Part One
There must be people still living who remember coming across old people who had never married because they had an hereditary disease “in the family”. Great-aunt Agnes ignored the warnings and married happily, but many did not. It was only a part, though not an inconsiderable one, of the tragedy of consumption, the great killer of the nineteenth century.
It had been known from the earliest times: there are cases among Egyptian mummies: but it raged through the crowded cities of the industrial age, causing something like a half of all deaths: most tragically because they were mostly of young people.
Doctors tried all kinds of remedies: the blood-letting that was the accepted remedy for almost everything, and probably caused more deaths than any disease; drugs, diet, and above all, for those who could afford it: a change of air. But little could in fact be done. It was agreed that the disease was hereditary, and so could be blamed on the selfishness of the parents, who should not have married.
The lifestyle could also be blamed: the story of the lady of the camelias, the beautiful courtesan who, as she was dying, danced, drank, and loved, could be used a warning by those who disapproved of such doings. Many other things were blamed, including the newly fashionable smoking, but especially “giving reign to one’s feelings”, “indulging the passions”. If you lived like a very quiet puritan, the disease ought to leave you alone. This meant that you as well as your parents could be blamed.
In 1868, Jean-Louis Villemin published proof of the disease’s contagious nature; in 1882 Koch proved the existence of the tuberculosis bacterium; [1] and as the fate of the “poor” grew to be more and more of an obsession with the mid and late Victorians, it became clear that the disease was more to be found linked with poverty, diet, and, above all, over-crowding, than with heredity or the passions. In 1908, 50 years after Villemin, the British government decreed that sections of acts applying to the prevention of infectious diseases should apply to TB. [2]
Yet all this had been known for a very long time. In the fourth century BC, the medical writings attributed to Hippocrates listed tuberculosis among the epidemics. [3] The theory of contagion had been plainly set out by Hyeronymus Fracastorius in 1546. [4] By the next century medical men took it for granted, and governments acted upon it. In England in 1689, Richard Morton listed nine causes, most reasonable enough, such as bad air, the physical constitution, and youth, which certainly play their part in the course of the disease. But his ninth cause was simply “contagion”. [5]
The first decree was passed by the Republic of Lucca in 1699. Ferdinand of Spain passed his in 1751. [6] Other southern states followed suit. In general it was ordered that the rich should be confined in their own homes, the poor in hospitals; the bedding and even the carriages of those who had died were to be destroyed. But though it was recognized that because of the stringent Spanish laws the Indians in their colonies remained free of tuberculosis longer than those in North America; and though, as George Sand noted in her visit to Majorca in the 1840s:
“Tuberculosis is scarce in these parts and is regarded as infectious”, (she did not seem to see any link between these facts); [7] yet the laws were gradually abrogated. Not all physicians were convinced: the application of the edicts was costly; personal interests were involved.
And above all the French medical establishment, in about 1650, declared against the theory. [8] It is difficult to understand why, unless it could be that the country was racked with civil war, the young king Louis XIV was an essential political tool, and about this time he was very ill. His father and mother had both died of tuberculosis, and later in life he certainly suffered from it himself. [9] If this illness was also tubercular, there were excellent reasons for not wishing to admit that sufferers should be shut away. Louis would have been little use politically.
French influence was enormous in all fields. Over most of Europe patients lived with their families, often sharing beds with family or friends, as was common then; in peasant households eating from the same dish.
Ordinary people continued to take a sensible view long after the medical establishment had ceased to do so. Tobias Smollett, in his novel Humphrey Clinker, published in 1771, [10] wrote of the absurdity of herding sick people together in spas or health resorts, when it was known that “consumption” was contagious; he spoke approvingly of the precautions taken in Italy; John Keats’ friend Severne took the ordinary man’s view that it was unwise for Keats to spend so much time shut up in the bedroom of his dying brother, [11] but Keats was a medical student and Severne was a layman. When Keats died, the cause was considered to be the cruel attacks of the critics and his “passion” for Fanny Brawne.
The lack of the most elementary precautions against infection seems ludicrous (except that it killed so many people). At the very end of the nineteenth century we are told of a young woman who had been ill for some time but who continued to work as a nurse. The informant was a Harley Street consultant: he helped her to find work. [12]
So in 1908, 362 years after Fracastorius, 209 years after the Republic of Lucca’s decree, the checking of the disease in the only realistic way was decided upon in Britain. In this King Edward VII played an honourable part, and he is credited with perhaps the last word on the subject. Told that tuberculosis is a preventable disease, it is said that he said: “Then why don’t you prevent it?” [13]
Part Two
Cancer too has been known from the earliest times. The useful ancient Egyptian mummies show signs of it. Hippocrates wrote of it, quite sensibly, in the fourth century BC. But as a disease mostly of older people, it made no such great inroads when most people died before they were forty. However, in the seventeenth century we hear of a “medical facility” (a clinic in modern terms?) set up in France because of the fear of contagious cancer. [14] In 1762, Richard Guy wrote: “May it not therefore be, with more Probability, inferred, that the cancerous humour is a Virus, sui generis...” [15]
[Viruses, once thought to be a sort of “germ” too small to be seen under a microscope or to be trapped in even the finest filter, are now known to be infective particles which act upon the body cells in such a way as to cause disease. It is now accepted that the submicroscopic particles “pilfer” a gene, (a functional unit specifying a single primary gene product: there are about 50,000 genes in an average human cell); in the case of cancer, the onco-gene, or cancer-causing gene, turns malignant when the virus works upon it].
