THE Neceſſity and Uſefulneſs OF THE DISPENSARIES.

THE Practice of Phyſick in London and ſeven miles round, being for near two hundred Years ſetled by Law wholly in the College of Phyſicians in London, and ſuch as they approve of upon Examination, and Licenſe; 'tis worth the while to enquire by what means they come to enjoy ſo ſmall a part of it. Chymiſts and Diſtillers, Aſtrologers and Mountebanks, Midwives and Nurſes, and the whole Train of Broken-Tradeſmen-Doctors have every one their ſhare. There are not a few that are their own Doctors, and practiſe upon themſelves; and there is hardly any one ſo unkind, as not to recommend to his ſick Friend what has done himſelf good. The College can only blame theſe laſt for Indiſ⯑cretion: And the former are the moſt of them hardly worth the charge of a Proſecution: yet the College have been ever and anon making an example of one or other of them, to ſtrike terror into the reſt.

But when I have reckoned up theſe and as many more ſuch as theſe, they have hardly all of them invaded the tenth part of the practice that one ſingle ſort of Men have uſurpt, viz. the Apothecaries. And theſe not only practiſe, but pretend to a Right, and to a Neceſſity ſo to do. As to their Right, tho' the Honourable Court of Kings Bench have more than once quaſht that pretence, and have ſufficiently determined the matter againſt them; yet I ſhall preſume to give a touch at it, after⯑wards [2]in this Paper. But as to the Neceſſity which they plead, I will conſider that here.

They plead a Neceſſity to practiſe upon the Rich, becauſe ma⯑ny times they cannot perſuade theſe to ſend for a Phyſician, when yet 'tis neceſſary that ſomething ſhould be done, and therefore they muſt do it. Now this ſeems a very odd way of arguing, That if the Patient will not ſend for a Phyſician, the Apothecary muſt needs undertake the Cure. For if the Patient be covetous, or fool-hardy, or will not believe himſelf ill e⯑nough to have the advice of a Phyſician, what's that to the Apo⯑thecary? Yes, for if one Apothecary will not give him ſome⯑thing, another will; and ſo the firſt ſhall loſe a Patient. This I muſt confeſs is a kind of neceſſity, ſe defendendo, for one A⯑pothecary to defend himſelf from the invaſion of another: But this is far from proving a Neceſſity with reſpect to the Patient, who I dare ſay had generally much better be without any of them.

Another Neceſſity to practiſe upon the Rich, is, when they are taken ſuddenly ill, and no Phyſician can be met with. As to Practiſing in this caſe of neceſſity, ſo long as ſuch neceſſity laſts, I dare ſecure the Apothecaries, or any other perſon that does his beſt in ſuch urgent Caſes, that they ſhall never be trou⯑bled for it by the College. But this Neceſſity is far from juſti⯑fying the Apothecaries continuing to practiſe even upon ſuch Patients from day to day, when better advice may be had.

Theſe two Caſes, I think, are the only ones for which they can plead Neceſſity, with reſpect to their practiſing upon the Rich; and how far they are from excuſing or juſtifying their practiſing upon any ſuch for Weeks or Months together (as they commonly do) is too obvious to be farther examin'd.

But then how ſhall I get over the other Neceſſity, the great Neceſſity, with reſpect to the Poor, who, if you will believe the Apothecaries, would all periſh for want of looking to, if they did not take care of them: for the Phyſicians (of the College) they ſay, will only viſit the Rich that can Fee them well.

I believe, this accuſation of the College-Phyſicians was never true: But that for ſeveral Years by-paſt it has been notoriouſly falſe, is known to the whole Town. For, that the Phyſicians [3]might clear themſelves of this falſe charge, they have been ob⯑liged to ſet their care of the Poor more in the eyes of the World than heretofore; not only giving advice gratis to the Poor at their own and the Patients Lodgings, but appointing publick Diſpenſaries alſo for the Poor to reſort to every day of the week (except Sundays) where they may both have the beſt ad⯑vice gratis, and alſo proper Medicins for their reſpective Ca⯑ſes at the loweſt value: whereby the Poor are at once delivered from the danger of the Apothecaries ignorance in practice, and alſo from the oppreſſive charge of his Medicins.

And the College have been forced to take this Courſe, not only to clear themſelves of the aſperſions caſt upon them, but alſo to make their charity in adviſing gratis, truly ſerviceable to the Poor: For unleſs Phyſicians could teach the Poor to make ſomething themſelves, their advice was ſeldom followed; be⯑cauſe the Apothecaries uſed to make them pay ſo dear for their Phyſick, and could by no Overtures or Arguments be induced to abate of their prices, tho' often preſt to it by the Phyſicians, as clearly appears in a Paper ſome years ago publiſhed under the Title of A ſhort Account of the proceedings of the College of Phyſicians, London, in relation to the ſick Poor of the ſaid City, &c.

