As I have indicated, the ideas of the mysterious M. Tanchou had spread, since their introduction to the U.S. in 1846, with the potent assistance of Dr. John Le Conte and others, to the regions of Alaska and northern Canada where uncivilized people still lived and might be observed.
But of Tanchou himself I was for some time able to learn practically nothing beyond what was to be inferred from the articles dealing with his views that were published by Le Conte at the mentioned intervals 1846-1872-1888. Even from these I received a disquieting and tantalizing sense of bewilderment. Apparently Le Conte, who clearly believed that an extensive manuscript on cancer had been entrusted to the French Academy by Tanchou in 1843, had never been able to see this manuscript nor any full publication of it — had seen nothing beyond some fairly lengthy summaries.
Feeling sure that such a manuscript must still exist, and thinking that probably it had been published or that longer extracts from it had been, I sent the aforementioned appeal to Dr. Alexander Berglas, member of the Cancer Research Foundation of the Pasteur Institute, to receive in reply a friendly and co-operative letter dated June 2, 1957, which however contained the sentence, “Regarding the work of Stanislas Tanchou, who is unknown to us, we have not as yet been able to obtain any information.”
This unawareness of Tanchou, coming from a center of French cancer studies, might perhaps have been dismissed as just a further instance of the Biblical principle that a prophet is not without honor save in his own country. But the quotations that were used by Le Conte, from a Tanchou memoir which the French Academy had in its custody, appeared to me to show that Tanchou had relied heavily on African sources for support of his thesis: “Mortality from cancer is in direct ratio to the intensity of human civilization.”
So I would at least go one step further and check as best I could on published cancer material from Africa. If I could learn nothing of Tanchou himself, I might nevertheless find African testimony for or against Tanchou's ideas.
First I turned to the cited Hoffman compendiums, the 1915 Mortality from Cancer Throughout the World and the 1937 Cancer and Diet. Among applicable references I found one in the 1937 book that does face squarely the issue of whether the advancing of Europeanization has been considered to have promoted cancer in Africa. The source given on Hoffman's page 41 is Cancer: The Problem of Its Genesis and Treatment, by Dr. F. W. Ross (London, 1912):
“... the savage negro in the interior of Africa is enjoying ‘His comparative immunity from cancer because his method of preparing his food and drink is different in every essential from the methods used by the more civilized negro and white man ...’”
An even more striking proof that a prophecy may be familiar to those who have forgotten the name of the prophet, is found in the already mentioned, important Cancer: Its Nature, Cause and Cure, published in English during 1957 at Paris by Dr. Alexander Berglas of the Pasteur Institute. Throughout the book runs the theme that cancer is a disease from which the nature peoples are relatively or wholly free. A most noteworthy statement of this view is contributed by Nobel laureate Albert Schweitzer in a preface from which I quote by permission of Dr. Berglas.
The sketch of Schweitzer begins, “Missionary surgeon, founder of the hospital at Lambaréné ...” The Schweitzer preface includes:
“On my arrival in Gabon, in 1913, I was astonished to encounter no case of cancer ... I can not, of course, say positively that there was no cancer at all, but, like other frontier doctors, I can only say that if any cases existed they must have been quite rare. This absence of cancer seemed to me due to the difference in nutrition of the natives as compared with the Europeans ...
“In the course of the years, we have seen cases of cancer in growing numbers in our region. My observations incline me to attribute this to the fact that the natives were living more and more after the manner of the whites ...
"I have naturally been interested in any research tracing the occurrence of cancer to some defect in our mode of nutrition ...”
What we know to be the essence of Tanchou's thinking was, then, endorsed from France and from French Africa by Drs. Berglas and Schweitzer, among others. So the mystery deepened of how the prophet could be so completely forgotten when the fulfillment of his prophecy was so well attested.
This mystery I was about to drop, as beyond my power to solve, when the possibility of solution came through a piece of news. My friend Phil White, distinguished cancer specialist, had been invited by the University of Paris to give a series of lectures. For half a year he would be associated with the present “Immortals” of France, whose Academy was custodian of the Tanchou memorial, if it still existed, and surely custodian of memories and records concerning it. Would Phil undertake the search? He would.
Since then the Whites have spent the half year in Paris, a good share of it in difficult and intricate pursuit of Tanchou clues and facts. We shall present Phil White's report below, but first we should like to present him to readers who are not cancer specialists.
According to American Men of Science, following 1945 Philip R(odney) White spent a number of years as senior member and head of the Division of General Physiology at the Institute of Cancer Research in Philadelphia. He now holds a similar position in cancer research with the Roscoe B. Jackson Memorial Laboratory in Bar Harbor, Maine. During the season 1958-59 he was on leave of absence for a year, lecturing about cancer and conferring on its problems, in France and several other countries in Europe.
