A farther ACCOUNT OF THE DISPENSARIES AT THE College of Physicians, and in St. Martin's Lane, Westminster, and others to be Erected in and about London, for the Service of the Public.  
Les Apoticairs d' Angleterre sont une grande company  
des Coupeurs des Bourses, & les Medicins les y aident.  Guy Patin. Med. Prof. Reg. Paris. Lett. 410. 
THE value of Health, which is Universally acknowledged to be a Blessing, is yet more intrinsically known to those, that have laboured under Sickness, who all unanimously confess the great usefulness of Physic, Skilfully Directed, and faithfully Administered.  
Yet notwithstanding the general agreement about the usefulness of that Art, it has of late Years fallen in our Nation (where perhaps it has been carried the farthest towards Perfection of any part in the World) under a sort of neglect, next to Contempt, to the great hindrance of the improvement of the Art itself, discouragement of its true Professors, and the general injury of the People.  
The causes of this decay, tho' in themselves obvious enough, are yet generally unheeded. Because the Persons most immediately concerned, (I mean the Sick) having scarce any understanding of the Art, are usually misled by implicit Faith in the confident, false pretensions of some, or the officious recommendation of others, who act with a different view from that, which they are supposed to have by the sick Person, who seldom trusts his own Judgement, or consults his own Reason in that, which most nearly concerns his Life.  
Thus are the Sick abused, by the self interested recommendation of the Apothecaries, who have ingross'd to themselves the sole Administration of Physic, and for the most part the Direction of it, both which were anciently lodged in the Physician alone, tho' since unhappily separated to the discredit of the Art, the injury of the Physicians, and the irreparable damage of their Patients, as will appear.  
While the Medicines in use here were but few, the providing and selling of 'em was a part of the Grocer's Trade, and Business. But Medicines in time multiplying considerably, they were thought to require the whole Care, and Attendance of him that dealt in 'em, that they might be faithfully made up, and carefully delivered in just Weight and Measure, as prescribed by the Physician.  
Thus were the Apothecary's separated from the Grocers, that they might give their whole attendance in their Shops on the making, and dispensing Medicines, carefully and faithfully; which reason holds much more strongly, at this day upon the account of the vast increase of the Galencial Compositions, the Invention or Introduction here, of the numerous Tribe of Chemical Preparations, the daily familiar Custom of the Physicians, to order Extemporary Compound Medicines, a mistake in any of which may, and does often prove fatal to the Patient.  
Since this separation, they have multiplied so excessively, that at the time of obtaining their Charter they were 114, a prodigious number in respect of what most well regulated Cities abroad find sufficient, divers of which (as big as London was at that time) do to this day restrain 'em to a Number, not exceeding Four or Six. But at present they are increased to near 1000, all Partners computed, who, tho' joined in a Shop, have Families to maintain severally.  
This overswarm of Apothecaries, not having whereupon to subsist at Home, by degrees, and in process of time over-ran their Neighbours. For the honest profits of their Employment being too narrow to Support such Numbers in their present way of Living, they have of a long time endeavoured by all manner of Artifices to encroach upon the Physicians, and exact upon the Sick, their Customers.  
In order to which they began first by Officious Visits, under pretence of carrying the Medicines themselves, to procure the reputation of careful Men, tho' in so doing they changed Offices with their Boys, and left them at Home to do the Duty of the Master, while themselves ran on the Errands. Yet by this they gained opportunities of insinuating themselves into Nurses, Servants, and other weak Persons, frequently attending on sick People, and by their means to be admitted to give their Opinion, and thence under pretence of good Husbandry for the Patient, to repeat the Physicians Bills without his Order, and so at length to prescribe without his Advice.  
Upon the same pretence of good Husbandry for the Patient, they wrought themselves into the sole care of such slight Indispositions, as of course were likely to determine in a short time without Medicine, which they failed not to improve into terrible Diseases, and mighty Cures, by Frighting the Sick, and those about 'em with Malignity, and dismal Prognostics. This gave 'em credit and authority enough with the Patient, to censure the Bills of Physicians, that did not please 'em, and behind their Backs to deliver Opinions contrary to the Physician's; to do which required no Judgement, a little craft sufficing: For they had it in their Power in many cases, to disappoint the Physician in his Prognostic by falsifying the Medicines prescribed, a fault they knew how to remedy for themselves, or the favourite they helped in, (when the other was dismissed) by making up the same Bill truly and well. Thus they made profit of their crimes, and gained the repute of honest knowing Men, by the skill of the Physician at the expense of his Fame and Interest.  
This point once gained, no bounds could hold 'em; there was nothing in Practice so bold, which they dare not venture at, nothing in Pharmacy so corrupt which they would not admit. They were now Physicians, and their Business was abroad, and the Boy at home, that scarce could write his Name, was good enough for an Apothecary. But as this new Dignity was not to be supported without an extraordinary Expense, New Methods were to be Invented, to lay an additional Duty upon their Medicines, to be paid by their Customers, now their Patients. Decoctions and Juleps must be divided into Draughts, and Electuaries into Bowls. By this means a Quart of Bitter Decoction, very well paid for at a Shilling, would fetch Twenty, and a Pound of Venice Treacle, perhaps worth Four or Five Shillings, as many Pounds, and so for all the rest.  
