L'auto-expérimentation athlétique du docteur Fernand Lagrange (1880-1900).

This article examines the efforts of Dr. Fernand Lagrange to establish the study of the physiology of exercise on a scientific basis. As a sports enthusiast and physician, Lagrande was inspired by the efforts of Claude Bernard and Étienne-Jules Marey to use his own body as a source of experimentation and methodical observation. Lagrande's self-experimentation pioneered the physiology of exercise, but his primary goal was to improve human health by demonstrating the benefits that could be derived from regular physical exercise. His observations of other human subjects, be they farmers, schoolchildren, students, or sportsmen, were always driven by the "moral motivation" for his new science to realize a more perfect knowledge of its object.

Cet article a pour but de dévoiler l'origine des travaux de Fernand Lagrange et la méthodologie qu'il a mise en place, à une époque où la physiologie des exercices corporels n'en était qu'à ses balbutiements. Il en ressort que ce docteur sportsman a éprouvé personnellement les choses avant de les éclairer scientifiquement. Dans la veine impulsée par Claude Bernard ou Étienne-Jules Marey, il a pratiqué ce que l'on est en droit d'appeler une auto-expérimentation athlétique. Précurseur incontestable et incontesté de la physiologie des exercices du corps, son objectif premier fut d'améliorer la santé de l'être humain en démontrant tous les bénéfices que ce dernier pouvait tirer d'une pratique physique régulière. Il a toujours porté un regard sur les autres, qu'ils soient paysans, écoliers, étudiants ou sportifs, avec une « motivation morale ¼, et ce en vue de fonder son intervention avec une parfaite connaissance de son objet.

Self-Experiments with Psychoactive Substances: A Historical Perspective.

The purpose of this chapter is to highlight the rich tradition of self-experiments (SEs) with psychoactive substances carried out by scientists and therapists for more than a century. Scientifically inspired controlled SEs dominated until the end of the twentieth century, when ethical requirements minimized controlled SEs and "wild" SEs expanded particularly with the emergence of new psychoactive substances. The review focuses on laughing gas (nitrous oxide), cannabis, cocaine, hallucinogens, entactogens, and dissociative hallucinogens. This is due to the fact that substances that induce "complex" effects such as alteration of space/time experience, ego dissolution, and increased feelings and insights (e.g., hallucinogens, entactogens) represent by far the majority of SEs, whereas SEs with substances inducing "simple" effects such as euphoria, anxiolysis, dissociation, or emotional blunting (e.g., cocaine, opioids) are much rarer or even absent (e.g., benzodiazepines). Complex drug effects are much harder to describe, thus allowing SEs to fulfill a more important function.SEs with psychoactive drugs appeared to emerge in the mid-eighteenth century, which triggered a long-standing tradition throughout the nineteenth and early twentieth century. SEs have been de facto performed for a variety of reasons, ranging from establishing scientific knowledge and gaining philosophical insights to compensating for personal deficits. Self-experimenters can be divided into two general types. Besides their scientific intentions, "exploratory" self-experimenters intend to expand awareness and insight, whereas "compensatory" self-experimenters might aim for coping with psychiatric symptoms or personality deficits. Scientific limitations of SEs are obvious when compared to double-blind, randomized, placebo-controlled trials. Whereas the former might lead to more "realistic" detailed description of subjective effects, the latter lead to more solid results in respect to objectively measurable "average" effects. Possible adverse effects of SEs were identified that resulted in loss of scientific objectivity and decreased control over substance use and addiction, development of isolation, problematic group dynamics, and "social autism."

Opening (and Swallowing) A Can of Worms to Treat My Crohn's Disease.

Editor's Note: This article discusses the experience, ingenuity, and determination of Sean Ahrens, a young patient with Crohn's disease who took it upon himself to treat his longstanding, symptomatic Crohn's disease with pig whipworm eggs. Reading this story will make some of you uncomfortable. You might question whether this work belongs in a medical journal or sends the wrong message to readers. However, we recognize that this topic is controversial and that N=1 reports cannot and should not change practice. The purpose of this story is not to encourage the use of pig whipworm or to demonstrate its efficacy (or lack thereof). We firmly believe that patients are uniquely qualified to provide insights into how they view their illnesses, weigh risks and benefits, and ultimately achieve self-efficacy. Stories like this are important for us to acknowledge and understand, even if they do not change our practice.

