WHO GOES FIRST? The Story of Self-Experimentation in Medicine By Lawrence K. Altman, MD Random House. 448 pp. $22.50

Remember"Microbe Hunters"?

Those valiant scientists battling ignorance, superstition and prejudice? The personal costs they paid in the cause of human betterment? Well, medical research fans, I have good news. Lawrence K. Altman, MD, has gathered a gallery of heroes every bit as inspiring, every bit as intriguing and even, if possible, more noble. If their tales aren't told with Paul de Kruif's memorable e'lan, they're still clear, cogent and almost uniformly admirable. And "hero" is none too strong a word for many of these men (and a few women). They didn't merely put their careers and reputations on the line to advance unpopular ideas. They put their own bodies where their theories were. Each of them did a crucial -- and sometimes very dangerous -- experiment on himself.

In an age when many doctors practice with an eye on their malpractice premiums, it's heartening indeed to read of medical men who, given a chance to lessen suffering, consulted their consciences, not their underwriters. And it's astonishing to realize the size of our debt to those surprisingly numerous souls who were (and continue to be) willing to take that chance. To self-experimenters we owe anesthesia and heart catheterization, many important drugs and understandings of numerous grave diseases. Altman's subjects tried to give themselves, among other things, anemia, scurvy, hookworm, fungal and staph infections, yellow fever, even leukemia. They subjected their brains and bodies to LSD, the bends, curare. And some of them lost their health, even their lives, in the process.

Indeed, Altman believes, the Army's great hospital/research complex on 16th Street should by rights be the Jesse Lazear Medical Center, after a researcher who undertook a fatal experiment in yellow fever transmission, while his better-remembered colleague, Walter Reed, reneged on a promise to take part.

Altman, a medical correspondent for The New York Times, is exquisitely conscious of the politics of credit and risk in science, and his keen ethical sense is one of the book's real strengths. He knows that not all scientists undertake research solely to assuage illness. Somewhere in the back of their minds may lurk the inkling that great experiments build great careers; that bold, brilliant results bring prizes, fame, influence, possibly wealth, perhaps even immortality.

But as research becomes ever more costly and bureaucratic, the inquisitive loner in his home laboratory and the studious general practitioner with a hunch have all but disappeared from the scientific journals. The man who might, a generation or two ago, have rolled up his own sleeve for the injection or probed his own stomach or intestine or heart, is now usually part of a large team following a complicated protocol. But the temptation to try dramatic procedures still lies before the ambitious researcher. So the ethic of scientists "going first," Altman believes, becomes ever more useful in keeping science honest.

The plain fact is that medical knowledge only advances through the performing of untried, even unprecedented, procedures on human bodies. "Clinical trials" are nothing more than human experiments by a fancier name. And it isn't only Mengele-style monsters who abuse the ethics of experimentation, although the Nuremberg Trials have drastically raised consciousness on the issue. (Indeed, Altman reports, since World War II self-experimentation has been de rigueur in Germany.) In 1963, for example, doctors at New York's renowned Sloan-Kettering Institute followed up a promising lead by placing live cancer cells in the bodies of unwitting patients.

"I would not have hesitated {to undergo the risk}," one of the researchers told Science magazine during the resultant furor, "if it would have served a useful purpose. But to me it seemed like false heroism, like the old question of whether the General should march behind or in front of his troops. I do not regard myself as indispensable -- if I were not doing this work, someone else would be -- and I did not regard the experiment as dangerous. But, let's face it, there are relatively few skilled cancer researchers, and it seemed stupid to take even the little risk."

Altman, along with the august company he chronicles, utterly rejects this argument. "One man's life is not more valuable than another's," he writes. "The lives of nonresearchers are just as valuable to their families and to society as are the lives of scientists ... If there is risk, why should someone other than the scientist take it first? It there is no risk, or if it is ever so slight, what then is the scientist's objection to going first?"

If only for raising an issue that will grow in prominence along with the number of new drugs, chemicals and procedures that need testing, this book deserves attention. But there are other, more basic reasons, too. It just might inspire more researchers to emulate these estimable colleagues. And simple decency demands that we who owe our lives and health to others' courage pay them the honor that is their due.

The reviewer is the author of the forthcoming "The Myth of Two Minds: What Gender Means and Doesn't Mean."