Origins
Medicine preparation has ancient roots—herbalists, healers, and physicians compounded remedies throughout history. Egyptian, Greek, Chinese, and Indian medical traditions developed pharmacological knowledge. But the pharmacy as distinct institution—a specialized establishment separating drug preparation from medical diagnosis—emerged in the Islamic world, where pharmacists (saydalani) operated shops distinct from physicians’ practices.
Baghdad’s pharmacies in the 8th century established the model. Under Abbasid patronage, pharmacists developed systematic knowledge of drugs, standardized preparations, and professional identity separate from physicians. Arabic pharmacology built on Greek foundations (Dioscorides’ De Materia Medica) while adding substantial original contributions. The pharmacy became a site of specialized expertise where trained practitioners prepared, stored, and dispensed medications according to physician prescriptions or traditional formulas.
European apothecaries emerged from the spice trade and guild system. Apothecaries originally sold spices and drugs interchangeably—both were exotic imports requiring specialized handling. Gradually apothecaries specialized in medicinal substances, developing expertise in compounding and eventually gaining recognition as separate profession from grocers and physicians. By the early modern period, European cities had apothecary shops regulated by guilds and inspected for drug quality. The pharmacy had become established feature of urban healthcare landscapes.
Structure & Function
Pharmacies prepare and dispense medications prescribed by physicians or requested by patients. Traditional pharmacies (compounding pharmacies) made medicines from raw ingredients according to formulas. Modern pharmacies primarily dispense manufactured medications, though compounding continues for specialized needs. Pharmacists verify prescriptions, check for interactions, counsel patients on medication use, and maintain drug inventories. The pharmacy thus serves as intermediary between medical prescription and patient consumption.
Pharmacy practice operates within regulatory frameworks. Pharmacists require professional credentials—licensure typically requires pharmacy school graduation and examination. Pharmacies must meet standards for drug storage, handling, and record-keeping. Controlled substances face additional restrictions. These regulations aim to ensure that patients receive correct medications in appropriate doses, that dangerous drugs are properly controlled, and that pharmacists possess necessary competence.
The pharmacy’s role has evolved significantly. Traditional compounding—mixing ingredients to make medicines—has declined as pharmaceutical manufacturing produces standardized products. But new functions have emerged: pharmacists counsel patients on medications, monitor drug therapy, administer vaccines, and provide health screenings. “Pharmaceutical care” models position pharmacists as healthcare providers rather than mere dispensers. Meanwhile, mail-order pharmacies and online drug sales challenge the traditional brick-and-mortar pharmacy model.
Historical Significance
The pharmacy institutionalized the separation of prescribing from dispensing. Physicians diagnose and prescribe; pharmacists prepare and dispense. This division of labor—now so familiar as to seem natural—emerged historically from distinct developments in Islamic and European medicine. The separation provides checks and balances: pharmacists verify prescriptions, identify errors, and counsel patients. But it also creates inefficiencies and interprofessional tensions. Alternative models (physicians dispensing directly, pharmacists prescribing) persist in some contexts.
Pharmacies served as sites of pharmaceutical knowledge development. Before modern pharmaceutical science, pharmacists accumulated practical knowledge about drugs—their sources, preparation, effects, and combinations. Pharmacopoeias (official drug compendia) codified this knowledge. Chemical analysis transformed pharmacy in the 19th century, enabling isolation of active ingredients and standardization of potency. The pharmacy’s knowledge function migrated to pharmaceutical companies and research laboratories, but pharmacists retain expertise in drug effects and interactions.
The modern pharmaceutical industry grew from pharmacy traditions. Drug manufacturing began when pharmacists scaled up production of popular preparations. Many pharmaceutical companies (Merck, Pfizer, Eli Lilly) trace origins to pharmacy operations. The relationship between pharmacies and pharmaceutical companies has shifted from pharmacy dominance to industry dominance—pharmacies now primarily distribute what companies manufacture. Yet pharmacies remain essential infrastructure connecting pharmaceutical production with patient consumption.
Key Developments
- c. 754: Baghdad pharmacies emerge
- c. 850: First pharmacy regulations (Baghdad)
- 1100: Apothecaries appear in European cities
- 1180: First European pharmacy regulations
- 1240: Frederick II separates pharmacy from medicine legally
- 1498: Florence pharmacopoeia published
- 1617: Worshipful Society of Apothecaries (London)
- 1729: First American pharmacy (Philadelphia)
- 1821: Philadelphia College of Pharmacy founded
- 1852: American Pharmaceutical Association founded
- 1906: Pure Food and Drug Act; pharmacy regulation expands
- 1914: Harrison Narcotics Act; controlled substance regulation
- 1951: Durham-Humphrey Amendment; prescription/OTC distinction
- 1970: Controlled Substances Act
- 1990: Omnibus Budget Reconciliation Act; counseling requirements
- 2000s: Expanded pharmacist scope of practice
- 2010s: Specialty pharmacy growth