And notwithſtanding that the Phyſicians, as appears in the ſaid Paper, were ſo forward to adviſe the Poor gratis, and the Apo⯑thecaries ſo backward in contributing their part; yet theſe did not only continue to inſinuate to the Town, that the care of the Poor lay wholly upon them; but when about ſeven years ago they petitioned the High Court of Parliament to be exempt⯑ed from Offices as the Phyſicians are, they had the confidence to ſuggeſt the ſame there alſo, and endeavoured to get a Clauſe in their Bill, that they might have liberty to give Phyſick to the Poor, who otherwiſe were like to periſh for want of due care to be taken of them.

The Phyſicians being thus unjuſtly calumniated before the whole Nation, 'twas high time for them to think of an effectual remedy. Wherefore Dec. 22. 1696. a Propoſal was made in the publick College for a ſubſcription by the ſeveral Members thereof, to raiſe a Fund for the furniſhing a Repoſitory of Medicins for the uſe of the Poor: which Propoſal was then approved of, [4]and a ſubſcription immediately made to the effect follow⯑ing.

‘"Whereas the ſeveral Orders of the College of Phyſicians London, for preſcribing Medicins gratis to the Poor Sick of the Cities of London and Weſtminſter and parts adjacent, as alſo the Propoſals made by the ſaid College to the Lord Mayor, Court of Aldermen and Common Council of London, in pur⯑ſuance thereof, have hitherto been ineffectual, for that no Me⯑thod hath been taken to furniſh the Poor with Medicins for their Cure at low and reaſonable rates: We therefore whoſe Names are here underwritten, Fellows or Members of the ſaid College, being willing effectually to promote ſo great a Chari⯑ty, by the counſel and good liking of the Preſident and College declared in their Comitia, hereby (to wit, each of us ſeverally and apart, and not the one for the other of us) do oblige our ſelves to pay to Dr. Thomas Burwel, Fellow and Elect of the ſaid College, the ſumm of Ten Pounds apiece of Lawful money of England, by ſuch proportions, and at ſuch times as to the major part of the Subſcribers hereto ſhall ſeem moſt con⯑venient: Which Money when received by the ſaid Dr. Thomas Burwel, is to be by him expended in preparing and delivering Medicins to the Poor at their intrinſick value, in ſuch man⯑ner, and at ſuch times, and by ſuch Orders and Directions, as by the major part of the Subſcribers hereto, ſhall in writing be hereafter appointed and directed for that purpoſe. In Witneſs whereof we have hereunto ſet our hands and Seals this 22. December 1696."’

This was in a few days ſubſcribed by above forty, (and has by ſeveral more, ſince.)

The Subſcription being made, a College was called, That a Grant might be forthwith made by way of Leaſe to the Subſcri⯑bers, of the College-Laboratory, and other Rooms and conve⯑niencies neceſſary for executing the intended Charitable deſign: And a Grant was accordingly made and Sealed in open College. Whereupon the Subſcribers preſently choſe a Committee of twelve to manage this affair, who were ſo diligent in it, that in about half a year they got it into a ſerviceable condition and method.

But this deſign being wholly new, no wonder if at firſt it was not brought to that degree of Serviceableneſs it is now improved to. At firſt thoſe Poor only were ſupplied with Medicins that repaired for advice to the ſeveral Subſcribers Lodgings, or thoſe whom they were called to in their reſpective Neighbourhoods; which in compariſon were but few: for the Apothecaries ſtill made a ſhift to keep moſt of them in their own hands, ſo loth were they to part with their objects of Charity, for reaſons beſt known to themſelves. Wherefore the Subſcribers thought it adviſeable for the inlarging of their Charity, to appoint certain days wherein two Phyſicians (by turns) ſhould attend at the College, to give advice gratis to all the Poor that would reſort thither; and to give notice of this not only in the publick Prints, but alſo by Papers which they printed and gave away for the in⯑formation of the Town. By this means far greater Numbers flocked for advice, and many from the remoteſt parts of the Town; for whoſe conveniency it has been thought fit not only to continue the Attendance (with the Diſpenſary for Medicins) at the College; but alſo to erect two Diſpenſaries more, one in S. Martin's Lane in the Fields, and the other in Grace-Church ſtreet, that the ſick Poor might not have too far to go for relief; and might at one or other of theſe Places have advice any day in the Week, and Medicins every day at all of them. Thus two Phyſicians attend in the afternoons on Monday in S. Martin's, on Tueſday in Grace-Church-ſtreet, on Wedneſday at the College; and ſo on Thurſday in S. Martin's, on Friday in Grace-Church-ſtreet, and on Saturday at the College. And the Phyſicians attendance at theſe Places, is not intended at all to excuſe any Subſcriber from giving advice gratis at his own Houſe or in his Neighbour⯑hood: But becauſe a Phyſicians hours are uncertain, being obli⯑ged to be abroad whenever called; that the Poor who can ill loſe time, may not be diſappointed when they ſeek for advice, certain proviſion is made for them by theſe fixed days and places.

By this means 'tis hoped the Phyſicians have ſufficiently wiped off the Scandal they lay ſo long unjuſtly under, and the Poor have that care taken of them, and kindneſs ſhew'd them, that we challenge any City in Europe to parallel.

