Townsend Letter, the Examiner of Alternative Medicine, publishes a print magazine about alternative medicine. It is written by researchers, health practitioners and patients. As a forum for the entire alternative medicine community, represents scientific information (pro and con) on a wide variety of alternative medicine topics.
The Examiner of Alternative Medicine
Marcus Cohen wrote about:
Emanuel Revici, MD:
Efforts to Publish the Clinical Findings of a Pioneer in Lipid-Based Cancer Therapy
Part 1, Part 2 and Part 3
Dr. Emanuel Revici died during his 101st year on January 9, 1998, after a career that bridged seven decades in the history of modern medicine. Since the 1980s, mainstream research has independently confirmed a number of his therapeutic breakthroughs.
Dr. Revici was the first physician to develop selenium compounds low enough in toxicity to give cancer patients doses far in excess of safety limits for ordinary forms of selenium.1 He was among the first research clinicians to treat cancer with naturally derived Omega 3 fatty acids.2 He also appears to have been a pioneer in utilizing lipids to transport cytotoxic agents through the bloodstream to sites of abnormal tissue.3
Still awaiting mainstream corroboration are numerous reports of patients with advanced cancer who obtained long-term remission under his treatment after failing to benefit from any other therapy.
New York's Office of Professional Medical Conduct (OPMC) revoked Revici's license to practice in 1993. The formal charges against him amounted to a sharp divergence in approach from conventional oncology practice. The state education department returned the license in late 1997. (In New York, the health department – OPMC – revokes the licenses of physicians, the education department processes applications to restore them.) Governor George Pataki wrote a letter in support. New York Assemblyman Sheldon Silver, Speaker of the Assembly, issued a legislative resolution posthumously lauding Revici’s accomplishments and devotion to patients.
The behind-the-scenes campaign to reinstate Revici’s license has droll and infuriating moments worth telling, but it is too long to relate here. This article, in three parts, concentrates on Revici's efforts to publish his findings and on evaluations of his therapy. The history of Revici's publications and evaluations, extending back to World War II, exemplifies the problems that most originators of non-standard approaches to cancer experience in seeking mainstream understanding and trials of their therapy.
Emanuel Revici, born September 6, 1896 in Romania, received his doctorate in medicine and surgery from the University of Bucharest in 1920.4 Teaching himself advanced chemistry in the mid-1920s, he became absorbed in exploring the relationship between lipids and cellular metabolism. Eager to further his investigations, he sampled the facilities available at the foremost European research centers, opting for Paris in 1936, where he pursued his studies at hospital clinics and laboratories directed by academic physicians.
Revici's Parisian years ended in March 1941. The head of the Paris police department, a fast friend, warned him that he could no longer protect him from the German occupation forces rounding up the city's Jews. (Revici was Jewish.) Shortly after the warning, Revici fled to Nice and spent the next six months in southern France as a leader of the Resistance.
Revici had discovered a lipid substance that staunched bleeding within minutes, enabling wounded Underground fighters to avoid notice by the Gestapo, but the Gestapo soon tumbled onto his clandestine activities. Comrades in the Resistance spirited him overland into Portugal and from there by sea to Casablanca, Morocco, where he boarded a ship carrying members of the Spanish Republican government – in exile after Generalissimo Franco's fascist regime controlled Spain. On the prowl in the North Atlantic, U-boats in the German "wolf pack" were raising their periscopes to sight the vessel, bent on torpedoing it.
The ship inched down the west coast of Africa, sailing at night without lights, then steamed across the southern Atlantic to the Bahamas, a voyage lasting two months.
The Underground had entrusted to Revici a microfilm with information for the Allies. At the Portuguese border, guards had detained and searched him and would have executed him on the spot had they discovered the film. Patting his body from heels to head, poking their fingers into every possible hiding place in his clothing, they never thought to pry apart the fingers of his upraised hands.
When the ship anchored in the Bahamas, Revici was the first passenger British intelligence officers debriefed. He delivered the microfilm and also, unexpectedly, a roll of film showing the German submarine installations at Casablanca, which he had snapped on his own (another impromptu act of daring, punishable upon discovery by summary execution). Revici then settled in Mexico City for the duration of the war.
In 1942, Dr. Revici converted a modern hotel in the Mexican capital into a medical institute. With over 100 rooms, it specialized in cancer, treating patients free. The idea and money came from a friend, Gaston Merry, formerly European representative of E.I. Du Pont de Nemours & Co, the chemical and pharmaceutical giant, headquartered in Wilmington, Delaware. Merry had tracked Revici's research in Paris, where their professional relationship had warmed into a deep friendship. After the fall of France, Merry requested reassignment by Du Pont to Central America, sharing a house with Revici and his family in Mexico City.4
"Our Institute," recalled Revici in 1954, when the memory was vivid, "consisted of a clinic for outpatients, a hospital with all modern equipment, a Clinical Laboratory, a Research Department with eight laboratories, and a section for experimental research on animals. The staff...numbered 15 physicians and chemists, in addition to a personnel of 60 which included nurses, helpers, and orderlies. The records were kept in Spanish."4
Completing the picture, Revici noted: "Besides obtaining the services of competent Mexican physicians and scientists, we were fortunate in interesting several eminent physicians, surgeons, and scientists who were also refugees in Mexico City...who, after investigating my background and research, joined the Institute staff. The object of the Institute was to concentrate on following my line of research."
While still in Romania, Revici had patented a process for refining crude oil into a lubricant for airplane engines. "Revoil," as the product was known, yielded him royalties that had financed his travels and research in Europe. The war had interrupted the flow of these payments (Romania fought against the Allies), but they resumed just before the war’s end. Revici repaid Merry, then the flow ceased permanently with the postwar Communist take-over of Romania. (The Communists nationalized the oil industry, expropriating the "Revoil" refineries.)
Dr. George Dick, dean of the University of Chicago medical school, brought Revici to the US in 1946, promising him research facilities. Dick resigned suddenly the next year, and Revici promptly accepted an invitation from physicians, businessmen, and civic leaders to found an experimental cancer clinic in New York City.4 The clinic, named the Institute of Applied Biology (IAB), opened later in 1947. He earned his medical license in NY by examination in 1947 and maintained his dual career as a scientist and physician in New York City until his death.
Scientific Findings & Medical Applications
Revici's medical findings derived from a number of different lines of investigation, each simple enough by itself. Interwoven, they make a complex body of knowledge.5 The starting point was an observation Revici made in the 1920s, while he was still in his 20s.
Cancer patients in pain showed a cycling in their levels of discomfort. In some patients, the pain worsened in the morning; in others it intensified at night. Eating eased the pain in some, but sharpened it so much in others, they dreaded eating. Hypothesizing that this cycling might relate to an underlying cycling of the patients' physiology, Revici looked at various aspects of blood and urine (using the relatively simple technology available to him at the time). His investigations showed that healthy persons typically had daily rhythmic fluctuations in such basic physical parameters as urinary pH and levels of free potassium in the blood. In contrast, cancer patients had abnormal fluctuations, showing either patterns of acidic imbalance or alkaline imbalance.
Further investigation found that patients in acidic imbalance could relieve their pain temporarily by ingesting a small amount of sodium bicarbonate. But patients in alkaline imbalance who ingested sodium bicarbonate suffered worse pain. Repeating the experiment with dilute phosphoric acid gave roughly converse results. Realizing that these small amounts of dilute acid or base wouldn't change bodily pH, Revici next placed platinum electrodes in painful loci of patients with superficial tumors, as well as in non-painful parts of the tumor mass and in normal tissue. All these experiments led Revici to conclude that the pH of painful local lesions was not only different from the rest of the body, but that ingestion of small amounts of base or acid could specifically and quickly alter these painful lesions.
