Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5227_Библиотеки_им_академика_М_И_Перельмана.pdf
THE ELIXIR OF LIFE
practised as a doctor in Argentina and Paraguay in the 1850s and selfexperimented with the local plant stimulants, guarana and coca. Unlike
von Bibra, Mantegazza appreciated coca’s stimulant effects immediately and pursued them vigorously. ‘As soon as one chews one or two
drachms’,25 he wrote in his 1859 monograph ‘On the Hygienic and
Medical Values of Coca’,
the nervous excitement is always followed by movements that are
exaggerated or violent, and always irregular; there is a general
confusion of thoughts and muscular activity, while in the inebriety
produced by coca it seems that the new strength gradually drenches
one’s organism in every sense, as a sponge soaks itself with water.
Thus the delight of the period consists almost completely in an
increased consciousness of being alive.
26
Mantegazza found in coca not a productive stimulant for the sober
self, but a radically altered state of consciousness. Unlike caffeine,
higher doses brought not overstimulation but ever more pleasurable
and remarkable effects. By chewing 8 drachms in a day and a further 10
the same evening, about the most he could physically manage, he
attained what he called ‘the delirium of coca intoxication, and I must
confess that I found this pleasure by far superior to all other physical
sensations previously known to me’.27 He recorded his pulse before the
evening dose at 83 per minute; half an hour later it had risen to 120.
He felt supremely happy, and on closing his eyes was presented with
‘the most splendid and unexpected phantasmagoria’, kaleidoscopic
images succeeding each other too fast to record, or even to communicate by announcing them in rapid fire to the colleague beside him. He
attempted to transcribe them, missing ten for every one he managed to
capture:
A cave of lace through the entrance to which can be seen, toward
the back, a golden tortoise seated on a throne made of soap . . .
31
THE NEW ACCELERATOR
A battalion of steel pens fighting against an army of cork-
screws . . .
Lightning, consisting of glass threads, piercing a whole Parmesan
cheese crowned with ivy and berries . . .
A saffron inkwell from which is born an emerald mushroom
studded with rose fruits . . .
A ladder made of blotting paper lined with rattlesnakes from
which several red rabbits with green ears come jumping down . . .
28
Mantegazza embraced coca’s euphoric and visionary properties,
which convinced him that ‘all this will be great science in the near
future’.29 The desire and capacity for ecstasy was a constant throughout
human history, but he believed that its limits were still unexplored. On
his return to Italy he became a medical professor in Pavia, founded the
Italian Anthropological Society and began work on a massive survey of
inebriation and human nature, which ran to 1,200 pages when it was
eventually published in 1871. His expansive category of inebriants
included non-chemical stimuli such as joy, love, ambition, youth and
religious ecstasy: ‘each passion’, he argued, ‘may have a paroxysm resembling inebriation’.30 He placed the pleasure produced by drugs such as
coca at the heart of his vision of a progressive future in which humanity
would attain a new form of ‘inebriation caused by far-sightedness and
optimism’. As science advanced, nature and chemistry would reveal ‘a
thousand new nervine nourishments’, and a society would arise in
which ‘men will always have feasts and inebriations’.31 For his part,
Mantegazza continued to use cocaine in a ‘wise and copious’ manner
into his advanced old age.
32
In his first paper on the topic in 1884, ‘Über Coca’, Freud adopted a
strikingly innovative literary style, quite different from anything that he
would write subsequently, which aimed to balance the sober, quantitative approach of Aschenbrandt’s researches with the intoxicating qualities of Mantegazza’s. He began with a conventionally written botany and
history of the coca plant, but in the physiological section, ‘The Effects of
32
THE ELIXIR OF LIFE
Coca on the Healthy Human Body’, he switched abruptly to first-person
testimony: ‘I have carried out experiments and studied, in myself and
others, the effects of coca on the healthy human body; my findings agree
fundamentally with Mantegazza’s description of the effects of coca
leaves.’33 He described his first dose with clinical precision – 0.05g of
cocaine in a 1 per cent water solution – but then shifted voice once
more, to the indirect conversational form, ‘you’ or ‘one’:
A few minutes after taking cocaine, one experiences a sudden exhilaration and feeling of lightness. One feels a certain furriness on the
lips and palate, followed by a feeling of warmth in the same areas;
if one now drinks cold water, it feels warm on the lips and cold in
the throat.
