Self-experimentation in medicine

Practice of researchers trying procedures on themselves

Self experimentation refers to scientific experimentation in which the experimenter conducts the experiment on themself. Often this means that the designer, operator, subject, analyst, and user or reporter of the experiment are all the same. Self experimentation has a long and well documented history in medicine which continues to the present. Some of these experiments have been very valuable and shed new and often unexpected insights into different areas of medicine. There are many motivations for self experiment. These include the wish to get results quickly and avoid the need for a formal organisational structure, to take the ethical stance of taking the same risk as volunteers, or just a desire to do good for humanity. Other ethical issues include whether a researcher should self experiment because another volunteer would not get the same benefit as the researcher will get, and the question of whether informed consent of a volunteer can truly be given by those outside a research program. A number of distinguished scientists have undertaken self experimentation, including at least five Nobel laureates; in several cases, the prize was awarded for findings the self experimentation made possible. Many experiments were dangerous; various people exposed themselves to pathogenic, toxic or radioactive materials. Some self experimenters, like Jesse Lazear and Daniel Alcides Carrión, died in the course of their research. Notable examples of self researchers occur in many fields; infectious disease (Jesse Lazear: yellow fever, Max von Pettenkofer: cholera), vaccine research and development (Daniel Zagury: AIDS, Tim Friede: Snakebite), cancer (Nicholas Senn, Jean Louis Marc Alibert), blood (Karl Landsteiner, William J. Harrington), and pharmacology (Albert Hofmann, and many many others). Research has not been limited to disease and drugs. John Stapp tested the limits of human deceleration, Humphry Davy breathed nitrous oxide, and Nicholas Senn pumped hydrogen into his gastrointestinal tract to test the utility of the method for diagnosing perforations.

There is no formal definition of what constitutes self experimentation. A strict definition might limit it to cases where there is a single subject experiment and the experimenter performs the procedure on himself. A looser definition might include cases where the experimenters put themselves amongst the volunteers for the experiment. According to S. C. Gandevia of the University of New South Wales, who was looking at the question from the perspective of ethics, it is only self experiment if the would be self experimenter would be named as an author on any subsequent published paper. That is, the person who would receive the academic credit for the experiment must also be the subject of it. in 1947, which was a result of the trials of Nazi doctors at the Nuremberg trials accused of murdering and torturing victims in valueless experiments. Several of these doctors were hanged. Point five of the Nuremberg Code requires that no experiment should be conducted that is dangerous to the subjects unless the experimenters themselves also take part. The Nuremberg Code has influenced medical experiment codes of practice around the world, as has the exposure of experiments that have since failed to follow it such as the notorious Tuskegee syphilis experiment. That remained the case until the yellow fever program was referenced in the drafting of the Nuremberg Code.|author=Charles Édouard Brown Séquard

Self experimentation has value in rapidly obtaining the first results. In some cases, such as with Forssmann's experiments done in defiance of official permission, results may be obtained that would never otherwise have come to light. However, self experiment lacks the statistical validity of a larger experiment. It is not possible to generalise from an experiment on a single person. For instance, a single successful blood transfusion does not indicate, as we now know from the work of Karl Landsteiner, that all such transfusions between any two random people will also be successful. Likewise, a single failure does not absolutely prove that a procedure is worthless. Psychological issues such as confirmation bias and the placebo effect are unavoidable in a single person self experiment where it is not possible to put scientific controls in place. His later self experimentation of ether and chloroform took place in 1848, and he eventually became addicted to chloroform due to excessive use. He inhaled chloroform as an anaesthetic shortly before committing suicide on January 24, 1848. Lidocaine, the first amino amide–type local anaesthetic, was first synthesized under the name xylocaine by Swedish chemist Nils Löfgren in 1943. His colleague Bengt Lundqvist performed the first injection anaesthesia experiments on himself. Much earlier, in 1808, Jean Louis Marc Alibert injected himself with a discharge from breast cancer. The site of injection became inflamed, but did not develop cancer. In March 2020, the Rapid Deployment Vaccine Collaborative (also known as RaDVaC) developed, produced, and published technical specifications for a modular, intranasal COVID 19 vaccine. Numerous scientists working directly and indirectly on the group's vaccine development also began self experimentation using the project's multiple vaccine candidates. In March 2020, Hans Georg Rammensee, professor of immunology at University of Tübingen and co founder of CureVac began testing a COVID 19 vaccine on himself. In May 2020, Alexander Gintsburg, director of the Gamaleya Research Institute of Epidemiology and Microbiology announced that several vaccine specialists had begun self experimentation with the Sputnik V COVID 19 vaccine.

