Follow the £.S.D.
Follow the £.S.D.
Dr Joel Elkes and early LSD funding in Britain
There is a slight mystery at the very beginning of the LSD therapy story in Britain. From 1952, the most renowned researcher, Dr Ronald Sandison, spent two years investigating LSD in the main Powick Hospital building in Worcestershire. He then applied to the Birmingham Regional Hospital Board for funding to establish a dedicated, purpose-built LSD unit for treating patients. He was granted £50,000 (equivalent to over £1.15 million today), and it opened in 1956.
According to historian Andy Roberts, both the speed at which the unit was granted funding and rapidly built—especially considering its high cost—raises certain speculative questions.1 As Harry Shapiro asks, ‘Did the local authority hospital board really have that amount of money to spend on a project like this? Who else had an interest in seeing a special unit built away from the public gaze?’2 The suggestion made by both historians is that it was related to the dark money and interests of the military or secret services.
Aside from the economic question of funneling so much money into a basically novel substance, a potential military connection is suggested by the role played by Dr Joel Elkes. Elkes, a psychiatrist also investigating LSD, led the Department of Experimental Psychiatry at the University of Birmingham. He and Sandison became friends after Elkes attended an LSD lecture by him, and Elkes was instrumental in Sandison’s LSD unit proposal, giving ‘every possible help’.3
What Sandison did not then know about was Elkes’ relationship with the War Office (later renamed the Ministry of Defence), advising them on LSD, while they conducted their own clandestine experiments. It is curious, as Roberts notes, that Elkes wrote in the Lancet in 1955 about the dangers of using the drug with out-patients, yet shortly afterwards apparently u-turned by promoting Sandison’s LSD unit. Was this a personal reconsideration or a wider conspiracy at work?
Shapiro even goes slightly further and suggests that the US military may have contributed to the unit in order to observe LSD psychotherapy at close quarters.4 Leaving this aside for the moment, the mystery is about the potential relationship between the military and public health. Did the military or secret service have a hand, financial or otherwise, in establishing early LSD therapy research in Britain? And, by extension, was there any ongoing relationship?
Without evidence of a smoking gun—which may or may not exist in many still highly classified documents—there are certain other questions we can ask, and answers we can proffer, in an attempt to shed light on this situation. Could Britain afford and build such a unit? Was it economically viable? If it was possible, and advantageous, we don’t necessarily need a military conspiracy to explain the LSD unit’s existence.
Britain’s National Health Service was promised by the wartime coalition government in 1944, and founded in 1948. Hospitals, both voluntary and municipal, were nationalized, although it remained some way short of a fully socialized service; consultants, for instance, could retain a private practice; the pharmaceutical industry was not nationalized. Overall, however, especially in regard to expenditure, the British state had something akin to a public health monopoly.5
In a scene all too familiar for anybody who has observed the British state’s capacity for undertaking large projects since WW2, the budget for the NHS in 1951/52 was over twice as large as originally estimated in 1945—a figure made even more significant by poor postwar productivity and the cost of rearmament amidst the Korean war and ongoing cold war tensions. The Atlee Labour government’s ‘New Jerusalem’ experiment, as Correlli Barnett called it, proved unwieldy from the outset.6
First Labour, and then the Tories when they were elected on the eve of 1952, tried to limit expenditure—reducing the service in regard to dental care for example. These cuts proved fruitless, as the budget and expenses continued ballooning anyway. It would seem odd, therefore, that any Regional Hospital Boards would be sanctioning expensive and unproved medical research in light of the fiscally-restricted world of public health.
One might answer this by saying that it was precisely this type of spending that blew the budget every year for the NHS. However, it would appear that such research units were in fact attempts to reduce long-term spending. In order to explain this, let’s turn to the story of Joel Elkes and the Experimental Psychiatry Department.
Elkes & Experimental Psychiatry
A Jewish émigré from Eastern Europe, Dr Joel Elkes moved to Britain in 1931, eventually following his mentor Alistair Frazer to Birmingham University, where the latter was appointed Professor of Pharmacology. Shortly after, two official-looking men came to see Frazer, and Elkes, still regarded as an alien and on curfew at the outbreak of WW2, feared he was being deported. Instead, Fraser told him, ‘They’d like you to work in the chemical defence experimental establishment on anti-cholinesterases, the gasses, atropine-like substances and so on’ at Porton Down; the British chemical weapons research facility.
The extent to which Elkes continued working with, or advising, the War Office after WW2 is unclear. At Birmingham, Elkes and his colleagues worked on a programme broadly titled, ‘Drugs and the Mind’, in the late 1940s. It was during this time that Elkes became increasingly interested in psychiatry, and the idea for an Experimental Psychiatry Department (EPD) was first mooted. In 1950, he received several fellowships and was granted leave to study in America at various institutions for a year. He did not, however, see the full year through.