As a result of these studies, Revici proposed that a crucial distinction be made between pathological pain and what he termed "physiological pain" (a distinction supported by many subsequent years of research). To ease pain in his cancer patients, he then turned to developing lipidic means to change pH, recognizing that interventions based on amino acids, ions, or proteins would not last long enough for meaningful relief.
Before proceeding, he felt it necessary to redefine lipids (fatty acids and sterols), which were generally regarded in the early 20th century as greasy, water-insoluble substances extractable in ether, a definition that still appears in many biochemistry books.
Decades ahead of anyone else in the field, Revici described lipids at a molecular level, correctly noting the importance of their polar and non-polar regions. As his career progressed, Revici's definition guided his clinical use of lipids by supplying an accurate structural guide for analysis of therapeutic compounds he wished to create.
During his European years, Revici also launched into a systematic study of the effects of different elements on bodily function, a research path ending in his categorization of elements as either inducing anabolic or catabolic states of metabolism. Later, he discovered that within a vertical series of the Periodic Table, elements acted similarly – their valency shell partly determined their bioactivity, and the concentration of an element in different organizational levels of the body was both precisely regulated and a key determinant of normal and pathological states.
By the time he had emigrated to the US, Revici's investigations into the molecular structure of carcinogens and other bioactive molecules had revealed that many bioactive molecules exhibited a charge structure in which adjacent carbon atoms would be predicted to carry identical charges. The concepts Revici evolved from study of these "twin formations" (as he termed them), or energetic centers, also played a crucial role in his design of therapeutic agents. As with so much of his work, examination of molecular structures makes one wonder why Revici's American peers resisted this discovery: Flip the pages of the Merck Index, and example after example of bioactive molecules with such an energetic configuration march by.
Repeatedly, Revici's studies on lipid function pointed the way to findings that predate ideas widely accepted today. Decades before Bengt Samuelsson reported on leukotrienes, earning a Nobel Prize, Revici essentially described them, indicating their crucial role in inflammation.6,7 It was characteristic of him, though, to view these compounds as part of a much larger picture. Instead of choosing to concentrate on this one topic for years, he swiftly moved on to elucidate the role of bioactive lipids in the early stages of cellular and systemic host defense processes. Intervention by lipids at this level of the body's defenses, he reasoned, might affect outcome and even the extent of mobilization at other levels.
As he developed his theories and applications, Revici incorporated another basic insight: The damage caused by disease frequently isn't done by the pathogenic focus alone, but by the body's defense mechanisms as well. He may not have been the first to codify this key insight as a therapeutic principle, but once more, he seems to have preceded the mainstream in incorporating the principle to treat patients.
Because Revici believed that these defense mechanisms might do more harm than the pathogenic focus itself (once activated into disequilibrium), he devoted himself to devising therapeutic agents that could restore normal bodily function. Based on his European research, he utilized the properties of elements to alter different levels of function and the ability of lipids to induce longer-lasting alterations to create a large series of therapeutic compounds in which elements were conjugated into lipids. He thereby anticipated, again by decades, interest in lipids as carriers of pharmaceutically useful compounds.
In sum, the different paths of research Revici followed throughout his career enabled him to pioneer, intentionally and with foresight, a great number of therapeutic compounds designed to produce specific effects on the function of normal and diseased tissues. Without exaggeration, then, one may say that he developed a theory of rational drug design long before the concept entered the imagination of the larger scientific community.
1. Revici E. Research in Physiopathology as Basis of Guided Chemotherapy: With Special Application to Cancer. Princeton: D. Van Nostrand, 1961; also: Schrauzer GN. Selenium and cancer: Historical developments and perspectives. In Spallholz JE, et al. (eds). Selenium in Biology and Medicine. Westport: AVI Press, 1981:98-102.
2. Revici E, 1961, op cit.; Also: Simopoulos AP, Robinson J. The Omega Plan. New York, NY: Harper Collins, 1998:61-74.
3. Revici E, 1961, op cit.; Also: Mizushima Y, et al. Use of lipid microspheres as a drug carrier for anti-tumor drugs. J Pharm, Pharmacol. 1986;38:132-134.
4. Revici E, Affidavit, sworn and notarized 2/3/55. This document serves as the basis for all biographical information included here.
5. Prof. Mark D. Noble originally prepared the section here on Revici's scientific findings and medical applications for an appraisal of Revici published in The Journal of Alternative and Complementary Medicine. 1998; 4 (2).
6. Samuelsson B, Leukotrienes. Science. 1987;237:1171-1176.
7. Revici E, The influence of irradiation upon unsaturated fatty acids. Paper read by Robert Ravich, MD, before the Sixth International Congress of Radiology, London, 7/26/50.
Emanuel Revici's difficult publishing history began in Paris on the eve of World War II and continued through the end of the war in Mexico City, where US physicians visiting the medical facility he had opened witnessed the results of his lipidic treatment for cancer. Most of Revici's publishing history took place in New York City, after he moved to the US in 1946, and where, a year later, he founded the Institute of Applied Biology (IAB), which specialized in clinical cancer research. Revici's 50-year struggle to publish exemplifies the problems most originators of non-standard approaches to cancer experience in seeking mainstream understanding and acceptance of their therapies.
Publications, 1930s & 1940s
Emanuel Revici's medical research commanded attention during his years in France (1936-41). Between 1937 and 1938, the sub-director of the Pasteur Institute deposited five papers by the Romanian-born physician in the National Academy of Sciences, a prestigious way of registering scientific innovations.8 These papers summarized observations Revici had made about the influence of lipids in pathological pain and cancer.
In 1943, a year after establishing his Institute in Mexico City, Revici sought to acquaint visiting US physicians with his findings, hoping they would assist in publishing them in peer-reviewed English-language journals. His associate and friend Gaston Merry, in a personal letter dated September 5, 1945, aired his suspicion that the US doctors had intended to publish Revici's findings as their own. Perhaps with that aim in mind, these physicians took a glancing swipe at Revici. The Journal of the American Medical Association (JAMA), August 18, 1945, printed a letter signed by these physicians under the heading, "A Mexican Treatment For Cancer—A Warning." The letter, not referring to Revici by name, disparaged both his theories and results.
"What seems to be behind the paper," Merry wrote, "is the desire to work along the ideas of Revici and to claim the paternity of some of his ideas. A hint is given by an article published in Cancer Research on page 480 of the August number and called 'The Effects of 3–4 Benzpyrene on the Auto Oxidation of Unsaturated Fatty Acids.' It is signed by G.C. Meuller and H.P. Rusch, the latter being the doctor from Wisconsin who came at the end of 1943 to spend about 5 weeks here and who came again at the end of 1944."
"His article," continued Merry, "is the reproduction of an experiment made in Paris, the conclusions of which having been published at two or three occasions. When Dr. Rusch was here in December 1943, I was present at the conversations as an interpreter, and Revici candidly discussed his findings at length, mentioning specifically the linoleic and linolenic acids which are also the ones used by Dr. Rusch who took plenty of notes during the conversations…As you know, according to Revici's classification, 3–4 Benzpyrene is one of the first bodies to be considered as Lipobase. Dr. Rusch does not go so far as to talk about Lipobases and Lipoacids but his method is a close reproduction of the technique mentioned by our friend. I am afraid that all the notes taken 18 months ago and later will serve as subjects for publications which so far could not be made from here."
