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Experimental physiology, Everest and oxygen: from the ghastly kitchens to the gasping lung

  • VANESSA HEGGIE (a1)
Abstract
Abstract

Often the truth value of a scientific claim is dependent on our faith that laboratory experiments can model nature. When the nature that you are modelling is something as large as the tallest terrestrial mountain on earth, and as mysterious (at least until 1953) as the reaction of the human body to the highest point on the earth's surface, mapping between laboratory and ‘real world’ is a tricky process. The so-called ‘death zone’ of Mount Everest is a liminal space; a change in weather could make the difference between a survivable mountaintop and a site where the human respiratory system cannot maintain basic biological functions. Predicting what would happen to the first human beings to climb that high was therefore literally a matter of life or death – here inaccurate models could kill. Consequently, high-altitude respiratory physiology has prioritized not the laboratory, but the field. A holistic, environmentally situated sort of science used a range of (often non-scientific) expertise to prove the laboratory wrong time after time. In so doing, Everest was constructed paradoxically both as a unique field site which needed to be studied in vivo, and as a ‘natural laboratory’ which could produce generalizable knowledge about the human (male) body.

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References
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1 Bert Paul, La pression barométrique: Recherches de physiologie expérimentale, etc., Paris: G. Masson, 1878.

2 For consistency, I will be using metric measurements when discussing the heights of mountains.

3 Dr Raymond Greene had succeeded in taking alveolar air samples just over seven thousand metres above sea level on Everest in 1933, but this lies just outside the ‘death zone’; this is a rather colloquial phrase used to indicate roughly the crucial ‘last’ thousand metres of the mountain. Greene R., ‘Observations on the composition of alveolar air on Everest, 1933’, Journal of Physiology (1934) 82, pp. 481485.

4 Kohler Robert E., Landscapes and Labscapes: Exploring the Lab–Field Border in Biology, Chicago: University of Chicago Press, 2002.

5 Bynum W.F., Science and the Practice of Medicine in the Nineteenth Century, Cambridge: Cambridge University Press, 1994; Cunningham Andrew and Williams Perry (eds.), The Laboratory Revolution in Medicine, Cambridge: Cambridge University Press, 1992.

6 For animal foetuses and human babies see Robert F. Grover, ‘Failing hearts at high altitude’, in John T. Reeves and Robert F. Grover (eds.), Attitudes on Altitude: Pioneers of Medical Research in Colorado's High Mountains, Colorado: University Press of Colorado, 2001, pp. 1–24; and Lorna Grindlay Moore, ‘Small babies among big mountains’, in Reeves and Grover, op. cit., pp. 137–160. For the Olympian see Heggie Vanessa, ‘“Only the British appear to be making a fuss”: the science of success and the myth of amateurism at the Mexico Olympiad, 1968’, Sport in History (2008) 28, pp. 213255. For ICU patients see Grocott Mike, Richardson Alan, Montgomery Hugh and Mythen Monty, ‘Caudwell Xtreme Everest: a field study of human adaptation to hypoxia’, Critical Care (2007) 11, p. 151.

7 The ‘bible’ for the history of high-altitude physiology is West John B., High Life: A History of High-Altitude Physiology and Medicine, New York: Published for the American Physiological Society by Oxford University Press, 1998. This can be usefully supplemented with work by Kellogg and Rodway: Kellogg R.H., ‘“La pression barométrique”: Paul Bert's hypoxia theory and its critics’, Respiration Physiology (1978) 34, pp. 128; Rodway George W., ‘Prelude to Everest: Alexander M. Kellas and the 1920 high altitude scientific expedition to Kamet’, High Altitude Medicine & Biology (2004) 5, pp. 364379; Rodway George Ingle Finch and the Mount Everest expedition of 1922: breaching the 8000-m barrier’, High Altitude Medicine & Biology, (2007) 8, pp. 6876; Rodway Ulrich C. Luft and physiology on Nanga Parbat: the winds of war’, High Altitude Medicine & Biology (2009) 10, pp. 8996. The secondary literature on mountaineering is vast, but here I have made particular use of Unsworth Walt, Everest: The Mountaineering History, 3rd edn, London: Baton Wicks, 2000; and Isserman Maurice and Weaver Stewart, Fallen Giants: A History of Himalayan Mountaineering from the Age of Empire to the Age of Extremes, New Haven: Yale University Press, 2008. For a history of the technology of climbing, see Parsons Mike and Rose Mary B., Invisible on Everest: Innovation and the Gear Makers, Philadelphia: Northern Liberties Press, 2003.

