【Neil Bradbury: A Taste for Poison |毒药的味道】
2022-08-10
A Taste for Poison |毒药的味道
by Neil Bradbury
Insulin and Mrs. Barlow’s Bathtub | 胰岛素
Atropine and Alexandra’s Tonic ｜ 阿托品
Insulin and Mrs. Barlow’s Bathtub | 胰岛素
- What was the price of insulin’s patent? | 胰岛素的专利卖了多少钱？
One Canadian dollar. | 一加元。
Insulin was discovered by Frederick Banting and Charles Best, but its first production also involved James Collip and John Macleod. Unfortunately the amazing story of insulin’s discovery was marred by scientific jealousy, intense business competition, and even fistfights in the laboratory. Despite all four scientists being involved in testing insulin, only Banting and Macleod were given the Nobel Prize for insulin’s discovery. Banting and Collip sold the patent for insulin to the University of Toronto for one Canadian dollar.
- Insulin shock therapy and “A Beautiful Mind” | 胰岛素休克疗法和《美丽心灵》
“When the patients were injected with insulin, it caused a dramatic drop in their blood glucose levels, depriving the brain of an essential component for normal physiological function. The patients began to sweat profusely, requiring repeated baths to wash away the sweat. As glucose levels fell further, patients became increasingly restless, followed by major convulsions that ended only when they entered into a coma, at which point the patients all had fixed, widely dilated pupils.”
“Although the symptoms of schizophrenia, including delusions, hallucinations, agitation, and inappropriate reactions, seemed to abate after insulin shock, no one knew whether the effect was due to the insulin itself or to the coma induced by the insulin.”
“Nobel Prize–winner and mathematician John Nash, who won the Nobel Prize for Economics in 1994, suffered from schizophrenia, and was subjected to insulin shock therapy to treat his illness. His life story, and his insulin therapy, were portrayed in the 2001 movie A Beautiful Mind.”
当时人们认为，给人注射大量胰岛素，让他/她们昏迷和休克，可以用来治疗精神疾病。诺贝尔奖获得者、数学家纳什就是该疗法的体验者之一。2001年的电影《美丽心灵》讲述了他的人生故事以及胰岛素疗法。
- Controversies in science community | 科学界关于胰岛素休克疗法的“撕”
In 1953 Dr. Harold Bourne, an experienced British psychiatrist, published a paper titled “The Insulin Myth,” arguing that there was no sound scientific basis for the validity of insulin coma therapy. He maintained that the initial psychiatric diagnoses were most likely flawed and based on unreliable and questionable tests. Bourne also claimed that the results of insulin coma therapy were biased by selecting particular patients and ignoring others. More alarmingly, it became apparent that no two hospitals were performing the coma therapy in the same way, with some clinics inducing a coma for one hour and others for an astounding four hours.
The immediate response to Bourne’s concerns was not a “thank you for showing us where we’ve gone wrong,” but rather a wave of condemnation from the medical community. Leading psychiatrists sent letters to medical journals criticizing Bourne, with one stating: “it is clinical experience that counts here, despite all [evidence] to the contrary.” It would be another five years before a carefully controlled study on insulin coma therapy would be published, a study that clearly showed, beyond any doubt, that insulin coma therapy was a sham.
1953年，经验丰富的英国精神病学家哈罗德-伯恩（Harold Bourne）博士发表了一篇题为《胰岛素的神话》的论文，认为胰岛素休克疗法的有效性没有合理的科学依据。医学界什么反应呢？一片谴责。其中一位指出： “尽管所有的[证据]都是相反的，但临床经验在这里才是最重要的。”
又过了五年，一项关于胰岛素休克疗法的精心设计严格实验的研究才得以发表，这项研究明确表明，胰岛素休克疗法是一个骗局。
- Uxoricide: husband killing wife | 胰岛素杀妻案
1957, England, Bradford. Kenneth Barlow used insulin to kill his wife Elizabeth Barlow.
Kenneth, a nurse, claimed to have given his wife Elizabeth an injection of ergometrine (a drug used in obstetrics to prevent heavy bleeding after childbirth by causing uterine contractions and also to induce abortions) with her informed consent, yet what was actually injected into her body was a lethal dose of insulin.
Elizabeth’s symptoms are the same as those of insulin shock: exhaustion, weakness, vomiting, profuse sweating, dilated pupils. She went to take a bath in the bathtub to feel better, only to fall into a coma and drown, or, after passing out, being pushed into the water by her husband.
