Introduction - Uppsala Monitoring Centre

8. Were the patients adults or children?
9. For what ailment was the drug taken?
10. Was it ordered by a physician?
11. Was it used internally or externally?
12. Quantity taken?
13. Give brief history of cases observed by you, omitting details.
14. Have you observed any cases of habitual use of any of these
drugs or of any preparations containing them?
15. In what form was the drug taken?
16. Were there any ill effects? Give brief description.
17. Were there any protracted ill effects?
18. Give a brief clinical history of each case.
Nine hundred and twenty-five letters were sent out and there were
400 replies (Total number of doctors in the US at the time –
125,000). Quote: ‘Granting that the 525 physicians who did not reply
had no cases to report.’ They, therefore, calculated that there were
925 patients with 814 cases of poisoning, which included 28 deaths
ascribed to the drugs and 136 cases of habitual use. They gave the
results of an extensive worldwide literature search. The results were
similar to those of the BMA survey (see 1894). The use of all three
drugs was diminishing at the time of this survey. These biases were
similar to those with the BMA survey (Kebler et al., 1909). Acetanilid
(antifebrin) was removed from the Japanese market in 1971 due to
its propensity to cause aplastic anaemia. Antipyrin (phenazone) was
removed from the market in Argentina in 1981, Malaysia in 1986 and
also in Bahrain.
In a lecture on Salvarsen in 1910 Wihlem Wechselmann said ‘Is the
eventual risk of the drug in an acceptable balance with the size of its
[beneficial] effects?’ (Wechselmann, 1910). This probably the earliest
correct version of the cost/benefit ratio.
First commercial ECG sold (Burnett, 1985).
1911 Founding of the Drug Commission of the German Medical
Association as a panel of the German Society of Internal Medicine.
Its main objective: ‘...if it is possible that the congress could
independently take action to set a boundary to the escalating
mischief regarding to production and particularly marketing of new
drugs which becomes more and more intolerable.’
The UK National Insurance Act 1911 provide medical treatment and
attendance, including provision of proper and sufficient medicines.