34
As he moved on from the physical to the psychological effects, the
voice shifted yet again, now alternating the personal address to the
reader with the impersonal tone of scientific authority:
The psychic effect of cocaïnum muraticum in doses of 0.05–0.10g
consists of exhilaration and lasting euphoria, which does not differ in
any way from the normal euphoria of a healthy person. The feeling of
excitement which accompanies stimulus by alcohol is completely
lacking; the characteristic urge for immediate activity which alcohol
produces is also absent. One senses an increase of self-control and feels
more vigorous and capable of work; on the other hand, if one works,
one misses that heightening of the mental powers which alcohol, tea
or coffee produce. One is simply normal, and soon finds it difficult to
believe that one is under the influence of any drug at all.
35
At times Freud describes cocaine with a breathless energy, intended to
convey the subjective sensations produced by the drug and inviting the
reader to share in the frank acknowledgement of its pleasures. At others,
he portrays it as a ‘sober intoxicant’ with no significant subjective effects.
33
THE NEW ACCELERATOR
In some passages he strikes a tone of objectivity and professional distance;
others are styled as personal confession, in which he claims the authority
of experience. The conversational ‘one’ or ‘you’ occupies a slippery
middle ground between the two: intimate and direct but not, on close
inspection, based firmly on either evidence or experience.
These shifts in style were a carefully modulated solution to the paradoxes of self-experiment, which were well recognised. Ernst von Bibra,
similarly, had commented in his essay on coca that ‘two persons, as it
were, seem to be present, one feeling all the effects of the narcosis, the
other conscious of them’.36 He might have added a third perspective:
that of the author, balancing the voices of observer and subject to present
the experience to the reader. Looking back on his cocaine researches,
Freud would be more specific: ‘I realise that such self-observations have
the shortcoming, for the person engaged in conducting them, of
claiming two sorts of objectivity’, the perspective of the researcher and
that of the experimental subject.37 But these shifts in style also reflected
Freud’s ambition to address several different audiences at once: his
medical colleagues and superiors, the pharmaceutical trade on which
cocaine’s success or failure would depend, and the general public who
would be its eventual customers. He was attempting to present himself
simultaneously as a medical expert, a salesman for a revolutionary new
pharmaceutical, and a conquistador of the mind. In doing so he needed
to unite two opposing schools of the self-experimental method that had
coexisted from the origins of modern science: one demanding professional distance from the subject of his inquiries, the other pushing him
deeper into the terrain of introspection and subjectivity.
* * *
‘Nullius in Verba’: the motto of the Royal Society, adopted on its foundation in 1660, placed experiment at the heart of the scientific revolution. It announced that nothing was to be taken on hearsay: direct
evidence, generated by experiment and first-person observation, was to
34
THE ELIXIR OF LIFE
replace the traditional reliance on classical and scholastic authorities.
Experiments, in turn, were to be confirmed by replication. When they
were demonstrated in the semi-public space of the Royal Society, a
register book was supplied for witnesses to testify and endorse what
they had seen. The readers of the Society’s published Proceedings were
invited to repeat the experiments themselves, and to write in with
evidence that confirmed or denied them.
The Royal Society’s leading figures, including Robert Boyle and
Isaac Newton, developed mechanical and material theories that created
a distinction between two different types of evidence. ‘Primary’ qualities such as size, shape or weight were directly measurable and, as we
would say today, objective; ‘secondary’ qualities were those such as
texture, taste or feeling that described human sensations and responses.
The Society’s researches favoured the demonstration of primary qualities, but sensation and perception were legitimate fields of inquiry, and
certain classes of data could only be demonstrated by self-experiment.
In a famous and graphic example, when Isaac Newton wished to establish whether a change in the curvature of the eye would present a
distorted image to the perceiver, he took a large needle, or bodkin, and:
put it betwixt my eye & the bone as neare to the Backside of my eye
as I could: & pressing my eye with the end of it (soe as to make the
curvature a, b, c, d, e, f in my eye) there appeared several white
darke & coloured circles r, s, t, &c. Which circles were plainest
when I continued to rub my eye with the point of the bodkin, but
if I held my eye & the bodkin still, though I continued to presse my
eye with it yet the circles would grow faint & often disappeare untill
I renewed them by moving my eye or the bodkin.
38
The letters are keys to Newton’s accompanying drawing, which shows
the shape of the eye indented. It was not possible to present direct
evidence for the coloured circles since they only existed in Newton’s
mind, yet his fellow philosophers were not obliged simply to accept
35
THE NEW ACCELERATOR
Newton’s word for them. They were described in such a way that any
sceptic, if they so wished, could repeat the experiment on themselves.
This was also the case for drugs that acted on the mind. Like the
circles in Newton’s vision, the changes in thought, mood, sensation or
perception they produced were secondary qualities with no material
existence, but this did not mean they were delusions. There was no
correct or perfect way to present them, yet they offered unique insights
into mental functioning. The language that offered itself most plausibly for describing them was that of medicine, in which the physician
could only report the patient’s sensations and state of mind at second
hand, but could add judicious glosses and interpretations suggested by
their professional learning and experience of similar cases.
