Introduction - Uppsala Monitoring Centre

‘It presents several advantages over salicylic acid. It does not
irritate the stomach. There is no cardiac depression. In ordinary
doses there is no tinnitus or headache...and [it] is best prescribed in
wafers or sachets for acute and chronic rheumatism, polyarthritis,
and pleurisy...but it is ineffective in neuralgias and pleurodynia.’
(British Medical Journal, December 9, 1899; p. 96.) It was marketed
at a dose of 625 mgm four hourly.
Original reservations about the effects of Aspirin (ASA) on the
heart prevented its widespread use; however, persistent provision of
ASA to local physicians returned nothing but praise and optimistic
results.
Witthauer said ‘..it can be given without deranging the stomach…
ringing in the ears is hardly ever observed with Aspirin… Its taste is
much less unpleasant than salicylate of sodium.’
Wohlgemuth described a case of a 21 year old with fever and
swelling of hand and knee. Given 3G Aspirin daily in dilute alcoholic
solution the pain was at once relieved. After a few days the patient
complained of pain in the stomach, this immediately subsided when
the medicine was stopped. There was no loss of appetite or tinnitus.
‘The pain in the stomach was no doubt due to the alcohol’; the
patient at the first disliked the strong smell of alcohol in the medicine.
In the further experiment Aspirin was given in the form of powder in a
dose of 1.0 G. No pain in the stomach was noticed when the drug
was given in this form (Wohlgemuth, 1899; Wohlgemuth, BMJ,
1899).
July 22nd 1899. The Bayer Company stated ‘..not dissolving
appreciably in water but easily in alcohol. It disappears, however, in
weak potash solutions, the addition of acid to this alkaline solution
leading to the reappearance of a crystalline substance. This fact is of
clinical importance, since Aspirin would pass through the stomach
unchanged until it reached the alkaline digestive juices in which it
would be decomposed and the salicylic acid would be appropriated.
On this account the irritation in the stomach caused in some cases
by salicylic acid and its salts is prevented. Further, it is said that
owing to Aspirin decomposing gradually the singing in the ears
sometimes produced by ordinary salicylates is to some extent
avoided. Aspirin is almost free from taste but is slightly acid; it is not
sweet like the salicylates.’ The suggested dose was 15 grains (972
mgm).