Chapter 1 History of Medicine and Pharmacy Copyright © 2004 by Elsevier Inc. All rights reserved.

Chapter 1Chapter 1

History of Medicine and History of Medicine and PharmacyPharmacy

Copyright © 2004 by Elsevier Inc. All rights reserved.


Ancient Beliefs and TreatmentsAncient Beliefs and Treatments

• Medicine has been practiced for Medicine has been practiced for thousands of yearsthousands of years

• Remedies such as herbals have been Remedies such as herbals have been used throughout historyused throughout history

• Many popular beliefs have disappeared, Many popular beliefs have disappeared, for example: Trephining–a cut made for example: Trephining–a cut made into the skull to give disease a portal into the skull to give disease a portal to leave throughto leave through


Ancient Beliefs and TreatmentsAncient Beliefs and Treatments

• Severe illnesses caused by evil spiritsSevere illnesses caused by evil spirits

• Tribal shamans (medicine men) had Tribal shamans (medicine men) had gift of being able to communicate gift of being able to communicate with spiritswith spirits

• Other illnesses cured by the placebo Other illnesses cured by the placebo effect–patients believed so strongly effect–patients believed so strongly in the treatment rendered that they in the treatment rendered that they were curedwere cured


The Medical StaffThe Medical Staff

• Aesculapius–Greek God of medicineAesculapius–Greek God of medicine

• His symbol–a staff with a snake His symbol–a staff with a snake wrapped around itwrapped around it

• Treatments for illnesses were based Treatments for illnesses were based on dreams and visions of the believerson dreams and visions of the believers

• Authoritarians–set forth dogmatic Authoritarians–set forth dogmatic beliefs like gods being able to cure beliefs like gods being able to cure illnessesillnesses


Medicine in Its InfancyMedicine in Its Infancy

• Plagues killed many peoplePlagues killed many people

• Microbes not known to be responsible Microbes not known to be responsible for many diseasesfor many diseases

• Prayer–most common form Prayer–most common form of treatmentof treatment



• Hippocrates–3Hippocrates–3rdrd generation physician generation physician

• Believed life consisted of a balance Believed life consisted of a balance of four elements linked to qualities of four elements linked to qualities of good health: wet, dry, hot, coldof good health: wet, dry, hot, cold

• Illnesses resulted in imbalance of four Illnesses resulted in imbalance of four humors–blood, phlegm, yellow bile, humors–blood, phlegm, yellow bile, black bileblack bile



• Four humors were linked to the Four humors were linked to the four elements:four elements:

– Blood = airBlood = air

– Phlegm = waterPhlegm = water

– Yellow bile = fireYellow bile = fire

– Black bile = earthBlack bile = earth

• Treatment: bloodletting, laxatives Treatment: bloodletting, laxatives



• Hippocrates–responsible for Hippocrates–responsible for advancements in medicineadvancements in medicine

• His observations included effects His observations included effects of food and climateof food and climate

• First physician to record patient’s First physician to record patient’s medical illnessesmedical illnesses

• Promoted rest and eating light foodsPromoted rest and eating light foods



• Corpus Hippocratum–documentation Corpus Hippocratum–documentation of Hippocrates’ writingsof Hippocrates’ writings

• Hippocratic oath–“Doctors act only Hippocratic oath–“Doctors act only for the good of their patients and for the good of their patients and keep confidential what they learn keep confidential what they learn about their patients.”about their patients.”

• Hippocrates–known as the Father Hippocrates–known as the Father of Medicineof Medicine



• Aristotle–Greek philosopher and Aristotle–Greek philosopher and scientistscientist

• Responsible for many advancements Responsible for many advancements in biology and medicinein biology and medicine

• Studied and classified various Studied and classified various organismsorganisms

• Described human anatomy from Described human anatomy from observations after dissecting animalsobservations after dissecting animals



• Claudius Galen–followed many of Claudius Galen–followed many of Hippocrates’ beliefs like eating a Hippocrates’ beliefs like eating a balanced diet, exercise, and good balanced diet, exercise, and good hygienehygiene

• Contributed greatly to study Contributed greatly to study of medicineof medicine

• Wrote on topics such as physiology, Wrote on topics such as physiology, anatomy, pathology, diagnosis, and anatomy, pathology, diagnosis, and pharmacologypharmacology



• Roger Bacon–philosopher and Roger Bacon–philosopher and alchemistalchemist

• Refined and explained the importance Refined and explained the importance of the experimental methodsof the experimental methods



• Paracelsus–Swiss physician and Paracelsus–Swiss physician and alchemistalchemist

• Believed in treating illnesses with one Believed in treating illnesses with one medicine at a timemedicine at a time