8 Kellogg, op. cit. (7), p. 5.

9 Bert, op. cit. (1), p. v.

10 It also reflects Bert's anti-clericalism, as his dismissal of ‘folk tales’ about mountain sickness mirrors his critique of what he considered the superstitious beliefs of some branches of Catholicism. Kellogg, op. cit. (7).

11 Jourdanet had been part of the Mexican Scientific Commission sent by Napoleon III in 1864, an essentially military venture during the French intervention in Mexico; adaptation to altitude was a question crucial to the successful founding of strategic high-altitude bases. Felsch Philipp, Laborlandschaften: Physiologische Alpenreisen im 19. Jahrhundert, Göttingen: Wallstein Verlag, 2009, pp. 6162.

12 Bert, op. cit. (1), p. iii: ‘et de résoudre par voie purement expérementale ces importants problèmes’.

13 The first measurement taken on the summit in 1981 gave a value of 253 torr, which is approximately equal to 253 mmHg; these measurements can vary with the weather (see below). West J.B. et al. , ‘Barometric pressures at extreme altitudes on Mt. Everest: physiological significance’, Journal of Applied Physiology (1983) 54, pp. 11881194.

14 Bert, op. cit. (1), p. 1105.

15 For a general history, see Isserman and Weaver, op. cit. (7). On pundits and mapping in particular see Kapil Raj, ‘When human travellers become instruments’, in Marie-Noëlle Bourguet, Christian Licoppe and Heinz Otto Sibum (eds.), Instruments, Travel and Science, London: Routledge, 2002, pp. 158–188.

16 For the ‘early’ discussion (i.e. pre-1900) of an attempt on Everest see Unsworth, op. cit. (7), pp. 11–12.

17 Kellogg, op. cit. (7).

18 Dufour M., ‘Sur les mal des montagnes’, Bulletin de la Société médicale de la Suisse romande (1874) 8, pp. 7279.

19 Quoted in Bert, op. cit. (1), p. 1047.

20 On observatories see the special edition of Science in Context (2009) 22, particularly Deborah R. Coen, ‘The storm lab: meteorology in the Austrian Alps’, pp. 463–486, and Stéphane Le Gars and David Aubin, ‘The elusive placelessness of the Mont-Blanc Observatory (1893–1909)’, pp. 509–531. For context on the astronomical observatories see David Aubin, Charlotte Bigg and H. Otto Sibum (eds.), The Heavens on Earth: Observatories and Astronomy in Nineteenth-Century Culture, Durham: Duke University Press, 2010. For a view of high-altitude labs in the primary literature see Anon., ‘A scientific laboratory two miles in the air’, Popular Science Monthly, September 1917, p. 410. As a starting point for labs of other kinds, a 1954 UNESCO/US National Science Foundation-sponsored survey is particularly useful: Korff Serge A. (ed.), The World's High Altitude Research Stations, New York: New York University Press, 1954.

21 Becker Catherine Nisbett, ‘Professionals on the peak’, Science in Context (2009) 22, pp. 487507.

22 It is notable that few (possibly none) of these high-altitude sites used systematic oxygen supplementation for researchers until the late twentieth century, despite the documented effects of hypoxia on close work and careful measurement. West J.B., ‘Oxygen enrichment of room air to relieve the hypoxia of high altitude’, Respiration Physiology (1995) 99, pp. 225232. Cf. the deep concern about the ‘human factor’ in astronomy in the nineteenth century: Canales Jimena, ‘Exit the frog, enter the human: physiology and experimental psychology in nineteenth-century astronomy’, BJHS (2001) 34, pp. 173197; Schaffer Simon, ‘Astronomers mark time: discipline and the personal equation’, Science in Context (1988) 2, pp. 115145.

