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By Root 2064 0

Paolo di Romani obtained a patent in 1594 for a way of rendering a herbal syrup in solid form, but the city's collegio of apothecaries persuaded him to share the privilege among his peers.29 In England, Grew in 1698 was quite possibly the first person to obtain a privilege for manufacturing a pharmaceutical as such. The next such patent (the first on a compound medicine) was issued in 1711, for a substance called sal oleosum volatile. It was soon followed by another for Stoughton's elixir, and then by many more in the eighteenth century. So it really does seem as though Grew's bid for protection marked the origin of a trend.30 Or perhaps it more truly marked the end of one.

Early modern medicine was typically understood in terms of a tripartite structure, comprising physicians, apothecaries, and surgeons. The relatively few physicians were the Latinate elite. They supposedly conducted consultations, recommended dietary regimens, and wrote prescriptions. Ever since classical times, their recommendations had relied largely on regimen and herbal medicaments, tailored, in theory, to the circumstances of individual patients. Polydore Vergil averred that their original bailiwick had been dietetics.31Apothecaries made up medicaments to their bills. And surgeons handled bodily manipulations. The realitywas much more complex and fluid than this representation implied, however. While this tripartite structure was enshrined in institutions in many cities, and "colleges" ofphysicians claimed the authority to maintain it, in fact licensing regimes were very incomplete, and members of each rank routinely acted in ways that the others might perceive as intrusions.

Moreover, countless unlicensed practitioners-"irregulars," as Margaret Pelling calls them-serviced the majority of the population. The physicians regularly denounced these irregulars as "empirics," "mountebanks," "quacks," and the likeY But they vastly outnumbered the physicians, could sometimes call on alternative licensing authorities (like bishops) for legitimacy, might well appeal to newer kinds of knowledge and experience, and in practice were not infrequently patronized by the physicians themselves. The result was a consistently fraught medical culture, with each group struggling to distinguish and protect itself from the others. It was in this context that the physicians leveled charges that apothecaries and irregulars were tied to base, commercial interests. Those interests, they warned, tempted them to adulterate.33

The problem of adulteration was therefore inextricably bound up with contemporary medical institutions and identities. The only case in which a physician could trust to a medicine, it was said, was when he either prepared it himself or supervised its preparation in person. Doing otherwise meant trusting to "as great cheats as are now Extant in the World."34 The pugnacious physician Coxe added that London's apothecaries were so unreliable "that neither Physicians or the Diseased have reason to repose that trust in them which they challenge as their due."35 Trusting people and trusting things: this was what was at stake in the interminable battle between the physicians, apothecaries, "druggists," and irregulars. Counterfeiting was what cast such trust into the most acute doubt. Indeed, as the apothecaries grew into a discrete trade, the need for them to expel these "cheats" and police "untrue" drugs was a paramount concern. It loomed large in the creation of the Apothecaries' Company in 1617. The Company took seriously its mission to inspect members' premises and confiscate unsound substances-a practice that paralleled the searches of the Stationers' wardens for unsound books.36 By contrast, the Company did not stipulate that apothecaries were restricted to dispensing physicians' prescriptions, so there was nothing to prevent them dealing directly with patients.37The combination of these concerns -of adulteration and autonomy-triggered a crisis that pervaded London medicine, reaching a head alongside the Grew-Moult clash.

The problem of assessing the authenticity