Drugs and modern society
This option is concerned with the development of medicinal therapies from the end of the
nineteenth century to the beginning of the twenty-first. Throughout, I want us to ask ‘ What is a
drug’? The course is structured around a flexible framework of case studies of particular remedies,
and we will discuss of the development of the pharmaceutical industry, and explore questions such
as, Who makes drug discoveries? What are the institutional settings for drug discovery? With
particular regard to industry we will consider the impact of markets/demand/advertising (and the
effect of distribution networks and the rise of the ‘branded’ good). We will also make some
assessments of the changing patterns of human diseases, the inter-relationships of health policy and
health care systems with pharmaceutical advances, including technological developments in
formulation; manufacturing; marketing; drug packaging; storage; and drug delivery. What role do
drugs play in the doctor-patient relationship? The geographical focus will be Western Europe and
North America. There will not be a set reading for each week – rather a list of recommended
readings that each student is encouraged to explore.
Assessment will be in the form of two essays each of c3500 words (excluding footnotes and
bibliography). One will be chosen from a precirculated list, the other will be on a relevant topic of
the student's own choosing, with the agreement of the lecturer.
General and background reading
The American Chemical Society’s website has several pages devoted to chemical history, which
include:
Chronicles of Chemistry : http://pubs.acs.org/supplements/chemchronicles2/
The Pharmaceutical Century: http://pubs.acs.org/journals/pharmcent/index.html
Avorn, J (2005) Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs Vintage
Press
Anderson, S (ed) (2005) Making medicines: a brief history of pharmacy and pharmaceuticals.
Pharmaceutical Press
Bynum, W F, Hardy, A., Jacyna, S., Lawrence, C,., Tansey, E M (2006) The Western Medical
Tradition , 1800-2000, Cambridge University Press
Charlton, J., Fraser, P., & Murphy, M. (1997) Medical advances and iatrogenesis, in The health of
adult Britain 1841-1994, eds J. Charlton & M. Murphy, HMSO vol 1, pp 217-229.
Curth, L H (ed) (2006) From physick to pharmacology. Ashgate
Goodman, J (2000) Pharmaceutical industry In Medicine in the twentieth century ed R Cooter & J
Pickstone, Harwood, pp 141-154
Hardy, A. (2001) Health and medicine in Britain since 1860 Palgrave.
Le Fanu, J (1999) The rise and fall of modern medicine Little Brown & Company
Liebenau, J., Higby, G.J., & Stroud, E.C. (eds) (1990) Pill Peddlers: Essays on the History of the
Pharmaceutical Industry, American Institute of the History of Pharmacy, Wisconsin.
Lock, S. (1997) Medicine in the second half of the twentieth century, In Western medicine. An
illustrated history ed. Irvine Loudon, Oxford University Press, Oxford, pp 123-144.
Mann, J. (1999) The elusive magic bullet: the search for the perfect drug. OUP.
Parnham, M.J., & Bruinvels, J. (eds) Discoveries in Pharmacology, Vol 1: Psycho- and neuropharmacology. Elsevier.
1
Parnham, M.J., & Bruinvels, J. (eds) Discoveries in Pharmacology, Vol 2: Haemodynamics,
Hormones & Inflammation. Elsevier.
Parnham, M.J., & Bruinvels, J. (eds) Discoveries in Pharmacology, Vol 3: Pharmacological
methods, receptors and chemotherapy. Elsevier.
Rivett, G (1998) From cradle to grave: fifty years of the NHS Kings Fund. Some of these
chapters are also available at http://www.nhshistory.net/
Sneader, W (1985) Drug discovery: the evolution of modern medicines Wiley Re-issued as Drug
discovery: a history (2005)
Tansey, E.M. (1997) From the germ theory to 1945. In Western medicine. An illustrated history
ed. Irvine Loudon, Oxford University Press, Oxford pp 102-122.
Various (2000) Cutting Edge: an encyclopaedia of advanced technologies. OUP
Weatherall, M. (1990) In search of a cure: a history of pharmaceutical discovery OUP.
Week One: Pills, potions and the pharmaceutical industry: 1890-1918
This session will examine the state of pharmacy, the beginnings of the pharmaceutical
industry, particularly in Germany and Switzerland, and their impact on the USA and Britain
at the turn of the twentieth century. The development of new biological therapies, sera and
hormones will be highlighted, as will the impact of the first world war on the development
of pharmaceutical research, production and marketing.