Merry ended: "I guess the best thing would be to liquidate what we have here and have Revici working in a laboratory in the States with the proper help to repeat all his experiments in support of his theory and especially the suitable collaboration for writing up the publications. It is a great handicap for him that his English is too poor for writing the necessary articles. This is what we asked for when the Texas and Wisconsin gang came here but they acted deaf."9
From the moment Revici co-established the IAB in Brooklyn, New York, in 1947, the Institute reported on its investigational programs. Summaries of Revici's findings prior to the opening of the IAB appeared in booklet form, printed and bound in blue paper covers, with each booklet devoted to a single subject. Itemizations of new or ongoing studies periodically circulated as mimeographed typescripts. For example, "Report on the Research Conducted at the Institute of Applied Biology," issued 10/15/48 by the Cancer Research and Hospital Foundation (the IAB's funding arm), listed over 20 different experiments. "The fixation of oxygen, sulfur, and selenium in unsaturated fatty acids" was the second experiment in this itemization. The 21st experiment was "The influence of lipids in healing of tissue injured by radium emanation."10
Revici's research on radiation injury had blipped onto the US Navy's radar screen 18 months earlier. A letter from a Colonel Thomas G. Cassady, dated just four days before the IAB report, confirmed the Navy's interest: (Military scientists were testing nuclear weapons on isolated atolls in the Pacific Ocean in the late 1940s, seeking to protect servicemen on the battlefront from lethal radioactive fallout.)
"I have had several conversations," Cassady wrote, "at the Naval Medical Research Center at Bethesda, MD, regarding Dr. Revici…About a year-and-a-half ago …they had conversations with the Doctor. They were interested in his research work and offered him certain facilities…As well as I could, in my layman's language, I told them of his further research in the matter in question. They will see him again as it is their policy to leave no stone unturned in seeking relief or a possible cure for the type of injury in which the Doctor has made some progress."11
Twice in the late 1940s, the Office of Naval Intelligence cleared Revici to work on this top-secret project. Twice he declined, preferring to work on radiation primarily in relation to the broad problem of cancer.
Publications and Presentations, 1950s
Between July 1950 and June 1951, three papers about Revici's findings on lipids and radiation came to the attention of the clinical research community. Robert Ravich, a colleague at the IAB (fresh out of the College of Physicians & Surgeons, Columbia University), read a paper by Revici at the Sixth Annual Congress of Radiology in London on July 26, 1950. Titled "The Influence of Irradiation Upon Unsaturated Fatty Acids," this paper dwelt on abnormally conjugated lipids, which clearly fit Samuelsson's description of leukotrienes published in 1987.6 Revici didn't use the terms "leukotrienes" or "prostaglandins" here, but in later publications, he indicated the role these substances play in inflammation, and he attributed the high bioactivity of prostaglandins to a "twin formation…which appears through the cyclization of arachidonic acid."
Dr. Ravich presented another paper by Revici (co-authored by Ravich) before the American Association for the Advancement of Science in Cincinnati in December 1950. The paper bore the title, "The Effect of n-Butanol in Sodium Salt Solutions Upon Shock and the Survival of Mice Exposed to Severe Thermal Burns."12 Waldemar Kaempffert, a senior science writer for The New York Times, devoted a column to Ravich's presentation in the March 4, 1951 issue of the Times, stressing the potential value of Revici's findings on radiation injury should American cities be hit by A-bombs.13
"Fall-out" from a paper delivered by Leonard Goldman, MD, at a meeting of the AMA in Atlantic City, NJ, in June 1951 marked the first documented instance of mainstream opposition to independent clinicians trying to follow Revici's line of research. Notice of Goldman's study, titled the "Use of Lipids to Enhance the Effect of Roentgen Therapy in the Treatment of Pain from Advanced Cancer,"14 made its way into a dossier that the American Cancer Society (ACS) maintained on Revici. The dossier was labeled, "Summary of information contained in the American Cancer Society, Inc.'s files concerning the Institute of Applied Biology and Dr. Emanuel Revici, as well as other persons concerned in the matter."15 Here's an entry about a memorandum from Dr. B. Aubrey Schneider of the ACS, who had heard Goldman's paper, to Dr. Charles Cameron, scientific director of the national ACS: "In his memorandum to Dr. Cameron, Dr. Schneider adds that in a private conversation with Dr. George Cooper, Director of the Virginia Division of the Society, he indicated that he was going to try out the Lipid therapy on some cases now under his care at the University of Virginia Hospital. A copy of Dr. Goldman's paper is in the files."
Goldman had reported on the palliative effects of Revici's therapy. He next proposed a trial of its therapeutic effects, requesting approval from the Institutional Review Board (IRB) at Queens General Hospital, where he served as a resident. Another entry from the ACS dossier on Revici picked up the story: "Early in January, Dr. Cameron received a phone call from Dr. Alfred Angrist, Pathologist at Queens General Hospital. Dr. Cameron prepared a memorandum which is in the files. Dr. Angrist felt that Dr. Revici exerted strong psychotherapeutic influences on patients and discussed his personal feelings, as Chairman of the Hospital Committee on Research and Publications, with regard to hospital approval of a paper on the Revici treatment by Dr. Goldman. Because of Dr. Angrist's strong 'anti' feelings, an ad hoc committee had been appointed to consider the particular paper, and Dr. Angrist felt that the committee's membership had been stacked. At his request, Dr. Cameron suggested Drs. Gellhorn, Bodansky, and Schoenbach as additional committee members."16
Minutes from meetings of the IAB's board of directors in 1952 relate that the "restacked" IRB at Queens General denied Goldman approval. In 1986, Dr. Goldman addressed the Regents of the State of NY, in a written plea supporting Revici's struggle with the OPMC to remain in practice. He noted his early interest in Revici's treatment, and—for the first time publicly – he disclosed that his studies on lipid therapy had cost him his residency privileges.
While the ACS and associated elements in mainstream medicine were helping to clip Dr. Goldman's wings behind the scenes, The New York Times printed a feature on the IAB in its December 2, 1952 issue.17 The writer, William L. Laurence, was probably the most distinguished science reporter at that time; the US had broken the news of the A-bombing of Hiroshima and Nagasaki under his byline. The first three paragraphs of Laurence's report on the IAB ran as follows:
Animal experiments and tests on patients in advanced stages of cancer were described last night by leaders in medicine as lending "strong support" to a new concept of malignant disease that may lead to a radically new approach to its ultimate control. The progress reports on the new methods, developed at the Institute of Applied Biology, Brooklyn, were presented at the fifth annual dinner of the Cancer Research and Hospital Foundation at the Waldorf-Astoria Hotel. More than 400 leaders in medicine and other professions, as well as leaders in industry and civic affairs, were present.
One of the reports was prepared by Dr. John Masterson of Brooklyn, former president of the Medical Society of the State of New York and a member of the House of Delegates of the American Medical Association. He is now attending the AMA meeting at Denver and the report was read in his absence.
Other reports were presented by Dr. John M. Galbraith, past president of the Nassau County Medical Society; Dr. Emanuel Revici, scientific director of the Institute; and Dr. Robert Ravich, assistant director.
Laurence's last paragraph, notes: "Prof. Jacques Maritain of the Institute of Advanced Study at Princeton, NJ, one of the world's leading philosophers, is a director of the Cancer Research and Hospital Foundation, a non-profit organization to raise funds for the cancer research program of the Brooklyn Institution."17
By the mid-1950s, at least one of Revici's associates believed a distinct pattern had become discernible in the reception of papers submitted to peer-reviewed journals by the IAB. In a letter to one of the Institute's chief funders, dated 11/12/55, Robert Ravich recounted the publication history of an article he had co-authored with Revici, titled, "Antihemorrhagic Action of n-Butanol in Advanced Cancer" (Angiology, December 6, 1953).18 Bear in mind that butanol – the higher sterol Revici gave to control bleeding in Resistance fighters in southern France – worked so well, it set the Nazis on its developer's trail; in effect, it amounted to his "ticket" out of Europe. (See Part 1 for details.)