Nor was this all: For the Patient was sure not only to pay extortion for what he had, but even for what he had not, while Russian Castor, Pearl, and English Saffron, etc. were put into the Prescription, and New England Castor, Oyster Shells, and Turmerick, etc. into the Medicines. But what was yet worse, if under the direction of the Apothecary alone, or any Confederate of his recommendation, the Patient was sure to be Crammed with abundance of nauseous, unnecessary, and consequently hurtful stuff, till either his Stomach, his Purse, or the Grave put a stop to further Charges, which was done only to swell the account, and raise the Apothecary's gain, whose Fees by these Arts generally triple the Physician's under whom he is Employed, so obliging must the Physician be, that expects the recommendation of an Apothecary: Nay, farther some Apothecaries are, like Conscientious Men, arrived at taking Fees in ready Money, without making any Allowance, or Discount in the Bill.  
A farther, and perhaps yet greater Mischief, arising from the Apothecaries absenting themselves from the Duty of their Shops, is, that they can't attend the making of the standing Shop Compositions, which require great Care and Exactness to be well made, and many of 'em having been bred under Masters of that Humour, know not how to do it were they disposed. This obliges 'em to furnish themselves from the Wholesale Apothecaries, a sort of Men that deal in corrupt, sophisticated Ware, with which the Retail one's content themselves, out of Avarice, Ignorance, or Laziness, to the Destruction of the People. Hence it is plain, that most of 'em can't warrant the Physic they Sell, nor the Physician depend upon it, most of it being made by the Wholesale Man, and Chemist, and all of it dispensed by the heedless Boy, whom every amusement diverts from his attention to his Business, and any slight resemblance betrays into fatal mistakes; especially as their present use is, of putting Medicines indifferently into the Pots and Glasses, marked with other Names, which insensibly leads the Boys into very dangerous Errors.  
Nor is it from the corruption of the Wholesale Men, and the mistakes of Boys only, that the Sick are endangered. The unfaithfulness of the Shops in Sophisticating Drugs, Substituting one thing for another, vending perished Medicines, and making up Bills contrary to the direction of the Prescriber, is grown so general, and so notorious, that the ablest Physicians scarce know, what they are to expect from the certainest of their Prescriptions, as they are made up in the Shops.  
Another great mischief of the most Ruinous consequence to the Sick, is the early Officious Visits, which to show their Impertinent Care, the Apothecaries make in a Morning, and by their Unseasonable, Injudicious Prattle, Rob the Patient of the only time, wherein after the fatigue of an unquiet Night, he is usually inclined to Rest, which temper, thus ruffled by the Officious Intrusion of the Apothecary, is not again to be recovered in the whole Day, whence frequently follow a perpetual Inquietude, Delirousness, etc. And the Apothecary reaps Profit, and Thanks for his Mischievous ostentation of care.  
These Abuses were long since seen through and condemned by many Physicians, who all along abhored such scandalous practices. But the Apothecaries, whose interest it was to oppose any Reformation, entered into an Association to decry, and (as far as in them lay) to turn out of Business all Physicians, that should have the Honesty, and Courage to disavow these sinister Practices, and to recommend those only, that would confederate with 'em, and Countenance, Abett, and Justify their Irregular proceed.  
To this end Lists were handed through their whole Company, wherein the Physicians were all named, and Distinguishing Marks prefixed to their Names, that those who adhered firmly to the Interest of their Patients, and the Honour of their Faculty, might by all possible Shifts, and Artifices, be supplanted in their Business, and those that were in League with the Apothecaries, to support, and promote their enormous Gains, and Abuses might be brought over their Heads.  
This Method fastened to 'em divers, who were ready to sacrifice their Patients, and prostitute their own Honour, and Consciences to the Service of the Apothecaries, and their own immediate Profit. By these was introduced the Fashion of writing such expensive long Bills, that he that did not order enough every Day for the Apothecary to charge in slight cases at Twenty, Thirty, or Forty Shillings, was sure to be aspersed by him to the Patient as a Trifler, one that neither took the Case right, nor ordered any thing to the Purpose; tho' in most cases it is difficult for the Patient to take in one day to the real value of Half a Crown, Two Shillings, or in many even of One Shilling prudently Prescribed, and moderately Rated.  
For these Reasons are these Men cried up by 'em, their Fame is proclaimed in Coffeehouses, and whispered in the Ears of dying Men, as the only Persons able to put a stop to Fate, and reprieve from the Grave. To carry on this Intrigue the more smoothly, they have their Tavern Cabals with the Apothecaries, where they invent scandal on the rest of the Physicians, and contrive Ways and Means to spread and diffuse it, in order to destroy their Credit.  
