trust∣ing to Herb-women, Apothecaries, and such like.

This was the Primitive Practice of Physicians; and those of the greatest fame and renown, called the Princes of Physicians, gained that repute and esteem this way, by their great labour and dili∣gent search into Naturals, for the good of man∣kind; refusing no pains that might conduce to the advance of their knowledge. And this was the exemplary, laudable, and constant practice of Ae∣sculapius, Hermes Trismegistus, Hippocrates, Dio∣cles, Caristius, Galen, Scribonius Largus, Andro∣machus, Oribasius, and all the ancient Heroes in Physick: and that it was so, appears by the testi∣mony of authentick Writers, as also from their own Works. Hippocrates in his Book 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, in the seventh and eighth Sections, reckons up the accommodation that belongs to a Physi∣cian, of which he ought not to be destitute; a∣mongst which are Chirurgical instruments and me∣dicines of all sorts, that he ought always to have ready in his own keeping; and this he saith will make a Physician more confident in his Practice, and more readily applying himself to the sick, * 1.2 so he concludes the eighth Section of that Book.

Famous Quercitan upon this question, an medi∣cum deceat 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉? affirms that the Ancients were very industrious and diligent in the Prepara∣tion of their Medicines, which they kept in readi∣ness by them to serve their Practice. ‖ 1.3 Hippocrates ipse eorum faciem conspuisset, qui praeparandorum suorum remediorum scientiam illi detraxissent, quo∣rum

utique veteres tam vigiles fuerunt custodes, ut ea nequaquam publica facerent omnibus, sed magna cau∣tione sibi asservarent, & filiis ac nepotibus seriatim tandem committerent, ac per manus traderent. This also is affirmed by Sennertus, a judicious, mode∣rate, * 1.4 and faithful Writer, handling this question, an medico liceat componere medicamenta? holds the affirmative, both from the antiquity of the custom, as also the utility and advantage to Patient and Physician: Neque etiam praeter dignitatem medici esse componere medicamenta, antiqui illi viri pru∣dentissimi, medicique peritissimi satis docuerunt, qui etsi haberent unguentarios, seplasiarios, & id genus hominum, qui fucos, unguenta & similia praecipuè vendebant, ornando potius quam curando corpori utilia, totam tamen medicamentorum compositionem * 1.5 ipsis non committebant. Ipsi domi suae medicamenta composuerunt, neque sibi dedecori, sed laudi esse duxe∣runt, si rei humano generi utilissimae operam impen∣derent, neque plus rationis manuum suarum, quam animi haberent: imo ignaviorum potiùs esse videtur, omnia ministris committere, quorum vel avaritiâ, vel improbitate factum est saepius, ut medicamenta praestantissima quae 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 antiqui appellant, vel indoctissimis empyricis communicarentur, vel cor∣rupta & vitiata authoritatem suam amitterent, nec vires, ob quas ab antiquis praedicabantur, haberent. You see plainly the judgment of this grave Wri∣ter in the case, that the preparation of Medicines by Physicians is as profitable and necessary as ancient.

And as the preparation of Medicines was the general custom among the ancient Physicians; so likewise that laudable practice hath been continued

in all Ages by some of the most eminent and most industrious Physicians, even since the time Apothe∣caries have been in use; such were Paracelsus, Li∣bavius, Angelus Sala, Basilius Valentinus, Crol∣lius, Quercitan, Mylius, Mynsicht, Faber, Hart∣man, Schroder, Sennertus, Van Helmont, Glauber, Swelfer, &c. many more, the most eminent of their times and places where they lived, have been industrious operators in Pharmacy, whose Ex∣emplars are committed to us, to revise, meliorate, and improve.

The necessity for continuation of this Practice, and incouraging a general conformity thereto, will evidently appear to all rational people, if they consider the enforcements to it, arising from the whole interest and concerns of this Art, which are reducible to, or comprised under these 3 heads.

First, The improvement and advance of the Art it self.

Secondly, The security and utility to the Sick.

Thirdly, The advantages and satisfaction to the Professors.

We shall proceed distinctly upon these three capital parts, in the order as they stand. And first, that the Pharmacopaeian Practice of Physicians is the direct and only way to improve and draw neer to the perfection and compleating of the Pharma∣centic Art; upon which the whole success of the Medical Science does mainly and chiefly depend; is manifest from the original and primitive Practice, upon which this Science is built and founded: and secondly, from the successive and successful improve∣ments that have been made by Pharmacopoeian Do∣ctors, in all Ages to our present times.

That the origine and invention of Physick did first spring out of an empyrical knowledge of Me∣dicines, is confessed by most, if not all Writers, that treat of the Rise and Progress of Physick: there were no Principles, Rules, nor Method establish∣ed, but every one followed the dictates of his own fancy, to make tryal of this or that, or this with that, for a Medicine; which experiments and try∣als of Medicines of their own invention and facture, * 1.6 were recorded and reposited as their greatest se∣crets: So that Pharmacy was the foundation of Phy∣sick, and here it took its rise, and herein were Physicians first exercised, before any rules were given: and after the frequent exhibiting and ap∣plying of Medicaments in several cases, and obser∣vations thereupon noted; then the Art began to be modelled and framed into a Systeme of parts ratio∣nally composed, which by additions and culture from learned men through all Ages, hath arrived to this improvement we now see.

Scribonius Largus, an ancient Author of sixteen * 1.7 hundred years standing, in his Book treating of the composition of Medicines saith; est enim haec pars medicinae, ut maxime necessaria, ita certè an∣tiquissima, & ob haec (reckoning their virtues) primùm celebrata ac illustrata. And to what we have here asserted agrees Joan. Langius in his Me∣dical * 1.8 Epistles, a grave Author, conversant with antique Writings: Scis nempe principium omnium artium esse rude: at temporis successu & experi∣entia adaugeri, & excoli; quod certe medicina, omnium mortalium voto expetita, ac toties immutata indicat: hanc ante & sub Trojani belli temporibus

Aesculapius & tandem ejus liberi Machaon & Poda∣lirius, ac celebris ille Achillis praeceptor Chiron, * 1.9 vulnerum medelis & Pharmacia se exercebant, solis{que} his duabus partibus, nempe Chirurgia & Pharmacia, tum medicina constabat: and for this he quotes the Authors in the Margent.

I need go no farther to prove the antiquity of Medicines, nor their Authors to be Pharmacopoeian Physicians of the greatest repute, and that Physick was planted upon this foundation, being scarce denied by any. I now come to prove the necessity of continuing this Practice, in order to the im∣provement and advance of Physick, whereby chiefly the Art is truly enabled to do great things, and adorned with real performances in curing. So far is any Art or Science improved, by how much more it draws neer and acquires the end, for which it is intended and instituted; the regaining of health is that mark to which all Medicines are ultimately directed: now by the prudent election and exquisite preparation of Medicines is this end attained more especially, and sometimes indepen∣dently, without the contribution and assistance of the other parts of this Art. For the more distinct and clearer proof of this point I am now upon, I shall lay down these three following Positions, of a just latitude, which comprise the full scope of our matter; and which being proved, the first head of our triple division stands as a manifest truth.

That Pharmacy or the dextrous preparation of [Position 1] Medicines, is the most excellent and necessary part of Physick; and the main stress of curing,

lies chiefly in the compleat medicinal appara∣tus.

That true skill in Pharmacy, and a certain know∣ledge [Position 2] of Medicines, is not gained by reading, but by manual preparations and tryals; personally ob∣serving through the whole process of the Medicine, and noting all the circumstances appertaining to it, or casually emerging; whether successful or not; for a future guide, to direct and improve the next process, for the same Medicine; or to admonish, instruct, or caution in another, affine or analogous thereto.

That the preparation of Medicines is the proper [Position 3] and special business of every Physician; without which experience and certain knowledge in Medicines, he cannot be compleat in his Profession, but very insuf∣ficient in the grand and most weighty part of the Me∣dical Science.

