Introduction - Uppsala Monitoring Centre

types of reactions: Lewin’s ‘The incidental effects of drugs : A pharmaceutical and
Clinical Handbook’ (216 pages) published in German in 1881 with an English
translation in 1883. This book covered 105 medications. All of these books
discussed drug reactions in general and tried to explain them. Their authors were
handicapped in their explanations by ignorance of allergic mechanisms, which were
not known until Pirquet’s paper in 1907. There followed a gap of 34 years before the
next book on the side effects of modern drugs (Die Nebenwirkungen der Modernen
Arzneimittel) was written by Otto Seifert in 1915. Leonard Meyler’s first edition of
‘Side-effect of drugs’ (192 pages) in Dutch appeared in 1951 with an English edition
a year later (268 pages). There were subsequent volumes at two - four yearly
intervals, but in 1977 a ‘Side-effects of Drugs Annual’ was introduced. The latest
15th edition (2007) in 6 volumes dealing with about 1,550 drugs with 4007 pages
indicates the vast expansion that has taken place over the last 50 years. Meyler’s
books are the final expression of the total output of Pharmacovigilance. Two months
after Meyler published his first English edition another French book was published
‘Maladies Médicamenteuses d’ordre Thérapeutique et Accidentel’ by Claude
Albahary (751 pages). This book was written for clinicians with considerable detail
on the chemical properties and physiology as well as details of the clinical history
with many references. It is 38 times the size of Meyler’s first edition. In 1954 G.
Duchesanay wrote ‘Le Risque Thérapeutique, prevention et traitment des accidents’
(600 pages). The following year ‘Reactions with Drug Therapy’ by an American,
Harry L. Alexander, was published but this only dealt with allergic reactions.
French dermatologists seem to have been the first of the specialists to take an
interest in drug reactions, perhaps because the early treatment of syphilis–the
French disease - with mercury produced numerous skin reactions and that the
whole of the condition was obvious to both patient and physician from its first
manifestation. There has been a French predominance in the clinical aspects of
adverse drug reactions whilst the English-speaking world has been foremost in
pharmacoepidemiology. The first book on adverse drug reactions in Polish was
written by the late Professor Jan Venulet and was published in 1964 by Panstowy
Zaklad Wydawnictw Lekarskich. Its title was ‘Powiklania w leczeniu
farmakologicznym’.
Nearly all the writers from Hippocrates onwards criticize their predecessors and
their contemporaries for using the wrong dose, formulation or using them for the
wrong diseases. Ackerknecht names Asklepiades, Galen, Paracelsus, Fernelius,
van Helmont, Sydenham, Boerhaave and Gaub as those who have complained
about the misuse or abuse of treatments
Summary
The arrival of Aspirin with a very strong sales programme meant that its ADRs
would be discovered early due to its widespread usage. It had been preceded by