Discovery and Development of Magic Bullets and Miracle and Wonder Drugs

by

Toine Pieters

• LAST MODIFIED: 17 April 2025
• DOI: 10.1093/obo/9780197768723-0036

Introduction

The process of drug discovery and development lies at the heart of modern medicine, playing a pivotal role in the fight against a wide array of diseases. While government-funded basic research has often been the initial source of groundbreaking innovations, the pharmaceutical industry has been instrumental in transforming these drug innovations into marketable therapeutic drugs. Over the course of the twentieth century and into the twenty-first, pharmaceutical companies have introduced a wide range of medications to address conditions such as cancer, cardiovascular diseases, infectious diseases, and psychiatric disorders. Some of the most significant drugs or drug classes include insulin, penicillin, antibiotics, corticosteroids, diuretics, beta-blockers, oral contraceptives, antipsychotics, antidepressants, chemotherapeutic agents, and more recent molecularly targeted anticancer therapies such as trastuzumab and imatinib. From an outsider’s perspective, this history may seem like a continual success story, with each new innovator drug hailed as a “miracle” or wonder drug, promising to significantly improve health-care outcomes. At the center of this historical narrative is Paul Ehrlich, the 1908 Nobel laureate, whose pioneering work introduced the concept of the “magic bullet”—a drug capable of precisely targeting disease-causing agents without harming the rest of the body. Ehrlich’s magic-bullet vision has profoundly influenced generations of scientists and has driven the development of increasingly sophisticated treatments. This paradigm—focused on crafting precise remedies for specific diseases—has become a cornerstone of the biomedical model in contemporary medicine. The optimism surrounding this approach is further fueled by the rapid expansion of the global pharmaceutical market, which has grown from $73 billion in 1985 to over $1.6 trillion today. Historically, the pharmaceutical industry has been among the most profitable sectors in the global economy. With aging populations and the rising incidence of chronic diseases, the demand for pharmaceutical treatments will continue to surge. However, beneath this success story lies a more intricate reality. As we step further into the twenty-first century, the limitations of the magic-bullet ideology have become increasingly evident. Chronic conditions such as heart disease, diabetes, cancer, and mental health disorders continue to rise globally, affecting younger populations with increasing severity. Simultaneously, infectious diseases like HIV/AIDS, tuberculosis, and COVID-19 expose the fallacy of imagining single-drug solutions in the face of complex, systemic health challenges. Pharmaceuticals present a compelling lens through which to examine the complex relationship between medicine, political economy, and cultural symbols. They are not only integral to global flows of capital and commerce but also embody powerful symbols of hope, healing, and the promises and perils of modern technology. Therapeutic drugs play an active role in shaping healing practices and cultures. This bibliography examines studies on the development, marketing, and public perception of therapeutic drugs, particularly those heralded as “magic bullets,” “miracles,” or “wonder” drugs. Special focus is given to the role of medicines as symbols of modern medicine’s power and fallacies, and the ways they have become central to public and private narratives of mediation, imagination, and contestation.

General Overviews

Liebenau 1987, the first scholarly history of the pharmaceutical industry, focuses on a pivotal period in the sector’s early growth, highlighting the crucial interplay among science, medicine, and business that led to the creation of the first generation of patented prescription drugs, such as the “magic bullet” Salvarsan. Chandler 2005 shifts the lens to American pharmaceutical firms, examining their “learning bases”—the amassed knowledge, resources, competencies, and capabilities—and argues that firms follow distinct “learning paths.” According to Chandler, these “core companies” in high-tech industries, comprising early movers and fast followers, established their learning foundations early on, allowing them to leverage initial successes in both financial and intellectual terms. Landau, et al. 1999 emphasizes innovation as the primary driver of the pharmaceutical industry’s evolution from the late nineteenth to the late twentieth century. This work’s collected chapters explore the discovery and development of significant drugs and provide a thorough analysis of the economics underlying drug development. Hara 2003 adopts both historical and sociological perspectives to trace pharmaceutical advancements in Japan and the United Kingdom, presenting sixteen case studies on pivotal 20th-century pharmaceutical breakthroughs (e.g., beta-blockers and inhaled steroids). Tobbell 2012 adopts a more critical perspective, delving into the political and economic history of the growing alliance between the pharmaceutical industry, academic institutions, and organized medicine, and examining how corporate interests came to dominate American health care. Dutfield 2020, in a similar critical academic fashion, offers a compelling, contemporary account of the pharmaceutical industry’s evolution, emphasizing continuity in profit-driven practices and the enduring influence of “magic bullet” R&D priorities. This work covers the “long twentieth century” of drug development, ever-greening patenting strategies, and regulation. Tone and Siegel Watkins 2007 takes a more culturally oriented approach, viewing drugs as evolving social constructs, layered with meaning and situated within complex societal networks. This conceptual framework echoes Gaudillière 2005 and its notion of a “drug trajectory”; van der Geest, et al. 1996 and its “drug biography”; and Snelders, et al. 2006 and its drug life cycle. Building on these ideas, Bonah, et al. 2009 analyzes the multitude of actors and forces that shaped pharmaceuticals during the golden age of drug R&D, from 1930 to 1970, a period marked by the rise of “miracle drugs” that reshaped health-care systems and society alike. In a similar analytical vein, Greene 2007 explores how drugs and chronic diseases—such as hypertension, diabetes, and high cholesterol—were co-constructed, examining the evolving dynamics between medical treatments and chronic health conditions.

