16. The Twentieth Century Rediscovers Nineteenth

To the medical missionaries it would seem that Cope, reviewed a few pages back, explains just why Europe forgot Tanchou and why North America went sound asleep after the nineteenth-century awakening through Le Conte's efforts as chronicled by Hoffman in his books of 1915 and 1937.

Later in the present chapter, when the already quoted work of Dr. Berglas is taken up in greater detail, it will appear that things were indeed in a bad way when Dr. Cope was writing his Cancer: Civilization and Degeneration. But even as he published this book, in 1932, the rediscovery of the nineteenth century's approach to cancer was already in process, and in several parts of the world. With a bias resulting from my own study, I would have preferred to find the old belief returning to Europe through a resurrection of Stanislas Tanchou's memoir addressed in 1843 to the French Academy of Sciences. Or I would have liked the revival to come from the frontier doctors, perhaps from Alaska's beloved Dr. Joseph Romig or from the world's darling of music and medicine, Dr. Albert Schweitzer.

But the revival actually came simultaneously from many lands, and arose from none of these sources. In most places the revival seems to have stemmed from an unheralded rolling away of some stone from the door of a sepulcher of tact. In one case those who did the unrolling hailed from two countries, Britain and Denmark, The story is told in an article in the Danish Medical Bulletin for May 1955 on “The Danish Cancer Registry,” by Dr. Johannes Clemmesen, the registry's director:

“In 1937 [thus five years after the publication of Cope's book] Kennaway and Kennaway ... [reported] that mortality statistics from England and Wales had revealed differences in mortality from cancer between various social classes.

“Contrary to the expectations of the writer, his subsequent studies of cancer mortality among Danish breadwinners, of various occupations, confirmed that also in Denmark differences could be demonstrated between certain occupational groups, and between the capital, provincial towns and rural areas.”

On the principle that every effect has a cause, the obvious method was to record for every cancer victim everything conceivably pertinent about his ancestry, and about his life up to the time when the cancer struck. “It was therefore suggested by the author that continuous registration should be made of all cases of cancer in the Kingdom of Denmark ... On May 5th, 1942, the Danish National Anti-Cancer League opened a National Cancer Registry.”

Evidently Dr. Clemmesen had been feeling, much as Dr. Cope did, that cancer research had swung too far away from the comparative study of groups of peoples who have little or much cancer (endemiological research), and too exclusively toward animal experimentation — the artificial production of cancers in multitudes of small beasts, directed toward discovering, if possible, before or after they die, how to slow up or stop the deadly course upon which the creatures have been launched by the experimenters — a launching with the laudable purpose of finding out how to alleviate or cure malignant disease in humans, but with the deplorable actual result that, in fifty years and after hundreds of millions spent, we have not improved our skills in fighting cancer enough so that the annually increased number of cancers contracted is balanced in the mortality statistics by the annual number of deaths prevented. Like Dr. Cope, Dr. Clemmesen feels that this too great swing away from endemiological research took place around 1900, for he says:

“While experimental cancer research, since the beginning of the present century, has appealed successfully to the public for means to ‘solve the riddle of cancer’ and to ‘find a cure for cancer,’ the endemiology of neoplastic disease has been neglected."

This neglect, Dr. Clemmesen feels, has not only been specifically but also generally out of line with the history of medicine, especially as pertains to medicine's great advances. He cites historically well-known studies, such as he favors, that resulted in the alleviation and even the elimination of previously serious diseases. He urges that we now make active use of “the collection of information on the distribution of malignant disease, among various ethnological groups in different regions, in relation to any relevant focal factors.” This is, of course, what the medical missionaries have been urging right along.

Says Director Clemmesen: “Viewed in relation to the possibilities for obtaining new information on human cancer, an institute for endemiological research in cancer will be far less expensive than the more popular and common institutes for experimental cancer research, mainly because advantage is taken of the biological information collected in hospitals and medical practice at enormous cost in human suffering and money, primarily spent with a view to curing the patients ... [the Danish cancer registries gather facts from which we are able] to draw conclusions from the ‘experiment’ which Nature, and we ourselves, are carrying out on mankind.”

In 1957, two years after Dr. Clemmesen thus described a British and Danish return to approximately the nineteenth-century view of cancer, came the already touched-on work of Dr. Berglas, now to be reviewed in more detail.

