Imprimatur,  
Rob. Grove, R. P. Domino Episc. Lond. à Sac. Dom. Jan. 19 1669-70.   

A DISCOURSE Setting forth the UNHAPPY CONDITION OF THE PRACTICE of PHYSIC IN LONDON, And Offering Some means to put it into a better; for the Interest of Patients, no less, or rather much more, then of PHYSICIANS.  
By JONATHAN GODDARD Dr of Physic, Fellow of the College of Physicians, and of the Royal Society; and Professor of Physic in Gresham-College.  
LONDON, Printed by John Martin and James Allestry, Printers to the Royal Society. MDCLXX.   

ERRATA.  
THE Reader is entreated to take notice of these more considerable faults in printing. Page 10. Line 17. for their read other. p. 13. l. 14. for withal r. with all. p. 16. l 12. leave out him. p. 41. l. 11. for known r. unknown. p. 49. l. 11. for peculiar r. particular.   

A Discourse setting forth the unhappy Condition of the Practice of Physic in London, and offering some means to put it into a better; for the Interest of Patients, no less, or rather much more, then of Physicians.  
THE Art of Physic hath had in common with other Arts and Professions, the infelicity to be abused by the Professors thereof; who, either out of insatiable avarice to make the utmost advantage of gain to themselves thereby, or out of Pride and State, or Humour, have given just occasion to the World to judge, that they had not that care and consideration of the Lives and Healths of Persons with whom they had to do, as, in Humanity, Reason and Conscience, they ought to have had. Admitting this to be inexcusable, as to the Persons guilty of it, yet it may be said, as to the present Professors thereof, having the Legal Right to practise in the City of London; and undertaken on their behalf, that there was never in any Age, less grievance or cause of complaint upon any such account. However, that distinction between the Vices of Persons, and of Arts or Professions, is so clear and obvious, that whosoever transfers those of the one upon the other, must needs appear deficient in the use of his Reason, or else partial and injurious.  
As to the Art itself, though it cannot be denied, that it is, as all Humane Knowledge in other kinds, imperfect and defective; yet, that it should be an imposture (as ignorance in conjunction with confidence may surmise or charge upon it) the World doth so much abound with Persons learned and judicious, and (though not professed Physicians) competent to judge thereof, as to render it superfluous to go about to vindicate it from such an imputation. Neither is the imperfection and defect of knowledge in things relating to, or comprehended in the Art, so great, as to render it an empty or mere notional Speculation; but though it, as all other Arts and Sciences (the Mathematics excepted) hath too much abounded with Notions and Speculations wanting foundation in Nature and Experience; Yet it may Vie with any other for number of real Truths and Discoveries, sufficient to employ and take up the best intellectual abilities and studies of any person addicted to it, for his whole life: and especially in this Age, after great improvement lately made therein, by many happy discoveries in Nature, of great advantage and concern thereto.  
According to the grand importance of this Art, employed in the conservation of the Life and Health of Mankind, it hath been the wisdom of Princes and States, to provide for the Encouragement of the Professors thereof, by liberal Maintenance, Privileges and Powers, honorary and advantageous for the exercise thereof, whereby Persons of eminent Learning, Education and Abilities, might be induced to betake themselves to an Art standing in need of such Accomplishments; without which, in an inferior way of Education, persons could not attain to any such improved judgement, as is requisite to the understanding and comprehension of the vast variety and exquisite Subtlety of the things constituting the Subject of that Art, or relating thereto.  
Accordingly, it hath been no less the wisdom of the Princes and Parliaments of this Kingdom, to provide for the Encouragement and good Regulation of the Profession of Physic therein, especially in London: insomuch that by Law and Custom, it hath had as great advantages in the kinds beforementioned, with us, as in any Country in the World. And therefore it is the more to be taken notice of, that at this time it should be reduced, probably, to the worst condition that it is in, any where; more then probably, to such a condition as cuts off all hopes of honourable or free maintenance of the Professors thereof, or the most part of them, and of improvement in the Art itself, for the future; as may in some measure appear by what followeth.  
The dividing and separating of that part of the Art of Physic, which concerns the Preparation and Composition of Medicaments, from the body of it, so as to put the practice of it into other hands, was never heard of in the Ages of Hypocrates, Galen, and other ancient Physicians; and hath been judged by some of the chief Authors in Physic, to be of unhappy consequence to it, upon several accounts. Hence many Physicians, while there was a good understanding between them and the Apothecaries (these keeping within their own bounds) thinking it became them, in civil respect, to leave all to these, that belonged to their Art, and so not concerning themselves to be judicious and versed therein, became strangers to the Materials and Preparations of Medicines; and by consequence, less able to prescribe the making of them, to the best advantage. And this the Aporhecaries have not been wanting to make their Advantage of, to the disparagement of the Physicians: So that it is justly to be accounted an error and neglect in such Physicians; who if they had given their minds to it, might have been as conversant in, and as well acquainted with the materials of Remedies, whether Vegetables, Animals, or Minerals, and all the more considerable ways of preparations thereof, as many other Physicians, or any Apothecaries; by frequent Viewing, Inspection and Observation, and chiefly by experimenting and exercising themselves in preparations more accurate and of greater importance, Chemical, or other: which are the ways that enable a Physician authentically to prescribe.  
And yet, notwithstanding such an error and neglect of some Physicians occasioned by it, the distinct Practice and Exercise of that part by Apothecaries, as it hath been used in London, had its advantage; and was looked upon as a great ease and happiness to the Practice of Physic. For by this means Physicians were freed from some troublesome and inferior employment; and they had the advantage of giving account, and making appear, upon occasion, all that was done on their part, by their prescriptions extant in writing, in case of any ill success, (which might happen by error upon other account) or suspicion of hurt done to a Patient by any thing advised by them.  
But these are really, and upon the whole account, advantages to the Profession of Physic, only upon this supposition, that Apothecaries keep within the limits of their Work and Trade, not meddling with the Practice of Physic themselves; the Prescriptions of Physicians being faithfully and safely lodged with them, to the use of their Patients, and the benefit of the Apothecaries in their Trade. Otherwise, neither the Advantages before mentioned, nor any other, can ever compensate the disadvantage and detriment, not only to the Profession and Professors of Physic, but to the Public: in consideration whereof, it were to be accounted a small inconvenience, for Physicians to put themselves to the Drudgery of making all the Medicaments they have use of in their Practice, if need were; and to depend upon their own single reputation and credit with their Friends and Patients, for their Vindication, as the Case should require.  