In the US after the war, Revici had developed butanol for cancer patients too ill to stem internal hemorrhages surgically. Injected intravenously, it sped through the blood system to the site of a severed artery or vein, permanently constricting the muscle tissue circling the vessel at the rupture point. The Revici-Ravich paper reported on two small series of patients, one group injected with butanol and the other, control arm, not given Revici's antihemorrhagic agent. (Revici discovered the mechanism of action after publication.) Ravich's letter started with an assertion: "I told you that the Institute of Applied Biology had encountered a mysterious form of censorship whenever it attempted to have an article concerning cancer published in the regular channels. The following is a case history which…bears out my statement."19
In short, Ravich's case history of the butanol paper goes like this: rejection in 1951 by Cancer (after a recommendation to accept by the reviewer); rejection in 1951 by the Journal of Laboratory and Clinical Medicine and the Journal of the National Cancer Institute; and rejections in 1953 in the original submission and resubmission to the New York State Journal of Medicine. The editors cited various reasons. Consultants didn't think the paper represented a controlled clinical experiment (Cancer). The subject was not of sufficient interest to readers (Journal of Laboratory and Clinical Medicine). Not suitable for publication here: try a journal of a more general nature (Journal of the American Cancer Institute). It was doubtful that n-Butanol had any relation to the cessation of hemorrhage in the patients studied (New York State Journal of Medicine).
Dr. Ravich closed his letter with these paragraphs:
On August 12, 1953, the article was submitted to Angiology. It was accepted without comment and was published on December 6, 1953. Angiology is a journal with very limited circulation, and not one that is likely to be read by doctors interested in cancer or by general practitioners who might find the article of value. We have received requests for reprints from all over the country and the world and some interesting comments and observations.
The experience with this paper indicates beyond any question that the problem of publishing our work on cancer is not a simple one. Why this invisible form of censorship is permitted to exist in scientific and medical publications and how it operates are questions that I am not able to answer. But I do believe we are justified in saying, on the basis of such experiences, that the normal channels of publication have been closed to us and that we are therefore forced to take any other way that may be open, to get our findings before the medical and scientific public.
Then Ravich added a postscript, dredging up a wider, deeper history of attempts by Revici and the IAB to publish in the peer-reviewed literature:
Every paper we have submitted on subjects outside the field of cancer has been accepted; every one concerned with cancer has been rejected. When four articles were submitted by Dr. Revici by title alone, for presentation at the International Cancer Congress in Paris in 1950, all of them were rejected. Only seven papers in all were rejected, and almost a thousand read. I learned from Dr. Oberling that they had been rejected because of the intervention of Dr. Rhoades [sic] and others in this country on the program committee.19
Dr. Charles Oberling, a French academic physician who relocated in the US after World War II, was highly regarded by American oncologists. He would have known the circumstances behind the rejection of Revici's papers. Dr. Cornelius Rhodes, the first major postwar director of Memorial Hospital in New York City (later, Memorial Sloan-Kettering Cancer Center), had headed the Chemical Warfare division of the Office of Strategic Services (OSS), the predecessor of the CIA. Rhodes had used his wartime post to experiment with mustard gas – a chemical agent used in World War I – on human cancer. The Congress to which Ravich referred was the International Union Against Cancer, whose president and editor on different occasions was Prof. Joseph Maisin of Belgium.
Through the 1950s and early 1960s, IAB papers slipped into medical journals,20 and The New York Times covered a few of the IAB's research advances, in areas where the papers or research didn't concern Revici's theories and therapeutic applications in cancer.21 From time to time, research on lipids and cancer not originating at the IAB appeared in the scientific literature, focused on abnormal lipid metabolism, a prime Revici area of study.22
In 1961, D. Van Nostrand and Co. decided to distribute a text by Revici under its imprint. Research in Physiopathology as Basis of Guided Chemotherapy, With Special Application to Cancer had been in various draft stages for several years: IAB newsletters voiced news of its progress in the late 1950s. Close to 800 pages in print, Revici's monograph summed up his prolific findings from the mid-1920s through the 1950s.
When it undertook to bring out Revici's monograph, D. Van Nostrand had been publishing scientific volumes from its main office in Princeton, NJ, since 1848. It had earned a solid reputation for quality. A letter from the president, Edward M. Crane, on June 8, 1961, spoke of the publishing firm's "keen interest" in an "important and valuable book."23
Earlier that spring, in the March-April issue, Ca, a Journal for Clinicians had come out with a feature on Revici's method of cancer control, characterizing it as "unproven." How Van Nostrand expected to sell Revici's text after the ACS publicly questioned the effectiveness of his therapy is something of a mystery. Crane, D. Van Nostrand's president, in a telephone interview in the late 1980s (conducted by the writer), said he thought there was room at that time for another approach to cancer.
Revici had filled his book with explanations of his theories, with reports of experiments on their clinical application, as leads to follow and independently prove or disprove the efficacy of his therapy. He viewed his method as a way to manage cancer that differed in critical particulars from standard therapy: his treatments were comparatively non-invasive, negligible in toxicity, and individually guided. He also felt that the results of his treatment were equal or superior to the outcomes of treatments in common practice in a significant percentage of cases, especially in cases resistant to other approaches.
In blacklisting Revici's method of cancer control, the ACS aimed to keep patients from his therapy. To an incalculable extent, the Society succeeded. There's no telling how many of Revici's medical insights might have proven of value, had clinicians been able to get hold of his text, to familiarize themselves with his method, to test his treatments in practice. Most importantly, had the ACS not discouraged sales of his book, there's no estimating the number of patients who might have benefited from the free circulation of his ideas.
Publication of Revici's monograph was the high point of his efforts to disseminate his findings in the US—for that matter, in the world. This publication was also to prove the near terminal event in his attempts to acquaint his peers with his clinical research: one paper on the narcotic addiction treatment Revici developed in the early 1970s appeared by invitation in a Canadian government journal on addictions in Quebec in 1973.
1. Personal communication from C. Pouret, archivist, [French] Academy of Sciences, to Revici, 5/21/85, giving the deposit numbers and years: 11273 (4/12/37), 11322 (8/30/37), 11391 (2/28/38), 11417 (4/25/38), 11440 (7/4/38).
2. Letter from Gaston Merry to Col. Gustave Freeman, MD, 9/5/45.
3. Cancer Research and Hospital Foundation. Report on the research conducted at the Institute of Applied Biology. 10/15/48.
4. Letter from Col. Thomas G. Cassady to Andre Girard, 10/11/48.
5. Ravich RA, Revici E. The effect of n-butanol in sodium salt solutions upon shock and the survival of mice exposed to severe thermal burns. A paper presented before the American Association for the Advancement of Science, Cincinnati, Ohio, 12/50.
6. Kaempffert W. Burns are treated with n-butanol. "Science In Review". The New York Times. 3/4/51.
7. Goldman L. Use of lipids to enhance the effects pf Roentgen therapy in the treatment of pain from advanced cancer. A paper delivered at the meeting of the American Medical Association at Atlantic City, NJ, in June 1951.
8. The ACS file on Revici and the IAB comes from documents bequeathed by Fanny Holtzmann, Esq., to the American Jewish Archives, Hebrew University, Cincinnati, Ohio. Holtzmann, a celebrity lawyer with powerful political connections, was a staunch supporter of Revici's work at the IAB from the 1950s until her death.
9. Identification of two of the three doctors added to the committee Angrist chaired at Queens General is not certain. Bodansky is almost certainly Oscar Bodansky; Gellhorn is probably Alfred Gellhorn. Later, Bodansky and Gellhorn were affiliated with more prestigious institutions.
