An evolution of drug development and clinical pharmacology during the 20th century

The current state of clinical pharmacology and drug development did not just happen. Clinical pharmacology and the drug development process were born, evolved, and have come to the fore during the past 100 years. The past century has been one of accelerating progress in science and medicine. The progress has not been a straight line but rather more like a sidewinder moving across the desert. Drug development has moved from small experiments with concoctions, extracts, and potions along with the manufacturing and promotion of the purported remedies to processes that exploited unknowing patients to a process that now requires concept generation, discovery, research, planning, and development with many checks and balances for the protection of human subjects. The factors that contributed to this progression from inappropriate use of potions, concoctions, and snake oil to the highly regulated drug development process of today is described in some detail.