FACTFILE
Name: acetylsalicylic acid
Better known as: aspirin
Occupation: pain reliever (semiretired), heart disease prophylactic

Why it's in the news: it celebrated its
100th birthday this week

By Frank McNally

Considering it emerged from the same stable as heroin, aspirin has lived to
a surprisingly respectable old age. A hundred years after its birth in a
Bayer laboratory, the little white pill is going as strong as ever, albeit
in a new direction.

In the 1960s it was in danger of being run off the painrelief block by
newer arrivals like acetaminophin and ibuprofen, which one Dublin pharmacy
estimated yesterday were outselling aspirin by 10 to one.

The crucial difference is that aspirin has now established itself as an
agent against heart attack and stroke.

Back in the 1920s, Bayer still advertised its pill with the assurance that
it "does not affect the heart", but a series of studies has suggested that
aspirin slows the ability of blood platelets to form clots.

Prescribed at a much lower dosage than in its painrelieving form, regular
use of the drug is thought to reduce the risk of repeat heart attack by a
fifth.

Furthermore, according to the latest issue of Newsweek, the US Food and
Drug Administration is expected soon to approve its use to prevent a first
heart attack in highrisk groups.

Bayer's statistics show that prevention of heart disease now accounts for
37 per cent of aspirin use, with 23 per cent of people taking it for
arthritis. Oldfashioned ailments like headache (14 per cent), body ache
(12 per cent) and other pain (14 per cent) trail some distance behind.

Knowledge of the painrelieving properties of salicylic acid goes back more
than 2,000 years, to the father of medicine himself. At any rate,
Hippocrates knew that juice from the bark of willow trees, which contains
the acid, could be used to treat pain.

Up to the Middle Ages, herbalists still boiled willow bark for this reason,
until the needs of the wicker industry caused the stripping of the trees to
be outlawed.

The revival of the practice can be credited to Napoleon, whose continental
blockade of 1806 stymied the export of quinine from Peru to Europe. An
alternative painreliever had to be found and scientists turned back to the
traditional source.

It was a panEuropean effort. In 1828 a Munich pharmacologist, Johann
Büchner, boiled willow bark into a yellow substance he called salacin. A
year later, in France, the substance was converted to crystal form and
Italy refined salacin to form salicylic acid.

Acetylsalicylic acid (ASA) was finally produced in Strasbourg in 1853, but
it was chemically impure and could not be preserved. And it took the work
of another German chemist, Herman Kolbe, before the drug could be
synthesied for industrial production in 1874.

The synthetic product was offered at a tenth of the price of
naturallyproduced salicylic acid: but it tasted awful, and often had what
was described as an "aggressive effect" on the mucous membranes.

It is possibly down to Felix Hoffman's father that the drug was finally
produced in a palatable and stable form. Hoffman snr was crippled with
rheumatoid arthritis, and the existing medicines were having a severe
effect on his stomach. His 29 yearold son, a chemist with Bayer,
synthesised ASA in a form that was more acceptable to stomachs. And the
rest is history.

The late 20th century brought the effervescent tablet; the chewable
version; and finally the entericcoated, lowdosage form for heart
treatment, in 1992. In its various forms, the company now produces 11
billion tablets a year for sale in more than 70 countries. Sales in 1996
were worth more than £320 million.

Aspirin is still not for everyone, even those with heart disease. Between 2
and 6 per cent of the population are liable to gastric upset from taking
the drug. Indeed, while the Harvard School of Public Health estimates that
10,000 premature American deaths could be avoided each year if heart attack
survivors took regular aspirin, other figures show that 17,000 Americans
died last year of gastric bleeding, just from taking aspirin or other
nonsteroid antiinflamatory drugs, like ibuprofen.

But aspirin may still be a victim of its own success. The Harvard professor
who estimated the 10,000 potential lifesavings thinks "if aspirin were
half as effective and 10 times more expensive people would take it more
seriously".

As it sets out on its second century, Bayer is now citing studies which
suggest ASA can reduce the risk of colon cancer. And 3,500 scientific
papers a year are devoted to probing the drug's uses.

So the omens are good, if you ignore the one provided by Bayer's latest
house magazine. At the opening of its facility in Mexico, the caption tells
us Bayer's chairman is being shown the new plant by "Dr Ralph Sick".

© Copyright: The Irish Times