• Bonah, Christian, Christophe Masutti, Anne Rasmussen, and Jonathan Simon, eds. Harmonizing Drugs: Standards in 20th Century Pharmaceutical History. Paris: Editions Glyphe, 2009.

  Examines the multifaceted influences—scientific, economic, social, and cultural—that guided pharmaceutical development during the transformative period from 1920 to 1970. Through the lens of standardization, the book illuminates how the introduction of “miracle” drugs reshaped health-care practices and societal structures, marking the “therapeutic revolution.” This era saw rapid advancements in drug research and development of standardized medical treatments that contributed to a broader shift in public health perceptions, solidifying pharmaceuticals’ role as central to modern health care and everyday life.

• Chandler, Alfred D., Jr. Shaping the Industrial Century: The Remarkable Story of the Evolution of the Modern Chemical and Pharmaceutical Industries. Cambridge, MA: Harvard University Press, 2005.

  DOI: 10.4159/9780674029378

  Examines primarily American pharmaceutical companies through the concept of “learning bases”—the collective knowledge, resources, and competencies that drive innovation and market dominance. Argues that “core companies”—first movers and their rapid followers—established these bases early, securing competitive advantages and creating high barriers to entry. Highlights a “virtuous strategy,” where successful companies avoided unrelated diversification, channeling profits into new product generations. Through three thematic lenses, Chandler presents a history of stability and transformation, emphasizing science’s role as the industry’s growth engine.

• Dutfield, Graham. That High Design of Purest Gold: A Critical History of the Pharmaceutical Industry, 1880–2020. Singapore: World Scientific, 2020.

  DOI: 10.1142/11889

  Provides a comprehensive historical account of the pharmaceutical industry’s evolution, focusing on the interdependence between drug innovation, patenting, and regulation. Explores the industry’s roots in 19th-century drug production, highlighting Bayer’s branding of Aspirin as the first global pharmaceutical product. Bayer led the way in its sophisticated use of intellectual property, including trademarks, as well as in its scientific, research-based approach. Dutfield examines how intellectual property and market strategies, including evergreening, have shaped modern drug life cycles and profit motives. He criticizes current practices that prioritize profit over access and affordability.

• Gaudillière, Jean-Paul. “Introduction: Drug Trajectories.” Studies in the History and Philosophy of Biological and Biomedical Sciences 36 (2005): 603–611.

  DOI: 10.1016/j.shpsc.2005.09.005

  Explores how pharmaceuticals evolved from individually prepared remedies to industrialized, standardized products central to 20th-century health care. Examining the influence of scientific, social, and economic forces, Gaudillière emphasizes standardization as a tool for control, shaping drug manufacturing, quality, and clinical use. Through diverse case studies—ranging from penicillin’s industrial scaling during WWII to sex steroids’ development—Gaudillière underscores the interplay between science, industry, and regulation. This work highlights the complex networks binding scientists, manufacturers, clinicians, and patients in shaping drug making and drug use.

• Greene, Jeremy. Prescribing by Numbers: Drugs and the Definition of Disease. Baltimore: Johns Hopkins University Press, 2007.

  Examines the transformation in American health care from symptom-based treatment to preventive medicine, driven by pharmaceuticals that address conditions like hypertension, diabetes, and cholesterol. Through the historical trajectories of an antihypertensive, an antidiabetic, and a cholesterol-reducing agent, Greene traces how medical marketing, research, and practice evolved together. He describes the emergence of a new model of disease based on numerical deviations rather than symptoms and treated on a preventive basis before any overt signs of illness develop. This concept of treating “healthy” patients arose gradually in concert with the development and use of marketable prescription drugs.

• Hara, Takuji. Innovation in the Pharmaceutical Industry: The Process of Drug Discovery and Development. Cheltenham, UK: Edward Elgar, 2003.

