Happy Birthday Carl Koller!
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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.
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. 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!
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.