Cancer: Its Nature, Cause and Cure has four prefaces. The first, by the author himself, and the second, by Dr. Albert Schweitzer, have already been quoted, if too briefly.

In the third preface Dr. Antoine Lacassagne, vice president of the Cancer Research Foundation of the Pasteur Institute, supports Dr. Berglas in his contention that the cancer situation of civilized man is still going from bad to worse. “On the one hand, in spite of the progress of local therapy, and the increasing efforts of propaganda to aid in the fight, the rapid increase of the disease is a given fact ... the search for a general cancer therapy ... has led to failure.”

The fourth preface, by Professor Dr. Hans Lettré of the Institute of Experimental Cancer Research, Heidelberg, in approvingly summarizing the book, says: “Dr. Berglas emphasizes that the progressive artificialization of the environment of man — to which the human organism fails to adapt — may be an essential cause factor in carcinogenesis.”

In the body of his text Dr. Berglas reiterates that “there is yet no remedy for cancer,” that it is not infectious, and that cancer is the most frequent cause of death in highly developed countries (if we exclude death due to wear and old age). He concludes that “every one of us is threatened with death from cancer because of our inability to adapt to present day living conditions.” Civilization, he feels, is in terms of cancer a Juggernaut that cannot be stopped.

But later I shall quote others who, though they agree with Dr. Berglas on every other point, disagree with his feeling that it is impossible to bring about a change in food habits, and other ways of life, sufficient to slow materially the advance of cancer.

Under “Progress of Civilization and Increased Cancer Mortality,” Dr. Berglas says that “during the last fifty years, paralleling the progress of civilization, the frequency of cancer has increased ... in the future every human being will inevitably become a victim of cancer ... In 1900 statistics placed cancer eighth among the causes of death, whereas today [1957] it is placed second.”

Berglas feels that this worsening statistical effect is due in part to decreased mortality from nonmalignant disease — but not nearly so much so as the lay public would like to believe. He quotes Dr. H. E. Hilleboe, who has been the New York State Commissioner of Health since 1947:

“It is a common impression among lay people that cancer occurs almost entirely among older persons. Actually this is far from the truth. In ... upstate New York for the three year period 1950-53 ... malignancy ranked third as cause of death in 1-4 year olds, and was exceeded only by accidents and congenital defects. In other words, 12% of all deaths in this age group were caused by cancer. Among the 5-14 year olds malignancy ranked second to accidents as cause of death, and contributed 14% of all deaths ...”

Since neither accidents nor congenital defects are diseases, cancer was in upstate New York in 1953 the most often fatal of all young people's diseases, even during the first fourteen years from birth.

Under “Prediction of Cancer Mortality,” Dr. Berglas says the National Cancer Institute of the United States predicted (presumably In 1956) “that 32% of new born children are expected to contract cancer during their lifetime.” The same report states that 500,000 cases of cancer are being diagnosed annually [and also says that] “40 million of the population will contract cancer during their lifetime.”

Still on the topic of “Civilization and the Growing Menace of Cancer,” but now under the subhead “Defects of Nutrition,” Dr. Berglas continues: “... the more civilization has advanced, the farther we have come away from a natural diet ... Our present day diet consists to a large extent of adulterated and denatured foods, from which the most essential factors have been removed by coloring, bleaching, heating, preserving, etc. The visual impression of food often becomes more important than its value ... When we speak of diseases of civilization we are talking about diseases which, in many instances, could be corrected by proper diet.

“Attempts have been made to correct defects in nutrition by means of artificial compounds, such as synthetically produced vitamins. But it will never be possible to reconstruct a normal diet in this manner [a folly of which Dr. Berglas thinks the United States both one of the chief perpetrators and one of the chief victims] ... we agree with the [German] nutrition expert Kollath: ‘improper living and faulty diet constitute a lifelong preparation for cancer.’”

Dr. Berglas considers that “obese individuals contract cancer far more frequently than those of normal weight.” In this connection it should be pointed out that during the “cancer free” period among the Eskimos of northern Alaska, there was no obesity (cf. the 1854 testimony of Dr. John Simpson, the 1883 concurrence of the anthropologist John Murdoch, and my own observation of the years 1906-14); but in the present period of high-cancer incidence, obesity is “normal” among the Barrow Eskimos — “normal” presumably meaning that obesity is now about as frequent there among Eskimos as it is among the resident whites.

