History and Evolution of Pharmacy

• Pharmacy is an honorable profession with a history of over 5,000 years.
• This area of study includes drugs from Mesopotamia, China, India, Arabia, and Egypt used in ancient times.
• Eastern medicine was significantly impacted by the drugs mentioned.
• Western pharmacy, referred to as materia medica, originated in Greece and Rome, and other European nations such as Germany, Italy, Switzerland, and Belgium.
• The history of pharmacology follows a spiral pattern, continuously evolving and adapting while drawing upon previous drug knowledge.
• While pharmacies commonly stock herbal, mineral, and nutritional supplements, there is a lack of a system for purity, potency, dosage, and contraindications checks for these remedies.
• Germany is currently the leader in setting standards for natural remedies.

Greek Influence

• Some of the earliest healing centers were in Greece.
• An example is a temple dedicated to Aesculapius, the mythical god of medicine, on the island of Cos where people implored to gods.
• Physicians practiced medicine, and apprentices learned the art of healing.
• Circa 400 B.C., Hippocrates, the "father of medicine," practiced medicine and pharmacy in ancient Greece in such temples.
• Patients were diagnosed, treated, and cared for until they could return home with treatments including herbal remedies, mineral baths, exercise, fresh sea air, and sunshine.

Hippocrates

• Hippocrates lived circa 460–377 B.C.
• The concept of homeostasis, maintaining equilibrium through drugs and diet, was the traditional standard of his practices and writings.
• Hippocrates theorized disease resulted from a disturbance of body fluids like blood, phlegm, and bile and was treated by restoring equilibrium.
• He thought health was preserved by caring for the internal environment (diet, sleep, exercise) and properly reacting to the external environment to enhance physical harmony.
• The Hippocratic writings recommend over 200 herbal remedies and a dozen minerals.
• The juice of the poppy, known today as opium, was among the 200 drugs mentioned.

Theophrastus

• Theophrastus lived circa 370–287 B.C.
• Theophrastus was a Greek philosopher and botanist, living circa 300 B.C.
• Botany is closely related to pharmacognosy, the science dealing with medicinal ingredients in living plants.
• Theophrastus classified plants by leaves, roots, seeds, and stems.
• His observations related to medicinal plant classification and action earned him the title "father of botany".

Pedianos Dioscorides

• Dioscorides lived around A.D. 100
• The noted botanist and pharmacologist Dioscorides was the major authority on drugs for sixteen centuries.
• He added to Hippocrates' work using knowledge gained accompanying the Roman armies on their conquests.
• A major focus of his studies and writings was the use and biological effects of early remedies.
• Dioscorides's herbal, known in Latin as De Materia Medica, contained information on over 600 plants and 90 minerals.
• Dioscorides gathered knowledge from travels in Africa, Gaul, Persia, Armenia, and Egypt.
• The herbal incorporated remedies from these countries, giving plant/mineral descriptions, instructions for growing and preservation, dosage, medicinal uses, and side effects.

Roman Influence

• Claudius Galen lived around A.D. 130–200.
• Until 1950, pharmacy students took a course entitled “Galenical Pharmacy.”
• Galen, a Greek-born physician, practiced and taught both pharmacy and medicine in Rome.
• His principles, derived from Hippocrates' theory for medicine compounding, were followed in the Western world for 1,500 years.
• Galen organized the pharmacotherapy of humoral pathology into a scientific system.
• Galen compiled and added to drug information available in Rome in his writings, On the Art of Healing.
• This described the properties and mixtures of simple remedies and compounded drugs.
• Treatments described galenicals, standard preparations containing organic substances such as tinctures, fluid extracts, syrups, and ointment.

Jewish Influence

• The Jewish influence on health care is demonstrated in biblical records of the Old Testament, as well as by the teachings and works of Moses Maimonides.
• The Prayer of Maimonides for years continued the pledge of service made by pharmacists as they completed school and began professional practice.