In the following century scientists became preoccupided with the transmissibility of cancer, suspecting that it had a microbial origin. In 1842 William Budd of the British Medical Society noted the link between cancer of the penis in men and cervical or uterine cancer in their wives. [16] Hospitals set aside special wards for cancer patients, [17] and in New York a special hospital was built for them. [18] The entry in the great German encyclopedia, Brockhaus, of 1902, declares that it is not yet certain whether the cause is heredity or contagion. [19] Six years later it seemed that the question had been answered.
In 1908 Ellerman and Bang in Denmark identified a virus causing chicken leukemia, [20] and in 1910 Peyton Rous in the USA that causing chicken sarcoma. [21] In 1911 similar work was done in Japan, and in the three following years Rous and the Japanese Fujimani Inanoto identified three more viruses in chickens and ducks.
It seems that one of the consequences of so much of this work having been done on chickens is that to this day chickens can be immunized against cancer. [22]
In 1917, Waelsch identified the virus causing cancerous warts in human beings, and in 1919 Wile and Kinger in the USA found one which caused human papillomata (another sort of wart).
Rous’s work, in spite of the confirmation of it by these other researchers, was under attack as late as 1958: at the 7th International Congress Against Cancer, it was said that “the Rous sarcoma was a laboratory artifact which had misled cancer researchers for fifty years”.
[Yet the Rockefeller University Press’s “Peyton Rous” (1971) stated plainly: “Intellectual support for what had been called ‘the virus hypothesis of cancer’ was at its lowest ebb when elegant, experimental proof of it issued from Rous’s laboratory”. [23] It also remarked that “tumor after tumor ... had had infectious causes ascribed to it by the heroes of nineteenth century bacteriology”, and “at the present time, more than half the published work on cancer causation stems, and stems not at all remotely, from Rous’s 1910 discovery”. [24] But by then he had got an award from the World Health Organization, and the Nobel Prize].
However, a theory put forward by the German Boveri (1862-1915) had been gaining ground: the somatic mutation hypothesis. According to this, the disease was caused by changes in the chromosomes, the instruments of heredity. [25] [Indeed, as can be seen by the above remarks on viruses, the theories of Boveri and Rous are completely reconciled by the fact that it is viruses that cause changes in the genes that make up the chromosomes].
But the National Cancer Institute, founded in 1937 in the USA, considered it established that mammalian cancer was not infectious, and grouped viruses with other micro-organisms as etiological agents (causes) that could be disregarded. It was said that it seemed that the NCI had a deeper commitment to theories of treatment than it had to discovering the cause of cancer. But its founders knew what they did not like – viruses.
Bittner, who discovered in 1936 the milk agent in the cause of cancer of the mammary gland in mice, showing that viruses, anti-bodies, bacteria, hormones, and carcinogens (cancer-causing agents) can be passed from mother to offspring in suckling, avoided in his thesis the word virus, to which so many of his colleagues “were obviously allergic”. [26]
The viruses, however, continued to turn up, though as Bauemler tells us in his Cancer, in 1967, virologists had to mask their discoveries in general terms, and Dr Charlotte Friend of Sloan-Kettering Institute remarked, after announcing a new mouse leukemia virus in 1956, that anyone who found a new cancer virus was thought to have either a hole in his head or a hole in his filter. [27]
But Drs Gross, Sarah Stewart and Bernice Eddy at the National Institute of Health found the polyoma virus in mice, Dr Gross a leukemia virus also in mice. And in July 1962 the influential US magazine Life published a report on a survey carried out by the NCI in Washington County, Maryland. The 100,000 inhabitants of this area, which was known for its exceptionally careful keeping of records, were studied for five years. The article, by A. Rosenfeld, was headed “Clues to a Deadly Riddle”, and subtitled: “Scientists find new evidence that cancer may be infectious”. [28]
It was shown that in families cancers often occurred in a pattern of relationships that pointed clearly to a lengthy period of contact with a source of contagion: most common between husbands and wives, then between sisters, then brothers, and lastly between brothers and sisters, probably reflecting accurately the order of intimacy in family life.