身为护士的Kenneth声称在妻子Elizabeth知情同意的情况下，给她注射了麦角新碱（ergometrine，一种在产科使用的药物，通过引起子宫收缩来防止产后大出血，也可用于诱导堕胎），然而，真正注射到她体内的，却是致死剂量的胰岛素。
Elizabeth的症状和胰岛素休克的症状一样：疲惫，虚弱，燥热，呕吐，大汗淋漓，瞳孔散大，为了感觉好一点她去浴缸洗澡，结果却陷入昏迷，溺水而亡，或者，在昏迷后被丈夫推入水中而溺死。
“After a grueling five-day trial, the presiding judge instructed the jury that there was only one crime of which Kenneth Barlow could be convicted: “This is murder or nothing,” he told them. “If you are satisfied that he injected insulin into his wife, and knowingly injected it, you will probably find no difficulty in reaching the decision that he did so with intent to kill.” The jury took eighty-five minutes to find Barlow guilty. Sentencing him to life imprisonment, the judge described Barlow as “a cold, cruel premeditated murderer who, but for a high degree of detective ability, would not have been found out.” (The jury was also excused from further service for ten years, because they had listened to “a long and harrowing case.”)”
对Kenneth Barlow的案件审理长达五天。最后做出了有罪判决。该案的陪审团随后被免除了十年的服务，因为他们听了 “一个漫长而痛苦的案件”。
Kenneth Barlow的第一任妻子Nancy也死得很蹊跷，他们结婚十二年，在1956年突然“发病”，不到十二个小时就趋势了。在葬礼前曾有匿名电话打给警察让他们对Nancy进行尸检，但没有发现什么，只是脑部有轻微水肿。第一任妻子葬礼后两个月他就和第二任妻子Elizabeth结婚了，而她活了不到一年。
- Pharmaceutical insulin | 人造胰岛素
Although commercial insulin acts in the same way as the body’s natural insulin, small tweaks in the sequence of amino acids making up pharmaceutical insulin (to make it faster- or slower-acting) allow for easy confirmation that any excess insulin in a murder victim got there by nefarious means. In fact, murder by insulin poisoning is quite rare, with fewer than seventy documented cases worldwide, the vast majority occurring in the UK and the United States.
为Kenneth Barlow辩护的律师提出来的一个论点是，后来在Elizabeth体内检测到的大量胰岛素不是外来注射的，而是身体自己产生的。当然这很荒谬，我们的身体在正常条件下不会不受控制产生致死剂量的胰岛素。现在人造胰岛素的氨基酸序列和自然产生的胰岛素并不完全一样，所以如果再有辩护律师用这个理由，就可以轻易反驳了。不过，胰岛素下毒案比较少见，世界范围内有记录的不到七十例。
Atropine and Alexandra’s Tonic ｜ 阿托品
- Daredevil tomato eater ｜ 第一个吃番茄的勇士
“Members of the Solanaceae plant family, including such familiar foods as potatoes, eggplants (aubergines), chili peppers, and tomatoes, are eaten daily in homes across the country. Yet despite their regular appearance on present-day dinner tables, Solanaceae plants were initially treated with concern and suspicion. Tomatoes, brought to Europe from the New World by sixteenth-century Spanish conquistadores, saw merchants struggling to peddle this new fruit to consumers, who were convinced it would kill them. To combat this tomato phobia, vendors often employed people to eat tomatoes next to their stalls, giving what amounted to some of the earliest consumer reviews of products. The widespread use of tomatoes in cooking today is a clear testament to those early daring customers.”
茄科植物，比如土豆、茄子、辣椒和西红柿等，如今经常出现在餐桌上，但茄科植物最初作为食物却备受质疑。西红柿是由16世纪的西班牙征服者从新世界带到欧洲的，商人们努力向消费者兜售这种新水果，但消费者却不买账，认为这种水果会杀死他们。为了消除这种番茄恐惧症，商贩们经常雇人在他们的摊位旁边吃番茄。
- Deadly nightshade | 颠茄
“Among these is Atropa belladonna, an attractive plant with violet flowers that yield small shiny berries displaying a deep purple or black hue. A single berry incorporated into food or drink contains enough poison to cause death. Although the plant’s Latin name hints at its toxicity, its common name, deadly nightshade, leaves no doubt regarding its lethal qualities.”
人们害怕茄科植物，也并非意外。有的茄科植物看起来和番茄土豆差不多，但是却是致命的，比如颠茄，又名deadly nightshade.