To illustrate and prove the verity of first [Proof 1] Thesis, I proceed thus: The excellency of Pharma∣cy, and its super-excellency above the other parts of Physick (I mean Chymical Pharmacy chiefly) does appear; first, because it is the ground work and foundation of the rest, and it lays open the mysteries of the whole Science, and gives light to every part thereof. A compleat knowledge here∣in does discover the secret operations of Nature, whereby Diseases are more easily detected, and the manner of Curing more obvious and plain. Ʋbi definit Physicus, ibi incipit Medicus. Solid knowledge in Natural Philosophy, is the most necessary qualification, preparatory to make a good Physician: now this Philosophy must be expe∣rimental, solid, and certain: the notional Theorems

in Philosophy, the World hath too long insisted on, and spent much time to little purpose, in vain ratio∣cinations, speculative conjectures, and verbal proba∣tions. And as Natural Phrlosophy is praevious, and a sit qualification to ground a Physician on in a ge∣neral knowledge of Nature, and this knowledge is gained by experiments and mechanick tryals; so likewise the knowledge of the microcosme in a sound and morbid state, is acquired and discover∣ed; and the ways and manner of curing unfolded and directed; by observing artificial operations and mechanical tryals, which imitate Nature in her perfect and deficient actings: And upon this consi∣deration Zwelfer affirms, * 1.10 Chymiam esse artem nobi∣lissimam, & medico scitu summè necessariam, & includere universam Philosophiam practicam. And Sennertus treating of Chymical Pharmacy brings in * 1.11 Mesues to speak his thoughts, and to confirm his own opinion: Ʋt jam de eo nihil dicam quantum in naturae obscuritate investiganda Philosopho lucis praese∣rat Chymia: unde rectè à Mesue in Antidotar. Di∣stinct. 21. cap. de olco ovorum. Chymici appellan∣tur qui quae occulta sunt in rebus, manifestant & de∣tegunt: Ʋt confidenter dicere ausim, vix aliquem ad peritiorem rerum naturalium cognitionem pervenire posse, qui in Chymicis operationibus, quibus res na∣turales artificiosè resolvuntur, & quarum beneficio mirandi rerum consensus & dissensus, ac omnino plurimi effectus aliàs occulti deprehenduntur, exer∣cittus non est.

Gregor. Horstius also, and other eminent Writers (though adhering sufficiently and too much to Calenick Doctrine) yet will have an exact know∣ledge

of Chymical Pharmacy so necessary to the compleating a Physician, that without it he is of no * 1.12 account: Encomia Chymiae non opus est ut hîc re∣censeam, quia verum est, quod habet alicubi Heurni∣us: cespitat jam profectò sine hac arte medicina; quam ob causam rectè dicit P. And. Mathiolus in Epist. Ausim dicere, neminem medicum absolutum esse posse, imò nec mediocrem quidem, qui in hac nobi∣lissima distillandi scientia non sit exercitatus. And Helmont that profound Philosopher gives his testi∣mony * 1.13 of Chymistry in these words: praeparat intel∣lectum ad penetrandum occulta naturae, ponitque in∣vestigationem in natura vel ulteriorem, quàm aliae scientiae omnes simul; & penetrat usque ad ultimas profunditates veritatis realis. What is here attest∣ed of Chymistry in general, as the only Key to un∣lock Natures Cabinet, serves to prove, and does include Pharmaceutic tryals, to be the most neces∣sary and useful means to acquaint a Physician with the whole secrets of his Art.

From hence it is evident, that the constant ex∣ercise of Pharmaceutic Experiments, and diligent practice in the preparation of Medicines, gives a great advantage to a Physician, and is the most excellent Philosophical part of the medical Science, giving light to all the rest: for hereby not only a knowledge in Medicines is barely gained (though that is great) but a Physician is hereby acquainted with the operations and defects of Nature; is led into the knowledge of Diseases, and is taught how to adapt a Medicine aright, and how Nature re∣ceives help and assistance in several cases of di∣stress. An exact perspective knowledge of Medi∣cines

(gained by Experiments and not otherwise) dilates it self and extends farther than the Phar∣maceutick or Mechanick part of Physick; where∣by a Pharmacopoeian Physician is better enabled to give an account of all the operations and deficien∣cies of Nature in humane bodies, and the reme∣dies that answer thereto, and the manner of their performance, than any other person, taught from the various tryals of Medicinal Preparations, which not only discover their peculiar Natures in artifi∣cial processes, but withall by analogie unfold the latent operations and mysteries of the Microcosme. You cannot design a Medicine rightly, nor aim at any Disease judiciously and certainly, but from the knowledge you have gained in Pharmacopoie∣tick operations and tryals of Medicines; for, by correcting, digesting, fermenting, distilling, sublim∣ing, volating, fixing, &c. are Diseases known, by these artificial imitations of Nature, and does lay open the mystery of Curing.

But secondly, the super-excellency of Medicines [Proof 2] appears in their immediate approach to and en∣counter with the Disease; so that the stress of cu∣ring lies principally and mainly here, in the good∣ness and efficacy of Medicines, more than in the other learning of a Physician. The Art of Physick is stiled the most excellent of all Arts, because of the end it attains and effects (health) which is the most excellent and desirable thing. And although the whole Art does contribute to this end; yet more especially, necessarily, and immediately, Medicine does effect this; and this sometimes alone, with∣out the assistance of the other parts of this Science:

for a good Medicine shall perform much, given by an illiterate hand; but the most learned Physi∣cian can do but little to the praise and credit of this Art without a good Medicine. And there∣fore Blasius a Doctor of Amsterdam, speaking of the necessary accomplishments of a Physician, wherein his knowledge ought to consist; he gives the preheminence to Medicines, as the most requi∣site wherein his knowledge must not fail; because the burden and weight of Curing rests here: maximè tamen omnium mediorum (medicines) qui∣bus * 1.14 morbus propelli sanitasque restitui citò, tuto at{que} jucundè queat, natura adhibendique ratio. In his enim omnibus, quibuscun{que} Arti huic praestantissimae sese mancipare animus est, qui cum laude aliquando illam tractare desiderant, maximè ut excellant, im∣primis allaborandum est.

To the same purpose, and severely, Christ. Lan∣gius, a learned Doctor, urgeth the precedency of Medicines before all the rest; for as much as the life of the Patient, the credit of the Art, and re∣putation of the Physician, chiefly depends here, and is most eminently manifest: non immeritò au∣tem * 1.15 Medici omnibus nervis sollicitos se exhibent cirea remediorum sedulò continuatas inventiones & facturas; siquidem non tantummodò venerandam Antiquitatem hîc habeant fideliter praeeuntem, ac Iatro-Chymicorum Coronam hodieque presso pede lau∣data hujus vestigia insequentem; verum ipsissima etiam necessitas & conscientiae cultus impensè id in∣culcet; quum tam aegrotantium vita, quam medi∣cinae gloria ac medentis fama in remediorum dextrè paratorum sinceritate omnino atque certitudine con∣sistat.

I could cite many others of good Authority, whose judgments concur in this point, and do af∣firm the same: but what need I summon in Autho∣rity to countenance our Doctrine, when Reason urgeth so strongly, and proves our assertion so clearly and undeniably.

Having shewed you the excellency of Medi∣cines, and confirmed their dignity and merit, as the chiefest part of our Art: I come now to make good the second Thesis: that true skill, certain knowledge, and improvement of Medicines, is not attained by reading Authors, but by prepara∣tion and mechanick tryals. To introduce a belief hereof we have

[Argu∣ment. 1] First, the Pattern and Example of all the Anci∣ents (as appears pag. 3, 4, 5.) who were industrious and laborious to gain the knowledge of Medi∣cines.

[Argu∣ment. 2] Secondly, The meliorations and improvements of those antique Medicines, by our modern Phar∣macopoeian Physicians, confirms it farther: for, when Medicines are any ways improved, by bet∣ter and more artificial preparation, it hath been done by some industrious Physicians who were operators in Medicines, and such were the modern Authors before named in pag. 6. hence it appears, that the whole knowledge of Medicines is found∣ed here, and springs from this root; viz. manual preparations and tryals of making Medicines, and not otherwise. And as there is yet a Plus ultra, room enough for greater Discoveries in Pharmacy; either by invention of new Medicaments, or by modelling and improving of the old, which yet

deserves correction: there is no other way of pro∣gress, rational, secure, and certain, but this of preparation and manual facture, as did our Prede∣cessors, and is now imitated by the most ingenious, and ablest Professors of this Age: what otherwise is suggested by putation or traditional Writings, is dubious at best, fallacious oftentimes and erro∣neous upon tryal; and therefore not becoming an Artist, nor an honest man of so weighty a charge, as life and health, to venture and rely on.

I might here bring in the sentiment of many learned men to this purpose; but to be brief, one shall speak the sense of the rest; and this from a judicious late Writer, a Collegiate Physician of London, complaining of the unhappy state of Phy∣sick; offers what I now urge, as the only remedy for redress, and as the most advantagious means to improve the Art: his words are these. Besides the securing of the Practice of Physick to Physicians, * 1.16 and the preventing its falling into other hands, which is a necessary advantage; there is another of happy consequence and more honorable, which, by this course of Physicians making their own Medicaments, may be attained; that is, a great improvement in the Art it self, hinted before: For when judicious Physi••ians come to be more familiarly acquainted with the materials of Medicaments, and also to ex∣periment and observe operations, and processes upon them; especially the more accurate and artificial, as in Chymical Preparations; they will discover the most advantagious ways of preparation, and the most rational proportions in order to composition; and come to contrive and invent new Medicaments,

exceeding others in their kinds, and improve, be∣yond what they can imagine of themselves, before they have entered this way, and what they can ever otherwise attain; as some learned and ingenious Physicians have done. This is very plain, and fully asserts the truth of our second Position; and concurs with other heads of this Tract.