A telegram arrived while Elkes was there informing him that the EPD at Birmingham had been granted the go-ahead, and inviting him to take on the Directorship. He swiftly accepted and shortly after returned to the Midlands.7 The EPD was officially set up in 1951 with the aim of developing and applying experimental methods to problems in clinical psychiatry. Elkes remained the director until relocating to the United States in 1957. During that time the EPD conducted Britain’s first trial with Chlorpromazine, and early LSD experiments.
The department concentrated on laboratory work investigating the physiology and chemistry of the brain, this included examining the structure of neural tissue, the enzyme system, and electrical activity in the brain. In a short article from 1953, Elkes says the aim of the EPD was to therapeutically apply its research in an ‘economic and efficient’ manner. This is hardly the wild spending criteria one might expect from a budget running out of control but, I would argue, it does speak to the aforementioned financial situation that the NHS found itself in.8
Practically speaking, the Regional Health Board was responding to widespread and long-term mental health problems in postwar Britain, which an NHS already stretched by the poor physical health of the population was having to deal with. Of nearly 400,000 hospital beds, for instance, 147,000 were taken up with those suffering from mental health conditions.9 Every Board in the country was attached to a hospital for training and research in medicine, Birmingham’s was obviously the same-named university, and they were used to develop/trial novel processes to address such systemic and long-term issues.
Along with the laboratory, therefore, the EPD team also set-up the Uffculme Clinic in the Cadbury Mansion in Birmingham. The Uffculme was designed as an early treatment hospital in order to keep people out of mental health institutions in the first place, and was thus supported by the Birmingham Regional Hospital Board in its wider remit. It was designed to be a social and therapeutic centre to guide patients and their families through the process of healing, i.e. an early form of community-centred therapy. This brings us to the funding question.
In a later interview, Elkes cites the support he received at Birmingham, not only from the university, but also the Rockefeller Foundation (RF) and the Medical Research Council (MRC).10 This can be observed from the RF Annual Reports. In 1953, the RF gave Elkes and the EPD £28,800 for the setting up of what became the Uffculme Clinic.11 This is equivalent to over £1.1 million today. Moreover, the MRC were also regularly granted money from the RF for projects and fellowships—in 1951 for example, they were awarded $38,000, through its director Sir Charles Harington.12
Not only was the expenditure justified by the long-term considerations of bringing down the number of hospital beds used by patients with mental health problems, thereby reducing costs, but also it did not rest on tax-payer money alone, relying on grants from abroad too. Now, there still remains the question of whether any ‘dark money’ was involved—either through clandestine US services funnelling it through the RF, or the extent to which the British equivalents did similar activities. However, does the public health context alone do enough to explain why LSD research was being backed?
The underlying belief of the EPD at the time it was set-up was that problems with brain chemistry unscored mental illness. Taking what we now call the ‘psychotomimetic’ approach, they investigated mescaline and LSD, and aimed at developing antagonists to these compounds. The belief was that a close correspondence between the effect of these substances and certain mental health conditions might mean an antagonist to the drugs would be useful in treating the apparent brain chemistry imbalance. This was coupled with examining their metabolization in schizophrenic patients.13
Accounts differ as to when the EPD first came across LSD. Elkes appears to suggest they first received the drug in 1950 or 1951, and began testing it by Christmas of either year. His colleague Philip Bradley appears to suggest it was a year or two later. It is unclear from their later testimonies.
Regardless of the exact date, according to Bradley, they were turned onto LSD when Sandoz’s chief pharmacologist, Ernst Rothlin, visited Birmingham and gave them a lecture on the subject. Usefully, he left a little of the chemical with them to experiment with. And, as Bradley remembers, ‘perhaps foolishly, we did experiments on a group of about 12 normal volunteers, including ourselves and other members of staff of the Medical School and All Saints Hospital.’14
Elkes reported, ‘We did it using a throat microphone for subjective experience, EEG and stroboscopic photic stimulation done to 14 cycles per second.’15 Bradley recorded brainwaves in the healthy subjects on LSD, categorizing the relative signal strengths according to a schema developed at the Burden Neurological Institute.16 According to him, ‘The drug appeared to exaggerate underlying personality traits in subjects, so people who were slightly obsessive became more so, and subjects who were slightly paranoid showed increased symptoms.’17
Suffice to say, researching LSD as an experimental drug fitted perfectly with the EPD’s specific psychiatric theories as well as the wider remit of the Regional Health Board. It would be odd had they not done any LSD experiments. If any dark money was involved, it was, indirectly at least, seemingly being used to hopefully shore up the fiscal future of the NHS; an investment that might scale-up as a longer term solution.
Yet, why then did Elkes come out against using LSD in the context of out-patient clinics, only to then support Sandison’s proposal for one shortly afterwards?
As Elkes later told an interviewer, ‘[LSD research] was an astonishing introduction to this whole world which made it Holy Ground for me but also within two years made me and Charmian and Mayer-Gross write a letter to the BMJ advising against using this [in] outpatient settings.’18 Was LSD used in the Uffculme clinic itself? And, if so, did they have negative results? Or, did their initial research just give Elkes pause for thought about the repercussions of such a powerful drug? Answers to these questions are unclear but, either way, it did not prevent his backing of Sandison.
