Dr Phil Hammond, GP and atheist presenter of BBC1's Heaven and Earth Show

One of the first columns I wrote for Guidelines in Practice was about Dr Joseph Goldenberg, an American physician practising a century ago, who was so convinced that pellagra was an infectious disease that he injected the blood of diseased patients into his shoulder, and rubbed their phlegm and nasal secretions into his own mouth and nose.

When that didn't give him pellagra, he went the whole hog and swallowed his patient's urine, faeces and skin. For the sake of balance, he also forced this menu on his friends and family. Some of them felt a bit unwell, but none got pellagra.

After seven failed attempts, he stumbled across a cure for pellagra (brewers' yeast) and the true cause (niacin deficiency). He may have been wrong, but you don't see that sort of heroic dedication from today's junior doctors.

Another self-experimenter who actually got it right is the Australian, Dr Barry Marshall.

Barry was convinced that the bacteria Helicobacter pylori caused stomach ulcers, but back in 1982 his peers thought he was away with the fairies. So he asked his mate John Noakes (no relation to Valerie Singleton) to knock him up a heavy suspension of the bug scraped straight off the agar plate. And he sculled it, down in one.

As John put it, "It's not the sort of thing you'd want to sip down, probably."

"No" confirmed Barry. "It was like swamp water, quite putrid in fact ."

Way to go, Barry.

And he did. He woke at 3am with terrible stomach cramps and started a lengthy affair with his toilet. These were extremely good signs. On day eight, he woke at 6 am and had a curious vomit.

"I couldn't taste any acid. It looked just like water I was bringing up but I hadn't been drinking anything so it was quite puzzling."

He later realised that the bacteria had caused all the protective acid to disappear out of his gastric juice.

After ten days of suffering, he had a celebratory endoscopy. Hurrah! He had early signs of a stomach ulcer.

"Unfortunately my wife insisted I start taking antibiotics after that because she was worried about me getting worse or something bad happening ."

The antibiotics cured the ulcer, Barry became a medical hero and further research proved that eradicating the bug not only cures peptic ulcers but decreases relapses and saves money in the long run because of a reduction in the prescription of more expensive acid-suppressing drugs.

Alas, good research takes aeons to get into everyday practice so many of your ulcers are probably still infested with Barry's putrid swamp water.

Dr Albert Hofmann was also a keen self-experimenter. In 1943, he swallowed the drug extract of a fungus which he hoped would help people with breathing difficulties. Unfortunately the drug preferred to camp out in his mind, giving him vivid hallucinations on his bike ride home. "It was so unusual that I really got afraid that I had become insane."

Yes, Albert had discovered LSD and taken the world's first trip. Not quite enough for a Nobel Prize, but enough for ever-lasting adoration from the world's acid heads.

No Nobel Prize either for Dr Pierre Bestain, who was so convinced he'd discovered the antidote to Death Cap Mushroom that he wolfed a whole plateful, fried with a knob of butter. He survived, told the tale and word soon spread of his amazing antidote.

Alas, when others tried it to treat unintentional overdoses, it failed without fail. Pierre, it seems, was just genetically immune to the mushrooms. His cure was an irrelevance.

So what can we deduce? Certainly one person's personal experience doesn't quite constitute scientific proof. You need to road test your theory on more than your own gene pool before you can call it evidence based medicine.

True, being your own guinea pig has its limits and it's not without considerable risk, but if you pull it off, you'll go down in history. Or the very least get a mention in Guidelines in Practice.

Guidelines in Practice, September 2001, Volume 4(9)
© 2001 MGP Ltd
further information | subscribe