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Doc, What Is Your Favorite Herb?
(ASA - Acetylsalicylic Acid)

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page 19 in the November 15-16, 2003 issue of
The Mississauga News under the feature: Health & Wellness, Doctor's Corner.

Without any doubt whatsoever, it is extract of willow bark! This is one medicine that has been around for thousands of years and keeps on amazing me with new uses. It has even gone to the moon, and is a basic ingredient in my black bag. More commonly, you may know this wonder drug as ASPIRIN.

Salicin is the active ingredient in several plants including willow bark that has been extracted in brews over the years as a remedy for fever and pain. In the last century, Salicin was produced as a powder, which was very bitter tasting and irritating to the stomach. In 1897, Felix Hoffmann, a German chemist sought to treat the arthritis afflicting his family members and synthesized acetylsalicylic acid (ASA) which was easier to swallow and less irritating.

Aspirin is an excellent pain reliever and anti-inflammatory medicine. When I was a child, it was the first choice for fever, and many people remember the small orange tasting little pills that dissolved in our mouths. By the early 1970's a rare condition called Ryes Syndrome sometimes developed in children when they were given aspirin for high fevers associated with viral illnesses. The popularity plummeted and parents switched to the "safer" acetaminophen compounds found in the Tylenol brands and others. But other interesting observations began to emerge. For one thing, aspirin was found to be able to thin the blood. This was certainly an advantage in different conditions where the blood clots, such as embolic strokes and heart attacks. Nowadays, the first thing to do at the first suspicion of a heart attack is to pop an aspirin. In one study, it was estimated that this simple maneuver alone could save as many as 50,000 lives in North America. It still is a popular drug for headaches and arthritis. How popular? Over 80 billion aspirin tablets are served up each year!.

One action of aspirin is to bind to an enzyme called COX-2 (cyclooxygenase 2). This enzyme is a protein found in most normal tissue whose job is to help manufacture prostaglandins. Prostaglandins signal pain, and begin a process of inflammation meant to heal injury. Prostaglandins can also cause blood platelets to clump and form clots. In the stomach, they help maintain the lining from harmful acids. Understanding the action of aspirin explains the so-called side effects. Aspirin also inhibits the COX-1 enzyme in the stomach. Less prostaglandin means less lining and more stomach irritation. To get around this, manufacturers coat their products so that they pass through the stomach with minimal effect. The term "baby blue" is used for the 81mg coated aspirin product that is widely used to help prevent stroke and heart attack.

Even more exciting is the newer uses for aspirin. There are observations emerging that suggest it may play a role in the prevention of gastro-intestinal cancer, help lower blood pressure in problem pregnancies, and slow the development of cataracts. Just imagine, all this in one drug, herbal, substance or whatever you want to call it. On the flip side, it still accounts for a great many overdoses, ulcers and bleeding problems in persons who cannot tolerate it or take too much. Despite this, it still remains a favorite of mine. The old joke of "take 2 aspirins and call me in the morning" needs to be modernized to "take 1 aspirin and live to see me next year!"

Related resources:

Aspirin from Wikipedia. Headache.

Aspirin 101 by Lucas Hoffman, MD PhD. How Aspirin Works, from Health Howstuffworks.

How Does Aspirin Relieve Headaches? By Ashlee Simmons, eHow Contributor. Video. 2:30 min.

Over-the-Counter Drugs and Head Pain from Teri Robert, former About.com Guide.

Head Massage - 5 Simple Exercises to Reduce Headaches. Video, 3:39 min. Demonstration of exercises by Beijing doctor (in Mandarin Chinese) to help reduce headaches / migraines. View video to copy movements:
    • 1. Rub head from front to back with both hands as if combing hair, 20 times .
    • 2. Rub over both ears top to bottom, 20 times.
    • 3. Massage forehead and temporal area, 20 times.
    • 4. Locate grooves at base of skull in neck region, massage with thumbs, 20 times.
    • 5. Relax hands and lightly tap all over head for 1 minute.

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