- Atropos: the Fate who cut the thread of life | 剪断生命之线的命运之神
“In Greek mythology, when a newborn was three days old, three Fates would visit it to determine its destiny. Clotho (the Spinner), the youngest of the Fates, spun the thread of life from dark and light fibers. Lachesis (the Apportioner) determined the length of the thread of life, and Atropos (the Inevitable) held the shears to cut the thread of life, sealing the length of the person’s life. Little wonder, then, that Atropos lent her name to belladonna’s most lethal component, atropine.”
在希腊神话中，当一个新生儿出生三天后，三位命运之神会来拜访它，以决定它的命运。命运之神中最年轻的Clotho (the Spinner）用深色和浅色纤维纺出了生命之线。Lachesis (the Apportioner)决定生命之线的长度，而Atropos (the Inevitable)手持剪子剪断生命之线。 颠茄最致命的成分——阿托品——的名字由此而来。
- Atropine | 阿托品
“Atropine, when pure, is a white odorless crystalline powder, first purified from Atropa belladonna berries and leaves in 1833 by the German chemist Philipp Lounz Geiger and his Swiss student Germain Henri Hess”.
阿托品是一种白色无味的结晶性粉末，1833年由德国化学家Philipp Lounz Geiger和他的瑞士学生Germain Henri Hess从颠茄的浆果和叶子中提纯出来。阿托品溶于水后很苦。颠茄果实也一样。
- Mona Lisa’s eyes | 蒙娜丽莎的眼睛
颠茄的拉丁文名 belladonna 来源意大利语，意为美丽的女士。
Venetian actresses and courtesans would squeeze a drop of juice from a belladonna berry into their eyes to dilate their pupils and achieve a fashionably alluring appearance. It is alleged that part of the attraction of Da Vinci’s Mona Lisa is due to the belladonna-induced dilation of the Mona Lisa’s eyes.
威尼斯的女演员和宫女会将颠茄果实的一滴汁液挤入眼睛，以扩大瞳孔，达到诱人的效果。据称，达芬奇的《蒙娜丽莎》的部分吸引力是由于颠茄引起的蒙娜丽莎眼睛的扩张。
Dilation of the pupil should permit more light into the eye to see clearly, but the atropine in belladonna also has the effect of relaxing the muscles controlling the lens, so that courtesans really couldn’t see who they were flirting with. Prolonged use of belladonna is also likely to lead to blindness. Although belladonna berries are no longer used to dilate pupils for romance, the same premise is still employed by restaurants that use dim lights and candles on the tables, causing the pupils to dilate spontaneously and allow more light into the eye.
瞳孔的扩大允许更多的光线进入眼睛，以便看清楚，但颠茄中的阿托品也有放松控制晶状体的肌肉的作用，所以女士们其实看不到她们在和谁调情。长期使用颠茄素也可能导致失明。
- Soup and sparks | 汤和火花
Based on careful examination of hundreds of brain slices, Cajal proposed his neuron doctrine, in which he concluded that the nervous system was not one gigantic mesh, but was in fact composed of many individual nerve cells, and that between each nerve cell was a tiny gap called a synapse.
The primary question at the turn of the twentieth century was how information crossed that gap. Always up for a good argument, scientists divided themselves into two camps. There were those who believed pulses of chemicals were sent across the gap—adherents of this position calling themselves “soups”—whereas those who believed that a jolt of electricity spanned the gap were self-styled “sparks.” Not even political meetings can attain the acrimony and bitterness of two groups of scientists, each convinced of the merits of their position, and the lack of any credibility in their opponents’ platform. Indeed, this scientific feud would shape neuroscience for the next fifty years.
基于对数百个大脑切片的仔细检查，Cajal提出了他的神经元学说，他认为神经系统不是一个巨大的网状结构，而实际上是由许多单独的神经细胞组成的，每个神经细胞之间有一个微小的间隙，称为突触。
二十世纪之交的主要问题是:信息如何穿过这个间隙。科学家们总是喜欢争论，有一些人认为化学物质的脉冲被送过这个间隙，这一立场的支持者称自己为 “汤”；而那些认为是电的冲击跨越这个间隙的人则自称是 “火花”。即使是政治会议也无法比拟两组科学家争论的尖锐和激烈，每组科学家都坚持自己的立场，而坚信他们的对手缺乏任何可信度。事实上，这场科学上的争斗将在接下来的50年里塑造神经科学。
Intrigued by the sparks-and-soups debate, a young German scientist, Otto von Loewi, brashly decided that he would solve the riddle. If you were to look up “absentminded professor” on the internet, you might find a picture of Loewi. Even as a student, he often neglected his biology classes, favoring trips to the opera or philosophy lectures instead.
to be cont.