The current state of clinical pharmacology and drug development did not jus
t happen. Clinical pharmacology and the drug development process were born,
evolved, and have come to the fore during the past 100 years. The past cen
tury has been one of accelerating progress in science and medicine. The pro
gress 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 promoti
on of the purported remedies to processes that exploited unknowing patients
to a process that now requires concept generation, discovery, research, pl
anning, and development with many checks and balances for the protection of
human subjects. The factors that contributed to this progression from inap
propriate use of potions, concoctions, and snake oil to the highly regulate
d drug development process of today is described in some detail. (C)2000 th
e American College of Clinical Pharmacology.