Hormones of Life

Hormones of Life: Endocrinology, the Pharmaceutical Industry and the Dream of a Remedy for Sterility, 1930–1970

Christer Nordlund

This project analyzed the science, production, and marketing of a series of hormone preparations for sterility, notably the first original hormone drug invented in Sweden—Gonadex, Leo—which was launched in 1948 as a true “miracle drug.” One of the aims is to demonstrate how complicated an innovation process in the life sciences can be, and in that way make an empirically sound contribution to the current debate about innovation theory. However, the project also has a broader historical aim, which is to observe, through the prism of Gonadex, the development of endocrinology and its early connection with the population question and the introduction and establishment of hormone replacement drugs in gynecological practice during the period stretching from 1930 to 1970 (before the breakthrough of In Vitro fertilization, or IVF).

The guiding theoretical principle of the study was that modern drugs are techno-scientific artefacts that come into being and are used and developed within the framework of a ”medico-academic-industrial complex,” where the boundaries between science, technology, and medicine are blurred and where academic knowledge development, industrial product development, and clinical practice are apprehended as mutually influential rather than separate processes. According to this perspective, what eventually gets to be a commercial drug cannot be taken for granted; drugs are not necessarily the result of a given, intra-academic knowledge accretion converted into industrial product development and ending up on the pharmacy shelf. Nor is it given that the drug’s significance for the patient or society will be exactly as planned; no drug has only one single effect and the diagnoses for which the drug is prescribed are not always those for which it was developed. Further complicating the situation is the fact that the drug can both affect the body of the user and influence her attitude toward its significance and consequences, which can in turn influence the opinion of many others. A drug can also have different “meanings” over time. It can undergo ”identity shifts,” even have ”multiple personalities,” depending on where and how it is used by different social groups. For example, it can at one and the same time be the object of research in a laboratory, a medical tool in the clinic, a product on the market, and a biomedical symbol in popular culture.

In order to capture the many dimensions of Gonadex, a biographical method was applied. Since the term ”biography” refers to a written account of the life of a human being, this suggestion may seem odd at first glance. But the term should be understood metaphorically rather than taken literally. It is an approach which follows the object of study through its life cycle rather than the history of a particular discipline, a particular business, a particular individual, illness, patient group, or discovery. Much as the biography of an individual, artefact biography can also use its study object as a prism through which to view larger social phenomena and events, in the present instance the development of endocrinology, the population question and the introduction and establishment of hormonal drugs in gynecological practice. The biographical approach was complemented with a network analysis, offering the research a narrative strategy of following the object wherever it leads, thus allowing a relationally based biography to be constructed. It localizes the varying actors and things which over the course of time are ”enrolled” in the medico-academic-industrial complex and lays bare common interests and channels of communication. This analysis also intends to show that as a new drug is born and is ”stabilized” as a reliable medical instrument, new social categories tend to be created and ”stabilized,” too.