Aspirin ... the Original ‘Wonder Drug’

By Nancy Berkoff, RD, EdD

How many of us can remember a glass bottle of aspirin in the medicine cabinet, the contents doled out one tablet at a time, for whatever ailed us? Aspirin has retained its popularity. As of 2023, aspirin was the most used drug worldwide.

Aspirin has been called one of the most important pharmacological achievements of the twentieth century. Before aspirin, your headache might have been treated with trepanning (drilling a small hole in the skull to relieve pressure), or “botanical” cures that may have contained cocaine, opium or even kerosene.

Although Bayer may have been the first to put aspirin in a bottle, willow bark, which contains aspirin’s active ingredient, was used as a painkiller and antipyretic ( fever controller) by Sumerians and ancient Egyptians, Greeks and Romans over 3500 years ago. The Ebers papyrus, an ancient Egyptian medical text, refers to willow as an anti-inflammatory or pain reliever, for non-specific aches and pains. Hippocrates provided willow-leaf tea, which contains the natural compound from which aspirin is derived, to women to ease the pain of childbirth.

Beginning in the 1700s, salicylates, aspirin’s active ingredient, were extracted from willow bark and used for medicinal purposes. Acetylsalicylic acid was named “aspirin” by a chemist from the Bayer Company. The letter ‘A’ stands for acetyl, a compound added to prevent the natural bitterness of salicylates. The “spir” comes from a plant known as “spiraea ulmaria,” a source of salicylates, and “in” was a common suffix used for drugs at the time of aspirin’s first manufacture.

In 1950, aspirin made the Guinness World Record for being the most frequently sold painkiller. A professor of pharmacology, John Vane, won the Nobel Prize for his research into the mechanisms of aspirin in the body.

In addition to its antipyretic and anti-inflammatory properties, aspirin became known for its antiplatelet properties, a milestone in preventing cardiovascular and cerebrovascular diseases in the 1970s. As of 2024, there is ongoing research as to the true cardio-protective effect of aspirin. Over the years, there has been evidence of aspirin’s possible preventive effect against colorectal and other types of cancer.

Even “miracle cures” have “howevers” associated with them. If aspirin is an approved choice for you, it should never be taken without food. Aspirin and an empty stomach can mean stomach irritation, affecting the inner lining of the stomach and possibly causing gastric ulcers or bleeding. Consultation with a medical professional should always be done before considering aspirin.

Aspirin should never be given to children as it may cause Reyes syndrome, a serious disease that affects all body parts including liver and the brain.

An overdose of aspirin can affect hearing, from ringing in the ears to total deafness. According to a study published in the American Journal of Medicine, individuals who take an aspirin two or more times a week may increase their risk of hearing impairment by one third. Again, get with your doctor…

Over four hundred drugs are known to interact with aspirin, including antidepressants, antacids, blood thinner, insulin and other pain relievers. Again, speak with the doc!

One person who should not have been given aspirin was a member of the Russian royal Romanov family, Alexei, who had hemophilia. Aspirin would have made the bleeding from this disease worse. But the imperial doctors insisted he take the new wonder drug. Alexi probably improved because the mystic Grigori Rasputin told his family to rely on spiritual healing rather than modern methods. Rasputin’s influence on the Romanov family may have contributed to the uprising against them, making aspirin a possible participant in the end of czarist Russia.

As a side note, it has been said that if aspirin had to go through today’s FDA process it most probably would not be approved. How aspirin actually works in the body is poorly understood, it can cause excessive internal bleeding and there is a risk of severe allergic reactions.

The jury is still out about the absolute properties of aspirin, but its role in providing comfort over the years is indisputable.

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