The practices of do-it-yourself brain stimulation: implications for ethical considerations and regulatory proposals.

Scientists and neuroethicists have recently drawn attention to the ethical and regulatory issues surrounding the do-it-yourself (DIY) brain stimulation community, which comprises individuals stimulating their own brains with transcranial direct current stimulation (tDCS) for self-improvement. However, to date, existing regulatory proposals and ethical discussions have been put forth without engaging those involved in the DIY tDCS community or attempting to understand the nature of their practices. I argue that to better contend with the growing ethical and safety concerns surrounding DIY tDCS, we need to understand the practices of the community. This study presents the results of a preliminary inquiry into the DIY tDCS community, with a focus on knowledge that is formed, shared and appropriated within it. I show that when making or acquiring a device, DIYers (as some members call themselves) produce a body of knowledge that is completely separate from that of the scientific community, and share it via online forums, blogs, videos and personal communications. However, when applying tDCS, DIYers draw heavily on existing scientific knowledge, posting links to academic journal articles and scientific resources and adopting the standardised electrode placement system used by scientists. Some DIYers co-opt scientific knowledge and modify it by creating their own manuals and guides based on published papers. Finally, I explore how DIYers cope with the methodological limitations inherent in self-experimentation. I conclude by discussing how a deeper understanding of the practices of DIY tDCS has important regulatory and ethical implications.

Nasal Foreign Bodies: A Sweet Experiment.

INTRODUCTION: It is generally accepted that paediatric intranasal foreign bodies should be removed in the emergency setting. In the case of a difficult to access dissolvable foreign body in an uncooperative child, the question must be raised regarding whether or not a watch and wait strategy is more appropriate. We ask: How long does it take for popular sweets (candy) to dissolve in the human nose? METHODS: Five popular UK sweets were placed in the right nasal cavity of a 29-year-old male (the author) with no sino-nasal disease. Time taken to dissolve was recorded. RESULTS: All five sweets were completely dissolved in under one hour. DISCUSSION: A watch and wait strategy in favour of examination under anaesthetic may be a viable option in some cases. Limitations of the study include the age of the participant and size of the sweets. It is also important in practice that the clinician is able to elicit an accurate history regarding the exact nature of the foreign body. CONCLUSION: It remains prudent to perform an examination under anaesthetic of an uncooperative child with a solid or unknown nasal foreign body. However, if the clinician can be certain the foreign body is a small sugar or chocolate based sweet only, a watch and wait strategy may be a reasonable choice.

"They Sweat for Science": The Harvard Fatigue Laboratory and Self-Experimentation in American Exercise Physiology.

In many scientific fields, the practice of self-experimentation waned over the course of the twentieth century. For exercise physiologists working today, however, the practice of self-experimentation is alive and well. This paper considers the role of the Harvard Fatigue Laboratory and its scientific director, D. Bruce Dill, in legitimizing the practice of self-experimentation in exercise physiology. Descriptions of self-experimentation are drawn from papers published by members of the Harvard Fatigue Lab. Attention is paid to the ethical and practical justifications for self-experimentation in both the lab and the field. Born out of the practical, immediate demands of fatigue protocols, self-experimentation performed the long-term, epistemological function of uniting physiological data across time and space, enabling researchers to contribute to a general human biology program.

Self-awakening improves alertness in the morning and during the day after partial sleep deprivation.

The ability to awaken at a predetermined time without an alarm is known as self-awakening. Self-awakening improves morning alertness by eliminating sleep inertia; however, the effects of self-awakening on daytime alertness and alertness that has deteriorated as a result of sleep loss are unknown. The aim of this study was to determine the effects of self-awakening on both morning and daytime alertness after partial sleep deprivation. Fifteen healthy males without the habit of self-awakening participated in a cross-over trial including forced awakening and self-awakening conditions. In each condition, participants' sleep was restricted to 5 h per night in their homes for 4 consecutive days. They completed a psychomotor vigilance task and subjective ratings of sleepiness immediately upon awakening each morning. On the fourth day, participants completed subjective ratings of sleepiness, a psychomotor vigilance task and sleep latency tests in the laboratory seven times at 1-h intervals during the day. The response speed on the psychomotor vigilance task, in the morning and during the day, was higher in the self-awakening than the forced awakening condition. Our results showed that self-awakening improved alertness (assessed by response speeds) by reducing sleep inertia and alleviated daytime sleepiness heightened by partial sleep deprivation.