23 Cogo A. et al. , ‘Italian high-altitude laboratories: past and present’, High Altitude Medicine & Biology (2004) 1, pp. 137147.

24 Mosso A., Life of Man on the High Alps, 2nd edn (tr. E. Lough Kiesow), London: Taylor Unwin, 1898.

25 Mosso studied under Karl Ludwig, met Claude Bernard and Etienne Jules Marey on a visit to Paris, and hosted Nathan Zuntz in his laboratory.

26 Kellogg, op. cit. (7).

27 For this and other examples of the uselessness of oxygen, see Chapter 13 in Mosso, op. cit. (24).

28 For more on Mosso's work in the broader European context see Felsch, op. cit. (11).

29 Mosso, op. cit. (24), p. 127.

30 Mosso, op. cit. (24), p. 118.

31 Mosso, op. cit. (24), p. 126

32 Anon., ‘Book review: Life of Man on the High Alps’, Nature (1899) 59, pp. 289–291, 289.

33 Zuntz N., Loewy A., Müller F. and Caspari W., Hohenklima und Bergwanderungen in ihrer Wirkung auf den Menschen: Ergebnisse experimenteller Forschungen im Hochgebirge und Laboratorium, Berlin: Verlagshaus Bong, 1906. See also Gunga H.C. and Kirsch K.A., ‘Nathan Zuntz (1847–1920)’, Aviation, Space, and Environmental Medicine (1995) 66, pp. 172176; Forbes R.M., ‘Nathan Zuntz’, Journal of Nutrition (1955) 57, pp. 115.

34 Douglas C. Gordon, Haldane J.S., Henderson Yandell, Schneider Edward C., Webb Gerald B. and Richards J., ‘Physiological observations made on Pike's Peak, Colorado, with special reference to adaptation to low barometric pressures’, Philosophical Transactions of the Royal Society of London, Series B (1913) 203, pp. 185318; Dill D.B., ‘Mabel Purefoy Fitzgerald – our second centenarian’, The Physiologist (1973) 16, p. 247; Robert W. Torrance and John T. Reeves, ‘Major breathing in minors: Mabel Purefoy Fitzgerald, an intrepid scientist, visits Colorado's high mines’, in Reeves and Grover, op. cit. (6), pp. 59–86; FitzGerald Mabel Purefoy, ‘The changes in the breathing and the blood at various high altitudes’, Philosophical Transactions of the Royal Society of London, Series B (1913) 203, pp. 351371.

35 Mosso spends several pages arguing that a Himalayan expedition is more necessary and just as noble as a polar exploration. Mosso, op. cit. (24), pp. 314–316.

36 West, op. cit. (7), p. 114.

37 Unsworth, op. cit. (7), Chapter 1.

38 Kellas A.M., ‘A consideration of the possibility of ascending the loftier Himalaya’, Geographical Journal (1917) 49, pp. 2646, 46.

39 This was an insult used by German physiologist Guenter Dyhrenfurth to dismiss the work of Charlie Houston (see below); Dyhrenfurth also criticized the prevalent German scepticism of oxygen, which makes arguments about characteristically British sportsmanship retarding the use of oxygen hard to maintain. Dyhrenfurth G., To the Third Pole: The History of the High Himalaya (tr. Hugh Merrick), London: Werner Laurie, 1955, p. 14.

40 Kellas was the first Westerner to recommend Sherpa guides. Rodway, ‘Prelude to Everest’, op. cit. (7), p. 365.

41 Even the pro-oxygen lobby critiqued Kellas's experiments for being conducted at too low an altitude to be of relevance to a summit dash on Everest. Memo from T.H. Somervell to Everest Committee, January 1922, Royal Geographical Society, Everest Papers (henceforth RGS/EP) EE38/4/10. Rodway George W., George Ingle Finch's ‘The Struggle for Everest’, Trowbridge: Cromwell Press, 2008, p. 57.