The Committee who are new choſen every Year, meet twice [6]every Week for the looking after the due management of this Undertaking: and they chuſe two Curators Monthly, whoſe peculiar buſineſs it is to buy in the beſt Drugs they can meet with, and to ſee that the Compoſitions for the Diſpenſaries be duly prepared. And that theſe may be the better inſpected, they are all ordered to be made at the College, and to be con⯑veyed from thence to the other two Diſpenſaries as they are wanted.

And as the Medicins at all the Diſpenſaries are the beſt that can be made: So they are ſold out for no greater gains than will juſt bear the Charge, viz. of Houſe-Rent and Servants wa⯑ges. So that the Price is ordinarily 8d. or 9d. in the Shilling leſs than the Apothecaries uſe to exact.

And now that the Poor are ſo very well taken care of by the Subſcribers to the Diſpenſaries, one would think the Apotheca⯑ries ſhould be very thankful that ſo much trouble is taken off their hands: But inſtead of that, (to ſhew that their gains by Practiſing upon the Poor, is more in their eye, than their relief) they rail every where againſt the Subſcribers as men that would undo them, and have entred into a Combination to hinder them of all the buſineſs they poſſibly can: while they careſs and bring into buſineſs ſuch Phyſicians as have refuſed to be concerned in the Subſcription. They make it their buſineſs alſo in all Com⯑panies, to raiſe Objections againſt the Diſpenſaries, as well as to miſrepreſent the deſigns of thoſe that have ſet them up. As I have therefore plainly ſhewn the Subſcribers deſign to be the moſt Laudable that can be; and that they were neceſſitated to erect them, as well for the relief of the Poor, as in their own vindication: So to prevent all groundleſs prejudices, I will give a full Anſwer to all ſuch Objections as the Apothecaries have raiſed againſt them.

Theſe Objections may, I think, be reduced to ſix.

I. They ſay, That Phyſicians ought not to give Phyſick, but only preſcribe it.

II. That they have no right to erect publick Diſpenſaries.

III. That if the Diſpenſaries be ſuffered, the Apothecaries will all be undone.

IV. That Phyſicians Fees are as unreaſonable and oppreſſive, as the Apothecaries prices.

V. That the Rich are ſupplyed with Medicins from the Diſpenſaries as well as the Poor.

VI. That the Diſpenſaries ſell Medicins as dear as the Apothe⯑caries.

Obj. 1. That Phyſicians ought not to give Phyſick, but only pre⯑ſcribe it.

Anſw. It might ſuffice in anſwer to this to ſay, that it is as little the Apothecaries province to adviſe the ſick, as they can ſuppoſe it to be the Phyſicians to give them Phyſick: and yet where is the Apothecary that does not do this every day? How unfit then are the Apothecaries to impute that as a Crime to Phyſicians, which they are ſo notoriouſly guilty of themſelves, viz. of intruding into other Mens buſineſs? I ſay, this might ſuffice as an Anſwer to them: but I ſhall conſider the accuſation it ſelf, and demonſtrate, that Phyſicians when they give Phyſick, are in their own lawful proper buſineſs; and that Apothecaries are not ſo, when they preſcribe it.

When a Phyſician has arrived at the skill to know Diſeaſes and their Symptoms, and to take Indications for their Cure as to the quid agendum; he muſt then proceed to find out the quo, i. e. Operations, or Medicins, to ſatisfie thoſe Indications: And when he has found theſe out, can any Man think it reaſonable, that he ſhould be obliged to communicate all his skill in every particular Cure, to what perſon ſoever the Patient is pleaſed to call in for an Apothecary, ſo as to make him preſently Maſter of all thoſe Secrets that by long ſtudy and obſervation he has arrived at the knowledg of? Whoſoever is the Author but of one Invention uſeful to the Publick, has a right by Law to the ſole benefit of it for many years: And ſhall Phyſicians that are continually inventing new and more effectual Remedies for the Diſeaſes of Mankind, be bound to divulge and proſtitute all their Inventions to Men, that if they can help it, will never let the Inventors have twice the benefit of the ſame Preſcription, but preſently uſurp the uſe of it themſelves, and leave the Phy⯑ſicians at leiſure to invent more? I know the Apothecary that is ignorant of the Reaſons and Natures of things, by unfitly applying good Remedies ſhall never perform the ſame Cures that the learned Phyſician can: but while the Apothecaries pretend [8]to do it, and give thoſe remedies to Patients, tho' theſe receive no benefit, the Phyſician is no leſs injur'd. I ſay then, 'tis againſt all the reaſon and juſtice in the World, to hinder the Phyſician himſelf from adminiſtring to the ſick ſuch remedies as he has invented. 'Tis as abſurd, as to hinder a Workman from uſing his own Tools which he has invented, and which he alone knows the right uſe of. And the Parliament of 32 H. 8. for this, and other weighty reaſons, did wiſely enact, ‘"That any Phyſician being admitted by the Preſident and Fellowſhip of Phyſicians in London, may any where within this Realm practiſe and exerciſe the Science of Phyſick in all and every its members and parts."’ Which Clauſe is plainly applied to making and giving Medicins, in the Charter granted to the Apo⯑thecaries by K. James I. For after the Charter had granted them divers Immunities, Powers and Privileges, particularly the ſole making and vending of internal remedies, &c. at length there is this Clauſe added: Et deni (que) volumus — quod Fraeſi⯑deus & Communitas Medicor. (Civit. Lond.) omneſ (que) & ſinguli Medici de eodem Collegio ſive Communitate, & ſucceſſores ſui, ſicut & Me⯑dici Regis, Reginae & Principum impoſterum debeant, & pro arbitrio ſuo poſſint artem medicam in omnibus ſuis partibus exercere, &c. i. e. ‘"And laſtly we will — That the Preſident and Commonalty of Phyſicians (in the City of London) and all and every the Phyſicians of the ſame College or Commonalty, and their Suc⯑ceſſors, as alſo the Phyſicians of the King, Queen and Princes, hereafter ought, and at their pleaſure may exerciſe the Art of Phyſick in all its parts."’ And to drive the matter yet further out of all diſpute, it is immediately added, & inſuper gaudebunt, utentur & fruentur, & gaudere, uti & frui valeant & poſſint eiſdem & conſimil. juriſdictionibus, authoritat. ſuperviſ. & correctionibus, ac omnibus aliis poteſtatibus, privileg. & libertat. qualibus unquam antehac Pharmacopolae uſi & gaviſi fuerunt, &c. i. e. ‘"And ſhall moreover enjoy and uſe, and have a right to enjoy and uſe the ſame and like Juriſdictions, Authorities, Superviſings and Cor⯑rections, and all other POWERS, PRIVILEDGES and Liberties which the Apothecaries have ever hitherto uſed and enjoyed, &c."’ What words can be more comprehenſive and full to continue in the Phyſicians of the College an equal [9] power and priviledge with Apothecaries themſelves, to make and vend Medicins?

