visit history of aspirin page
Physicians, Fads, and Pharmaceuticals:
A History of Aspirin
Anne Adina Judith Andermann*, B.Sc., M.Phil. Cantab
* To whom correspondence should be addressed: Faculty of Medicine, McGill
University, 3655 Drummond St., Montreal, QC, Canada H3G 1Y6"Politics is not
out there in society.
----------------------------------------------------------------------------
Politics is down there in the laboratory."
--Bruno Latour (1).
Aspirin is a product of the late-nineteenth-century laboratory,
pharmaceutical industry, and medical community. The prevailing scientific
techniques, industrial approaches, and medical beliefs were instrumental in
the development, promotion and reception of the drug. As a result, the
present account does not extend further back than a few decades prior to the
release of aspirin from the laboratories of Farbenfabriken vormals Friedrich
Bayer & Co. in 1899. In contrast, much of the current literature on aspirin
(2,3,4) attempts to trace the compound back to antiquity through the Ebers
papyrus, the Hippocratic writings, and the works of Galen. Such histories
tell a simple, linear tale of the numerous "discoveries" proposed to have
led to the use of certain salicylate-containing plants, such as willow bark
and wintergreen, or salicylate-related compounds, including salicilin and
salicylic acid, as cures for a variety of ailments. Indeed, according to
Mann and Plummer:
Both [salicilin and salicylic acid] attacked fever and pain, and
their partisans advocated the salicylates' use as antiseptics,
mouthwashes, and water preservatives for ocean voyages; one
important chemist further suggested (erroneously) that sodium
salicylate, a chemical relative, would successfully treat scarlet
fever, diphtheria, measles, syphilis, cholera, rabies and anthrax
(5).
However, it is difficult to establish what effect, if any, these examples of
the "historical" uses of
"proto-aspirin" had on the impetus for and modes of developing and using the
actual drug called aspirin. As a matter of course, aspirin is usually
described as the natural descendant from these salicylate forefathers.
However, the history of aspirin is not as straightforward a tale as
conventional histories suggest, but rather is a complex narrative of the
people and circumstances involved in transforming a simple chemical compound
into a popular pharmaceutical product that has remained one of the most
widely consumed drugs for almost a century.
Bayer began in 1863 as Friedrich Bayer & Co., a dye-manufacturing plant in
Germany. When the dye industry began to wane during the late 1880s, Bayer
made the transition into the more active and lucrative sector of
pharmaceuticals by developing, producing, and marketing phenacetin
(acetophenetidin) from a dye-making by-product. The company's switch from
dyes to pharmaceuticals was so rapid that the first lots of the drug were
alkylated in make-shift containers--empty beer bottles wrapped in
towels--before the company decided to invest in suitable equipment and
proper facilities for its production (6). However, despite the change in the
products being manufactured, Bayer retained many of the methods used
previously in the sale of dyestuffs in highly competitive markets: sales
representatives, advertisements in trade journals, and the use of patents
and trade names. As McTavish, a noted medical historian, remarks:
By restricting its market to the pharmaceutical and medical
professions, the chemical industry avoided the unseemly trappings
of the nostrum trade and established itself as a member of the
'ethical' fraternity (7).
From then on, McTavish affirms, "[drug production] took place in an
industrial setting. Drugs were commodities similar in most respects to any
other commodity: they were manufactured for profit" (7). During the 1890's,
Carl Duisberg and other key figures at Bayer were busily involved in
reorganizing the company, in setting up pharmaceutical laboratories for the
development and standardization of drugs, and, most importantly, in
establishing links with the medical world.
The late nineteenth century saw an unprecedented rise in the number of new
pharmaceutical products on the market. One physician in 1889 commented:
"Every week, almost every day, brings its new drug, each in turn praised as
being the greatest discovery of modern therapeutics" (8). McTavish
attributes this tremendous influx of new products to "the increasing
industrial role of the laboratory, especially in the drug industry" (7).
However, the utility of these novel therapeutic products in medical practice
was a source of great debate. Certain physicians staunchly opposed what they
saw as "the growing tendency among German medical men to convert the
'Republic of Science' into a commercial oligarchy for the benefit of
plutocrats at the expense of suffering humanity" (7). Others were more
accepting of the new developments, but remained wary of those who hailed new
compounds as milestone drugs or panaceas, "lest they bring into discredit
both their own calling and that of the pharmaceutical chemist" (9). In an
address on the Progress of Medicine in the Nineteenth Century, Dr. F.
