That High Design of Purest Gold: A Critical History of the Pharmaceutical Industry Graham Dutfield (2020) 510pp., £60 paperback, World Scientific, Hackensack NJ, ISBN 978-981-124-992-1

Drug production as ‘industry’ becomes practical only with the era of mass manufacture, so this history is relatively short, perhaps 150 years. Dutfield covers it in detail, with an engaging narrative flow, and with specific important cases and examples highlighted. To a great extent, the history of the pharma industry complements and runs parallel to modern medicine, with the rapid development and deployment of scientific research methods, mainly beginning in the mid-nineteenth century. Florence Nightingale’s systematic visualization of the casualty and sickness data in 1850s Crimea is an early example of science applied to medical research. It is true that medicine and medical practitioners can be traced back thousands of years but, as Dutfield explains, the early model of treatment (shown by such texts as The Housekeepers Guide in 1835) was one in which each person was perceived to have a unique sickness and an individual treatment for it. Discoveries about disease transmission and prevention, by Pasteur and others, led to the realization that diseases could be identified, and treatments developed, independently of any prospective patient. This opened the way for drug development and production on a grand scale, ideally suited to the industrial factory methods that had begun to flourish (with pottery and fabrics) in the late eighteenth century. The fabric revolution required research into dyes, which in turn led to the growth of research in chemistry and a chemicals industry. This coincided with the flourishing of the limited liability corporation in the nineteenth century and the opportunities for capital investment and corporate growth this presented. Limited liability is, as the Economist (1999) puts it, ‘The key to industrial capitalism’. Removal of risk and uncertainty for the investor was a crucial element in industrial and technological revolutions. The scale of investment required to mass-produce and market products is far beyond the capability of the individual or the small firm.