But where is the clauſe in any Statute or Charter (even their own) that gives or reſerves a power to the Apothecaries to practiſe Phyſick, and to diſpenſe out all the Medicins in their Shops to Patients without the preſcription or advice of any Phy⯑ſician? If they can ſhew none, then I affirm, that they do this againſt plain poſitive Law, while Phyſicians have Law as plain and poſitive to empower them to prepare and give Phyſick.

Obj. 2. That Phyſicians have no right to erect publick Diſpen⯑ſaries.

Anſw. To this I anſwer, that it ſeems ſtrange, if each particular Phyſician have power by Law to prepare and give his own Phyſick, (as has been ſhewn) that two or three, or any number of theſe Phyſicians, may not for their own convenience prepare their Medicins together, and have one common place from whence to diſpenſe them; eſpecially when all the benefit of ſuch conve⯑niency accrues to the Patient, who by that means has his Medi⯑cins conſiderably cheaper than they could be afforded, if every Phy⯑ſician were at the charge to keep Servants and a Diſpenſary of his own. But ſuppoſe there were any weight in this Objection, of what advantage would it be to the Apothecaries to have the Phyſi⯑cians debarr'd from this convenience? There would perhaps in ſuch Caſe be as many Diſpenſaries as there are now Subſcribers to the three in being: And whereas each Subſcriber ſends in compariſon but few of his Patients at preſent to the Diſpenſaries; if he had one at his own Houſe, he would probably ſupply all his Patients with his own Medicins. The Objectors therefore had much better, in my opinion, quietly endure three common Diſpenſaries ſet up for the uſe of the Poor, than by endea⯑vouring to pull theſe down, to give occaſion to ſet up forty or fifty private ones, for the uſe of the Rich as well as the Poor.

Obj. 3. That if the Diſpenſaries are ſuffered, the Apothecaries will all be undone.

Anſ. It muſt be confeſt, that part of their buſineſs, eſpecially that relating to the Poor, muſt indeed be abated; and that bu⯑ſineſs which they retain, will hardly be ſo profitable to them as formerly, when the Rich underſtand how unreaſonable their [10]gains have been. But if the Apothecaries pleaſe, they may in good part make up theſe Loſſes by contenting themſelves to live in Houſes of leſs Rent, to bear only the port of Labouring or handy-crafts-men (as indeed they are) but eſpecially by keeping fewer Servants, and putting their own hands to their own work, and by making ſuch Bylaws to their Company in relation to ta⯑king Apprentices, as may leſſen the number of Apothecaries, who are now grown ſo over numerous. And if notwithſtand⯑ing, they cannot get ſo much by their Trade as they have done, every unprejudic'd Man will conclude it more reaſonable and juſt, that a few Men ſhould be leſſen'd in their gains and gran⯑deur, than that a thouſand times their number ſhould be op⯑preſs'd for the ſupport of them. And all muſt confeſs, that the ambition of theſe Men is very Extravagant, that deſire with an hundred pound Stock (many not with half ſo much) to vie with the beſt Shop-keepers or Merchants in their Neighbourhood, that employ fifty times as much in their buſineſs.

Obj. 4. That Phyſicians Fees are as unreaſonable and oppreſſive as the Apothecaries prices.