Personal knowledge and study participation.

Scientists in earlier times considered personal research participation an essential component of their work.Exposing themselves to untested interventions was seen as the most ethical way to gauge the human response to those interventions. The practice was also educational, for it generated useful information that helped researchers plan subsequent human studies.Self-experimentation was eventually replaced by more comprehensive ethical codes governing human research.But it is time to bring back the practice of self-experimentation, albeit in modified form. Through serving as a study subject, investigators and other research professionals can obtain valuable information about their work.

Self-experimentations with psychedelics among mental health professionals: LSD in the former Czechoslovakia.

This article enquires into auto-experiments with psychedelics. It is focused on the experiences and current attitudes of mental health professionals who experimented with LSD in the era of legal research of this substance in the former Czechoslovakia. The objective of the follow-up study presented was to assess respondents' long-term views on their LSD experience(s). A secondary objective was to capture the attitude of the respondents toward the use of psychedelics within the mental health field. A total of 22 individuals participated in structured interviews. None of the respondents reported any long-term negative effect and all of them except two recorded enrichment in the sphere of self-awareness and/or understanding to those with mental disorder(s). Although there were controversies with regard to the ability of preventing possible negative consequences, respondents were supportive towards self-experiments with LSD in mental health sciences. This article is the first systematic examination of the self-experimentation with psychedelics that took place east of the Iron Curtain.

The persistence of the subjective in neuropsychopharmacology: observations of contemporary hallucinogen research.

The elimination of subjectivity through brain research and the replacement of so-called "folk psychology" by a neuroscientifically enlightened worldview and self-conception has been both hoped for and feared. But this cultural revolution is still pending. Based on nine months of fieldwork on the revival of hallucinogen research since the "Decade of the Brain," this paper examines how subjective experience appears as epistemic object and practical problem in a psychopharmacological laboratory. In the quest for neural correlates of (drug-induced altered states of) consciousness, introspective accounts of test subjects play a crucial role in neuroimaging studies. Firsthand knowledge of the drugs' flamboyant effects provides researchers with a personal knowledge not communicated in scientific publications, but key to the conduct of their experiments. In many cases, the "psychedelic experience" draws scientists into the field and continues to inspire their self-image and way of life. By exploring these domains the paper points to a persistence of the subjective in contemporary neuropsychopharmacology.

The pain of weight gain: self-experimentation with overfeeding.

The Vermont overfeeding studies were published 50 y ago and began a change in the acceptance of obesity as a bona fide area of academic interest. This article chronicles the experience of the author with acute weight gain while overfeeding, in the context of current obesity research, and presents a glimpse of things to come. The pain associated with acute overeating is illustrated by the firsthand experience of the author. The rapid return to normal weight contrasts with the difficulty that almost all people with obesity experience when they attempt to lose and maintain weight loss. Contrasting the response to overfeeding of individuals who are "resistant" to obesity with those who are obesity prone provides an avenue for unraveling the difficulties people with obesity face when they try to lose weight.

Current Day Auto-Experimentation of Psychotropic Medications by French Psychiatrists.

Auto-experimentation is a relatively unknown practice, albeit central to the history of medical discoveries. Outside of the context of research, auto-experimentation with psychotropic medications by psychiatrists currently persists in an informal manner. However, this contemporary practice has never been studied so far. This study was conducted by distributing an electronic questionnaire to French hospital-based psychiatrists and residents of psychiatry in the summer of 2016. Lifetime prevalence of taking psychotropic medications and the context of this ingestion were questioned: "therapeutic", "auto-therapeutic", "research protocol", "auto-experimentation/curiosity", "recreation" or "other". We only studied "auto-experimentation/curiosity" in this article. Participants were also asked their age and gender. Seven hundred and sixty-four participants were included. 15.1% of participants declared having already taken psychotropic medication at least once in the context of "auto-experimentation/curiosity". We found that those who reported taking medication for "auto-experimentation/curiosity" had a significant association with being male (p < .001) but no relationship to age. This practice highlights and questions psychiatry's relationship with formal and informal knowledge, the importance of the subjectivity of each professional in psychiatry and the epistemological foundations of our discipline. The strong ambivalence of the medical field toward this relatively taboo practice deserves further exploration.