Roberts confessed:
Out of the enormous number of medicinal agents brought under our
notice by puffing advertisements in the press, medical as well as
lay, by pamphlets or even large books delivered by post, or by
actual 'specimens for trial' which are nowadays so liberally
delivered at our residences, comparatively few hold their ground,
or stand a fair and candid criticism and investigation of their
vaunted merits. Still a certain proportion do and I see every
reason to anticipate that, as the result of the systematic
researches, scientific and practical, now carried on in so many
laboratories, valuable additions will be made from time to time to
the medicinal agents at our disposal for the help and comfort of
our patients. I only hope that in our love for the new we will not
entirely throw out old friends which have done real and effective
service in the past and are today as deserving of our regard as
ever (10).
Therefore, for those pharmaceutical companies that had managed to establish
a place for themselves within the medical community, drug production became
a legitimate science-based industry, whereby manufacturers and medics
engaged in a profitable producer-consumer partnership. For instance, as
written in the Lancet in August 1899, many new pharmaceuticals were the
product of the increased attention paid "to the toleration of drugs and to
the avoiding of effects which are undesirable" (11). Furthermore:
Modification of the salicylates and the introduction of new
morphine derivatives [which were both activities carried out in
the Bayer laboratories] occur as single examples. In these matters
it is satisfactory to find that the pharmacist is guided by the
medical man and not solely by a knowledge of the chemistry of the
principles concerned (11).
Thus, the inspiration and drive to produce aspirin can be explained in terms
of a medico-industrial relationship in which the pharmaceutical companies
supplied products that interested the doctors, and the doctors, in turn,
maintained an active interest in what the pharmaceutical companies had to
offer.
During the 1880s and 1890s, when physicians became intensely interested in
the possible adverse effects of fever on the human body, the use of
antipyretics became one of the hottest topics in therapeutic medicine.
According to one pharmacology textbook published at the beginning of the
20th century:
From the highest to the lowest in the profession, the fad was to
regard fever as the most deleterious factor in a case, and to
treat it as if it were a part of the disease, or the disease
itself, instead of a symptom of almost all infections, and one
which in itself is not capable of doing harm, unless it is
excessive or very prolonged. [It was believed] that not only did
fever, when sufficiently high, coagulate the protoplasm of vital
parts, but that the patient was having his tissues burnt up, and
that this excessive combustion, or conflagration, must be arrested
even though the disease spent itself unaltered in its other
clinical manifestations and pathological tendencies. The discovery
by numerous laboratory investigations that this group of drugs
decreased heat production, and increased heat dissipation, seemed
to fit them in a peculiar manner to meet the therapeutic needs of
the hour, and they were tested on a scale of experimental
therapeutics hardly before equaled. At first, cases of untoward
effects were frequently recorded, with fortunately very few fatal
cases. Often these effects were due to heroic doses; in other
cases, when patients in low fevers received the drug, the fall in
temperature which succeeded produced collapse; while in maladies
like pneumonia, with deficient aeration of the blood, or other
pulmonary affectations, cyanosis, excessive sweating, and
feebleness of the circulation occurred (12).
Therefore, until the fever fad ended at the turn of the century, most likely
as a result of the increasing popularity of the germ theory, most physicians
concentrated their efforts on treating pyrexia. The drug companies responded
to the medical demands of the day by catering to, and perhaps even fueling
the fires of, the antipyretic era. New antipyretics and analgesics--most
drugs in this class were believed to possess more or less of both
properties--were introduced monthly: "those coal-tar crystalline products
which have almost deluged the market as quinine substitutes, [were] being
offered from time to time as analgesics, anodynes, antipyretics, as the case
may be" (13). Moreover, most of these new therapeutic compounds were
commonly promoted as and subsequently referred to by catchy brand names such
as malarin, pyrantin, cosaprin, phesin, eupyrine, and, of course, aspirin
(14).
Still, it is not exactly clear how aspirin came to be. Many give the title
of "discoverer of aspirin" to Felix Hoffmann, a chemist at Bayer whose
father suffered from rheumatism. According to legend, Hoffmann's father was
taking salicylic acid, already mass-produced, widely used, and highly
profitable by the end of the 1870s, to treat his rheumatic condition.
Unfortunately, the drug was terribly irritating to the stomach and was
associated with other ill-effects: most notably, in addition to having an
unpleasant, sometimes nauseating, taste, it was believed that salicylic acid
disrupted digestion and had an enfeebling action on the heart (16,17).
