Pharmacy

History of American Pharmacy

The existence of pharmacists was rare in Colonial America. Drugs and “patent medicines” (i.e., cheap and supposedly curative tonics, pills, and other concoctions, which often contained large proportions of alcohol, opium, or laxatives) were readily available and hawked for sale without a prescription at general stores and by traveling salesmen. In the late 1700s, physicians compounded drugs they prescribed (i.e., prepared specially customized medicines), or their apprentices prepared the drugs under their supervision. Apothecary shops were generally owned by physicians and were located in large cities. The local drug clerk was a shop employee whose role was more akin to a wholesaler than retailer; the drug clerk primarily compounded, stocked, and distributed medicines for physicians. The job of the drug clerk was viewed as a trade occupation, which was best learned by daily application of repetitive practices. The apprentice drug clerks eventually developed more expertise in pharmaceuticals, far beyond the knowledge of most physicians, and they enjoyed a close working relationship with physicians, since they usually operated the shops on behalf of them.

Over time, the physician-owners of the shops moved away and/or sold their businesses to their former drug clerks, which began the establishment of the independent retail drugstore trade. In the early to mid-1800s, independent apothecary shops and drugstores proliferated, and the businesses became increasingly profitable. As proprietors, the former drug clerks adopted the titled of apothecaries or druggists (and a few called themselves pharmacists). The first college of pharmacy was established in Philadelphia in 1821, and a small number of other pharmacy colleges were founded, though most druggist-practitioners lacked formal training. From the mid-1800s through the early 1900s, the country lacked laws and regulations governing foods, drugs, and healthcare practice. The sale of inefficacious, possibly poisonous, and mislabeled patent medicines were sold by self-designated apothecaries and other merchants. Some 19th-century druggists diagnosed patients and dispensed medicines, which conflicted with medical practice. Physicians widely criticized the apprentice-trained employees as unknowledgeable and unscrupulous. Many physicians continued to dispense their own medicines, and a widening rift developed between pharmacy and clinical medicine.

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