War, On Drugs

On March 18, 1944, a Finnish ski patrol was ambushed by Russian soldiers. Whilst fleeing from the Russians, one exhausted Finnish soldier, Aimo Koivunen, was carrying his entire squad’s supply of Pervitin. Pervitin was a methamphetamine drug supplied to German and Finnish soldiers during World War II to help them stay alert and focused during long stretches of combat.

Aimo was running out of steam, and the mittens he wore prevented him from fishing out an individual pill, so he took an entire 30-man patrol’s supply of Pervictin as a single dose.

Aimo slipped in and out of drug-induced delirium. During his hazy confusion, he had somehow been separated from his entire squad, escaped pursuing Russian troops, and survived laying in a ditch for several days after stepping on a landmine. The only foods he managed to eat were pine buds and a raw bird he managed to catch.

By the time he was found, he had travelled 400 kilometres. He was taken to a Finnish hospital, where staff recorded his heart rate at 200 beats per minute and weighed him in at 43 kilograms (94 pounds).
Aimo Koivunen died in 1989, aged 72.

Testostergroan

Ageing, insecure men have always grasped for elixirs of youth. Today, the male anti-ageing movement is placing bets on testosterone, seemingly oblivious of the misspent efforts of similar-minded individuals back in the roaring twenties.

Over the last one hundred years, hormones have played a colourful role in the senescent male’s search for virility. A prevailing belief that eunuchs possessed inferior physical and mental abilities gave rise to pioneers in the field of hormone replacement. Scientists reasoned that testicles produced a magical substance that conferred youth, explaining the perceived frailty of eunuchs.

French physician Charles-Édouard Brown-Séquard injected himself with extracts from the crushed testicles of dogs and guinea pigs, hoping to regain his lost youth. Thousands of physicians offered Brown-Séquard’s treatment to an eager public, but the anecdotal success of these injections was hit-and-miss.

Hence, a Professor of Physiology at the University of Vienna, Eugene Steinach, invented a more elaborate treatment. He performed a partial vasectomy procedure known as the Steinach operation. In theory, he believed that the surgery would stimulate the production of anti-ageing substances. The rich and famous lined up for Steinach’s procedure—influential men like Sigmund Freud and William Butler Yeats went under the knife.

Dr. Serge Voronoff developed a technique of grafting monkey testicle tissue into men. Sewing the monkey testicle onto a human’s scrotum was supposed to restore youth and prolong life. The tissue was initially harvested from criminals, but with demand outstripping supply, he switched to monkey gonads he could freely obtain from his monkey farm on the Italian Riviera.

Driven by the power of a placebo, Voronoff’s popular procedure led to a doping scandal in English soccer. When struggling Wolverhampton Wanderers Football Club inflicted crushing defeats on rivals after Wolves’ players got monkey gland injections, other teams rushed to adopt the unorthodox treatment. The 1939 FA Cup Final was contested between two teams who relied on monkey glands to enhance performance, so the press called it the ‘Monkey Gland Final.’

Catnip for human catnaps?

Catnip (Nepeta cataria) is a plant used as a recreational drug to entertain cats but whether cats respond to it is genetically determined. The active compound in catnip which produces its stimulating effect in cats is called nepetalactone. This chemical, which mimics feline sex hormones, protects the plant by attracting lacewings that eat pests like aphids and mites. Nepetalactone also repels mosquitoes. Rubbing against catnip makes cats more resistant to mosquito bites.

Catnip has been used by humans for centuries as a natural remedy for headaches, digestive issues, and insomnia. Mostly employed as a herbal tea, catnip was smoked in the 1960s as a marijuana substitute.

Autumn skin colours

Green

Green Nail Syndrome is a greenish discolouration of the nail cause by Pseudomonas aeruginosa infection. This bacterium flourishes in wet environments, such as jacuzzis, contact lens solution, sinks, and bath sponges. When it grows, it produces green pigments called pyocyanin and pyoverdin. Pseudomonas aeruginosa can also result in green urine when causing urinary tract infections.

Yellow

Jaundice is a condition where the skin turns yellow because of a high level of bilirubin. Bilirubin, a yellow-orange bile pigment, is a breakdown product of red blood cells which is removed from the body by the liver.