There were whole families: four brothers in one case; father, mother, six children and the lone grandchild in another, all dying of cancer. It occurred too in specific places: a school; a small district in a city in which there were 25 cases, though in the neighbouring area there were only three. There was evidence that “old wives’ tales” about cancer houses were indeed based on fact, and there were two cases of trees afflicted with cancer-like growths found near to “cancer houses”.
The article quoted at length from a lecture given by Dr Robert J. Huebner, director of the National Institute of Allergy and Infectious Disease, given at the New York Academy of Medicine in 1960. It was called “Cancer as an infectious disease”. It apparently received little attention.
He attributed the widespread refusal to accept the virus theory to an “intellectual impediment” (described more politely by Rous himself as “metaphysics”), namely the habit of thinking of cancer as an unique disease.
“The central message of the microbial theory” said Huebner, “states simply that a specific microbe is the ‘essential’ cause of an infectious disease, and that all other contributing factors necessary for its clinical expression are secondary or ‘proximate’ causes”.
It was perhaps also a sign that views were at last changing (for it was the NCI that carried out the survey, and it had once known that it didn’t like viruses); another sign was that 52 years after his discovery, Dr Peyton Rous received an award from the World Health Organization. The Director General said: “The part played by viruses in causing cancer was brilliantly demonstrated half a century ago...” [29]
He hedged his bets by giving awards also to a number of other researchers for work on environmental causes and the relationship between lung cancer and smoking, and also what was described as “the theory of experimental design in epidemiological studies of cancer”.
In 1966, 56 years after his discovery, when he was 85 years old, Dr Peyton Rous got the Nobel Prize. He had given up his work long before. But as Rous himself wrote: “Cancer research is the one of the last strongholds of metaphysics”. [30]
Replying to Boveri’s somatic mutation hypothesis, he wrote: “A hypothesis is best known by its fruits. What have been those of the somatic mutation theory?...It has led within the year to an authoritative statement, in the lay press, that as cancer is certainly due to somatic mutations, the possibility of having it is ‘inherent’; and that this being so, the most man can ever do is to palliate such malignant tumors ... here is fatalism to blast many a hope and effort [and a reminiscence, perhaps, of the understandably anonymous colleague of Sir Richard Doll’s who in the 1940s said it was a waste of time and immoral to try to prevent cancer...]...Most serious of all the results of the somatic mutation hypothesis” continued Rous “has been its effect on research workers: it acts as a tranquillizer on those who believe in it.”
Certainly at this time and up to the present some confusion could be expected, since among the causes of cancer were or are listed, besides somatic mutation (changes in the actual cells) whether admitted to be caused by viruses or not:
Carcinogens such as soot, bischloromethyl ether used in the chemical industry, vinyl chloride fumes in the rubber industry, asbestos, chrome, ionizing radiations, carcinogenic hydrocarbons produced by fires, urban pollution, hormonal secretions; natural foods such as peanuts and maize containing aflatoxin in conjunction with the hepatitis B virus; man-made foods, the herb comfrey, not eating enough carrots, eating mouldy bread and pickled vegetables, a particular kind of salt-cured fish eaten in China; chewing betel nut in India, smoking cigars with the burning end in the mouth (this is done somewhere in the East); eating bracken in Japan; heredity; eating fat; being fat; being old; drinking alcohol and coffee; having an active sex life; having no sex life; and smoking.
There is point in the title of an article in the Consumer Research Magazine of May 1989: “Does Everything Cause Cancer?”
In the Royal Society of Medicine’s Stevens lecture in London in 1986 [31], Sir Richard Doll lists some of these causes, and adds that “when tobacco is smoked it is responsible for the vast majority of all cancers of the lung throughout the world”. He includes besides lung cancers, cancers of the mouth, pharynx, oesophagus and larynx, besides one- to two-thirds of cancers of the pancreas and bladder, and probably also some cancers of the kidney.
“Reduction in the use of tobacco would not, however, have much effect on some of the very high rates of oesophageal cancer that occur in parts of the USSR, China, and East and South Africa”. He does not explain this statement.
But he does list fourteen cancers definitely or possibly caused by viruses, and goes on to say that bischloromethyl ether is an extremely powerful carcinogen that causes lung cancer especially of the oat-cell type.
All or any of these may be contributory causes: there were many factors that contributed to tuberculosis (though there were a number of cases where none of them seemed to apply), but if a disease is virus-borne then the virus must be present for that illness to appear. The patient may well get something else if he’s doing a number of unhealthy things, but not that.
As was said in the Hoxsey Clinic’s Cancer and Cure: “The destruction of cells locally does nothing to eradicate the cause of that cancer, and as long as that is still operating in the body, cancer...is bound to break out again in some other weak spot”. [32]
It looks as if there is proof that cancer, like tuberculosis, seeks out the weakest part of the organism. As tuberculosis could show itself as lesions in the lungs, the neck (scrofula), the bones, the intestines; as meningitis, anal fistula, or skin disease, so cancer takes many forms. Dr Gross (another recipient of the WHO award) and Drs Sarah Stewart and Bernice Eddy had found that the polyoma virus could produce more than twenty different varieties of malignant tumour, and this in other creatures than the mice in which it was first found.
