The Pharmaceutical Industry and the Growth of Clinical/Biomedical Research

by

Joseph M. Gabriel, Gabriella Rivera

• LAST MODIFIED: 17 April 2025
• DOI: 10.1093/obo/9780197768723-0033

Introduction

Scientific research and the commercial development of new drugs have long been intertwined. This simple observation has led to a wealth of scholarly work that examines the history of the pharmaceutical industry and its relationship to scientific reasoning and practice over the past three centuries. Most of this scholarship—at least that which is written in English—has focused on either the twentieth-century United States or Europe, while a smaller amount examines other regions and/or the nineteenth century. There is also a significant body of scholarship on the early modern period that focuses on either European countries and their colonies, the Atlantic world, or, to a lesser extent, other parts of the globe. Not surprisingly, the relationship between commercial firms and scientific research has been a central concern of this literature. Historians have traced the development of experimental methods in laboratory and clinical research, for example, as well as their use by industry to develop new products. Other work has examined efforts to standardize pharmaceutical markets, the complex relationship between drug advertising and disease classification, the origins and trajectory of pharmaceutical regulation, and numerous other issues at the intersection of medical research and commercial practice. Not all of this work has been done by historians. Indeed, scholars and social scientists who study the pharmaceutical industry come from a wide variety of fields, including anthropology and sociology, and employ a diverse set of methods in their efforts to analyze this complex industry. There have, of course, been profound changes in the scientific basis of pharmaceutical development, the scope and scale of scientific research employed by the industry, and numerous other issues over the past three centuries. Yet there have also been recurring themes and sets of concerns that have proved remarkably stable over time, including the dynamic and often tense relationship between scientific and commercial practice, struggles between scientific experts and other communities of actors for authority and power, and the difficulty of establishing equivalence between goods sold under the same or similar names. We have arranged this bibliography to try to capture this sense of both similarity and difference. The first two sections divide the historiography into two distinct time periods: the first covers the early modern period or earlier, while the second covers the nineteenth century to the present. The remaining sections are organized according to theme: the third is about cooperation between drug manufacturers and other parties, in particular academic researchers and the medical community, while the fourth covers the history of clinical research, controlled drug trials, and risk. The next sections focus on drug advertising, a theoretical framework called pharmaceuticalization, and pharmaceutical regulation. The final section of the bibliography includes selections related to intellectual property rights and innovation.

Early Modern Origins

Historians generally trace the roots of the contemporary pharmaceutical industry to the drug trade, the practice of pharmacy, and the development of experimental science in the seventeenth and eighteenth centuries. As Leong and Rankin 2017, Rankin 2021, and Ragland 2017 make clear, Europe has a long tradition of experimentally testing drugs that stretches back to the medieval period, if not earlier. Chakrabarti 2014, Crawford 2016, and Schiebinger 2017 demonstrate that this scientific tradition was deeply intertwined with both European colonial ambitions and the Atlantic trade in enslaved peoples. They also make the crucial point that the knowledge-making practices of Indigenous and enslaved peoples directly contributed to the direction and shape of this tradition. Walker 2010, Crawford and Gabriel 2019, and Dorner 2020, in turn, show that both European imperial ambitions and the transatlantic trade in enslaved peoples were an important part of the development and transformation of the early modern global trade in healing goods more generally. These and other profound changes often appear, through the lens of historical analysis, to place Europe and its people at the center of the origin story of both the pharmaceutical industry and medical science. Of course, this historiographical tradition may need to be rethought; as Bian 2022 makes clear, other parts of the world have their own healing traditions and knowledge-making practices, and, as de Vos 2020 argues, the distinction between “Western” and “non-Western” traditions is not as clear as scholars often assume. Indeed, historical narratives that trace the origins of modern life to economic and social changes in Europe reflect a civilizational discourse that assumes European superiority and ignores the fundamental narrativity of the categories (such as “capitalism”) that are used to interpret the past. A similar point can be made about the history of science: numerous scholars have made clear how scientific practice has been deeply embedded in the broader social context in which it takes place; Klein 2008 and Dorner 2020 both make clear, for example, that European laboratories should be understood not only as experimental locations but also as manufacturing sites tied to networks of trade that shaped scientific practice in material ways. Indeed, the very epistemic categories that guide inquiry (such as “objectivity”) themselves change over time. The closer one looks, the less clear the boundary between “science” and other forms of knowledge-making becomes. This is not to say that there are no meaningful distinctions between science and non-science, but simply that the so-called demarcation problem between the two is historically contingent and not at all straightforward. As the history of early modern healing goods suggests, the question of how to distinguish between the two is also deeply intertwined with the reification of race and other social categories at the heart of the modern world.