Under “Carcinogenic Noxae in Food,” Dr. Berglas quotes German Dr. G. Schenk: “‘It is the nature and essence of industrial civilization to be toxic in every sense ...’” His own comment is that Dr. Schenk's “dictum applies above all else to those noxae in food and environment [e.g., smoke in the air, gas fumes] which we must recognize as deleterious to cells and hence as factors in carcinogenesis. The food we eat has, in a few decades, been so altered and contaminated with chemicals that every mouthful we consume contains traces of harmful substances ... it becomes understandable that nearly 50% of cancers in man occur in the gastrointestinal tract ...”

In a section too long and complicated for us to abstract, Dr. Berglas names, as carcinogenic, many things that have become standard in our diet during the period in which cancer has been gaining rapidly in its destructiveness — among these he includes sprays and other chemicals used in cultivating fruits and vegetables, dyes to make them look more attractive, various chemical food preservatives and also overhot foods and drinks, as well as “excessively toasted breads and biscuits, over-cooked meats ...” and otherwise chemically preserved foods, and canned ones.

That Dr. Berglas thinks overcooked meats provocative to malignant disease is reminiscent of a like opinion expressed by some of the best witnesses to the former absence of cancer among the Eskimos. For northern Labrador, for instance, Dr. Hutton comments: “In this connection [absence of cancer] it may be noted that ... most of the food is eaten raw ...” Similarly Dr. Romig, in telling about the “cancer-free” Eskimos of Temperate Zone Alaska around 1900, says that the food, while usually cooked, was boiled or roasted only to the degree we call medium or rare, and that foods and drinks were served lukewarm rather than hot.

Dr. Berglas emphasizes that there is nothing suddenly disastrous about the carcinogens in modern foods as there is with strychnine or botulism: “As a rule a relatively long latency period of carcinogenesis, often lasting several years, is observed in man.” But from this follows also that if we were to change this year from our dangerous food practices it might be several years, perhaps ten, before we could breathe freely on the score of cancer.

As to the contrast between “civilized” and “uncivilized” countries since 1900, Dr. Berglas says: “Accounts of regions free from cancer reveal the influence of civilization on the processes of cancer. This influence resides in the totality of civilizational noxae, i.e., stresses of chemical, physical, nutritional and environmental nature. We are faced with the grim prospect that the advance of cancer and of civilization parallel each other.”

In this section of his book Cancer, Dr. Berglas uses as his last subhead: “Are There Regions with Little or No Cancer?” He thinks there are, generally speaking; but he does not go far into this topic, and names examples only from the tropics and from the southern edge of the North Temperate Zone — does not mention any from the region which we have been specially studying, the northern edge of the North Temperate and the southern edge of the Arctic Zone. Berglas starts his brief listing of cancer-free regions wit northern India:

“In the secluded Karakorum ... live the Hunzas ... They are untrammeled by technological progress or industry. Their diet is simple and natural ... Sir Robert McCarrison, a surgeon in the Indian Health Service, observed a total absence of all diseases during the time he spent in the Hunza valley [seven years]. In particular, no cases of cancer came to his knowledge.” (This is dealt with further in Chapter 17 “The ‘Cancer Free’ People of Asia.”)

Next Dr. Berglas summarizes Dr. Schweitzer's statement, quoted previously as to how cancer was nearly or quite absent from Gabon, tropical French Africa, in 1913; how the people are now becoming severely afflicted; and how Dr. Schweitzer thinks this change has come about because the natives are now “living more and more after the manner of the whites.”

Dr. Berglas mentions that “Dr. Eugene Payne, who examined approximately 60,000 individuals during a quarter of a century in certain parts of Brazil and Ecuador, found no evidence of cancer. This was some time ago and it is likely that the inroads of civilization, together with its modern foodstuffs, may have altered the situation.”

