View source for Autoexperimentation with a Drug by Arthur Conan Doyle

{{Cargo_Research_Articles
 |date=1999-06-01
 |author=Alvin E. Rodin
 |topic=Medicine
 |summary=This article examines Arthur Conan Doyle's 1879 self-experiment with increasing doses of gelseminum and places it in the context of nineteenth-century medical research. It argues that this episode reflects both historical drug experimentation practices and Conan Doyle's personal taste for risk, drama, and adventure. 
}}
''Autoexperimentation with a Drug by Arthur Conan Doyle'' is an article written by [[Alvin E. Rodin]] published in the [[A.C.D. - The Journal of The Arthur Conan Doyle Society]] (Vol. 9, june 1999).

This article examines [[Arthur Conan Doyle]]'s 1879 self-experiment with increasing doses of [[Gelseminum as a Poison|gelseminum]] and places it in the context of nineteenth-century medical research. It argues that this episode reflects both historical drug experimentation practices and [[Arthur Conan Doyle|Conan Doyle]]'s personal taste for risk, drama, and adventure. 


== Autoexperimentation with a Drug by Arthur Conan Doyle ==
[[File:Acd-society-journal-1999-vol9-p75-autoexperimentation-with-a-drug.jpg|thumb|250px|right|[[A.C.D. - The Journal of The Arthur Conan Doyle Society]] (Vol. 9, june 1999, p. 75)]]
[[File:Acd-society-journal-1999-vol9-p76-autoexperimentation-with-a-drug.jpg|thumb|250px|right|[[A.C.D. - The Journal of The Arthur Conan Doyle Society]] (Vol. 9, june 1999, p. 76)]]
[[File:Acd-society-journal-1999-vol9-p77-autoexperimentation-with-a-drug.jpg|thumb|250px|right|[[A.C.D. - The Journal of The Arthur Conan Doyle Society]] (Vol. 9, june 1999, p. 77)]]
[[File:Acd-society-journal-1999-vol9-p78-autoexperimentation-with-a-drug.jpg|thumb|250px|right|[[A.C.D. - The Journal of The Arthur Conan Doyle Society]] (Vol. 9, june 1999, p. 78)]]
[[File:Acd-society-journal-1999-vol9-p79-autoexperimentation-with-a-drug.jpg|thumb|250px|right|[[A.C.D. - The Journal of The Arthur Conan Doyle Society]] (Vol. 9, june 1999, p. 79)]]

''This study was presented in part before the American Osler Society in San Francisco on 27 March 1979. The article was originally published in Journal of the History of Medicine, October 1980, pp. 426-30.''

Self-medication with drugs by physicians is not unusual. Self-experimentation with drugs, however, is less common, and even rarer today than in the nineteenth century. (1) Such a personalized approach to research is of historical interest as one method of advancing medical knowledge. It has certain advantages. The investigator is considered more ethical in being willing to subject himself as well as others to human experimentation. (2) With himself as the subject he can perceive the effects of a drug directly instead of indirectly from another individual. There are also disadvantages. (3) Preexisting biases of the researcher are likely to be magnified when he uses his own body. Also, any conclusions derived from himself are based on reactions to a drug in only one individual. 

[[Arthur Conan Doyle]] engaged in an autoexperimentation study in 1879 while a third-year medical student. (4) He was serving for several summer months as a medical assistant to Dr Reginald Hoare of Birmingham in order to earn some money. [[Arthur Conan Doyle|Conan Doyle]]'s principal responsibility was to prepare and dispense prescriptions, for a salary of two pounds per month. (5) An account of this episode of autoexperimentation is provided by [[Arthur Conan Doyle|Conan Doyle]] in a letter dated 20 September 1879 to the editor of the British Medical Journal. (6) Because of persistent neuralgia [[Arthur Conan Doyle|Conan Doyle]] had been taking tincture of gelsemium. Such therapy is highly recommended for neuralgia in William Osler's textbook of 1892. (7) 

Gelsemium is the dried rhizome and root of yellow jasmine. (8) Its actions are similar to those of nicotine but with a stronger central depressant action. There is no pharmacologic explanation for the use of gelsemium in neuralgic conditions. According to Proctor, (9) gelsemium was discovered accidentally by a Mississippi planter whose servant used, by error, the root of jasmine to make a tea for his master who was suffering from a bilious fever. There was a resultant loss of muscular power and disappearance of the fever. In the middle of the nineteenth century it was used chiefly by eclectic practitioners of the Midwest. (10) By 1874 gelsemium was included in both American and British pharmacopoeias. (11) Recommended uses were for pneumonia, pleurisy, neuralgia, and intermittent and yellow fevers. Although described in the 1973 edition of the ''United States Dispensatory'', (12) gelsemium is no longer included in the United States and British pharmacopoeias. 

[[Arthur Conan Doyle|Conan Doyle]] took increasing doses of the tincture of gelsemium in order to ascertain how far one might go with the drug'. (13) He began at forty minims (two ccs) on the first day with six daily increments. There was onset of giddiness with 90 minims (4.5 ccs) on the third day, then difficult eye accommodation at 120 minims (6 ccs) on the fourth, and severe headaches and diarrhea at 150 minims (7.5 ccs) on the fifth day. [[Arthur Conan Doyle|Conan Doyle]] persisted until the seventh day when 200 minims (10 ccs) resulted in severe depression in addition to the other symptoms. 