• Bian, He. Know Your Remedies: Pharmacy and Culture In Early Modern China. Princeton, NJ: Princeton University Press, 2022.

  A sweeping history of pharmaceutical knowledge in China from the end of the Ming dynasty (roughly the late sixteenth to mid-seventeenth centuries) through the High Qing era (the late seventeenth and eighteenth centuries). Argues that Chinese approaches to medicinal goods were radically transformed during this period due to the development of urban pharmacies, the shift to writing formularies by private parties, and the growing importance of foreign products. Shows that the Chinese pharmaceutical tradition was dynamic and responsive to the development of the early modern global economy.

• Chakrabarti, Pratik. Materials and Medicine: Trade, Conquest and Therapeutics in the Eighteenth Century. Manchester, UK: Manchester University Press, 2014.

  A wide-ranging and engagingly written book arguing that non-Western forms of therapeutic knowledge in India and Jamaica directly influenced the development of British science through the colonial encounter. Details the complex process through which medical ideas were exchanged between colonial subjects and their colonizers and then returned to Europe. “Western” medical science was thus forged in the context of imperialism and Atlantic slavery in ways that directly altered its trajectory. Also provides a useful historiographical overview.

• Crawford, Matthew James. The Andean Wonder Drug: Cinchona Bark and Imperial Science in the Spanish Atlantic, 1630–1800. Pittsburgh: University of Pittsburgh Press, 2016.

  DOI: 10.2307/j.ctt1f89t3p

  A meticulous study examining the Spanish involvement in the cinchona trade. Cinchona bark was used to treat fever and is now recognized as having been useful in the treatment of malaria. Crawford describes how the Spanish Crown tried to dominate the trade by establishing a plantation in Quito to grow cinchona trees; in doing so, he argues, Spain engaged in a new form of imperialism based on the blending of science and commerce. He also argues that this effort ultimately failed due to the efforts and beliefs of a variety of groups, including Indigenous peoples.

• Crawford, Matthew James, and Joseph M. Gabriel, eds. Drugs on the Page: Pharmacopeias and Healing Knowledge in the Early Modern Atlantic World. Pittsburgh: University of Pittsburgh Press, 2019.

  The twelve chapters in the collection examine pharmacopeias in the early modern Atlantic world, although the term is defined broadly. Overarching themes include the standardization of scientific knowledge, secrecy and monopoly protection, the relationship between orthodox medical science and Indigenous forms of knowledge, and the role of pharmacopeias in the early modern nation-state. Taken together, the volume provides an overview of the relationship between pharmacopeias and other early modern texts, the drug trade, and the development of medical science and research.

• de Vos, Paula S. Compound Remedies: Galenic pharmacy from the ancient Mediterranean to New Spain. Pittsburgh: University of Pittsburgh Press, 2020.

  DOI: 10.2307/j.ctv1bkc3w7

  A sweeping history of Galenic pharmacy, which, as de Vos notes, “guided early modern pharmaceutical theory and practice in the West from the first centuries of the Common Era well into the nineteenth century.” (p. 4). Traces the history of Galenic pharmacy over more than a thousand years and a variety of geographic areas that are often considered distinct from one another, including Europe, Mesoamerica, and the Muslim world, thereby challenging what de Vos calls “the false dichotomy often made between ‘Orient’ and ‘Occident’ in the establishment of that tradition.”

• Dorner, Zachary. Merchants of Medicine: The Commerce and Coercion of Health in Britain’s Long Eighteenth Century. Chicago: University of Chicago Press, 2020.