Therefore, the dutiful son took on the task of developing a less toxic
replacement. However, acetylsalicylic acid (ASA)--the common chemical name
of aspirin--may have already been produced by the French chemist Charles
Frédéric Gerhardt in 1853, although he called his compound acetosalicylic
anhydride, which was not necessarily the same as ASA. The compound was
synthesized in a purer form by Johann Kraut in 1869. Indeed, acetylsalicylic
acid was already being manufactured by the Chemische Fabrik von Heyden
Company in 1897, although without a brand name. Therefore, it is difficult
to determine whether Hoffmann truly developed a new chemical compound or
even a novel method of producing a known one, which could then have been
patented in Germany.
In addition to the uncertainties regarding the chemical origins of ASA, the
prevailing medical opinions concerning the widely-used salicylic acid and
related compounds, including acetylsalicylic acid, were mixed. Similarly,
there was a wide divergence in opinion within the Bayer pharmaceutical
laboratories concerning the value of the work being done on ASA in 1897.
According to Mann and Plummer, there was a certain degree of animosity
between Arthur Eichengrün, who ran the research and development-based
Pharmaceutical Division where Hoffmann worked, and Heinrich Dreser, who was
in charge of testing and standardization in the Pharmacological Division
(5). Eichengrün supported Hoffmann's chemical compound, whereas Dreser
initially had no interest in even testing it as a potential new drug.
Apparently, Eichengrün even went so far as to surreptitiously distribute the
compound to physicians for trials. However, it was Dreser who eventually
published the first article on aspirin. His change of heart regarding the
value of this compound likely reflects his own financial interests, since,
according to Mann and Plummer:
[Hoffmann and Eichengrün] had contracts with Bayer by which they
would receive a royalty on any patentable product they invented.
Since there was no patent, neither of them received any royalties
from the sale of aspirin in Germany. However, Heinrich Dreser had
an agreement with Bayer by which he would receive a royalty on any
product that he introduced. Thus he received a very substantial
royalty for aspirin and was able to retire early a very rich man
(5).
As suggested in the July 1899 issue of the Lancet:
No one [in the pharmaceutical industry] would undertake the
irksome task of making new products known to the medical
profession without being, whether rightly or wrongly, convinced of
their superior properties (17).
Therefore, once Dreser finally chose to promote Hoffmann's chemical compound
as aspirin, he certainly built up a strong case for its superiority over
other available remedies.
In his article published in the Archiv fur die Gesamte Physiologie in 1899,
Dreser begins by describing the unsatisfactory nature of the drugs then
available, thereby creating the need for new alternatives:
In many diseases related to common cold, the use of sodium
salicylate would be definitely much more popular if it would not
provoke strong rejection by its disgusting sweet taste which can
be corrected only to some extent (18).
Dreser then suggests:
Pharmacological chemistry should develop synthetically a new
preparation which would avoid in addition to the disgusting sweet
taste other undesirable characteristics such as the overloading of
the stomach. After resorption, the active salicylate should be
rapidly split off from the new product.
These improvements are precisely what Dreser claims to have achieved through
the synthesis of aspirin. First, the taste was refined by masking the free
phenolic hydroxyl group of salicylic acid through substitution of the
hydrogen atom with a methyl group. To prove that aspirin is reabsorbed and
cleaved into salicylic acid, Dreser cites the work of the German scientist
Lesnik published in the Archiv fur Experimentelle Pathologie und
Pharmakologie to maintain that the increase of nitrogen in the urine "could
be due only to the nitrogen-containing metabolic product of salicylic acid .
. . also clearly shown by aspirin."
Dreser then carried out comparative studies of aspirin and other salicylates
to demonstrate that the former was less noxious and more beneficial than the
latter. For instance, he tested the sodium salt of aspirin and sodium
salicylate on normal rabbits and on cold-blooded animals, which, to his
mind, "showed clearly that aspirin is less poisonous than salicylic acid."
Dreser also tested aspirin on the most fine and delicate tissues, such as
the gills of fish, to further demonstrate the gentleness of the compound.
Finally, to put to rest any fears that aspirin might depress the heart, he
conducted experiments to show that sodium salicylate decreased cardiac
output, whereas the sodium salt of aspirin increased it. Dreser concludes
his article as follows:
Summing up the most important pharmacologic characteristics of
aspirin we may suggest the following: The aspirin has a more
pleasant harsh acidic taste than sodium salicylate before
resorption. It is also more protective to the stomach wall
according to the above experiments. It is very advantageous,
furthermore, that aspirin is split by the gastric hydrochloric
acid only to a small extent (0.2%). Differences are evident
between aspirin and sodium salicylate also after resorption...