Biblical Records

• From around 1200 B.C.
• The Old Testament Book of Sirach (38:4–8) states that the Lord created medicines and gave skill to men to be glorified in His works.
• Genesis mentions myrrh, a remedy used as an appetite stimulant, carminative, and skin protectant.
• Olibanum (frankincense) is a gum resin mentioned in Exodus, Jeremiah, Ezekiel, and the Song of Solomon.
• Drugs in the Old Testament still in use include garlic (Numbers 11:5).
• Aloe, mentioned in the New Testament (John 19:39) but available much earlier, is an official ingredient in the compound benzoin tincture.
• Acacia (Exodus 26:15), used earlier for building, is now commonly used as an emulsifying agent.

Christian Influence

• Cosmas and Damian lived around A.D. 303.
• The early Greeks had gods and goddesses of healing (Aesculapius, Hygeia, and Panacea).
• Early Christians venerated those saints who contributed to healings
• Cosmas was a physician, Damian practiced pharmacy.
• They were martyred during Diocletian's persecutions (A.D. 303-313).
• They have been honored as patron saints of medicine and pharmacy.

Eastern Influence

• The earliest recordings for use of remedies goes back to 3000 B.C in Mesopotamia.
• Early findings include inscriptions on clay tablets found in Mesopotamia and the Pen T’sao, found in China written on bamboo slats, which covered +10,000 remedies.

Clay Tablets of Mesopotamia

• From around 3000–2500 B.C.
• Among thousands of clay tablets unearthed in Iraq and the Persian Gulf, +800 tablets contained materia medica information.
• These first pharmaceutical texts contained +500 remedies from plant, mineral, and other sources.

China

• From around 500 B.C.
• Drugs used in early China include ephedra, cassia, rhubarb, camphor, and ginseng.
• "Yin” drugs were cold and wet, and "yang" drugs were warm and dry.
• "Red" drugs treated heart conditions, and “yellow” drugs treated liver problems.

Mithradates VI

• Mithradates lived in around 63 B.C.
• Early in history, drug effects were a concern.
• Mithradates might be the “father of toxicology".
• Mithradates writings are related to preventing/counteracting poisonous through antidotes.

Military Influence

• Wars accelerate the need for health care.
• Military medicine has provided the stimulus for improvement in infection control, surgical interventions, and trauma management.
• The Crusaders brought support to hospitals in the areas of conquest between A.D. 1096 and 1291 and built hospitals in the Holy Lands.
• The Hospitalers of the Order of St. John of God were established to staff hospitals and care for the wounded.
• This order continues to maintain health facilities throughout the world.

Influence of Western Europe

• From around A.D. 500–1200
• Medieval physicians prescribed about 1,000 natural substances, mostly plant-based.
• Herbs were the main source of medication.
• Materia medica was derived from the Greeks, Romans, and Arabs.
• Monasteries in England, Germany, and France preserved this and added to the medicinal herbs.
• Explorers brought back to Europe native remedies such as quinine.

Other Influences

• Scientific discoveries in one country are never limited to only applications in that country, since their impact can be felt across the globe
• Banting and Best discovered insulin (1922), saving and enhancing the lives of patients with diabetes.
• The WHO published the first International Pharmacopoeia in Geneva, Switzerland, in 1951, assisting in setting internationally acceptable drug standards and listing drugs of proven therapeutic value.

Key Figures And Discoveries

• 1721 A.D.: Dr. Zabdiel Boylston was the first person in the United States to administer a smallpox vaccine.
• 1785 A.D.: William Withering published his study of the foxglove plant and digitalis, used to treat heart disease.
• 1796: Edward Jenner used a cowpox vaccine to inoculate against smallpox.
• 1803: Frederich Serturner extracts morphine from opium.
• 1846: The first publicized operation using general anesthesia is performed in Boston. Ether is the anesthetic
• 1864: Louis Pasteur's experiments show microorganisms cause food spoilage, and that heat can kill them and preserve food.
• 1884: Carl Koller discovers cocaine is useful as a local anesthetic in eye surgery.
• 1899: Aspirin is developed due to difficulties in using salicylic acid from willow trees.
• 1921: Banting, Best, and Collip showed that insulin extract lowers blood sugar and may be useful in treating diabetes leading to human trials in 1922.
• 1928: Alexander Fleming discovers penicillin
• 1943: Russell Marker creates progesterone from Mexican yam.
• 1957: Albert Sabin develops an oral polio vaccine using a weakened live virus.