Why Aspirin?

Photo by Susan Crossett

The question seemed natural (once it occurred to me).

I had just completed what became last week’s Musing on hearts and their diseases. When a heart attack is suspected, the advice was to call 911 and then chew up an aspirin.

It seemed obvious that chewing will get the ingredients more quickly into the bloodstream, the point of the aspirin at that time anyway. But why aspirin? Why not a handful of M&Ms which I, at least, would find much more pleasant to chew. Aspirin is bitter.

On the other hand, hospitals routinely recommend Motrin or Advil. So why not one of those? Is there a reason it has to be aspirin?

I’ll let you in on a little secret — which is no secret at all. The discovery of the ingredient in aspirin is very old. Very old indeed. Turns out Hippocrates was giving it to women to relieve the pain of childbirth in 400 B.C. The supposing it that it goes back far beyond that. Ancient Egyptians, even the Chinese, knew of it then.

No, of course all those old-timers weren’t opening a bottle and popping a pill. What they had discovered was that chewing willow bark relieved fever and inflammation.

Jumping ahead to 1763 (people presumably still chewing bark in between), the Reverend Edward Stone of Chipping Norton near Oxford, spent five years of experiment giving a dried powdered willow bark to fifty parishioners suffering from rheumatic fever. The Royal Society of England reported on Stone’s success, the first time it had been written about in a Western medical journal.

Later chemists were able to isolate the source, salicylic acid which can be found in jasmine, beans, peas, clover and certain grasses and trees. Besides being very bitter, it caused gastrointestinal irritation so couldn’t be taken long term. Some couldn’t handle it at all.

Now jump to Germany in the late 1890s. Chemist Felix Hoffmann distilled the powder into the form of acetylsalicylic acid which he used to alleviate his father’s rheumatism. Chemist Hoffmann happened to be working for Bayer who distributed the powder by 1899, giving it to physicians to give to their patients. It was the company that named it. The letter “A” stands for acetyl, “spir” is derived from the plant Spiraea ulmaria (meadowsweet) which yields salicia, and “in” was a common suffix used for drugs at that time.

Bayer, however, was denied a patent in Germany as acetylsalicylic acid had been synthesized earlier. Bayer marketed aspirin “aggressively” and got a patent in the U.S. on February 27, 1900. When the patent wore out in the 1930s it became a generic drug as we know it today. I for one am grateful every time I buy a bottle for, usually, I can find it for a penny a pill, a bargain anytime.

It wasn’t until the 1970s that scientists began to uncover its secrets. In 1974 a Professor Elwood provided the first evidence that aspirin can prevent heart attacks by preventing further clot formation and cardiac tissue death. In 1989 the first reports were published that aspirin may delay the onset of senile dementia. This was followed by evidence in 1995 that it could protect against bowel cancer. Now it may also be prescribed for patients with high cholesterol levels, high blood pressure, pre-eclampsia and foetal growth retardation as well as diabetes. And let’s not forget hangovers.

So, if it’s so good for so many things, why aren’t we all gulping it down? Well, they figure around 35,000 metric tons (yes, tons!) of the stuff is consumed each year so maybe we are.

Surprisingly, aspirin doesn’t even make the top 5 list of painkillers. Advil, Tylenol and Aleve are at the top of the list. There are reasons.

“Aspirin has a lot of cheerleaders, but it’s important to keep the downsides in perspective. Dr. Scott Fishman, chief of pain medicine at the University of California, Davis, points out that as a pain reliever, aspirin’s effects are potent but short-lived. The way that aspirin inhibits enzymes in the stomach can lead to ulcers, which can be especially harmful in combination with decreased clotting.

” ‘Patients should not just take it without consulting their physician. Certain conditions such as bleeding disorders make taking aspirin dangerous. Some supplements, such as fish oil and garlic, can also cause bleeding problems in combination with aspirin,” Fishman added.

It continues, however, to have its strong supporters who believe that even more benefits will be discovered in the years to come. We tend to take this drug for granted when more emphasis should be placed upon its powers.

“If I’m stranded on a desert island, and I can take one drug with me, that’s the one I’m taking.”

Susan Crossett has lived outside Cassadaga for more than 20 years. A lifetime of writing led to these columns as well as two novels. “Her Reason for Being” was published in 2008 with “Love in Three Acts” following in 2014. Both novels are now available at Lakewood’s Off the Beaten Path bookstore. Information on all the Musings, her books and the author may be found at Susancrossett.com.