42 Anon., ‘Dr Kellas’ Expedition to Kamet’, Geographical Journal (1921) 57, pp. 124130.

43 E.g. West John, ‘Alexander M. Kellas and the physiological challenge of Mt. Everest’, Journal of Applied Physiology (1987) 63, pp. 311.

44 For the bigger picture see Edgerton David, Science, Technology and the British Industrial ‘Decline’, 1870–1970, Cambridge: Cambridge University Press, 1996.

45 Anon., ‘A new Mount Everest expedition’, Geographical Journal (1932) 80, pp. 334335; Haldane J.B. [J.S.] et al. , ‘Equipment for high altitude mountaineering, with special reference to climbing Mount Everest: discussion’, Geographical Journal (1923) 61, pp. 199207. See also suggestions of a change of consensus in 1914 in Freshfield Douglas, ‘The conquest of Mount Everest’, Geographical Journal (1924) 63, pp. 229237.

46 As late as the Cho Oyu pre-Everest reconnaissance in 1951 Dr Pugh wrote, ‘supplementary oxygen improved work rates considerably, but the effect was largely counterbalanced by the weight of the apparatus’. Pugh to Roxburgh, 16 September 1952, Mandeville Special Collections Library, University of California–San Diego. This is a special collection, gathered by John West, on high-altitude physiology; papers are divided by surname and will be referred to as Mandeville/Surname, e.g. Mandeville/Pugh, Box 33, Folder 1.

47 Georges Dreyer was one of a few physiologists who insisted on the necessity of oxygen on Everest, and his work influenced a 1922 Alpine Journal article on the topic which appeared critical of Kellas's work. But Dreyer had a long-standing rivalry with Haldane (as Younghusband put it, ‘Dreyer is a scientific enemy of Haldane’), and, as Kellas had experimented with Haldane, an attack on one was an attack on the other, and was as much about the oxygen secretion debate as about Everest. Dreyer was an ‘armchair theorist’ and consequently, as Younghusband put it, ‘we do not consider Dreyer the last word on the subject’. Younghusband to Bruce, 12 April 1922, RGS/EP EE1/18/1/55; Unna P.J.H., ‘Everest 1922 – oxygen equipment’, Alpine Journal (1922) 34, pp. 235242.

48 ‘Young Haldane’ is almost certainly J.B.S. Haldane, who at this point had just taken up his readership in Biochemistry at Trinity College, Cambridge. Baldrey to Colonel Bruce, 22 November 1923, RGS/EP EE/22/1/8.

49 Rodway, op. cit. (41), p. 196.

50 Unsworth, op. cit. (41), p. 78. Blakeney T.S., ‘A.R. Hinks and the first Everest expedition, 1921’, Geographical Journal (1970) 136, pp. 333343.

51 E.g. Unsworth, op. cit. (7), Chapter 3 (heading); Simons E. and Oelz O., ‘Mont Blanc with oxygen: the first rotters’, High Altitude Medicine & Biology (2001) 2, pp. 545549.

52 In fact Hinks followed the general Everest Committee line that if oxygen was necessary it should be used. Anon., ‘The Mount Everest expedition’, Geographical Journal (1922) 59, pp. 379–383, 381.

53 See note 47. Georges Dreyer is sometimes rendered as ‘George’, e.g. in Rodway, ‘George Ingle Finch’, op. cit. (7).

54 This was the Matthews Respirator. Unsworth, op. cit. (7), p. 163. Matthews developed the respirator as a consequence of work done on the International High-Altitude Expedition to Chile in 1935, led by David Bruce Dill of the Harvard Fatigue Laboratory. West, op. cit. (7), p. 255.