[Argu∣ment. 3] Thirdly, The Nature and Reason of the Work it self, requires autoptical Experiments, and proofs by manual facture.

No man can attain to a compleat skill in manual Arts, but by manual operations; Pharmacy is a manual Art, therefore not acquired but by fre∣quent practice in preparation. The force of our argument is obvious to ordinary capacities; being drawn from daily experience in other manufacto∣ries: as Painting, Carving, Writing, Building, Cookery, Engines of all sorts, &c. where there is a manifest sensible work to be effected and wrought, resulting from some formed or model∣ed matter, and remaining after the Artist ceaseth to operate; the perfection thereof, or a sufficient knowledge therein, is not acquired by contempla∣tion * 1.17 and Book reading, but by repetition of acts, in the manual labour and business of that Work. To what I have alledged, agrees the saying of Ga∣len, an ancient and famous Master in this Art. And so I pass on to the next considerable assertion: that this preparation of Medicines, and the various experiments belonging thereto, is the proper work of every Physician.

[Reason 1] The first Reason is drawn from the Example and Custom of the Ancients (whose industrious Practice

was so, and proved, pag. 3, 4, 5.) to whom we are ob∣liged for their labours in setling some foundation for us to tread on; and from which we ought not to depart and separate; unless it be for truths sake, or some necessity urging: which cannot be alledg∣ed in this case.

[Reason 2] The second pleads thus: for as much as the true knowledge of Medicines and improvement of Phar∣macy, depends upon practice in preparation (as is already proved pag. 15, 16.) this knowledge and im∣provement ought to spring from the Physician, and be reposited in him; else he cannot be able to di∣rect, correct, and improve Medicines: consequent∣ly then, he is very unfit to undertake the Sick; ve∣ry unskilful to adapt, order, and appoint Medi∣cines; very unable to perform a Cure; his Title and abilities are very incongruous, and more pro∣perly he deserves the Character of an Empirick (in the worst sense) than Doctor Medicinae; because he is medicamentorum imperitus.

Quercetan urging this duty upon the Physician, * 1.18 severely checks the ignorance of him who is not well exercised and skilful in the Preparation of Medicines: Quam turpe est medico, sibi doctor is ti∣tulum arrogare, & materiam, qua uti debet, modum∣que illius parandae ac administrandae ignorare, pa∣tique se à ministris suis superari? an ignoras expe∣rientiam rerum esse magistram? ergo Pharmacopoei∣us eam Callens magister erit, tu verò bruta statua Ca∣thedrae affigeris. Construe that your self, for I am ashamed to render it in English. Where would you have the knowledge to be treasured up, but in him that is Master of the Art: he that appoints

the medicine, ought to know all that belongs to the medicine, both for the matter and manner of preparation.

The Colledge of Physicians of London, considering the many inconveniencies that emerge from the neglect of medicines, and trusting that business in other hands; have lately voted it honorable for a Physician to prepare his own medicines: Truly, if also they had voted it dishonorable not to do so, they had then enacted compleatly: that was well done, this ought not to be long undone. Well then, if it be honorable so to do, do you thus hono∣rably, and then will you have honor and praise with all knowing men. There can be no greater, nor more acceptable and advantagious service to this Profession, than the regaining of it entire to the true owners; and delivering it successively to the Sons of Art, as their inheritance; which injuriously and absurdly hath been alienated from the Aescula∣pian Family. But Rome was not built in a day; * 1.19 great Affairs move slowly: a general radicated custom, is not suddenly broken; but there are great presages of a Change.

In the interim, the preparation of medicines now, is not so scandalous to a Doctor of Physick as formerly; who if once taken notice of for a Pra∣ctiser with his own medicines, ipso facto, he was pronounced a Quack or Empirick; he that toucht a medicine went in danger of his reputation: but now aliares est; the scene is changed; and I expect very justly too, that it will be cujus contrarium: for this is a plain truth, he that does not handle medicines is not fit to touch the sick: he comes

illotis manibus, not well prepared and qualified for that undertaking: in plain terms he is defici∣ent; and that deficiency the greatest a Physician can be guilty of. To separate Medicines from the Physi∣cian, and make Pharmacy a distinct business, is to abstract from him the quintessence of his knowledge, is to disarm and disable him from relieving the sick; and to rob him of the best and most considerable part of his Art.

If talking learnedly would charm or cure a Dis∣ease; then the Physician need not so much regard medicines, but leave that for any body to manage. Sed herbis, non verbis, 'tis medicine that cures; here then must be the Physicians great care, and exquisite skill; which cannot be expected, but from him that operates and prepares medicines: An majestas & pompa, hellenismus & latinismus medici nomine tenus, non re,—so Quercetan (though him∣self a learned man) goes on sharply reproving the * 1.20 vanity and insufficiency of learning dis-junct and separate from the deligent labour and acquired knowledge in the preparation of medicines. Doubt∣less it is a most absurd deficiency, for a Physician to be wanting in the true experienced knowledge of medicines: a Physician to be ignorant of medi∣cines, is as absurd and irrational, as a Master of a Ship to be ignorant of the Compass: he that knows not medicines, is little better than he which knows no∣thing: What! practice at a venture! you may as well throw the Dice, whether the Patient shall re∣cover or not, as give medicine at random: the old Woman is as safe a Practiser as you, that dare give a medicine of you know not what; nor you

know not how made; being not privy to the choice of ingredients, nor present at the prepara∣tion.

However, though the game goes thus general∣ly, yet I am glad (tandem aliquando) to see that the preparation of Medicines comes to be esteem∣ed and adjudged an honorable employ, befitting a learned Doctor and Philosopher: indeed it is so befitting, that he which is not thus employed, is but a Truant and a Loyterer in the School of Physick; an verum est? imò verissimum. Well then, you Prescriber in the mode of male-Practice; that have accounted it a dis-honor, and a Physicians shame, derogating from his dignity, to make Medicines; may now for shame, come and make them your self: the shame now lies at your door; and there it will lye, until the reproach be taken off, by your return to the primitive, industrious, and most rational Practice, of inspecting and operating in Medicines.

Doctor Thompson, a learned Physician and expert operator in Medicines; lays this charge upon * 1.21 every Professor, and shews the advantages that assurge from thence in these words, Physicians ought to make their own Medicines, for thereby they shall prepare them with a satisfactory elegance and exactness, improve them to the greater advantage and gradation; understand their vertues more clear∣ly; administer them with the more discretion, and acquire a far greater confidence of their success; then may he be stiled 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, an officious Physician indeed; otherwise he can deserve no other title than of a meer Trifler in his Function;

acting 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, carelesly, perfunctorily, and cru∣elly.

That Medicines are the Physicians business, and his proper concern, I further prove thus; That which is of the greatest importance, and most ne∣cessary to be exactly done, requires the greatest care, and strictest curiosity by the Physician: but medicines are the grand and chiefest part of a Phy∣sicians business, upon which more especially success or frustration does depend: therefore medicine is his proper and personal business most strictly to be regarded. The major, or first proposition I sup∣pose none will deny; the minor or assumption I have proved at large in pag. 10, 11, 12, 13. that I need not repeat here, but refer you back to view the proof. Sennertus a Writer of great note and e∣steem, incourageth and adhorts Physicians to this duty of preparing Medicines for their own Practice, as a work of great merit and desert. Nec, ut de * 1.22 Jul. Contareno in hoc negotio scribit Horat. Augeni∣us, culpandus est, si pharmacorum compositioni in∣cumbat medicus, sed potius maximis extollendus landibus, ac praeterea honore atque praemio afficien∣dus: Nemo enim rectiùs composuerit medicamenta quàm medicus; utpote qui materiam remediorum, in qua maxima est differentia, agnoscit iis signis, quae alias indoctis vix commodè explicari queunt; & novit quo pacto integris facultatibus utile ab inutili, purum ab impuro secerni possit; quique mixtionis modum, insperatis quandoque morbis necessarium, optimè tenet, quem indoctus Pharmacopoeius vix asse∣quitur. And in the same Chapter he saith; prae∣stantissimi medici domi suae suis manibus medica∣menta

composuerunt, & suis nominibus insignive∣runt: Then he brings in Valeriola, though seem∣ingly against this Practice; yet cannot deny but the best Physicians in Galen's time prepared their great Antidotes themselves, and accounts it the happiness of that Age. Then says Sennertus; Et * 1.23 cur non sit summa felicitas, si ea medicamenta, in quibus vita hominum sita est, ipsi etiam medici com∣ponant, nec omnia non rarò indoctis hominibus com∣mittendum. This Author (much approved and followed) declares himself very plainly for our present purpose: and indeed most Physicians now are sensible of the error they are fallen into, by being snared and carried away with the common prescribing custom; and what disadvantages and abuses it hath brought upon this Profession: but such as are riveted in that Practice by combina∣tion with Apothecaries, and enticed away with the profit and ease of it, are loth to be rousted out; and they can be contented to smother and wink at all the injuries I can reckon up, to Physician, Patient, and the Art it self: so long as it goes well with them, so long as money comes in freely and easily this way, what care they; what need they trou∣ble themselves about medicines: but those who desire sincerely to discharge their duty towards the sick; to advance the reputation of this Science, and exercise their Profession knowingly, and conscien∣ciously, will have special regard to the medicine, in the election and choice of ingredients; will per∣sonally be at the Preparation; give out the medicine with due cautions; and not commit this, the weigh∣tiest part of his business, to other men and their Servants.

