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Helicobacter pylori: what does it taste like?

Barry J Marshall
Med J Aust 2014; 201 (1): 22.
doi:
10.5694/mja14.00487

The Journal's early support for a Helicobacter pioneer allowed publication of key results

Helicobacter pylori: what does it taste like?

The title above is the most common question people ask me about the spiral bug. By the time this article comes to press the answer might even be published. But the question leads back to my paper in the MJA 29 years ago.1 It described the deliberate self-administration of Helicobacter pylori and the observation that it caused an acute upper gastrointestinal illness with vomiting, halitosis and an underlying achlorhydria. Embarrassed to admit that it was a self-experiment, I wrote the paper in the third person at the suggestion of my coauthors, but they at least had witnessed my sufferings over a 14-day period, so it was not entirely subjective and anecdotal. It came to be published in the Journal because I had received a letter from the Editor at the time, Alistair Brass, saying how much he liked the Lancet paper I had coauthored with Robin Warren,2 and did I have any others up my sleeve on the subject? Warren and I had had such a bad run with editors by then that it seemed a breath of fresh air to meet an editor who actually liked original material. So I finished the paper and submitted it to the Journal in about September 1984. However, then showing his true colours, the Editor sent it out to scrupulous reviewers who asked for a complete rewrite, which made it a much better paper, but delayed its publication until April 1985.1

I obtained incredible value from the MJA publication. Who knew that so many people were following the MJA? In a Lancet editorial soon afterwards, then Editor David Sharp “re-tweeted” the MJA paper, agreeing that H. pylori infection explained a mysterious illness that was spreading from time to time in gastroenterology laboratories performing acid secretion studies.3 An unnoticed infectious agent was contaminating their equipment and infecting many of the volunteers.4,5

Re-reading that paper every few years, I am impressed by how far the MJA Editor was “sticking his neck out” in allowing me to publish a hypothesis as to the cause of peptic ulcer. It was a further 5 years before journals allowed the word “cure” to appear in articles about duodenal ulcer,6 and almost a decade before mainstream United States journals could accept it as proven.7

Provenance: 
Commissioned; not externally peer reviewed.
Barry J Marshall, MB BS, FRACP, NL, Clinical Professor of Microbiology
Marshall Centre for Infectious Diseases Research and Training, School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA.
Correspondence: 
Competing interests: 

No relevant disclosures.

Reference Text: 
Marshall BJ, Armstrong JA, McGechie DB, Glancy RJ. Attempt to fulfil Koch's postulates for pyloric Campylobacter. Med J Aust 1985; 142: 436-439.
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1
Reference Text: 
Marshall BJ, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet 1984; 1: 1311-1315.
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2
Reference Text: 
Pyloric Campylobacter finds a volunteer [editorial]. Lancet 1985; 1: 1021-1022.
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3
Reference Text: 
Ramsey EJ, Carey KV, Peterson WL, et al. Epidemic gastritis with hypochlorhydria. Gastroenterology 1979; 76: 1449-1457.
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4
Reference Text: 
Gledhill T, Leicester RJ, Addis B, et al. Epidemic hypochlorhydria. Br Med J (Clin Res Ed) 1985; 290: 1383-1386.
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5
Reference Text: 
Rauws EA, Tytgat GN. Cure of duodenal ulcer associated with eradication of Helicobacter pylori. Lancet 1990; 335: 1233-1235.
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6
Reference Text: 
Marshall BJ. The 1995 Albert Lasker Medical Research Award. Helicobacter pylori. The etiologic agent for peptic ulcer. JAMA 1995; 274: 1064-1066.
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7