We have been deconstructing the Androgen Deficiency in Aging Males (ADAM) syndrome and its associated questionnaire developed by Morley et al (2000). Morley and his colleagues reference Charles-Édouard Brown-Séquard three times in their study. Given the importance of Brown-Séquard in the development of the ADAM questionnaire, it might be helpful to briefly review Brown-Séquard and his work.
Charles-Édouard Brown-Séquard was a 19th century neurologist and pioneer in the field of endocrinology. In 1889, and at the age of 72, Brown-Séquard described the effects of injecting himself with a series of extracts of crushed guinea pig and dog testicles. Brown-Séquard found that these injections had a rejuvenating effect on himself and he reported greater energy, strength, and stamina as a result. He also noted improved urination and more satisfying bowel movements.
To Brown-Séquard’s credit, he did consider the possibility that his reaction to his injections might be a form of wish fulfillment and not due to any active ingredient found in his elixir. However, he did, ultimately, reject this possibility. In his own words:
- My first communication to the Paris Biological Society was made with the wish that other medical men advanced in life would make on themselves experiments similar to mine, so as to ascertain, as I then stated, if the effects I had observed depended or not on any special idiosyncrasy or on a kind of auto-suggestion without hypnotisation, due to the conviction which I had before experimenting that I should surely obtain a great part at least of these effects. This last supposition found some ground in many of the facts contained in the valuable and learned work of Dr. Hack Tuke on the ” Influence of the Mind over the Body.” Ready as I was to make on my own person experiments which, if they were not dangerous, were at least exceedingly painful, I refused absolutely to yield to the wishes of many people anxious to obtain the effects I had observed on myself. But, without asking my advice, Dr. Variot, a. physician who believed that the subcutaneous injections of considerably diluted spermatic fluid could do no harm, was made a trial of that method on three old men-one fifty-four, another fifty-six, and the third sixty-eight years old. On each of them the effects have been found to be very nearly the same as those I have obtained on myself. Dr. Variot made use of the testicles of rabbits and guinea-pigs.
- These facts clearly show that it was not to a peculiar idiosyncrasy of mine that the effects I have pointed out were due. As regards the explanation of those effects by an auto-suggestion, it is hardly possible to accept it in the case of the patients treated by Dr. Variot. They had no idea of what was being done; they knew nothing of my experiments, and were only told that they were receiving fortifying injections. To find out if this qualification had anything to do with the effects produced, Dr. Variot, since the publication of his paper, has employed similar words of encouragement, whilst making subcutaneous injections of pure water on two other patients, who obtained thereby no strengthening effect whatever.
- I believe that, after the results of Dr. Variot’s trials, it is hardly possible to explain the effects I have observed on myself otherwise than by admitting that the liquid injected possesses the power of increasing the strength of many parts of the human organism. I need hardly say that those effects cannot have been due to structural changes, and that they resulted only from nutritive modifications, perhaps in a very great measure from purely dynamical influences exerted by some of the principles contained in the injected fluid. (p. 106)
Following Brown-Séquard, from the 1890s to the 1920s, there was an explosion of therapies and treatments intended to bolster male vigor based for on many forms of injectable and implantable human and animal fluids and tissues. However, Organotherapy, as it was then called, eventually fell into disfavor.
Similarly, given the weak concentration of Brown-Séquard’s serum, it is currently felt that any improvement noted by Brown-Séquard was mostly likely due to a placebo response. That is, the active ingredient in Brown-Séquard’s elixir was Brown-Séquard’s belief in his elixir.
Of the two contemporaries, it was Tuke, and not Brown-Séquard, who was prescient.
- Cussons, A. J., Bhagat, C. I., Fletcher, S. J., & Walsh, J. P. (2002). Brown-Séquard revisited: A lesson from history on the placebo effect. Medical Journal of Australia, 177, 678-679.
- Brown-Séquard, C. E. (1889). Note on the effects produced on man by subcutaneous injections of a liquid obtained from the testicles of animals. Lancet, 2, 105-107.
- Tuke, D. H. (1873). Illustrations of the influence of the mind upon the body in health and disease. London: J. & A. Churchill.