Anſw. 'Tis denied, that Phyſicians Fees are either unreaſona⯑ble or oppreſſive: For how ſhould they be ſo, when the Patient is at liberty to give what he pleaſes? Every one is the beſt judge of his own condition and ability: And accordingly ſome give a Guinea, ſome ten Shillings, ſome a Crown and ſome nothing: And whatever other Phyſicians do, the Subſcribers to the Diſ⯑penſaries profeſs themſelves as ready to ſerve the two laſt as the two firſt. And take theſe one with another, how far ſhort will Phyſicians Fees come of thoſe of Lawyers, which yet are not diſ⯑puted? And the diſproportion will ſtill appear the greater, when it is conſidered, that for one Client the Lawyers have in forma pauperis, the Subſcribers to the Diſpenſaries have fifty or an hundred gratis Patients, there being ſeveral hundreds of them every Week. So that take one Patient with another, Rich and Poor, and I dare confidently aver, that no Phyſician that duly attends at the Diſpenſaries, has a Crown a Bill for all the Bills he writes through the Year; nay I can be poſitive, that ſome have not half a Crown. And what ground then can there be for this great cry againſt Phyſicians Fees?

But ſuppoſing they were indeed unreaſonable, this Objection would only argue, that Phyſicians were not fit perſons to accuſe the Apothecaries of exceſſive gains; but it does no way excuſe or juſtifie them. And I will make it appear, that there is no proportion between their gains and Phyſicians Fees. In Chronical Caſes, when the Patient can come to the Phyſician, he ordinarily gives him but half a Fee; for which he expects to be put into a courſe of Phyſick that ſhall cure him, which generally laſts ſeveral Weeks. In this time the Phyſick commonly comes to ſeveral pounds; of which, three parts in four at leaſt ſhall be gains, (as I will undertake to prove, if it be denied.) And if the ſame Patient chance to relapſe into the ſame Diſeaſe, he ſhall re⯑peat the courſe toties quoties without ever conſulting his Phyſician again. So that by ſuch a Patient the Apothecary ſhall get (at time and time) perhaps twenty times as much as the Phyſician.

Yea tho' the Patients Caſe be acute and require the daily at⯑tendance of the Phyſician, the Apothecary's gains ſhall far ex⯑ceed his Fees, eſpecially if the Phyſician be one of the Apothecaries Friends, and have the knack of writing well, as their cant is. I could give Inſtances enow of this: But I appeal to the experience of moſt that have been ſick of Fevers (for inſtance) wherein they have had an Apothecary, with a Phyſician of his recommending: Let them caſt up the Phyſician's Fees, and compute three parts in four (at leaſt) of the Apothecaries Bill to be gains, and they ſhall generally find the latter greatly to outbalance the former. Only I muſt here except two or three Phyſicians (not concerned in the Diſpenſaries) who have got a way (under the ſpecious pretence of being careful Men) to viſit their Patients twice or thrice a day, when once would ſerve, only to Multiply their Fees. I am not writing an Apology for ſuch; but am content they ſhould fall under the ſame cenſure with the Apothecaries, of being unreaſonable and oppreſſive.

Obj. 5. That the Rich are ſupplyed with Medicins from the Diſ⯑penſaries, as well as the Poor.

Anſw. The prime reaſon of ſetting up the Diſpenſaries was (as has been ſhewed) the ſupplying the Poor with Medicins at a low rate: And that the Subſcribers do ſtill put them to this uſe, hundreds of poor People can Weekly teſtifie. And if there are [12]any Rich ſupplyed with Medicins from thence, the Apothecaries may thank themſelves for it. For this I will affirm, that what⯑ſoever Phyſicians (Subſcribers to the Diſpenſaries) ſend their Rich Patients thither for Phyſick, it is for one or more of theſe following Reaſons. Either firſt, becauſe of the general Combi⯑nation of the Apothecaries to keep out or turn out the Subſcri⯑bers from all Patients where they have an intereſt to do it, in order to bring in thoſe Phyſicians that will not be concerned in the ſubſcription. And ſo the Subſcribers find this the only way to retain ſome of thoſe they have left. Or ſecondly, becauſe the Apothecaries by ſending in ill prepared Medicins diſappoint them in their Practice, on purpoſe to make the Patients queſtion their Phyſician's skill, and to ſend for ſome other of their recom⯑mendation. (Which I have often known to be done.) Or Thirdly, when the Patients themſelves complain not only of the dearneſs but of the badneſs of their Apothecaries Medicins, and deſire they may be ſupplyed from the Diſpenſaries, where they are not only cheap, but good. Or fourthly, when the Apothecary has for many days together (even in dangerous and acute Diſeaſes) kept the Patient in his own hands, till almoſt all opportunity of bene⯑fiting him is loſt: For in ſuch Caſes the Subſcribers think it juſt, that the Apothecaries ſhould receive ſome check, to deter them from ſuch unfair and dangerous Practices. Or Laſtly, when the Phyſician preſcribes ſome ſecret Medicin that is kept at the Diſpenſaries, which he thinks not fit to make known to the Apothecaries, leſt they ſhould preſently (as is uſual with them) fall a practiſing therewith themſelves to his diſadvantage. And to theſe I may add a Sixth reaſon, which is only accidental, viz. When Perſons of Condition come to the Diſpenſaries for gratis advice on the uſual days, in forma pauperum, and the Phyſicians attending are ignorant of their quality, and ſo are impoſed upon.

