[Congressional Record (Bound Edition), Volume 145 (1999), Part 4]
[Extensions of Remarks]
[Page 5388]
[From the U.S. Government Publishing Office, www.gpo.gov]




               THE URGENT NEED FOR A NATIONAL DRUG EXPERT

                                 ______
                                 

                            HON. JOE BARTON

                                of texas

                    in the house of representatives

                        Tuesday, March 23, 1999

  Mr. BARTON of Texas. Mr. Speaker, I submit the following paper as a 
request for a constituent of mine from Burleson, Texas. His name is 
Kenneth Hunter and he collaborated with Prof. Rinaldo DeNuzzo on the 
following article which cites a need for a federal office with a 
national drug expert. This is not an endorsement either for or against 
their effort, but a submission of their idea.

                   The Urgent Need for a Drug Expert

       In recognition of the dynamic changes which continue to 
     occur in the delivery of health care services in the United 
     States and globally, it is suggested that the President and/
     or Congress re-establish the office of Apothecary-General 
     which disappeared from the United States Army in the first 
     quarter of the nineteenth century. This skilled health care 
     professional of equal status, while working in tandem with 
     the Surgeon-General, would provide advice and counsel to the 
     office of the President, the Congress and others. This 
     professional with offices in Washington, DC, will serve to 
     coordinate and oversee all aspects of mandated and other 
     programs involving drug use or abuse by the general public, 
     military, veterans, and others.
       Originally, the Office of Apothecary was created by action 
     of the American Congress in 1775. The need for such an 
     official became evident to Dr. John Morgan, the second of 
     four Medical Directors of the American Revolutionary Army. 
     Morgan recognized the need for coordination of the valuable 
     skills provided by the apothecaries as well as those by the 
     surgeons. The Congress also established a military hospital 
     to care for the 20,000-man militia involved in the 
     Revolutionary War. As with other medical care personnel, the 
     apothecaries were directed to visit and tend to the needs of 
     those who were sick or wounded.
       Dr. Morgan, physician-apothecary, as director of the 
     Department of Hospitals wrote to Dr. Jonathan Potts, deputy 
     director, informing him that ``a warrant to Mr. Andrew 
     Craigie to act as an apothecary'' had been issued. Potts was 
     advised that the appointment of Craigie will be particularly 
     useful due to his experience. ``Without such a one, I know 
     not how you could either procure sufficient medicines for 
     your department or dispense them when got.'' Dr. Morgan was 
     an influential advocate for the separation of medicine and 
     pharmacy in America. He taught pharmacy and is credited with 
     the introduction of prescription writing in America.
       Morgan, additionally admonished Dr. Potts ``to make it a 
     part of the duty of mates to assist the apothecary in making 
     up and dispensing medicine.'' He states, ``The Apothecary to 
     all intent is to be looked on in rank as well as pay in the 
     light of the surgeon and respected accordingly and if he is 
     capable, he should in return, do part of the surgeon's 
     duty.'' During the period of 1775-1780, there were several 
     Apothecary-Generals serving in three of the four 
     Revolutionary War Districts. In 1780, a reorganization of the 
     military medical department concentrated all authority in one 
     medical staff, and Andrew Craigie became sole Apothecary-
     General. He served as such until the end of the War when a 
     treaty with Britain was signed in 1783.
       Many apothecaries played vital roles in the American 
     Colonies' struggle for independence. Among them was American 
     military hero Dr. Hugh Mercer, physician-apothecary, who 
     operated a pharmacy in Fredericksburg from 1771 until the 
     beginning of the Revolution. General Mercer suffered wounds 
     and died on the battlefield in 1777. Following his death, the 
     Congress approved a monument to be erected in Fredericksburg 
     with the following inscription:
       ``Sacred to the memory of Hugh Mercer, Brigadier-General in 
     the Army of the United States. He died on the 12th of 
     January, 1777, of the wounds he received on the 3rd of the 
     same month, near Princeton, NJ, bravely defending the 
     liberties of America. The Congress of the United States, in 
     testimony of his virtues and their gratitude, has caused this 
