The Salicylates: A Critical Bibliographic Review

Long before the time of Hippocrates man began to apply the bark of the willow tree to the successful symptomatic therapy of various disorders that were either painful, inflammatory, or febrile. Subsequently, its active ingredients, salicylates, have been identified, purified, synthesized, and derived upon to yield several useful drugs, most notably, aspirin. Today, salicylates have established securely their position as the most widely used class of drugs in the world. It is not surprising that a rich and voluminous literature has accumulated on the effects that salicylates and various organisms , both intact and fragmented, exert on each other. The authors of this review have done the service of compiling some of the significant literature on this topic in a concise and easily readable fashion. They state correctly that their review is not exhaustive. Generally, they lhave selected important references on important topics. I was surprised to find, however, that among the subjects they chose to omit was a discussion of the antipyretic effects of salicylates. Also, they have generally adhered to their objective of a critical review of the literature. One notable exception wvas found in the chapter on analgesic effects. The author of that chapter tused it as a vehicle for presenting and defending his own view that salicylates act peripherally to relieve pain; the case for the possibility that this might be a central effect was not given a fair hearing. This book offers material that should be of interest to a wide variety of readers. Those who are interested in basic aspects of drug action will find chapters on metabolic interactions; there are many correlations of mletabolic actions with therapeutic effects but, unfortunately, no clear insights into mechanisms of action at the molecular level. Those who are interested in some practical aspects of salicylate therapy (and isn't everybody) will find information that provides a rational basis for their clinical tuse and for understanding the pathogenesis and management of some of their more important toxic effects. Those who are interested in problems of clinical investigation will find in the chapter on analgesia a monument to the ingenuity of the many investigators who have attempted to assess objectively the relief of the subjective sensation of pain.