In comparison to Physicians, it may easily be made out, what advantages Apothecaries taking upon them to practise, may have in London, upon their particular communication of all their Remedies, to them, to get the whole, or somuch of the Practice from the Physicians, as shall not leave a competency for them to subsist upon. For the Apothecaries being bred up all the time of their Youth as Apprentices in London, (while Physicians are studying at the Universities) and having so much the more advantage to get a numerous acquaintance (besides that by keeping open Shops, more general notice may be taken of them) when they shall be able to pretend to, and make ostentation of being Masters of, or knowing all the Secrets and Practice of all the Physicians in London; it is obvious, how much this must take with the Vulgar, and with all such persons, as being not bred up to Learning themselves, cannot be sensible of the advantage of a generous Education in all kinds of Learning, for improving the Mind and Understanding, and enabling of it to exercise such a piercing Judgement and large Comprehension of so subtle and numerous natures and things, as the knowledge whereof is requisite to the Art of Physic. And therefore though there be not so much danger of such ostentation prevailing among the Nobility, Gentry, and Persons of Learning and Parts in the City; yet how far it may, amongst others, who are the great number and bulk, is not hard to conceive by what hath been experienced.  
For, allowing a Physician, in his youth, to have had the reason, parts and ordinary capacity of another of his age; and then to have been bred up in learning of Languages, to render him Master of the Knowledge contained in Books written in those Languages; then, in Arts, some whereof minister Advantages to the understanding of the nature and causes of things; all do improve the Mind and Understanding, by Exercise at least, to discern and judge of things: then supposing him to apply his study to Natural Philosophy, such as is more real and solid in this Age, by many happy Experimental Discoveries in Nature: and lastly to the Art of Physic, and the knowledge of the Body of Man, withal the parts of it, by Anatomical Administrations, Experiments and Observations; of the Actions and Uses of the same; the Diseases to which they are obnoxious; with the Remedies thereof: and admitting a Physician to make it his continual Work, to improve in the knowledge of all these (which his interest must incline him to do) by the Study, Practice and Experience of twenty years or more: now supposing all this, in the common reason of mankind, he must have a manifold advantage to the understanding of the Nature, Cause, and Cure of a Disease, above another, whose education hath rendered him uncapable of any of the accomplishments before mentioned, or of any considerable share thereof: and yet many times it is found, that one that is illiterate and can speak no reason of any thing, but only make ostentation with a few canting terms; yea sometimes a Nurse, or such kind of Woman, by a confidence arising out of ignorance, shall arrogate more knowledge or ability to themselves, and shall be better thought of among the unlearned and incompetent to judge, than such a Physician as hath been described before: and how much more may an Apothecary, upon the pretensions before mentioned, carry a reputation with such people, above such a Physician?  
And if the Art of Physic, or one half of it, were the knowledge of Receipts or Forms of Medicines to cure Diseases, Apothecaries might have more pretence to vie with Physicians; but, to be sure, that is far the least part of it; and a manifold greater proportion of Judgement and Skill is requisite to discover the Disease, than to apply the Remedy; and without such discovery, abundant and frequent mischief may be done, even to the destruction of life, by applying Medicines in themselves safe, and (according to the vulgar term) wholesome: and not only so, but by the omission of the proper Remedies in their seasons, through the same want of judgement; which mischiefs by omissions, as well as otherwise, whoever pretends to the Practice of Physic, hath to answer for. In such cases, how can that be a sufficient plea (which passeth for currant generally) That nothing was done, but only some Cordial given, or what was very safe? (though at best nothing to the purpose) whereas in the beginning of many Diseases, while the opportunities of applying the Great Remedies, and doing to the purpose, are either only, or to the best advantage to be taken, that doing nothing but etc. is the undoing of the Patient, if loss of life be so to be accounted; there being so much difficulty and danger in many Diseases, that carry the least appearance of either, as to require the first and earliest opportunities for a Physician to act towards their Cure.  
This communication of Medicines by Physicians to Apothecaries (whereby they come to be so great Masters of Receipts) is in the plain reason and nature of the thing, a Trust, whereof they are free to make the advantage or profit that belongs to their Trade, by selling such Medicines at valuable rates, according to their costliness or elaborateness in their preparation: but the advantage of directing and prescribing their use in all cases, belongs to the Physician: and the hindering him herein, to the impairing him of his Practice, is a breach of Trust, and unworthy, as well as injurious dealing by him, as may farther appear by the following Consideration.  
All Laws of Nature and Nations, all Justice, Equity, and Reason of Mankind, do allow to every person the benefit of his own Invention; which, if it be of that Nature, that the bringing of it into use and practice, doth necessarily import the discovery of it, according to our Laws, Patents for terms of years are granted: but if an Invention be of such a nature, that it may be concealed in the use and practice, no limitation for private advantage or profit thereby, is set by Law; it is only Honesty, Ingenuity or Interest, that can restrain from making unreasonable or unconscionable advantages in such case. Now any Medicines or Receipts for Cure of Diseases, invented by Physicians, or coming to their private knowledge only; or any new use or virtue of an old known Medicine, discovered by any Physician; in relation to those Physicians by whom they have been invented or discovered (as far as they are of any consideration or value) are of this Nature, that is, Inventions that may be kept secret by them; and whereof nothing hinders them from making the advantage; the Laws of the Land (as well as in other Countries) allowing and authorising Physicians to practise their Art in all its parts and members, and so by consequence to make any Medicines, themselves. The case being thus, how unreasonable and unequal is it, that when a Physician hath by his Industry found out, or by some Felicity lighted upon a Discovery that hath proved remarkably successful in some particular disease or case; upon his communication of it to an Apothecary, he shall have only an inconsiderable matter? (not worth the owning many times) in case the Patient come or send to him; or at most an ordinary Fee in case of Visiting the Patient; whereas the Apothecary being one that takes upon him to practise, shall not only repeat the same Medicine many times over, to the same Patient, but also give into any other Patients, whose case he judges to be the same, or of affinity to it; and drive a Trade with it all his life time; and so gain (as it is well known, and hath been upon occasion, by some confessed or boasted of) by one Receipt, an hundred times as much as the Physicians Reward or Fee for prescribing it: so that he only cures the Patient once for an ordinary Fee at most, and teaches the Apothecary, when the same case occurrs, to do it ever after.  
