Introduction - Uppsala Monitoring Centre

adverse effects more willingly. Now we have effective drugs most of our illnesses
can be cured and we live to have more side effects from the next treatment for the
next illness, but one can see from the life expectancy figures that for our ancestors
their first illness was often their last, as most medicines were to relieve symptoms
rather than cure illnesses. It is apparent that from the earliest times writers have
experimented upon themselves and since they almost certainly did not have the
ailment for which the drug was appropriate the assessment of any reaction would
not have been confused by alternative diagnoses. However, since they were only
experimenting upon themselves only the most common ADR would have been
discovered by this means.
Terminology: the meaning of words changes with passage of time, semantic
shift, and many new specific terms have appeared. There was no standardization of
language, such as MEDRA 180 or its equivalent, so foreign languages need to be
translated and their everyday language interpreted.
5. Publication
1) Prior to 1750 the literature was confined to generalisations befitting their
educational purpose and it was only when medical journals appeared that
individual case histories were published frequently.
2) The herbals, dispensatories and pharmacopoeias covered such a large number
of medicines that it would not have been feasible to mention anything but the
most serious adverse effects.
3) The early authors would not have treated enough patients to pick up a sufficient
number of rare ADRs to have made a generalisation.
4) The steady increase in the number of medical journals published meant that there
was a greater opportunity to be published.
The ever increasing availability of ever increasing numbers of powerful drugs to
an increasingly rich and sophisticated and ever increasing population of patients has
produced and will continue to produce an exponentially increasing number and
variety of ADRs. The number of reported serious adverse events from drug
treatment more than doubled in the United States from 1998 to 2005, rising from
34,966 to 89,842 and the number of deaths relating to drugs nearly tripled from
5,519 to 15,107 (Moore, 2007).
Conclusion
To cover drug safety worldwide across 7,000 years is an impossible task. My
attempt has been restricted by my limited knowledge of foreign languages, the
relative inaccessibility of the data, and time. The means of communication over this
period changed radically from oral to written, written to printed and then from printed
to electronic. From a trickle to a flood; from oracle stones and cuneiform tablets to
Google. The information has varied from warnings of possible death or ‘Poison’ to