15. The Twentieth Century Forgets The Nineteenth

In 1915 the Prudential Insurance Company of New York startled practically nobody by saying that uncivilized people, among whom they named the Canadian Eskimos, have little or no cancer. But in 1956 The Canadian Medical Association Journal of Toronto startled practically everybody by saying the like about uncivilized Canadian Eskimos, saying it, that is, over the names of a group of McGill University doctors.

Why was the medical world so ready to accept the medical missionary type of frontier report in 1915, so unready in 1956? To this question I shall present several replies. For incisiveness and sweep the reply of Dr. John Cope will be given first. The introduction to his book indicates that he is writing under a pseudonym, so I shall introduce him by quoting from a signed book that introduced him to me.

The Mortality from Cancer Throughout the World, a work I have cited frequently, was issued during 1915 by the Prudential; it is an 826-page volume by Dr. Frederick L. Hoffman, head of the company's statistical department as well as chairman of the Committee on Statistics of the American Society for the Control of Cancer. As implied above, it runs through Hoffman's work that uncivilized people seldom if ever have cancer. Throughout it is implied, and now and then stated, that this is a common and orthodox belief.

But in later works it appears that Hoffman, though still himself of the same view, realized that there were many skeptics. This is especially apparent in the second of his huge volumes, Cancer and Diet (1937). Here, page 90, is the passage I shall use to introduce Cope:

“An exceedingly important work on Cancer: Civilization and Degeneration by John Cope, was published in London in 1932. Cope discusses the early eating habits of the English and the rarity of cancer at the time, the disease increasing as the consumption of meat decreased. He deplores certain civilized customs ...”

Elsewhere I shall go into some of the civilized practices which Cope deplores. Here I quote,* abridge, and paraphrase his views on how and why skepticism arose concerning the reports and views of medical missionaries, and of other frontier doctors. I quote from Cope's “Preface and Introduction”:

“Until the beginning of this century the search ... was for the most part unsystematic ... Cancer was studied mainly as it existed in human beings — that is to say, in the consulting-room, at the bedside, in the operating theatre and in the post-mortem room ... The search was of the widest possible character. Not only pathology, but physiology, anthropology, zoology, botany were made to contribute material, and so also were history, chemistry and statistics ...

* I quote Cope at greater length because his book is hard to come by. It seems to be owned by less than half a dozen of the great libraries in the United States; and when the Dartmouth College Library borrowed one copy especially for me, I had to return it before I had made up my mind what to quote from it. Then I got the idea of trying to buy a copy in England but failed. The next step was to try to borrow a copy in London, and I managed this by getting a doctor friend over there to borrow one and send it to me surreptitiously.

“While the nineteenth century workers were engaged in this comprehensive, if loose investigation, two great discoveries were announced. ... One was the discovery by Pasteur in 1873 that many diseases are due to the invasion of the body by minute forms of animal or vegetable life; the other the discovery (by Moreau, 1891; Loeb, 1900; and Jensen, 1902) that cancer-cells can be successfully grafted from one animal to another of the same species.

“It would be difficult to exaggerate the expectations which were aroused by the progress in scientific method implied by these two events. Towards the end of the century the opposition with which Pasteur's work had at first been received gave place to a tendency to look for micro-organisms as the cause of every disease; and so it naturally came to pass that the methods of experimental laboratory research, which had proved so successful with cholera and tuberculosis, were made use of to throw light on the nature and origin of cancer.

“Nothing, therefore, could have been more opportune than the discovery that cancers can be grown artificially in lower animals, for it seemed enormously to facilitate the investigation of this disease. Instead of being hampered by dependence upon human beings for the material to be studied, or upon rare cancers in lower animals, the researcher could pursue his investigations unchecked. Whole villages of mice could be collected and observed within the compass of a workshop or laboratory; and, instead of having to wait some forty or fifty years before the growth of the cancer begins, as is generally the case with human beings, the disease could be produced artificially within a few weeks ...

“The researcher, moreover, could use the mouse as he would a test-tube or flask, and throw it away when done with it, whereas the study of cancer in human beings is beset with obstacles. In these, and other ways, so great is the ease of cancer research among mice compared with its difficulties among human beings, that there was every justification for the optimism with which Jensen's discovery was regarded as ‘almost tantamount to the solution of the cancer problem.’

“More than thirty years have gone by since this discovery was made; a whole generation of human beings has been born, has lived and has died; laboratories have been built in all parts of the civilized world; many thousands of pounds have been spent; the lives of many able scientists have been devoted to the quest, and whole libraries of magazine articles and books testify to the patience, industry and ability with which this pursuit has been conducted.

