8 Perhaps most indicative of the medical profession's inherent antipathy toward fever is the fact that an estimated 70% of nurses and 30% of physicians routinely use antipyretic drugs to suppress fever. This suspicion is reflected in the results of surveys reporting that approximately 40% of parents and other caregivers regard temperatures encountered during fever as harmful, 11, 12 and that 12% of physicians believe that fever has the capacity to cause brain damage. Their widespread application by primary care physicians, 8 emergency department nurses, 9 pharmacists, 10 parents, and other caregivers 11, 12 has been, at least in part, motivated by a general suspicion that fever is inherently noxious. 2Ī little less than a century later, the marketplace is replete with drugs capable of suppressing fever. 1 During this same period, acetanilide and phenacetin were derived from para-aminophenol compounds in coal tar, and pyrazolon compounds such as aminopyrine were developed. In 1899, the Bayer Company launched the modern era of antipyretic therapy with the introduction of aspirin as the world's first commercially available antipyretic drug. Salicylic acid was first synthesized by Gerland 5 in 1852, some 8 years before Kolbe and Lautemann, 6 who are frequently credited with this accomplishment, and just a year before von Gerhardt 7 developed acetylsalicylic acid (aspirin) during efforts to find a more palatable form of salicylate. 3 Less than 80 years later, Piria 4 succeeded in preparing salicylic acid from salicin, a glycoside component of willow bark.
2 However, it was not until 1763 that the Reverend Edward Stone gave the first scientific description of the clinical benefits of willow bark to the Royal Society of London. 1, 2 Ancient Assyrian, Egyptian, and Greek physicians all apparently knew of and exploited the antipyretic property of extracts of the bark of the willow ( Salix alba). Shared Decision Making and CommunicationĪntipyretic agents have been used to lower febrile body temperature for well over two millennia.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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