I think it much more necessary, that a Physician look into the medicine, than the Chamber-Pot or Close-Stool, as a matter of greater concernment; and he shall practice with less hazard to his own reputation, and more security to his patients life. And I must say, an error, mistake, or abuse in the medicine, is far greater and more dangerous than a deficiency or error of the Physician in his judg∣ment of the Patients Disease: For, a good medi∣cine is not so tied up and restrained to one disease, but it shall operate for good in many others; so that if a Physician do not so exactly determine aright concerning the Patients Case; yet if the di∣stemper he imagines have but an affinity, or some proportion with that which really afflicts the Pati∣ent, and he gives a proper good medicine accord∣ing to his own determination; this medicine shall succeed well and prevail: but an adulterate bad medicine, though adapted and appointed by the most skilful head and deliberate consultation, shall take no effect, for the purpose intended, or else have bad effects. And therefore I may confident∣ly affirm, that a Physician of ordinary Parts, with extraordinary curious medicines, of his own Prepa∣ration, well tryed and proved, shall perform more and greater Cures, and have less miscarriages, than the most knowing and learned with sophisticate, and ordinary Shop medicines, of which no man can have confidence but a presumption. All the curious knowledge that can be comprised in one man or many, cannot cure without good efficaci∣ous medicines; cannot command a bad medicine from doing mischief; therefore good medicine is

most to be esteemed, and nicely to be lookt after, as the most excellent and most serviceable part of this Art; and the Physicians personal business, his grand and peculiar concern.

I see no reason, but that a Physician may as well depend upon the Chyrurgions skill in Anatomy, as the Apothecaries skill in medicines; and lay aside that trouble of dissecting, as well as this of pre∣paring medicines: why you should be so much concerned for Anatomy, and so little regard medi∣cines, the reason does not appear to me, nor is there any thing to be produced: this I am sure, that a good medicine without an exact anatomical know∣ledge, will perform its work; but the greatest skill in Anatomy, will not make amends for a frivolous or bad medicine. A competent knowledge in Ana∣tomy, and an expert accurate judgment in medici∣nal preparations, makes an able good Physician; and with this man you may freely and safely trust your life: but if he be the best and most compleat Anatomist in the world, having spent much of his time to gain repute in that curiosity, and neglected medicines; save only a speculative traditional knowledge, and what he hath gained by Books on∣ly; he may talk finely, but he can do little; he may get esteem with some kind of people, by his words and terms of Art, but not by his works; Cures will not fame him; he is an uncertain and a ha∣zardous Practiser; subject to miscarriages and great errors in his undertakings: yet I would not have any think hereby, that I slight Anatomical disquisition and knowledge, but I blame the pre∣ferring of this before the other; the insisting too

much upon Anatomy, and neglecting Pharmacy, which is chief, and gives the main stroke in Cu∣ring.

And for as much as the mystery and dexterity of Curing, lies principally in the compleat knowledge of Pharmacy, gained by preparation and constant exercise therein (as appears pag. 10, 11, 12.) then he that is not a Pharmacopoeian, is but half a Physician, and the worst half: for, the Pharma∣ceutick knowledge excels all the rest, as most use∣ful and safe in Curing: and if a Physician may be allowed some grains, or abatement in knowledge, and pass currant; much better it is that he want weight in any part of this Science, than in the Pharmaceutick; this being the greatest requisite to constitute a good Physician, and render him most serviceable to the Sick; and so necessary, that without it his seeming abilities are a meer imposture, and he undertakes at a venture.

Hence it plainly and undeniably appears, by what we have said and proved; that not to be skil∣ful and expert in the manual preparation of Medi∣cines, is a great and absurd deficiency in a Physi∣cian: not to be privy to all that appertains to any Medicine exhibited to the Patient, is a very irra∣tional custom; is very dubious and uncertain in the management; is very dangerous and oft pernicious to the Sick: and therefore against all reason it is, that Medicines should be separated from the Physi∣cian, as a distinct charge and business; when in∣deed the Preparation of Medicines is the 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, the main business, the chief office, and principal duty of a Physician. And here was his rise, and

it was this work that did first constitute and make him a Physician; and here he ought to continue in this excellent fundamental employment; trying and searching out the virtues and properties of naturals, in their simple genuine, and various com∣pound state, by different preparations and tryals, and divers probations in their use of curation: that from hence by ocular inspection, and manual tra∣ctation, which daily brings in a considerable im∣provement of requisite and necessary knowledge; we may hereby arrive at more certain solid judg∣ment, have a more firm assurance and confidence in this our Art, than hitherto the most have had, by trusting too much, and relying upon Books as perfect Copies, and Pharmacopoietick substitutes, sufficient and as a full discharge of that duty; both which are great enemies to the proficiency and com∣pleatment of our Science. And therefore that Phy∣sician who departs from the primitive, most rational, certain, and improving practice in the preparation of medicines; for a new fangle and fashion, of pre∣scribing to Apothecaries; he deserts the most Phi∣losophical, most necessary, and best part of this Pro∣fession; he degenerates much from a compleat Physician; he goes out of himself, and halts shame∣fully in his abilities, being dismembred in the most substantial part; he is but a piece of a Physician, maimed and disabled from doing true service, and exercising his function iudustriously, knowingly, and faithfully as he ought.

Having urged strongly this duty and charge of Medicines upon the Physician: I will now make some objections, the most plausible and seemingly

valid that can be pleaded against it, in the behalf of those that would be exempt from the exercise of this part of their Profession and desire to live at ease.

To excuse the Physician from the business of Me∣dicines, and to free him from that trouble, it may be pleaded, Huic operi non vacat; he hath not [Object. 1] time and leisure from visiting and being visited, to attend the Preparation of Medicines, making choice of the best Drugs, and what else belongs to this business.

[Answer.] To this I answer: First, no Physician ought to take more business upon him, than what he can discharge carefully, safely, and honestly; not trust∣ing and relying upon assistants (in the principal part) that may hazard and frustrate the whole suc∣cess of his undertaking.

[ 2] Secondly, if a Physician's Practice be so great, he cannot attend the whole, but must neglect or fail in some part of his duty; then let him fail in the lesser, and not in the main point; upon which the whole affair does chiefly depend; as it is the case of Medicines already proved. Abate some of your superfluous visits; receive an account at home sometimes, of the operation of your Medicines, which will give you very good information, how it fares with the Patient, whether better or worse, what hopes, and what symptome urgeth most, to occur and obviate next by a secure, efficacious, proper Medicine; and therefore it is much safer for the Patient, and the Physician shall better de∣serve his Fee, to be absent sometimes, in provid∣ing good medicines carefully and exactly, than he

that often comes to ask the Patient how he does, and leaves the charge of Medicines (the grand work) to be managed by another, and his Ser∣vants. Besides, all Diseases are not acute, are not so swift in motion, nor suddenly varying with un∣expected and unwonted accidents; but many are Chronick, and do not call upon the Physician so quick, and so often, but do give him time and leisure, to attend at his best conveniency.

The Patient thinks, and the Doctor would have him believe so; that when he hath visited him, seen his Urine, felt his Pulse, heard his complaints, writ his Bill to the Apothecary; that then help is at hand, great care is taken for his recovery, no∣thing can be done more or better. Oh, you are much mistaken, the great business is yet to do: the medicine which is more considerable, than all the contents of this visit, that is referred to the care and skill of the Apothecary and his Boys. You are more under these hands than the Doctors; you are now turned over to the Medicine Makers and Traders; in whose power your life is, and you are liable to suffer for any default, by their neglect, want of skill, sparing cost, inadvertency, and over∣sight, casualty, or haste of other business, shall ex∣pose you: and that from hence Patients do often suffer and miscarry: take the testimony of Do∣ctor Merrett, a Collegiate Physician of London, and a Practiser for 30 years with Apothecaries, * 1.24 gives this account of them in his Book lately put forth.

