The glorious – yet gruesome – tale of the world’s greatest self-experimenter, Dr Joseph Goldberger, and how he discovered the cause of a baffling epidemic.
The beauty of science is that anyone can come up with a hypothesis and test it out. If you get the results you wanted, and other people can repeat your experiment under similar conditions, you can win a Nobel prize — or at the very least, a gold star from your chemistry teacher.
But just as important as the amazing breakthroughs are the glorious failures. It’s just as useful to prove A doesn’t cause B, although you’re much less likely to get your results published in the Lancet or the British Medical Journal. There is a Journal of Negative Results, which nobody’s heard of, but just occasionally, a negative result gets the glory it deserves. For example, in 2002, a massive study of 450,000 children who’d had MMR, and 100,000 who hadn’t, found no difference in rates of autism, thus disproving, as far as is statistically possible, any link between the vaccine and autism.
If you can’t find 550,000 children to test out your theory on, you can start with a few willing volunteers, or failing that, yourself. My favourite self-experimenter of all time is Dr Joseph Goldberger of the US Public Health Service. A century ago Dr Goldberger wanted to find out the cause of pellagra, a disease that sounds like a delicious pasta dish but, sadly, kills you with diarrhoea, dermatitis and dementia. In America, where pellagra had previously been rare, suddenly there were huge and totally unexplained outbreaks. Hundreds of people died.
Like a good scientist, Goldberger decided to prove pellagra was infectious by experiment. He started off gently — extracting blood from one of his pellagra patients and injecting it into his own shoulder. Then he collected phlegm and snot from the mouth and nose of the patient and rubbed it into his own mouth and nose. Nausea, vomiting, bloody diarrhoea, depression, psychosis and scaly skin awaited Goldberger if his experiment worked. It didn’t. Goldberger naturally concluded he hadn’t gone far enough.
Three days later, he decided to swallow some sodium bicarbonate to neutralise the acid in his stomach and maximise his chance of getting infected. Then he swallowed, in turn, samples of urine, faeces and skin taken from his obliging if slightly puzzled patient. Unsurprisingly, he got one of the three Ds (diarrhoea), but he didn’t develop pellagra. A few days later, he managed to persuade four close friends to join him in eating skin, faeces and urine from a pellagra patient.
Must have been one hell of a dinner party. But none of his posse got the disease. Goldberger repeated this experiment an impressive seven times, before convincing himself that this was not an infectious disease. A glorious, negative result — making it extremely unlikely that pellagra was infectious.
After many years of research, he tracked down a cure: brewer’s yeast. Pellagra was caused by a shortage in the diet of the B vitamin niacin and the reason for the outbreak also became clear. At the turn of the last century people had changed their eating habits, going from wholemeal grain to fancier and finer ground grain. Unfortunately, this process also removed some essential vitamins. With niacin added back in, the pellagra epidemic disappeared.
Good for Goldberger.
This article first appeared in issue 12 of benhealth, the magazine for Benenden Healthcare members.
