The World's Best Is Also the Cheapest

Machines at New Jersey's Sterling Drug Inc. have just produced their 100 billionth Bayer aspirin tablet for the in satiable U.S. market. All in all, U.S. industry now manufactures 27 million Ibs. of aspirin a year -- enough to fill four 100-car freight trains, enough for the 16 billion straight, five-grain aspirin tablets that Americans swallow each year, plus an even greater amount for the children's miniature aspirin and such formulations as Bufferin, APC tablets, Coricidin and Alka-Seltzer.

Aspirin well deserves its popularity.

It is the world's first true wonder drug, and though it cures nothing, it is still the best palliative for an astonishing variety of ills, ranging from the common cold to the crippling deformity of rheumatoid arthritis. After 65 years of high-pressure research, surprisingly little is known about how aspirin works, but one thing is comfortingly certain: at about half a cent a tablet it is the world's cheapest drug.

From the Willow. It must have been salicylic acid that Hippocrates was dealing with when he recommended extracts of willow bark-for relieving pain and fever. American Indians gave willow-bark tea for rheumatism and fevers.

In 1763, an English clergyman, Edward Stone, found that willow tea eased the agues of malaria. By 1840, chemists isolated salicylic acid and thought they had a wonder drug, only to have physicians drop it quickly because it had too many harmful side effects. In 1853, Charles Frederic Gerhardt did a bit of molecular manipulation in his Strasbourg laboratory and made acetylsalicylic acid (C9HSO4). Having found it, he failed utterly to appreciate its value, and put it on the shelf.

There it stayed until the 1890s, when Felix Hoffmann, working for Friedrich Bayer & Co. outside Duesseldorf, tried the drug on his father and found that it miraculously eased the old man's rheumatic pains. Hoffmann's boss, Heinrich Dreser, coined the name aspirin, and rushed the drug to market. Aspirin was a registered trade name, and still is in Germany, though it lost that privileged status in the U.S. in 1917, when the Monsanto Co. began to make it in large quantities. Like nearly all other important chemicals, it is now made synthetically from coal tar.

Universal Sovereign. In the early years, doctors learned about aspirin from their patients. They prescribed it for rheumatic pains, and patients volunteered the information that it also cured headaches. It has become the universal, sovereign remedy for dropping a fever, and for pain of practically any kind from hangover to cancer. In the rheumatic disorders, aspirin has a double action: it not only eases pain but, by lowering the temperature of inflamed joints and muscles, actually helps to check the disease process itself. It has a similar double action in gout. Aspirin's supremacy as an antirheumatic was threatened for a while after the hormones cortisone and ACTH appeared in 1949, but it is once again "the drug of choice," except in special cases where doctors find the risks of the hor mones' side effects are justified.

Some physicians have found evidence that aspirin may literally act like the hormones and stimulate the patient's adrenal glands to work better. A similar added benefit is suspected, but not yet proved, for victims of kidney stones: originally prescribed only to relieve the pain, aspirin may help to keep new stones from forming.

Aspirin has a great advantage over most other painkillers, notably morphine, in that it is nonaddicting, and the dosage does not have to be progressively increased. It has no attraction for suicidal adults: the vast majority of people can take huge overdoses without killing themselves.

But an overdose may be lethal for small children, and 100 or more in the U.S. die from aspirin poisoning in an average year. Thousands more, beguiled by candy coatings and flavors, are made so deathly ill that they have to have their stomachs pumped out. Aspirin irritates the lining of the stomach, and ulcer victims often find the effects of the medicine worse than the headache they are trying to cure. In extreme cases, they suffer internal bleeding or their ulcers perforate. As with all drugs, a few people are abnormally sensitive to aspirin; even a normal dose may cause dizziness, nausea, a skin rash, or an asthmatic crisis.

But such unfortunates are the exception. By and large, aspirin is good for what ails you.

*The name salicylic acid is derived from the Latin salix, willow, though the same substance occurs in many plants, including spiraea, from which the word aspirin is derived.

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