The Mythology of Aspirin

Aspirin is one of the modern medicine'sbest known and successful medications. It was the first safe effective anti-inflammatory treatment. It was one ofthe safest early pain medications. Initiallyused for fevers, aches, and pains, it is known world wide. Similar to allmedicines aspirinhasside effects and dangers but overall it is one of the most successful medications, ever.

There is a mythology that surrounds the origin of aspirin. It is commonly believed to be a folk herbal remedy that became a medicine. According to legend, aspirinwas widely usedin the ancient world as inflammation reducer. It was obtained primarily from willow bark and is often trumpeted by naturalists and homeopathy proponents as a shining example of how folk medicine produced a winning treatment. For years I wrongly assumed that this legend is in fact the history of the drug. Although it's a compelling narrative that plays well in the alternative medicine community, it is a confabulation. The story of aspirin is not a success story for folk medicine herbalists. It is a story about the success of science based synthetic medicine.

Here is a typical example of the alternative medicine narrative surrounding aspirin, taken from the CNN online article, "From a tree, a 'miracle' called aspirin":

The word 'aspirin' wasn't a coincidence. It comes from Spiraea, a biological genus of shrubs that includes natural sources of the drug's key ingredient: salicylic acid. This acid, resembling what's in modern-day aspirin, can be found in jasmine, beans, peas, clover and certain grasses and trees.

The ancient Egyptians used willow bark as a remedy for aches and pains, said Diarmuid Jeffreys, author of 'Aspirin: The Remarkable Story of a Wonder Drug.' They didn't know that what was reducing body temperature and inflammation was the salicylic acid.

Hippocrates, the Greek physician who lived from about 460 to 377 B.C., wrote that willow leaves and bark relieved pain and fevers.

It wasn't until thousands of years later that people began to isolate the key ingredients of aspirin. An 18th-century clergyman, Edward Stone, rediscovered aspirin, in effect, when he wrote a report about how a preparation of powdered willow bark seemed to benefit 50 patients with ague and other maladies, Roueché wrote.

Ague is a vague archaic term for malaria and/or other febrile illnesses. There is a major component missing from this narrative. Willow bark or other natural forms of "aspirin" arenot aspirin. Willow bark yieldssalicylic acid. Salicylic acid derived from willow bark does indeed have a medicinal effect. It can be an erratic fever reducer/anti-inflammation chemical. I use the term erratic because the dose varies from plant to plant and even the same tree's bark can yield different levels. The story of aspirin is much better than "willow bark gave us aspirin."

Salicylic acid was used to treat fevers. It worked, somewhat. It had a major failing: it made people vomit. Also, salicylic aciddoes not provide pain relief. It wasn't until a chemist began looking for a use for the industrial waste coal tar that aspirin was devised. Coal tar derivativeacetanilidehad been successfully used to create the medicine paracetamol (Tylenol®). A German chemist named Felix Hoffmannsought to find an alternate way to treatarthritisutilizing sodium salicylate. The therapeutic dose to decrease inflammation was a massive 6-8 grams. Itcaused patients considerable pain andgastrointestinalirritation. He began looking for a less acidic formulation, which led him to synthesize acetylsalicylic acid, a compound that shared the therapeutic properties of other salicylates but not the strong acidity that he believed caused stomach irritations.

Bayer Pharmaceuticals' archives gives this account of Hoffmann's discovery:

It was mostly by chance that he made a discovery of historic significance on August 10, 1897. By acetylating salicylic acid with acetic acid, he succeeded in creating acetylsalicylic acid (ASA) in a chemically pure and stable form.The pharmacologist responsible for verifying these results was skeptical at first, yet the extent of this pharmaceutical wonder became clear once several large-scale studies to investigate the substance's efficacy and tolerability had been completed: Hoffmann had discovered a pain-relieving, fever-lowering and anti-inflammatory substance. The company then worked flat out to develop a cost-effective production process that would allow the promising active ingredient to be supplied as a pharmaceutical product. In 1899 it was launched for the first time under the trade name Aspirinâ„¢, initially as a powder supplied in glass bottles. Aspirinâ„¢ has made the Bayer name world-famous like no other drug product.

Although it is true that the name is a portmanteau of the word "acetyl" and the taxonomic name for Meadowsweet (Spiraea ulmaria), derivedfrom the old German word for salicylic acid,Spirsäure, the drug was named and trademarked by the Bayer corporation. The namewas the brainchild of the drug's inventorâ€"not a homage to the herbal remedies of old.

Aspirin is not a testament to what folk/herbal medicine can teach us. Rather it is a shining example of what modern chemistry and the scientific method can do.Aspirin has stood the test of time and is primarily used today as an anti-platelet drug. Aspirin representsthe benefits of modern scientific methodology and chemistry. Without modern chemistry and science we might still be using salicylic acid to treat arthritis. I wouldn't want to drink wart remover daily for arthritis. For, you see, thatis what salicylic acid is currently used for... burning off warts.