The consequence of this to Physicians, must be the impoverishment of many; who, in regard of the charges of their Education, and the use and consequence of their Profession, deserve to get as great Estates, as are gotten in any Profession or way of Trading, and yet shall scarce be able to subsist, though as Learned and able in their Profession, as their Predecessors, who thirty or forty years ago, got great Estates, when the Apothecaries kept within their own bounds, or inconsiderably encroached upon the Physicians. For now a Physician will be of use only amongst great persons, or persons of learning and parts to value him: whereas others that are of ability enough for Estates, and would be ready to entertain him, are so amused by Apothecaries, their ostentations and pretensions before mentioned, their canting upon the common notions and terms of Humours, Fumes, Obstructions, etc. (which an empty illiterate pretender, having confidence enough, may so manage, as to make a more graceful sound, than the most solid and able Physician) that they are generally entertained in the beginning of sicknesses, and made Judges whether or no, and when any, and what Physician shall be sent for: (being accounted a check upon the Physician by such a sort of People) who for the most part, is not called, till the other is willing to go no farther, because it is not his interest, that the person should die under his Cure; and then he says it is work for a Doctor; who shall have nothing to do amongst these people but in desperate cases: whereas (as hath been hinted already) in difficult cases, the best Physician may stand in need of all advantages, especially timely opportunities to apply proper and effectual Remedies for Cure.  
And where the Apothecary hath the nomination of the Physician, it is easily judged, what one he is like to be, that is one between whom and him a design is driven of mutual furtherance, or one that he knows will comply with him, that is content to succeed him, and approve of what he hath done before; or one that is noted in general to prescribe most for the Apothecary's profit. Upon such accounts some Physicians are cried up, and others decried (if not traduced) of no less, or of much more and longer approved ability, worth, and honesty. To be sure no Physician taken notice of to have and give any Medicine of his own preparation, shall be called in, if the Apothecary can hinder it. Persons may if they please be undeceived upon this account, and understand how little reason they have, and how little it may be their interest to be ruled by Apothecaries in their choice of Physicians.  
And if Patients understood their interest, they would take no such satisfaction, as they seem to do, in the Visits of Apothecaries; but rather wish them in their Shops to make, or oversee the making of their Medicines prescribed by Physicians, which are left to their Servants, many times raw and slovenly Apprentices, while the Masters spend their time abroad, Physician-like, in Visiting.  
Another consequence must be utter discouragement to study, or endeavour after, or to make use of, by prescribing to Apothecaries, any more excellent or effectual Medicaments; since the advantage will be so inconsiderable to the Physicians themselves, in comparison of what it may be to others, who have so little right thereto, and deserve so little from them. So that all encouragement to, and hope of improvement of the Art itself, by the present Physicians is cut off: and for a succession, if the present state and condition of the Profession continue, how can it reasonably be expected or supposed, that persons of considerable learning parts, or abilities, will ever apply themselves to the study of Physic? and what the consequence of all may be to the Public, is submitted to their estimation, who are most competent to judge of the great concerns thereof.  
The profession of Physic being under so hard a condition, and not to be exercised in the ordinary way, but upon the disadvantages before set forth; the Remedies of the same, and the means to reduce it to a better state, must needs deserve serious consideration, being of importance, not only to the Physicians, but also to the Public good and safety, as the lives and healths of persons are considerable thereto. These may be several and of different kinds; some relating to the higher Powers, as provision of good Laws in this behalf, etc. And indeed in this Kingdom, the Wisdom of Princes and Parliaments hath not been wanting, in providing for the Regulation of the Profession; according to which, no person not legally authorized, can practise without breaking the Laws in that behalf, or incurring the penalties of them; which, according to the times wherein they were set, were very high; but in these times, they are easier to be born, rendering the adventure so much less, which is a great imboldening of persons having no legal right to practise, to run the hazard of those Penalties: besides, the difficulty of Discovery and Proof, the tediousness in Processes, and prosecution of the advantages by those Laws against Delinquents, not without uncertainty in the issue, as in other cases never so just, do much more encourage such persons; till there may come a time and opportunity for supplying any defects in the Laws already made.  
But if there be any advantage in the power of Physicians themselves, which they may lawfully, honestly, and fairly make use of, to put themselves into a better condition for the exercise of their profession, it may be of good consequence to consider thereof. Since all Law, Equity, and Reason allows them as well as others (as was touched before) to make advantage of their own Inventions, and since they are of such nature, as they may keep them secret to themselves, in the use and practice of them, they being not bound to discover them to Apothecaries or any others, but free to prepare them themselves, as hath been made appear: whether may not this Course set upon, though attended with some trouble and inconvenience, be an effectual means, at least in reasonable time, very considerably to advantage and better the condition of Physicians in their Practice?  
In this undertaking it is not at all necessary, that any Physician should be put to the drudgery or trouble of making, or overseeing the making of every Medicine, that he may have occasion to use; or to have a Magazine furnished with all common things, as Distilled Waters, Syrups, Conserves, etc. for the Practice of Physic, may easily by able and judicious Physicians be managed with the tenth part of the things commonly in use, and the Remedies reduced accordingly, and this reduction so far from being a detriment, that it may be a great improvement of the Art.  