Orange

Carotenemia is abnormal yellow-orange discolouration of the skin; usually due to excessive dietary beta-carotene intake. It may be caused by excessive intake of nutritional supplements or beta-carotene rich foods (such as carrots, spinach, sweet potatoes, broccoli, and winter squash).

Red

Erythroderma (“red skin”) is a serious condition marked by redness and scaling involving all or most of the skin. In most cases, it is triggered by an underlying condition or drug reaction. A serious reaction to the drug vancomycin causes the ‘Red man syndrome’.

Brain Gout

The breakthrough treatment for Bipolar Disorder was discovered by an ex-POW (prisoner of war) who injected guinea pigs with human urine.

John Cade’s accidental discovery is even more fascinating if we consider that Cade’s theory was wrong, his observations were wrong, and his experiments do not meet modern-day standards.

During his time in a Japanese prisoner-of-war camp, Cade was put in charge of the psychiatric section, observing the disease-causing effects of vitamin deficiencies in his fellow prisoners.

Later, as a psychiatrist, he wondered if Bipolar Disorder was caused by too much or too little of an unknown substance. He recognized that mania resembled an overactive thyroid while depression resembled an underactive thyroid. So it made sense to him that a chemical, like a thyroid hormone in the dysregulated thyroid states, was to blame. To find this substance, Cade took urine from people with mania and injected it into the abdominal cavities of guinea pigs. Thinking that the urine of manic patients was more lethal to guinea pigs than the urine of regular patients, he guessed that manics have higher levels of a toxin in their urine. Cade knew of two toxins in the urine: urea and uric acid. The amount of urea in the urine of manic and non-manic patients did not differ remarkably, so he began testing uric acid.

Uric acid does not dissolve in water, and Cade needed a soluble form of uric acid to inject into the guinea pigs. Adding lithium to improve the solubility of uric acid, he injected the guinea pigs with lithium urate. To his surprise, the injections of lithium urate calmed the guinea pigs. Cade, of course, was wrong. The guinea pigs were not calm; they were poisoned. But Cade misinterpreted the signs of poisoning as calmness and wondered if it could calm humans too. He learned that the calming action was not due to urate but, instead, lithium. He started experimenting on himself before experimenting on his human patients.

The psychiatric community took notice of Cade’s raw experiments and lithium was subsequently introduced as a new treatment for Manic-Depression (Bipolar Disorder).

Lithium is a naturally occurring element named after the Greek word for stone (lithos) because it is present in rocks. Historically, people have frequented lithium-rich mineral springs for their supposed healing properties.

Which beverage ‘takes the ouch out of grouch’?

Launched shortly before the stock market crash in 1929, Bib-Label Lithiated Lemon-Lime Soda proved a hit during the Depression. The soda appealed to a wide audience and recommended itself “for hospital or home use”. The drink’s name was later changed to 7-UP. During the Depression, 7-UP contained an ingredient which serves as our modern medical treatment for bipolar patients. Lithium. Lithium was listed on the 7-UP label until the 1940s. Today, lithium is the first line treatment for mania and bipolar depression.

From LSD to AA

Members of Alcoholics Anonymous (AA) are sometimes referred to as “friends of Bill”. So who was Bill?

Bill Wilson was the co-founder of AA. He died 36 years sober, pleading for whiskey on his death bed. Instead, it was another addiction that killed him, namely tobacco. A heavy smoker, Wilson suffered from emphysema and developed fatal pneumonia. He continued to smoke despite needing an oxygen tank in the late 1960s.

Given his addictions, it seems ironic that Wilson searched to cure his alcoholism with another drug. The origin story of AA is deeply rooted in Bill’s experience with LSD.

When LSD was discovered, the psychiatric community was very interested because LSD could make a normal person psychotic. That suggested a chemical basis for insanity, so if scientists could discover the chemical imbalance, they could cure schizophrenia.

Two Saskatchewan researchers, Abram Hoffer and Humphry Osmond experimented with LSD on alcoholics and schizophrenics. Hoffer, Osmond and their wives all consumed LSD as part of self-experimentation while treating their Canadian patients. Both these prairie psychiatrists have fascinating backstories.

