A Short View of the Frauds and Abuses Committed by Apothecaries Part 1

A Short View of the Frauds and Abuses Committed by Apothecaries.

by Christopher Merrett.

A _Short View_ of the _Frauds_ and _Abuses_ committed by _Apothecaries_, as well in Relation to _Patients_, as _Physicians_; and of the only remedy thereof by _Physicians_ making their own Medicines.

Doubtless it will seem strange to most men, that after 30 years not unsuccessful practice in this great City, I should now at last forbear sending my Bills to the Apothecaries, knowing that hereby a whole Company of men interested in the World (who by their number, noise, and tricks, may be able to decry any Physician) will become my implacable adversaries, and by their private whispers of untrue tales, will endeavour to their utmost, either to keep me from any new, or shuffle me out of my fixed imployment. But not fearing the utmost their malice can invent, or proclaim; I shall publickly a.s.sert what I privately practice, preferring the publick good, and the honour of my profession before my own private profit. And although I have had some experience what their groundless anger can do, when they some years since proclaimed me in their publick Hall their Enemy, for acting the College Interest, and of late for saving my Patients lives and purses, by dispencing gratis my Medicines. Yet I hope no indifferent person, when he knows that I have thus long slighted their weak endeavours, will believe I can now at length have so poor an end as revenge; especially when they shall consider on the one hand, the universal and daily complaints of both Patient and Physician, the great cause they have to do so, and the little hope of a remedy, and on the other, besides that general obligation all men have of doing their Country-men good, and the particular necessity I have of justifying my actions, by leaving the World their judg upon the account I shall here deliver of them. And lastly, that which will leave my Enemies not any objection, I take upon me not only a great trouble, but charge, without any other design then doing mankind good, by endeavouring to restore my profession to its ancient and deserved honours. And had I none of these inducements, I am sure the vulgar excuse of friends importunities may be satisfactory to all persons for my publishing what I here do, when I must acknowledge that many of my Collegues and other Practisers in several parts, upon reading these papers furnished me not only with some bad practices of their own experience, but thereupon enjoyed the publishing of them. So that in these papers I do but speak the common language of all Physicians, and of very many Patients. Neither are all their frauds and abuses here inserted, the rest (perhaps more in number) being reserved to another opportunity. I shall only add by way of preface; that the last year a Book was printed on the same argument, by an inquisitive person, now Dr. in Physic, which might have spared me this labour, but that it was too large for every ones reading, and in some things short. It was his fate to be called by them Fool, a.s.s, and Simple Fellow, and much worse language, bragging that some of their Boys should answer him. But upon more serious thoughts, the whole Company have suffered it to find the credit it well deserves, without the least reply but that of revilings.

In these ensuing papers, I hope to prove, that these abuses complain'd of by all sorts of persons, arise from this only cause, that Physicians dispence not themselves such Medicines, they use for the relief of their Patients, but commit this work to the Apothecaries, or rather their Servants.

Now the Apothecaries abuses generally relate either to the Medicines, Patients, or Physicians; which three do comprehend all I shall say on this subject.

But the Reader is to take notice, that all here charged on the Apothecaries, is not meant of every single one, but of some, or more of them, and may in a short time in all probability be verified of them all, according as their number, cajoling the ignorant, and bold daring in Physic increase.

But before I descend to particulars, I shall first lay down this Proposition, their own confession, and in their own Language, viz.

That they may be the veriest Knaves in England. Because they may put in bad ingredients, and more or less then the composition requires, they may subst.i.tute one thing for another; and all this without being detected, and consequently not be punished for such misdemeanors; but more especially in Medicines for private mens uses, wherein they may do what they please without the least discovery of the Patient, and from this general confession of theirs, it clearly follows, that whatsoever deceit, covetous wits can invent, may at least be suspected to be used by them, and whatsoever is here alledged may find easier belief.

And Secondly, Most men wonder, that this Corporation, being but of few years standing, and to the setting up of whose Trade so small a Stock is necessary; should live so high, spend so freely, gain so great Estates, by their return of so little money yearly, which how 'tis done every man may conceive to be effected by the following Artifices.

