91色情片

As a junior doctor, Barry Marshall was so sure the medical establishment was wrong about the cause of stomach ulcers that he swallowed the bacteria he believed were to blame. It still took years to convince everyone 鈥� but it was to win him a share in a Nobel prize. Alison George asked him how he did it

What made you decide to swallow the bacteria?

It was so frustrating to see ulcer patients having surgery, or even dying, when I knew a simple antibiotic treatment could fix the problem. Back in 1984, conventional medical wisdom was that ulcers were caused by stress, bad diet, smoking, alcohol and susceptible genes 鈥� and that no bacteria could survive in the stomach. Working with pathologist Robin Warren, I found a bacterium called Helicobacter pylori in all duodenal ulcer patients and in 77 per cent of those with gastric ulcers. We tried to infect animals to prove this bacterium was the culprit but that failed, so we had to find a human volunteer.

Why did it have to be you?

I was the only person informed enough to consent, so I decided to be my own guinea pig. I didn鈥檛 seek approval from the hospital鈥檚 ethics committee because I didn鈥檛 want to risk being turned down, and I didn鈥檛 even tell my wife until I had swallowed the bacteria. By then I had successfully treated several patients suffering from H. pylori infections using antibiotics, so it seemed that I had a cure.

What happened after you swallowed the bacteria?

I was fine for three days, then began to feel nauseous, and soon began vomiting. My wife told me I had 鈥減utrid breath鈥�. After 10 days, a biopsy confirmed the bacteria had infected my stomach, and the stomach wall was inflamed with gastritis, which can eventually lead to ulcers. My experiment overturned 100 years of knowledge about ulcers. We published our results in The Lancet and waited for the sparks to fly.

But your findings didn鈥檛 set the world on fire?

No. After all, gastroenterologists thought they already knew the cause of ulcers, and there were very effective treatments which acted by reducing stomach acid 鈥� though they weren鈥檛 a cure. By the time we presented our findings at meetings, our research had advanced so far that we were convinced these bacteria were causing ulcers, so we seemed far more confident than the data warranted. The audience was sceptical about us reaching such expansive conclusions when our research seemed very preliminary. Also, neither Robin nor I were gastroenterologists: I was a fairly junior doctor and he was a pathologist, so we didn鈥檛 have a reputation in the field.

Why did you discover this, not the specialists?

Many people built careers on researching ulcers, but they were barking up the wrong tree. It was much better for us to be coming from a position of ignorance. We didn鈥檛 have a plan to find a cure for ulcers 鈥� we were simply trying find out what these bacteria were. If people don鈥檛 have an investment in the existing paradigm, they are free to invent a new one. There is a lot of inertia in research. People running major research projects can鈥檛 suddenly change tack and move the whole lab into another area.

Did you ever wonder if you might just be seen as an eccentric, shouting about the cure you鈥檇 found?

A bit, I suppose. In those days, specialist gastroenterologists knew little about microbiology. If you know nothing about a subject, and someone comes up with an idea, you can鈥檛 tell whether the person is crazy or not. We knew we could be wrong, we were constantly thinking: 鈥淲hat else am I missing?鈥� At that point, though, I was curing people in weeks who had had chronic problems with ulcers most of their lives. It must have been real, not some mysterious laying-on of hands.

鈥淚 was curing people who had had ulcers for most of their lives鈥�

Was it hard to convince the world that such a 鈥渕iracle cure鈥� existed?

Yes. When The Lancet finally used the word 鈥渃ure鈥� in 1989 we thought that everybody must believe us now, but it was another eight long years before most people in western countries were aware that H. pylori caused ulcers. In the meantime, millions of people had taken unnecessary drugs or had surgery, at a cost of billions of dollars.

Did you find that infuriating?

At the time I thought it was somewhat immoral, because doctors who were sceptical about H. pylori were making decisions that permanently affected the lives of their patients. It was very easy for them to stick with the old treatments. I was annoyed about the level of opposition to our theory, and that people were not testing it, but now I realise that it takes time for an idea to gain acceptance.