Readings:
Church, R A & Tansey, E M (2007) Burroughs Wellcome & Co.: Knowledge, trust, profit and the
transformation of the British pharmaceutical industry, 1880-1940 Crucible Books
Collier, H.O. (1984) The story of aspirin In Parnham & Bruinvels vol 2. pp 555-593.
Fisher, J.W. (1986) Origins of American pharmacology Trends in Pharm Sci Feb: 41-45.
Parascandola, J. (1982) John J Abel and the early development of pharmacology at the Johns Hopkins
University Bull Hist Med 56:512-527.
Robson, J. (1990) The French pharmaceutical industry, in Liebenau et al , pp107- 122.
Tansey, E.M. (1995) Pills, profits and propriety: the early pharmaceutical industry in Britain: The
1995 Foundation lecture Pharmaceutical Historian 25:3-8.
Tansey, E.M., & Milligan, R.C.E. (1990) The early history of the Wellcome Research Laboratories,
1894-1914 in Liebenau et al, pp 91-106.
Weatherall Chap 3.
For light reading you might like to look at H G Wells’ Tono-bungay
2
Week Two: Interwar growth and specialisation, 1920-1939
The major therapeutic advances during this period will be discussed, focussing on insulin,
vitamins and hormones. The role of organisations such as the League of Nations in
supporting international agreements on Biological Standards, and the Medical Research
Council in promoting national legislation on therapeutics will be included. This session will
end with the discovery of sulphanilimide and the beginning of large scale introduction of
sulphonamides.
Apple, R. (1996) Vitamania: vitamins in American culture. Rutgers UP.
Bangham, D. (1999) A history of biological standardization. Society for Endocrinology, esp chap 4,
origins of biological standardisation 20-31.
Bliss, M. (1982) The story of insulin University of Chicago Press.
There are a number of versions of this book, including a ‘25th anniversary’ edition, in which
the author reflects on the process of researching & writing the book.
Kamminga, H. (2000) “Axes to grind”: popularising the science of vitamins, 1920s and 1930s in
Food, Science, Policy and Regulation in the twentieth century ed D F Smith & J Phillips,
Routledge, pp 83-100.
Weatherall, M. (1990) Chapter 7.
Week Three: Antibiotics:1939-1950, and beyond
Starting from the sulphonamides, this session will focus on antibiotic drugs and the
discovery and usage of penicillin, its production and related legislation, including issues of
industrial collaboration and liaison, and the increasing recognition of bacterial resistance.
Bud, Robert (1998) Penicillin and the new Elizabethans Brit J Hist Sci 31: 305-333
Bud, Robert (2007) Penicillin: triumph and tragedy, Oxford University Press
Le Fanu chapter 1
Reynolds, L A & Tansey, E M (eds) (2008) Suberbugs & superdrugs: a history of MRSA
Wellcome Witnesses to Twentieth Century Medicine, vol 32 London.
Tansey, E.M., & Reynolds, L.A. (eds) (2000) Post penicillin antibiotics: from acceptance to
resistance? Wellcome Witnesses to Twentieth Century Medicine, vol 6. London.
Weatherall, M. (1990) chapters 8 & 9.
Yoshioka, A. (2002) Streptomycin in postwar Britain: A cultural history of a miracle drug in
Gijswijt-Hofstra, M. Van Heteren, G.M., & Tansey, E.M. Biographies of Remedies: Drugs,
medicines and contraceptives in Dutch and Anglo- American healing cultures. Rodopi,
Amsterdam, pp 203-227.
There are numerous accounts of the discovery of penicillin, and biographies of those
involved. You may like to look at the several books in the Wellcome Library and make an
assessment of their contributions to the history of penicillin. Of the many biographies, those
of Alexander Fleming and Howard Florey, both by Gwyn Macfarlane, are well worth longer
perusal, and Eric Lax’s ‘The mold in Dr Florey’s coat’.
3
Week Four: Post war public health 1950s
This session will consider the growth of health care provision, especially the British
National Health Service, and the concomitant expansion of therapeutic expectations, and
public health initiatives. There will be a particular focus on vaccination programmes,
especially the cases of polio and smallpox.
Black, K. (1996) In the shadow of polio: a personal and social history. Harlow.
Blume, S. & Geesink, I. (2000) A brief history of polio vaccines Science 288: 1593-1594.
Braxby, D. (1999) The end of smallpox History Today 49: 14-16.