More particularly, the Frauds by them committed relate either to their falsifying of Medicines, or secondly, to the number of their Bills, and prescriptions, or thirdly, to the prices of them.

First, They use Medicines quite contrary to the prescription, Myrtle-leafs shewed the Censors for Sena, a Binder for a Purger.

Mushroms of the Oak, &c. rub'd over with Chalk for Agaric, which Mr.

Evelyn in his late publisht Book of Forest Trees, pag. 27. observes, to the great scandal of Physic as he adds; Hemlock-Dropwort Roots for Paeony Roots, Poysons for wholesome remedies; Privet by some, by others Dog-berries, for those of Spina Cervina, no Purgers for a strong one.

Sheeps Lungs for Fox Lungs, the Bone of an Oxe Heart for that of a Stags Heart, Damsons for Damasc Prunes, Syrup of Limons, for that of Citrons, Bryony Roots for Mechoacan, &c.

Secondly, They falsify the grand Compositions of the London Dispensatory. It being a common trade with them to buy unsound, and decayed Simples of some Druggists, and to return them back so much of the composition as will pay for the Simples. Secondly, whereas Apothecaries are bound to shew publickly to the Censors of the College, and the Master and Wardens of their Company, Mithridate, Diascordium, Alkermes, &c. Yet for all this some of them privately make a great deal more of the Composition then is shewed, of unsound Drugs, and some without any view at all; others put in the Sc.r.a.pings that ought to be thrown away; and by these Arts they under-sell, and ruine one another, selling the Composition at a lower rate then good Ingredients cost them; and with these complaints they daily mutiny amongst themselves.

Thirdly, 'Tis very common for them to load Medicines with Honey, and other cheaper ingredients, and to leave out in whole or in part, those of greater value; viz. Saffron in Ruffus Pills, and in Oxycroceum Plaster, which latter, they colour of a saffron colour with Turmeric, Sanders &c. Ambergrise in Alkermes, Diascordium was found by the Censors in their search made only of Honey, and Bole-Armeniac. Which false composition was taken away by the then Master of the Company.

Such Chymists which sell preparations honestly made complain, that few Apothecaries will go to the prices of them. Whence it comes to pa.s.s, that most of the preparations found in the Shops are sophisticated, to the great abuse of City and Country. These abuses daily increase since the Censors, discouraged by the mult.i.tude of Empirics swarming in every Corner, have omitted their wonted searches, being to their loss of time, and expences out of their own Purses for the publick good only. Now since the Chymical Oyls, by reason of their great prices are most of them adulterated, and very few of them right good, and that nothing hath been published on this matter, and to leave the buyers of them unexcusable, I shall here add briefly, yet sufficiently the ways to discover these Cheats. First for sweet-scented Chymical Oyls, viz.

those of Cloves, Cinnamon and Sa.s.saphras. Only drop a little of them into fair water, and that part which is true good will sink under the water, but the adulterated part will swim on the top of it. Some others draw deep tinctures from the said Spices with Spirit of Wine highly rectified, and sell them for the Oyls; but these mix with the water throughout, neither swimming, nor sinking. Others more craftily digest with the said tinctures some of the true Oyls, which compound being put into water, will for a time render it white. Another way of sophisticating is with Oyl of Turpentine mixed in great quant.i.ty with that which is adulterated; You may easily discover the Oyl of Turpentine, by setting it on fire, for it yields abundance of ill-scented smoak, with very little savour of the Herb, Flour, or Seed, &c. and soon takes fire. To correct the ill smell of the Turpentine, they digest it with, and distil it off with Spirit of Wine. Those sophisticated with Turpentine, fired in a Silver Spoon colour it, and quickly diffuse themselves upon a Knife, or Paper. The best way to try by firing, is to put a drop or two of these Oyls on the end of a broad pointed Knife, which being first heated, and then thrust into a lighted Candle, presently take fire, and break out into a flame with much dark smoak; but if you will try them in a Spoon, heat it first over a Candle, and then blow the flame of lighted paper, or of a Wax Candle on them. To try the scent, blow out the flame of the good Oyls, and your smell will soon discover the ill scent of the Turpentine from that of the good Oyl. But on the contrary, all Oyls drawn from Plants by distillation hardly flame, and the flame soon goes out, and the smoak gives a full flavour of the Plant it self, whereas those sophisticated as before, differ from the true in both.