Pag. 8. They use Medicines quite contrary to the Prescription, Myrtle leaves for Sena, &c.

they falsifie the grand compositions of the London Di∣spensatory, &c.

Pag. 9. 'Tis very common for them to load Me∣dicines with Honey, and other cheaper ingredi∣ents, and to leave out in whole or in part those of greater value, &c. Such Chymists which sell prepa∣rations honestly made, complain that few Apotheca∣ries will go to the price of them. Whence it comes to pass, that most of the Preparations found in the Shops are sophisticated, to the great abuse of City and Country, &c.

Pag. 12. As to their use of decayed Drugs, 'tis so common a practice that I need not give instances of it, &c.

Pag. 18. First, they frequently mistake the Phy∣sicians directions, which of what dangerous conse∣quence it is, every one can tell. Secondly, they car∣ry a Medicine appointed for one sick person to ano∣ther. Thirdly, they often neglect the sending of a Medicine in due time, especially such as have no Ser∣vants, or but raw ones, when the Master is out of Town, or upon long Visits.

If a Physician seriously considers the casualties that attend Medicines, and their uncertainty be∣ing not of his own providing; doubtless he can∣not with confidence, nor with an honest face, excuse himself from this business, and say, he hath not time to look after Medicines. That's a pitiful un∣warrantable pretence, to say, you have not time to look after Medicines; then, I say, you have not time to be able and knowing in your Profession; then you have not time to take a faithful and due care over the sick: then you have not time to be

an honest Physician, and you are but a slight and a hazardous undertaker in this weighty affair: you can find time enough to make visits for the Fees sake; but you cannot spare time to perform your whole duty; nor the principal part of your duty, upon which curing, and the safety of the Pa∣tient does chiefly depend.

[ 3] Thirdly, A Physician being provided with a good Stock of Medicines, well designed and proved by frequent use, to answer the general operations that practice will put him upon: Ca∣thartick, Emetic, Diaphoretic, Diuretic, Anodyne, with some appropriate Medicines to principal parts, Cephalic, Pulmonic, Cardiac, &c. he being thus accommodated, shall not be puzled or di∣sturbed to appoint sufficient and compleat Medi∣cines out of this apparatus for all his Patients, al∣though his Practice be great, and have many un∣der his charge.

Now how this Stock of Medicines shall be raised, and how it will be managed and maintained with that facility and readiness, as not to impede and check a Physicians Practice, appears thus. It is ratio∣nally supposed, that a Physician upon his first en∣trance into this Profession, does not jump present∣ly into a full Practice; but he must stay some years for it, perhaps many; before business throngs him: during which time he hath then leisure enough, to make his tryals in the preparation of Medicines; to be throughly acquainted with the materia me∣dica; and be raising himself a stock of well ap∣proved Medicines in the several operations of Phy∣sick; such as his repeated experiments in their pre∣paration

and use, shall give him full satisfaction and a just confidence to rely on, as his standing Medi∣cines for all emergent occasions: and his Repository being thus compleatly furnished; he is then well prepared, fit and ready for a great practice: and this stock of Medicines thus gradually and satis∣factorily acquired; shall be maintained and supplied with great ease and delight; supposing he make but one Medicine in a Fortnight, or perhaps a longer time: for the Medicines thus designed by Physici∣ans, will not be like those of the Shops (soon fading and losing their virtues, that little they have) but such as will preserve themselves (with good keep∣ing) many years: no great bustle then to manage a full practice, no Pots nor Kettles upon the fire all day; no syruping, no apozems, no Barly waters, no Clyster decoctions, no pulping for electuaries, Lohochs, &c. none of this dirty work nor hurry upon sud∣den occasions, that makes a great clutter at the Apothecaries Shop, if practice comes in pretty fast. There is a much better and more curious de∣signment of Medicines, a far neater way of pre∣paring them; less troublesome, more noble and Philosophical, more delightful, and satisfactory, longer lasting, easily and presently dispensed, appositely serving to the whole Practice of Phy∣sick, and readily answering all occasions that pre∣sent.

To this purpose, a forementioned Author does * 1.25 declare himself; shewing the facility of a Physi∣cians managing his whole business: Pag. 28. Who∣ever with judgment peruseth the London Dispen∣satory, may soon estimate, to what an Epitome

it may be reduced, how many Compositions may be spared, how many ingredients almost in every Compo∣sition: and whoever with the like judgment consi∣ders and casts up the main intentions and indica∣tions that occur in Practice, it will not be hard for him to state the remedies adequate and proper to such intentions as are of greatest importance; and by con∣sequence to be stored with Preparations and Compo∣sitions ready made of the choicest materials, to the best advantage for use and Practice, more grateful and effectual, and every way more considerable than the Shop Medicines; as Purges, Cordials, Antidotes, &c. which by judgment and Chymical Art, as the case may require, may be so prepared as to last long, without impairing the virtue by keeping, and there∣fore to be always ready; to be of such form as is convenient to be given, either alone, or with some vehicle; which may easily be had, or prepared by the Patient, or any about him. And in Page the 30. he farther saith. And it will not be hard for a Phy∣sician, making use only of a Servant or Servants (who shall be no ways capable of discovering his se∣crets, but only fit to kindle fires, tend a Still, or Fur∣nace, beat at a Mortar, &c.) to oversee and with his own hands prepare and compound what is neces∣sary for himself to do; and by this means, though he be in full Practice, at the expence of a few spare hours, to store himself sufficiently for all his occa∣sions, of such great remedies and secrets of impor∣tance.

And to the same purpose, another late Writer of the Colledge of London; urging the Prepara∣tion of Medicines upon the Physician, as the only

means to redress the abuses that have been befallen this Profession, and chiefly from the Apothecaries, who have betrayed their trust. Pag. 48. of that * 1.26 Answer he saith: your 9^th (reason) consists of many Parts, but all the difficulties insinuated in it, as to the hazard, and charge a young Physician, at his first entrance to Practice may run, in making a competent provision of Medicines, may be obviated easily enough by what you insinuate your self, of remitting easie things, as common Decoctions, Clysters, Ptysans, &c. to Patients themselves; which may also upon occasi∣on, and according to emergent exigencies, be actuated by little quantities of generous and lasting remedies; which no Physician that will attempt the way, that you or I would have, but must always have a compe∣tent stock of, readily to supply the Sick with upon oc∣casion; and I doubt not when you and I meet, but that I shall satisfie you, that some of us have con∣trived à materia medica, consisting of generous, la∣sting, and acknowledgedly the most effectual known Medicines; which when the trouble of making them is once over, may be contained in a Cabinet not of the largest size; and by present mixtures, accord∣ing to the occasion, and the help of easily prepared Vehicles, may serve as effectually as any other what∣soever, to cure all the Diseases that infect miserable man; or at least to give him all that relief his condi∣tion is capable to receive from Medicines: I cannot therefore think, that having some Medicines made from Shops, renders the way you propose better, be∣cause less troublesome then that of the Antients; for I am one of those that cannot value any trouble, that is indeed really necessary to the acquiring an honest

and an honourable purpose;—And so he goes on worthily to encourage Physicians in this under∣taking of Medicines. Neither was this, or the whole discourse, the single judgment of this Author; but in the front of these Printed Papers, you may read there; that they were made publick at the request of several Members of the Colledge of Physicians, which argues their concurrence and consent here∣in. And in the last Page of those Papers, he de∣clares his perseverance, where he saith: That all the Reasons of the 17^th Proposition are likewise better complyed with, and all the advantages better acquired by the way of wholly making our own Medicines, and having nothing to do with those men (Apotheca∣ries) who have used us so unkindly.

You plainly see here that in what I urge, I am not singular; nor is it so difficult, unreasonable, and unpracticable, as some may imagine, or would fain perswade to that belief: but as it is most advanta∣gious to advance the credit of Physick, and secure it from the many abuses now exposed to, and suffered under; so is it very facil and easie to be undertaken: and therefore the objection offered, as a bar to this laudable and much desired work, proves of no validity to discourage the industrious Physician, from this attempt of preparing his own Medicines, as did our Ancestors of famous me∣mory.

[Object. 2] A second objection and discouragement, to hinder and keep off Physicians from managing the business of Medicines may be this: That in regard strange accidents do happen sometimes to a Patient upon the exhibiting of a Medicine, which no way caused

such effects, but arising otherwise: or if the Me∣dicine did produce them per se; it was from some mistake, neglect, or other fault of the Apothecary or his Servant, that prepared the Medicine, not from the Prescriber: therefore to justifie the actions of Phy∣sicians, and to clear them from any unjust imputa∣tion or censure, from such unwonted strange Sym∣ptomes that may happen, or unexpected sudden death; the Bills upon the file are a sufficient testi∣mony to aver his innocency, sound judgment and skill, and to take off any such scandal: which had he acted alone, and none privy to the Medicine; he could not so well clear himself, but must lye under the reproach.