The College of Physicians of London, in compiling their Dispensatory, following the Example of other Societies of Physicians abroad, have set down the ancient Forms and Compositions of Galen and the old Greek Physicians, of Mesue and the Arabians, with some other of later Authors; in consideration of the reverence due to the antiquity of some, with the approved use and experience of all. And it may vie with any public Dispensatories in Foreign parts, as to choice and usefulness of the Prescriptions it contains, being as little redundant in Superfluities, and deficient in Necessaries, as they: but it was never intended or pretended that it should contain all Medicines necessary to Practice, or the best of them; and therefore the Invention and Use of others was ever allowed to able Physicians; considering withal, at what uncertainty the Translators and Interpreters of those Authors, especially of the Arabians, are concerning some words and the Ingredients thereby signified; and at what disadvantage we must have and use the Medicaments produced in their Countries, upon transportation so far, or production in colder Climates; all which must render those Compositions less certain and efficacious: wherefore they did not think themselves concerned to make that Book so much their own, as that there might be no impertinencies, irrational prescriptions, or (perhaps) errors therein: whence it is no wonder, that such a foul- mouthed impudent scribbler as the Translator of it (for want of better employment to relieve him in his necessitous condition) should take occasion to make such work as he hath done about it; and the more, through his ignorance and confidence, calumniating falsely in divers particulars.  
This being the condition of that Book, the Physicians of the College have no such cause as the common People may think, to envy them the Translation of it; nor have they any such Treasure of it, as they may suppose themselves: nor is it the translating of all Physick-Books extant into the Vulgar Language, that will edify much, or enable Persons of other employments to be their own Physicians (whatever may be thought otherwise) or the reading of them in their own Language by Apothecaries, who have Latin enough so to do, that will make them Physicians, since there are innumerable particular Cases, that fall out every day, requiring answerable remedies, to be discovered and made out upon an Habit, and Principles, enabling to Judge and Discern, not to be found in Book-cases, all which put together do not reach or comprise them. And the Dispensatory before mentioned, or any other, is far short of prescribing Remedies for them all. And as to the Forms or Receipts of which it is made up; it was never judged otherwise by able Physicians, but that there are in them many Ingredients impertinent, and some contrary to the main intentions for which they are in use: besides irrational proportions and quantities, though upon the whole, they have been Successful; and that such Physicians are far from being tied to them in their Practice, as being able to invent better, more easy to be prepared, more grateful and convenient for use. For a multitude of Ingredients (wherein many of those ancient Receipts are luxuriant, upon a design to bring in every good thing into our Medicine is so far from bringing a Comparison, that it is, at the best and for the most part, an Alloy to it, and renders it less effectual; whereas a judicious choice of a few ingredients, is the greatest advantage to the virtue and use of it.  
Whoever with judgement peruseth the London Dispensatory, may soon estimate, to what an Epitome it may be reduced, how many Compositions may be spared, how many Ingredients, almost in every Composition: and whoever with the like judgement considers and casts up the main Intentions and Indications that occur in Practice, it will not be hard for him to state the Remedies adequate and proper to such intentions as are of greatest importance; and by consequence to be stored with Preparations and Compositions ready made of the choicest materials, to the best advantage for Use and Practice, more grateful and effectual, and every way more considerable than the Shop-Medicines; as Purges, Cordials, Antidotes, etc. which by judgement and Chemical Art, as the case may require, may be so prepared as to last long without impairing the virtue by keeping, and therefore to be always ready; to be of such form as is convenient to be given, either alone, or with some Vehicle, which may easily be had, or prepared by the Patient, or any about him.  
And if Patients knew all, they would not be best satisfied in the greatest number and variety of the Medicines administered, & the most frequent plying of them therewith: for this may be (as was hinted before) of design in some Physicians, to render themselves the more acceptable to Apothecaries in general, as using to prescribe much Physic; or upon some combination between the Physician and Apothecary mutually to advantage each other; or an intention in the Physician to oblige some Apothecary in hope of some answerable return: as on the contrary it hath been the complaint of the Apothecary sometimes, that the Physician, of ill will, hath prescribed little, and chargeable things; both which are great disadvantages to their Bills: whereas when they are made up of numerous particulars of things less chargeable, how much soever is gained thereby, they appear more reasonable to the Patients. Now though in some cases, there may be need of more Medicaments, in greater variety and more frequently plied: yet in most other cases, a rational and judicious choice of one, or a very few Medicines, may signify much more to the good of the Patient, than a luxuriant variety.  
And it will not be hard for a Physician, making use only of a Servant or Servants (who shall be no ways capable of discovering his Secrets, but only fit to kindle Fires, tend a Still or Furnace, beat at a Mortar, etc.) to oversee and with his own hands prepare and compound what is necessary for himself to do; and by this means, though he be in full Practice, at the expense of a few spare hours, to store himself sufficiently for all his occasions, of such great Remedies and Secrets of importance: and for other Medicines of less value and consequence, they may be had at the Apothecaries, or taught the Patients or those about them (as was said of Vehicles) without any considerable prejudice to the Practice of Physic. To be sure, it were far better to teach Patients any Medicines, then practising Apothecaries; for those, if they have any ingenuity, will be sensible of the benefit, and at most, but use it again for themselves, some friend, or the poor for charity; whereas these will not only use it toties quoties to the same Patient, but make a trade of it to all others, whom they have to do with, and judge in the like condition.  
Nor can it be any dishonour to a Physician, thus to employ himself between while, in the making of such choice and important Medicines; as it is upon record and clearly appears, that Hypocrates and his Sons, Galen, and other ancient Physicians, did the like: nor is there the least appearance that they had any Apothecaries, or ever wrote Bills to any. And to be sure, in our times, we see, how worthy Ladies and Gentlewomen of quality, do employ themselves in making Confections, and Medicines internal and external: and it is known, what Countesses and great persons of both Sexes have done the like; (whence some Medicines have their names) to none of which it was ever reputed a dishonour: and how then can it be to Physicians? whose employment in this kind need not be more troublesome or laborious, and in respect of the near relation of it to their Profession, must be to the greater advantage, and more general concernment of the life and health of mankind.  
If it be thought, that this Expedient of Physicians making their own Medicaments, comes now too late for the securing of the Practice of Physic to themselves; the Apothecaries being already so stocked with innumerable Receipts for all Cases, upon the communication of the Practice of Physicians for so many years, or some Ages, that they need no more: It is to be considered what great variety of new Cases do daily emerge, what Diseases, and new faces and conditions of Diseases, every year almost produceth, not to be found described in all Physic Books extant; for which they may not have one proper Receipt in all their store, or if there be any such, it may be long enough before they find it: nor is there any other way but by Principles and Habit of judging and discerning in a Physician to come to the knowledge of such Diseases and Cases, their Nature, Causes, and Cure; so that, without father communication to Apothecaries, they must come to be at a loss, for all their great stock and store of old Receipts.  
