Medicolegal Issues

The Colonial Formulary


Pharmacies have plotted a dynamic course through history, arriving late to North America in relation to other nations. Before the origin of the first true hospital pharmacy, medicinal therapies were often distributed by public officials, heads of households, and religious leaders or sold in drug stores and other free-standing apothecaries. Colonists followed books on self-treatment and methods of cultivating herbs. With the introduction of hospitals came the hospital pharmacy.

Great Britain had long been a glowing example of how pharmacists could prepare, compound, and administer prescriptions ordered by physicians in an organized manner. In contrast, the role of physicians, surgeons, and apothecaries in the British colonies were blurred, each with overlapping responsibilities of caring for patients and treating ailments.

It was not until 1751 after Benjamin Franklin and Dr. Thomas Bond founded the first hospital in the British Colonies—Pennsylvania Hospital in Philadelphia—that the idea for a hospital pharmacy was cultivated in North America. Because the first hospital’s mission was to provide charity for the poor, there initially was resistance to Dr. Bond’s idea of creating an apothecary in the same institution. Colonists feared that it would become costly to those in Philadelphia being served by the hospital. However, with Franklin’s persuading, enough funds were eventually solicited to purchase more than 112 pounds worth of drugs from London. In 1752, these drugs filled shelves in the hospital president’s office in the Pine Building of Pennsylvania Hospital instituting the first “Apothecary’s Shop in the Hospital” in the British colonies.

The first salaried hospital pharmacist, making 15 pounds per year, was Jonathon Roberts who worked until 1755 fulfilling the role of preparing medications requested by physicians. Medical and surgical students were often hired for short tenures in the apothecary to obtain experience in pharmacy or to simply cover their room and board expenses. John Morgan replaced Roberts in May 1755, and he worked for only one year before using that experience as a springboard for stirring up great influence in the future direction of American pharmacy. Morgan went on to become a physician and a vocal advocate for a more distinct separation of professions among physicians, surgeons, and pharmacists in America.

Most of the drugs available in the first American hospital pharmacy could be found in the London Pharmacopoeia of 1650, whereas very few drugs were of North American origin. Contributions from the colonies came primarily from the American Indian traditions that involved the extraction of botanical drugs such as cascara, bloodroot, and jalap. Nearly 170 of these particular preparations used by Indians north of the Rio Grande or their derivatives are still used today.

Other drugs used at the time of the first hospital pharmacy included emetic ipecac, an expectorant made of benzoin known as “Jesuit’s Drops,” antimony in “Plummer’s Pills,” and tincture of lavender (originally referred to as “Palsy Drops” and used to treat muscle spasms and headaches).

The advent of the American Revolution made importing drugs nearly impossible, requiring an increase in the number of patented drugs from North America. The first colonial hospital pharmacy, thanks to the ingenuity and persistence of Benjamin Franklin and Dr. Bond, set the stage for the development and transformation of pharmacies as we know them to today. TH

Nordman is a senior medical student at Penn State University.


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