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THE HISTORY OF PHARMACUTICAL COMPOUNDING
The History of the Pharmacy and Pharmacology dates back to
the medieval times with priests, both men and women, who ministered to the sick with
religious rites as well. Many peoples of the world continue the close association of
drugs, medicine, and religion or faith. Specialization first occurred early in the 9th
century in the civilized world around Baghdad. It gradually spread to Europe as alchemy,
eventually evolving into chemistry as physicians began to abandon beliefs that were not
demonstrable in the physical world. Physicians often both prepared and prescribed
medicines; individual pharmacists not only compounded prescriptions but manufactured
medicaments in bulk lots for general sale. Not until well into the 19th century was the
distinction between the pharmacist as a compounder of medicines and the physician as a
therapist generally accepted.
Pharmacy
phar·ma·cy (fär¹me-sê) noun
plural phar·ma·cies
Abbr. phar., Phar., pharm., Pharm.
1. The art of preparing and dispensing drugs.
2. A place where drugs are sold; a drugstore. In this sense, also called apothecary.
[Middle English farmacie, a purgative, from Old French, from Medieval Latin
pharmacìa, a
medicine, from Greek pharmakeia, use of drugs, from pharmakon, drug.
(The American Heritage® Dictionary of the English Language,
Third Edition copyright © 1992 by Houghton Mifflin Company. Electronic version licensed
from InfoSoft International, Inc. All rights reserved.)
The origin of the word "pharmacy" is generally ascribed to the Greek pharmakon
("remedy"). It has been suggested that there is a connection with the egyptian
term ph-ar-maki ("bestower 
of
security"), which the god Thoth, patron of physicians, conferred as approbation on a
ferryman who had managed a safe crossing. The notion of an Egyptian origin has a certain
romantic appeal, but in all likelihood the word "pharmacy" and its many cognates
derive, like so many other scientific terms, from the Greek.
As much as 80,000 years ago, people of the Paleolithic period were interested in the flora
around them to engrave a variety of plants, bones and deer antlers. It is fruitless to try
to determine when Pharmaceutical practice started because Pharmacy in a rudimentry form
existed before the word.
Combining different agents, or compounding, was considered an art form practiced by
Priests, and Doctors. The first known chemical processes were carried out by the artisans
of Mesopotamia, Egypt, and China. Most of these craftspeople were employed in temples and
palaces, making luxury goods for priests and nobles. In the temples, the priests
especially had time to speculate on the origin of the changes they saw in the world about
them. Their theories often involved magic, but they also developed astronomical,
mathematical, and cosmological ideas, which they used in attempts to explain some of the
changes that are now considered chemical.
GREEK NATURAL PHILOSOPHY
The first culture to consider these ideas scientifically was that of the Greeks.
From the time of Thales, about 600 BC, Greek philosophers were making logical speculations
about the physical world rather than relying on myth to explain phenomena. Thales himself
assumed that all matter was derived from water, which could solidify to earth or evaporate
to air. His successors expanded this theory into the idea that four elements composed the
world: earth, water, air, and fire. Democritus thought that these elements were composed
of atoms, minute particles moving in a vacuum. Others, especially Aristotle, believed that
the elements formed a continuum of mass and therefore a vacuum could not exist. The atomic
idea quickly lost ground among the Greeks, but it was never entirely forgotten. When it
was revived during the Renaissance, it formed the basis of modern atomic theory (see Atom
and Atomic Theory).
Today modern
pharmacist deals with complex pharmaceutical remedies far different from the elixirs,
spirits, and powders described in the Pharmacopeia of London (1618) and the Pharmacopeia
of Paris (1639). In the U.S. today, major medicines, those regarded as having the greatest
therapeutic value, are selected for inclusion in the Pharmacopeia of the United States,
first published in 1820, by a Committee on Revision on which all colleges of medicine and
pharmacy, all state medical and pharmaceutical associations, and the U.S. surgeon general
are represented. After the drugs have been chosen, the standards for quality and potency
are formulated by pharmacists and pharmaceutical chemists. Similar criteria for drugs
regarded by the committee as having less therapeutic value are set forth in the National
Formulary, published by the American Pharmaceutical Association (founded 1852) since 1888.
Any significant variation from pharmacopeia and formulary standards may be prosecuted by
the Food and Drug Administration under the Pure Food and Drug Acts.
Pharmacy, science of compounding and dispensing medication; also, an establishment used
for such purposes. Modern pharmaceutical practice includes the dispensing, identification,
selection, and analysis of DRUGS. Pharmacy began to develop as a profession separate from
medicine in the 18th cent., and in 1821 the first U.S. school of pharmacy was established
in Philadelphia.
Pharmacology (fär´me-kòl¹e-jê), study of the changes produced in living animals by
DRUGS, chemical substances used to treat and diagnose disease. It is closely related to
other scientific disciplines, particularly BIOCHEMISTRY and PHYSIOLOGY. Areas of
pharmacologic research include mechanisms of drug action, the use of drugs in treating
disease, and drug-induced side effects.
Pharmacy, practice of compounding and dispensing drugs; also the place where such
medicinal products are prepared. Pharmacy is an area of materia medica, that branch of
medical science concerning the sources, nature, properties, and preparation of drugs.
Pharmacists share with the chemical and medical profession responsibility for discovering
new drugs and synthesizing organic compounds of therapeutic value. In addition, the
community pharmacist, or druggist, is increasingly called upon to give advice in matters
of health and hygiene.