Theſe Reaſons I alledge in anſwer to this fifth Objection, not that the Subſcribers need give a reaſon for what they do in this particular (for they have an undoubted right to give Phyſick to whom they pleaſe, as I have proved before in the anſwer to Obj. 1.) but that all the World may ſee, how every way juſtifiable the Subſcribers are, as to any complaint the Apothecaries make [13]againſt them. And after all the noiſe of ſending the Rich to the Diſpenſaries for Medicins, I dare ſay, take all the Subſcri⯑bers together, and they do not ſend one Bill in thirty (that they write for the Rich) thither: And if ſome ſend more than others, it is upon account of greater injuries and affronts they have met with from the Apothecaries, for appearing more for⯑ward than their Brethren in this charitable Undertaking.

Obj. 6. The laſt Objection is, That the Diſpenſaries ſell Medicins as dear as the Apothecaries.

Anſw. 'Tis confeſt, that ſome Apothecaries, eſpecially the Wholeſale ones, do ſell ſome Medicins as cheap as the Diſpen⯑ſaries can afford them. But pray what Medicins are they? They are either ſimple Medicins and Drugs, the nature and value whereof moſt people know; or ſuch ſingle compound Medicins as are kept ready prepared in Shops, to be ſold out when call'd for, by their proper and peculiar names, the value whereof is as commonly known as that of Drugs and Simples. As for in⯑ſtance, Venice Treacle, Mithridate, Diaſcordium, &c. tho' very compounded Medicins, are ſold as cheap (I will not ſay ſo good) by the Wholeſale Apothecaries as at the Diſpenſaries; and the reaſon is, the Buyer underſtands what he buys, and the current price of it, and ſo cannot be impoſed upon by the Apothecary. And the gains the Apothecary has by theſe Medicins thus ſold, was never called unreaſonable and exceſſive by the Subſcribers to the Diſpenſaries. But the gain complain'd of as unreaſonable and oppreſſive, is, when Medicins either ſimple or compound are mixt together, or diſguiſed, and have a new name put upon them, denoting only their form, or their uſe and virtue, and the Patient is ignorant what they conſiſt of. As for inſtance, a Cordial bolus ſhall be priced at 1 s. 6 d. (by ſome at 2 s. 6 d.) when the Ingredients of it are not worth 2 d. A doſe of purging Pills at the ſame price with the Cordial bolus, when they are on⯑ly half a dram of extract. Rudii, Pil. Ruffi, or Cochiae, worth 2 d. A Cordial draught ſhall be 1 s. 6 d. when the Waters and Syrup of which it conſiſts, are dear of 3 d. A Vomit is 1 s. 6 d. (or 2 s. 6 d.) when it is not intrinſecally worth above 1 d. or 2 d. A Sto⯑machick Apozem of a quart is never rated at leſs than 2 s. 6 d. when the Ingredients that are boil'd in the water are bought for [14]3 d. or leſs, as in the bitter Decoction. And many Apothecaries are ſo void of all Conſcience, as to make eight Shillings of ſuch an Apozem, by dividing the quart into eight parts, and ſend⯑ing it in to the Patient for ſo many draughts (with ſome cramp name annexed) at 1 s. per draught. The like extravagant way of increaſing the price do they very often take, by dividing an E⯑lectuary worth (it may be) 1 s. into twelve parts or more, and ſending in the parts ſo divided to the Patient under the name of bolus's at 1 s. a piece at leaſt. And ſo if a Phyſician preſcribe a powder of an ounce, to be taken by half a dram at a time: Though the whole ounce be dear of a Shilling, as conſiſting on⯑ly of teſtaceous Powders, Sal prunellae, Sugar of Roſes, &c. yet the Apothecary by officiouſly dividing the ounce into ſixteen Papers, ſhall make 8 s. of it, viz. 6 d. a Paper. Now whoſoever will take the pains to enquire, at what rate the very ſame bolus's, Pills, Vomits, Cordial draughts, Apozems, Powders, &c. are priced at the Diſpenſaries, he will ſee that they are generally at leaſt 9 d. in the Shilling cheaper than what the Apothecaries fell them for. Who then does not ſee a notorious fallacy in the Objection, when they affirm, that they ſell Medicins as cheap as the Diſpenſaries, when it holds not true in a fiftieth part? And only in thoſe, wherein the People cannot be impoſed upon?

And beſides, there is another circumſtance that makes it yet exceedingly dearer to have Phyſick from the Apothecaries, than from the Diſpenſaries; and that is, that if either the Apothe⯑cary be Doctor himſelf and ſend in Medicins to the ſick of his own head; or if he be able to bring in a Favourite Phyſician that is an Enemy to the Diſpenſaries, they ſhall either of them pour in upon the Patient three times as much Phyſick as the Subſcribers to the Diſpenſaries uſually preſcribe in like Caſes, the greateſt part whereof, I dare be bold to ſay, is nothing to the purpoſe of the Cure, but ſerves only for Pomp and to raiſe the Apothe⯑caries Bill, or perhaps does the Patient a great deal of harm.