The same Oyls are also sophisticated with cheap ones drawn from decayed Oringes, and Limons; Your smell on firing will soon discover these mixtures. A third way of sophisticating Chymical Oyls is, by mixing with them such Oyls as are made by expression, which are easily discovered by rubbing them on white paper, which being held and dryed at the fire, the Chymical part soon flyes away, and leaves the paper transparent, looking no otherwise then oyled paper; but pure Chymical Oyls totally fly away, leaving the paper white as 'twas before, and not transparent, and in this way Oyl of sweet Almonds and Spike have a great share. As for Oyls drawn by Retort, they all of them smell so strong of the fire, that neither smell nor tast can well discover any fraud in them. Now for the fixed Salts, most of them are made of the Ashes of Tobacco-stalks, &c. More might be said for the discovery of the Cheats of other Chymical preparations, which shall be reserved to another opportunity, and had Physicians just encouragement, they would spend both their time and moneys on the like discoveries for the publick Utility.

Fifthly, Add to the former (though perhaps 'tis an error of ignorance only) that if such Simples are prescribed they know not, they fetch from the Herb-women what they give them, true or false; for many of these Women give to very many Plants false names; Now if the Apothecary be so careful to consult an Herbal, which few have, and fewer know how to make use of, yet they too frequently mistake the thing by reason of several names given to the same thing, or of one name to several things, and many of them consult the common Dictionaries only, which are most erroneous in the names of natural things; insomuch that in my first practice (being curious of these particulars) I have found two or three mistakes in one prescription, a Catalogue of which mistakes, and names ill given, I had collected, but the late fire consumed it, though many of them my memory hath reserved.

Sixthly, Many of the London, and most of the Country-Apothecaries, buy of the whole-sale men, who affirm of one another, especially of such who gain great Estates in short time, that they cannot sell their Medicines honestly made at so low a rate as they do.

Seventhly, I shall need to say little of such distilled waters, as discover themselves neither to smell, nor tast, but shall only recite a known Story of an Apothecary, who chid his man for sending away a Customer that came for Plantan water, telling him there was enough at the Pump.

Eighthly, As for Ointments, and Plasters, they are sold by some at so low a price, viz. 3 d. per l. for Ointments, as I have been informed, that 'tis not possible to make them at, and yet such however falsifyed maintain a trade amongst Country, and low-priced City-Apothecaries, and the Chirurgeons profess they cannot effect their Cures with the Shop-Medicines, and that this is the reason why they make their own Oyls, Oyntments, &c. as the Apothecaries Charter allows them to do; and why may not Physicians think this to be the cause why they sometimes fail in their Cures, as well as Chirurgeons? and also make their own Medicines as well as they, especially since the Apothecary may as easily falsify, and to greater profit in the one, then in the other?

Ninthly, As to their use of bad or decayed Drugs, 'tis so common a practice that I shall need to give but one notorious instance of it, and 'tis this, I having occasion to use some Seeds, sent for them to a Seeds-man, the Messenger desiring to have those of the same Year. The Tradesman knowing him to live with me, asked, if they were for Physical use, he replyed in the affirmative, whereat he presently shewed him others, which were of 6 or 7 years old (as he confessed) affirming them to be as good for that use as the newest, which he sold only for sowing, and that he kept the others, though never so old, for the Apothecaries only, who still asked for them, buying them though 20 years old, not regarding if they were decayed and wholy effete (for no Seed will preserve its vegetative faculty above 7 years much less its Physical) so they could but have them cheap. Besides their pretty knacks (as they call them) of making their Compounds fair to the eye, more vendible, but worse for use, by restoring them to their colour and consistence, that they may pa.s.s for good, which perhaps 'tis better to pa.s.s over in silence, lest by confuting I should teach the younger Fry, who may better be honestly ignorant of them. Now for their subst.i.tuting one thing for another, and detracting where they please, I shall add but one Story of an Apothecary, who commanded his man (who told him they had no good Rhabarb in the house) that he should put in double quant.i.ty of what they had. Nay I have known one simple of a quite different nature used for a whole composition.

