# Transcript

SIMON WHISTLER

Hello I’m Simon Whistler, you’re watching the ‘Today I Found Out’ YouTube channel, in the video today we are going to address the myth that stress causes stomach ulcers and the extreme lengths that one scientist went to, to prove his hypotheses about these ulcers, let’s get started.

VOICE OVER

Nobel Prize winner Barry Marshall and his several decade fight against the medical community over the cause of ulcers.

When it comes to science we think there’s a saying that is fairly applicable ‘who dares, wins’.

Fans of military history may recognise that as the motto of the Special Air Service SAS however, we feel scientists and researchers deserve to use it just as much because sometimes they take risks too, just ask Nobel Prize winner Barry J. Marshall if you don’t believe us.

Marshall is known primarily for his work revolving around peptic ulcers, if you don’t think that sounds important ask someone who has had one just how painful they are and then shield your groin from the barrage of kicks as they try to give you some idea of the crippling level of pain. Beyond the agony and decreased quality of life it can cause, peptic ulcers have been linked to increased chances of one getting stomach cancer.

Prior to Marshall’s Work was commonly accepted by the medical community that ulcers were caused by a combination of stress, spicy food, and too much stomach acid being produced something that many people still believe to this day; seriously ask anyone on the street what causes stomach ulcers and stress will likely be one of the answers you get.

Marshall’s first significant encounter with stomach ulcers was while training to become a specialist in Gastroenterology, during his time he came into contact with Dr. Robin Warren who just so happened to be treating several patients with crippling stomach ulcers. During treatments Warren collected samples of bacteria that seemed present in every ulcer patient, this bacteria Helicobacter pylori was later found to be directly responsible for ulcers that said neither Warren nor Marshall discovered the bacteria.

In his work Helicobacter pylori: Physiology and Genetics, Marshall himself penned a section on how humanity has been aware of the bacteria since 1893. Along with this, links between the bacteria and ulcers have been suggested as early as 1940 by Dr. A. Stone Freedberg, a cardiologist from Harvard.

In fact it’s widely accepted that if Freedberg would have continued with his research into these microbes and ulcers, he likely would have solved the problem decades before Marshall did. However, Freedberg’s boss pressured him to abandon his research in favour of something that would be easier to prove, so that’s exactly what he did.

In the meantime, millions of people suffered and loss trunks of their stomachs by a wholly unnecessary surgery.

One of the reasons Freedburg and indeed just about every other scientist and microbiologists that wasn’t a crazed Australian, gave up on this line of reasoning was due to overwhelming opposition from the wider scientific community.

As mentioned, up until Marshall shotguns a glass of the bacteria, the commonly accepted cause of ulcers with stress and stomach acid, as it was believed that no bacteria could thrive in the highly acidic environment of the stomach. You know, even though people had been finding said bacteria in stomachs since 1983.

There was also the fact that there was lots of documented evidence that antibiotics cleared ulcers right up. In the case of Freedberg, when he made his prediction about the link between bacteria and ulcers and tests were inconclusive his superiors essentially told him to give up and stop wasting his time.

On a similar vein, when Greek Dr John Lykoudis presented his findings that antibiotics eradicated ulcers in 1964, his evidence was largely ignored because it went against the current consensus.

In fact, in 1968 when Lykoudis refused to stop treating and curing his patients’ stomach ulcers with antibiotics, he was fined four thousand Drachma for his troubles and was largely regarded as a quack until Marshall went freshman on a glass of Helicobacter pylori.

In other words, suggesting ulcers were caused by anything other than stress was career suicide. Regardless, both Marshall and Warren continued with their research and although the pair managed to cultivate Helicobacter Pylori they couldn’t make it cause stomach ulcers, regardless of how many piglets they injected it into.

As Marshall stated:

‘… 1984 was a difficult year. I was unsuccessfully attempting to inject an animal model. There was interest and support from a few but most of my work was rejected for publication and even accepted papers were significantly delayed. I was met with constant criticism that my conclusions were premature and were not well supported. When the work was presented my results were disputed and disbelieved, not on the basis of science because they simply could not be true. It was often said that no one was able to replicate my results. This was untrue it became part of the folklore of the period. I was told that the bacteria were either contaminants or harmless commensals.

