The History of Pharmacy

The earliest civilizations where somewhat surprisingly, some of the most advanced. Mesopotamia is considered the birthplace of writing and the beginning of recorded history. From the Mesoptamians and their medicinal recipes on clay tablets to the Ancient Greeks, the early history of pharmacy is filled with discoveries of plants and herbs as effective remedies for a variety of conditions. Many of these discoveries became the foundation of healthcare for future civilizations.

In the middle ages, advances in botany and chemistry led to the development of pharmacology; the science of how drugs act on biological systems and how the body responds to these drugs. There began to be a clearly defined separation between the physician and pharmacist. 

As the world began to modernize and colonize, there was an increased emphasis on training and formal education, ensuring patient safety and overall integrity of the pharmacist as a patient care provider. New discoveries in medicine helped to eradicate a variety of diseases, while new legislation and regulations focused on patient safety and the advancement of medical research helped to improve the health of the population as a whole.  

Pharmacy in Mesopotamia and Egypt

Early on in Mesopotamia’s history (around 3500 BC), cuneiform records using impressed signs on wet clay were invented. The first recorded pharmaceutical texts were written on these clay tablets. These tablets contained instructions for pulverization, infusion, filtering, boiling, and spreading. In addition to plants and herbs, other ingredients including beer, tree bark, and wine are mentioned.

Evidence of the first known apothecary was found in the state of Babylon in Mesopotamia. Approximately 5,000 medical prescriptions have been found in libraries, temples, and cities across Babylon. These cuneiform clay tablets provide evidence that these early medications were effective in treating a variety of complaints, diseases, and illnesses.

Ancient Egyptians knew of the many therapeutical effects of medicinal plants. This knowledge was taught at home from father to son. As interest grew in the medical sciences, temples began to establish medical and pharmaceutical schools. 

Pharmacy in Ancient Greece

There was a separation between the physician and the herbalist in Ancient Greece. The herbalist supplied physicians with plants and other raw materials to make medicines. Before, during, and after the time of Hippocrates the “Father of Medicine”, there were a group of experts in medicinal plants. The most important of these was Diocles of Carystus (4th Century BC). He is considered to be the source of all Greek pharmacotherapeutic texts between the time of Theophrastus and Dioscorides.

Between 60-78 AD, the Greek Physician Pedanius Dioscorides wrote a 5 volume book “De Materia Medica” covering over 600 different plants and their medicinal uses. Each entry gives a substantial amount of detail on each plant, its benefits, and guidance on drug preparation. This book became the basis for many medieval texts to follow. 

Pharmacy in Ancient Asia

The earliest Chinese literature on medicinal formulations and treatments included a list of prescriptions for specific ailments in the “Recipes for 52 Ailments” which was a found in Mawangdui, sealed in 168 BC. 

The first Chinese manual on the medicinal uses of plants and herbs is the Shennong Ben Can Jing (The Divine Farmer’s Herb-Root Classic) dating back to the first century AD. This text was written during the Han Dynasty and attributed to the mythical Shennong. 

The first known compilation of medical substances in India is attributed to Sushruta (6th Century BC), an ancient Indian physician. The Sushruta Samhita (Sushruta’s Compendium) is one of the most important surviving ancient works on medicine and is considered the foundational text of Ayurveda. Ayurveda is an alternative system of medicine that includes herbal medicines, special diets, meditation, yoga, massage, and medicinal oils.

Pharmacy in the Middle Ages - Middle East

In Baghdad, the first pharmacies were establish in 754 AD under the Abbasid Caliphate during the Islamic Golden Age. By the 9th century, these pharmacies were self-regulated. The advances made in botany and chemistry led to the development of pharmacology. Rhazes (865-915 AD) began to promote chemical compounds. Abulcasis (936-1013 AD) pioneered preparations of medicines that were compounded into complex drugs.  

Al-Biruni (973-1050 AD) wrote the Kitab al-Saydalah (Book of Drugs), where he gave detailed knowledge of the properties of drugs and outlined the role of the pharmacy and the functions and duties of the pharmacist.