Report of Dr. Philip R. White on his Tanchou Inquiry
On February 13, 1959, Carol and Phil White wrote from Paris. Phil's part of the letter said:
“Yesterday I sent you a packet of papers on the Tanchou affair. Today ... Carol urged me to write a little squib of a different sort [for possible use in a magazine]. I have written one; but clearly it should have your approval, if forthcoming, before being submitted.” It received my approval and I present it here:
“There is probably no more august body of savants in the world than that created by Descartes and Pascal, sanctified by Richelieu and the Roi Soleil, abolished by the French Revolution, rejuvenated by Napoleon; the Académie Française and its associated academies which make up the Institut de France: ‘The Immortals.’ Under the dark dome of the institute, on the Left Bank of the Seine, in the old Palace of the Four Nations, these men meet to ponder the problems of the world ...
“A year ago one of the youngest old men I know, Vilhjalmur Stefansson, arctic explorer, authority on Eskimo life, teetotal carnivore at eighty (he eats only [fat] meat), still exploring new trails, set me on one which has led me a merry chase. The Eskimos seem not to have had cancer under their primitive way of life. Neither do certain South American Indians, so the tale goes. Nor do the natives of Central Africa.
“A century ago a French doctor, Stanislas Tanchou, who had served with Napoleon in Russia and at Waterloo, retired to Paris and private practice after the wars. At the end of a lifetime of experience and study of the statistical distribution of cancer, by peoples, by profession, by sex, age, and habits, Tanchou propounded the theory that cancer was a disease of civilization. Coming to the attention of Californians ... the idea impressed itself upon the minds of doctors and sea captains in the Alaska trade so that the early observations on the Eskimos were more than casual notations; these men were looking for cancer. That they did not find it gives their data added weight.
“But this information in the hands of Arctic ship surgeons was second or third hand. Just what had Tanchou himself said, and what was the basis for his conclusions? My friend Stef wanted to know. And the Surgeon-General's lists, the Archives of the Library of Congress, were rather reticent. A few brief notes but nothing like the extensive papers which the British and American medical journals of the 1840's had ‘reviewed.’ Where were the originals? Perhaps somewhere in Paris, where one can find anything if one looks long enough. I was going for some months to Paris. Would I see what I could find?
“I love a hunt. Starting from the Surgeon-General's list I went first to the Library of the Académie des Sciences. Yes, Tanchou had presented many papers before the Academy, on a variety of subjects; in fact he had three times presented himself as a candidate for election to that body, and three times failed. Among the papers published in the Comptes rendus des séances hebdomadaires were two which dealt with distribution of cancer, presented in 1843 and 1844. I asked to see them. No, these were only brief notes: ‘M. Tanchou summarized as follows. ...’ And no bibliography, no cross references. Perhaps at the library of the École de Médecine? The Surgeon-General listed four papers there by or about Tanchou. One was clearly wrong: it said 1844 but the journal named didn't start publishing until 1847. Another proved to be only an obituary notice. A third was also partly wrong — the journal had twiced changed its name in 100 years — but by persistence we tracked it down, only to find that the particular weekly number which should have contained Tanchou's article was missing from the file. That left only one, an English journal of 1843. Not very promising. But here we were in better luck, for the Lancet appeared to have translated almost literally the missing article from the Gazette des Hôpitaux Civiles et Militaries. But this again was clearly an abbreviated version of a longer paper which Tanchou said he had published elsewhere. Where?
“On a hunch I went back to the Academy and asked if Tanchou might perhaps have filed a manuscript with them, a manuscript which he had hoped to publish but had not done so. Into the archives again, this time not just to their index but into the actual files for 1840 to 1845. There were many items; twenty-two case histories gleaned from the literature of the world, drawings of operations for cancer of the breast, notes on dissolving bladder stones without operation and, ah, yes, two of interest. One was a twenty-page manuscript which appeared to be, in fact, what I was looking for, though upon closer study it proved disappointing, adding nothing essential to the material in the shorter summaries. The other, however was intriguing. It was simply a notation: ‘Tanchou, deposited June 5, 1843, a sealed packet.’ That was all.
