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safety. These were small-molecule drugs—precise, low-
weight chemical entities that could be easily manufactured,
modified, and standardized.

The timeline reads like a textbook of 20th-century
breakthroughs. In the early 1900s came aspirin, synthesized
from willow bark derivatives, establishing the first
blockbuster anti-inflammatory. The 1930s brought sulfa
drugs, laying the groundwork for antimicrobial therapies.
The 1940s ushered in the penicillin revolution, which
changed the course of medicine—and war. By mid-century,
we had insulin (synthesized and later refined),
corticosteroids, and the early antihistamines. The 1970s and
1980s expanded the arsenal further: beta-blockers for heart
disease, statins for cholesterol, SSRIs for depression, ACE
inhibitors for hypertension. Each new class of drug
emerged from labs defined by glassware and chemistry,
not cell cultures or genetic code.

These compounds were elegant in their simplicity. They
were tiny, stable molecules designed to fit into the grooves
of receptors like keys into locks. They could be taken
orally, absorbed through the gastrointestinal tract,
metabolized by the liver, and cleared by the kidneys. Their
pharmacokinetics were predictable. Their toxicity profiles
could be systematically mapped. And because they were
chemically defined and relatively easy to synthesize, they
laid the foundation for generics—bioequivalent versions
that could be reproduced at scale, bringing costs down and
access up.

This was the golden age of chemistry-driven
pharmacology. And it produced remarkable gains in public
health. Life expectancy rose. Chronic conditions became
manageable. Infectious diseases were conquered—or at

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