And it is farther to be considered, that the consequence of Physicians exercising themselves in the preparation of Medicines will be the Invention of such as shall be more effectual, pleasant and convenient for use than the Shop-Medicines, and shall among those that have experienced them, beget a nauseating of and aversation to the other, and beat them quite out of use or esteem.  
And considering how Apothecaries may and do censure the whole Practice of some Physicians, and of those in the fullest employment, to be upon a few ordinary or inconsiderable Prescriptions; and pretend their own to be upon rare Secrets or choice Prescriptions of some most eminent ancient Physicians, and such as have proved most successful: it is high time for Physicians to go out of the road, and do something extraordinary to secure themselves from such imputation.  
If upon the consideration of the great variety of Diseases and Cases, it be questioned how a Physician will be able to apply proper Remedies, out of a few choice and effectual Medicaments of his own preparation; it is answered, by Composition, and by addition of others, in some cases, though of less importance of themselves (easily to be directed to Apothecaries, or any about the Patient, if the Physicians do it not himself) sufficient variety of Medicaments, accommodated to the particular Diseases and Cases, may be produced; as we see what infinite variety of articulate Sounds are, by various compounding or placing the twenty four Letters of the Alphabet. And to be sure one may be at a greater loss, by confusion amongst a multitude of superfluous, impertinent, luxuriant and inconsiderable Medicaments, than amongst a small number of Choice and Effectual ones: with which a small Closet furnished, may afford more to answer all Intentions, than many of the greatest shops of Apothecaries, as they stand now furnished, put together; and may better enable Physicians to make good that Distich, Et quoniam variant Morbi, variabimus Artes; Mille mali species, mille salutis erunt. Besides the securing of the Practice of Physic to Physicians, and the preventing its falling into other hands, which is a more necessary advantage; there is another of happy consequence and more honourable, which, by this course of Physicians making their own Medicaments, may be attained; that is, a great improvement in the Art itself, hinted before. For when judicious Physicians come to be more familiarly acquainted with the materials of Medicaments, and also to experiment and observe Operations and Processes upon them; especially the more Accurate and Artificial, as in Chemical Preparations; they will discover the most advantageous ways of Preparation, and the most rational proportions in order to Composition; and come to contrive and invent new Medicaments, exceeding others in their kinds, and improve, beyond what they can imagine of themselves, before they have entered this way, and what they can ever otherwise attain; as some learned and ingenious Physicians have done. Nor can it be denied, that in this course, some Empirics have stumbled upon very considerable and effectual Medicaments, wherewith in some particular cases, they have outdone learned Physicians: and by the advantage of making their own Medicaments, they bear up, and will do, till they be outdone in the same kind by such Physicians.  
Nor hath a Physician any way of vying upon equal terms, with an Empirick, but by giving his own Medicines, as well as he; and by concealment, securing them from Censure or Undervaluing, as the other doth: and much less can he vie with a practising Apothecary, when called in to a Case, after he hath undertaken and administered according to his skill: for in this case, it is not his interest, that a Physician should have better success than himself: and therefore, how faithfully and accurately the Physician's Prescriptions will be prepared, may be a doubt: but to be sure, nothing is more obvious, than for the Apothecary to undervalue them, and to say, that the same, as good, or better have been given already; which suggestions, how false soever, cannot but raise a diffidence or prejudice in the Patient to disadvantage of the success.  
There is one farther advantage of great importance, by the Physician's giving his own Preparations; that is, the certainty he shall be at in all his Medicaments, as to their efficacy, strength and operation; much beyond what can be in the way of writing Bills to Apothecaries. It is sufficiently known, and most frequently experienced, that, let a Physician write the same Bill to several Shops, the Medicine shall be very different in the sensible qualities, scent, taste, colour, strength, pleasantness, etc. according to the goodness of the Ingredients, or the cleanly and accurate making; which may cause great difference, and in reason cannot but cause some in the Operation, while in the mean time the Physician must answer for all, and all reflects upon him: whereas a Physician using always the same Preparation or Composition, will be at a certainty of the effect, on the part of the Medicine; and any difference must be, in the disposition of the body on which it operates.  
But how can it be honourable for a Physician to sell Medicaments, may be a question: to which may be answered, that for a Physician to drive such a trade for its own sake, or merely for profit that might accrue to him thereby, could not be of credit; but in order to so necessary an end, as the securing of his Practice, and the benefit of his own Industry to himself; and to so good an end as the improvement of his Art to the benefit of others, it can be no more dishonourable to him to sell Physic, than to persons of Honour, and great Estates to sell their Corn, cattle, Wool; or foreign Princes their Wines. But another question may hereupon arise, how it may appear to satisfaction, that he deals reasonably and honestly in the prices and rates of his Medicines; it may be answered, that in the ordinary dealing of Apothecaries with their Customers (whom they call their Patients, but very improperly, except when they take upon them to be their Physicians) by their Bills and the names of the particulars therein, it doth not at all appear, how reasonable their rates are; all the satisfaction is in the good opinion of their honesty, and in their assertions and protestations concerning the reasonableness of their prices; which indeed are arbitrary, and can hardly be other, because of the endless variety of Medicines prescribed, not being of the cognisance of others (except Physicians and Apothecaries, upon perusal of the Receipts) as are the Wares and Commodities wherein other Tradesmen deal. And if Physicians have the happiness to be thought honest men, amongst their Friends and Patients, they may give them as good satisfaction concerning their usage of them in this kind.  
