Aspirin Is A Wonder Drug With A Long History

March 23, 2020 at 4:13 p.m.

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One of the first drugs we studied in pharmacy school was aspirin and rightly so because of its long term use and multiple indications.  

Acetylsalicylic acid, the chemical name for aspirin, is a derivative of salicin, found in myrtle or willow leaves.  These salicylate-containing plants were used by the Assyrians and Egyptians for more than 3,500 years as a treatment for joint pain. The use of willow bark for pain relief continued through ancient Greece, where it was recommended by Hippocrates to relieve the pain of childbirth.

In 1763, the Royal Academy in England published a report detailing five years of experiments using dried, powdered willow bark in curing fevers (an antipyretic). In 1828, a German chemist, Joseph Bruchner, extracted the active ingredient in willow, producing bitter tasting yellow crystals, he named salicin.

A French chemist, Charles Gerhardt, in 1853, was the first person to synthesize aspirin in a crude form, but his findings were ignored. (He modified salicylic acid with the introduction of an acetyl group in place of a hydroxyl group.) The first clinical trial of salicin was published by Thomas Maclagan in 1876. He investigated the use of salicylate in relieving the symptoms of rheumatic fever.  

The drug was later studied by Felix Hoffmann and Arthur Eichengrum, both chemists, and Heinrich Dreser, a pharmacologist,  in Germany in 1897. Hoffmann tested the drug on himself and his father, who suffered from chronic arthritis.  It was first branded in 1899 by Bayer Laboratories, as aspirin. (“A” stands for acetyl, ”spir” is derived from the plant known as Spiraea ulmaria, a source similar to willow species and “in” was a common suffix used for drugs as the time of the first synthesis of acetylsalicylic acid.)

Aspirin soon became a profitable over the counter treatment for rheumatism, and sales were bolstered by the Spanish flu epidemic of 1918.  The drug was patented in the U.S. until 1917, and competition by other manufacturers heightened from then on. Aspirin is now the most commonly used drug in the world. Its role in preventing cardiovascular and cerebrovascular diseases has been revolutionary and one of the biggest pharmaceutical success stories in the last century.  

A good resource about the history of aspirin discovery was published in a paper written by Michael Desborough and David Keeling in the British Journal of Hematology in 2017.

Uses

Aspirin is used as a potent analgesic (pain relief), antipyretic (temperature reduction) and as an anti-inflammatory agent.  It was subsequently found to have antithrombotic (blood thinning) properties as well.  In 1950, a general practitioner published observations that excessive bleeding occurred after tonsillectomy patients chewed aspirin gum for pain relief.  

By the 1990s, the drugs antiplatelet effects were definitely established.  According to Diarmuid Jeffreys in his book, “Aspirin,” there is evidence to show that aspirin might prevent heart attacks, strokes, deep vein thrombosis, bowel, lung and breast cancer, cataracts, migraine, infertility, herpes, Alzheimer's disease and much else. The list is growing every year, which might go some way towards explaining why over 25,000 scientific papers have been written about aspirin and why an estimated one trillion little white pills have been consumed since it first came into being.

Drawbacks

Aspirin has suffered a number of setbacks  during its history. In 1932, it became apparent after the invention of the gastroscope, that aspirin use was associated with gastritis and gastric bleeding. Further problems were identified when aspirin was proposed to be associated with Reye syndrome in children. Over the following years there was mounting evidence for this association and aspirin is no longer recommended for anyone under the age of 16 years, with some exceptions.

Aspirin And Heart Disease

If you have had a heart attack or stroke your doctor may advise you to take a daily low dose of aspirin (81 mg) to help prevent another.  Aspirin is part of a well established treatment plan for such patients. Because of the risk of bleeding, aspirin therapy is not recommended if you never had a heart attack or stroke, except for certain carefully selected patients. The American Heart Association (AHA) suggests that anyone older than 70 who takes aspirin for the purpose of preventing the first heart attack could do more harm than good.  

Because aspirin thins the blood, it can cause several complications. You should not take daily low dose aspirin without talking to a doctor if you have an aspirin allergy or intolerance, are at risk for GI bleeding or hemorrhagic stroke, drink alcohol regularly or undergoing any simple medical or dental procedure. The more important thing to do if any heart attack warning signs occur is to call 911 immediately. Don’t do anything before calling.  In particular, do not take aspirin, it won’t treat your heart attack by itself. The AHA has an excellent website (see heart.org).

Max Sherman is a medical writer and pharmacist retired from the medical device industry. He has taught college courses on regulatory and compliance issues at Ivy Tech, Grace College and Butler University. Sherman has an unquenchable thirst for knowledge on all levels.  Eclectic Science, the title of his column,  touches on famed doctors and scientists, human senses, aging,  various diseases, and little-known facts about many species, including their contributions to scientific research. He can be reached by email at  [email protected].  