This episode is of interest for several reasons. First, it is an apparent example of the selfless contribution of a medical student to the delineation of the side effects of a drug. Second, it suggests a curiosity and a dedication to medical knowledge that [[Arthur Conan Doyle|Conan Doyle]] did not exhibit otherwise. In his autobiography he stated, 'I had no great interest in the more recent developments of my own profession, and a very strong belief that much of the so-called progress was illusory.' (14) In 1890 he did rush to Germany to see first hand Köch's tuberculin cure for tuberculosis. But this appears to have been a dramatic flourish rather than any deep concern for new medical knowledge. 

There are some references to drugs and poisons in the [[Sherlock Holmes]] stories, used primarily for characterization and plot development. (15) Many of these drugs have dramatic effects. (16) For example, Josiah Amberley attempted suicide with cyanide after murdering his wife and her lover ('[[The Retired Colourman]]'). [[Dr. Watson|Watson]] administered a hypodermic of morphine to Professor Presbury who had been bitten by his wolfhound ('[[The Adventure of the Creeping Man]]'). Watson recognized that Juan Murillo had drugged his governess with opium because of her small pupils ('[[Wisteria Lodge]]'). Fresh air, ammonia, and brandy were used by [[Dr. Watson|Watson]] to overcome the effects of carbon monoxide poisoning ('[[The Greek Interpreter]]'). The mydriatic properties of belladonna helped [[Sherlock Holmes|Holmes]] to simulate a rare tropical disease ('[[The Dying Detective]]'). [[Sherlock Holmes|Holmes]] choloroformed the German spy von Bork in order to retrieve secret British naval documents ('[[His Last Bow]]'). [[Sherlock Holmes|Holmes]], himself, was addicted to the stimulant action of cocaine. (17) There is no reference to gelsemium in the [[Sherlock Holmes]] stories. 

Quite surprising is that [[Arthur Conan Doyle|Conan Doyle]] undertook autoexperimentation with gelsemium even though he was aware that fatalities had been reported in patients taking the drug. His letter of 1879 refers to a case described some time ago in which 75 minims proved fatal'. (18) Prior to 1879 there were many reports of death ascribed to gelsemium in German, American, and English medical journals. Death is due to respiratory arrest. The report most likely seen by [[Arthur Conan Doyle|Conan Doyle]] was a letter to the editor of the Lancet dated 27 September 1873, (19) six years before his self-experimentation. One death is described after 50 minims of tincture of gelsemium and another after 120 minims. In 1882 Dr Wormley collected a series of reports on twenty-five deaths related to gelsemium. (20) The smallest doses involved were twelve minims in a three-year-old child and sixty minims in a healthy male adult. Sollman's Manual of Pharmacology of 1948 states that 'a drachm of fluid extract (sixty minims, four ccs) is said sometimes to cause death, and 30 minims are dangerous'. (21) [[Arthur Conan Doyle|Conan Doyle]] took 3.3 drachms (200 minims). 

Why [[Arthur Conan Doyle|Conan Doyle]] disregarded the possibility of death while taking gelsemium is not known. We can, however, draw some inferences on the basis of his other activities and writings. Altman, (22) in discussing reasons for the selection by investigators of themselves as experimental subjects, included reliability, dependability. convenience, suicide, ethical code, and a spirit of adventure. [[Arthur Conan Doyle|Conan Doyle]] is quite unlikely to have taken gelsemium in a suicidal attempt because of the complete lack of any such indications in his autobiography or his exploits, and because of his zest for life. (23) His disregard for the possibility of a fatal outcome was not likely due to a belief in life after death, because his complete acceptance of Spiritualism did not occur until 1917. Uninterested in medicine or medical research, he was unlikely to have been motivated by concerns for experimental reliability, dependability, or convenience. 

[[Arthur Conan Doyle|Conan Doyle]]'s apparent defiance of death was most likely a reflection of the bravado, the sense of the dramatic and the spirit of adventure, that he exhibited in many of his endeavours. While a fourth-year medical student in 1880 he spent seven months on an Arctic whaler as a ship's surgeon. On graduation from medical school he held a similar position for three months on an African steamer. 

[[Arthur Conan Doyle|Conan Doyle]] eagerly sought out direct involvement in war. In 1896 he was a war correspondent in Egypt, observing Kitchener's desert campaigns. During the Boer War he served as senior physician of the Langman Field Hospital in South Africa, funded and organized by private individuals. During World War I he agitated for military service but was rejected because of his age. Undaunted, he organized and trained a defence militia of volunteers in southern England. He did visit the French and Italian battlefronts in 1917 as a special observer. [[Arthur Conan Doyle|Conan Doyle]]'s zeal for war is also evident in his detailed histories of the Boer War (24) and of World War 1, (25) the latter being six volumes in length. He was knighted in 1902 by King Edward VII for his support of the British position in the Boer War. 