  DOI: 10.4337/9781843765660

  Offers an in-depth historical and sociological analysis of the drug development process, highlighting how stages—compound creation, application, organizational approval, and market entry—are shaped by diverse actors and institutions. Distinguishes between three types of pharmaceutical innovation: paradigmatic, application-based, and modification-based, each with unique characteristics. Through a comparative study of British and Japanese cases of drug discovery and development, the book uncovers historical, structural, economic, and cultural influences on drug making. This work provides valuable insights into stimulating and managing pharmaceutical innovation.

• Landau, Ralph, Basil Achilladelis, and Alexander Scriabine, eds. Pharmaceutical Innovation: Revolutionizing Human Health. Philadelphia: Chemical Heritage Press, 1999.

  A comprehensive collection of essays that explore the history of the American pharmaceutical industry in the twentieth century, examining both technological advancements and business strategies. Emphasizing the industry’s research- and marketing-intensive nature, the book discusses how the United States emerged as a global leader after World War II, with six of the top eleven pharmaceutical companies based in the United States by 1998. The essays focus particularly on the industry’s commitment to research, experimentation, and innovative practices that have driven its competitive success.

• Liebenau, Jonathan. Medical Science and Medical Industry: The Formation of the American Pharmaceutical Industry. Baltimore: Johns Hopkins University Press, 1987.

  DOI: 10.1007/978-1-349-08739-6

  Examines the American pharmaceutical industry’s evolution from a sales-focused market to one rooted in scientific rigor and innovation. Emphasizes two pivotal events: the emergence of biological drugs in the 1890s, which positioned public health agencies as leaders in serum production, and the disruptions of World War I. This curtailed German imports and stimulated U.S. research. Liebenau’s primary interest lies in how pharmaceutical companies leveraged the image of science to bolster their credibility with physicians. He illustrates how competitive pressures and government regulations drove the industry’s modernization, establishing it as one of the first science-based sectors.

• Snelders, Stephen, Charles Kaplan, and Toine Pieters. “On Cannabis, Chloral Hydrate, and Career Cycles of Psychotrophic Drugs in Medicine.” Bulletin of the History of Medicine 80 (2006): 95–114.

  DOI: 10.1353/bhm.2006.0041

  Examines the historical trajectories of two psychotropic drugs in 19th-century Western psychiatry: Cannabis indica and chloral hydrate. Used similarly for conditions like mania, delirium tremens, and drug dependence, both drugs experienced what the authors term “Seige cycles”—phases of initial enthusiasm, followed by negative reevaluation, and eventual restricted use. While both drugs follow similar cycles, chloral hydrate, as a synthetic introduced in 1869, reached more dramatic highs and lows than Cannabis indica, a “premodern” drug rooted in Romanticism. The authors propose the drug life cycle as a valuable framework for analyzing drug histories.

• Tobbell, Dominique. Pills, Power, and Policy: The Struggle for Drug Reform in Cold War America and Its Consequences. Berkeley: University of California Press, 2012.

  Examines the historical dynamics between the pharmaceutical industry, academic medicine, and regulatory efforts in the United States during the twentieth century. Explores how alliances between industry and academia expanded post–World War II, fostering clinical research and training while resisting aggressive reforms like Senator Estes Kefauver’s investigations. Highlights key moments, including the 1962 Kefauver-Harris Amendments and the establishment of the Drug Research Board, which influenced drug regulation. Critically illuminates how these alliances shaped modern debates on affordability and regulatory oversight.

• Tone, Andrea, and Elizabeth Siegel Watkins, eds. Medicating Modern America: Prescription Drugs in History. New York: NYU Press, 2007.

  Explores the profound impact of prescription drugs on American society, focusing on eight influential drugs—antibiotics, mood stabilizers, hormone replacement therapy, oral contraceptives, tranquilizers, stimulants, statins, and Viagra. Through a historical lens, the authors examine the cultural and medical forces that have made prescription drugs a cornerstone of both medical practice and daily life. Highlighting recurring controversies, the book reveals how current debates about pharmaceuticals resonate with past concerns. This comprehensive analysis unearths the complex narratives behind America’s pharmaceutical dependency and challenges.

• van der Geest, Sjaak, Susan Reynolds, and Anita Hardon. “The Anthropology of Pharmaceuticals: A Biographical Approach.” Annual Review of Anthropology 25 (1996): 153–178.

  DOI: 10.1146/annurev.anthro.25.1.153

  Examines pharmaceuticals through a social and cultural lens, tracing their journey from production to consumption and efficacy. Each phase in the drug “life cycle” involves unique actors, contexts, and values, offering insight into the social transactions and meanings that shape pharmaceuticals in various settings. Through manufacturing, trading, prescribing, buying, and consuming, people give pharmaceuticals a “social life” and agency. By exploring issues central to both medical anthropology and health policy, this work intersects with broader anthropological themes such as culture versus nature, symbolization, and globalization.