Normal dosage may cause nausea, vomiting, diarrhea, or gastrointestinal bleeding. Large doses cause acid-base imbalance and respiratory disturbances and can be fatal, especially in children. Aspirin also has been linked to the development of Reye's syndrome (a combination of acute encephalopathy and fatty infiltration of internal organs) in children who have taken it for viral infections. Acetaminophen (Tylenol), which does not cause gastric irritation but does lower fever and relieve pain, is often substituted for aspirin.
Aspirin, although usually made synthetically now, was originally derived from salicin, the active ingredient in willow bark. Willow bark had been used for centuries in folk medicine in certain parts of the world. Acetylsalicylic acid was first prepared by the German chemist Felix Hoffmann, an employee of Friedrich Bayer & Co., in 1897. It is now the active ingredient in many over-the-counter preparations; estimates put American consumption at 80 billion tablets annually.
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