[Answer.] This seems to be a fair pretence at first sight, to discharge a Physician from the undertaking of Me∣dicines; but look further into it, you will find no substantial matter, only a spectrum and shadow of reason, which will vanish into nothing. First, By this suggestion, you comply with me, and insinuate that Medicines is the grand business in Curing; which according as that is managed, well or ill, a Physician is justified or condemned: if his Pre∣script be but innocent, he is acquitted and discharg∣ed from any scandal; intimating thereby that Me∣dicine is the main and chief, whereon a Physicians reputation hangs; which does or undoes all.

Secondly I say, (and admit Medicines to be the main) that an innocent Medicine does not acquit a Physician, either from malice (if you can imagine it) or ignorance; but he may do mischiefs enough intendedly or ignorantly, and the Medicine not to be accused in sua natura, but pro re nata; which none

can fully judge of, but a Physician that is con∣versant with the Sick; and none shall detect him, if he be cunning to palliate, or disguise and repre∣sent the case otherwise then re vera it was: So that the producing of harmless Medicines off the file, does not clear a Physicians reputation sufficiently (to knowing men in these matters) but he must stand a farther tryal and probation of his judgment, in traversing this matter of Fact. You may as well and easily kill your Patient, with an innocent, slight, frivolous, or a good Medicine; as with a dan∣gerous and desperate Medicine that is more manifest in the effects: Do you think to clear your self from scandal by producing the Bills from the Apotheca∣ries files? it was but an innocent Cordial of aq. The∣riac. Syr. Caryophill. &c. such like: it was but a common Clyster; it was but Barly water, or a Julip of stilled waters and syrups: it was but this or that common Medicine, which is well known to be safe and harmless. The vulgar perhaps may clear you upon this, but the Judicious and knowing will not acquit you thus: Notwithstanding these innocent Medicines (as you call them, and some may think so) you may do great mischief with them and abuse the Sick; you may be a very dunce and proceed indirectly, ignorantly and sottshly. To give such an innocent slight Medicine worth nothing (at least to that purpose) when the Patient stands in need of an efficacious Medicine, fully to answer the Indication prompting and requiring: To give a Cordial when the case indicates a Purge, or è con∣tra; to exhibit a Diuretic, when the indication prompts am Emetic, or è contra; to appoint a Julip

when the case urgeth for a Diaphoretic: to give an Opiate when the case forbids all Somniferous re∣medies: to Phlebotomise and exhaust nature, when you should restore and strengthen with generous no∣ble Medicines; you are hereby accessory to the death or miserable life of the Patient, by such im∣proper absurd courses wherein you can hardly be detected, if a Physicians eye be not over you; and you may do what mischief you please, (if advan∣tage lye in that way) and the medicine not appa∣rently accuse you; and therefore this filing of Bil•••• with Apothecaries is not sufficient to clear a Physi∣cian, and to justifie him in Practice; but he may be culpable grosly, and the medicines not condemn him.

Thirdly, In the difficult and weighty under∣taking of a Prince, Governour, or other great person of publick and eminent concern, where suspition of treachery and perfidious practice may arise; very rare it is that a Physician acts alone, but two, three, or more consult and determine the quid agendum and quibus auxiliis; so that no defamation or suspition can lye upon a single person, as to the medicine, but all are privy to, and acquainted therewith: but suppose a Physician be sole Agent, and have the whole charge committed to him; he may easily free his private Medicines from suspicion and unjust scandal; if a part of every medicine given, be se∣parated in the presence of the standers by, and safely kept by them, to be produced and tryed afterwards upon others; if there should be cause of suspicion by strange accidents that may attend the sickness, or unexpected ill success, that may fol∣low the exhibiting of any medicine.

Fourthly, In the charge of Patients of a lower quality and inferiour concern; better it is, and more safe for the Doctors reputation, that he suffer under an unjust censure, sometimes and seldom by igno∣rant and unskilful people; then often to suffer from the Apothecaries default undetected; which al∣so may justly be charged upon the Physician, being his substitute and acting in his place, what the Phy∣sician ought to have done himself: and it is a well grounded truth, that a Physicians reputation lyes more and oftner at hazard by the deficiency of me∣dicines from the Apothecaries management, than otherwise from the rash undeserved censure of the Patient: and although we do admit that Patients sometimes or their friends, may accuse and asperse a Physician; better it is that he suffer innocently, having discharged his Conscience in the full per∣formance of his duty, and managing of medicines carefully himself; than deservedly from his per∣functory slight undertaking, and committing that grand work to others, which is the ground work and foundation of Curing: Nor are Physicians exempt from censure and scandal, although their medi∣cines be recorded with the Apothecary; but as often shall suffer an ill report, as those whose practice is entire to themselves, and none privy thereto.

Fifthly, Since of late years Apothecaries have betrayed their trust; are become such bold intruders and invaders of this Profession, setting up themselves and affirming their abilities in this undertaking, vyeing with the learned Professors in Practice. It is very rational to assert, that Physicians reputation cannot be safe to be trusted in such hands; and a

great imprudency to expose the success of their en∣deavours to the will and power of those, that are so unjustly and unworthily become their Competitors.

Nor is this my sense alone, but others very knowing Men in this Faculty are very sensible of the same, and have declared it publickly; advising Physicians to a more secure way of Practice; that is, by preparing and giving their own medicines. Dr. Merret being well acquainted with the carri∣ages and inclinations of Apothecaries towards Phy∣sicians, having practised with them for many years, gives them this Character. As to the Physicians in * 1.27 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. Then he goes on to demonstrate: First, They have always en∣deavoured and aimed at the depression and ruine of the Colledge of Physicians, the only Corporation of that Art in England, considering rightly that the de∣pression of the Colledge is their interest and rise, and the total subversion of it will make them absolute Ma∣sters in Physick, and Physitians their Servants.

Secondly, They have continually traduced the Col∣ledge and troubled them in Parliaments, at the Council board, &c. * 1.28

And another member of the Colledge complains of them, and warns Physicians to secure themselves by declining that hazardous way of Practice with Apothecaries; his words are these: Physicians are subject to suffer from the malice or design of Apothe∣caries; 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, &c. Then he goes on to shew how they * 1.29 may, and how they have wronged Physicians close∣ly and slily.

And a fore-named Author, in his serious dis∣course of Physick, takes cognizance of the abuse Physicians are liable to from Apothecaries; and that * 1.30 the Physicians reputation lyes at their mercy. I shall not recite his words (for brevity sake) but re∣fer the Reader thither. Now these things being seriously considered, the filing of Bills with Apothe∣caries is not a prudent course to secure a Physici∣ans reputation; but rather exposeth him to con∣tempt, and he hazards his credit every day: and therefore this objection in hand is of no force to keep of, or excuse a Physician from preparing his own medicines.

A third Objection against what I have urged may be this: That the making and selling medi∣cines is too Mechanick, and below a Doctor to stoop to such an inferiour employ; not becoming him, but proper for an Apothecary and Tradesman.

[Answer] I Answer, and do confess that some of our Pro∣fessors have been so proud, and I may say shallow∣brain'd (by what I have heard and seen) as to con∣sent to and comply with this Objection; and have lookt superciliously in scorn, and elated them∣selves above those Physicians that have managed the business of medicines; and the Apothecaries (to bring such Physicians under contempt and disesteem) call them Quacks, and their Practice Quacking;

and the vulgar (taking their information from such aspersions as these) have had the most industrious, knowing and choicest Physicians in the repute of Mountebanks or Empiricks; or at best, but Physi∣cians of the lower Classis and inferiour rank, that are content with a pedling Practice. But their vanity, folly, and madness, does evidently appear by what I have said; and farther I have to say; that although such as these men, biassed from right reason, by pride, self interest, ignorance, and mis∣information; do disdain the preparation of Medi∣cines in Physicians, as unsutable and improper for them; yet this Phantastic opinion is but of late standing; it was not so from the beginning, nor is it so now with the the most judicious, and serious inquisitive Persons. And I pray, who are they now of this opinion, or that would perswade the People into this opinion; as for the Apothecary it is his interest so to do, and to vilifie all Pharmaco∣paeian Physicians, because his trade will lessen if such men gain credit and acceptance with the People: and in time when People can see their advantage, perhaps bring their trade out of use. As for the Men of our own Profession, that disswade and draw back from us, to hinder this great work of return∣ing to the Primitive Practice; who are they? and what is their ends? a lazy prescribing Doctor, per∣haps here and there one; such as had rather live in ignorance and ease, than carefully and industri∣ously gain a compleat knowledge in their Art, and discharge their duty honestly towards the Sick. A Doctor! do you disdain the principal part of your Profession? the foundation of your Art,