Fenner, F. (1993) Smallpox: emergence, global spread and eradication Hist Phil Life Sciences 15:
397-420, especially smallpox eradication pp 406-414.
Gould, T. (1995) A summer plague: polio and its survivors. Yale U P, especially Chap 6 A planned
miracle, pp111-158.
Meldrum, M. (1998) A calculated risk: the Salk polio vaccine field trials of 1954 BMJ 317: 123336.
Melnick, J.L. (1996) Oral polio vaccine and the results of its use in Vaccinia, vaccination ,
vaccinology: Jenner, Pasteur and their successors. eds. S.A. Plotkin & B. Fantini. Paris.
Seavey, N.G., Smith, J.S., Wagner, P. (1998) A paralysing fear: the triumph over polio in America,
esp Chap 5, Salk, Sabin and the search for a vaccine, pp 163-229.
Tucker, J.B. (2001) Scourge: the once and future threat of smallpox Atlantic Monthly Press.
Week Five: Drugs for the mind 1950s - present
The impact of the discovery and therapeutic utilisation of Chlorpromazine will be
considered, as will the development of drugs for a variety of psychiatric disorders, and the
recreational use of drugs.
Readings
Abraham, J., & Sheppard, J. (1999) The therapeutic nightmare: the battle over the world’s most
controversial sleeping pill. Earthscan. London.
Healy, D. (1997) The antidepressant era Harvard U P.
Healy has also edited a number of books of interviews with psychopharmacologists and the
development of this specialised field.
Le Fanu (1999) Chapter 4
Snyder, S. (1986) Drugs and the brain Scientific American Library.
Tansey, E.M. (1998) They used to call it psychiatry: aspects of the development and impact of
psychopharmacology. In Cultures of Psychiatry and mental health care in postwar Britain
and The Netherlands ed Gijswijt-Hofstra & Porter, Rodopi, Amsterdam pp 79-102.
Thuillier, J. (1999) Ten years that changed the face of mental illness. Martin Dienitz, London
Weatherall, M.(1990) Chapter 13.
Wurtzel, E. (1995) Prozac nation: young and depressed in America, a memoir. Quartet, London.
3rd – 7th November - reading week
4
Week Six: Thalidomide and Problems 1950s-1960s
Using the thalidomide tragedy as a case study this session will examine, inter alia, issues of
drug safety and relevant legislation.
Readings
Corley, T.A.B. (2005) UK Government regulation of medicinal drugs, 1890-2000. Business History
47: 337-351
Doll, R (1998) Controlled trials: the 1948 watershed BMJ 317:1217-20
FDA History at www.fda.gov/oc/history.
Insight Team, The Sunday Times (1979) Suffer the children: the story of thalidomide Andre
Deutsch.
Jepson, M H (2005) ‘From secret remedies to prescription medicines: a brief history of medicine
quality’, in Anderson, S (ed) (2005) pp 223-241
Marks, H (1997) The progress of experiment: science and therapeutic reform in the United States,
1900-1990. CUP, Chapter 3.
Stephens, T. & Brynner, R. (2001) Dark remedy: the impact of thalidomide and its revival as a
vital medicine. Perseus.
Tansey, E.M., & Reynolds L.A. (eds) (1997) The Committee on Safety of Drugs. In Wellcome
Witnesses to Twentieth Century Medicine Vol 1, Wellcome Trust pp103-135;
Weatherall, M. Chapter 14.
Week Seven: ‘The Pill’ and pills – 1960s-1970s
The development of the contraceptive pills will be considered, in the context of debates
about the use of pharmaceuticals for 'non-medical reasons', conflicts between
pharmaceutical companies and the medical profession, and consumer demand.
Readings
Djerassi, C. (1984) The chemical history of the Pill in Parnham & Bruinvels vol 2, pp 339-361.
Djerassi, C. (1994) From the lab into the world: a pill for people, pets and bugs Creators of modern
chemistry, Washington.
Djerassi, C. (2001)This man's pill: reflections on the 50th birthday of the pill OUP .
Goldzieher, J.W. (1982) Estrogens in oral contraceptives: historical perspectives Johns Hopkins
Med J 150: 165-169.
Greep, R.O. (1984) The biological history of the Pill in Parnham & Bruinvels vol 2, pp 321-337.
Junod, S.W. (2002) Perspectives on the pill: an essay review J Hist Med Allied Sciences 57:333339.