10. Laurence W. Cancer attacked by a new method. The New York Times. 12/2/52.
11. Revici E and Ravich A. Anti-hemorrhagic action of n-butanol in advanced cancer. Angiology. 1953;4:510–515.
12. Letter from Robert Ravich, MD, to Mrs. Ethel Pratt, 11/12/55.
13. The following list represents a selection of papers published in the peer review literature by Revici and his colleagues at the IAB. The full list, seven pages long, was compiled by the late Prof. Harold Ladas, a patient of Revici. With his wife, Dr. Alice Ladas, Harold Ladas organized and helped fund Revici's patients in their successful campaign to prevent the NY Health Dept. (OPMC) from revoking Revici's medical license in the mid-1980s. An asterisk at the beginning of a citation signals that Revici was a co-author.
- *Blechmann M, et al. The effect of unsaponifiable fraction of lipids (sterols) on morphology and growth metabolism of mycobacterium tuberculosis var. hominis and var. bovis (BCG). The American Review of Respiratory Diseases. 1964;89(3): 448–49.
- *Blechmann M, et al. Ring and lysis zones in cultures of tubercle bacilli in medium enriched with unsaponifiable lipid fractions The American Review of Respiratory Diseases. 1963;87(5).
- LeShan L. Psychological states as factors in the development of malignant disease: a critical review. J Nat. Cancer Inst. 1959; 22 : 1–18.
- LeShan L. Basic psychological orientation apparently associated with malignant disease. Psychiatric Quarterly. 1961.
- LeShan L. The world of the patient in severe pain of long duration. J. Chronic Diseases. 1964; 17: 119–26.
- Ravich RA. Relationship of colloids to the surface tension of urine. Science. 1953;117: 561.
- Ravich RA. Pain—controlled and uncontrolled. Science. 1953;118 (3057): 144–45.
- Revici E, et al. Surface tension of urine in old age. Geriatrics. 1954;9(8) : 386–89.
- Welt B. Head and neck pain: role of biological imbalance in its pathogenesis and therapy. AMA Archives of Otolaryngology. 1955; 61:280–312.
- Welt B. Vertigo: a further contribution to therapy based upon its physiopathological aspect. Archives of Otolaryngology. 1956; 63: 25–29.
- A letter from Henry L. Williams, MD, to Bernard Welt, MD, 1/29/54, referred to an article Prof. Ladas did not include in IAB bibliography. Williams was at the Mayo Clinic, Rochester, Minnesota, Welt at the IAB. The full text of this short letter follows: "I read with considerable interest your article on a new theoretical approach in vertigo which came out in the September Archives [Archives of Otolaryngology, an AMA journal]. I have tried your method of therapy on some cases of vertigo and several with headaches. They have given very good response.
"I have been asked by the Academy of Ophthalmology and Otolaryngology to organize a symposium on the treatment of headache to be given in New York City for a two day period between September nineteenth and twenty- fourth. This is to be in the teaching section, a two hour session being held on each of the two days. The members of the panel will discuss their treatment for ten minutes apiece during the first hour. The second hour will be devoted to the answering of questions from any auditor present. Your therapy is extremely new and unusual and I would be very happy indeed if you would agree to be a member of this panel."
14. Schmeck HM, Jr. Chemists study adrenal action. The New York Times. 9/19/59.
15. Letter from Fanny Holtzmann, esq., to S.A. Logan, First National City Bank, 4/13/55. The pertinent paragraph reads: "In the current issue of CANCER, official organ of the American Cancer Society (March, April 1955) there is an article by Dr. Marion Barclay, et al., entitled "Lip-Proteins in Normal Women and in Women with Advanced Carcinoma of the Breast." The title carries the unusual footnote "The authors wish to thank Dr. Cornelius P. Rhodes for suggesting this problem and for his continuing support and interest." The article concludes that cancer patients have abnormal Lip-Protein metabolism "which is associated with a severe defect in lipid metabolism. This is precisely the premise from which Dr. Revici set out on his biochemical explorations more than thirty years ago."
16. Letter from Edward M. Crane to Mrs. Sherman Pratt. 6/8/61.
There are few greater hazards to a scientist's career than perceiving a truth before the means exist to test it. Repeated assertions of one's insight will first invite insistent demands for proof, then skepticism, followed by silence, ridicule, and often the loss of research funds.
— Nicholas Wade
"A Lonely Warrior Against Cancer: Scientist at Work–Judah Folkman."
The New York Times, 12/9/97
Dr. Emanuel Revici pioneered nontoxic lipid treatments for cancer in the mid-1920s – 80 years ago. Barely in his 30s at the time, Revici was in private practice in Romania, still associated with the University of Bucharest where he had received his medical education.
Knowledge about these water-insoluble substances was comparatively crude at the time. Combining Newtonian physics and quantum mechanics, he redefined lipids, accurately describing their molecular activity, organization, and properties.
Revici moved to Paris in 1936, seeking technologically advanced research facilities. As World War II loomed, French academic physicians encouraged him to continue his studies, occasionally requesting him to apply his laboratory findings to terminal cancer patients under their care. These therapeutic experiments, said one doctor, always resulted in relief of pain and often in tumor regression (see below, 1936-41: Paris).
Relocating in the US after the war, Revici repeatedly tried to inform doctors about his research on lipids in physiopathology through peer-reviewed journals and scientific conferences, but elements in the medical establishment frustrated his efforts. His concepts were foreign to their knowledge bank, so they derided or slighted his investigations. (See parts 1 and 2 of this appreciation of Revici's lifework.)
Modern molecular biologists began publishing their insights into lipids in the 1980s, and virtually no clues in the English-language scientific literature pointed toward Revici as their predecessor. Bengt Samuelsson's research on leukotrienes, which earned him a Nobel Prize in 1982, exemplifies independent confirmation of Revici's groundbreaking experiments. Samuelsson published his observations almost a generation after Revici had described these fatty acids in a paper read by a colleague at an international radiology conference in London in 1950.
By the 1980s, Revici had been a US resident (and naturalized citizen) for close to four decades, treating cancer patients at his New York City Institute of Applied Biology (IAB) since 1947 with compounds derived from his clinical research. These agents, negligible in toxicity, included selenium in lipid bases and Omega 3 fatty acids extracted from fish oil, especially salmon.
Unlike his scientific investigations, Revici's medical applications quickly attracted the attention of establishment institutions, the American Medical Association (AMA) and the American Cancer Society (ACS) foremost among them. The Journal of the American Medical Association (JAMA) published a joint letter in August 1945, warning about the treatment for cancer at a clinic that Revici had established in Mexico City in 1942.1 (Driven from Europe by World War II, Revici had first taken refuge in Mexico.) The signers were US physicians who had visited the clinic between the fall of 1943 and the summer of 1945. This Part 3 of my appreciation of Revici presents excerpts from letters those physicians wrote to each other; their private correspondence was largely at variance with the public letter they signed.
JAMA published a report by the AMA Council on Pharmacy and Chemistry in 1949, which associated Revici's method of cancer management with quackery and denigrated the research at the IAB.2 In 1949, the IAB was located in Brooklyn, and the Brooklyn Cancer Committee of the ACS reprinted and distributed the AMA report. Revici and the IAB sued the Brooklyn Cancer Committee for libel. The facts relating to the 1949 JAMA report slandering Revici and the IAB and the consequent IAB suit are provided in the account here. Note that, since the 1940s, the ACS has been the prime source for stories spread among the medical profession about Revici. The media, for the most part, has echoed the Society in reporting about him to the public—as they have done in general with unorthodox approaches to care branded heretical, in effect, by the ACS.
The most elaborate ACS version of Revici's career appeared in the March/April 1989 issue of CA – A Cancer Journal For Clinicians, an ACS publication. It spoke matter-of-factly of evaluations of his cancer therapy by US physicians in the mid-1940s. As this part of the Revici appreciation will show, all the tests of Revici's therapy which the ACS represented in this piece as actually occurring in the 1940s turned out to be hearsay, misunderstandings of situations, or opinions expressed in correspondence.