Hoffer blamed schizophrenia on a substance in the body called adrenochrome. Although psychiatrists had long forgotten about Hoffer’s adrenochrome hypothesis of schizophrenia way back in 1950, Hollywood and QAnon conspiracies recently brought the word back into fashion and public awareness. The less said about such nonsense, the better.

Hoffer’s colleague, Humphry Osmond gave us the term “psychedelic”.

Whilst Hoffer and Osmond were experimenting with mescaline, a naturally occurring hallucinogen found in the peyote cactus, Osmond was approached by the famous poet and playwright Aldous Huxley. Huxley asked the Canadian psychiatrist for some mescaline. How would Osmond describe the experience of taking mescaline to Huxley? Osmond didn’t even have a word to describe mescaline’s effects.

Huxley sent Osmond a rhyme with an invented word: “To make this mundane world sublime, just half a gram of phanerothyme”. Osmond, not liking the sound of that, responded with, “To fall in Hell or soar Angelic, you’ll need a pinch of psychedelic”.

Huxley, himself, was eager to look to the drug cabinet to solve the world’s problems. In his dystopian novel, Brave New World, Huxley introduces a fictional cure-all drug called Soma which he described as having “All the advantages of Christianity and alcohol; none of their defects.”

Back to Humphry Osmond. During this time, one of Osmond’s patients was Bill Wilson, co-founder of AA.

Wilson used LSD in a medically supervised experiment. Under the influence of LSD, Bill claimed he experienced a spiritual awakening that allowed him to overcome his addiction to alcohol.

Bill’s spiritual interests went beyond the LSD epiphany because he believed that a 15th-century monk named Boniface and other spirits helped him write the Twelve Steps and Twelve Traditions, which detailed the basic principles of Alcoholics Anonymous. Wilson and his wife invited guests to their house to participate in seances using an Ouija board.

Whatever text Bill Wilson may have attributed to ghostwriters, it is clear his writing was influenced by two intellectual powerhouses: Carl Jung and William James. Bill Wilson strongly identified with some of the concepts these two men endorsed. Wilson wrote to Dr Carl Jung. He had also read “The Varieties of Religious Experience” by William James. Bill Wilson recognized how Carl Jung promoted religious conversion to deal with a drinking problem and how James had written that “the only cure for dipsomania is religiomania.”

Bill Wilson’s spiritual experience with LSD inspired the discovery of Alcoholics Anonymous and kept him sober for 36 years. However, at the end of his life, he asked for a whiskey. But the nurse never gave him one.

“Alcoholics Anonymous (AA) is an international fellowship of support groups comprised of individuals in recovery, which offers emotional support and a structured “12-step” approach to achieving abstinence. A central concept in AA is that substance use disorders are a spiritual disease, and that recovery is a journey involving belief in a higher power, personal exploration, and acceptance.”

A Malaria Prescription

Doctors used to prescribe malaria to treat syphilis. After observing that a high fever cured some patients of disease, doctors began to therapeutically inoculate patients with malaria parasites (known to cause high fever). Julius Wagner-Jauregg won the 1927 Nobel Prize in Medicine for demonstrating success in the treatment of dementia paralytica (caused by neurosyphilis) through inducing fever with malaria parasites. Unfortunately for patients, the mortality rate of malariotherapy was as high as 15%.

The ballet dancer and the beautiful mind

In the 1920s and 1930s, the world desperately needed some form of treatment for schizophrenia. At the time, psychiatric facilities served a simple custodial function where patients were incarcerated for lack of treatment options.

Against this desperate backdrop, a psychiatrist named Manfred Sakel worked with drug addicts in a Berlin hospital. While treating a famous diabetic actress, Sakel accidentally put her into a coma by administering too much insulin. Upon revival, the actress appeared to have less craving for opiates, so Sakel was encouraged to use insulin to treat withdrawal symptoms among his morphine addicts.

One such morphine addict also happened to be psychotic. Sakel gave him an overdose of insulin and, in another accidental finding, Sakel observed that the patient’s mental clarity seemed improved after recovering from the coma.