• Produced many nontoxic medicationsProduced many nontoxic medications

• Introduced Laudanum–popular tonic Introduced Laudanum–popular tonic to deaden pain to deaden pain


Ancient Herbal RemediesAncient Herbal Remedies

• Prevalent treatments–multiple mixtures Prevalent treatments–multiple mixtures of plants, roots, and other concoctionsof plants, roots, and other concoctions

• Belief held that digesting the type of Belief held that digesting the type of plant resembling organ affected by plant resembling organ affected by the disease cured the illnessthe disease cured the illness


Prevalent Ancient Herbal RemediesPrevalent Ancient Herbal Remedies

• Examples of prevalent treatments:Examples of prevalent treatments:

– Garlic–inflammation of bronchial Garlic–inflammation of bronchial tubestubes

– Liverwort plant–for liver problemsLiverwort plant–for liver problems

– Wine and pepper–stomach ailmentsWine and pepper–stomach ailments

– Onions–wormsOnions–worms

– Tiger fat–joint painTiger fat–joint pain


Medicine in the Fourteenth CenturyMedicine in the Fourteenth Century

• Belief that evil spirits caused diseaseBelief that evil spirits caused disease

• Treatments through trial and error–Treatments through trial and error–some were effective; some caused some were effective; some caused deathdeath

• New scientists emerged and new New scientists emerged and new methods were devised to test methods were devised to test hypotheses, which gave way to hypotheses, which gave way to advancementsadvancements


Medicine in the Eighteenth Century Medicine in the Eighteenth Century

• Religious leaders became very active Religious leaders became very active in researching medicinal remedies to in researching medicinal remedies to treat the sicktreat the sick

• Gregor Mendel–famous scientist and Gregor Mendel–famous scientist and monk–found the basis of genetics and monk–found the basis of genetics and how genes are woven into heredityhow genes are woven into heredity

• Known as the Father of GeneticsKnown as the Father of Genetics


Medicine in AmericaMedicine in America

• Early America–immigrants brought Early America–immigrants brought diseases from other parts of the worlddiseases from other parts of the world

• Doctors–responsible for diagnosing Doctors–responsible for diagnosing conditions and preparing remedies conditions and preparing remedies to cure patientsto cure patients

• First druggists were doctorsFirst druggists were doctors



• Early American remedies:Early American remedies:

– Cinchona bark (quinine)–malariaCinchona bark (quinine)–malaria

– Mercury–syphilis Mercury–syphilis (very toxic and caused deaths)(very toxic and caused deaths)

• Average life expectancy–40 yearsAverage life expectancy–40 years

• Childhood diseases–no vaccines Childhood diseases–no vaccines availableavailable



• Most treatments were concoctions Most treatments were concoctions handed down through family traditionhanded down through family tradition

• There were few doctors and fewer There were few doctors and fewer hospitals throughout the colonieshospitals throughout the colonies

• Civil War–brought about a clear Civil War–brought about a clear division between physicians and division between physicians and pharmacistspharmacists


The Use of Opium and AlcoholThe Use of Opium and Alcohol

• Most popular tonic for medicinal use; Most popular tonic for medicinal use; very addictivevery addictive

• Given as a sedative to dull the Given as a sedative to dull the sensation of painsensation of pain

• Civil War–used to treat painful woundsCivil War–used to treat painful wounds


The Use of Opium and AlcoholThe Use of Opium and Alcohol

• Households–used it for less severe Households–used it for less severe problems and depressionproblems and depression

• Addiction–alarming rateAddiction–alarming rate

• Absinthe–alcohol-based liquid; herb Absinthe–alcohol-based liquid; herb mixed with alcohol; served with water mixed with alcohol; served with water and sugar for tapewormsand sugar for tapeworms


Early PharmacistsEarly Pharmacists

• ApothecariesApothecaries (pharmacies)–sprung up (pharmacies)–sprung up after the Civil Warafter the Civil War

• Manufacturing plants were builtManufacturing plants were built

• Training took place to give medications Training took place to give medications accurately accurately

• Pharmacists moved into the role Pharmacists moved into the role of druggistsof druggists



• First Pharmacy School–Philadelphia First Pharmacy School–Philadelphia College of Pharmacy and Sciences College of Pharmacy and Sciences (1821)(1821)

• 1800s–Pharmacists compounded 1800s–Pharmacists compounded nearly every drug ordered by nearly every drug ordered by physiciansphysicians

• Cisterns–large ornate jars used to Cisterns–large ornate jars used to store various herbs and ingredientsstore various herbs and ingredients



• Recipe book–where remedies were Recipe book–where remedies were containedcontained

