According to one study, during just the past 200 years, there have been 465 cases of self-experimentation documented in the medical literature, with eight recorded deaths. Most instances occurred in the United States during the first half of the twentieth century.
Here are seven notable instances of medical self-experimentation.
The pellagra ‘filth parties’
Dr. Joseph Goldberger was an epidemiologist and quarantine physician in the U.S. Public Health Service. As such, it was his responsibility to figure out the causes of diseases.
In 1906, the first large outbreak of pellagra occurred in the United States. Pellagra is a disease marked by dementia, diarrhea, and dermatitis (the three Ds).
At the time, scientists thought that pellagra was infectious. To test this hypothesis, Goldberger and colleagues took part in “filth parties,” where they ingested the skin, urine, and feces of patients with pellagra. (For what it’s worth, they made capsules of this human waste.) They also rubbed themselves with the nasal and oral secretions of those with pellagra.
In other experiments, Goldberger supplemented the diets of children at an orphanage with eggs, meat, milk, oatmeal, and beans, which caused incidents of pellagra to stop. Moreover, he found that placing prisoners on a low-protein—but otherwise healthy—diet could produce pellagra. Years later, other researchers showed that pellagra resulted from a deficiency in the B-vitamin niacin.
Yellow fever kills brave physician
Although Dr. Walter Reed received much recognition for the discovery that yellow fever is spread by mosquitoes, the heroics of the discovery go to his colleagues on the Yellow Fever Commission he led in Cuba in 1900. None of Reed’s colleagues were delighted by the prospect of exposing themselves to the deadly yellow fever virus, and Reed himself returned to Washington, D.C., before he could be bit.
Eventually, Drs. James Carroll and Jesse Lazear, both military physicians, agreed to be bit by the mosquitoes. Carroll ended up enduring lifelong complications from yellow fever, and Lazear died from the disease.
Physicians try polio
In 1934, Dr. Maurice Brodie, of McGill University Medical School, took the grounded spinal cords of monkeys infected with polio, added formaldehyde, and produced a solution that he hoped could serve as a polio vaccine.
Along with Dr. William H. Park, of the New York City Department of Health, the experimental vaccine was injected into monkeys, which were the only animals at the time that demonstrated susceptibility to the poliovirus.
The vaccine resulted in antibody production and immunity in the monkeys, but the animals experienced severe skin irritation and sloughing of the skin. Once the concentration of formaldehyde was lowered, the skin irritation stopped, and no other adverse effects occurred.
At the 1934 annual meeting of the American Public Health Association, Brodie stated the following: “It was deemed advisable to try it upon ourselves, not that we had misgivings about the possibilities of infection, but rather to determine whether the vaccine produced any disagreeable local or general reaction.”
Brodie, Park, and colleagues inoculated themselves with up to three doses of the vaccine, and although soreness and swelling resulted at the injection site, no systemic reaction was observed. Blood tests demonstrated that the vaccine produced antibodies in human recipients.
Co-infection with syphilis and gonorrhea
Although likely apocryphal, one bit of self-experimentation lore involving the revered British surgeon John Hunter bemuses medical historians to this day. In an attempt to demonstrate that both gonorrhea and syphilis are caused by the same disease, Hunter is said to have exposed himself to pus from a woman with infection. He is said to have then developed symptoms of both diseases.
In an alternative version of this yarn, Hunter exposed someone else to this pus and not himself, which, if true, casts an ignoble light on the famous surgeon.
For two years, Dr. Barry Marshall argued that the bacteria Helicobacter Pylori could cause gastritis, or stomach inflammation, and perhaps ulcers years later. However, Marshall was having trouble developing an animal model for infection.
He finally took matters into his own hands and ingested a “brew” of H. Pylori, which caused gastritis, or stomach inflammation, and epithelial damage on visualization with endoscopy and biopsy. Marshall cured the infection with antibiotics, and later won the Nobel prize for his work, along with Dr. Robin Warren, his collaborator.
“After five days, I started to have bloating and fullness after the evening meal, and my appetite decreased,” said Marshall in an interview published in the Canadian Journal of Gastroenterology and Hepatology. “My breath was bad and I vomited clear watery liquid, without acid, each morning at approximately 06:00.”
Understanding a deadly bleeding disorder
On a hot and sticky day in 1945, a 17-year-old girl came to the Cambridge City Hospital in Boston with complaints of profuse vaginal bleeding. In cursory fashion, the physician wrote the presentation off as a failed abortion.
However, results from a complete blood count indicated that the teen had very low levels of platelets, a condition referred to idiopathic thrombocytic purpura (ITP). People with ITP bleed and bruise easily. Of note, platelets help with clotting.
Although physicians at the time did not understand the cause of ITP, they did know that removal of the spleen and treatment with steroids helped. Unfortunately, the young patient initially written off by a cynical physician later died of a botched splenectomy.
An internist named Dr. William J. Harrington watched in a mix of disgust and horror at the poor and bigoted treatment that this teen received. This experience inspired him to become a hematologist and later receive a National Institute of Health (NIH) grant to study ITP with a colleague named Dr. James Hollingsworth.
Based on the observation that the children of ITP mothers were born with low platelet levels, Harrington and Hollingsworth had a hunch that something in blood plasma was responsible for platelet destruction in ITP; something autoimmune in the plasma was crossing the placenta and to the baby before birth.
Because animal models are not known to develop ITP, humans needed to be tested. Hollingsworth proceeded to transfuse Harrington with plasma from a consenting patient with ITP. Soon, Harrington’s platelet levels dropped dramatically, and there was evidence something in the plasma caused platelet destruction.
For a week, Harrington was pretty sick and experienced bleeding from the mouth, nose, and rectum. Precautions were taken so that Harrington would not experience a hemorrhagic stroke. But after a week, he was better and soon other colleagues were self-experimenting in the same fashion to figure out the effects of different titrations of plasma. These efforts laid the foundation for later work by Nobel prize-winner Dr. Jean Dausset’s discovery of antiplatelet antibodies in plasma.
Taking self-experimentation to heart
For eons, humans have viewed the heart as the spiritual and physical center of life. However, it was only starting in the 21st century that physicians have been able to access it. This accomplishment can be attributed to pioneering work done by a young German internist named Dr. Werner Forssmann
Forssmann was intrigued by the work of French physiologists who accessed a horse heart by means of the jugular vein—located in the neck—without hurting or killing the horse. He wondered whether a similar procedure could be done in humans. Consequently, he asked the physician who he was apprenticed to, Dr Richard Schneider, whether he could try doing this procedure on either deceased patients or even himself. His requests were summarily dismissed.
Undeterred, Forssman decided to secretly do the procedure on himself. He enlisted the help of a senior nurse, whom he took under his wing, and after much preparation, he slit his brachial vein, which is located in the forearm, and passed a really long piece of tubing (called a ureteric catheter) to his heart.
Excited, he rushed to the get an x-ray done for proof when one of his colleagues attempted to stop him by pulling the tubing. Eventually, however, the colleague desisted, and the x-ray was taken. Voila! The door to cardiology opened.
The role of self-experimentation in medicine is currently quite limited. In an evidence-based world, self-experimentation is rife with concerns about validity, reproducibility, and ethics. Nevertheless, historical analysis of self-experimentation is important because it elucidates how we value altruism and human life. It also provides insight into whether researchers would subject themselves to the interventions they design for other human participants.
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