A parallel to the just cited information of Dr. Payne regarding Brazil and Ecuador is given from Bolivia by our frequently quoted source, Dr. F. L. Hoffman. In 1923 he addressed the Belgian National Cancer Congress at Brussels. The text of his speech is available through an undated booklet, “Cancer and Civilization,” that was issued, presumably late in 1923, by the Prudential Insurance Company of America, at Newark, New Jersey. In connection with like testimony from numerous sources, Dr. Hoffman here quotes the renowned anthropologist of the Smithsonian Institution, Dr. Aleš Hrdlička, on primitive natives of the Americas: “‘Malignant diseases, if they exist at all — that they do would be difficult to doubt — must be extremely rare.’” Speaking for himself, Dr. Hoffman then says:

“The foregoing observations have been emphasized by personal investigations among the Indians of Bolivia, among whom I was unable to trace a single authentic case of malignant disease. All of the physicians whom I interviewed on the subject were emphatically of the opinion that cancer of the breast among Indian women was never met with ... Hence the conclusion, supported by a large amount of additional evidence from primitive people throughout the world, that malignant diseases among native races are of extremely rare occurrence.”

At the close of his section, “Are There Regions with Little or No Cancer?” Dr. Berglas concludes: “These few accounts of regions and peoples free from cancer deserve attention, for they indicate a correlation between civilizational noxae and cancer.”

About the “correlation between civilization and cancer,” the medical missionaries (quoted throughout the present volume) could not agree more! And they would also more than agree with most of the rest of Berglas' book. In particular they would subscribe to the grim Berglas prognosis, reviewed a few pages back, which appears under the head of “Civilization and the Growing Menace of Cancer.” But, as I have already predicted, surely a majority of the frontier doctors would nevertheless disagree with the startling pessimism of Dr. Berglas' own page 63:

“We have to face the fact ... that no one can protect himself from cancer under present-day conditions.”

More nearly than agreeing straight out, the medical missionary would likely first agree to the gloomy premises of Dr. Berglas and then bring in a hopeful note, perhaps after the manner of the famous London physician, Sir Arbuthnot Lane, who pronounced darkly on cancer but then changed his tune, as frontier doctors often do. In his preface to the 1926 London edition of Ettie A. Rout's Maori Symbolism, Dr. Lane says, for example:

“There is something radically and fundamentally wrong with the civilized mode of life; and I believe that unless the present dietetic and health customs of the White Nations are reorganized, social decay and race deterioration are inevitable.”

But, like the typical frontier doctor, Sir Arbuthnot follows his “unless” with this famous rallying cry:

“I shall not die of cancer. I am taking measures to prevent it. What I am doing anyone can do. It is not a matter of money. It is a matter only of forethought and forbearance. What I am doing everyone should do if he would avoid the risk of death from a disease more terrible than syphilis ...”

Fashionable and respected, Sir Arbuthnot Lane died in 1943 at eighty-seven, an age which certifies that his way of life did not provoke an early cancer. As his words show, he was in agreement with the frontier doctors, quoted frequently herein, in believing that diet may advance or retard malignant disease.

But, while sharing the view that a right diet protects from cancer, Dr. Lane seemingly did not make an impartial valuation of frontier testimonies if they seemed to him contradictory. For instance, there was perhaps really equal reason to believe Dr. Robert McCarrison, who found no cancer during the years 1904-11 as an army surgeon among a certain large number of Hunzas in India, and to believe Dr. Samuel King Hutton who found no cancer during the years 1902-13 as a medical missionary among a comparable number of Eskimos in North America. But Dr. McCarrison's “cancer free” Hunzas ate little meat, Dr. Hutton's “cancer free" Eskimos ate little else but meat, and Dr. Lane was a vegetarian. Naturally he accepted for frequent quotation the Hunza evidence, but does not appear to have made use of that of the Eskimos.

With a bias for meat as strong as Dr. Lane's for vegetables, I have been equally partial. For nearly half a century, after being told by northern frontier authorities that uncivilized Eskimos never get cancer, I felt inclined to weigh such testimony as Dr. Hutton's and to dismiss unweighed the McCarrison variety. But now that I have finally spent some years comparing vegetarian with meat-eater evidence in relation to cancer, I have a hunch that both sides are right and both wrong — each right in praising its own diet but each wrong in condemning the other; both wrong in feeling that there is a necessary contradiction between them.

So, after giving at length the testimony of observers who searched vainly for cancer among 50,000 mainly or wholly carnivorous Eskimos in North America, I shall now present, at some length, the testimony of observers whose corresponding search is still going on in Asia among the largely vegetarian Hunzas.

Chapter 17 >>