One of the first drugs we studied in pharmacy school was aspirin and rightly so because of its long term use and multiple indications.  

Acetylsalicylic acid, the chemical name for aspirin, is a derivative of salicin, found in myrtle or willow leaves.  These salicylate-containing plants were used by the Assyrians and Egyptians for more than 3,500 years as a treatment for joint pain. The use of willow bark for pain relief continued through ancient Greece, where it was recommended by Hippocrates to relieve the pain of childbirth.

In 1763, the Royal Academy in England published a report detailing five years of experiments using dried, powdered willow bark in curing fevers (an antipyretic). In 1828, a German chemist, Joseph Bruchner, extracted the active ingredient in willow, producing bitter tasting yellow crystals, he named salicin.

A French chemist, Charles Gerhardt, in 1853, was the first person to synthesize aspirin in a crude form, but his findings were ignored. (He modified salicylic acid with the introduction of an acetyl group in place of a hydroxyl group.) The first clinical trial of salicin was published by Thomas Maclagan in 1876. He investigated the use of salicylate in relieving the symptoms of rheumatic fever.  

The drug was later studied by Felix Hoffmann and Arthur Eichengrum, both chemists, and Heinrich Dreser, a pharmacologist,  in Germany in 1897. Hoffmann tested the drug on himself and his father, who suffered from chronic arthritis.  It was first branded in 1899 by Bayer Laboratories, as aspirin. (“A” stands for acetyl, ”spir” is derived from the plant known as Spiraea ulmaria, a source similar to willow species and “in” was a common suffix used for drugs as the time of the first synthesis of acetylsalicylic acid.)

Aspirin soon became a profitable over the counter treatment for rheumatism, and sales were bolstered by the Spanish flu epidemic of 1918.  The drug was patented in the U.S. until 1917, and competition by other manufacturers heightened from then on. Aspirin is now the most commonly used drug in the world. Its role in preventing cardiovascular and cerebrovascular diseases has been revolutionary and one of the biggest pharmaceutical success stories in the last century.  

A good resource about the history of aspirin discovery was published in a paper written by Michael Desborough and David Keeling in the British Journal of Hematology in 2017.

Uses

Aspirin is used as a potent analgesic (pain relief), antipyretic (temperature reduction) and as an anti-inflammatory agent.  It was subsequently found to have antithrombotic (blood thinning) properties as well.  In 1950, a general practitioner published observations that excessive bleeding occurred after tonsillectomy patients chewed aspirin gum for pain relief.  

By the 1990s, the drugs antiplatelet effects were definitely established.  According to Diarmuid Jeffreys in his book, “Aspirin,” there is evidence to show that aspirin might prevent heart attacks, strokes, deep vein thrombosis, bowel, lung and breast cancer, cataracts, migraine, infertility, herpes, Alzheimer's disease and much else. The list is growing every year, which might go some way towards explaining why over 25,000 scientific papers have been written about aspirin and why an estimated one trillion little white pills have been consumed since it first came into being.

Drawbacks

Aspirin has suffered a number of setbacks  during its history. In 1932, it became apparent after the invention of the gastroscope, that aspirin use was associated with gastritis and gastric bleeding. Further problems were identified when aspirin was proposed to be associated with Reye syndrome in children. Over the following years there was mounting evidence for this association and aspirin is no longer recommended for anyone under the age of 16 years, with some exceptions.

Aspirin And Heart Disease

If you have had a heart attack or stroke your doctor may advise you to take a daily low dose of aspirin (81 mg) to help prevent another.  Aspirin is part of a well established treatment plan for such patients. Because of the risk of bleeding, aspirin therapy is not recommended if you never had a heart attack or stroke, except for certain carefully selected patients. The American Heart Association (AHA) suggests that anyone older than 70 who takes aspirin for the purpose of preventing the first heart attack could do more harm than good.  

Because aspirin thins the blood, it can cause several complications. You should not take daily low dose aspirin without talking to a doctor if you have an aspirin allergy or intolerance, are at risk for GI bleeding or hemorrhagic stroke, drink alcohol regularly or undergoing any simple medical or dental procedure. The more important thing to do if any heart attack warning signs occur is to call 911 immediately. Don’t do anything before calling.  In particular, do not take aspirin, it won’t treat your heart attack by itself. The AHA has an excellent website (see heart.org).

Max Sherman is a medical writer and pharmacist retired from the medical device industry. He has taught college courses on regulatory and compliance issues at Ivy Tech, Grace College and Butler University. Sherman has an unquenchable thirst for knowledge on all levels.  Eclectic Science, the title of his column,  touches on famed doctors and scientists, human senses, aging,  various diseases, and little-known facts about many species, including their contributions to scientific research. He can be reached by email at  [email protected].  



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