• Examples: chalk–for heartburn; rose Examples: chalk–for heartburn; rose petals–for headachespetals–for headaches

• Apothecary–filled with oils, herbs, Apothecary–filled with oils, herbs, and spicesand spices


Early Pharmacy TechniciansEarly Pharmacy Technicians

• First pharmacy technicians–family First pharmacy technicians–family members of the pharmacists who members of the pharmacists who owned the corner drugstoreowned the corner drugstore

• Wives–helped behind the counter Wives–helped behind the counter and waited on customersand waited on customers

• Older children–filled in as clerks, Older children–filled in as clerks, waited on customers, and stocked waited on customers, and stocked shelvesshelves


Early Pharmacy TechniciansEarly Pharmacy Technicians

• Clerk training–filling medication Clerk training–filling medication drawers, profiling doctor’s orders, drawers, profiling doctor’s orders, compounding simple mixturescompounding simple mixtures

• Early clerks–became pharmacy Early clerks–became pharmacy technicianstechnicians


The Soda Fountain/Pharmacy The Soda Fountain/Pharmacy in Americain America• Early pharmacists played a minimal Early pharmacists played a minimal

role in healthcarerole in healthcare

• 1800 to 1900–soda fountain became 1800 to 1900–soda fountain became an extension of a town’s drugstorean extension of a town’s drugstore

• Mineral water–became treatment Mineral water–became treatment for different ailmentsfor different ailments


The Soda Fountain/PharmacyThe Soda Fountain/Pharmacyin Americain America• Pharmacists–sold soda and ice cream, Pharmacists–sold soda and ice cream,

worked the lunch counter, and filled worked the lunch counter, and filled the day’s prescriptionsthe day’s prescriptions

• Pharmacy setting–promoted trust in Pharmacy setting–promoted trust in the pharmacistthe pharmacist


Changing PharmacyChanging Pharmacy

• Doctor of pharmacy degree Doctor of pharmacy degree (PharmD) required in United States(PharmD) required in United States

• Today’s druggist–needs in-depth Today’s druggist–needs in-depth and broad communication skills and broad communication skills with doctors and customerswith doctors and customers

• Today’s technicians–required Today’s technicians–required to get education in addition to to get education in addition to on-the-job training in some stateson-the-job training in some states



• Technician duties–preparing Technician duties–preparing prescriptions and compoundingprescriptions and compounding

• Hospital duties–supply floorstock, Hospital duties–supply floorstock, prepare parenteral medications, prepare parenteral medications, transcribe doctor’s orders, fill transcribe doctor’s orders, fill patient’s cassettespatient’s cassettes

• Specialized technicians–order Specialized technicians–order drugs and suppliesdrugs and supplies



• Technicians need strong Technicians need strong communication skillscommunication skills

• Pharmacists–can also specialize in Pharmacists–can also specialize in interpreting lab results, oncology, interpreting lab results, oncology, and compounding, to name a fewand compounding, to name a few


ProtocolProtocol

• A set of standardized rules that are A set of standardized rules that are agreed on within a pharmacy settingagreed on within a pharmacy setting

• Drug Education Coordinators (DECs)–Drug Education Coordinators (DECs)–meet to discuss new medications, meet to discuss new medications, review them, and determine if they are review them, and determine if they are better and cost effective; also consider better and cost effective; also consider new literature from drug companiesnew literature from drug companies


Trust in Pharmacist/Trust Trust in Pharmacist/Trust in Techniciansin Technicians• Pharmacists–can be trusted to provide Pharmacists–can be trusted to provide

truthful information and be a confidanttruthful information and be a confidant

• Clinical pharmacist–works alongside Clinical pharmacist–works alongside doctors to prescribe medications and doctors to prescribe medications and dosagesdosages

• Community pharmacy–pharmacists Community pharmacy–pharmacists required to counsel patients; technicians required to counsel patients; technicians trusted to provide the best care by filling trusted to provide the best care by filling the correct medicationthe correct medication


Technicians of theTechnicians of theTwenty-First Century and BeyondTwenty-First Century and Beyond

• Pharmacists–moving into a more Pharmacists–moving into a more highly clinical role not only counseling highly clinical role not only counseling but also working with medical staffbut also working with medical staff

• Technicians–moving into transcribing Technicians–moving into transcribing orders, pulling medications, and filling orders, pulling medications, and filling prescriptionsprescriptions

Chapter 1 History of Medicine and Pharmacy Copyright © 2004 by Elsevier Inc. All rights reserved.

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Transcript of Chapter 1 History of Medicine and Pharmacy Copyright © 2004 by Elsevier Inc. All rights reserved.