An early example was Robert Hooke, curator of experiments at the
Royal Society, whose diary records the effects of the many drugs he
used for overlapping purposes: verifying medical claims, managing his
pain and moods, and ‘refreshing’ himself during social and business
meetings in the coffee houses he frequented in the afternoons, following
his morning routine of experiments and instrument-making.39 He
recorded his impressions of alcohol, chocolate, tea, coffee and tobacco,
and on 18 December 1689 delivered a lecture at the Royal Society entitled ‘An Account of the Plant, Call’d Bengue’, or cannabis. ‘It is a certain
Plant which grows very common in India’, Hooke related, ‘and the Use
thereof (though the Effects are very strange, and at the first hearing
frightful enough) is very general and frequent’:
This Powder being chewed and swallowed, or washed down, by a
small Cup of Water, doth, in a short Time, quite take away the
Memory & Understanding; so that the Patient understands not,
nor remembereth any Thing that he seeth, heareth, or doth, in that
Extasie, but becomes, as it were, a mere Natural, being unable to
speak a Word of Sense; yet is he very merry, and laughs, and sings,
and speaks Words without any Coherence, not knowing what he
saith or doth; yet is he not giddy, or drunk, but walks and dances
36
THE ELIXIR OF LIFE
and sheweth many odd Tricks; after a little Time he falls asleep, and
sleepeth very soundly and quietly; and when he wakes, he finds
himself mightily refresh’d, and exceeding hungry . . .
40
Hooke begins by announcing that he has a fantastical-sounding tale
to report, and takes care to set it in its geographical context, but his
impersonal narrative voice leaves the provenance of the story in doubt.
Who was the patient or subject, and who was the observer? The author
identifies himself as neither, though he may have been either or indeed
both. Hooke’s usual inclination was to experiment on himself, and in
his diaries he writes of drugs in the first person (‘I took spirit of urine
and laudanum with milk for three preceding nights. Slept pretty well’).41
Yet in this case the observer may equally have been his friend Robert
Knox, a sailor who had passed on a sample of the plant extract to him
when they met in a London coffee house in November 1672. Knox had
a remarkable story: he had been held captive in Sri Lanka for several
years before escaping on a stolen ship and almost dying of fever, from
which he was rescued only by his discovery that cannabis worked as ‘an
Antidote and Counter-Poyson against the filthy and venomous water’.
42
By the new standard of ‘Nullius in Verba’, the testimony Hooke
presented fell somewhat short of scientific evidence. Travellers’ tales of
exotic drugs and miracle cures were an inheritance from classical literature, where they inhabited a murky borderland between history, botany
and folklore, much as they still did in the seventeenth century. Hooke
was offering the Society a plausible account, but one that was not subject
to checking except by self-experiment. What emerged was something
like a medical case history: anecdote rather than data, but mediated and
endorsed by an expert witness. Individual and bodily experience – of the
kind elicited by doctors with the question ‘how do you feel?’ – was never
able to produce the kind of replicable results generated by the Society’s
vacuum pumps or thermometers. In its place an informal criterion of
expertise emerged, dubbed by the historian of science Simon Schaffer
‘the Cartesianism of the genteel’: the assumption that trained or educated
37
THE NEW ACCELERATOR
observers were capable of using their minds to assess the evidence of
their bodies – or, in the terms established by the philosophy of John
Locke, of separating the intellect from the passions.43 As in Hooke’s
case, it became the convention to relay such evidence in the third person
or passive voice favoured by physicians, with the confessional first
person confined to diaries and private records.
As pharmacology developed through the eighteenth century, this
language of quasi-medical reportage became firmly entrenched. Selfexperiment with drugs was common practice, for ethical as well as
practical reasons: physicians were obligated to treat the sick according
to the Hippocratic oath, doing no harm, and experimenting on them
was the mark of an unscrupulous quack. Working with medicines of
unknown purity, and with only a partial grasp of their active chemical
principles, doctors reported experiments as far as possible through
external measurement of physical signs: pulse, temperature, stools or
urine. Practising physicians were aware that responses to drugs could
vary widely between individuals, and prescribed individually tailored
regimes of medicines and other treatments to their fee-paying clients.
Administering drugs was the business of apothecaries, a lower status
profession whose members were more likely to deal in standard doses.
