When the Nobel Prize for medicine was awarded to researchers Barry Marshall and Robin Warren earlier this month, a good number of news reports made mention of Marshall’s most famous exploit - deliberately infecting himself with the bug that causes stomach ulcers.
The year was 1984, and the two researchers from Perth, Western Australia, had been having a hard time convincing the medical world that the bacterium Helicobacter pylori really did cause the peptic ulcers that everyone else considered to be a side-effect of stress and lifestyle. So Marshall decided the time was ripe to put his money where his mouth was, so to speak, and show them once and for all.
What he specifically wanted to do was fulfil Koch’s postulates, a set of rules formulated by the German Nobel laureate Robert Koch in the late 19th century to help clarify what causes an infectious disease. They state, very roughly speaking, that to show a bug causes a disease it must be found in all individuals suffering from the disease; should cause disease when taken from a sick individual and introduced into a healthy one; and be detectable in the newly infected individual.
So Marshall, an energetic and more than slightly gung-ho character, hatched a plan. One day in early June he asked a colleague to examine his stomach with an endoscope to confirm there were no signs of infection with the bacterium. Later that same day he isolated some bugs from the gut of a man with heartburn and an inflamed stomach and proceeded to grow large numbers of them on Petri dishes.
Just before noon on June 12, he gulped down about 30mls of the bacterial solution - a broth that apparently tasted a bit like swamp water.
For a week, little happened other than tummy rumbles. Then, on the seventh day, Marshall woke up and vomited a clear, acid-free liquid. This was repeated for another three days, leaving him feeling pretty rough. He was examined again with a tube down his throat - and lo and behold, he was infected.
At this point, Marshall recalls in his book, Helicobacter Pioneers, he trotted home feeling rather pleased with himself to tell his wife, who was already in a less than ideal mood having suffered cracked ribs and whiplash in a recent car accident. She apparently hit the roof, not least because the infection had given him a distinct case of sewer breath, and she insisted he treat himself with antibiotics, pronto.
Marshall was ready to comply with this request, and two weeks after downing the bacterial beverage went for a last endoscopic examination with the antibiotics ready in his pocket, but the bacterium had already disappeared, leaving his stomach returning to normal.
So much of the story is pretty well known, and widely reported. But what’s less well known is that a scientist from New Zealand, one Arthur Morris, repeated the process a couple of years later but with a much less satisfactory outcome.
While Marshall’s immune system apparently fought off the bacterium quickly, Morris wasn’t so lucky. Despite antibiotic treatments and the whole works, his infection lingered and lingered to the point that at one medical conference a colleague asked him whether he wasn’t worried about getting gastric cancer - one of the possible outcomes of long-term H. pylori infection. (He’s OK now, I understand.)
Anyway, Marshall and Morris were doing what they thought needed to be done in the name of research. In fact, they’re part of a historical tradition of self-experimentation. From Isaac Newton onwards, scientists in a jam have turned their own bodies into single-patient studies.
Take Max von Pettenkofer, for example. In 1892, the German pioneer in hygiene and epidemiology downed a glass of water containing Vibrio cholerae during a cholera epidemic in Hamburg. A man who wants to stand above the animal, he wrote, “must be willing to sacrifice even life and health for higher, ideal goods”. Apparently he had a massive bout of diarrhoea, but he didn’t die.
Then there’s Albert Hofmann, a Swiss scientist whose self-experimentation with lysergic acid diethylamide in 1943 triggered at least one extraordinarily psychedelic bicycle ride and spawned a whole acid subculture. More frighteningly, in 1997 a group of doctors known as the International Association of Physicians in Aids Care volunteered to be the first human guinea pigs for an HIV vaccine.
Although Marshall, Hofmann and the Aids doctors are modern examples of self-experimentation, I think the practice must be far less common now than it was in the more swashbuckling days of science. After all, experiments these days need to be passed by ethics committees in universities or other institutes before they can get funding. Human experimentation - even on yourself - is frowned upon.
Obviously self-experimentation should be as carefully monitored as any other type of experimentation, especially if other members of a scientist’s lab get involved in the research. But I can’t help but admire the passion and dedication of those who indulge in it. Not that I’m volunteering, mind you.
