Medicine in the Early 20th Century Part 2
—- The Pharmaceutical Industry
During spring break, I had the opportunity to visit a pharmaceutical company in Xi’an that produces anesthetics as their main product. During my visit at the factory, the manager showed me the many precautions taken by the company to minimize the possibility of contamination and ensure the safety of their products. In addition, the company has dedicated a significant amount of resources and space in keeping samples of every batch of past products and monitoring their status. My experience there elicited my curiosity about the pharmaceutical industry. In this blog post, I will look at the history of the pharmaceutical industry with a specific focus on its development in the 20th century.
— History of Pharmaceutical Industry —
The 20th century saw the booming of the pharmaceutical industry around the world, thanks to multiple unprecedented breakthroughs in medicine and high demand of drugs during the two world wars. The origin of this industry could be traced back to the small apothecaries that sold traditional remedies in the medieval period.(Parker) The Scientific Revolution of the 17th century contributed to the development of studies in chemistry and eventually successes in the 19th century in isolating active ingredients to be used in medications.(Walsh) The discovery and isolation of insulin and penicillin at the beginning of the 20th century launched the pharmaceutical industry into a new era, establishing its foundation as a future multi-billion dollar enterprise.(Parker)
After World War Ⅱ, social healthcare systems started to form in many countries around the world, marking the beginning of the standardization of the pharmaceutical industry. While the industry boomed with new drugs entering the market and new advancements made, the ethical issues surrounding the selling of medical products gradually emerged.(Walsh)
“We try never to forget that medicine is for the people.”– George W. Merck
The Thalidomide Scandal — 1961
Perhaps one of the biggest scandal in the history of medicine is the Thalidomide Scandal in 1961. In the 1950s, Thalidomide was first introduced to the market by German pharmaceutical company Chemie-Grunenthal as a sedative with no negative effects. Thalidomide’s proclaimed absolute safety and promising effects in treating morning sickness in pregnant women resulted in its distribution in 46 countries around the world. However, after a decade, it was confirmed to be the culprit for severe birth defects in children, causing debilitating limb malformations. It is often referred to as “the largest man-made medical disaster in history,” affecting over 10,000 children and their families.
However, the disaster did not happen in the U.S.. Thalidomide was not approved to be sold in the U.S. because of one FDA physician– Frances Kelsey. During the process of approving durg licenses, Kelsey had concerns about the safety of thalidomide because of several reports about thalidomide-induced teratogenesis. Despite the overwhelming pressure to allow the drug into the U.S. market at that time, Kelsey’s work prevented the tragedy. She was later awarded the President’s Award for Distinguished Federal Civilian Service by John F. Kennedy.(Vargesson)
As a lasting influence of the Thalidomide Scandal, a new amendment was made to the US Food and Drug Administration regulations, stating that proof of efficacy along with accurate disclosure of side-effects are required for all new medications.(Walsh) In addition, the scandal completely altered the research and testing protocols for drugs.(Vargesson)
In the 21st century, the tragic aftermath of the scandal still exists. There is a generation of Thalidomide-damaged children who are now middle-age adults. Gruenthal, the company responsible for the scandal, however, was never prosecuted. It was not until 2012 that the company made a public statement, claiming responsibility and offering an “apology”.(Vargesson) This article titled “How Men Who Blighted Lives of Thousands Evaded Justice” from The Guardian examines the Thalidomide Scandal and how political interference betrayed thousands of victims.
AlGhatrif, Majd, and Joseph Lindsay. “A brief review: history to understand fundamentals of electrocardiography.” Journal of community hospital internal medicine perspectives vol. 2,1 10.3402/jchimp.v2i1.14383. 30 Apr. 2012, doi:10.3402/jchimp.v2i1.14383
Bantinghouse. “Before Banting: Treatments for Diabetes in the Pre-Insulin Era.” Banting House, 29 July 2016, bantinghousenhsc.wordpress.com/2016/07/29/before-banting-treatments-for-diabetes-in-the-pre-insulin-era/. Accessed 11 Apr. 2019.
Blood for Britain Campaign. U.S. Army Medical Department, history.amedd.army.mil/booksdocs/wwii/blood/default.htm.
C. H. Best and F. G. Banting. Wikimedia Commons, commons.wikimedia.org/wiki/File:C._H._Best_and_F._G._Banting_ca._1924.png. Accessed 11 Apr. 2019.
Edan SE-1200 Express Basic 12-Channel ECG Machine. Tiger Medical, www.tigermedical.com/Products/12-Channel-ECG-Machine__EDASE-1200ExpressBasic-.aspx. Accessed 11 Apr. 2019.
“EKG Machine and ECG Machine Buyer’s Guide for Medical Professionals.” USA Medical and Surgical Supplies, 6 July 2018, www.usamedicalsurgical.com/blog/ekg-ecg-machine-buyers-guide/. Accessed 11 Apr. 2019.
Parker, Steve, editor. Medicine– the Definitive Illustrated History. New York, DK Publishing, 2016.
Quianzon, Celeste C, and Issam Cheikh. “History of insulin.” Journal of community hospital internal medicine perspectives vol. 2,2 10.3402/jchimp.v2i2.18701. 16 Jul. 2012, doi:10.3402/jchimp.v2i2.18701
Sir Alexander Fleming. 11 Mar. 1955. Time, time.com/4049403/alexander-fleming-history/. Accessed 11 Apr. 2019.
Type 1 vs Type 2 Diabetes. Today Health Tips, www.todayhealthtips.com/types-of-diabetes/. Accessed 11 Apr. 2019.
Vargesson, Neil. “Thalidomide-induced teratogenesis: history and mechanisms.” Birth defects research. Part C, Embryo today : reviews vol. 105,2 (2015): 140-56. doi:10.1002/bdrc.21096
Walsh, Robin. “A History of the Pharmaceutical Industry.” Pharmaphorum, 1 Oct. 2010, pharmaphorum.com/articles/a_history_of_the_pharmaceutical_industry/.