55 Those involved in expeditions consistently claimed that part of their purpose was to produce new physiological knowledge: see RGS/EP EE/54/2. See also the same reference for an extremely balanced, but sadly anonymous, analysis of the state of the oxygen debate and evidence for its utility (which tentatively comes out in favour of planning for an oxygen-assisted summit attempt) titled ‘The oxygen problem’ and marked with the original reference code 42/8. Even when expeditions were designed as ‘purely’ mountaineering or ‘resolutely’ non-scientific, considerable research was often still conducted. See, for example, this account of work done on the 1936 expedition, which had no formal scientific programme: Warren C.B., ‘The medical and physiological aspects of the Mount Everest expeditions’, Geographical Journal (1937) 90, pp. 126143.

56 Pugh L.G.C.E., ‘The effects of oxygen on acclimatized men at high altitude’, Proceedings of the Royal Society of London, Series B (1954) 143, pp. 1417.

57 See note 54.

58 ‘It is now certain that it is a quite unjustified physiological risk to attempt to reach the summit without oxygen equipment’. Untitled report, probably by Pugh for the MRC High Altitude Committee or the Oxygen Sub-committee, n.d. (c. October 1952), Mandeville/Pugh, Box 36, Folder 8.

59 Dyhrenfurth, op. cit. (39); L.G.C.E. Pugh and M. Ward, ‘Appendix VIII: physiology & medicine’, in John Hunt, The Ascent of Everest, London: Hodder & Stoughton, 1953, pp. 270–279.

60 For example, Raymond Greene: ‘the business of getting up Everest will not be finally settled until somebody has got up without oxygen’, in Mason Kenneth et al. , ‘The Mount Everest expedition of 1938: discussion’, Geographical Journal (1932) 92, pp. 490498. Greene was generally in favour of the use of oxygen, but this view coincides with that of those who were not, e.g. Tilman: ‘my feeling is that a successful oxygen attempt would merely inspire a wish to do it without.’ Tilman H.W., ‘The Mount Everest expedition of 1938’, Geographical Journal (1938) 92, pp. 481490.

61 Steve Sturdy, ‘From the trenches to the hospitals at home: physiologists, clinicians and oxygen therapy, 1914–30’, in John V. Pickstone (ed.), Medical Innovations in Historical Perspective, London: Palgrave Macmillan, 1992, pp. 104–123.

62 Houston Charles S., ‘Operation Everest: a study of acclimatization to anoxia’, US Naval Medical Bulletin (1946) 46, pp. 17831792.

63 Houston, op. cit. (62), as quoted in Abstracts, Anaesthesiology (1947) 8, pp. 442–443, 443.

64 There are now dozens of ‘standard atmospheres’ in use. See American Institute of Aeronautics and Astronautics, Guide to Reference and Standard Atmosphere Models, 2004, ANSI/AIAA G-003B-2004.

65 Pugh L.G.C.E., ‘Resting ventilation and alveolar air on Mount Everest’, Journal of Physiology (1957) 135, pp. 590610, 604605.

66 Zuntz, op. cit. (33).

67 The deviation becomes noticeable around 4,500 metres. Haldane J.S. and Priestly J.G., Respiration, Oxford: Clarendon, 1935.

68 Dill D.B. and Evans D.S., ‘Report barometric pressure!’, Journal of Applied Physiology (1970) 29, pp. 914916.

69 West J.B., ‘Barometric pressures on Mt. Everest’, Journal of Applied Physiology (1999) 86, pp. 10621066.

70 See also note 47 above.

71 This was particularly illustrated by deteriorating handwriting and the inability to write series of numbers at simulated (or real) altitudes. Felsch Phillippe, ‘Mountains of sublimity, mountains of fatigue: towards a history of speechlessness in the Alps’, Science in Context (2009) 22, pp. 341644; Kehrt Christian, ‘“Higher, always higher”: technology, the military and aviation medicine during the age of the two world wars’, Endeavour (2006) 30, pp. 138143. But see note 22 above, on astronomers and low-oxygen environments.