Dr Sakel began putting patients in deliberate comas instead of accidental ones. Sakel shared his techniques and research findings, reporting an 88% improvement rate for schizophrenics treated with insulin coma therapy. Sakel was now convinced he could “shock” the body out of schizophrenia. Insulin shock therapy (also known as deep insulin coma therapy) soon spread worldwide. Psychiatric textbooks described the treatment, and psychiatrists undertook training in the technique.

Patients would be put in daily comas before being revived using glucose antidotes after 30 minutes or longer. The daily treatment would continue for six weeks or more. Deeper comas were believed to yield better results. Some of the patients developed seizures, but many psychiatrists thought that convulsions demonstrated further proof of the effectiveness of the treatment.

It was a dangerous therapy, but the alternative was to be locked away in an asylum with little chance of recovery or rehabilitation. Insulin doses varied from person to person and from day to day. The depth of the coma also varied constantly. Even after revival, patients had to be continuously monitored for ‘aftershocks’ of hypoglycaemia. Patients would become obese, and some would develop brain damage. The death rate was estimated to be around 1%.

Famous names like the ballet dancer Vaslav Nijinsky, and John Nash (the Nobel Prize winner honoured in the movie ‘A Beautiful Mind’) underwent insulin coma therapy.

With the adoption of antipsychotic drugs in the 1960s, insulin coma therapy finally went out of fashion. The new drugs were safer, easier to administer, cheaper, more effective, and required less nursing supervision.

My favourite snack

Biltong is a South African national delicacy made from air-dried meat, prepared with vinegar and spices.

It was a valuable food source for the Afrikaans-speaking Boers fleeing from British rule during the Great Trek. Later, during the South African war, biltong helped Boer Commandos stay in the field with limited supplies.

This tasty snack is high in protein and low in carb content. It is also a rich source of iron, magnesium, potassium, and B vitamins. Unlike jerky, biltong is not cooked or smoked. Instead, it is simply soaked in a vinegar solution, which inhibits Clostridium botulinum bacteria, and spiced with salt, coriander, pepper, and cloves which all have antimicrobial properties.

The Thalidomide Scandal

Germany desperately needed antibiotics in the aftermath of World War II, but the Western Allies had crippled her key industries with their “industrial disarmament” policy. As the industrial dismantling ended, a German pharmaceutical company, Grünenthal, emerged to produce penicillin and experimented to find new antibiotics.

Grünenthal was a haven for ex-Nazi scientists, the most infamous being Otto Ambros, an inventor of sarin (the nerve gas). Ambros, who had been found guilty at Nuremberg of mass murder, served a short stint in prison before becoming the chairman of Grünenthal’s advisory committee.

Another ex-Nazi scientist, Heinrich Mückter, was Grünenthal’s chief scientist and head of research. Mückter, who had carried out medical experiments on concentration camp prisoners in Auschwitz and Buchenwald, discovered a new molecule called thalidomide.

Although thalidomide lacked antibiotic and antiviral properties, it excelled at calming animals. Recognizing an opportunity to flood the market with a safe tranquillizer, Grünenthal gave out free samples across Germany. In 1957, the company marketed thalidomide as the first over-the-counter sedative. Word and sales soon spread to the U.K. and the rest of the world.

Pregnant women visiting their doctors took thalidomide for morning sickness.

But, in the 1960s, it became clear that thalidomide caused severe birth defects. Thalidomide was a teratogen, meaning it malformed the human foetus. It specifically caused phocomelia (malformed arms and legs).

By the time the effects of thalidomide were studied on animals and the consequences on human fetuses became known, it was already on the market. Over 10 000 children between 1957 and 1962 were affected.

Further tragedy was averted because Frances Kelsey, a Canadian-American reviewer for the FDA, refused to authorize thalidomide for the U.S. market. Her reservations about the drug’s safety spared many North American patients.

All drugs have effects: some good, some bad. So what could scientists learn from thalidomide? Could it be put to other uses? They wondered: If thalidomide is toxic to growing tissue, can it be helpful as an anti-cancer drug?

The answer to their question provides an excellent example of medical science repurposing drugs. Thalidomide — and medicines derived from it— has inspired new cancer treatments.

Today, thalidomide is used to treat a cancer of white blood cells called multiple myeloma. It is also still prescribed for leprosy.