Introduction - Uppsala Monitoring Centre

Committees report in 1922 said that after a course of Salvarsan there
was, in practically every instance, ‘evidence of hepatic insufficiency’
demonstrated by two tests: the laevulose toleration test (discovered
the previous year) and the estimation of lipase (more a test of the
pancreatic function than liver function). There were few positive tests
after a course of six injections, but after three months all tests were
positive only to become negative at six months. The report doesn’t
come to a conclusion as to the exact cause of the acute yellow
atrophy (Salvarsan Committee, 1922). In 1902 there were no liver
function tests mentioned (Hutchinson & Rainy, 1902), but in the
same book eleven editions later in 1951 the laevulose test has been
replaced by the galactose tolerance test measuring carbohydrate
metabolism and there are tests for protein metabolism: Takata-Ara
test, colloidal gold reaction, cephalin-cholesterol flocculation test, the
thymol turbidity test and plasma prothrombin. There were two tests of
excretion and detoxification: the bromo-sulphone-phthalein test and
the hippuric acid test. There was only one enzyme test–alkaline
phosphatase (Hutchinson & Hunter, 1951).
A similar outbreak in Dublin in soldiers treated with
neoarsphenamine concluded that malaria had been transmitted via
the apparatus for the neoarsphenamine injection. The former
outbreak might have had the same mechanism (Wade, 1970).
1919 William Osler (1849–1919) ‘We doctors have always been simple
trusting folk. Did we not believe Galen implicitly for 1500 years and
Hippocrates more than 2000 years?’
1920 UK Dangerous Drugs Act. These drugs: cocaine, morphine and
opium could be sold only to a physician’s prescription and import,
export and manufacture of raw opium, cocaine, heroin and morphine
was prohibited except under licence (RPSGB).
Insulin discovered.
MRC Salvarsen Report. In addition to the problem of acute yellow
atrophy there were problems with encephalitis haemorrhagica, which
occurred within 2–3 days after a injection, and exfoliative dermatitis.
A course of treatment was usually followed by a period of hepatic
insufficiency, which was thought to be due to the drug (Salvarsan
Committee, 1922).
Widal describes asthma, rhinitis and urticaria with Aspirin (Widal et
al., 1922) 9th February 1921 after 100 mgm Aspirin there was an
immediate hemoclastic crisis with a fall in leucocytes, general