72 Roxburgh H.L., ‘Oxygen equipment for climbing Mount Everest’, Geographical Journal (1947) 109, pp. 207216, 208.

73 Ward identified covert aerial surveillance photos in the RGS archives and combined these with various maps and plans to draw up a new, feasible, route to the summit of Everest via the Western Cwm. Ward Michael, Everest: A Thousand Years of Exploration, Glasgow: Ernest, 2003; Rodway George W. and Windsor Jeremy S., ‘Pioneer of the high realm: Michael Ward's life of medicine, mountaineering and exploration’, Wilderness and Environmental Medicine (2008) 19, p. 52. As early as 1918 Kellas had given the RGS a presentation on the value of aerial reconnaissance: Kellas A., ‘The possibility of aerial reconnaissance in the Himalaya’, Geographical Journal (1918) 51, pp. 374382.

74 This was the reconstituted Everest Committee, still a collaboration between the RGS and the Alpine Club, although now with a slightly broader remit.

75 Isserman and Weaver, op. cit. (7), p. 262.

76 This party was led by Eric Shipton, and included the New Zealanders Eric Riddiford and Edmund Hillary, as well as Ward and the oxygen expert Tom Bourdillon.

77 Pugh's leading place on this team was funded by the Royal Society; £600 was paid to allow him to be ‘attached’ to the 1951 expedition. L.P. Kirwan to Pugh, 22 November 1951, Mandeville/Pugh, Box 33, Folder 1.

78 I would like to thank Harriet Tuckey, Dr Pugh's daughter, for providing me with material from her forthcoming biography of Dr Pugh.

79 For a general report on the expedition see Shipton Eric, ‘The expedition to Cho Oyu’, Geographical Journal (1953) 119, pp. 129137.

80 West John B., ‘Failure on Everest: the oxygen equipment of the spring 1952 Swiss expedition’, High Altitude Medicine & Biology (2003) 4, pp. 3943; Dittert René, Chevalley Gabriel and Lambert Raymond, Forerunners to Everest, London: Hamilton & Co., 1956.

81 Hunt, op. cit. (59), p. 228.

82 Closed-circuit systems ‘recycle’ exhaled air by passing it through a chemical filter which removes excess carbon dioxide, making them more efficient than open-circuit systems where up to 90 per cent of the oxygen inhaled is not used by the body, but lost on exhalation. ‘Report of Dr Pugh's discussion at Dr Shipton's lecture at the RGS’, 24 April 1953, Mandeville/Pugh, Box 33, Folder 1; see also Mandeville/Hornbein, Box 31, Folder 6.

83 Mallory G., ‘The first high climb’, Geographical Journal (1922) 60, pp. 400412, 410.

84 Jones Max, The Last Great Quest: Captain Scott's Antarctic Sacrifice, Oxford: Oxford University Press, 2003.

85 Stewart G.T., ‘The British reaction to the conquest of Everest’, Journal of Sport History (1980) 7, pp. 2139.

86 Pugh and Ward, op. cit. (59), p. 276. Pugh was less critical when addressing the RGS: Pugh L.G.C.E., ‘Scientific aspects of the expedition to Mount Everest, 1953’, Geographical Journal (1954) 12, pp. 183192.

87 Mallory, op. cit. (83), pp. 410–411.

88 Greene, op. cit. (3); Somervell T.H., ‘Note on the composition of alveolar air at extreme heights’, Journal of Physiology (1925) 60, pp. 282285.

89 Formally, ‘The 1960–61 Himalayan Scientific and Mountaineering Expedition’. Milledge James S., ‘The Silver Hut Expedition, 1960–61’, High Altitude Medicine & Biology (2010) 11, pp. 93101; Pugh L.G.C.E., ‘Himalayan scientific and mountaineering expedition 1960–61: the scientific programme’, Geographical Journal (1962) 128, pp. 447456.

90 Pugh's work on a largely American team was sponsored (to the tune of £2,300) by the Wellcome Trust; Hillary's was paid for by the government of New Zealand. Anon., ‘Medical news’, British Medical Journal (1957) 2, pp. 1061–1062.

