The Uncertain Origins of Aspirin

Summary

‍On a cool starlit night in ancient Egypt, a wife brews willow-bark tea for her husband, hot with fever;While Athens and Sparta wage war, Hippocrates hurries to the river to shave some more willow bark, intending to cool down another sick child brought to his door; While George III marries Princess Charlotte, a son dashes off into the woods in search of willow bark to treat his mother’s worsening fever.While these anecdotes are familiar from cinema and literature, the history of aspirin and the willow bark from which it is (supposedly) derived is far from clear.For instance, it is often said that Hippocrates prescribed willow bark tea to treat inflammatory pain. In a perfect world, we would know this because a verified scroll from around 400 BC would exist, stating: “For inflammation, I recommend willow bark tea, and so does everyone I know. So sayeth Hippocrates of Kos, future father of medicine and writer of the eponymous oath.”Of course, such primary material does not always come to light. And many who recount medical and scientific histories (or, indeed, any history at all) do so despite incomplete information. In these cases, however, it’s still important to cite what evidence there is: what, for example, has led so many people to believe Hippocrates prescribed willow bark tea for inflammatory pain? If the answer is “someone said so,” who was that someone, and why did they think it was true?This history of one of the world’s most widely consumed classes of drugs demonstrates the difficulties that surround the fact-finding of its origins. Some of these difficulties are historic, such as bad record keeping or obscure translations, and some are of continued relevance, such as political upheaval or the prejudice that often interferes with science.My goal is not only to tell the story of a pharmaceutical staple but to share what my decades-long work in evidence synthesis in epidemiology has taught me about researching scientific history. In doing so, I’ll differenti...