Another expression of a zest for life and for the dramatic relates to [[Arthur Conan Doyle|Conan Doyle]]'s involvement as an active participant in the more physical and dangerous sports, such as auto racing, rugby, and boxing. He introduced cross-country skiing into the Swiss Alps. His political activities had the flavour of fighting against the odds. He ran unsuccessfully for Parliament as a conservative candidate in a seat which had always been a radical stronghold. He personally undertook the investigation of several cases of individuals whom he considered falsely accused of crimes. (26) In doing so he spent much time and effort, over a period of many years, in actively opposing the legal establishment of England. Such tenacity was consistent with [[Arthur Conan Doyle|Conan Doyle]]'s persistence in taking increasing doses of gelsemium in spite of severe symptoms. 

[[Arthur Conan Doyle|Conan Doyle]] was thus a man of his times-the late Victorian and the early Edwardian ages, in which considerable value was placed on the dramatic gesture, the romance of insurmountable odds, and the heroic sacrifice to a cause. [[Arthur Conan Doyle|Conan Doyle]] composed the epitaph for his own tombstone, now at Minstead in Hampshire — Steel True, Blade Straight'. (27) Most fittingly the marker is carved out of stout British oak. Ours is a different age, with a different emphasis on our value-symbol system. And perhaps this is one reason why autoexperimentation has decreased in incidence and prominence. 


'''References'''

1. A. C. Ivy. The history and ethics of the use of human subjects in medical experiments'. Science, 1948, 108, 1-5 

2. S. E. Stumpf. Momentum and morality in medicine'. Ann. Int. Med., 1967, 67, 10-14 

3. H. K. Beecher. 'Experimentation In man'. J. Am. Med. Ass., 1959, 169, 461-78 

4. C. F. Kittle. 'Arthur Conan Doyle, doctor and writer (1859-1930)'. J. Kansas Med. Soc., 1960, 61, 13-18 

5. J. D. Carr. The Life of Sir Arthur Conan Doyle. London: John Murray, 1949, pp. 38-9 

6. [[Arthur Conan Doyle|A. C. Doyle]]. '[[Gelseminum as a Poison|Gelsemium as a poison]]'. Br. Med J., 1879, ii, 483 

7. W. O. Osler, The principles and practice of medicine. New York, 1892, p. 962 

8. William Martindale. The extra pharmacopoeia: incorporating Squire's 'Companion', 27th edition, ed. Ainley Wade. London, 1977, p. 1763 

9. W. Procter, Jr. 'On gelsemium sempervirens or yellow jassamin'. Am. J. Pharm, 1852, 2nd ser. 18, 307-10 

10. F. D. Hill. 'Gelsemium sempervirens'. Eclectic Med. J., 1852, 4, 353-4

11. R. E. Griffith and J.M. Maisch. Universal formulary containing the methods of preparing and administering officinal and other medicines, 3rd ed. Philadelphia, 1874, p. 307 

12. A. Osol and R. Pratt. The United States Dispensatory, 27th ed. Philadelphia, 1973, p. 545 

13. [[Arthur Conan Doyle|Doyle]] (n. 6) 

14. [[Arthur Conan Doyle|A. C. Doyle]]. [[Memories and Adventures]]. London: Hodder & Stoughton, 1924 

15. R. B. De Waal. The World Bibliography of Sherlock Holmes. New York, 1974, pp. 266-8 

16. W. S. Baring-Gould. The Annotated Sherlock Holmes. 2 vols. New York, 1967 

17. D. F. Musto. 'A Study in Cocaine: Sherlock Holmes and Sigmund Freud'. J. Am. Med. Ass., 1968, 204, 125-30 

18. [[Arthur Conan Doyle|Doyle]] (n. 6) 

19. J. N. Freeman. 'Gelsemium'. Lancet, 1873, ii, 475 

20. T. G. Wormley. 'Is gelsemic acid identical with aesculin?' Am. J. Pharm., 1882, 10, 1-8 

21. T. Sollman. A manual of pharmacology and its application to therapeutics and toxicology, 7th ed. Philadelphia, 1948, p. 353 

22. L. K. Altman. 'Auto-experimentation: an unappreciated tradition in medical science'. New Engl. J. Med., 1972, 286, 346-52 

23. C. Higham. The Adventures of Conan Doyle: the life of the creator of Sherlock Holmes. New York, 1976 

24. [[Arthur Conan Doyle|A. C. Doyle]]. [[The Great Boer War]]. London, 1900 

25. [[Arthur Conan Doyle|A. C. Doyle]]. [[The British Campaign in France and Flanders]]. 6 vols. London 1916-19 

26. [[Arthur Conan Doyle|A. C. Doyle]]. '[[The Case of George Edalji: A Question for Ophtalmologists|The Case of George Edalji: a question for ophthalmologists]]'. Lancet, 1907, i, 189 

27. R. A. Mannion. An appreciation of medical men of literature. 1. Sir Arthur Conan Doyle.' J. Indiana S. Med. Ass., 1974, 67, 191-3 












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