After the fifth century fall of the Western Roman Empire, medicinal knowledge in Europe suffered due to the loss of Greek medicinal texts and a strict adherence to tradition, although an area of Southern Italy near Salerno remained under Byzantine control and developed a hospital and medical school, which became famous by the 11th century.
In the early 11th century, Salerno scholar Constantinos Africanus translated many Arabic books into Latin, driving a shift from Hippocratic medicine towards a pharmaceutical-driven approach advocated by Galen. In medieval Europe, monks typically did not speak Greek, leaving only Latin texts such as the works of Pliny available until these translations by Constantinos. In addition, Arabic medicine became more widely known due to Muslim Spain.
In the 15th century, the printing press spread medicinal textbooks and formularies; the Antidotarium was the first printed drug formulary.
In Europe pharmacy-like shops began to appear during the 12th century. In 1240 emperor Frederic II issued a decree by which the physicians and the apothecarys professions were separated.
Old pharmacies continue to operate in Dubrovnik, Croatia located inside the Franciscan monastery, opened in 1317. The Town Hall Pharmacy in Tallinn, Estonia, which dates back to at least 1422, is the oldest continuously run pharmacy in the world still operating in the original premises.
The trend towards pharmacy specialization started to take effect in Bruges, Belgium where a new law was passed that forbid physicians to prepare medications for patients.
The oldest pharmacy is claimed to be set up in 1221 in the Church of Santa Maria Novella in Florence, Italy, which now houses a perfume museum. Florence is also the birthplace of the first official pharmacopeia, called the Nuevo Receptario, in which all pharmacies would use that document as guidance for caring for the sickly.
The Royal College of Apothecaries of the City and Kingdom of Valencia was founded in 1441, considered the oldest in the world, with full administrative and legislative powers. The apothecaries of Valencia were the first in the world to elaborate their medicines, with the same criteria that are currently required in the official pharmacopoeias.
The Republic of Venice was the first State with health modern policies which requires that the nature of the drug is public. In actuality, thirteen secrets survive which were offered to sale to the Venetian Republic.