“Early in its existence the Academy took upon itself the responsibility of serving as custodian of ideas, public or private. In the seventeenth and eighteenth centuries in particular, ideas might be dangerous, and since plagiarism was common, even perfectly safe ideas might be hoarded. If a man had such an idea and wanted to establish his right to it without making it public, he could deposit it with the Academy. Thereafter he could, during his lifetime, request the return of his deposition; after his death his heirs could request that it be opened and read but could not have it relinquished to them; and, after 100 years, if requested by anyone not an heir, the Academy reserved the right to open such a packet and decide whether its contents should be published, should be destroyed, or should be returned to the archives for another century. In practice they never destroy anything.
“Was this another manuscript? It had been sealed for 116 years, I could at least see it. This required a formal letter ... A letter was dispatched and permission duly granted to ‘examine’ the packet. On my next visit to the Academy the librarian brought it to me. No, this could not be a long manuscript; it was too small, no larger than a letter, probably only a single sheet of paper. But permission to ‘examine’ did not include permission to open ... So I sat down to write a second letter ... Official approval was granted and a date set for the formal opening.
“Such occasions are impressive. The long paneled hall, a central podium for the president and the two secretaries, an oval series of desks with six transverse lines seating the eighty Immortals, benches along the walls for visitors (the sessions are open to the public), to the left, right, and front statues of Molière, Racine, and Corneille, between these, busts of Buffon, Lamartine, Pascal, Chateaubriand, Laplace, and others. The Immortals file in, sign the register, take their places. There is the usual reading of minutes; a paper is presented ... And then the announcement, ‘The Academy has before it a request from an American colleague, M. White, that a sealed packet deposited in 1843 by M. Tanchou, physician to the King, be opened ... Do I hear any objections? If not it will be done ... In that case we will open the packet.’ An officer beckoned to me to step forward ... He broke the seal and with some difficulty opened the brittle folded paper. It contained a second sealed paper. This seal was also broken and a double sheet of paper spread out ... The ink was dim and the writing ancient ... There was a word underscored in the second line, a short word. What was it? ... It was ‘SEXE’! The paper had nothing to do with cancer.
“My search was ended. I am not sure my friend Stefansson will be content with the result ...”
In a way, I am content with the result. Dr. White's search has, for one thing, indicated what sorts of difficulties may have hampered Dr. John Le Conte in a search for the Tanchou memoir which, it is hard to doubt, he must at some time have made — perhaps in the 1880's, with all the dignity of a university president, preparing for his third statement on Tanchou, the one he issued in 1888.
The more formal report from Dr. White was dated February 11, 1959, two days earlier than the one just quoted. It is to the same effect, and concludes: “... Tanchou had a good idea on the effects of civilization ... He should be remembered for having tried to deal with the question on a statistical basis. His idea of the influence of civilization was fruitful in pointing to facts which need to be studied ...”
With the Dead Sea Scrolls throwing unexpected light on the founder of Christianity, with family revelations throwing expected light on the founder of Darwinism — with such portents, the expected or unexpected may happen to throw new light on Tanchou. But it will then probably be too late for use in this book. Therefore I shall summarize and add further bits.
Though Tanchou is now forgotten in his homeland, and though Africa may be fulfilling his prophecies without knowing they are his, it was not always thus.
It was not so in 1850, the year Tanchou died. That year, pages 487-90 of the Revue Médicale Française et Étrangére carry an affectionate, heartbroken, laudatory appraisal by Boys de Loury, secretary general of the Paris Society of Medicine. However, though the memorial praises Tanchou as a soldier and citizen, and is full of admiration for him as a leading and inspiring figure in the domain of medicine, it says of him in relation to cancer only, “Tanchou's researches on the diseases of women stand out particularly, and especially those on cancer.”
The “Memoir on the Frequency of Cancer,” which Tanchou in 1843 “addressed to the Academy of Sciences,” appears to have made the following points, among others:
According to the Hospital Gazette (Civilian and Military) for July 6, 1843, charts show that cancer is much more frequent in Paris proper than in its suburbs: “... [the like] has been noticed in Berlin and in England ... we know that the number of cancer cases is increasing ... this disease seems to be very old in the civilized world. The first example is that of Atossa, daughter of Cyrus and wife of Cambyses, in 521 B.C. ... many cancers have been found among the mummies of Egypt; and M. Homem ... who spent 14 years in the service of Mahomet Ali, never saw cancer among the peasant women but only among the [aristocratic] Turkish women.
“Cancer is like insanity, found most often in the most civilized countries ... in the Orient it has been found more frequent among Christians than Moslems. Fabrice de Hilden believed that cancer appeared more often in the temperate zone than in the other zones. M. Rouzet says that it is very rare in Africa.