(18).
By publishing these findings in a physiological journal, Dreser was able to
provide a "scientific" and "objective" account of this new compound as a
potentially powerful pharmaceutical product with few side-effects. At the
same time, he was one of the top employees at Bayer, and would therefore
benefit personally from the success that his pharmacological analysis had
brought upon aspirin.
In concert with Dreser's efforts, physicians were co-opted into supporting
the effectiveness and harmlessness of aspirin. Two such doctors cited in
Dreser's article were Dr. C. Witthauer, who published a paper on his
experiences with aspirin in Die Heilkunde in April 1899, and Dr. Julius
Wohlgemuth, who had his results published in Therapeutische Monatshefte in
May of the same year. Both Witthauer's and Wohlgemuth's articles (19,20)
provide a general introduction to the novel powder, corroborate Dreser's
findings, and describe the results of clinical trials with aspirin.
Unequivocally, they conclude that the new drug is superior to the other
pharmaceutical products then available.
The elegance of the early medical and pharmaceutical reports lies in their
ability to ally aspirin with the already widely accepted salicylic
compounds, whilst concurrently presenting aspirin as distinct from them.
Thus, the new drug possessed a certain familiarity, and more importantly,
the manufacturers could then claim the proven medicinal properties of
salicylic acid and related compounds by association. However, it was equally
important to disassociate aspirin from the negative qualities that had been
attributed to these products through the development of scientific truths in
the laboratory which attested to such differences. In this way, a white
powder that had spent many years collecting dust on a shelf along with
hundreds of other chemical compounds stored at Bayer was transformed into a
substantive pharmaceutical product. Since then, each new report by members
of the medical community or pharmaceutical world has expanded and altered
the ever-growing narrative on aspirin.
On July 22, 1899, aspirin was featured in the "Analytical Records from the
Lancet Laboratory" along with several other products that had undergone the
rigors of scientific analysis: an old pale cognac found to be suitable for
medicinal purposes; Johannis potash water, a diuretic and alkaline
treatment; Sandron's iron tonic, which was found to contain a very small
quantity of iron; and finally, two specimens of Scotch whisky. The journal's
announcement of The Bayer Company's latest drug resembled, in both content
and intent, the articles published previously by Dreser, Witthauer, and
Wohlgemuth. Within a few years, a barrage of articles singing the praises of
aspirin had been published. The clinician Floeckinger even went so far as to
take two large doses of aspirin himself: first 75 grains and then another 60
grains (21). After the first dose he found himself "without toxic effects,
except violent headache and tinnitus" which lasted for 16 hours, until it
subsided following profuse sweats. After the second dose, Floeckinger
experienced "increased pulse, reduced temperature, and flashes of light
before the eyes." Nonetheless, Floeckinger concludes his article as follows:
[It] presents several advantages over salicylic acid. It does not
irritate the stomach. There is no cardiac depression. In ordinary
doses there is no tinnitus or headache...and [it] is best
prescribed in wafers or sachets for acute and chronic rheumatism,
polyarthritis, and pleurisy...but it is ineffective in neuralgias
and pleurodynia (21).
Any adverse effects experienced when taking aspirin were attributed not to
this new drug, but rather to extrinsic factors, such as the medium of
administration or the magnitude of the dose. Although certain physicians
claimed that "some observers--Osler, for instance--recognize little or no
advantage in salicylates beyond some power in relieving pain" (15), most
physicians strongly supported aspirin as a valuable addition to the
pharmacopoeia.
Soon after its release onto the market, aspirin began to appear in the new
pharmacological texts. Nonetheless, there were still many recent and
reputable works that did not mention Bayer's new drug (12,22,23). Indeed,
even when aspirin was included in these works, it was not always cited for
use in treating ailments with which one now associate the drug. The Index of
Diseases and Remedies in an American textbook on materia medica,
pharmacology and therapeutics, for example, cites aspirin for the treatment
of certain diseases, but does not prescribe it as a general substitute for
salicylic acid and the other salicylates. The text lists salicylic acid as a
drug useful for burns, eczema, ephelides (freckles), lupus vulgaris,
pertussis, and ulceration. Salicilin, salol, salipyrin, and other
salicylates are recommended for different disorders such as chorea, diabetes
mellitus, endocarditis, fever, pharyngitis, and pleurisy, whereas aspirin is
recommended, in addition to other drugs, in the treatment of influenza,
neuralgia, and neuritis (24).