In 1936, Dr. Emanuel Revici uprooted himself from Bucharest to settle in Paris, where the scientific environment for his research seemed more hospitable. Late in life, reflecting on his Parisian period, he confided to friends that he never would have left France were it not for World War II.3 Between 1937 and 1938, the sub-director of the Pasteur Institute deposited five research summaries by Revici in the National Academy of Sciences.4 This appears to have been a prestigious way in France of recognizing scientific discoveries.5 Revici's summaries concerned novel observations on lipids and cancer.4
Revici maintained that the Minister of Defense and a Councilor of State proposed awarding him Legions of Honor in the late 1930s. (As defined by Revici, a Councilor of State was the rough equivalent to an advisor to the US president.) The Minister wanted to honor him for two patents he handed the government for rapid mass incineration of official papers in the event of war. The Councilor wanted to honor the entire body of his research after Revici had put the Councilor's cancer-ridden wife in remission. Concerned that these awards might politically taint his scientific work, Revici nixed both proposals.6
World War II aborted his French career. The first part of this series on Revici recounted his eleventh-hour escape from the German forces occupying the French capitol. (The Nazis were rounding up Jews in Paris for deportation to death camps. Revici, who was Jewish, had retained his Romanian citizenship, and Romania was fighting on Germany's side. Such "distinctions" would have counted for naught had the Nazis landed him in their nets.) Fleeing with his wife and daughter to Nice in Vichy, France, Revici bore with him letters of recommendation written on the eve of flight in March 1941.
Dr. Roger Leroux wrote: "Dr Revici has been working in my laboratory for two years. He is carrying on a program of very interesting research of a physiopathological nature on the metabolism of lipids. He has brought to this question several new ideas of the greatest interest. It is vital that his research be continued without interruption, for the results obtained by Dr. Revici open a multiplicity of new paths to research of all kinds, particularly in the field of cancer." Leroux was Professor of Pathologic Anatomy at the Faculty of Medicine, University of Paris.7
Dr. Chifoliau extolled Revici: "On several occasions, in cases of patients afflicted with grave surgical conditions, I requested the aid of Dr. Revici, who willingly applied to our patients the results of his laboratory research. The result obtained in most hopeless cases were always the amelioration of pain and quite often, the progressive disappearance of large tumors. Dr. Revici's research must be continued and fostered, and may change the therapy of tumors completely." Chifoliau was an Honored Member of the Hospitals of Paris and a Member of the Academy of Surgery of France.8
1942-46: Mexico City
Twenty years after the Second World War, a member of the high command of the Resistance in southern France recalled Dr. Revici's clandestine service in the Underground: "Revici volunteered in our resistance in which we badly needed secret help. . .Revici risked his life doing such jobs. . .He could have been arrested any time...His wife would have been deported...I never forgot his quiet courage and the lives he saved."9
Fellow leaders of the Underground sped Revici and his family out of Europe in the Fall of 1941.10 Mexico agreed to entry visas, and by early 1942, the Revicis had resettled in Mexico City. Encouraged by Gaston Merry, a friend, Revici converted a modern 100-room hotel into a medical institute devoted to his lipid research. Formerly the European representative for E.I. Du Pont de Nemours, Merry was a chemical engineer who had grown interested in Revici's study of lipids while both were in Paris. (Du Pont had long positioned itself in the business world as a multinational combine specializing in chemical research and manufacture.)
Revici's Mexico City institute had 15 qualified physicians and chemists on staff, with 60 support personnel. Most of the doctors and chemists were Mexican, but several eminent European physicians, surgeons, and scientists also in refuge, signed on. The facilities included a hospital equipped with the latest technology, a clinical lab, a research department with eight labs, a section for experiments on animals, and an outpatient clinic that charged patients not a peso for treatment and medication. Concentrating on Revici's explorations of lipid metabolism and disease, the researchers studied sulfur incorporated into lipids for antibiotic use, fatty acids as factors in arteriosclerosis, and shock. The work on cancer focused on treatment of terminal cases with lipid extracts.10
Toward the end of 1943, a banker in Wilmington, Delaware, the global headquarters of Du Pont, got word from Merry and others involved with Du Pont about Revici's Mexican clinic. The banker's father had been a founder of the McArdle Memorial Laboratory for Cancer Research at the University of Wisconsin, Madison, and he passed the word about Revici to the physician-director of the McArdle center. The director traveled to Mexico City and spent more than a month at Revici's clinic, summing up his impressions to the banker at the beginning of December: "My visit with Dr. Revici," he said, "was very worthwhile, and I am enthusiastic about some of his ideas. Most of his work is of a fundamental scientific nature. I believe that further work in that direction is indicated. This is especially true of his work concerning the fundamental concept of his theory."11
By the summer of 1944, two physicians from Texas had learned about Revici; one of them recently appointed the first director of M.D. Anderson Hospital, the other associated with the new cancer center in Houston. In early September, the associate visited the Mexican clinic and reported his observations to the director. Revici, he noted, had refused offers of money to finance his clinical research; he didn't want to work under anyone's direction. Revici also struck him as well educated in medicine and biochemistry.12 In a supplementary report, the associate described eight cases of cancer, each different, each with objective signs of improvement. He concluded: "I am now fairly convinced that Dr. Revici is completely sincere in what he is doing, and the more I see of his work, the more I believe that he may possibly have something of value, even if it is nothing more than the relief of pain without the use of narcotics. Dr. Revici expressed a very great willingness to tell us of everything he uses and the way in which he treats his cases."13
Over the next year, more physicians from Wisconsin and Texas and a radiologist from California made site inspections. Letters to curious cancer researchers traveled back and forth between the West and East Coasts.14 The observers and correspondents basically agreed: Revici's scientific concepts seemed plausible; his medical applications appeared to benefit an unusual percentage of difficult cancer cases; and he was absolutely open about his theories, method of care, treatment outcomes, and the operation of the clinic (including patient charts and evaluative procedures and tests).15
Meanwhile, inquiries from doctors, patients, and relatives around the US flooded the Mexican clinic. Many of these people had contacted the physicians from Wisconsin and Texas who had witnessed dramatic improvement in Revici's patients. To each inquirer, Revici addressed a careful disclaimer: his approach was in an investigational phase, not a "cure."10
When the August 18, 1945 issue of JAMA arrived in Mexico City, he and Merry were surprised to find a letter in the correspondence section headed "A Mexican Treatment For Cancer—A Warning."1 The letter didn't name Revici, but the facility it described unmistakably matched his institute. Speaking of "the physician in charge," the letter emphasized that there was no "positive evidence" that the "peculiar methods" devised by him and his associates interrupted the usual course of a malignancy. To underscore this point further, the letter declared that the theoretical basis for the treatment was "not in accord in any way with established biochemical or pathological considerations."
A decade later, the shock imprinted in memory, Revici conveyed his reaction: "I read the letter with bewilderment as it was in total contradiction with the facts and the correspondence which the doctors who signed the statement sent to me after their last visit to Mexico."10 His 1955 explanation of the astonishing turn-around was partly right: "When I had occasion to visit Texas later," he said, "I was given to understand…that several of the doctors were embarrassed by the trek of cancer patients to Mexico City, for which they alone could be blamed."10
But his explanation didn't cover Chauncey Leake, PhD, whose signature led the others under the JAMA letter. Dean of the School of Medicine, University of Texas, Galveston, Leake was the only signer who was not a physician. (His doctorate was in chemistry.) According to Revici, he stayed no more than a half-hour on his sole visit to the Mexican clinic.10 Yet several months before publication of the JAMA letter, Leake had written to the observer from M.D. Anderson: "I think that Dr. Revici…has no basic knowledge of modern biochemistry or of any other modern scientific development that is significant with respect to the cancer problem. Further, I am convinced that he has no satisfactory concept of the principles of science which are so important in judgment on so complex a matter as cancer."16 Note that Leake's assessment was the polar opposite of the eminent French physicians' view of Revici's clinical research in 1941.