Tenthly, I shall conclude this ungrateful Discourse, with saying that by reason more frauds may be committed by the Apothecaries, then by any other Trade, and by supposition that gain will tempt most men to dishonest actions, especially where they may act undiscovered; I say; that this seems to be the cause why they have two Supervisors set over them more then any Company that I know of, viz. the Censors of the College of Physicians, and the Master and Wardens of their own Company.

The next thing is the inlarging and multiplying their Bills and Medicines.

First, When in Chronical Diseases a Physician is consulted, they go on of their own heads with the same prescription, frequently enough to the Patients great disadvantage, both of health and purse.

Secondly, By giving and intermixing Medicines of their own Phancy, with the Physicians prescriptions, viz. some pleasing Medicine, whereby too often the Physicians intention is quite crost, and the effect made uncertain, and hazardous.

Thirdly, By giving Medicines themselves on small accounts, and such as require only a good ordering, and no more.

Fourthly, By repeating long courses of Physic unadvisedly, and needlesly, when either nothing, or very little is needful to be done.

Fifthly, By creating diseases in easie mens Phansies, and so decoying them into courses of Physic.

Sixthly, Some of them get private and worthless receipts, and sell them at what rate they please; Mr. Delaune by one Pill alone, though not a very safe one, got some thousands of pounds.

Seventhly, If one of them get a private receipt from a Physician called by the inventor his Nostrum, if another Apothecary have occasion to use it, he shall be sure to pay sawce for it.

Eighthly, Another trick is when the Patient is cured, and the Physician therefore hath given over his Visits, then comes the Apothecary and insinuates by his words and pa.s.sions, either some danger of relapse, or some other present distemper, and repairs to the Physician for a Bill to cure the imaginary disease.

Ninthly, But their princ.i.p.al Art of all is, to cry up, and bring in to Patients such Physicians, who through design must comply with the Apothecaries Interest, and such Practisers they extol and cry up for good Physicians, which some of them call more expresly good Apothecaries Physicians, and such without doubt, the whole Company will endeavour to raise unto a fame and practice. But such as write only for the good of the Patient, and not at all for the benefit of the Apothecary (as all honest men ought to do) they will endeavour to prevent their calling in, or to shuffle them out.

Now this good Apothecaries Physician, they describe by his frequent though needless visits, but especially by the mult.i.tude of his Bills, by his visiting twice a day, or oftner (a very careful and painful Doctor) and by still writing new Medicines, when half the former, or perhaps none of them have been taken, making an Apothecaries Shop in the Patients House, planting the Cupboards and Windows with Gla.s.ses and Gally-Pots, and not a quarter of the whole made use of. He prescribes a Medicine for every slight complaint, and never goes away from the Patient or the Patient from him, without a Bill, for fear of the Apothecaries grumbling.

And from this burdening the sick with multiplicity of Medicines, too often contrary to, and destructive one of another, it proceeds that in the Small Pox, and Measles, many are afraid to use Physicians, and commit the care of the sick to Nurses, and Old Women, and perhaps sometimes not without cause, for by continual multiplication of Medicines, the humours of the body may be made, or kept in too great a state of fluidity, whence the Flox followeth. Whereas a Medicine or two duly administred, may suffice to bring them well forth, and then there needs no more but good ordering, unless perhaps some accident arise, which may require further care. And here as well as in other Cases, the Patient is to be rectified, who requires the Physicians Visits, and yet dismisseth him without a reward, unless he writes a Bill, whereas it might have been better if nothing at all had been prescribed; and the Physician left to his own judgment; and hence it is that many enlarge their Bills, that the Patient may think he hath enough for his money, whereby the Apothecary is gratified, who ought to commend the Medicines as necessary for the sick person, and singular in themselves, whereas in truth this great farcy proves ungrateful to the tast and stomach; inconvenient to health, by curing one disease, but creating more; and by this means keeping them continually in a way of Physic.