“We have gathered information on this last point that leaves no doubt. Dr. Bac, surgeon-in-chief of the Second African Regiment, never found a case in Senegal, where he practiced medicine for six years. Many other health officers of our brave army have told us the same thing. M. Baudens, surgeon-in-chief at Val-de-Grâce, who practiced civilian medicine in Algiers for eight years, said he met only two or three cases. Finally: Dr. Puzin established a civilian hospital in 1835, 10 leagues from the front; out of 10,000 sick whom he examined there was only one cancer case, the breast cancer of a woman.”
So far as it is possible yet to tell from the documents studied, Tanchou's chief material for arriving at his law came from North Africa, and involved a higher observed cancer rate among the dominant French than among the lowly peasants. The main observations Tanchou bolstered with like Asiatic testimonies, and with statistics comparing metropolitan with suburban Paris, and Paris with England and Wales, also Paris with London. In Europe this all seemingly passed without creating emotional flurries.
In the United States of 1843, the War of 1812 with Britain was still a fresh memory; nor had the embers of the 1776 revolution quite died down. So it was the American fashion to twist the British lion's tail. In his 1846 presentation of Tanchou's ideas, Le Conte, instead of playing up the French-Africa situation as we now feel he should have done, played up the Paris-London statistics, and suggested that, from applying the Tanchou principle to the figures, “it clearly follows that Paris is 4 times more civilized than London.”
But from the Tanchou principle, applied to the African testimony, it follows even more strikingly that the French are more civilized than certain Africans — not by a mere 4 times, but by perhaps 40 times, or 400 times. (The British-French and metropolitan-suburban comparisons are carried further in Chapter 16 in the discussion of the Danish Cancer Registry studies of the twentieth century.)
Though perhaps not with the clarity that leaps to the eye when we compare Le Conte's interpretation of Tanchou's thinking with what medical missionaries think they have observed in Alaska, Tanchou's own version of his law has been confirmed too in that law's homeland, Africa; and continues being proved, at least in the opinion of medical missionaries, as has been shown in the early part of the present chapter through the 1957 quotation from the surgeon-missionary Albert Schweitzer.
Tanchou, as I have indicated, was recognized by Le Conte as contributing many other notions about cancer besides the conception of its being, in its death rate, more severe on a people the more civilized they are. One of these points, of which this review has not yet sufficiently taken notice, is that Tanchou appears to equate “civilization” and “domestication,” as to what he believed to be the canceriferous results of both. Among the documents I have read so far, this is brought out most clearly in the notice of the Tanchou memoir in the Comptes rendus des séances de L'Académie des Sciences (Paris), January-June 1844:
“The disease seems to occur more frequently in the cities than in the country; it is almost unknown in [the natives of] America and Africa. In Egypt one finds it among the Turkish women but not at all among the Egyptian peasants ... The disease is not rare among domestic animals, nor among those in menageries; but there are no cases known among wild animals."
In a way, it is a satisfaction to infer that Le Conte had the same difficulty with his basic source that I have had. He apparently never saw the Tanchou memoir itself, nor any full copy of it. At least he wrote his chief paper, the one of May 1846, without this advantage. For on page 258 he has a footnote:
“For abstracts of M. Tanchou's Researches see London Lancet for August 5, 1843, Am. Ed., p. 593, from Gazette des Hôpitaux for July 6th, 1843, p. 200; and Medico-Chir. Rev. for Jan. 1844, p. 213, from Gazette des Hôpitaux."
Nor did Le Conte add materially after 1846 to his citations of Tanchou, either in his 1872 Western Lancet article or in the last of his formal summations, in the Tenth Biennial Report of the State Board of Health of California (1888). What Le Conte does add is support of Tanchou's conclusions from other sources.
No doubt Le Conte had the advantage over me that he read current discussions of the Tanchou memoir other than those I have yet seen. And then, as Le Conte emphasizes in his “Statistical Research on Cancer,” he had actually himself studied, and publicly commented upon, much of the evidence which Tanchou is said by his various reviewers to have used. Indeed Le Conte had used some of this evidence more than a year ahead of the Tanchou notice of July 6, 1843. In another 1888 footnote Le Conte says of his own publication:
“This monograph on Cancer was read before the Society of Alumni of the College of Physicians and Surgeons of the University of the State of New York on the 18th of October, 1842; and was published in the first number of their ‘Transactions,’ and likewise in the New York Lancet for Oct. 29th and Nov. 5th, 1842, pp. 484 and 299.”
With this digressional summary of nineteenth- and twentieth-century opinion and testimony concerning the relation of European culture to the cancer problem in Africa, and concerning how Tanchou's ideas are thought to have measured up to African eventualities, I shall now return to my main theme, the observations and opinions of frontier doctors and nurses relevant to the malignancy problem in Alaska and northern Canada.