Treatment of duodenal ulceration with Furazolidone in China preceded the discovery of its association with H pylori

TO THE EDITOR

It is not generally known that patients with duodenal ulceration were being treated with an antibiotic, Furazolidone, in China five or more years before Marshall and Warren[1] published their seminal paper in 1984 about the association between duodenal ulceration and Campylobacter like organisms in the stomach, later named H pylori. Marshall and Warren won the 2005 Nobel Prize in physiology or medicine for their work on how a bacterium can relate to gastric inflammation or peptic ulceration.

In 1981 I was invited by the Bureau of Health to a lecture/research tour of rice-growing areas of China in connection with research into the geographical prevalence of duodenal ulceration in relationship to staple diets. During that visit I met Professor Zhi-Tian Zheng at the Third Teaching Hospital in Beijing, and he told me about a series of duodenal ulcer patients, 80% of whose ulcers had healed, and had remained healed for 3 years, following a 2 wk course of treatment with Furazolidone. At the time I was very sceptical about this.

I was invited back to China in 1984, this time to make a tour of the wheat and millet-growing areas, and once again I visited Professor Zhi-Tian Zheng in Beijing. By then he had gathered a much larger number of patients whose duodenal ulcers had healed following treatment with Furazolidone, and who were remaining in remission. I persuaded him to publish this, and a letter from him and his colleagues appeared in The Lancet in 1985[2].

Later in this tour I found that Professor Huai-Yu Zhao in Lanzhou had similar findings which he and his colleagues also reported later in the same year in a letter to The Lancet[3].

It seems only right that Professors Zhi-Tian Zheng and Huai-Yu Zhao and their colleagues in China should have some of the credit for having linked persistence and recurrence of duodenal ulceration with a bacterial infection.