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Medical Monopoly

Intellectual Property Rights and the Origins of the Modern Pharmaceutical Industry

Medical Monopoly

Intellectual Property Rights and the Origins of the Modern Pharmaceutical Industry

During most of the nineteenth century, physicians and pharmacists alike considered medical patenting and the use of trademarks by drug manufacturers unethical forms of monopoly; physicians who prescribed patented drugs could be, and were, ostracized from the medical community. In the decades following the Civil War, however, complex changes in patent and trademark law intersected with the changing sensibilities of both physicians and pharmacists to make intellectual property rights in drug manufacturing scientifically and ethically legitimate. By World War I, patented and trademarked drugs had become essential to the practice of good medicine, aiding in the rise of the American pharmaceutical industry and forever altering the course of medicine.
Drawing on a wealth of previously unused archival material, Medical Monopoly combines legal, medical, and business history to offer a sweeping new interpretation of the origins of the complex and often troubling relationship between the pharmaceutical industry and medical practice today. Joseph M. Gabriel provides the first detailed history of patent and trademark law as it relates to the nineteenth-century pharmaceutical industry as well as a unique interpretation of medical ethics, therapeutic reform, and the efforts to regulate the market in pharmaceuticals before World War I. His book will be of interest not only to historians of medicine and science and intellectual property scholars but also to anyone following contemporary debates about the pharmaceutical industry, the patenting of scientific discoveries, and the role of advertising in the marketplace.

Listen to an interview with the author on the New Books Network.

344 pages | 10 halftones | 6 x 9 | © 2014


Economics and Business: Health Economics

History: History of Technology

History of Science

Law and Legal Studies: General Legal Studies



"Immensely informative."

New York Review of Books

"Gabriel’s brilliant account of patent and trademark law and use is the first comprehensive attempt to integrate the history of pharmaceuticals . . . in the wider setting of economic history and intellectual property law history and represents a milestone in that respect."


"In his thought-provoking and well-researched book, Gabriel explores the evolution of patenting, and to a lesser extent, trademark registration, in the American pharmaceutical industry. It is a fascinating and timely contribution."

"To legal historians interested in the regulatory state and corporate capitalism, Gabriel's well researched book offers new insight into monopoly as an analytic category and antimonopoly sentiment as a driver for law and policy. Gabriel also provides a unique perspective on the development of modem intellectual property, a story not previously told from the viewpoint of pharmacists and travelling drug salesmen."

Law & History Review

"This fascinating book serves as a pointed reminder that the sources of therapeutic rationale are just as much tied to the production and regulation of therapies as the collective decision-making on ethical practice."

New Books in Medicine

"Medical Monopoly: Intellectual Property Rights and the Origins of the Modern Pharmaceutical Industry, by historian of medicine and the biomedical sciences Joseph M.Gabriel, is a significant and beautifully written book. By linking the study of patenting and other monopolistic practices in the pharmaceutical industry, such as trademarks, to the history of therapeutic reform, it makes an original and valuable contribution to the historiography in a variety of fields, from intellectual property to therapeutic reform, medical ethics, and the pharmaceutical industry. Medical Monopoly is therefore of relevance to a broad range of scholars, but also to clinicians, bioethicists, and the wider public concerned by the power of companies and the potential for conflicts of interest within modern medicine."

Bulletin of the History of Medicine

"Gabriel’s study of the early pharmaceutical industry in the U.S. is an outstanding addition to new literature. To illustrate this complex argument, Gabriel does a superb job of weaving together broad trends in patent, trademark, and antitrust law with the evolution of drug manufacturing and medical practice. The book is packed with fascinating case studies of products and their makers. Like a skilled ethnographer, Gabriel is more intent on reconstructing how past actors conceived of their actions than passing judgment on them. Paying careful and fruitful attention to “the relationship between names and things,” he avoids oversimplifying the motives of makers, prescribers, and users of drugs. Gabriel rewrites not only the history of the pharmaceutical industry but that of American medicine as well. Specialists in the history of medicine, science, and technology will appreciate his work for the fresh perspective he provides on familiar subjects. Specialists in health care policy and public health will find useful insights into contemporary debates over bioequivalence and its global implications. Finally, historians of intellectual property rights will find much to interest them in this book."

The American Historical Review

“In this important new book, Gabriel traces the surprisingly dynamic relationship between intellectual property and the economics and politics of the pharmaceutical industry. Medical Monopoly narrates the formation and reorganization of the ‘ethical pharmaceutical industry’ in the nineteenth and early twentieth centuries around questions of patents, trademarks, and a series of mutually defining alliances made between the medical profession and the modern pharmaceutical enterprise. Gabriel’s research in preparation for this volume has been meticulous, and his narrative pacing will help audiences from many different fields engage with the provocative story he has to tell. The resultant work is an elegant demonstration of the power of historical analysis in understanding the present-day connections between patents, trademarks, medical science, and the marketplace, with substantial implications for contemporary policy and practice.”

Jeremy A. Greene, Johns Hopkins University School of Medicine

“In this lively account, Gabriel takes us back to the nineteenth and early twentieth centuries to explore the early histories of the manufacturing, marketing, patenting, and regulation of drugs and their roles in transforming the practice of American medicine. Marrying a keen eye for detail with attention to the larger picture, Gabriel explores the tensions between beneficence and business in the emergent pharmaceutical industry. This meticulously researched book establishes Gabriel as one of the nation’s experts on the pharmaco-medical enterprise in America from the early Republic to the Progressive Era.”

Elizabeth Watkins, University of California, San Francisco

Medical Monopoly is a fascinating book about the history of intellectual property (IP) rights in pharmaceuticals. Gabriel traces the role that patents and trademarks played in the development of the pharmaceutical industry, explores the question of whether IP rights promoted research and development, and identifies the changing attitudes of physicians and scientists to the propriety of patenting drugs. The book reaches a number of conclusions that are surprising to the contemporary student of both IP and pharmaceuticals, and Gabriel does a nice job of marshaling the massive amount of evidence he uncovered into a chronological narrative. This important work will be of interest to historians of patents and trademarks; to historians of medicine, science, and technology; and to scholars of contemporary IP and science policy.”

Catherine Fisk, University of California, Irvine

Table of Contents

A Note about Terms

1 Medical Science and Property Rights in the Early Republic
2 Monopoly and Ethics in the Antebellum Years
3 In the Shadow of War
4 Therapeutic Reform and the Reinterpretation of Monopoly
5 The Ambiguities of Abundance
6 The Embrace of Intellectual Property
Conclusion: The Promise of Reform

Archival Collections Consulted


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