  DOI: 10.7208/chicago/9780226706948.001.0001

  Examines the manufacture, sale, and study of medicines by British merchants in the context of British colonialism and the Atlantic trade in enslaved peoples. Argues that the laboratories in which medicines were produced should be understood as industrial locations akin to factories tied to long-distance commercial networks. At the same time, newly emergent health-care systems and the medical needs of empire lumped people into groups that could be systematically studied and treated through the use of these goods according to developing principles of abstraction and equivalence.

• Klein, Ursula. “The Laboratory Challenge: Some Revisions of the Standard View of Early Modern Experimentation.” Isis 99.4 (2008): 769–782.

  DOI: 10.1086/595771

  Argues that laboratories in the early modern period should be understood not just as places where chemical operations and investigations took place. Laboratories were also artisanal workplaces in which medicines and other goods were prepared. As a result, they should be understood as proto-industrial in nature. Also offers some thoughts on how conceptualizing early modern laboratories in this way changes our understanding of the history of the experimental sciences.

• Leong, Elaine, and Alish Rankin, eds. Special Issue: Testing Drugs and Trying Cures. Bulletin of the History of Medicine 91.2 (2017): 157–429.

  A special edition of the Bulletin of the History of Medicine on drug testing in medieval and early modern Europe. The collection includes an introductory essay by Leong and Rankin, eight full-length papers, and a concluding essay by Jeremey A. Greene on “the enduring legacy of early modern drug trials.” Taken together, the papers in the collection explore a variety of themes that are relevant to current debates about the industry and its relationship to biomedical science, including the development of clinical testing protocols, medical ethics, and patent monopolies.

• Ragland, Evan R. “‘Making Trials’ in Sixteenth-and Early Seventeenth-Century European Academic Medicine.” Isis 108.3 (2017): 503–528.

  DOI: 10.1086/694430

  Places the early modern testing of medicines in the context of the experimental tradition in natural history during the sixteenth and early seventeenth centuries. Argues that, unlike other experimentalists at the time, physicians associated with universities regularly conducted experiments in order to test universal claims. As a result, Ragland argues, the sixteenth- and early-seventeenth-century history of medical science should be understood as an important component in the broader emergence of experimental science.

• Rankin, Alisha. The Poison Trials: Wonder Drugs, Experiment, and the Battle for Authority in Renaissance Science. Chicago: University of Chicago Press, 2021.

  DOI: 10.7208/chicago/9780226744995.001.0001

  Examines the practice of testing antidotes on condemned prisoners in sixteenth-century Europe. Unlike medicines, which were thought to have complex interactions with a person’s humoral system, Rankin argues that both poisons and antidotes were thought to either work or not work in a straightforward fashion; they could therefore be tested through experimental means in ways that medicines could not. These experimental practices significantly predate the purported origins of experimental science in the eighteenth century.

• Schiebinger, Londa. Secret Cures of Slaves: People, Plants, and Medicine in the Eighteenth-Century Atlantic World. Stanford, CA: Stanford University Press, 2017.

  DOI: 10.1515/9781503602984

  Examines the development of what Schiebinger calls an “Atlantic world medical complex” and the search for new cures in the eighteenth-century British and French West Indies. Describes both efforts by Europeans to test new medicines on enslaved people and the perspectives and therapeutic knowledge of enslaved peoples themselves. Also offers a series of arguments about medical ethics and human experimentation in the eighteenth century, including a troubling argument about how slavery supposedly protected enslaved people from experimentation.

• Walker, Timothy. “The Early Modern Globalization of Indian Medicine: Portuguese Dissemination of Drugs and Healing Techniques from South Asia on Four Continents, 1670–1830.” Portuguese Literary and Cultural Studies 17/18 (2010): 77–97.

  Examines the significant role of Portuguese imperial power and commercial agents in the spread of drugs and healing techniques originating from South Asia in the early modern global economy. In doing so, Walker demonstrates the profound impact of Portuguese channels of trade in facilitating the globalization of Indian medical knowledge during this transformative era.