“I decided to perform some investigations on my own body”: Cocaine and Self-experimentation - a blog post from the Heritage Centre
On 15 September 1884, Dr Joseph Brettauer made his way to the podium at the German Ophthalmological Society meeting in Heidelberg. He delivered the paper to a stunned audience, who quickly realised the importance of what they were witnessing, the sense of excitement and opportunity palpable in the auditorium. Its author Dr Carl Koller, Brettauer’s colleague, was a young doctor who could not afford the journey from Vienna to Heidelberg to present his findings himself. Despite his absence at the congress, Koller’s name should soon be known internationally as the news of his discovery spread with incredible speed: cocaine could produce an effective local anaesthetic.
Coca leaves
The quest for a reliable local anaesthetic agent had begun four decades before Koller published his findings, soon after ether and chloroform had been introduced into clinical practice. The numbing effect of chewing coca leaves had been widely reported, and after Albert Niemann had successfully isolated cocaine in 1860, its anaesthetic effects were even recorded by Friedrich Wöhler, whom Niemann assisted: “It tastes bitter and produces a peculiar effect on the nerves of the tongue, inasmuch as the point of contact becomes deadened and very nearly insensitive.” Twenty years later, Dr Basil von Anrep experimented with cocaine and explicitly recommended “that cocaine be tested as a local anaesthetic and in melancholia.”
Once satisfied with the outcomes of the experiments involving frogs and dogs, he and colleagues were happy to put the agent to test on themselves.
Four years after von Anrep’s comment, aspiring ophthalmologist Koller found himself working in a research laboratory, searching for an alternative agent to ether, which was unsuitable for eye surgery. At this time, cocaine was used to treat a myriad of diseases and afflictions, including morphine addiction. Only after he had experimented with various different agents without success did Koller turn to cocaine.
Self-experimentation had always been rife in medicine, and the field of anaesthesia was no exception; more than one anaesthetic agent was ‘discovered’ at a dinner party.
Once satisfied with the outcomes of the experiments involving frogs and dogs, he and colleagues were happy to put the agent to test on themselves. A head of a pin was brought to the cornea, the conjunctiva of the bulb grasped with a toothed forceps, and the cornea pitted by pressure – all in the name of science!
Cocaine bottle - Science Museum
Self-experimentation had always been rife in medicine, and the field of anaesthesia was no exception; more than one anaesthetic agent was ‘discovered’ at a dinner party. Nitrous oxide, ether, and chloroform were all used recreationally to some extent before their anaesthetic properties were fully appreciated. James Young Simpson is said to have hit his knee on a dinner table after one such chloroform party, noticing the absence of pain. Shortly after, he started experimenting with the agent, which was eventually introduced into clinical practice in 1847. In more recent history, forty years ago Archie Brain tested his prototype of the laryngeal mask on himself – indeed, it became a unique party trick – before it got anywhere near patients.
However, as news of the efficacy of cocaine as local anaesthetic spread, doctors appeared to be particularly adventurous. Many others were inspired to self-experiment with the agent and described their experiences before the year was out. In November 1884, American Drs Richard Hall and William Halsted reported that they had performed the first nerve block. Regularly posing as test subjects for each other, they managed to block almost every peripheral somatic nerve before the end of 1885. On one occasion, while exploring the effect of cocaine on dental nerves, Halsted thrust a pin through Hall’s lips and hit his teeth with the back of a knife, allegedly none of which caused any pain.
Thus, one August evening, Bier ordered his assistant Dr Hildebrand to inject him with half a syringe of a 1% solution of cocaine.
About a decade later, Dr August Bier, the German surgeon who performed the first spinal anaesthesia in 1898, had already used cocaine on six patients of varying ages with varying outcomes. Most of them had experienced headaches after their operations, some vomiting. “To reach a well-informed opinion,” Bier declared, “I decided to perform some investigations on my own body.”
Their experiments ranged from the tickling of the sole of the foot to a strong blow to the shin with an iron hammer, with some avulsion of pubic hairs and traction to the testicles in between, all in the space of only forty minutes.
Thus, one August evening, Bier ordered his assistant Dr Hildebrand to inject him with half a syringe of a 1% solution of cocaine. Poor Hildebrand botched the procedure and Bier retained full sensibility in his legs. Hildebrand promptly volunteered to be the subject instead. What followed was a series of experiments that would probably not withstand any ethics committees today.
Starting fairly innocently with needle pricks in his thigh, Hildebrand had a long needle pushed down to his femur just three minutes later. Immediately after that, Bier applied a burning cigar to Hildebrand’s leg. Their experiments ranged from the tickling of the sole of the foot to a strong blow to the shin with an iron hammer, with some avulsion of pubic hairs and traction to the testicles in between, all in the space of only forty minutes. After the anaesthetic had worn off, they proceeded to eat dinner, drink wine, and smoke cigars.
The discovery of a local anaesthetic constituted a milestone in the development of anaesthesia. Yet, as important as these experiments were, they often came at a price; both Hall and Halsted, for instance, became addicted to cocaine as a consequence of their self-experimentation and suffered from this addiction for the rest of their lives. We owe a lot to these pioneers, whose courage and desire for knowledge have improved our understanding of anaesthesia and ultimately made operations safer.