Daniel Zagury, in 1986, was the first to test his proposed AIDS vaccine.

Daniel Alcides Carrión, in 1885, infected himself from the pus in the purple wart (verruga peruana) of a female patient. Carrión developed an acute form of bartonellosis now known as Carrion's disease or Oroya fever. This is a rare disease found only in Peru and certain other parts of South America. He kept detailed notes of his condition and succeeded in showing through this self experiment that the chronic and acute forms were the same disease. He died from the disease after several weeks. A student who had assisted Carrion in carrying out this work was arrested and charged with murder, but later released.

Max von Pettenkofer, in October 1892, drank bouillon deliberately infected with a large dose of cholera bacteria. Pettenkofer was attempting to disprove the theory of Robert Koch that the disease was caused by the bacteria Vibrio cholerae alone. Pettenkofer also took bicarbonate of soda to counter a claim by Koch that stomach acid killed the bacteria. Pettenkofer escaped with mild symptoms and claimed success, but the modern view is that he did indeed have cholera, luckily just a mild case, and possibly had some immunity from a previous episode.

Marshall's investigation was preceded by David A. Robinson who, in 1980, ingested Campylobacter jejuni, a bacterium found in cow's milk, to investigate whether gastritis could be caused by drinking milk infected with C. jejuni. Robinson became sick as a result. Robinson needed to do a human experiment because the alternative, testing on cows, was not viable as infected cows frequently do not become ill.

Gail Monroe Dack (1901–1976), a former president of the American Society for Microbiology, gave himself food poisoning by eating cake tainted with Staphylococcus. Attempts to send infected snails, the intermediate host, by mail had been unsuccessful. He refused treatment, despite being desperately ill by December, so as not to lose the eggs for further study. He finally passed 4,630 eggs in his semen and 200 eggs in his urine. The U. S. government decided not to use the eggs, so his self sacrifice was to no avail. It was November 1945 before he finally cleared all the parasites, after treatment with tartar emetic.

William Bosworth Castle, in 1926, ate minced raw beef every morning, regurgitated it an hour later, and then fed it to his patients suffering from pernicious anaemia.

Elliott Cutler (1888–1947) took sufficient thyroid extract to give himself hyperthyroidism and enable him to study the effect of the condition on kidney function.

In 1936, Edwin Katskee took a very large dose of cocaine. He attempted to write notes on his office wall, but these became increasingly illegible as the experiment proceeded. Katskee was found dead the next morning.

Chauncey D. Leake, in 1930, took furan as a possible substitute for aspirin but it just gave him a splitting headache and painful urination that lasted three days.

As part of the team who developed ibuprofen in the 1960s, Stewart Adams initially tested it on a hangover.

Friedrich Sertürner isolated morphine from opium in 1804. Morphine was the first ever alkaloid isolated from any plant. Sertürner wanted to prove his findings to his colleague with a public experiment on himself and three other friends. Jacques Joseph Moreau published his study "Du Hachisch et de l'aliénation mentale" in 1845. He self experimented with hashish and observed its varying effects on other people. Moreau insisted that researchers should self experiment to gain understanding of the altered states of consciousness produced by psychoactive substances. Psychopharmacologist Arthur Heffter isolated mescaline from the peyote cactus in 1897 and conducted experiments on its effects by comparing the effects of peyote and mescaline on himself. Albert Hofmann discovered the psychedelic properties of LSD in 1943 by accidentally absorbing it and later intentionally ingesting it to verify that the effects were caused by LSD. He was also the first to isolate psilocybin from psilocybin mushrooms and self experimented with it to prove it to be the active principle of psilocybin mushroom's psychoactive effects. Timothy Leary took LSD and was a well known proponent of the social use of the drug in the 1960s. He developed a system known as the Shulgin Rating Scale for his research group to use during the self experimentation of psychedelics.

Around 1886, Nicholas Senn pumped nearly six litres of hydrogen through his anus. Senn was a pioneer of using this technique to determine if the bullet in gunshot wounds had penetrated the intestinal tract. In experiments on gunshot wounds to dogs, Senn verified that the gas escaping from the wound was hydrogen by setting light to it. Reports that Senn used helium in this experiment but not isolated until 1895, and extractable reserves not found until 1903.

Humphry Davy self experimented with breathing of several different gases, most notably nitrous oxide.

Self experimentation with gene therapies have been reported. Every gene therapy has a unique risk of harm, including the risk associated with the gene delivery method (i. e., the particular viral vector or form of transfection) that is used and the risk associated with a specific genetic modification. Examples of potential risks for some gene therapies include tissue damage and an immune response to foreign DNA, His 1990 revised paper covered 78 such species.