A third abuse of the Apothecaries relates to the prices of their Medicines; first they put what rates they please on their Simples, Compounds, and Receipts, and none are judges of them, but those of their own Trade; insomuch that they gain a 11 d. in the Shilling, if they say true of themselves. Whereas the Colleges of Physicians beyond Sea, yearly set a tax upon the Simples, and Compounds of the Shops. So that the Customer can tell the price of what he hath occasion to use, and not stand at the mercy of the Apothecary to rate them as he lists, and to this purpose they put in print the prices of them every year.

Secondly, Suppose a Physician hath prescribed a Pint of Juleb, &c. to be taken at four several times, some Apothecaries carry not the whole pint at once, but divide it into four parts, and carry but one at a time, and so of other Medicines, and then will charge their Bill for every single Potion, or Draught, as they ought the whole Pint; so that by this Art they gain four times as much for the whole Medicine as in Conscience they ought; and a Juleb, which cost them six pence, will be rated at 10, 12, or more Shillings. But perhaps 'tis fit they should be paid for their created Visits; and for this unnecessary officiousness, persons of great estates may be contented to pay roundly, if they please.

Thirdly, When a Physician hath prescribed 20 Pills, some of the Apothecaries will make 30 of them, under pretence the Patient cannot swallow them else; now reckoning each Pill at a certain rate (as they usually do) they gain a third part more then they ought.

Fourthly, To advance the prices, you shall hardly ever see a Bill without Bezoar, or Pearls in it, to make people think them very chargeable; whereas sometimes there is not above a grain or two of these dear ingredients in the prescription, and a few grains of these or Ambergrise doubles or trebles the prices of the Medicines, and are sure never to be omitted in their Bills, besides the guilding of the Pills, and covering their Bolusses, and Electuaries with Gold (which have only an imaginary and no real use in Medicines so used) much inhanseth their prices, and a rich Cordial inserted exceedingly advanceth most of their Bills; or if China or any other dear ingredient be in the receipt 'tis not omitted.

Fifthly, Some Apothecaries offer, and perhaps some Physicians have taken presents to help them to Customers, which must necessarily be squeazed out of their higher-rated Medicines.

Sixthly, I have heard some prudent persons complain of their bringing in their Bills but once in a year, or two; supposing they made them pay Lombards Usury for their forbearance. And through this neglect they sometimes lose their money, and whether they raise other Mens Bills to make up these losses, I affirm not.

Seventhly, Another cause of raising their prices is a necessity of keeping in their Shops such Medicines as are seldom used, or such as must upon necessity decay, and grow useless. Now suppose they throw such away, this reason is good, but you will find a remedy for this hereafter.

To conclude this second Complaint. By reason of the dear Bills of the Apothecaries, many are deterred from going to the Physician, and run to common Mountebanks, and I think this to be the reason (as some disabused persons have confessed to me) why they have so much cryed up the abilities of Apothecaries for practice, because they would save their credit in taking Physic of them. St. Augustine candidly in his Book of Confessions declares, that through covetousness he repeated a course of Physic, without consulting the Physician (who had before cured him of the same disease) to his greater charge, danger of his life, and offence against G.o.d.

Having done with the Apothecaries abuses relating chiefly to the Patients Health and Purse, and such as are willfully committed (though all of them reflect on the Physician) I shall now touch on a few neglects, and mistakes proving often very mischievous.

First, They frequently mistake the Physicians directions, which of what dangerous consequence it is, every one can tell.

Secondly, They carry a Medicine appointed for one sick person to another.

Thirdly, They often neglect the sending of Medicines in due time, especially such as have no Servants, or but raw ones, when the Master is out of Town, or upon long visits.

Having now done with the Apothecaries as they relate princ.i.p.ally to the sick, I shall in the next place speak of them, as they relate to Physicians, and that either to the profession in general, or to the particular practisers of it.

As to the Physicians in 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. And that this hath been and is their intention, the following particulars will clearly demonstrate.