So that take all conſiderations together, and who ſees not, that the Diſpenſaries are the greateſt relief to the Poor that can be imagined, when, for it may be, five Shillings they ſhall have as much help in their reſpective Caſes, as the Rich who are ſup⯑plied [15]with Medicins from the Apothecaries, can have for five pounds? and at the ſame time have the eaſe of taking only a few neceſſary Medicins, when the others are cramm'd and drench'd all day and night long with one ſlap or other?

And now that I have given a full Anſwer to all the Apothe⯑caries Objections againſt the Diſpenſaries, I ſhould have put an end to this Paper, were there not two Objections more, com⯑monly to be met with in the Town, which it may be neceſſary to ſay ſomething to, viz. One on the Apothecaries behalf, a⯑gainſt Phyſicians having the whole adviſing part of Phyſick; and the other againſt one particular in the preſent Management of the Diſpenſaries.

1. On the Apothecaries behalf people argue, That an Apo⯑thecary who has for many Years made up Phyſicians Preſcriptions for Patients, and has obſerved their Operations and effects, ought to have a right to adminiſter ſuch Medicins as have had good effects, to other Patients in like Caſes, when he is deſired, without conſulting any Phyſician.

Anſ. In anſwer to this, we will firſt ſuppoſe, that the Apo⯑thecary is of a capacity to make obſervations, and to know when a like Caſe occurs; And yet in ſuch caſe I affirm, that he ought not of his own head to adminiſter the moſt ſucceſsful remedy to any other Patient than him for whom ſuch remedy, was firſt preſcribed, unleſs in caſe of urgent neceſſity, and when the Phyſician that preſcribed it cannot be had. For a Phyſician has a double property in his Preſcriptions: Firſt, in that when a Phyſician preſcribes for a Patient, he preſcribes only pro hoc & nunc, for this Man and at this time; and for doing that alone he receives his Fee. He does not ſell his Preſcription by way of alienation, ſo that it ſhould be to his Patient and to his Heirs or Aſſigns for ever; much leſs does he paſs any title over to the Apothecary, who is only employed by the Patient to make it up, and who ought to return the Bill when he is paid for it, either to the Patient, or to the Phyſi⯑cian that writ it: and if he either detain it, or tranſcribe it, in order to make uſe of it to other Patients, without the firſt Preſcribers lieve or direction, he is manifeſtly guilty of frau⯑dulently uſurping anothers Property. Secondly, a Phyſician [16]has another property in his Preſcriptions, in that no Man yb Law has a right to preſcribe but himſelf: And as I take it, there is as real a property in Practice, as in Eſtate. No Man ought to meddle in that profeſſion, that he is not brought up to, or has not a Legal admiſſion into. Not to mention the Miniſtry; this is plain in the Law, wherein no Sollicitor or Attorney, how long ſoever they have practiſed, and how well ſoever verſed in their buſineſs, can take upon them the practice of a Lawyer either in the Chamber or in Court. Preparing of Me⯑dicins is but one, and that the meaneſt and moſt mechanick part of Phyſick: this part is committed to the Apothecaries by ſuch Phyſicians as will not undergo the more ſervile and toilſome part of their Profeſſion, or through multitude of buſineſs are not at leiſure for it; but ſtill it remains inſeparable from it, and whatſoever Phyſician will, may exerciſe it. But the Apo⯑thecary, whoſe ſole Trade is to prepare Medicins according to the Diſpenſatories, or Recipe's put into his hands by Phyſicians, has no more a right to invade the adviſing and preſcribing part, than the Sollicitor or Attorney the practice of Councel learned in the Law.

But letting paſs this argument from property, I will in further Anſwer to the Objection demonſtrate, that Apothecaries are not ca⯑pable of making obſervations, nor of judging of like Caſes, and there⯑fore ought not to have the Right contended for.

Every one knows an Apothecary's Education to be, to come to the Trade from a Grammar School, where he has learned to conſtrue or to make a little Latin; 'Tis very rare that any deſigned for that employment, have any ſmattering in the Greek. Thus qualified he comes Prentice, and is preſently ſet to the Peſtil and Mortar, to run of errands, &c. And after a Year or two when he has learned to know one thing in the Shop from another, and to read a Phyſicians Bill, he begins to be employed in making up Medicins and carrying them out to Patients, and continues ſo to do till his time runs out. All this while he has neither time to read, nor can have capacity to underſtand ſuch Books as teach the Art of Phyſick: Nor can he know any thing (to any purpoſe) of the Diſeaſes for which the Medicins he car⯑ries out are adminiſtred. For any Patient would reckon it Sanci⯑neſs [17]in Boys to be inquiſitive about their Caſes, in the enquiry whereinto a Man muſt be very nice and particular, or he ſhall be never the wiſer. And during this time of his Apprenticeſhip he generally loſes the little Latin that he had when he came from School, ſaving what the Phyſicians Bills preſerve.

Well, now he is out of his time, what muſt he do but ſet up? excellently qualified for the Practice of Phyſick no doubt! Yes, there were ſuch and ſuch famous Doctors writ to his Maſter's Shop, and he ſaw all their Bills, and made many of them up and carried them out to Patients, of whom he ſaw ſome live, and ſome die; and ſo he muſt needs know ſomething of the matter! Well, to judge of that, let us conſider what the matter is, viz. The Art of Phyſick.