In return of these Favours the Confederate Physicians are obliged, whenever they are called in by the Apothecaries, where no Physician has been consulted in the case, to Approve and Justify the Practice of the Apothecary, tho' the Patient be dying of bad or improper Medicines, or for want of sufficient help in due time. But if any other Physician, whom the Apothecary does not like, has been first advised with, his Method, tho' never so proper, and well directed, is to be Condemned, and his Medicines laid aside, and the poor Patient, if he lives, is to run the Gauntlet afresh through all the Forms of Physic.  
These Artifices have frighted many Gentlemen, of better principles than to comply with 'em in all their measures of iniquity, from asserting themselves, and disabusing the World with that Vigour and Courage, that they ought to do, for fear of being worked out of their Practice.  
Yet there wants not a sufficient Number of Physicians of Integrity, and Resolution to redress these Grievances, and to assist all Persons of what Rank or Condition soever, who are willing to open their Eyes to their own Interest. In order whereunto they have erected an Office at the College of Physicians, called the Dispensary, where all Officinal Compositions, Galenical, and Chemical are faithfully prepared, of the best Drugs, and where already near Twenty Thousand Prescriptions have been made up, and delivered, and about Three Hundred Bills are Weekly dispensed by Servants of their own, and under their own Inspection, at a Price put upon the Bill by the Prescriber, which is at least Fifteen Shillings in the 〈◊〉 Lower, than the most modest Rates of the Apothecaries.  
The extraordinary relief, that vast Numbers of People have found, from their Distempers at such ease Rates by the Dispensary, has brought so much Business to it, that it gins to grow impracticable to serve 'em all at one place. And therefore, that no Person of what condition soever, may be denied the benefit of Good Medicines at easy Prices, the Physicians have resolved to erect divers others in several parts of the Town.  
In persuance of this resolution they have already fitted up another in St. Martin's Lane, Westminster, where constant attendance is given by their Servants, in order to make up all such Bills, as shall come to their Hands, from the Physicians Subscribing, and where likewise the Physicians themselves will meet every Monday, and Thursday in the Afternoon, for the particular Service of the Poor, where such of 'em, as resort to 'em there, may have their Advice Gratis, as at the College on 〈◊〉, and Saturdays.  
And that these Dispensaries may be made as serviceable as possible to the Public, the Subscribers have there lodged very considerable Arcana in Practice unknown to any Apothecary, of which they were before Masters, but unwilling to prostitute to the Adulterations, and Corruptions, which other Medicines undergo in the Shops. The Subscribers likewise have resolved, according to the Ancient Laudable Practice, of the Physicians of London, to set apart some Hours in the Morning and Afternoon, for the Service of such, as in the Less acute and Chronical Cases, shall think fit to consult 'em at Home.  
The Apothecaries have made their Boast, that they Command all the Families in Town, in respect to Physic. But unless the People are resolved to be led by the Nose, they will have no cause to brag at that rate for the future, the advantages of these Dispensaries to all Mankind, that are visited with Sickness, are so self-evident. For unless Men have a mind to purchase Diseases, or take Physic out of wantonness, they will shut the Apothecaries out of their Doors, till they shall keep to their Shops, and Carefully, and Faithfully, make and dispense such Medicines, as shall be ordered by Physicians, make their prices supportable to the People, lay aside their dishonest Arts of swelling their Bills, and Debauching Members of the College, to the Scandal of their Profession, and Destruction of their Patients.  
If any Gentlemen shall think the foregoing Charge upon the Apothecaries, and their Confederates too severe, or the Expressions too harsh, let 'em rest assured that every particular therein shall be made undeniably clear from sufficient Evidence of Fact, whenever the Apothecaries shall call for such Proofs. As for the Expression, let 'em but consider how rudely and scandalously the Honest Physicians have been, and are daily Treated, both in Public and Private, by the Apothecaries and their Adherents, and they will excuse some warmth, (if any appear) especially when the general Good is in view, provided it transports 'em not beyond the Bounds of Truth and Decency, which, 'tis hoped, are not trangress'd in this Paper.  
There remains one Objection, which sticks to some compassionate Persons, otherwise convinced of the Justice and necessity of this Design; which is, that should it obtain universally in this Town, the Apothecaries, who are a great Company, must be inevitably ruined. But the Answer is easy, that if to Reform 'em, be to Ruin 'em, they are ripe for Destruction: For no Civil well Constituted Government, aught to suffer one Party of Men to Live upon the Spoil and Plunder of the rest, especially in their Distress: 'Tis like Robbing Houses on Fire, under pretence of help. If therefore the Apothecaries think a Reformation of these Abuses of such ruinous Consequence, they ought to consider, how by retrenching their Extravagancies to suit their living to honest Profit, or in time to betake themselves to some more Honest Employment.  
FINIS.