Pharmacy in the Middle Ages - Europe

After the fall of the Roman Empire (476 AD), medicinal knowledge in Europe suffered due to the loss of Greek medicinal texts and strict adherence to tradition. In the 11th century, Constatinos Africanus began translating Arabic books into Latin, moving away from Hippocratic medicine towards a pharmaceutical driven approach advocated by Galen. Pharmacies began to appear in Europe in the 12th century. In 1240 AD, it was Emperor Frederic II that issued a decree stating the physician and apothecaries professions would be separated.

The Bubonic Plague (also known as the black death) wipes out nearly one third of the world’s population from 1347 to 1351 AD. This event lead to a series of religious, social, and economic upheavals that would have profound effects on the course of European history.

In the 15th century, the printing press helped spread medicinal text books throughout Europe and the rest of the world. The role of pharmacy specialization started in Belgium where a new law was passed (1683 AD) that forbid physicians from preparing medications for patients.

Pharmacy in the 1700s

In the 1700s as America was still developing, there was much less regulation in medical practice here than in Europe and other parts of the world. In Colonial America, the line between physician and pharmacist was blurred. Medical practitioners tended to dispense their own drugs and apothecaries also practiced patient care like a physician. 

Born in Dublin, Ireland in 1709, Christopher Marshall studied in England before settling in America in the 1720s. In 1729, he opens one of Colonial America’s first apothecaries in Philadelphia, PA. His shop ultimately began to manufacture pharmaceuticals, was a wholesaler to physicians and land holders, trained apothecaries, and supplied medicines to the American soldiers under George Washington.  

In 1751, Dr. Thomas Bond and Benjamin Franklin established the first hospital pharmacy in Philadelphia, PA in Pennsylvania Hospital, which was the first hospital in North America.

English physician John Ferrier discovers the effects of dried foxglove plant on the heart in 1799. This lead to the development of the heart medication digoxin.

Pharmacy in the 1800s

In the 1800s, the lack of regulation in medical practice continued in America, despite an increasing interest in pharmacy due to the discovery of new native herbs and plants after the end of the Revolutionary War. The separation between physician and pharmacist remained blurred, and the rise of non traditional medical practitioners began.  

Christopher Marshall’s daughter Elizabeth becomes the first American Woman apothecary in 1805. In 1820, the United States Pharmacopoeia (USP) is created, which offers a system of standards to be used as a reference guide for pharmacists. In 1821, Christopher Marshall’s son Charles becomes the first president of the Philadelphia College of Pharmacy, America’s first school of pharmacy. 

Elis Durand becomes one of the first pharmacists to introduce the soda fountain to his shop in 1825. The soda fountain would become the hallmark of the American Drugstore from the 1860s to the 1950s. 

The United States forms the American Pharmaceutical Association in 1852. It’s main purpose is to advance the pharmacist’s roles in patient care, assist in furthering career development, and raise awareness about the roles of pharmacists and their contributions to patient care.

Legal regulation in pharmacy did not occur on a national level until after 1870. Around this time, the manufacture of drugs began to transition from the local pharmacy to larger companies. 

After several years of development, Louis Pasteur develops the rabies vaccine in 1885. Joseph Meister, aged 9, is the first to be successfully treated with the vaccine.

German pharmacist Felix Hoffman successfully synthesizes salicylic acid or aspirin for commercial sale in 1887. This would become the most widely used drug in modern times.

Pharmacy in the 1900s

In the 1900s, as new drugs were being developed and drug manufacturers began mass producing drugs, patient safety and proper education became increasingly important. During this time, there was an emphasis on pharmacist education requirements and creation of new legislation to ensure compliance and patient safety.  

In 1905, New York State requires graduation from a minimum two-year course in pharmacy before taking the licensing examination. Two years later, Paul Ehrlich discovers arsphenamine (Compound 606), the first effective treatment against syphilis in 1907, for which he is awarded a Nobel Prize the following year.

The Harrison Narcotic Act established in 1914 requires all parties who manufacture or import addictive substances, such as opium and cocaine, as well as licensed prescribers and pharmacies, to be registered. Canadian scientists Frederick Banting, Charles Best, John Macleod, and James Collip isolate insulin in 1922, which Eli Lilly and Company introduces commercially the following year. And in 1928, Alexander Fleming discovers Penicillin.