and the safety of the Sick? who, and what are you? Certainly some great Dunce, or great∣here must be great ignorance, or notable knavish confederacy in the case: to vilifie an able Operator in Medicines, to asperse and scandalize an indu∣strious inquirer by Experiments, into the nature of all Medicinal Ingredients; a zealous labourer and prosecutor after knowledge in the preparation of Medicines; a careful undertaker of the Sick; a legitimate dignifyed Professor that performs his whole duty, and bauks at nothing he ought to do; a learned Philosopher, more learned and truly knowing then your self. This must needs be gross ignorance, or a crafty knavish device, to excuse your idle Worship from labour, diligence and in∣dustry in the duty of your employment; by de∣tracting from the worthiness of other men, and condemning that which is most laudable: rather than you will lose your ease and and gainful con∣federate friendship with an Apothecary; you will not stick to undervalue the most knowing and Phi∣losophical part of this Art, and despise the most learned exemplary Philosopher in this faculty. Are you better than Hippocrates and Galen, Libavius and Helmont? and all the Ancient and Modern Worthies that have been diligent labourers in Phar∣maceutic Experiments, and kept their Medicines in their own custody, and dispenced them to their Patients? how comes your honour to be infringed by this work more then theirs? and have we it not recorded in many good Authors which you own, that Kings and Emperours have made Medicines to be satisfied in, and commend the excellent know∣ledge

thereof to the world; and several Medicines are called by their names, as the Inventors and Authors thereof by preparation? and do we not know that great Ladies in these days do not think it dishonourable to busie themselves sometimes in the ordinary making of Medicines? and have we not a more sublime way of preparing Medicines, becoming and fit only for a great Philosopher and Doctor of Physick? oh, but you are a Doctor of the imperial part of Physick! you scorn the Me∣chanic part; a Doctor of the gentile, easie, talking Practice; you are a Pothecary Doctor! I cry you mercy Sir, I did not take so much notice hereto∣fore of the addition to your Doctoral Title; you have climed very high to step into a Pothecaryes shop. I hope you will not think your self affront∣ed, nor be disgusted, if I should call you a Journey∣man Doctor; much good may you do with your new honour, and much good may we have without it; proceed on if you think it well, but if we take you by the Ear sometimes, you must bear it pati∣ently, for I know not how you will help your self fairly; and justifie your self to be an honest, able, and careful Practiser.

As for the servile works that belongs to Medi∣cines, that is not the Doctors part; he is not re∣quired to toy in the drudgery of it, that is his Ser∣vants work; but he must supervise and take care * 1.31 there be no neglect, mistake or abuse: he may have work-men to do the work, but in the interim he must be work-master, to design the Medicine, to ap∣point, correct, and over-look the whole business; he is 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 and 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉; and where the curiosity,

mystery and Intrigue of the Art lies, that is to be done by his own hand, that is his Closet bu∣siness.

Quercitan a great Doctor of Paris, very famous * 1.32 in his time, and Physician to the French King; de∣rides the foolish pride of those men that think the preparation of Medicines an inferior work, and derogating from the Title of Doctor: he rather cen∣sures them as undeserving of that Title, that is not conversant and very knowing in the making of Medicines. See how he checks those men that scorn the preparation of Medicines. And Rolfincius says, * 1.33 that industry in the preparation of Medicines com∣mends a Physician, and adds to his reputation: Elevat mediri eminentiam & existimationem, si & manum & mentem adhibeat, ipse{que} modum compo∣nendi Selectissima arcana non solum norit, sed & * 1.34 eadum praeparet—submissio & humilitas haec pro salute aegrorum suscepta eum neutiquam dedecet, non magis, quam sputorum & urinarum inspectio, sterco∣rumque exploratio. Senertus likewise was of the * 1.35 same opinion, and exhorts to this work: Neque preter dignitatem Medici esse, componere Medica∣menta, antiqui illi viri prudentissimi, Medici{que} peri∣tissimi satis docuerunt—ipsi domi suae Medicamen∣ta composuerunt, ne{que} sibi dedecori, se••••audi esse dux∣erunt—

The Antients who called Medicines 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, did not judge it meet that they should be handled and managed by profane illiterate men; but made Me∣dicines their chief business and proper work: and as this was their Practice, so is it now approved by the most knowing men of our Age: and as I told

you before, the Colledge of London have voted it honourable for Physicians to make their own Me∣dicines: indeed it is so honourable and praise wor∣thy, that he which doth it not, cannot be a man of value and worth in the matter of Curing; for he is not an able and safe Practiser, let his parts other∣wise be ever so great and excellent. That Society claims a great share in the improvement of the Medical Art: this will abundantly be enlarged, and amount to more than all the rest; if they restore the Practice of Physick intire to the Prof••ssors again, as it was in ancient times. If this Colledge be the first Society that shakes of the yoke of Copartnership, and breaks of that pernicious custom of prescribing to, and filing Bills with Apothecaries; doubtless it will be recorded as the most prudent generous Act, and most advantagious to the honour and welfare of this Science, and an egregious exemplar for the whole world to follow; which doubtless will be general∣ly imitated and followed, when an eminent body shall lead the Van; as I hope it will be the honour of our Nation, thus to put formost, and shew a singular zeal to redeem this excellent Art, and rescue it out of bondage and insufferable inconvenien∣cies; this will be a work so worthy and memo∣rable, that our posterity and Successors will have an honourable mention and Cordate esteem for all those who have contributed their endeavours for so happy a restitution, and delivering this Art whole and intire to them; which while the world stands, will never be alienated nor divided again; having had a sufficient proof by our recorded complaints, of the great inconveniencies and danger that arise

thereby, to the insufferable disadvantages of all industrious Professors, and great injuries to the sick. This happy restauration of Physick will be cele∣brated to perpetuity, and this Annus Redemptionis, never to be forgotten by all honest Professors in this faculty. In other parts of the world they are sensible of what we now complain of, and have this matter under consideration, and many have de∣clined the Pen-practice, and are become industrious Operators in Pharmacy: As for those that are con∣tent to get money in a degenerate unwarrantable way; Oportet haberi, and care not how it come; all is well if it do but come, although ignobly by craft and complices; they are to be marked, nigro Carbone, as being of a spurious hatch, and a disgrace to the Aesculapian family.

But although we have evidenced the Preparation of Medicines to be a worthy employ, befitting, and properly the Doctors business; yet the selling of these Medicines some may scruple at, as inferiour and too like a Tradesman. I need give no other answer to this, then what a Professor before men∣tioned hath already done.

That for a Physician to drive such a trade for its * 1.36 own sake, or meerly for profit that might accrue to him thereby, could not be of credit; but in order to so necessary an end, as the securing of his Practice, and the benefit of his own industry to himself; and to so good an end as the improvement of his Art to the benefit of others; it can be no more dishonourable to him to s•••• Physick, than to persons of honour and great estates, to sell their Corn, Cattel, Wool, or Foreign Princes their Wines.

[Object. 4]

A fourth Objection comes in and crys very loud, and seemingly upon just grounds: That it is a very hard case, a company of men promoted by Physicians, and afterwards established by Law; should by Physi∣cians be decryed and set aside as useless, exposing them and their Families to necessity and unwarrantable Practices for their support; and they being increased in number treble within this forty years.

[Answer] I answer; First, That the imprudent and incau∣telous Act of our Pr••decessors, in dividing and se∣parating Pharmacy from the Physicians care and management (his chief and special business) is not a perpetual obligation upon their Successors, to ob∣serve and continue the same, against all inconveni∣encies and prejudices that shall arise thereby, be∣fore unthought of and unprovided against.

Secondly, The legal establishments of our Nati∣on are not like the Laws of the Medes and Persians unalterble; but according to the constitution of times and occasions, do admit of alteration or aboli∣tion: if Apothecaries in those days did seem to be a conveniency to Physicians and to the People, yet by what hath been manifestly proved, the case is altered, and the inconveniencies do preponderate that little good and advantage that first attended such an establishment.

Thirdly, If ruine must fall upon one party; bet∣ter and more reasonable the Apothecaries should suffer, than the Physicians: better for the Publick that it fall upon the Ministerial than the Magiste∣rial part; the unlearned men than the learned: he that is Master of the Art, that propagates, increaseth and advanceth it, more fit he should be regarded

and preserved, than he that is subvervient and an inferior Operator, that acts by instruction and ap∣pointment; huc us{que} deventum est, the one or the other must decay and grow out of esteem: for if this Art continue long as it is divided, between the Physitian and the Apothecary; this Agent in trust, by several sinister ways and advantages, will eat out the credit of his Master; and you will find the Professors to wither away by degrees, and grow less in the opinion of the People, as the other multi∣plies and gets repute: the presages are apparent e∣nough, and the Prognostick very rational: the Phy∣sicians support will decrease, being subtracted by their Agents; and their esteem will gather rust for want of employment, and their parts will be flat and dispirited, to see such subordinate inferior men incroach upon their rights, and act in their place as Physicians.

