Introduction - Uppsala Monitoring Centre

other salicylates, which were also effective and could have competed with Aspirin.
The 1894 BMA Survey and the 1908 U.S. Survey of acetanilide, antipyrin and
Phenacetin were the forerunners of Prescription Event Monitoring. The rapid
increase in synthetic drugs: Phenacetin, benzodiazepines, barbiturates,
arsphenamine, insulin, thyroxine, penicillin, dinitrophenol, amidopyrine, clioquinol,
prontosil, antibiotics, etc; meant that loopholes in the drug-testing programme were
soon discovered and various attempts were made to deal with these, but in the end
the thalidomide debacle over shadowed all the other problems. Several laws were
initiated to deal with failures, but other influences counteracted any major advances.
Conclusions to Part 1
Some of the civilisations, which started prior to the Christian era, do not appear to
have contributed anything to drug safety, e.g. Egyptian, Aztec, Sumerian and
Assyrian. Chinese and Indian medicine from the earliest times, c2,500 BC, until the
present day have been based on philosophies which are so different from those of
the Western World that their medicine bears no resemblance to our own. The result
has been that they have not contributed to the western notion of drug safety.
However, the Greek era, 800 - 50 BC, was extremely productive (the Hippocratic
school and Galen). When the Romans conquered Greece they maintained Greek
medicine and added to it. The Roman era started in 250 BC and in 364 AD the
Roman Empire split into the Western Empire, which after the fall of Rome to the
Huns, etc. in 476 AD disintegrated, and the Eastern Empire – Byzantium, which
continued to make modest contributions until it was ended by the Ottoman Empire,
but when they expelled the Nestorians in 431 AD the latter went to Syria and set up
a medical community in Edessa in Mesopotamia practising medicine in the Greek –
Roman pattern. They started to translate their texts into Arabic in c700 AD. Soon
the Arabs added to this previous knowledge and Arabic medicine flourished
(Geber, Al Tabari, Rhazes, Haly Abbas, Avicenna and many others) but had
declined by the mid 13 th century. When the Arabs invaded Spain (710 AD), Sicily
(827 AD) and Southern Italy (950 AD) they brought with them their translated texts
which were then translated back into Latin in Salerno by Constantinus Africanus
(c1080), in Spain by Gerard of Cremona and many others. From Spain and Italy the
new medicine, a mixture of Greek, Roman and Arabic medicine, spread rapidly
across Europe. The European Dark Ages are usually dated as starting with fall of
Rome in 476 AD and continuing until 800 AD. The Muslim dominance of Spain
lasted from 710 AD until 1276 and their medicine was ‘but a diluted or debased
strain of Greek medicine’ (Welch 1931). Spain’s ‘Golden Age’, which included its
colonies as far as medicine was concerned, was from 1479 – 1598 (Torella,
Villalobos and Pope John XXI). From the time of Constantinus c1050 books gave
more and more information on the adverse effects of herbs and metals. The
increase in knowledge of adverse drug effects paralleled that of the growth in