To be sure, the Apothecaries, upon this account, that the Medicines prepared and vended by them, are not of the cognisance of the Patients, or, however, are concealed from them, may make several advantages to themselves, not only of unreasonable profit to the burdening of the Patient, but also of undue reputation among the injudicious, to the injury of the Physician. That they may set unreasonable rates on their Medicines is obvious to conceive, and that they have done, is not unknown, upon discovery whereof, they justify all, by alleging their expense of time, and attendance; and this clearly infers, that they may in effect, by such means arbitrarily set unreasonable value upon their time and attendance, and such as may amount to more than the Physicians fees come to, all put together, when he hath been entertained and daily attended from the beginning of the Disease to the end: and if, when by occasion of Complaints of Patients to Physicians, notice hath been taken of such prices set upon some Medicines prescribed by them (requiring no great time or trouble to prepare) as may make the Apothecary a gainer at the rate of ninety in the hundred; with as good reason when they are sole Physicians, may they set yet higher prices on their Medicines, in consideration of their advice into the bargain, if they be not allowed distinctly for it. Whence it is the less wonder, how so many young Apothecaries as set up anew, and open Shops in every corner almost of the City, should subsist: for it requires no great sum to purchase fine painted and gilded Pots, Boxes, & Glasses; and a little stock is improveable to a manifold proportion of what it is capable of in other Trades. And it is as little wonder, if many Apothecaries in any considerable time grow rich; and more great Estates be gotten among them, in proportion to their number, than among Physicians (upon such advantages beyond them, and encroachments upon their rights) contrary to what was ever known of old.  
And they may take upon them to censure or pretend against the prescriptions of Physicians (as it is easy to carp or find fault with what is most perfect or innocent, and most obvious, out of ignorance or self-conceit so to do) and by this means puzzle and dissatisfie the injudicious (while no opportunity is afforded to the Physician to give satisfaction, or vindicate himself) and by raising prejudice, hinder the good effect of the Medicine, or divert the Patient from the use of it.  
And they may (and whether they have done so, is not known) vary from the prescription of the Physician, to impose upon him; and so, if the Medicine have a good success, they can tell the Patient, that it was not as the Physician prescribed it, but as they have altered it for the better, knowing his constitution, etc. or in plain English, none of his, but theirs; if it prove not successful, they can be silent; and by this means arrogate to themselves all good successes, and leave the other to rest upon the Physician, which latter, by such a practice they may be the Authors of: so that at this rate, all the reputation and success of the Physician may be in their power and at their mercy. Such most injurious and intolerable abuses, there is reason to expect from practifing Apothecaries, who are Emulators of Physicians, and indeed no better than Enemies unto and a Party against them; as some sufficiently discovered themselves in public when time served, by their vilifying and disparaging the Physicians before a Committee of the House of Commons. Now how much it concerns Physicians, and what reason they have to take any course, rather than so to be imposed upon by them, let the World judge.  
They that can vary from the Physicians prescript upon such an account, may with less dishonesty do it for saving, by leaving out in whole or in part, some chargeable Ingredients, which in many Compositions cannot be miss to sense, though in reason they cannot be abated, pretending, if it be discovered, that the Medicines may be more proper for the Patient, without them. And as to the goodness of their Drugs (on which the due estimation of their Rates depends) which doth no more appear to others, than the unreasonableness of the Rates, they may (whether they do or not) put off such as are defective, decayed, impure, etc. and in such respect, of little value: for, as hath been said, all failure of success, or ill success, is imputed to the Physician, whence it clearly may be inferred, how much better satisfaction and security against defectiveness in Medicaments, there may be in dealing with the Physician, than the Apothecary; since the perfection of any Medicine, is of such concernment to the success, which is the great interest of the Physician (and the more, while he acts alone) unless he be supposed so wicked, as to be corrupted to do mischief to the Patient: and in such case the Apothecary being corrupted, not only when he practiseth himself, but when employed under a Physician, by adding to, or altering what is prescribed, or giving one thing for another, may easily do the like mischief, undiscovered, with the great advantage of imputation to, or reflection upon the Physician.  
For it often falls out in Practice, that Medicaments in themselves safe and gentle, have rough and violent operations upon the body, meeting with some cause thereof within; and much more may stronger and churlish Physic have the like, which a Physician may sometimes be necessitated to prescribe, except he will merely trifle with the Patient and let him die: now a little alteration of such a Medicine by the Apothecary may be the death of a Patient; wherein he cannot be detected, and therefore it must rest upon the Physician.  
For avoiding suspicion, where the Physician may gain by the death of a Patient, as of a Parent, Wife, or Relation to whom he may be Heir, or any other by whose death some apparent advantage may accrue to him, it hath been the prudence of Physicians to decline acting alone, though no jealousy or caution on the part of the Patient hath given occasion thereof: and by this course it is in the power of Physicians to secure themselves from the suspicion, and of Patients, from the practice of any such wicked design against them, whereby those may become accessary to their death. In other cases, upon consideration it may clearly appear how much more the life and recovery of a Patient is the interest of a Physician, than of an Apothecary who only prepares the Physic for the Patient by the Physician's prescription. The Apothecary may lose a Customer and Friend, by whom in time to come he might have made good advantage; the Physician answerably may lose a Patient and Friend, who, in reason, might have been at least as beneficial to him. But this may be the least part of his loss, for, besides this consideration, upon the death of a person, especially of note, esteem, or interest in the world, all near relations, friends, and dependants take notice of, or are inquisitive after the Physician, and (though he be of eminent general repute, yet except he have the happiness to be well thought of among them, or the advantage to give them a satisfactory account) are ready to suspect some want of ability or judgement in him to discern the Disease or apply proper Remedies, or some want of care, consideration, or diligence requisite to the case; and thereupon to censure either the doing, or the omission of something as dangerous or fatal. Hereupon they have an aversation unto, or prejudice against that Physician for the future, so as to be inclined to make use of any other rather than of him; which consequence upon the death of a Patient may much more impair the Physicians practice, than all he can be supposed to lose by such a particular Patient. Now there is no such consideration or suspicion concerning the Apothecary (except any thing notorious be discovered against the goodness of his Medicines) whence it is seen amongst passionately affectionate persons, upon the loss of Children, near Relations, or dear Friends, that they are averse to the sight of the Physician that took care of them (though there hath not been the least ground or cause in reason so to be) and yet the Apothecary is in as good esteem with them as ever. Hence it is rational to infer, that whoever engageth a Physician in an action so much against his interest, as the being instrumental to procure the death of any person, must bid very high for it: and since his opportunity is only while persons are sick or taking Physic; and since it is so feasible towards persons in sickness or health, by the ways and artifices of Poison to dispatch them (wherein others are more versed than the Physicians of England were ever known to be, and which are usually managed and dispensed in Diet, toward which a Cook, Butler, other Servants, or any that may be frequently about the person, have more opportunity than a Physician, and in reason may be corrupted at easier rates) it may be presumed a Physician will not be made use of to such a purpose; according as there is little extant in History, and little reported of Physicians employed in such work, which others may so easily do, and have so frequently done.  