     monument to be erected.''
       Dr. Mercer's historic apothecary shop is currently 
     maintained by the Association for the Preservation of 
     Virginian Antiquities in Fredericksburg, VA. It is open to 
     the public.
       Apothecary Christopher Marshall was commissioned by the 
     Continental Congress in 1776, the year the Declaration of 
     Independence was signed, to oversee service given to the 
     needs of soldiers in Philadelphia hospitals. Two years later, 
     the first Military Pharmacopea was issued in Philadelphia.
       It is noted that the American Revolutionary War served to 
     provide us with independence and a foundation upon which the 
     practice of pharmacy in America is based. For example, we had 
     shops where medicines for consumer use were used to provide 
     necessary supplies for militia. The role of apothecary was 
     defined by Dr. Morgan as ``Making and dispensing 
     medication.'' Dr. Craigie facilitated the establishment of 
     laboratories and storehouses where medicines were prepared 
     and implemented, and the army apothecary visited (counseled) 
     the sick. From those humble beginnings, we have a 
     pharmaceutical industry which is second to none in the world.
       The last Apothecary-General, Colonel James Cutbush was also 
     an author and a teacher. He was appointed in 1814 as 
     assistant Apothecary-General of the United States Army and 
     served admirably during the War of 1812. By an act of 
     Congress in 1815, the Army was reduced to a minimum and many 
     officers were retired. President Madison, the same year, 
     directed that the Apothecary-General and two assistants be 
     retained in the ``Military Peace Establishment of the United 
     States.'' The office of Physician and Surgeon General was 
     abolished and the Apothecary-General became the ranking 
     officer in the Medical Department until 1818, when the first 
     Surgeon General was appointed. As a professor at West Point 
     Military Academy, James Cutbush became a pioneer in the 
     chemistry of explosives.
       In support of the proposal to re-establish the office of 
     Apothecary-General nationally, pharmacy practitioners with 
     expertise in drug use and misuse (abuse) make daily 
     contributions to the delivery of medical care. Pharmacists 
     are the most readily available and approachable 
     professionals, often working seven days a week and sometimes 
     24 hours a day. Frequently, they are the initial portal of 
     entry into medical care by advising the appropriate non-
     prescription drug for non-serious ailments, championing 
     healthy life styles, and making referrals to other 
     professionals for needed care when appropriate.
       Pharmacists provide the greatest number of professional 
     daily exposures to the population as more than two billion 
     prescriptions are dispensed annually. They also provide a 
     high level of pharmaceutical care by monitoring prescription 
     and non-prescription drug use to insure that therapeutic 
     objectives are achieved. Additionally, for the tenth 
     successive year, the Gallup Poll found that the American 
     consumer ranks the pharmacy practitioner as the most trusted 
     professional in the land.
       During the 1986-96 decade, alcoholism and drug addiction 
     were key elements in the explosion in our national prison 
     population. In a recent Columbia University study, the number 
     of inmates in federal, local, and state prisons tripled from 
     500,000 to 1,700,000. Drugs and alcohol were involved in 80% 
     of the incarcerations. The President's appointments of the 
     last two drug Czars consisted of an educator and a military 
     officer which led to a spirited attempt to solve our war on 
     drugs with limited positive results. It is time to appoint a 
     drug expert to solve the problems. Pharmacists' specialty 
     lies in the knowledge of drugs. They relate well to people in 
     a positive fashion, and have been found to be outstanding 
     administrators.
       The authors of this paper hope that their actions will 
     start a ground swell movement to give new recognition to the 
     practice of pharmacy and its practitioners in a rational and 
     accountable way. If action is taken, the use of an 
     Apothecary-General may lead to an increase in efficiency in 
     the Federal bureaucracy, a significant decrease in the number 
     of citizens incarcerated, and reduce Federal and State 
     spending. We have the talent and leadership ability; so let's 
     save the taxes. This is now the time to re-establish the 
     office of Apothecary-General.





                          ____________________