The Pharmaceutical Journal
Vol 269 No 7229 p919-920
21/28 December 2002

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The apothecaries: myth, legend and reality

For most 21st century pharmacists the word apothecary has little meaning save perhaps for some vague folk-memory of a long lost and enigmatic vendor of mysterious remedies. There is a sense, however, that pharmacists are the natural inheritors of these long forgotten practitioners, although the origins of pharmacy have quite a different foundation. So what became of the apothecaries, and what possible relevance do they have to pharmacy today?

The answer to this question, in England at least, is to be found today among the ancient guilds of the City of London. Most medieval cities developed trade guilds: associations, usually with an underlying religious affiliation, formed to give mutual support to those engaged in the same occupation. The earliest London guilds probably had their origins in Anglo-Saxon times and the first to gain official recognition was the Weavers Company, granted a royal charter in 1155. Others followed, some recognisable such as the drapers, goldsmiths and fishmongers, others more obscure like loriners and cordwainers.

Historical background

In 1180, the pipe rolls from the reign of Henry II record that a guild of pepperers was fined 16 marks for associating without a licence. This first mention of a group of merchants trading in spices marks the origins of the Grocers Company, those who traded en grosse, and who imported many of the essential herbs and foodstuffs required by medieval society. From its earliest times, one sector of the company specialised in smaller quantities of the more esoteric imports, and these spicer-apothecaries stood somewhat apart from their more generalist associates. By 1617 their agitation for separate recognition as specialists in medicinal products was finally recognised by James I who agreed to their separation from the Grocers Company to form the Worshipful Society of Apothecaries. It is this city company that still exists to this day.

From the viewpoint of history, one might have assumed that these apothecaries would develop in time into the pharmaceutical practitioners of today. Indeed they did so in most other European countries, including Scotland. However, by a quirk of fate the Rose case of 1704, which legitimised the activities of apothecaries in the practice of physic, resulted in increasing numbers of apothecaries leaving their shops to minister to the sick, and gradually the English apothecary metamorphosed into the general practitioner. This development has not only left us with the legacy of the dispensing doctor, but has some interesting parallels when we consider the development of prescribing among modern day pharmacists.

For the Society of Apothecaries, these historical developments from the 17th century onwards meant that it increasingly functioned as a medical body rather than a pharmaceutical one, although at least some apothecaries, including, notably, Charles James Payne, the Pharmaceutical Society's second president, continued to practise pharmacy.¹ However, this was not to last and for a while pharmacists were excluded from the higher echelons of the Society of Apothecaries. In turn, the society was granted statute powers by the Apothercaries' Act 1815 to regulate the practice of medicine.

It was not until the mid 20th century that pharmacists once more gained prominent positions within the society, notably with the election in 1982 of the late Douglas Whittet as master, the first pharmacist to hold the position for some 200 years. Since then there has always been at least one pharmacist serving on the Court of Assistants, the society's governing body, and two more currently hold elected positions on the Livery Committee, the body which functions as an events or social committee. It can be seen therefore, that pharmacists are able to join and play a role in what is largely a medical body, and currently, out of a total membership of 1,735, some 84 are pharmacists.

Today the society is one of over 100 livery companies in the City of London so called because in former times they clothed, or provided "livery" for their members. The companies continue with their age old city tradition of regularly dining together in one of the many fine halls dotted round the city, of which the Apothecaries', rebuilt immediately after the Great Fire of 1666, is the oldest still standing. The society has no secret traditions and there is no bar to membership on any grounds of race, sex or religion. However, in common with all the city livery companies, admission to the society is generally by invitation only, and two proposers from among existing members are needed to support an application to join, with the final decision at the discretion of the court. However, although there are therefore some restrictions on becoming a "Liveryman" or full member of the society, there are, nevertheless, several ways in which pharmacy and pharmacists interact with the society.

The faculty

The principal activity in which any pharmacist can play a part in the society is through the Faculty for the History and Philosophy of Medicine and Pharmacy. The faculty was founded in 1959 as a separate charity within the society to foster and extend interest in medical history. It is academic in character and its membership is open to any pharmacist and, indeed, to any interested member of the public. A number of pharmacists are members and several have served on the executive committee.

The faculty organises a number of lectures during the year, generally held in Blackfriars at Apothecaries Hall, the society's historic headquarters. As expected these range over a number of relevant topics. Recent lectures have included one by Terry Waite on the psychological aspects of his captivity in Beirut, a fascinating presentation on genetic manipulation and human rights, by Professor John Harris, and the Sirs Hans Sloane Medal Lecture given by Emeritus Professor David Phillipson from the Centre for Phytotherapy at the "Square". Those planned for 2002/3 include a lecture on the Barbers and Barber Surgeons, a history of the King's Fund, and a presentation entitled "Allocating scarce health care resources: maximising welfare or satisfying needs?" to be given by Professor Tony Hope, professor of medical ethics, University of Oxford. The lectures, which are free to faculty members and their guests, are followed by supper in the hall at modest cost.