‘At the time I was successfully experimentally treating patients who had suffered with life-threatening ulcer disease for years. Some of my patients had postponed surgery which became unnecessary after a simple two-week course of antibiotics and bismuth.

‘I had developed my hypothesis that these bacteria were the cause of peptic ulcers and significant risk to stomach cancer. If I was right then treatment for ulcer disease would be revolutionised. It would be simple, cheap and it would be a cure.

‘It seemed to me that for the sake of patients this research had to be fast tracked. The sense of urgency and frustration with the medical community was partly due to my disposition and age.

‘However, the primary reason was a practical one. I was driven to get this theory proven quickly to provide curative treatments for the millions of people suffering with ulcers around the world.’

He finally reasoned that there had to be an easier way. Even though Marshall was absolutely convinced the bacteria caused stomach ulcers, he couldn’t test his theory on humans. However, no law could stop Marshall from testing his theory on himself. Which is exactly what he did on the 12th of June 1984.

Marshall finished his workday after drinking the bacteria. If movies have told me anything, scientists who test their theories on themselves invariably become either the superheroes or super villains, and that’s kind of what happened here. At least, I assume most people who’ve had the misfortune of suffering from ulcers consider Marshall to be something of a superhero.

So what exactly happened after he drank the offending microbes? Despite Marshall thinking it would take weeks if not months for anything significant to occur, just a few days later, he developed ulcers for the first time in his life, along with presumably the inability to stop extending his middle finger at the medical community.

Marshall put a stop to his little experiment after two weeks when his wife found out about it. He didn’t need to be a scientist to know that upsetting your wife is worse for one’s well-being than stomach ulcers, even when factoring in the potential increased risk of getting stomach cancer. But, as he said ‘She was already convinced about the risk of these bacteria and I knew I would never get her approval. This was one of those occasions when it would be easier to get forgiveness than permission.’

After a biopsy to further document this event, even treated himself with antibiotics and was fully cured of the ulcers. At this point certain people within the medical community started paying closer attention to Marshall’s research and taking it a whole lot more seriously. However, it still took time and a significant amount of work and publicity to get the message across; even into the early nineteen nineties after curing numerous people of ulcers and publishing several papers on the subject, many in the medical field still scoffed him and even outright accused him of pushing snake-oil like treatments on to their patients through the media who was eating up the battle Marshall was waging.

Finally in 1994 it all changed when the National Institutes of Health NIH held a two-day summit in Washington D.C. over the matter. They could no longer ignore the evidence. At the end of the summit they released a statement stating that ‘the key to treatment of duodenal and gastric ulcer was detection and eradication of Helicobacter pylori.’

With that stamp of approval on his work, the majority of holdouts in the medical community switch their stance and accepted Marshall’s hypothesis. Eleven years later, in 2005, he was given a Nobel Prize for his work, which was all the more impressive given the extreme opposition he faced.

Sure scientists and really everyone should always question new ideas and thoroughly vet them. But when a mountain of well documented evidence easily repeatable scientifically performed experiments clearly shows the old theory was wrong and the new one right, one shouldn’t continue to oppose it just because it’s not believed before.

Yet, it took Marshall climbing on top of that mountain of evidence and showing is ulcer filled stomach before anyone started to listen.

Let that be a lesson to everyone. Even the smartest of us humans are amazingly susceptible to getting stuck in a knowledge rut. Always question everything, and never stop learning.

Bonus facts: Funnily enough the first news agency to report on Marshall’s little experiments was the Star newspaper, which as he put it was ‘a tabloid that often features stories about alien babies being adopted by Nancy Reagan. This was right up their alley. The next day the story appeared, Guinea-pig Doctor discovers new cure for ulcers … the cause.’

Needless to say this wasn’t an auspicious beginning to being taken seriously, but certain key people did take notice thanks to the story, and funding for further experiments started to trickle in.

I’m not sure what’s more interesting about this fact that such a tabloid actually broke a major world news story or the revelation that they actually do real reporting sometimes rather than just sit around making stuff up.

So I really hope you liked that video, and if you did liked it click like below and leave us a comment to let us know what you think, and also check out a couple of our other videos which are linked to on the screen now. And don’t forget to subscribe for brand new videos every day. Thanks for watching.