Marks, L. (2001) Sexual chemistry: a history of the contraceptive pill. Yale UP.
Watkins, E.S. (1998) On the pill: a social history of oral contraceptives, 1950-1970 Baltimore.
5
Week Eight: Maintenance and enhancement, 1970s onwards
Examining case studies starting with the use of L-DOPA for Parkinson's disease, this
session will include discussion of the development and impact of drugs for long term
maintenance of degenerative conditions, such as beta-blockers, and the significance of
pharmaceutical advances in facilitating the development of transplant surgery.
Readings
Shanks, R.G. (1984) The discovery of beta adrenoceptor blocking drugs in Discoveries in
Pharmacology. Volume 2: Haemodynamics, hormones and inflammation ed M J Parnham &
Bruinvels, vol 2, pp Elsevier, Amsterdam.
Sourkes, T L & Gauthier, S (1983) Levodopa and dopamine agonists in the treatment of
Parkinson’s disease In Parnham & Bruinvels, vol 1, 249-267
Vos, R (1991) Drugs looking for diseases: innovative drug research and the development of the
beta blockers and the calcium antagonists. London, especially Chapter 3. Experimental &
therapeutic profiling in drug innovation: the early history of the beta blockers, pp 71-79,
Chap 4 Industrial research and beta blockade, pp 81-122
Vos, R & Bodewitz, H (1988) Pharmacological and therapeutic profiling in drug innovation: the
early history of the beta blockers Perspec Biol Med 31:469-480
Week Nine: New diseases, new therapeutic challenges, 1980 – present
An examination of how new health problems, especially the emergence of AIDS, and
returning diseases like tuberculosis have provided new challenges to the pharmaceutical
industry and policy makers.
Readings
Berridge, V. (1996) AIDS in the UK: the making of policy 1981-1994 OUP, esp pp 182-189.
Douglas, R.G. (1995) The implications of AIDS for the development of therapies and vaccines: a
pharmaceutical industry perspective. In AIDS and the public debate: historical and
contemporary perspectives, eds C. Hannaway, V. Harden & J. Parascandola, IOS Press, pp
86-97.
Fisher, M A (2003) Physicians and the pharmaceutical industry: a dysfunctional relationship
Prospect. Biol. Med. 46: 254-272
Galambos, L. & Sewell, J.E. (1995) Networks of innovation: vaccine development at Merck, Sharp
& Dohme, and Mulford, 1895-1995 CUP, chapters 7 & 8.
Hilleman, M.R. (1999) The business of science and the science of business in the quest for an
AIDS vaccine Vaccine 17:1211-1222.
Moynihan, R., Heath, Iona, & Henry, D (2002) Selling sickness: the pharmaceutical industry and
disease mongering BMJ 324: 886-891
Moynihan , R & Cassels, A (2005) Selling sickness: how drug companies are turning us all into
patients Allen & Unwin
Thomas, P. (2001) Big Shot: Passion, politics and the struggle for an AIDS vaccine. Public Affairs.
For light reading try John Le Carre’s The constant gardener.
6
Week Ten: Genes, cancer and the biotech industry 1980 - present
The final lecture will examine modern advances in genetic engineering, cancer research and the rise
of biotechnology companies, including discussion of rational drug design and the impact of
combinatorial chemistry. We will also review the course as a whole.
Readings
Bud, R. (1993) The uses of life: a history of biotechnology, Cambridge , especially chapter 9
Marsa, L. (1997) Prescription for profits: how the pharmaceutical industry bankrolled the unholy
marriage between science and business. Scribner, New York
Day, M. (2000) Rational drug design in The Cutting Edge, OUP pp 215-218
Downey, P. (2000) Combinatorial chemistry in The Cutting Edge, OUP, pp 43-46
Quirke, V (2005) ‘From alkaloids to gene therapy: a brief history of drug discovery in the 20th
century’, in Anderson, S (ed) (2005), 177-201
Tansey, E.M. & Catterall, P.P. (eds) (1997) Technology transfer in Britain: The case of Monoclonal
Antibodies. In Wellcome Witnesses To Twentieth Century Medicine Vol 1, London, pp 134
Walsh, V. & Goodman, J. (2001) The story of Taxol: nature and politics in the pursuit of an anticancer drug. CUP.
Weatherall, M. Chapter 11.
Professor Tilli Tansey
Room 607
Tel 020 7679 8124 /8106
t.tansey@ucl.ac.uk
7