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aspirin

14 july 2010

My mother had certain words she delighted in knowing how to spell. "Mississippi" was one of them; "separate" was another (it takes "a rat" to spell "separate"). And another was "acetylsalicylic acid."

One of the many things I learned from Diarmuid Jeffreys's book Aspirin was the etymology of both "salicylic," the core of the generic term for "aspirin," and of the trade name "aspirin" itself. "Salicylic" comes from the Latin salix, "willow," distantly cognate with an old English word for "willow" that survives in poems like John Keats's "To Autumn":

Then in a wailful choir the small gnats mourn
Among the river sallows, borne aloft
Or sinking as the light wind lives or dies

"Salicylic" acid, because the stuff comes from the bark of willow trees (where it was discovered by the Sumerians and Egyptians, and later by the Greeks, and rediscovered by a village clergyman in 18th-century England). But "aspirin," the now-common name, comes from the concentration of salicylic acid in spirea, a bushy plant with seasonally lush flowers that grows a few feet from my back door, and I intend to chew on the next time I have a toothache.

Jeffreys tells a heavily-populated story of a drug that exemplifies the progress of the pharmacopoeia under capitalism. Willow extract wasn't really a folk remedy, and didn't thrive as a pre-industrial medicine. For one thing, it wasn't a "specific": it wasn't good at just one thing, as "Peruvian bark" (active ingredient: quinine) was a "magic bullet" for malaria. (One thing I learned from Aspirin was that 18th-century England was a malaria region.) Willow reduced fever and lessened pain, but so did leeches, mustard plasters, sugar pills, and getting up off your rear end and stopping your complaining, to a greater or lesser degree. It took mass production and indiscriminate swallowing to establish that acetylsalicylic acid was an all-purpose drug that actually featured clinical effectiveness.

French, Swiss, and German research chemists, in the 19th century, learned how to isolate salicylic acid, and then to combine it with "acetyl" groups to make it digestible. (For all his detailed narrative, Jeffreys actually seems to omit a step wherein botanically-derived salicylic acid was replaced by the coal-tar derivatives that are the basis of synthetic aspirin – well, the more likely case is that I'm an idiot, but I went over and over the relevant chapters without finding the link.)

When the Bayer company (whose founder didn't live to see aspirin) began to manufacture and trademark "ASA" as "Aspirin" in the late 19th century, one of the more bizarre stories of the modern business world developed. Jeffreys's saga involves both trademark and patent law, wartime seizures of alien assets, a patchwork of multinational companies and intranational rulings, hyperbolic advertising, intense pressure to innovate, and, till recent years, an utter lack of basic research. Once that research was begun, aspirin incredibly found itself more of a celebrity substance for the 21st century than it had been in any of the previous three.

Very early in the game, the Bayer company of Germany lost the trademark on the name "Aspirin" – at least in some countries. (They lost their patent almost before they registered it, inasmuch as acetylsalicylic acid was not a new nor a terribly distinctive substance; you can fabricate it in Chemistry 101.) Originally (in 1899), only Bayer could call ASA "aspirin." That's still the case in Canada and some other countries. In the UK, the Bayer trademark was nullified during the First World War – hey, invade Belgium and you deserve to lose a few intellectual properties. In the United States, the trademark was stripped from Bayer after the War by the great federal judge Learned Hand, who ruled that the name "aspirin" had become so widespread that it was a common noun.

Meanwhile, oblivious to all the litigation, people were gobbling down aspirin left and right. The pills seemed to be good for anything and everything, as Fred Astaire observed in Broadway Melody of 1940:

George Murphy (who has just struck out with Eleanor Powell): "She said she had a headache. But I sent her orchids!"
Astaire: "You should have sent her aspirin."

In fact, it's a wonder that cardiac disease made such inroads on the world in the 20th century, given that doctors seemed to respond to every complaint with the proverbial "take two aspirin."

People took so much aspirin that some of the older ones developed serious gastric bleeding, and some of the younger ones developed Reyes Syndrome. For a while, aspirin seemed to be on the outs, the medicine of the grey-flannel-suit generation. In David Rabe's Sticks and Bones, a character tells an aspirin-chewer that it will make his stomach bleed: it's a metonym for the repressed 1950s guy being eaten up within. A Woody Allen character made fun of his neuroses by saying that he was so addicted to aspirin he "boiled the cotton on top to get the extra." Between Tylenol and a coupla Advil, by the 1990s nobody took aspirin any more; it was like watching Lawrence Welk re-runs.

And then, almost overnight, everyone was taking aspirin again, albeit the tiny children's-cherry-flavored variety instead of the extra-strength size. Studies show it keeps our arteries clear – and who wants coronary thrombosis?

I suspect that the final chapter on aspirin is far from being written, but Diarmuid Jeffreys had to stop his narrative at the present day. That day was in 2004, but my pleasure in his writing was delayed till last week, when I found Aspirin in a remainder catalog and promptly chose the even cheaper route of checking it out of the library. Even though its hero is a little white pill, it's one of the more spellbinding adventure stories I've read this year.

Jeffreys, Diarmuid. Aspirin: The remarkable story of a wonder drug. New York: Bloomsbury, 2004.

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