Additionally, the faculty runs two lecture courses, one in the history of medicine and one in the philosophy of medicine. These take place on alternate Saturdays throughout the year at the Wellcome Building in Euston Road, London. Both are open to students of any discipline, and provide a strong background course to underpin the corresponding postgraduate diploma of the society.

Membership of the faculty is reasonably priced at £20 and more details including a downloadable application form can be found on the Society of Apothecaries website at www.apothecaries.org. Additionally, links are now being fostered between the faculty and the British Society for the History of Pharmacy.

Medical examinations

In former times, particularly during the 20th century, the Society of Apothecaries strongest link with pharmacy was through its examination of pharmacy technicians. Those who were successful received the Apothecaries Hall certificate, regarded by many as the gold standard for technicians. Sadly, with the advent of national vocational qualifications, the examination was discontinued in 1998. However, the society continues to run a number of postgraduate medical qualifications and some of these are open to pharmacists. In particular, the Diploma in the History of Medicine (DHMSA) and the Diploma in the Philosophy of Medicine (DPMSA) are both, like their corresponding faculty courses above, open to other health care workers including pharmacists. At least one pharmacist to my knowledge (Dr Michael Jepson, formerly of the University of Aston) has gained the DHMSA.

Although most other diplomas offered by the society are exclusively medical, the Diploma in Forensic Medical Science is open to those with expertise in the field, and an appropriate course to prepare for the examination is run by the University of Glasgow. Similarly the Diploma in the Medical Care of Catastrophes is open to many who work in medical response teams, particularly those in the medical services of the armed forces. Finally, although the society's Diploma in Clinical Pharmacology is presently restricted to physicians working in the clinical trials field, there have been moves to widen its scope, and two pharmacists currently serve on its examiners committee.

The society's philosophy has been to develop examinations in specialties where there is currently no other opportunity to demonstrate an expertise, and it has many years of experience in the field of medical examinations. Although there are no postgraduate pharmacy examinations offered at present, if such a need were to be demonstrated, or a home required, any serious proposal would be viewed sympathetically.

Charitable aims

The city companies traditionally supported those of their number who had fallen on hard times. Although this tradition continues to this day, all the companies now have much wider charitable aims and some have substantial funds at their disposal. The Society of Apothecaries policy is that its main charitable focus should be in supporting medical and pharmaceutical students. Although in comparison with some other companies it has modest means (and efforts are underway to increase the reserves available), it is nevertheless currently able to offer support to one medical student from each of the country's medical schools, and to a small number of pharmacy students. Present grants are up to the value of £1,000 and are available to third and fourth year undergraduates. Students are considered for a grant only if they have fallen into debt through no fault of their own (for example, through the loss of a parent or withdrawal of overseas funding) rather than poor management of their credit card. Applications are routed to the Apothecaries either by the Royal Pharmaceutical Society's benevolent fund or through the head of the applicant's school of pharmacy. This scheme is of fairly recent origin, and so far few pharmacy students have been helped. It is hoped that a wider appreciation of its availability will lead to more grants being awarded to those pharmacy students who encounter genuine hardship.

Archive material

In recent years, following the appointment of a full-time archivist, much more attention has been focused on the archive material held by the society. Many of the records have been carefully catalogued and preserved, and may be accessed by those engaged in serious historical studies in pharmacy and medicine. Additionally, the society holds a large number of pharmaceutical objects including collections of drug jars, pill tiles and other pharmaceutical artefacts. Records are also available for every meeting of the society's court since 1617, as well as many personal records on individual apothecaries. Of particular interest is the recent acquisition of account books, dating from 1695, which belonged to Thomas Mayleigh, the apothecary to whom Silvanus Bevan, founder of Allen and Hanbury's Plough Court Pharmacy was apprenticed. This significant find throws new light on the early history of pharmacy.

Conclusion

Overall therefore, the Society of Apothecaries is very much alive and well, and I hope that this article has demonstrated that it continues to play a part, albeit small, in the pharmacy profession of today. In the 21st century, the society has no wish to encroach in any way on the functions of any pharmaceutical body; rather it seeks only to act in a complimentary and supportive way within the profession. Far from being just a rather exclusive dining club, the society aspires to play a real role in the study and preservation of pharmacy history, in education, and in charitable giving.