Editor’s Note: Patrick M. Walsh is a doctoral candidate in the Department of History at the University of Wisconsin–Madison. He studies the the cross-talk between bacteriology, immunology and endocrinology in the late-nineteenth and early-twentieth centuries.
Blood is everywhere I look in the Kremers Reference Files (KRF) at the American Institute of the History of Pharmacy (AIHP). It’s in trade manuals published from the 1890s to the 1930s by Parke-Davis, Eli Lilly, and H. K. Mulford. It’s in advertisements from meatpacking-turned-drug companies, including Bovinine and the Cudahy Packing Company. It’s in dusty, century-old newspaper clippings that describe how tons of animal flesh were transported from slaughterhouse to factory line, ripe for experimentation and drug production.
I came to the KRF to start my dissertation work about the American vaccine industry at the turn of the twentieth century, but, instead, all I found was blood. Image after image of blood being suctioned out of stable-bound horses. Blood coursing through plastic tubes that look like fiberoptic cables. Blood being rapidly deposited into oversized receptacles, red foam climbing up the sides of the glass. Some of the images look almost staged—deliberately and self-consciously reenacting a scene from Mary Shelley’s Frankenstein, then just 80 years old.
Maybe I shouldn’t have been surprised. I knew before going into the KRF that the vaccine industry was fully launched in the 1890s with the diphtheria antitoxin vaccine, that this was a “serotherapy,” and that all serotherapies involve a process of blood harvesting. It is a vampiric practice by definition. Hundreds of horses stand at attention, and scientists buzz around them like angry mosquitoes, directing their syringes with precision into pulsing jugulars, delighting at the extraction of potent antitoxins that hurtle invisibly through equine vascular systems. Antitoxin-rich blood was as good as gold at the turn of the century, and it brought companies like Parke-Davis and H. K. Mulford material, social, and political capital.
I had read general descriptions of serotherapy in countless scholarly works, but the archival sources felt somehow different. I wasn’t prepared for the gore. And it wasn’t just blood. There were guts and organs too: alongside serotherapies, all manner of “biologicals” were produced from animal tissues and flesh. What’s more, all this detail was splayed proudly throughout trade booklets and pamphlets produced by the pharmaceutical companies themselves—an open advertisement about how exactly they made drugs. Trade ephemera shows company men feeding still-fresh-and-quivering endocrine glands into what look like spaghetti grinders and large industrial vats grinding desiccated animal organs into fine powder.
We’re conditioned to think of scientific medicine as a clean and organized enterprise, prescribed to us by physicians and delivered into our hands in professional-looking cardboard boxes. Pills pop out from airtight pockets, offering us the welcome illusion that we are the first to touch this drug. After leafing through thousands of trade documents at the KRF, I began to form a new impression about the history of scientific medicine production. Behind the chocolate-coated tablets presented in pharmacy shop windows, there were the entrails and bodily fluids of an untold number of animal carcasses.
Why don’t we, as historians, talk more about the bloody busines of drug production? Historians of science and medicine don’t normally shy away from gruesome details, so why has their predilection for the morbid not extended to what happened at pharmaceutical companies? Conversely, why were turn-of-the-century pharmaceutical companies so eager to talk about blood and guts, as evidenced by the images of blood harvesting that frequently appeared in company advertisements?
The answer might lie in the history of pharmaceutical companies themselves. As Joseph Gabriel has so convincingly shown in Medical Monopoly, big pharmaceutical companies at the turn of the century, such as Parke-Davis, H. K. Mulford and Eli Lilly, operated in a medical marketplace that was undergoing rapid change. For much of the nineteenth century, orthodox physicians—the kind sanctioned by the American Medical Association and who had licenses to prescribe drugs—rejected pharmaceutical companies as profit-seeking proprietors of ineffective medicines.
The goal of the drug company, in the view of the medical establishment, was to make a quick buck without concern for human health or scientific doctrine. But all this started to change in the 1890s, and some would argue that this change was occasioned by pharmaceutical companies. Smarter and more ingenious firms like Parke-Davis and Mulford spied an opening in the market. If they could look more “scientific,” and manufacture “scientific” drugs, then they might crack into the orthodox medical market and hawk their wares to MD-carrying physicians.