Indeed, within the first five years after its release, aspirin was seen less
and less as an antipyretic, and was increasingly prescribed for the relief
of pain. By 1903, "numerous observations had been made on the analgesic
effect of aspirin in neuralgias and other painful affectations," including
carcinoma (25). In this way, aspirin was similar to its predecessor
phenacetin, which "found its birth in what may be called the antipyretic era
[of the 1880s and 1890s, and] like its relatives has come to be employed
chiefly for the relief of pain" (12). The shift in interest from the
antipyretic to the analgesic properties of these drugs in the early
twentieth century is best summarized by the entry in the Text-book of
Pharmacology and Therapeutics of 1901:
As the fad for antipyresis waned by its loss of novelty,
physicians began to ask each other whether these drugs which acted
so well in reducing fever had any influence in shortening the
course of the disease, and it was speedily determined that they
did not. Simultaneously, the increasingly thorough investigations
into the pathology of fever, and our increased knowledge of the
life history of the organisms causing disease, made it clear that
fever was a comparatively unimportant factor in a given case,
unless excessive; and it begins to be apparent that fever is not
only not a peculiarly harmful process, but in some cases may be
actually of value... Finally, the recollection of the fact that
the use of these drugs necessitates their absorption and
elimination, changed or unchanged, and that in these processes
they may be guilty of a deleterious influence, has still further
decreased their popularity as antipyretics, while the discovery
that all of them possess pain-relieving properties has also
diverted attention to their use for other purposes than
antipyresis (12).
Thus, the uses of aspirin changed with the changing trends in the medical
profession, becoming progressively less linked to the drug's initial
description and indications first marketed by the pharmaceutical company.
The original experiments conducted on aspirin in the Bayer laboratory were
superceded by more recent clinical findings conducted by medical men not
affiliated with the pharmaceutical company. Gradually, all the stories told
by those who had been instrumental in presenting and promoting
acetylsalicylic acid as aspirin faded into the background. By 1903, authors
no longer felt the need to include comprehensive profiles of aspirin in
their articles: "the remedy is now sufficiently known to make its
description unnecessary here" (15). Thus, the original narrative of aspirin
had been disseminated and accepted by the medical profession to such an
extent that it no longer needed repeating.
Aspirin had quickly become a household name around the world, finding its
way even into literary works of the early twentieth century. For instance,
when the young Lady Caroline Desta of Elizabeth von Arnim's 1922 novel The
Enchanted April complained of a headache during a holiday in Italy, one of
her companions asked, "Do you know what aspirin is in Italian?"--to which an
erudite old Englishwoman interjected that "the proper remedy for
headaches...is castor oil." In a similar vein, Franz Kafka once explained to
his fiancée Felice Bauer, in the course of their tormented relationship,
that aspirin was one of the few things that eased the unbearable pain of
being (5).
Aspirin has certainly been put to many different uses throughout the
twentieth century, and serves as an example of one of many products of the
novel and tenuous relationship that developed during the late nineteenth
century between laboratory science, the manufacturing industry, and medical
humanitarianism. Indeed, the early pharmaceutical industry's establishment
of a close association with the medical community and its adoption of
scientific techniques, or, at the very least, a scientific veneer, were
instrumental in its success, "and changed the character of medical practice
as much as it did the industry itself" (26). Over the years, these
medico-industrial connections have consolidated to form the modern
pharmaceutical industry of today, an industry that has pervaded almost all
aspects of medical science and practice.
The story of aspirin--its origins, popularization, and varied uses--is
rather unique:
Few groups of drugs have provided the manufacturers with such
fortunes, physicians with such therapeutic resources, and the
laity with so many semi-proprietary remedies as have the so-called
antipyretic or analgesic derivatives of coal tar. Nor is there any
group which illustrates so well the close relationship between
chemistry and practical therapeutics, and the relation of chemical
constitution to physiological action (12).
Yet, the story of aspirin to a great degree epitomizes the stories of many
pharmaceutical products developed both for increased therapeutic efficacy
and for profit. The histories of these products generally share certain
themes. The usually vague and contentious origins of a drug soon become
overshadowed by the multitude of clinical reports produced with the help of
medical allies. Extensive clinical trials serve to introduce new drugs to
the greater medical community, to specific patient groups, and eventually,
to the population at large. As the years pass, however, many drugs are used
to treat diseases different from those for which the drugs were originally
intended. For example, with the advent of the "anti-coagulant era," aspirin
has acquired new indications as a platelet anti-aggregant, and is already
widely used in the prophylaxis and treatment of strokes and myocardial
infarcts. Therefore, drugs currently being produced and prescribed remain a
reflection of the ever-changing state of medical knowledge and of the
pharmaceutical industry's eagerness to meet the needs of the day.
