Introduction - Uppsala Monitoring Centre

caused by diphtheria antitoxin in 1905 (Pirquet & Scich, 1905).
1893 The first recognition of hypertension as a disease entity ‘Une maladie
d’hypertension arterielle’ (Huchard, 1893). A ‘hard pulse’ had been
noted from the early days of Chinese medicine and in 1760
Schaarsschmidt and Nicolai treated ‘spastic constrictions of the blood
circulation with nitrate salts’. (Backer, 1944). And then after Hale’s
discovery clinicians started to associate high blood pressure with
different disorders. Treatment with sodium thiocyanate was the first
treatment of ‘hypertension’ in 1900 (Esunge, 1991).
1894 Introduction of anti-diphtheria serum.
The Therapeutic Committee of the British Medical Association set up
an inquiry regarding the importance of ill-effects following the use of
antipyrin, antifebrin, and Phenacetin. The aim ‘was to ascertain the
‘impression’ which any ill-effects, met with had made on the mind of the
observer; in particular whether that impression was of such a kind as to
prevent him using the drugs as frequently as he would otherwise have
done.’ They approached the 34 BMA branches and invited them to
furnish a limited list of names of members to whom an inquiry might
usefully be addressed. Each doctor was told ‘There seems to be an
impression that the effects are of such a character and frequency as
materially to limit the usefulness of these drugs.’ They were then asked
the following questions:
The amount of experience you have had in the use of these drugs,
whether as an antipyretic or analgesic agent.
The doses you habitually give.
The nature of any ill-effects you have observed.
Their comparative frequency
Your opinion as to their comparative importance. Do they
materially limit the usefulness of the drugs?
Twenty seven branches responded. The results showed that the
ill-effects were strikingly infrequent and that placing them in the order
their freedom from ill-effects: Phenacetin, antipyrin and antifebrin. It is
easy today to criticize the methodology used, but this was one of the
earliest attempts to find the ill-effects of a series of drugs.
Biases: answer suggested, arbitrary choice of doctors, memory
dependent, dependent on doctors’ diagnoses of ADRs. More of an
opinion poll than a scientific investigation (see 1909) (Leech &
Hunter, 1894).
1895 Buss introduced sodium salicylate (Buss, 1895).
Heinrich Koebner (1838–1904) published a study on quinine