91 E.g. Mosso, op. cit. (24), pp. 314–316.

92 Pugh L.G.C.E. et al. , ‘Muscular exercise at great altitudes’, Journal of Applied Physiology (1964) 19, 431440.

93 West John, ‘Climbing Mt. Everest without oxygen: an analysis of maximal exercise during extreme hypoxia’, Respiration Physiology (1983) 52, pp. 265279.

94 E.g. Odel N.E.l, ‘So-called “deterioration” and the use of oxygen at high altitudes’, Geographical Journal (1954) 120, pp. 131133.

95 Hillary himself maintained a belief that Everest was scalable without oxygen, writing in 1976, ‘I have always thought that men could reach the top of Everest without any use of oxygen’. Hillary to West, 23 February 1976, Mandeville/West, Box 74, Folder 15.

96 Quoted in Schoene R.B., ‘Limits of human lung function at high altitude’, Journal of Experimental Biology (2001) 204, pp. 31213127, 3121.

97 The first direct measure of barometric pressure on Everest's summit was not taken until 1981, and, as the physiologist and historian Kellogg wrote, ‘The physiologist … is somewhat relieved to find that the barometric pressure is indeed elevated above the standard US Atmosphere value … for that reduces the problem of explaining adequate oxygen supply for survival.’ Kellogg to West, 10 January 1981, Mandeville/West, Box 10, Folder 14.

98 One climber and two Sherpa also reached the summit. West John, ‘Man at extreme altitude’, Journal of Applied Physiology (1982) 52, pp. 13931399.

99 These difficulties, as with debates earlier in the century, were technical, personal, ideological and ethical. See Mandeville/West, Box 89, Folder 4.

100 West, op. cit. (7), p. 350. West to Houston, 11 September 1987, Mandeville/West, Box 8, Folder 27. West to Schoene, 25 July 1987, Mandeville/West, Box 26, Folder 27.

101 West, op. cit. (7), p. 352.

102 The phrase ‘natural laboratory on the mountain’ is explicitly used by Pugh to highlight the issue of acclimatization. Memo from Pugh to [physicist] Sheldon Shultz, 9 February 1982, Mandeville/Pugh, Box 15, Folder 32.

103 Although the risk of death on a medical expedition with carefully screened participants and heavy medical support is probably significantly lower than that on less selective ‘commercial’ expeditions.

104 Some of these ideas were consolidated by attending meetings of the Caudwell Xtreme Everest group in London, in December 2009 and February 2010. I would like to thank the group for letting me sit in on their meetings, and particularly Dr Andrew Murray and Dr Mike Grocott.

105 There is much more that is of interest to historians of science and medicine in the work done on, near, for and about Everest. Climbing and research expeditions are models of international cooperation and often pose awkward problems of technological and methodological incommensurability. Funding is also worth exploring, as most expeditions are paid for by multiple interests with sometimes competing desires – the Silver Hut Expedition had money from the Daily Mail to undertake a hunt for the Yeti. Expeditions also involve close working with local people, guides and Sherpa. On Yeti spotting, see Wyss-Dunant Edward, ‘The first Swiss expedition to Mount Everest, 1952’, Geographical Journal (1953) 119, pp. 266277; for lyrical work on the Sherpa see Ortner Sherry, Life and Death on Mt. Everest: Sherpas and Himalayan Mountaineering, Princeton: Princeton University Press, 1999.

106 Medawar to Pugh, 29 November 1967, Mandeville/Pugh, Box 8, Folder 39.

As this research is just part of a much larger project, it has accrued many debts, not least to the co-funders, the Wellcome Trust and the Isaac Newton Trust. Thanks are due to the archivists at the Wellcome Library, the Mandeville Special Collections Library at UC San Diego, and the Royal Geographical Society; to Ms Harriet Tuckey and Professor John West for information and inspiration; and to Dr Andrew Murray and Dr Mike Grocott (and the members in general) of the Caudwell Xtreme Everest Expedition. This article has been substantially improved by feedback from the audience of my Departmental Seminar at the Department of History and Philosophy of Science, Cambridge, from Simon Schaffer and from two reviewers.

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