What Barry Marshall Knew In His Gut

It took a decade, but Dr. Barry J. Marshall has launched a medical revolution. As an obscure Australian doctor, Marshall startled his profession in 1983 by contending that ulcers and other stomach ills were caused not by stress but by a mysterious, spiral-shaped bacterium. "The idea was considered completely crazy," says David Alpers, chief of gastroenterology at Washington University in St. Louis--in part because Marshall and his colleague J. Robin Warren, a pathologist at Australia's Royal Perth Hospital, could show only that people with ulcers harbored the bacteria, not that the germs actually caused disease. By June, 1984, Marshall was so desperate to prove his point that he acted as his own guinea pig: He swallowed a foul-tasting concoction containing the microbe and came down with a roaring case of stomach inflammation, or gastritis, the precursor to ulcers.

The experiment "certainly got people's attention," says Dr. Walter L. Peterson, a gastroenterologist at the University of Texas Southwestern Medical School in Dallas. It fed Marshall's reputation as a scientific rebel. And it helped stimulate new research that has recently accumulated overwhelming evidence for the link between bacteria and ulcers. New studies at Stanford and other universities also provide strong evidence that the germ, H. pylori, is a major factor in causing stomach cancer. Nowadays, "people who don't accept the idea that this bacterium causes disease are either stubborn or uninformed," says Dr. Martin J. Blaser, a professor of medicine at Vanderbilt University School of Medicine.