Leake's correspondence is preserved in the National Library of Medicine, Bethesda, MD. Other letters in this collection left no doubt that he initiated and drafted the 1945 JAMA warning and that he browbeat at least one physician who was unwilling to sign into affixing his signature.17 The letters in this cache also revealed that he served Eli Lily as a consultant on development of Mexican pharmaceutical markets.18 Nothing in this correspondence hints at the basis for his put-down of Revici's understanding of science in connection with cancer. His evident rationale for issuing a joint public statement was "to save the expense, the trouble, and the disappointment that are sure to come to patients who go to Dr. Revici."16 Neither the Leake papers nor any other documentary evidence surviving from Revici's Mexican period lend credence to formal trials of his therapy in Mexico City or at the University of Wisconsin, Madison, which the ACS accepted as factual in its 1989 piece on Revici.
1946-49: Chicago, Brooklyn
The 1989 ACS piece also stated as a matter of fact that Revici demonstrated his method at the University of Chicago in 1946, trying it on 52 cancer patients with "no favorable effects" attributable to his treatment. The Society's source was an AMA file.2 Who supplied this story to the AMA awaits an airing of AMA informants on Revici.
Indisputably, Revici was in Chicago in 1946—thanks to Gustave Freeman, an assistant professor of Medicine at the University of Chicago. Freeman had stumbled onto Revici in 1944 while serving as a major in the US Army in Mexico, where his duties involved official liaison with the Mexican government and research on controlling typhus. A lieutenant undergoing treatment at the Mexico City clinic had aroused his curiosity. Six times over two months, without prior notice, Freeman dropped into the clinic, speaking with Revici for many hours. (His fluency in Spanish gave him an edge over other US physicians appraising Revici's research.)19
On February 12, 1945, Freeman reported to Dr. George Dick, chief of the Department of Medicine, University of Chicago, that Revici seemed "properly scientific in his outlook." None of the American physicians investigating his clinic had discovered any unethical activities, including a San Antonio surgeon, Dudley Jackson, who had exposed cancer quacks for the US Public Health Service and was sending patients to the Mexican clinic. Remarking that Revici's approach was "so much more promising than anything that has appeared in the field of cancer," Freeman urged Dr. Dick to offer adequate lab facilities and patients for a fair trial.19
Dr. Dick extended an invitation. Revici shuttered his Mexican institute, arranging for patients under treatment to continue, and drove by car with his family to Chicago.10 Visas ordered by a special wartime assistant to President Franklin Roosevelt, Sumner Welles, eased his entry into the US. (The visas, requested by commanders of the Resistance, recognized both Revici's service with the French Underground and his promising cancer research.)10 En route, Revici stopped overnight in San Antonio to pay respects to Dr. Dudley Jackson. Jackson had been asked by Chauncey Leake to sign the 1945 JAMA letter.20 Instrumental in founding the National Cancer Institute in 1937,21 he had the political muscle to refuse. Confirming Revici's suspicion that Leake had authored the JAMA warning, Jackson added an intriguing bit of information. Leake, he said, had been inspired by Cornelius Rhoads, head of the chemical warfare division of the Office of Strategic Services during World War II. (Postwar director of Memorial Hospital in NYC, Rhoads had used his military position to test deadly chemical agents as chemotherapy for cancer.)22
Shortly after Revici's arrival in Chicago, Dr. Dick's term as dean expired. The new dean, unsympathetic to Revici, forbade him to treat patients at the university hospital.23 Shelved in Chicago, Revici interviewed several doctors in the eastern US interested in cancer, choosing Abraham Ravich, a urologist with a large practice in Brooklyn, NY. Ravich quickly convinced prominent local physicians, businessmen, educators, judges, and attorneys to back Revici's research. In March 1947, this group chartered two non-profit organizations; the Institute of Applied Biology (IAB), and the Cancer Research and Hospital Foundation. Dr. Ravich was named director of the IAB; Revici was named the scientific director (a position he held until 1990). Dr. Gustave Freeman resigned from Chicago University and moved to Brooklyn to work alongside Revici. Ravich's son Robert, fresh out of the College of Physicians and Surgeons, Columbia University, also threw in his lot with Revici and the IAB.24
In April 1947, Freeman sent a detailed letter to an associate editor of JAMA, providing information on Revici and the nature of the IAB clinical research. Most likely, Freeman was responding to an AMA request for background on Revici, because his letter touched on the story about Revici testing his method in Chicago. Freeman told the editor that conditions and facilities didn't permit Revici to treat any patients at the University of Chicago hospital.23
Through the Freedom of Information Act, this writer obtained an FBI dossier on Revici in the late 1980s. Consisting of investigative and surveillance reports dating between the late 1950s and mid-1960s, it indicated that the FBI had cleared Revici, but most pages were unreadable, blacked out with "Top Secret" stamped at the top. A deep wartime friendship between Revici and Constantin Omansky, Soviet Ambassador to Mexico, may have sparked the Bureau's concern, putting agents on his postwar trail to snoop for residual ties with the Communist bloc in Eastern Europe. On several pages, one can make out that an agent checked Revici's medical activities in Chicago, finding no trace of him in the university hospital records.
Four years after the 1945 warning about Revici's treatment in JAMA, bad publicity lingered as a major "stumbling block" to fundraising. But the "highly ethical conduct of the research and the favorable results obtained" in terminal cancer cases at the IAB were gradually dispersing the murky cloud over Revici created by that public statement.25 Then, on January 8, 1949, JAMA ran a report by the AMA Council on Pharmacy and Chemistry, headed "Cancer and the Need for Facts."2 The report named various individuals and groups as charlatans and purveyors of quackery, Revici and the IAB among them. The sole basis for including Revici appeared to be the 1945 JAMA warning.
A number of organizations widely propagated the AMA report, the American Cancer Society and the Consumers' Union in the lead. The report blasted IAB hopes of getting grants from the NCI. The president of the local ACS chapter, the Brooklyn Cancer Committee (BCC), reprinted the section on Revici and distributed the excerpt. Subsequently, the Visiting Nurse Association refused to service IAB ambulatory cases, and the county medical society barred the IAB from using the society's auditorium to defend its research before the medical profession. Of course, lay members of the IAB experienced extreme difficulty in collecting funds to support lab and clinical programs.25
To protect their reputations, the lay sponsors of the IAB demanded legal action, first against the local arm of the ACS, next against the AMA. A suit for libel was soon filed against the BCC and its president. A libel suit against the AMA, the laymen decided, would be too costly and difficult, so they abandoned the idea. The suit against the BCC never proceeded to trial. Dr. John Masterson, president of the Medical Society of the State of New York, intervened, called the parties to a conference over which he presided, and issued a statement agreed to by all parties. The BCC declared it never authorized or knew in advance about the reprint and its distribution, disavowed the letter by its president accompanying the reprint, and disavowed any slanderous inferences in the reprint and letter. The BCC president acknowledged that he had acted on his own, regretted his action, and also disavowed the contents of the reprint, his letter, and libelous inferences in both. All parties agreed that the section on Revici and the IAB in the AMA report was unjustified. Revici and the IAB withdrew their suit.26
In the near aftermath, JAMA published a letter from Dr. Abraham Ravich, IAB director, in its July 9, 1949 issue. The letter began: "An article entitled 'Cancer and the Need for Facts' that appeared in The Journal (January 8, p. 93) contained a number of unwarranted statements derogatory to the research of Dr. Emanuel Revici and the Institute of Applied Biology. These statements were based on a correspondence item published in The Journal on Aug. 18, 1945 (p. 1186). We have in our possession and submit conclusive documentary evidence from a majority of these signers that completely contradicts their published unfavorable correspondence. Accordingly, the statements that appeared in The Journal were without justification if based on these alleged facts."27
To this writer's knowledge, neither the AMA nor the ACS has ever coupled the 1945 letter warning against Revici's Mexican clinic or the 1949 report by the AMA Council on Pharmacy and Chemistry with this IAB letter in their presentations questioning the efficacy of Revici's therapeutic method. Nor have the AMA and ACS ever referred to the out-of-court settlement of the suit against the BCC that vindicated Revici and the IAB.