The Powick LSD unit, also backed by the Birmingham Regional Hospital Board (although it is as yet unclear if other funding was involved), was after all a specialized unit, and Elkes had great faith in Sandison. On seeing Sandison lecture, he said, ‘It was a rainy afternoon, only 7 or 8 of us turned up and he gave us this extraordinary account of this LSD work with schizophrenics and I felt I had listened to something very important and profound.’ In fact, so impressed was Elkes with Sandison, that when he was asked to chair a prestigious WHO board on the matter, he invited Sandison to join.19
It is quite possible then that, while he was still unconvinced by LSD’s therapeutic value, Elkes believed that if anyone might develop the correct procedure in Britain, it was Sandison. A specialized unit, with LSD-trained nurses and doctors, might prove the perfect environment for developing the right protocol for an out-patient clinic that would ultimately reduce the number of hospitalized in-patients. This is, however, just a suggestion. Ultimately, Elkes was increasingly very worried about the drug and during the 1960s he was self-admittedly partly responsible for restrictive rulings around it in the US.
Conclusion
In some respects, the mystery with which we began still remains, and certain questions still need answering. While Elkes was advising the War Office, did he continue to do so into the 1950s, and did his role extend beyond merely advice? Did this connection influence his backing of Sandison’s LSD unit? Thanks to the centralization of the British state during war time, and its continuation through Labour policy post-war, there was undoubtedly a great deal of confluence between the institutions of the Establishment.
Yet, were there more malign reasons involved? On the face of it, there needn’t be anything nefarious. The LSD unit, like Elkes’ EPD, fitted neatly within the Public Health remit of the period—fiscally and medically. And while there was certainly what people today might deem unethical practices in medicine (court cases separately involving Sandison and the military began cropping up in the 1990s), this was not limited to LSD and was more indicative of the wider medical culture of the period.
What about the money? So far as the Rockefeller Foundation goes, while their grant to Elkes was unusually high (possibly the largest in Europe), there was no suggestion it was for LSD in particular. In fact, it was part of the foundation’s own public health remit. Following the £.S.D in this case means thinking about what people hoped LSD potentially treated in 1950s Britain—not only individual health problems, but institutionally-defined fiscal ones too.
Finally, it is of course absolutely bonkers from today’s position in Britain that the LSD unit could have been approved and built so very quickly—but, I suggest, perhaps this says a lot more about our world today than it does the 1950s.
Dr Robert Dickins is the author of Cobweb of Trips: A literary history of psychedelics.
If you would like to support our independent research and writing, including funding archive visits and materials, please consider becoming a paid subscriber to the Psychedelic Press:
Roberts, A (2012) Albion Dreaming: A Popular History of LSD in Britain. Marshall Cavendish. 30
Shapiro, H (2021) Fierce Chemistry: A History of UK Drug Wars. Stroud: Amberley Publishing. 100
Roberts 2012, 30
Shapiro 2021, 102
Addison, P (2010) No Turning Back: The Peacetime Revolutions of Post-War Britain. Oxford: Oxford University Press. 35-27
Barnett, C (2001) The Verdict of Peace: Britain Between Her Yesterday and the Future. London: Macmillan. 45, 51
‘The Department of Experimental Psychiatry’ in University of Birmingham Gazette: Vol 7, No 4. 44–47
Turner, J et al. (2015) ‘The History of Mental Health Services in Modern England: Practitioner Memories and the Direction of Future Research’ in Med. Hist: vol.59(4), pp. 599–624
Shorter, E [ed] (2011) An Oral History of Neuropsychopharmacology: The First Fifty Years. Volume 1. Brentwood: ACNP. 218
RF Annual Report 1953. Online: https://www.rockefellerfoundation.org/wp-content/uploads/Annual-Report-1953.pdf
RD Annual Report 1951. Online: Annual-Report-1951.pdf (rockefellerfoundation.org)
‘The Department of Experimental Psychiatry’ in University of Birmingham Gazette: Vol 7, No 4. 44–47
Fink, M (2011) ‘Interview with Philip Bradley’ in An Oral History of Neuropsychopharmacology: Volume 2 Neurophysiology. Brentwood: ACNP. 133
Bradley PB, Elkes C, Elkes J (1953) ‘On Some Effects of Lysergic Acid Diethylamide (LSD-25) in Normal Volunteers’ in Journal of Physiology: 121, 2, 50–51
Fink 2011, 133
Ibid.
Interesting. Humphrey Osmond & Dr. John Smythies, were at St.Georges few years prior to this time frame.
Since the RF is documented to have funneled CIA money for LSD research (in Norman Ohler's recent book Tripped), with other projects outside the US like McGill University, it's not hard to believe that's what happened here (likely in coordination with MI6).