Before germ theory, before chemistry, before the scientific method, there were pharmacies. Pharmacies of a sort even predate history itself (something prehistoric denotes anything occurring before the invention of writing). Remains of several plants known for their medicinal properties—yarrow, cornflower, grape hyacinth, and hollyhock among them—have been uncovered in caves and burial sites dating back tens of thousands of years.

Modern pharmacies have evolved significantly since the days of chewing herbs and trepanning (drilling holes in the skull), especially since Galileo refined and popularized the scientific method. Although centuries have passed since then, modern medicine still clings to a few traditions from the early days of pharmacology. Some are centuries old, a few have held on for millennia.


What’s with the Cotton Balls?

CHILDREN’S ASPIRIN WITH COTTON BALL, 1960s

Why is the cotton ball bunched up above the pills in in containers? Because consumers EXPECT a cotton ball to be bunched up above the pills in containers. That sounds like a “chicken crossing the road” bit, but it is not.

Bayer* made its fortune in formulating and selling aspirin, originally a folk medicine extracted from willow bark. Instead of the typical powders sold by pharmaceutical companies, Bayer compressed and packaged the drug in pill form. As convenient as these pills were, they quickly crumbled during transportation. As a solution, Bayer inserted wads of clean cotton in the bottles. Other drug makers copied this solution, until most pill bottles contained the obligatory cotton ball.

By the 1980s and the improvement of drug manufacturing, coated tablets rendered the cotton ball obsolete. The first company to utilize this industry trick was also the first to abandon it. Cotton balls were removed from bottles, which now had a tamper-evident seal. Sales plummeted. Consumers firmly associated safe and effective medicine with the cotton ball. When Bayer replaced it, sales returned to normal.

*Bayer’s reputation would later be forever tarnished by its marketing of heroin as a cough suppressant and for the company’s use of slave labor during World War II.




Rx Means What? 

SCRIPT FROM 1700s (RX ON LEFT SIDE)

Rx is among the most common and universally recognized abbreviations in Western civilization, yet few people know its denotation (much like RSVP, AM/PM or n/a). Uncovered in manuscripts dating from the 16th century, the R is an abbreviation of recipio in Latin, which is an imperative or command form of to take. Anyone familiar with basic algebra can explain the second part: X (as in x + 2 = 5). This stands for an unknown, a portion the doctor or healthcare professional would fill out, depending on the patient’s condition.

It’s an easier to imagine this way: Rx literally means a doctor is writing down your prescription and then shoving it at you with the command “TAKE THIS!”


Pharmacy vs. Apothecary

MEDIEVAL GERMAN APOTHECARY

In the Tragedy of Romeo and Juliet, a desperately misinformed Romeo seeks deadly poison from an apothecary, who at first refuses, then relents when the young man waves a small fortune at him. For most of us, that brief scene was our first and only exposure to the once-common term.

An apothecary, seldom used interchangeably today, referred to a pharmacist that not only dispensed medicines, but also manufactured and often prescribed them. A thousand or even a few hundred years ago, if you had a powerful headache or upset stomach, you wouldn’t contact a doctor or physician first, but travel to an apothecary. In a sense, these medical “professionals” were our first general practitioners, just without required training.

Although this practice is still common in Traditional Chinese medicine (which is almost entirely holistic, and ineffective), Western medicine no longer condones it. Physicians realized unethical pharmacists—whose income is based on the quantity and cost of medicine sold—might misdiagnose conditions or favor less effective drugs for a “kickback” from a drug company or even a physician. In the United States, a physician may diagnose AND dispense medicine from an office, but a pharmacist may only dispense medicine.

Sadly, as seen with the recent opioid epidemic, this system of ethics is not always ethical.

The Traditional Drug Store Soda Fountain?

PHARMACY SODA FOUNTAIN, c. 1920

Natural mineral springs have been utilized for their health benefits even before Caesar walked the Earth. Humans found the water, bottled and sold as “soda water,” had powerful restorative properties. It did and does not. Other than the benefits of drinking water, there is no additional health benefit to naturally or artificially carbonated water. Any claims otherwise have no scientific basis, and the FDA’s only official conclusion is that soda water is of “minimal nutritional value.”

As pharmacies were typically small businesses until the 1950s, and the owners were always looking for additional methods of revenue, the invention of artificially carbonated soda seemed readymade for a small town drug dispensary. Efficient carbonation required cold water and soda fountain remained out of reach for all but the largest drug stores, until the iceless soda fountain came around in 1908 (it’s prototype was installed in an Indianapolis pharmacy).

During Prohibition, these ornate pharmacy soda fountains became social gathering places, and it wasn’t uncommon to use coded language and have the pharmacist add a little “kick” to your drink. Selling or dispensing alcohol was illegal from 1920-1933, but pharmacists and doctors were exempt from this, since patients “needed” alcohol for its medicinal value. Whiskey was a common prescription. Even after Prohibition ended, these soda fountains remained and grew in popularity with the growth of the soft drink industry. By the 1950s, pharmacy soda fountains had evolved into ice cream parlors as well, earning a form place in 50s-themed nostalgia.

Then the Chicago-based Walgreens drug store chain came along and introduced a 100% self-service drug store. Patients could wander in, browse the shelves of over-the-counter remedies and purchase products quickly, discreetly, and at a lower price. Over ten or twenty years, this innovation ended the reign of the pharmacy in the social life of Americans, and with it went the soda fountain.