American schools of pharmacy begin to require completion of a four-year program to receive a Bachelor of Pharmacy or Bachelor of Science in Pharmacy degree in 1932. A few years later, Congress passes the Food, Drug, and Cosmetic Act in 1938. This law requires that new drugs be tested and approved by the Food and Drug Administration (FDA) before being sold on the market. 

In 1940, Oxford University scientists Howard Florey, Norman Heatley, and Ernest Chain develop penicillin in medicinal form. By 1943, several US Pharmaceutical companies were mass producing penicillin for the US military during World War II.

The American Society of Hospital (now Health-System) Pharmacists is created in 1942, which represents the interests of hospital pharmacists through advances in education, professional development, and patient advocacy.

Selman Waksman and his colleagues at Rutgers University discover streptomycin in 1944, the first lab created antibiotic not derived from fungi or bacteria. Shortly after this discovery, Waksman initiated a collaboration with Merck and Company, which led to the development of processes for the mass production of streptomycin, riboflavin, cortisone, vitamin B12, and others. Waksman would later win the Nobel Prize in 1952 for his discovery of streptomycin, which was the first antibiotic effective against tuberculosis. This award, along with his decades of research, earned him the title of “Father of Antibiotics.” 

In 1950, the FDA approves the first diuretic to treat high blood pressure. Before the development of this medication, hypertension was considered an untreatable condition. The available medications preceding the development of diuretics for treatment of hypertension had severe side effects.

The American Association of Colleges of Pharmacy (AACP) approves a proposal in 1954 requiring the completion of 5 years of academic training to earn a pharmacy degree effective April 1, 1965.

Jonas Salk tests the injectable polio vaccine with a large scale national study, with over a million test subjects in 1954. He also tested the vaccine on his wife, himself, and their children. In April of 1955, he announced the polio vaccine was safe and effective. By 1959, the vaccine was being mass produced and available in about 90 countries.

In 1957, Dr. Albert Sabin developed the oral polio vaccine. The vaccine would be tested between 1957 and 1959 on millions of people throughout Europe and Asia, before coming into commercial use in 1961. In many parts of the world, it would replace the injectable vaccine developed just a few years prior.

In 1964, James Black developed propranolol and pronethalol, the first clinically significant beta-blockers used for the treatment of cardiac arrhythmia and high blood pressure. This discovery would ultimately change the practice of cardiology. 

The hepatitis virus was discovered in 1965 by Dr. Baruch Blumberg, who won the Nobel Prize for this achievement. He would later develop the first hepatitis B vaccine in 1970. In 1981, the FDA approved a more sophisticated plasma-derived variant of the original vaccine for human use. Later on in 1986, a second generation DNA recombinant variant of the vaccine replaced the previous version. 

In 1984, Congress passes the Hatch-Waxman Act, which balanced innovation and affordability. This makes it easier for generic drugs to be approved for sale while giving pharmaceutical companies longer market exclusivity in order to encourage ongoing research and development. The Hatch-Waxman Act established the legal and economic foundation for today’s generic pharmaceutical industry.

The FDA approves the drug known as AZT (Retrovir) in 1984, the first medication to help treat people infected with HIV/AIDS. AZT was originally developed in the 1960s as a way to treat cancer, but didn’t work as intended in initial lab testing. Decades later, a revised version of the drug was tested and found to block HIV cells activity. After initial trial testing, the drug was approved by the FDA and brought to market in 1987. 

In the 1990s, pharmacists begin to increase their role in directly administering vaccines to their communities. The training program, Pharmacy-Based Immunization Delivery begins in 1996, which supports pharmacists administering vaccinations.

Pharmacy Today

In the past few decades, there’s been an increase in educational requirements for pharmacists, as the Doctor of Pharmacy has been the standard since 2000. Additional post graduate training has also been the norm for pharmacists, as thousands have been trained to immunize their patients.

Since the early days of the Mesopotamians, the pharmacists role has always been to improve the quality of life of their patients. From plants and seeds and natural remedies to advances in pharmaceuticals, patient care has been a constant focus of pharmacists throughout history.

And that has always been our mission at National Specialty Pharmacy, to improve the quality of life for each and every one of our patients. Your health is our specialty.