Barry Marshall, from Quack to Nobel Prize

I love stories about quacks who become prophets. Medical breakthroughs are often made by doctors who were first ridiculed by their peers.
In 1983, Barry Marshall and John Warren presented a paper to the Australian Gastroenterological Society claiming that stomach ulcers are caused by infection. They never finished their paper because they were laughed off the stage. Barry Marshall became so upset that he swallowed a vial of the bacteria taken from a patient who had stomach ulcers, went into shock and almost died. He had to be hospitalized and was saved by massive doses of intravenous antibiotics.
Stomach Ulcers Caused by Acid?
The prevailing theory at that time was that stomach acids digest stomach linings to cause ulcers, and treatment was to put a tube down a person’s nose and into his stomach and pour two ounces of cream down the tube every 30 minutes. This didn’t cure ulcers, but 96 ounces of cream per day can cause a heart attack, and we now know that eating cream causes the stomach to produce ever more acid.

Ignored by Their Fellow Physicians
In 1868, Adolph Kussmaul, Professor of Medicine at Heidelberg (1857), thought that stomach ulcers were caused by infection. In 1940, Dr. Frank D. Gorham of St. Louis said that he had found that intramuscular injections of bismuth helped heal ulcers by killing germs. Also in 1940, Dr. A. Stone Freedberg, of Harvard found curved bacteria, now called H. pylori, in the stomachs of ulcer patients in Boston. However his chief of service, Dr. Herrman L. Blumgart, told him to stop fooling with stomach diseases and stick to his specialty of cardiology. He became a leading heart researcher instead of the person who cured stomach ulcers.
In 1946, Dr. Constance Guion at New York Hospital presented a paper on how she treated stomach ulcers with the antibiotic chlortetracycline. Her fellow physicians at the famous Cornell Medical School criticized her so severely that she abandoned her idea of prescribing antibiotics for ulcers.
Enter John Lykudis, a Greek physician practicing in Missolonghi, Greece, a town of about 10,000 people. Lykudis developed a bleeding ulcer and cured himself with antibiotics. Since antibiotics worked for him, he decided to try them on his patients who had ulcers. In the 1950s, he presented his findings to professors at several Greek medical schools. His colleagues laughed at him, and were jealous because people from all over the world came to his small town to have him treat their stomach ulcers.
Lykudis knew that he was right and the rest of the world was wrong, so he went to the Greek Minister of Health and even the prime minister of Greece. Both referred him to the chairmen of the department of medicine at Athens Medical School, who treated him as a nut. He submitted a paper to the Journal of the American Medical Association and it was rejected on September 1, 1956, with a rejection letter stating, “It does not seem appropriate for our journal.” He died in 1980, still viewed as a quack.

Vindication At Last
Three years after Lykudis’s death, Barry Marshall presented his groundbreaking paper about Helicobacter Pylori and stomach ulcers, but he was ridiculed by his colleagues. It took more than ten years for his theory to be confirmed by other researchers. Today, Barry Marshall has the Nobel Prize in Medicine for discovering that stomach ulcers are caused by bacteria and are cured by antibiotics. He is revered worldwide as the person who cured stomach ulcers (Lancet, November 6, 1999 p 1634). More on Helicobacter pylori
Lessons from Barry Marshall's Story

All new treatments in medicine should be met with some degree of skepticism until there is enough data to prove that that treatment really works.  Doctors used to: 

• take out appendices without hesitation until they learned that the appendix replenishes healthful colon bacteria after you have taken antibiotics 

• take out tonsils and adenoids without hesitation until they learned that they can help to protect you from throat infections

• prescribe addicting drugs like codeine to treat coughs in children until they learned that they cure nothing and can cause addiction

• over-prescribe electric shock therapy to treat depression until they learned that it can cause permanent brain damage 

• over-prescribe diet pills to treat overweight until they learned that they cure nothing without major permanent lifestyle changes, and have lots of side effects

• cut into the brain to disconnect parts (lobotomy) to treat mental and emotional diseases until they learned that it can cause permanent brain damage

• put stents in heart arteries of people who do not have blockage until they learned that stents can increase long-term chances for suffering clots and heart attacks

• prescribe long-term bed rest after a heart attack until they learned that lack of exercise increases chances for suffering another heart attack 

• prescribe moderate drinking of alcohol to prevent heart attacks until they learned that even low doses of alcohol can increase heart attack risk (American College of Cardiology's 68th Annual Scientific Session, Sunday, March 17, 2019)

• and so forth.
Barry Marshall
September 30, 1951 - present











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