“And now, after all these years of noble toil, not even the most sanguine research worker can point to anything that can by any stretch of the imagination be termed a solution of the problem which the researchers set out so confidently to answer.

“Perhaps no one has more decisively summed up the results than Dr. Woglom, a great American laboratory cancer researcher. And his words are so much the more effective in that he writes in appreciation of research. In an article published last year, with the object of summing up the achievements of laboratory cancer research, so far as human beings are concerned he is unable to point to any sign of progress, any advance whatever ...

“Of the quantity and quality of the labour bestowed upon laboratory cancer research there can be no question ... Nor are those engaged in this work apparently in the least discouraged by the lack of success. On the contrary, they seem full of conviction of the imminence of some discovery which will reward them for their industry and patience ...

“In accounting for this inveterate assurance of impending success, still existing after a third of a century of repeated failure, it must first be realized that the output of work by cancer researchers is enormous. Although it may be true that from this mountain of labour nothing has so far emerged but a cancer-bearing mouse, those who have been engaged in throwing up this mountain are able men, specially trained in the techniques of the laboratory and eminently fitted for their particular method of study. When, therefore, they assure us with the utmost confidence that at any moment something may happen which may transform this mountain of hitherto useless facts and data about cancer in mice into valuable material capable of solving the problem of cancer in men, we are bound to accept their assurance as the genuine belief of men, who, by their self-sacrificing devotion in the face of enormous discouragement, have earned the right to public respect.

“Yet at the same time it is equally right and equally in the interests of the public and of ourselves as members of the medical profession, that we should face certain consequences which must necessarily grow out of any movement, supported by the public, which fails in its purpose after many years of strenuous effort ...

“Experience has proved that those who have spent a good many years of their lives in experimental research have acquired modes of thought and habits of working which, to say the least, do not make them safe judges of the results of wider methods of inquiry. The very precision and exactitude of detail which are of so much value in intensive research, added to the restricted circumstances of the laboratory, lead to a narrowness of view, to a lingering over minutiae, which must needs unfit those so engaged from taking any part in forms of inquiry for which broad, spacious views are essential. Yet it happens that, thanks to the perseverance and ability of those engaged in research, to their wonderful optimism, and to the generosity with which the public has poured in its contributions, laboratory research has so increased in extent and in influence that it is now generally recognized as dominating all other forms of cancer inquiry. And those who are within its circle are those who now constitute the authorities on all that concerns investigations into the origin of cancer.

“Experimental cancer research has, in short, become so isolated and so entrenched that, without being aware of it, the researcher now almost instinctively regards those who criticize his opinion, question his authority, or adopt other methods of working, not as fellow workers, but as amateurs, as ‘outsiders,’ or even as positive enemies ...

“It must ever be held as one of the worst evils of laboratory cancer research that by its extreme caution, its timid reluctance to accept evidence, its insistence upon proofs suitable only for its particular method of inquiry, it is responsible for holding up for a generation one of the greatest and most promising advances of the nineteenth century.”

According to Cope, then, cancer research has been on the wrong track ever since it became overconverted to Pasteur. And, being on the wrong track, it got still further off course later through also becoming overconverted to the discoveries which we connect with the also truly great names of Moreau, Loeb, and Jensen.

Conclusions similar to Cope's have been arrived at by many, among them the famous authority on malignant disease, Sir Charles Dodds, professor of biochemistry in the University of London, one of the four vice presidents of the Seventh International Cancer Congress of July 1958. By his permission, I quote from “The Problem of Cancer” in the London Science News for October 1949:

“The principles of chemotherapy can be said to have originated in the classic researches of Ehrlich ... After Pasteur and his followers had established conclusively that the majority of diseases were due to the invasion of the victim by bacteria, Ehrlich was the first to conceive the idea of producing a chemical substance which would ‘shoot’ the bacteria but leave the tissues of the host unaffected ... The first great success in this field was the discovery of salvarsan ... This substance, relatively non-toxic to the host, becomes attached to the spirochaetes, the cause of syphilis, and kills them. Since the days of Ehrlich, we have seen ... progress in this field. The sulphonomides and the anti-malarial drugs are brilliant examples ...

“It is only natural that attempts should have been made to apply the same general principles to the treatment of cancer ... [but] the would-be chemotherapist is on very uncertain grounds, since he does not know the nature of the process he is attempting to reverse. The only knowledge he has got is that the cancer cells grow in an unrestrained and disorganized manner as compared with normal cells ...”