Evidence mounted of the variations produced by presumably the same virus. In 1940 it had been shown that among oil workers the whites tended to get more cancer of the skin, but the blacks, whose skins are better adapted for protection against such hazards, tended to get the disease internally. “...people with very light skins are especially liable to injury by ultra-violet rays. Dark-hued people with skins very rich in pigment are, on the other hand, better protected.” [33]
In Dutch Indonesia, soon after, it was shown that among 5,300 women those who had had the cervix removed had almost as many cancers outside the cervix as those still with cervices had in them. [34] Nuns almost never have cancer of the cervix, but more breast cancer than women who have born and suckled children.
7th Day Adventists, who don’t smoke or drink, have fewer cases of lung cancer, but the usual rate of other kinds. A report in the Lancet in January 1991 describes the occurrence in families of many different kinds of tumours: breast, lung, colon, pancreas, and prostate, all it seems caused by the same mutated chromosome. [35]
To the layman all this looks convincing enough. It’s infectious: you know what you do when your child’s got measles. There is, however, more to it than that. The analogy with tuberculosis may break down. You can get that from someone sneezing over you (though you are not likely to if you are healthy). But there are many ways in which contagion may be conveyed. Some require the assistance of rats, lice, or mosquitoes, others of a food or of sewage.
It is possible that the infective agent in cancer is the mouse. The polyoma virus has been found in house mice, and also in farm mice, both infected in huge numbers, and in the farms they
infest granaries and grain stores. Do they infect the bread we eat? [36]
Again the impatient layman will say: “All right, forget Mickey. The mouse is the enemy.” He may, if he knows something about it, point out that huge sums of money are continually being spent on cancer research: in the USA a billion and a half dollars in the one year 1987; since 1971 the National Institute of Health alone has spent six and a half billion dollars. How much of this has gone on practical measures (such as breeding more good mousers)?
The answer seems to be very little, if any. Far the greatest sums of money have gone to institutions that are researching, often painstakingly and brilliantly, the etiology (the ultimate cause) of the disease. This is extremely interesting work.
Time and again the accounts of the workers in this field speak of their fascination with the actual mechanics of the work. The virus, it seems, invades the cell, and seizes upon the chromosomes, the structures in the cell that carry the genes, which are responsible for the programming of the entire development of the body.
Researchers like to solve problems, and this is a particularly enthralling one, dealing as it does with the very stuff of life. “Mankind may ultimately stand at the very threshhold of creation...the question is
not only what is cancer but what is life?” says Bauemler. [37] This is not a question much concerning someone dying of cancer.
The ignorant reader can become fascinated too with this tiny world of genes and retroviruses, oncogenes, srcs (pronounced sarks), and many other terms in the exotic jargon.
“Molecular biologists” says the author of Natural Obsessions, “live in a beautiful crystal palace, where esoteric flowers of their own choosing leap into bloom...the integrated artifice within obscures and supplants the natural disjunctions without.” [38] Natural Obsessions is full of indications of the beauty and also of the unreality of this world. Each of a
dozen researchers declares: “I like to solve puzzles”. [39] We
are told of “the lush beauty of doing science...” [40]
“I’m quite high on this”. [41]
Another researcher speaks of “sheer delight” in his work. [42]
“No wonder [a scientist] prefers basic research to medicine. Oncology [cancer] wards
today remain ghettos of pain [my emphasis]”. [43]
Already in 1962 the United States Department of Health, Education and Welfare publication, American Scientists in Cancer-Virus Research, had listed nearly four hundred scientists in this field in the United States alone. And this was before unlimited money flooded in in the seventies.
With so much passionate interest in the great work, it seems impolite to recall the words of Professor Charles Huggins: “The day is not far off...to immunize our children against chemical carcinogens.” He was wrong: this
was in 1965: some of the children must already be dead. [44]
“If you’re giving me money, I’ll talk about cures...” Natural Obsessions quotes, and: “...in our work we
never think about such things [cures] even for a second.” [45] None of this is exactly reassuring to the relations or friends of a cancer victim, or to the victim himself. Still less is it to read this:
“There are some people who do think they are looking for a cure. They’re not basic researchers: they’re in a sort of applied field, medical research . They really don’t know what’s going on inside the cell. They’ll try any kind of desperate thing.” The contempt implied is not agreeable. What sort of
scientists do they think they are, trying to cure people? [46]
To Part Two Of This Pamphlet
Politics?
“Why Don’t YOU Prevent It?”
“Why Don’t You PREVENT It?”
To Notes And References
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