As the quest for more potent and less toxic drugs continues in the age of
rational therapeutics, advanced technology, and designer drugs, the
treatment of disease continues to be shaped by the symbiotic relationship
between physicians and pharmaceutical companies forged a century ago.
ACKNOWLEDGMENTS
The author wishes to acknowledge the assistance of Harmke Kamminga in the
preparation of this work. She also wishes to thank the Wellcome Trust for
awarding her the Masters Scholarship, and McGill University for their
generous Philip F. Vineberg Travelling Fellowship, both of which made it
possible to pursue this work towards an M.Phil. at the Wellcome Unit for the
History of Medicine in Cambridge, England.
REFERENCES
1. Latour B. "The Costly Ghastly Kitchen" in Cunningham A. and Williams P.,
eds., The Laboratory Revolution in Medicine. Cambridge: Cambridge University
Press; 1992.
2. Rainsford KD. Aspirin and the Salicylates. London: Butterworths; 1984.
3. Vane JR, Botting RM. Aspirin and other Salicylates. London: Chapman and
Hall Medical Publishers; 1992.
4. Mann J. Murder, Magic and Medicine. Oxford: Oxford University Press;
1992.
5. Mann CC, Plummer ML. The Aspirin Wars: Money, Medicine, and 100 Years of
Rampant Competition. Boston: Harvard Business School Press; 1991.
6. Verg E, Plumpe G, Schultheis H. Meilensteine: The official Bayer
publication in commemoration of the centenary of aspirin's release; 1989.
7. McTavish J. What's in a name? Aspirin and the American Medical
Association. Bulletin of the History of Medicine 61: 364-365; 1987.
8. Dr. Pope of the Leicester Infirmary and Fever House. The Lancet, April
13, 1889, p. 728.
9. The Lancet, July 22, 1899, p. 255.
10. The Lancet, Oct. 14, 1899, p. 999.
11. The Lancet, Aug. 5, 1899, p. 387.
12. Text-book of Pharmacology and Therapeutics. W. Hale White, ed.
Edinburgh: Young J. Pentland; 1901.
13. The British Medical Association's Annual Museum Exhibit on Drugs.
British Medical Journal, Aug. 5, 1899, p. 387.
14. Epitomes of the British Medical Journal, January to April, 1899.
15. Dr. Mackey. The Lancet, Nov. 7, 1903, p. 1293.
16. Dr. A. H. Smith. British Medical Journal, Jan. 27, 1900, p. 210c.
17. The Lancet, July 29, 1899, p. 318.
18. Dreser H. Archiv fur die Gesamte Physiologie 76: 306-18; 1899 (transl.)
in John C. Krantz, Historical Medical Classics Involving New Drugs.
Baltimore: The Williams & Wilkins Co.; 1974.
19. British Medical Journal, October 21, 1899, p. 68.
20. British Medical Journal, July 1, 1899, p. 34c.
21. British Medical Journal, December 9, 1899; p. 96.
22. Marshall CR. A Textbook of Materia Medica. London: J. & A. Churchill,
1905.
23. A System of Practical Therapeutics, 2nd ed. H.A. Hare, ed. London:
Williams & Noorgate; 1905.
24. Phillips CD. Materia Medica, Pharmacology and Therapeutics. N.Y.:
Longmans, Green & Co.; 1904.
25. The Lancet, April 4, 1903; p. 984.
26. Liebenau JM. Medical Science and Medical Industry, 1890-1929. Ph.D.
Dissertation in History and Sociology of Science submitted to the University
of Pennsylvania; 1981.
----------------------------------------------------------------------------
BIOGRAPHY
Anne A.J. Andermann graduated from McGill University (Montreal, Quebec,
Canada) in 1994 with a First Class Honours B.Sc. degree in Biology
(Molecular Genetics). Prior to commencing her medical studies, she completed
a Master of Philosophy degree in the History of Medicine at the University
of Cambridge (England). Her thesis work on John Hughlings Jackson was
awarded the Roland P. Mackay Award in History of Neurology by the American
Academy of Neurology. She is currently a second-year medical student at
McGill University, and was recently awarded a Rhodes Scolarship to pursue a
D.Phil. at Oxford University (Oxford, England) in October 1997.
by MJM