The growth of physical observation and measurement revealed that
mind and body influenced each other in mysterious ways, and that even
directly experienced phenomena could be proven false. One famous
example was the committee set up in 1784 by the French Royal
Academies of Science and Medicine, under the aegis of Benjamin
Franklin, to investigate Anton Mesmer’s theory of animal magnetism or
mesmerism. A series of blinded experiments, in which magnetised and
unmagnetised objects were swapped without the subjects’ knowledge,
showed that the dramatic effects of ‘animal magnetism’, from paralysis
to contortions to spontaneous healing, could manifest even when no
magnetism had been applied. This effect, which we would now call
placebo, even affected some members of the committee, who felt
twinges and electric sensations, though to a lesser degree than mesmer-
38
THE ELIXIR OF LIFE
ism’s true believers. ‘There is no proof of the existence of the Animal
Magnetic fluid,’ the committee’s report concluded; ‘the Imagination
without the aid of Magnetism can produce convulsions, but Magnetism
without the Imagination can produce nothing.’44 The lesson for selfexperimenters was that hypervigilance to one’s own sensations could
overinterpret the evidence of the body or generate symptoms based
solely on expectation. As the final report stated, ‘the first thing therefore,
to which the commissioners were bound to attend, was not to observe
too minutely what passed within them’.
45
For the generation that followed, however, subjectivity was the new
frontier of scientific knowledge. The inward turn emerged from the
philosophy of Immanuel Kant, whose treatise of 1781, Critique of Pure
Reason, made a primary distinction between the ‘phenomenal’ world
– reality as revealed by sensation and perception – and a ‘noumenal’
world of ideas and categories, including God, that existed prior to and
independently of human experience. According to Kant’s distinction,
the world as received via the senses was not the accurate reflection of
an external reality but a construct, shaped by the human senses and
limited by the parameters of the human mind.
This theory was strikingly corroborated in a series of drug experiments
by the young chemist Humphry Davy that were still commonly cited as
a touchstone for the practice of self-experiment in Sigmund Freud’s day.
In 1799, at the age of twenty, Davy was hired as the chemical assistant at
the Medical Pneumatic Institution in Bristol, an experimental project
initiated by the pioneering physician Thomas Beddoes for synthesising
and testing gases in the treatment of lung conditions. One of the first
compounds Davy created in the laboratory was nitrous oxide, a recently
discovered gas that was believed to be highly toxic. Davy suspected this
belief resulted from a confusion with a related compound, nitric oxide, a
red-brown gas that was a powerful irritant. ‘I made a discovery yesterday
which proves how necessary it is to repeat experiments,’ he wrote to his
and Beddoes’s friend Davies Giddy in April 1799; ‘The gaseous oxide of
azote [nitrous oxide] is perfectly respirable when pure.’
46
39
THE NEW ACCELERATOR
Excited to have established a virgin field of inquiry, Davy and
Beddoes heated ammonium nitrate crystals in an alembic and collected
the escaping gas in an air holder, from which Davy inhaled through a
breathing tube. As he filled his lungs, he noticed an unexpected sensation, ‘a highly pleasurable thrilling in the chest and extremities’. As he
continued, ‘the objects around me became dazzling and my hearing
more acute’, and the sensations built towards a climax in which ‘the
sense of muscular power became greater, and at last an irresistible
propensity to action was indulged in’. Beddoes recorded that Davy
leapt violently around the laboratory shouting for joy. For his own part,
Davy retained only vague recollections of these ecstatic moments, and
were it not for the scrawled notes he discovered the following morning,
‘I should even have doubted their reality’.
47
Unlike the speculative animal fluids of Dr Mesmer, there was no
doubt about the material cause of this paroxysm of pleasure. Nitrous
oxide – first isolated by Joseph Priestley, who had named it ‘dephlogisticated nitrous air’ – was a chemical substance with a known synthesis,
and the experiment could be replicated and verified in any home labora tory. The effects of the gas, however, could only be captured in firstperson testimony. Davy was quick to elicit such testimony, and was
perfectly placed to do so. The Pneumatic Institution was a hub for
Bristol’s freethinking writers, philosophers and physicians, and over
the summer of 1799 dozens of them came to visit and experience the
gas which the poet Robert Southey, the first of his friends to whom
Davy had offered it, described as ‘the wonder-working air of delight’.
After his first dose, Southey wrote to his brother that ‘Davy has actually invented a new pleasure for which language has no name’.48
Exploring it further was an invitation and a challenge that the keenest
minds of Bristol were eager to accept.
As the experiments progressed, Davy realised that a new ‘language of
feeling’, as he called it, was required to describe the effects of the gas.
The standard question of medical description, ‘How do you feel?’, was
tested to its limits by a torrent of sensations that encompassed dizziness,
40