As to the Rates of Medicines, if the Physicians did to all Patients, that do not undervalue them in their fees (though giving but according to the ordinary and accustomed rates time out of mind in England) give all the Medicines of their own preparation they should need to use; the condition of the Profession must be better, than by communicating to Apothecaries to give them such advantages against themselves as have been set forth: whence it is clear to infer, at how much cheaper rates a Physician may afford Medicaments, than an Apothecary; and therefore in all reason, supposing them to be men of honesty, or understanding their own interest, they will do so. And no doubt the event will show it, upon dealing with Physicians that take this course, when the difference shall appear, by comparing the charges, upon entertaining such a Physician alone, with what hath been usual, upon making use of a Physician and Apothecary both together, in like cases; or upon making use of an Apothecary alone, whereby many cannot but think that great matters must be saved; whereas if the Medicines brought in by him amount to ten shillings, he may get little short of a Physicians fee; but how much they multiply, and ply the Patient with Medicines, in such cases, is ordinarily seen; and a Physician that hath no end in favour of the Apothecary, may do the work with that which amounts to far the least part of what is usually obtruded in such cases; and though he receive some fees, yet may be less chargeable to the Patient, than an Apothecary entertained, as well as more satisfactory all such as allow more ability to a Physician in his profession, than to an Apothecary.  
It may be an objection against the course of Physicians preparing Medicines for their own peculiar use, that it will cut off all free communication between Physicians, and render Consultations insignificant. To this may be answered, that those Physicians engaged in this work, between whom there was a good understanding and a free communication formerly, may as freely communicate upon their peculiar preparations; or at least such account of them may be given, as shall be sufficient for judgement, whether they be proper in the peculiar case before them, or not. But it is not to be expected that all the considerable Physicians should engage in this Course, some being in full practice in combination or conjunction with Apothecaries, from whom it is not to be expected they should trouble themselves about preparing Medicines; and some depending upon Apothecaries to bring them into notice and acquaintance; who must therefore comply with them not only in writing Bills to their best advantage, but also, as occasion serves, enter on their leave of Practice, and perhaps consult with them. In such cases indeed it is not reasonable to expect that any Physician should communicate a peculiar preparation of his own to another, that can make no use of it but by divulging it to an Apothecary. But as to consultation it may be said, that any such Physicians meeting may proceed upon the Shop-Medicines to as good advantage as formerly; neither is any Physician that prepares his own Medicines the less able (to be sure) to write Bills to Apothecaries, but rather the more, in that respect, as far as he is free thereto.  
There remains one grand Objection, that this course of Physicians making their own Medicines, must ruin the Apothecaries, who are numerous, and a Company of the City of London, incorporated by Charter: to this it may be answered, that the Apothecaries are become so numerous in the City of London, very probably, upon encouragement by the advantages taken against Physicians, to practise themselves; and against Patients or Customers to set as high prices as they please: and it is easily granted, that without such courses a great part of them cannot subsist: whereas it may be said of all the Physicians in London, having any legal right to practise; that they might live well on their Practice, in the old course of writing Bills to Apothecaries, were it not for the practising Apothecaries and other Empirics: However, the numerousness of Apothecaries, doth not justify illegal and injurious advantages taken against Physicians, (no more than the numerousness of necessitous persons doth their indirect and unwarrantable courses of living) during which the present course of writing all in Bills to Apothecaries, must ruin the Physicians, whose Education doth cost a good Estate or Stock, and a great part of the time of their lives, before they can arrive to get any thing; and who in London are a Society incorporated by Charter, having that Charter and other Privileges established by Acts of Parliament, as the Authority or Privilege of them and others to practise elsewhere depends upon the Charters and Privileges of the Universities, which are also established by Acts of Parliament: so that for a legal Establishment, the Apothecaries can no ways vie with the Physicians. And as to the merits of the Cause, and Equity, let it be considered, that the Physicians did part with, and freely allow one part of their Profession to be exercised by others, yet never quitting the right of exercising that also themselves; whence, as elsewhere, so in England, it hath been always free (and the Law expressly allows it, and there is an express Reserve in the Apothecary's Charter to that effect) for Physicians to exercise their Art in all its parts: that upon this, advantage is taken by Apothecaries to invade the whole, by giving advice as well as making and selling Medicines; and so by consequence, if the Physicians should not resume the other, they themselves must be ruined, upon the abuses and advantages taken against them before set forth: and it will soon appear, whether it be not more equal, that the Physicians should preserve themselves by recovery of their own, than the other by invading theirs, and getting all from them; to which the former have all the right, and the latter none at all.  
