Roughly 24 centuries ago, the father of medicine, Hippocrates, urged women in the throes of childbirth to chew on willow bark. The bitter bark contained a substance that eased their pain. (There’s no record of what the women thought of his suggestion.)

By the 19th century scientists knew that mysterious substance was salicylic acid. Synthesized in 1838, it was used not only to relieve pain, but also in the making of dies. Its use increased even more in 1860 when a chemist figured out a way to manufacture it out of phenol, a chemical derived from coal tar.

Salicylic acid had serious side-effects-it was very hard on the stomach, for one thing-but in 1898 a chemist working for the German drug company Bayer came up with a less harmful form of salicylic acid: acetylsalicylic acid, or ASA for short.

As it happened, ASA had actually first been synthesized four decades earlier, so Bayer couldn’t patent the substance in most countries. What they could do, though, was come up with a trademarked name for it and market the heck out of it. The name they chose was “Aspirin,” and the rest is-well, history.

ASA has been marketed under many other brand names since then-Anacin, for instance-but Bayer got there first, and today “aspirin,” rather than the tongue-twisting “acetylsalicylic acid” is the generic term for what is increasingly being viewed as a miracle drug.

Thirty years ago you would have been laughed at for calling it that; it was thought of as just a low-grade, everyday reliever of pain, fever and inflammation. But recent studies have shown it can be beneficial in ways Frederich Bayer never dreamed of-although he’s probably kicking himself in his grave over the missed opportunity. It appears to reduce the risk of heart attacks (especially second heart attacks) and the most common form of stroke, and it may help lower the risk of colon cancer.

Even its time-honored effects aren’t exactly small potatoes. Reducing pain, fever and inflammation are nothing to sneeze at, and aspirin is good at all three.

How does it achieve all these things? That question went unanswered for decades, even while doctors were telling millions of patients a year to “take two aspirin and call me in the morning.” But in 1971, Sir John Vane, a pharmacologist at the Royal College of Surgeons in London, won a Nobel Prize for figuring out that aspirin interferes with the body’s ability to produce substances called prostaglandins, which regulate a variety of bodily functions. One called pyrogen triggers fever; that’s why aspirin is effective against it. Another prostaglandin activates the nerve endings that transmit pain. And still another one, called thromboxane, causes blood platelets to become sticky, which leads to blood clots, which can lead to heart attacks and strokes in people whose arteries are already partially clogged.

In other words, aspirin is a far more powerful drug than we give it credit for. Nor is it without side effects. In fact, if it were to come on the market today, it would almost certainly be sold only by prescription.

Among the side effects? Aspirin can make you drunk faster. It interferes with the production of a stomach enzyme that breaks down alcohol. It also interferes with a prostaglandin that causes the stomach to coat itself with protective mucus, so it can aggravate existing ulcers or lead to new ones. Excessive aspirin use can also be hard on your kidneys.

Since aspirin reduces clotting, it can lead to easier bruising and bleeding. That means that while aspirin can reduce the risk of the kind of stroke caused by blood clots, it may increase the risk of a rarer form of stroke caused by a hemorrhage in the brain.

A well-publicized risk involves children. Children with a viral infection should be given acetaminophen (such as Tylenol) instead of aspirin, because aspirin can increase the risk of a sometimes fatal complication called Reye’s syndrome. (Since this risk became known-aspirin bottles now carry warning labels regarding it-the incident of Reye’s Syndrome has plummeted.)

Aspirin may even cause a short-term 50-percent reduction in sperm motility, which means men trying to have children should stay away from it.

All of which should convince you that the last thing you should do is start popping aspirins just because you heard it might do you some good. Check with your doctor.

Just say Hippocrates sent you.

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