The first task of pharmaceutical companies aspiring to be “scientific” was to build laboratories and to hire PhDs from elite universities. This would start turning some skeptical heads. Next, the “scientific” companies needed to distinguish themselves from other patent proprietors through carefully orchestrated marketing campaigns. They advertised themselves as “ethical” manufacturers of drugs, signaling their sincere intention to make “real” medicines with strict attention to efficacy and patient safety—a far cry from the “patent” proprietors who were assumed to care about neither. Last, and most importantly, “ethical” companies needed to gain the confidence of the orthodox medical community, who would be their primary market. This involved careful advertising to physicians with “respectable” flyers and pamphlets sent directly to clinic doors and with delivery of the goods—drugs that worked according to (and beyond) the expectations of physicians.
In this context, the blood-speckled trade manuals take on more meaning. They were not intended as consumer advertisements—who wouldn’t be put off by the blood and guts?—but rather as purposeful communication devices that were sent directly to physicians. The bloody images in trade booklets conveyed a simple but crucial message, from company to doctor: we are scientific, we are sanitary, we make sophisticated drugs. Perverse as it may seem to our 21st-century eyes, marketing the bloody business of drug production was a strategic way for “ethical” drug manufacturers to demonstrate their scientific process. No physician wanted to pay money for “quack” medicines, but a growing number of physicians, especially the progressives, were eager to shell out cash for new “scientific” drugs. Serotherapies and other biologicals were the rage of scientific medicine in the 1890s, and blood was its scientific branding.
We can account for why these unusual images were boldly featured in trade ephemera, but can we account for why historians of science and medicine have not foregrounded such a bloody business in the historical literature? This can possibly be explained by the field’s notion of what counts as “science” and “medicine.” Historians of science and medicine, unlike historians of pharmacy, typically do not often use trade literature to craft their stories about the past, and pharmaceutical companies, themselves, have not often been subjects of historical investigation.
All people are shaped by their conscious and unconscious bias, and, for historians, this amounts to a preference for certain kinds of actors and certain kinds of archival sources. Historians of science, for example, who study the vaccine industry traditionally rely on laboratory notes, journal articles, and the letters or correspondence of well-known scientists like Louis Pasteur. Historians of medicine, on the other hand, are more likely to study non-scientists including physicians, patients, and public health officials, and they commonly use sources like patient notes, physician records, and government documents.
Between these two distinct research approaches, pharmaceutical companies—and their trade ephemera—often get overlooked. In older historical literature, pharmaceutical companies often got passed off as “non-science” and “non-medicine” because they didn’t count as either universities or clinics. Recent literature takes a more expansive view of “science” and “medicine,” yet we often still find ourselves working in the same traditions of past scholarship: when deep tracks are gouged into the earth it can be difficult to steer a new course. In this context, the bloody business of vaccine production appears less a topic that has been actively avoided by historians of science and medicine, and more a subject that has been obscured in not-frequently-visited places in the archive.
So, what can pharmaceutical companies and trade literature do for histories of science and medicine? Is it just about introducing some gore, or is there a deeper meaning? I would argue the latter. The rise of the vaccine industry and the associated production of biological drugs is often described by historians as a movement situated within the broader “revolution” of scientific medicine. Simply put, at the start of the nineteenth-century, medicine in America was neither lab-based, nor experimental, nor rooted in theories of microbial infection (germ theory). By the end of the century, medicine had become all of these things. Put another way, the “revolution” of scientific medicine was a revolution of infrastructure (read, labs), method (read, experimentation), theory (read, germ theory), and practice (read, aseptic technique).
What often gets left out from this narrative, however, is a serious consideration of the role that pharmaceutical companies played in bringing the new scientific medicine to market. The demand for vaccines, for example, could not be solely supplied by academic outfits like the Pasteur Institute of Paris. Large-scale drug production relied on industrial connections, scores of employees, and an effective marketing organ that simultaneously educated physicians about the principles of new scientific medicines and urged them to purchase drugs. Thus, the “revolution” of scientific medicine was also a pharmaceutical revolution—and drug companies were key sites of this history, just as much as the doctor’s office or Pasteur’s laboratory.
The gore, too, can help us think differently about the history of scientific medicine. Producing lab-based drugs at the turn of the century wasn’t just about mixing chemicals in polished glass beakers or grinding plants and roots in a mortar and pestle. Drugs were also produced from grisly biological material and delivered directly to laboratories from barnyards and slaughterhouses. The act of producing sophisticated and glossy “scientific” medicine was the same act as mincing and mashing organs through a strainer or filtering horse blood through thin paper. If we fix our attention to the process of drug production rather than the product and think about less well-known actors, like company workers and slaughterhouses, we might have cause to rethink what it meant to be “scientific,” “medical,” and indeed “biological” at the turn of the twentieth century in America.