But supposing such a course universally taken up, of Physicians making their own Medicines of importance, for their use in Practice; a ruining of Apothecaries would not necessarily follow; they would yet practise upon the meaner sort, and perhaps many others, whom for want of judgement, they would by their canting and ostentation, and by raising prejudice against Physicians, draw into a better opinion of themselves; beside the trade of their Shops: but because such Practice of theirs must be gained by false suggestions upon the ignorance and credulity of the people, and is illegal, and may do more mischief than good in the Kingdom; this answer is not to be accounted satisfactory, therefore, it is to be taken notice of, that though the making of all Medicines for his own use in his Practice do of right belong to a Physician; yet no such thing hath been here absolutely propounded or intended; but only of some choice ones of great importance and efficacy, and so many as may secure the Practice of Physic to the Physicians, which may be far the least part of what there will be occasion to use in the whole practice of a Physician: and so (besides the sale of Shop-Medicines not only by retail, but wholesale, whereby it is known many have gotten great Estates, without dispensing Physicians Bills) all other Medicines directed by Physicians may be had of Apothecaries; who according as they approve themselves fair and faithful to Physicians, will have the more furtherance in this kind from them. For what was said before of teaching Medicines and Vehicles to Patients, was intended to show, how a Physician, if he were put to it, might go through in a Cure, without an Apothecary, notwithstanding which, it is free for him to prescribe all such Medicines to any Apothecary that he is satisfied in. And it is far from the intention hereof to brand all Apothecaries; many of whom are allowed to be honest and conscientious, as well as eminently able and skilful in their profession, and such as may be trusted by Physicians, any of whom, as they appear to be such, for all that hath been said, may have as much to do in their own proper Work and Trade as formerly, or within a small proportion, while Physicians engage no farther in giving any thing of their own preparation, than the practice of Apothecaries hath necessitated them unto. And even as to those Medicaments to be prepared by Physicians, they also may be lodged with such Apothecaries, to be used by the Physician's prescription, or allowance, and not otherwise (for preventing mis-application by such as are ignorant of them, and ill success or fail of success thereupon, to the detriment of the Patients, and undue defamation of the Medicines) and vended at such rates, as may make him a saver (which ought to satisfy him since Concealment in his design) and the Apothecary a reasonable gainer, and yet not be burdensome to the Patient: by which means, when there is a good understanding between the Physician and the Apothecary, and no cause or provocation given, there need be no notice taken to the Patient of any such Medicine of the Physician's preparation administered, but all things may be supposed prepared by the Apothecary. And this Transaction between such Physicians and Apothecaries as shall agree upon it, will bring this whole affair into as good a condition for the benefit of the latter, as to their own Work and Trade, as ever it was heretofore when they kept within their own bounds, and as of right it ought to be: and therefore should seem very desirable and readily to be embraced by them, for avoiding greater inconveniences and disadvantages, which by transcending their bounds, and undertaking above their capacities, while they injuriously invade the rights of the Physicians, they may most justly bring upon themselves.   

A Postscript.  
THIS Discourse was written above five years since, not in any haste to be made public, but to give vent to and discharge the mind of the Author, of some working thoughts, wherewith it was frequently occupied, by occasion of what he had long observed, and could not but take notice of, tending to the ruin of the Profession of Physic, by the Practice and designs of the Apothecaries, if they should hold on the course they have used these many years, and nothing should be done to undeceive the world concerning them and their actings to the disadvantage of Physicians. It was some satisfaction of mind to make out in any rational deduction and coherence of things, what had so much exercised and taken up his thoughts, though it were but to lie by, or be communicated to private Friends at most: and there being at first little thought or inclination to publish what was so conceived in writing, the Plague and the Fire did successively for a long time after divert from any such thoughts. If an account be demanded, why this Discourse comes forth in public at this time; there shall no necessity of it be pleaded, as the manner is with some Authors to make the World believe them upon some account or other necessitated to publish their works: neither shall importunity of Friends be insisted upon, though something in that kind might be alleged. And, if the Author may be believed, it was no design of private advantage by gaining profit or credit, that induced him to the publishing hereof. They have been far different ways (and especially compliance with Apothecaries) that have been in use hitherto, to improve a Physician's practice: and therefore this, in reason, may be a course to ruin it; except he be one that hath the advantage of some reputation for approved ability and honesty, attended with some considerable success. All that the Author allegeth for this publication, is, that the causes exciting and provoking him to exercise his thoughts this way, and to put the same in writing, continuing and increasing (that is the invasion of the Practice of Physic by Apothecaries, and their actings to the prejudice of Physicians) begat a presumption in his weak judgement, that such a Discourse as this might do some right to the Profession of Physic, & might give occasion to Physicians of acting somewhat towards the securing of it from utter ruin (especially while it might be coincident with the honour of the Art) by improvement of that part which concerns the preparation of Medicines; without prostituting or exposing what they may attain thereby, to those that have no right to make such advantage thereof, as hitherto they have done against Physicians, upon their communications to them on the behalf of Patients. Another presumption was, that it might undeceive the people in reference to the supposed advantages of good received, or charges saved, by making use of such Apothecaries in place of Physicians, as take upon them to practise Physic.  
It hath been far from the intention of the Discourse to hinder Apothecaries, much less to ruin them (if that were possible) in the Trade that they have any right to exercise, that is the making and sale of Medicines; or to advantage the Practice of Physic, by the sale of any, of the Physicians own preparation: but (according to what was before expressed) to give occasion to Physicians to consider how much it concerns them in this age to endeavour the invention of better than the Shop-Medicines (toword which their own exercise and experience in the preparation will give great advantage and reserve them to themselves, that they may have something more than any Apothecaries can pretend to be Masters of, in order to improve the Art, as well as secure the practice to themselves; which by this means it is both lawful and fair for them to do. And though it be free for them to be so furnished as to be able to go through with any Cure without employing an Apothecary (as the Apothecaries do, without Physicians) yet this is not insisted upon, except in case of just provocation or necessitating thereto: otherwise, the hindrance of the Apothecaries in the Trade that of right belongs unto them, may be inconsiderable or in a small proportion, according to what is offered in the conclusion of the precedent Discourse; and that it should be any at all, is but what they have deservedly brought upon themselves.  
As to Empirics swarming so numerously in the City of London, and all parts of the Kingdom, it hath not been the work of the Discourse to animadvert upon them; because though many of them may be less fit to be tolerated in the practice of Physic than some Apothecaries, yet their practice is more obvious to public notice, and they having no such relation to Physicians as Apothecaries have, are in no such capacity of betraying any trust committed unto them by Physicians (which the communication of their practice to Apothecaries, in the nature of it, is) or of fight against Physicians with their own weapons.  
In the Discourse there hath been no affectation of style or language, only an endeavour after expressions adequate to the things intended: neither hath there been any strict observation of method; whence some things or passages, in effect the same, are more than once, upon several occasions, brought in; but all in this kind amounts not to so much, as to carry an appearance of a designed enlargement. If the main intention thereof prove grounded, and of any good importance to be publicly taken notice of; the defects or faults are presumed not to be more or greater than a candid Reader, may connive at, or pardon.  
FINIS.