One of the peculiarities of the historiography of twentieth-century medicine is that it has so far delivered little in the way of grand narratives on the period as a whole. While grand narratives such as the ‘birth of the clinic’ or the ‘laboratory revolution’ have done their part in furthering our understanding of earlier periods, the larger picture of twentieth-century medicine has remained some-what fragmented. There is, of course, no shortage of historical monographs, yet reflection on how such works figure in larger historical processes falls short of the level of reflection that has been achieved elsewhere. By comparison, general history has been engaged in debates about comprehensive twentieth-century narratives since the mid-1990s. The lesson to be drawn is not that historians of medicine should adopt these narratives, for example the notion of a short twentieth century (1914–90), which seems to be the dominant framework of interpretation in general history. Historians of medicine have long been aware that their histories follow different trajectories and there is no reason to assume that what holds for earlier periods should not apply to the recent past. But there are a number of candidates from which grand narratives could be developed. One such candidate comes into view if we relate the essays in this volume on biologics to a historical phenomenon that is usually described as the therapeutic revolution that transpired, roughly speaking, between 1930 and 1970.