In the early 1900s Nicolae Minovici, a professor of forensic science in Bucharest, undertook a series of experiments into hanging. At first he put the noose around his neck while lying down and had an assistant put tension on the rope. He then moved on to full suspension by the neck. Finally, he attempted suspension with a slipping hangman's knot, but the pain was too great for him to continue. He could not swallow for a month. Minovici was determined to surpass a record set by Dr. Fleichmann of Erlangen, who in 1832, self asphyxiated for two minutes. However, Minovici could not get close to this and disbelieved Fleichmann. Minovici and Fleichmann are not the only ones to self experiment with strangulation. Graeme Hammond, a doctor in New York, tried it in 1882. Francis Bacon described an even earlier occasion in 1623 when the self experimenter stepped off a stool with a rope around his neck, but was unable to regain his footing on the stool without assistance. that brought it to a rapid stop in around 1.4 seconds. In the most severe test, Stapp underwent an acceleration of 20 g as the rocket engine accelerated the vehicle up to speed and 46 g of deceleration (also a record) as the vehicle was brought to a stop. Stapp suffered numerous injuries in these tests (previous animal tests had shown that limbs could be broken merely by being pulled into the air stream), and several concussions. In the last test his eyes were bloodied as blood vessels burst in his eyes. These tests were carried out for the US Air Force to determine the forces that pilots could be subjected to and to enable better restraining straps to be designed. The result was the 1614 publication De Statica Medicina ("On Medical Measurements").

Allan Blair of the University of Alabama, in 1933, deliberately caused a black widow spider to bite him. At the time there was some doubt that the reported symptoms of some victims were the result of a spider bite or some other cause. Blair's experiment was intended to settle the matter. Blair became seriously ill and was hospitalised for several days in great pain, but survived.

Tim Friede created his own vaccine against snakebite using pure venom injections from all four species of mambas, and four cobra species to achieve high immunity. He also survived anaphylactic shock six times during the development of his vaccine. Others have also injected venom to create immunity to snake venom: Bill Haast, Harold Mierkey, Ray Hunter, Joel La Rocque, Herschel Flowers, Martin Crimmins, and Charles Tanner.

In 1921, Maurice Crowther Hall ingested carbon tetrachloride to test its safety with a view to its possible use as a treatment for hookworm. Hall reported mild side effects. Carbon tetrachloride has since been found to cause acute liver failure. In 1925, Hall ingested tetrachloroethylene (the most common dry cleaning fluid) for the same purpose.

Clinical application of cardiac catheterization began with Werner Forssmann in the 1930s, who inserted a catheter into the brachial vein of his own forearm, guided it fluoroscopically into his right atrium, and took an X ray picture of it. Forssmann did this procedure without permission. He obtained the assistance of a nurse by deceiving her that she was to be the subject of the experiment. He tied down her arms while inserting the catheter into his own arm, only releasing her at the point it was too late to change, and he needed her assistance. Forssmann was twice fired for carrying out these self experiments, but shared the Nobel Prize in Physiology or Medicine in 1956 for this achievement. Cardiac catheterization is now a routine procedure in heart surgery. However, the first surgeon to carry out this self operation, Evan O'Neill Kane in 1921, did so with an element of experiment. Although Kane's operation was necessary, it was not necessary to do it himself, so that in itself was experimental. More than that, Kane wished to experience the operation under local anaesthetic before trying the procedure on his patients. Kane advocated a reduction in the use of general anaesthetic by surgeons. In 2023, Michael Raduga, a Russian lucid dreaming researcher, performed self neurosurgery that included trepanation, electrode implantation, and electrical stimulation of the motor cortex.

John C. Lilly developed the first sensory deprivation tanks and self experimented them with the intention to study the origin of consciousness and its relation to the brain by creating an environment which isolates an individual from external stimulation.

Joseph Barcroft, in 1920, spent six days in a sealed glass chamber to investigate respiration at altitude. The partial pressure of oxygen was initially 163 mmHg falling to 84 mmHg (equivalent to an altitude of 18,000 ft) as the experiment progressed. Barcroft was attempting to disprove a theory of John Scott Haldane that the lungs actively secrete oxygen into the blood (rather than just through the process of passive diffusion) under conditions of low oxygen partial pressure. Barcroft suffered from severe hypoxia. At the end of experiment, part of Barcroft's left radial artery was removed for investigation.

Nico Dosenbach wore a pink cast over his (unbroken) right arm for two weeks in order to examine how brain circuits controlling movement are impacted by immobilizing illnesses or injuries. He did a 30 minute resting state fMRI study daily and identified an undiscovered pattern of pulses of rs fMRI signal in motor regions controlling the disused anatomy.