Education and
Practice
In the U.S., colleges of pharmacy offer 5-year undergraduate programs leading to the
degree of bachelor of science in the pharmaceutical sciences. All accept students directly
from high school and may grant advanced standing to college students or graduates.
Licenses are granted by states after the following requirements have been met: graduation
from one of the 72 colleges with programs accredited by the American Council on
Pharmaceutical Education; about 1500 hours of internship under a registered pharmacist;
satisfactory completion of a state examination. Pharmacists may practice their profession
in a pharmacy located in a hospital, nursing home, or special area of a drugstore. They
may also be employed by a pharmaceutical company in scientific research or the development
and production of new pharmaceutical products.
WHAT HAPPENED TO THE NEIGHBORHOOD COMPOUNDING PHARMACY?
THE INDUSTRIAL REVOLUTION
The rapid change from hand methods to machine methods of production that
characterized the Industrial Revolution found a ready application in pharmacy, especially
under the impact of the scientific developments of the nineteenth century. Phytochemistry
and synthetic chemistry created new derivatives of old drugs and new chemical entities of
medicinal value that strained 
the capacity of
the individual pharmacy. Large scale drug manufacturing had its strong hold on society
with the advent of machines and patents.
The progress made by this new industry is demonstrated by the catalogue of the American
firm G.D. Searle, which by the late 1880’s listed 400 fluid extracts, 150 elixirs,
100 syrups, 75 powdered extracts, and 25 tinctures and other drug forms.
THE DECLINING ART OF THE APOTHECARY
Industrialization had an impact on every aspect of the activity of the
pharmacist. First, it led to the creation of new drugs, drugs that the individual
pharmacist’s own resources could not produce. Second, many drugs that the individual
pharmacist was able to produce could be manufactured more economically, and in superior
quality, by industry. Third, industry assumed responsibility traditionally vested in the
pharmacist for the quality of the medication. The plethora of proprietary medicines,
widely and often blatantly advertised, deprived the pharmacist of a market for private
specialties; it forced the pharmacist to become a vendor of questionable merchandise; it
opened the way to much broader competition from merchants, grocers and pitchmen than the
pharmacist had previously encountered.
THE COMMUNITY PHARMACY
The nineteenth century did not see the end of the art of compounding, but the art
did give way, however grudgingly, to new technology. It has been estimated that a
"broad knowledge of compounding" was still essential for 80 percent f the
prescriptions dispensed in the 1920s. Although
pharmacists increasingly relied on chemicals purchased from the manufacturer to make up
prescriptions, there still remained much to be done secundum Artem. They spread their own
plasters, prepared pills (of aloes and myrrh or quinine and opium, for example), prepared
powders of all kinds, and made up confections, conserves, medicated waters, and perfumes.
They put up tinctures (of laudanum, paregoric, and colchicum) in five gallon demijohns.
And they frequently combined into a single dosage from several medicines, which normally
today would be written and dispensed as separate prescriptions. Further more, they were
often called upon to provide first aid and medicines for such common ailments as burns,
frostbite, colic, flesh wounds, poisoning, constipation, and diarrhea.
In addition to maintaining a prescription laboratory, pharmacists usually carried the
disliked but necessary patent and proprietary remedies along with herbs and locally
popular nostrums of their own compounding.
THE TWENTIETH CENTURY PHARMACIST
The most notable change in pharmacy in modern times has been the virtual
disappearance of the preparation and compounding of medicines. Whereas in the 1920s, 80
percent of the prescriptions filled in American pharmacies required a knowledge of
compounding, by the 1940s the number of prescriptions requiring compounding had declined
to 26 percent. As far back as 1971, only 1 percent, or less, of all prescriptions combined
two or more active ingredients. Moreover, the pharmacist’s commitment to maintaining
the quality of the drugs dispensed has been reduced to knowing such facts as the length of
shelf life and the effect of exposure to light and judging the reliability and reputations
of the manufacture.
All this meant
that the pharmacist’s education and activities had to undergo change. At the same
time that the scientific education of pharmacists was steadily becoming more demanding,
their role in the provision of health care was becoming more and more circumscribed.
Moreover, they were increasingly subject to government and institutional requirements that
diminished the importance of the patient-pharmacist relation. And, especially in the
United States and Great Britain, competition from prescription departments in chain and
department stores tended to demean both the role and the dignity of the pharmacist as a
health-care professional. The urban blight that attacked the neighborhoods was inevitably
a threat to the friendly neighborhood pharmacist.
The reaction to these conditions was apparent in the drop in the production of graduates
of American schools of pharmacy who were planning to go into the field of community
pharmacy. In 1947, about 90 percent of graduates planned to go into some aspect of
community pharmacy; in 1973, that figure had dropped to 76.6 percent; in 1988 it stood at
57.1 percent.
COMPOUNDING TODAY
Custom Compounding pharmacies are on the rise. Physicians, medical institutions
and patients are realizing more then ever the importance of tailoring an individuals
medications to specifically meet there needs. A majority of the Pharmacists that are going
back to compounding are doing so for the love of the science and interest in the patients
well being. Being able to be in the role of a problem solver opens the doors to creativity
and genius that the medical industry has been eagerly adopting for the last decade.
Note: Most of the information detailed in this report was found in the
definitive book on the history of pharmacy; Pharmacy an illustrated history, by
David L. Cowen and William H. Helfand, published byHarry N Abrams, Inc., New York. - ISBN
0-8109-1498-0 This is a beautifully illustrated, 250 page book that was published
in 1990.
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