This Noble Art conſiſts of five parts, of which the preparing of Medicins is but the leaſt part of one.

There is I. the Phyſiologick, which treats of the Subject and the end of Phy⯑ſick, and ſo includes the Anatomy of an humane Body, and explains its con⯑ſtitution and that of all its parts, with their uſes and actions, and the faculties of the Animal Soul.

II. The Pathologick, which treats of the nature, differences and cauſes of Diſeaſes and their Symptoms, and explains every Particular wherein an humane Body departs from its natural conſtitution.

III. The Semiotick, which teaches the ſigns whereby it may be known whether a Man is well or ill, and how diſeaſes latent in the body, with their cauſes, and events, may be diſcovered: Which ſigns are commonly called Diagno⯑ſticks and Prognoſticks.

IV. The 4^th part contains the knowledge of thoſe things which are as it were the matter of health, and are uſually called Non-naturals; as Air, Meat and Drink, Affections of the mind, exerciſe and reſt, Venery, Sleep and Watch⯑ing, with Excrements and Retents: And it contains alſo the knowledge of the right uſe of theſe Non-natural things, ſo as that health may be preſerv'd thereby.

And V. the fifth part, called the Therapeutick, ſhews how loft health may be reſtored, and diſeaſes with their cauſes and Symptoms removed. And to this end 'tis neceſſary to be inſtructed, firſt in Method, whereby according to indi⯑cations one may find out due helps; and then in the matter of ſuch helps, whether contained under Diet, Surgery, or Pharmacy.

Now this very laſt thing (viz. Pharmacy) is all that an Apothecary by his education can pretend to the knowledge of: And it is but the leaſt part of this neither that he can have ſuch pretence to. For the Pharmaceutick part contains not only the preparing of Medicins, but the knowledge of the Natures and Virtues of all thoſe things that are the matter of Medicins, whe⯑ther Vegetables, Animals, or Minerals, and this knowledge he is a ſtranger to.

With what patience then can a Man animadvert upon the aſſuming confi⯑dence of theſe Men, who will ſet up for Practiſers in ſuch a difficult and myſte⯑rious Art, that underſtand not any one part of it? A man is like to make ſpecial Obſervations that neither knows the Subject affected, nor the nature nor cauſe of the Diſeaſe, nor the nature of the Medicins that cure it. And he muſt needs be a Witch at judging of like Caſes, that for the mentioned defects could never be a competent judge of any one Caſe.

The Caſe in ſhort is this: An Apothecary when he learns his Trade, is taught to know one Drug from another, can tell which will melt, and which will powder, nay may obſerve which will purge, which vomit, &c. He learns alſo to make them up into different forms according to the preſcripts of Phyſicians; and I will grant he has opportunity to obſerve, that ſome are given moſt commonly in Fevers, others in Conſumptions, others in Dropſies, &c. But will any Man conclude, that becauſe an Apothecary knows and may have obſerved theſe things, that therefore he can judge with due accurateneſs either of theſe Diſeaſes, or the Methods or Reaſons of their Cure? There is no general Remedy nor Method for any one Diſeaſe: different Medicins and different Methods muſt be made uſe of in different Subjects, tho' the Diſeaſe in the main be the ſame. And hereof no Man can be a fit Judge, but one who is well verſed in all the parts of Phyſick. And therefore if there were no Law to reſtrain Apothecaries from practiſing, their undeniabl [...] [...]gnorance ought to keep all who value their Health or Lives, from depending on their advice.

2. The other Objection that the People make, is againſt one particular thing in the preſent management of the Diſpenſaries, and is to this purpoſe: If, ſay they, the Diſpenſaries ſell Medicins ſo cheap and ſo good, why may not any body have ſuch Medicins there as they have occaſion for, without the trouble of going to one of the Subſcribers for a Note?

I anſwer, 1. that People are not competent Judges of what they ail, or what will help them; and ſo the Phyſicians are willing to prevent their doing them⯑ſelves a miſchief by taking improper things.

2. Unleſs the Subſcribers be ſtill more provok't by the Apothecaries in juries, they are very unwilling to make that of common uſe, which was purely deſign⯑ed for the relief of the Poor only. For they have no intention to injure the Apothecaries in their proper Calling, if they will keep themſelves to that, will make good Medicins, and be content with moderate gains.

But 3. the Principal reaſon is, that Medicins are given out from the Diſpen⯑ſaries by Servants, who are (generally) directed what to take for every Medi⯑cin, by him that preſcribes it. And it might be very prejudical as well to Pa⯑tients, as to the Subſcribers themſelves, if the Servants might ſell out what they pleas'd without order, and might take of the Patient what they pleas'd for it. For they would be under a great temptation to ſell things and either never bring them to account at all; or to take more of the Patient then the ſtated price, and to put the Overplus into their own Pockets. And therefore how inconvenient ſoever it may ſeem to ſuch as would be their own Doctors, not to have from the Diſpenſaries what they think would do them good, the Subſcribers can by no means, for theſe reaſons, recede from their eſtabliſh'd method in this Particular.