Sir Charles then goes on to indicate that in a half century of this kind of study no appreciable progress has been made toward a cure for cancer:

“To conclude, it will probably appear to the lay reader that the situation borders on the hopeless and that, after fifty years of modern cancer research, it is unfortunate that so little progress has been made ...

“[But] advances in pathology and therapeutics cannot be forecast on a time basis, that is to say, in order to know twice as much as we know at the present time it may not be necessary to take another fifty years of intensive work. A discovery in some allied field may alter the whole nature of the problem ... the broader the basis upon which the research is conducted the more likely the successful outcome ... in an entirely unknown field, any form of knowledge may tum out to be of vital importance.”

To illustrate what sort of thing may eventually prove to have been wrong with the standard cancer study, Sir Charles takes a possibly analogous case:

“A hundred years ago one of the great menaces to life was suppuration ... One can well imagine a group of philanthropic people banding together to firm an organization to investigate the fatal malady. Having collected the money, they would be faced with how to proceed to spend it. One way would be to form institutes for the study of suppuration, and those would correspond to the purely cancer research institutes.

“Here one can imagine the workers collecting purulent discharges, analyzing, investigating them microscopically, and so forth. We know today that they could have gone on doing this to the present time without getting any nearer to the solution. Before the mystery of suppuration could be solved, Pasteur had to found the science of bacteriology ... we then had to have Lister with his development of antiseptic surgery ...”

Sir Charles Dodds' “The Problem of Cancer” is itself a 17-page abridgment and I have done it scant service by further abridging it. Sir Charles concludes:

“We should take the lesson [of the suppuration example] to heart and realize that everyone who is working in the biological sciences is a potential cancer research worker and may actually be paving the way to the knowledge that will discover a cure of this disease.”

With a reminder that I am quoting only a few of those who have been profoundly disappointed in the trend of cancer research since the close of the nineteenth century, I shall follow up Cope (1932) and Dodds (1949) with excerpts from an even more recent (1957) book which I have quoted at greater length in another section — Cancer, by Dr. Alexander Berglas of the Pasteur Institute in Paris. By permission of Dr. Berglas, I quote from his preface:

“Over the years, cancer research has become the domain of specialists in various fields. Despite the outstanding contributions of these scientists, we have been getting farther and farther away from our goal, the curing of cancer. This specialized work, and the knowledge gained through study of the individual processes, had the peculiar result of becoming an obstacle to the study of the whole.

“More than thirty years in the field of cancer research have convinced me that it is not to our advantage to continue along this road of detailed analysis. I have come to the conclusion that cancer may perhaps be just another intelligible natural process whose cause is to be found in our environment and mode of life.”

With this sentiment that might have come from Tanchou in 1843, or from any of the medical missionaries, I shall postpone to another chapter further consideration of the Berglas work and tum to the last distinguished proponent of the view that a cure for cancer is not to be expected from the kinds of researches that have occupied the professionals since 1900.

Sir Macfarlane Burnet is the director of the Walter and Eliza Hall Institute for Medical Research in Melbourne, Australia. He returned on August 26, 1958, from various medical conclaves and was interviewed in Sydney by United Press International:

“It is highly improbable that a cancer cure ever will be found, Sir Macfarlane Burnet, world famous Australian scientist, said today on his return from cancer conferences in London, Stockholm and Toronto.

“I do not want to be discouraging; but when it comes to cancer cures I am definitely a sceptic,” Burnet said. ... “It is foolish to talk of a cure being just around the corner.”

But although these authorities are pessimistic about the major trend in cancer study since 1900, which has been aimed at finding a cure, many of them are hopeful along nineteenth-century lines, namely prevention. That this was the main conclusion of the London conference of 1958 is indicated in a summary published on July 26 of that year by Science News Letter of Washington, D.C. Under the heading STRESS CANCER PREVENTION comes a subhead, “The Emphasis in Cancer Research May Soon Turn ... to Ways of Preventing Its Occurrence.” This is summarized:

“Moving from the diagnosis and treatment of cancer into how to prevent its occurrence, was the major step forward taken by the Seventh Congress, Dr. C. P. Rhoads, director of the Sloan-Kettering Institute in New York, said.”

Along the lines of hope in prevention indicated by Dr. Rhoads, I shall sketch some of the many ways in which the twentieth century has been rediscovering the nineteenth.

Chapter 16 >>