Scandalous Industry: When Medicine Goes Wrong
The pharmaceutical industry has always held a dichotomous position. Whilst the funding and facilities firms have provided for scientific pharmacists, chemists and their ilk have led to many of the most important breakthroughs in twentieth century drug treatments, the nature of the product they provide - drugs and by association good-health – has left them open to damning criticism. This essay shall examine one of the primary roots of such criticism; the drug scandal. By studying the cases of Sulfanilamide and Ritalin, this essay shall determine why such scandals have occurred throughout the century despite dramatic legal changes. Ultimately, this essay hopes to chart the evolution of such drug scandals, and the complex relationships therein, between government, pharmaceutical companies, medical professionals and consumers. It is the hope that by juxtaposing a relatively unambiguous incident, with one drastically more complex, this study shall offer a comprehensive analysis of such developments. The 1937 Sulfanilamide disaster in the United States provides a comprehensive case study in which to examine the roots of dangerous pharmaceuticals. But first one must consider the context in which the Elixir was produced. Prior to the 1930s, the most recent legislation passed by Congress was the 1906 Pure Food and Drugs Act, yet ultimately, as Abraham argues, this was a protectionist measure for the consumer against false advertising and not for drug safety at the point of manufacture. The Act, according to Conrad and Leiter, allowed only partial concessions to purity - and in later amendments - efficacy. Gordon Appelbe however, emphasises the role of the American Medical Association in pharmaceutical manufacture, as proponents of clinical trials, pharmacological testing for toxicity, and the praxis of individual agency in evaluating new drugs for the market, though their impact on such processes should not be overstated, as much of these processes were simply formalities, with clinical trials simply affirming a ‘preliminary investigation’. Moreover, John Abrahams identifies a polarity affecting national industry endeavours. On one hand, post-First World War industrial America was flourishing under the ‘Fordist modelling of mass production’, yet in the immediate context of the Sulfanilamide disaster, the economic devastation of the 1930s depression was still widely-felt, with ‘as many as one-third of the population’ in 1937 going hungry. Historically, Sulfanilamide was produced amidst easily abused legislation, poor pre-emptive steps towards drug safety control and a fragile binary position for industry, in which profit would mean prosperity or closure. Yet to what extent were these factors responsible for the disaster? First to consider is the role of S. E. Massengill, the pharmaceutical firm in Boston, Tennessee who manufactured Elixir of Sulfanilamide-Massengill. The historiography concurs over the grossest oversight of the manufacturers. Appelbe, Abraham, Mann and Weatherall all place the lack of clinical testing beyond a simple ‘taste-test’ at the crux of the scandal. Abraham directly relates this to the insufficiency of the ‘existing legislation’, and Mann elaborates, identifying sulphanilamide as a ‘readily accessible bulk chemical’ and as such was unavailable for patenting. Wetherall discusses the wider ‘primitive attitudes to medicine’ which limited call for reform, and Abraham himself draws attention to the fact that the manufacturer was not required to name the solvent on the drug’s label. Legal measures were evidently imbibed with lax attitudes towards the nature of pharmaceutical products. The case for error on the part of the manufacturer therefore remains blurred. Massengill’s oversights were irresponsible, but not illegal. Indeed, punitive action could only be brought against them on a trivial charge, i.e. the use of the term ‘elixir’ when no alcohol was contained in...
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