Fourthly, Since Apothecaries have betrayed the trust reposed in them by Physicians, which is essen∣tial to their being, and the great motive to their constitution; and have re••olted from that obser∣vance of Physitians business, regarding more a com∣mon trade of their own, and a usurped practice un∣worthily stollen from their M••••ters and Founders: I judge it most reasonable and the clearest justice, for Physicians to desert them, and re-assume that bu∣siness and trust into their own hands again; and not to do it, is to be stupid and sensless, unjust to them∣selves, connivers at their own and their Patients abuses, regardless of the honour and repute of that Science they profess.

Fifthly, The fafe and speedy recovery of the sick

(the aim and end of Physick) lying principally in the Physicians care and management of Medicines (as appears through the whole Discourse) this ought and must be preferred, and is of far grea∣ter concern, than the profit or maintenance of a particular company of men; whose constitution was intended and ordained for the welfare and benefit of Patient and Physician, in the good provision and secure dispensing of Medicines: but upon long and sad experience, not proving so to either, but much otherwise; there is no valid reason, nor plau∣sible Plea for their continuance, (as appendants to Physicians) contrary to the publick interest, the safety and advantage of all the people.

Sixthly, Although Apothecaries be multiplied in number, to the detriment of some few that would live honestly of their Trades; and puts the most if not all upon sinister ways, usurping the Physi∣cians right, and contriving gain more than the ex∣cellency and faithful provision of Medicines: yet this inconvenience and pretended necessity is from themselves; tolerating so many Apprentices to be admitted, which lies in their own power to obvi∣ate and prevent: but a great occasion of this was, that the Master being a Practiser in Physick, must have more than one Apprentice to make medicines, whilst he is visiting his Patients abroad, leaving Physicians Prescripts, and the Shop Trade to be managed by the Boys: So that this supernumerary was caused by your treacherous usurpation of the Physicians function; and improvident neglect of your future welfare, in the honest discharge of your Trade and trust: and must the Physician al∣ways

suffer, because you have wronged him, and continued it into a Custom? and will you alledge that for an argument against his just relief, which in his just complaint against you?

Seventhly, Although Physicians do depart from them, they are not then left destitute of a liveli∣hood; they have a Shop Trade to stick to; and such a Trade as no other hath the like gain, nor ma∣naged (caeteris paribus) with so little a stock: So that there is no such fear they will be exposed to hardship; and if you consider too, that although Physicians do recede from them, they will have Pa∣tients, as well as Customers to their Shop, and many people will apply to them: So good an opinion have many people of the skill and honesty of an Apo∣thecary, that you need not fear but he will live, and better perhaps than some able and worthy Phy∣sicians, that are very sedulous and industrious to gain a good repute in this Profession, by long stu∣dy and great charge.

Having made enquiry into, and run through the most material and valid objections that stand in op∣position to our third Position; I wave some trifling * 1.37 ones, and come now to the second enforcement of this duty urged upon Physicians; and that is drawn from the benefits that accrue to the Sick; and they are comprised (chiefly) under these two heads; Security and Ʋtility; which I shall handle di∣stinctly.

That the Patient is more safe, and free from ha∣zards, abuses, and casual accidents from mistakes or otherwise, under a Physician who takes upon him the management and care of Medicines; than un∣der

another (though very learned) who commits that trust into the hands of an Apothecary and his Servants; will appear an evident truth if we con∣sider.

First, The difference in point of ability and cer∣tain knowledge between the Pharmacopoeian, and the Prescribing Doctor: how the first excels and surpasseth the latter: and there is great reason for it; that a Physician constantly practising and pursu∣ing knowledge in the preparation of Medicines, should be far more able and expert in Medicines; more certainly and securely design them than any other (let his learning be ever so great) that directs and prescribes at a probable venture, from the as∣sistance of Books, and the fallacious reports of Au∣thors, that take up upon trust from one another: this is fully proved pag. 15, 16, and in the follow∣ing part of this Discourse.

Secondly, The great difference between the me∣dicines of the Pharmacopoeian Doctor; and those of the Pharmacopoeian Tradesman.

In comparing the two Physicians together, we prove the designment of medicines to be more skill∣ful, certain, and exact; and more knowing∣ly appointed by the one, than by the other. In comparing with the Apothecary we shall evidence that medicines have a better management, are more carefully and more honestly made, by the Physi∣cian than by him. The reasons perswading and urging to this belief are,

First, The incumbency of the charge and sole management, resting upon the Physician, rendring him inexcusable in the miscarriage or abuse of me∣dicines;

does therefore excite him to a double dili∣gence, having no way to evade the guilt, but must take it upon him. We may then reasonably ima∣gine, that a Physician having the whole charge up∣on him, and what miscarriage happens, or ill suc∣cess issues from any medicine must lie at his door, and be charged upon his account; must therefore have a sedulous care and diligent attention upon the whole affair, must be very exact in the election of ingredients, their due weight, proper prepara∣tion, and artificial composition; since his fame and credit only lies at stake for all; this must needs quicken him and stir him up to the greatest care and nicest observance imaginable. Now if an A∣pothecary and his Boys (bred up in a Shop trading way, and cursory managing of business) can be thus sensible, and always cogitative of this great charge that lies upon them; can be thus scrupulous and exact, in the compleat discharge of this great trust (the failing whereof is often mortal) judge you.

Notes

• * 1.1

  Plebeia ingenia magis ex∣emplis, auàm or a∣tione capi∣untur. Ma∣crob. Sa∣tur. l. 1.
• * 1.2

  〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉.
• ‖ 1.3

  Querce∣tan. redi∣viv. pag. 218.
• * 1.4

  Sennert. in∣stitut. med. lib. v. pars 3 Sect. 2. cap. 1.
• * 1.5

  Sennert. ibid.
• * 1.6

  Medicus absol. pag. 10, 11.
• * 1.7

  Scribonius Larg. de compos. medica∣mentor.
• * 1.8

  Joan. Lan∣gius, Epist. med. lib. 1. Epist. 51.
• * 1.9

  Cor. Cels. lib. 1. in prooem. Plin. lib. 29. cap. 1. Galen. ad Erasistrat.
• * 1.10

  Mantiss. Hermet. praefat.
• * 1.11

  Sennert. de confems. & diss. Chym. cum Galen. cap. 2.
• * 1.12

  Greg. Horst. lib. 10. de Pharma∣ceuticis.
• * 1.13

  Helm. Pharma∣cop. pag. 371.
• * 1.14

  Blasius in Pet. morel. method. Epist. De∣dicat. pag. 3.
• * 1.15

  Lang. mi∣scellan. cu∣rios. medi∣ca, p. 145.
• * 1.16

  D^r Jonath. Goddard. A Discourse of the un∣happy con∣dition of Physick, &c. pag. 34, 35.
• * 1.17

  〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. Ga∣len. de a∣lim. fac. cap.
• * 1.18

  Quercetan. rediviv. pag. 223.
• * 1.19

  〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉
• * 1.20

  Quercetan. rediviv. pag. 220.
• * 1.21

  D^r Thomp∣sons check to Hen. Stubbs. pag. 33.
• * 1.22

  Sennert. institut. lib. 5. part. 3. Sect. 2. cap.
• * 1.23

  Eodem cap.
• * 1.24

  D^r Merret his short view of the Frauds & Abuses committed by Apothe∣caries, &c.
• * 1.25

  D^r God∣ard's Di∣scourse of the unhap∣py conditi∣on of the Practice of Physick.
• * 1.26

  D^r C. T. his answer to a Letter concerning the Pra∣ctice of Physick in England.
• * 1.27

  D^r Merrets view of the Frauds & Abuses of Apothe∣caries, &c. pag. 19.
• * 1.28

  D^r Dan. Cox, A discourse of the Pati∣ents inte∣rest, &c. and Abuses of the Apo∣thecaries in preparing Medicines, &c. Pag. 13. 14. 15.
• * 1.29

  pag. 68. 69
• * 1.30

  D^r God∣dards dis∣course of the unhap∣py condition of Physick. pag. 41. 42 43.
• * 1.31

  Medic. absolut. pag. 92.
• * 1.32

  Quercet. rediviv. p. 219. 220.
• * 1.33

  Rolfine. Chym. in Art. form. redact. pag. 31.
• * 1.34

  pag. 32.
• * 1.35

  Sennert. institut. lib. 5. part. 3. Sect 2. Cap. 1.
• * 1.36

  D^r Jonath. Goddards discourse, &c. pag. 37.
• * 1.37

  Second en∣forcement.