There was another development in the aftermath of the suit against the BCC, which neither the AMA nor the ACS has ever disclosed: impressed by the treatment approach and results at the IAB, Dr. John Masterson became a member of the IAB's board of directors.28
1. Leake CD, et al. A Mexican treatment for cancer: a warning, correspondence, JAMA. 1945;128:1186.
2. AMA Council on Pharmacy and Chemistry: Report of the Council, Cancer and the need for facts. JAMA. 1949;139:93-98.
3. Personal communication with Dr. Emanuel Revici, c. 1984.
4. C. Pouret, archivist, National Academy of Sciences (France), letter to Dr. Revici, 5/1/85.
5. Center of Alternative Medicine Research, University of Texas Health Sciences Center, Houston. Available at: www.sph.uth.tms.edu/utcam. (8/19/06: Link to Center of Alternative Medicine Research no longer active. www.uth.tmc.edu works.)
6. Personal communication with Dr. Revici, c. 1984.
7. Roger Leroux, MD. Letter, March 1941; quoted from Project CURE, "Emanuel Revici: Evolution of Genius," Impact, (special supplement). Spring 1985.
8. Dr. Chifoliau. Letter, March 1941; quoted from Project CURE, "Emanuel Revici: Evolution of Genius," Impact, (special supplement). Spring 1985.
9. André Girard. Letter to Laurence Eldredge, Esq. 4/12/65.
10. Emanuel Revici. Affidavit; sworn and notarized, 2/3/55. Extending 41 pp., this document detailed Revici's life and career from 1896 to 1955.
11. Harold P. Rusch, MD. Letter to Thomas E. Brittingham. 12/1/43.
12. C.A. Calhoun, MD. Letter to E.W. Bertner, MD. 9/11/44.
13. C.A. Calhoun, MD. Letter to E.W. Bertner, MD.10/27/44.
14. For instance: Ross Golden, MD, The Presbyterian Hospital, New York City, Letter to Lowell Goin, MD, Los Angeles. c. 10/44.
15. For instance: Jas. Greenwood, Jr., MD. Letter to E.W. Bertner, MD. 11/10/44; and, C.A. Calhoun, MD. Letter to E.W. Bertner, MD. 10/27/44.
16. Chauncey D. Leake, PhD. Letter to C.A. Calhoun, MD. 5/29/45.
17. Chauncey Leake, PhD. Letter to Lowell Goin, MD. 5/29/45.
18. Chauncey Leake, PhD. Letters to Dr. Chen, Lily. 11/26/45, 12/17/45, 1/7/46.
19. Gustave Freeman, MD. Letter to George Dick, MD. 2/12/45.
20. Chauncey Leake, PhD. Letter to Dudley Jackson, MD. 6/22/45.
21. Dudley Jackson, MD. Letter to Chauncey Leake, PhD, 6/18/45. See also: James T. Patterson. The Dread Disease. Cambridge, MA: Harvard University Press, 1987.
22. Ralph Moss. The Cancer Industry. Brooklyn, NY: Equinox Press, 1996.
23. Marcus A. Cohen. Unpublished review of Revici's career, quoting firsthand sources, 1988.
24. Abraham Ravich, MD. Letter to André Girard. 4/5/47.
25. Robert Ravich, MD. Letter. c. May/June 1949; quoted in 23, above.
26. Statement of out-of-court settlement, jointly signed by the Brooklyn Cancer Committee, its president, and Dr. Revici and the IAB. 6/13/49.
27. Ravich A, MD. Institute of Applied Biology. Correspondence. JAMA. 1949;140:908.
28. Laurence W. Cancer attacked by a new method. The New York Times. 12/5/52.
AS BASIS OF
With Special Application to Cancer
EMANUEL REVICI, M.D.
Original Copyright © 1963
Written by Dr. Emanuel Revici, M.D.
Scientific Director, Institute of Applied Biology,
New York, N.Y.
Chief of Dept. of Oncology, Trafalgar Hospital,
New York, N.Y.
Republished in 2012 By HEALTH WAKE UP MERGER
11 Langwa Street, Strijdom Park, Randburg
Printed in 2012 in South Africa
Also Published in an E-Book Format
Reversing Cancer ISBN Number: 978-0-620-52910-5
Formerly: RESEARCH IN PHYSIOPATHOLOGY AS BASIS OF GUIDED CHEMOTHERAPY
With special Application to Cancer
THEORY AND FACTS xix
The Present State of the Cancer Problem xxii
The Atom 2
2. Biological Entities 12
4. Dualism 31
5. The Constituents 81
The Elements 81
The Series 82
6. Lipids and Lipoids 88
FATTY ACIDS 100
Functional Role 102
Double Bonds 102
Sex Hormones 109
The Luteoids 112
On Pain 124
Wound Healing 125
Organic Level 125
Nervous System 126
Systemic Level 127
On Temperature 127
Amino acids 131
7. Defense 133
Grafts in Humans 164
9. Shock 172
Types of Shock 172
Shock Mechanism 173
Water Metabolism 177
Other Changes 177
10. Radiation 180
Local Effects 191
Role of Adrenals 197
11. Problems in Cancer 202
Diagnostic Tests 203
Twin Formation 207
Plural Activity 225
12. Pharmacodynamic Activity 238
Fatty Acids 239
Selenium Lipoids 262
Sulfur Mustard 264
THE ELEMENTS 266
Heavier Elements 275
Higher Alcohols 291
Nonpolar Group 298
Other Alcohols 299
The Elements 302
14. Therapeutic Approach 317
The Agents 319
Fatty Acids 345
15. Therapeutic Approach to Cancer 353
Group of Agents 362
Sulfurized Oil 367
16. Present Form of Treatment 406
Criteria Used 406
Results Obtained 414
THEORY AND FACTS
FEW OTHER PATHOLOGICAL CONDITIONS have aroused, as cancer has, the interest of so many scientific disciplines. Problems related to cancer have become of continuously increasing concern in virtually every field of medicine. In some, such as pathology, they are a major preoccupation. But in sciences other than medicine, cancer also has been receiving increased attention. One of the most urgent activities of synthetic chemistry today is the search for new compounds which might possibly be effective in the control of cancer. Physical chemistry is trying to provide new explanations about the variety of processes present in cancer. Even mathematical studies which recently have offered an interesting application of quantum theory to carcinogenesis, have found new applications in cancer.
With the rapid development of physical sciences, the medical research worker bas hoped that from them might come some contribution that could help him ultimately in his difficult task. He also appears to have been anxious to take quick advantage of the progress of other disciplines for another reason, hoping that, through employing their findings and methodology, medicine in general and cancer research in particular, could be promptly changed from the empirical discipline it has been until now into a positive science. He has brought as many applications of other disciplines as possible into his study and this has led to a whole series of new methods of investigation through which interesting new information has been obtained. Yet, most of these applications have been tried, chiefly because they have been at the immediate disposal of the scientist rather than because they have represented a missing link in the development of his own ideas.
The outcome has not been rewarding. Medical knowledge appears not to be sufficiently advanced to successfully utilize the avalanche of new, highly specialized information offered by the investigative methods derived from other disciplines. Basic theoretical knowledge in medicine in general, and about cancer in particular, has not yet reached the level necessary to relate and assimilate the new data. To a large extent, basic concepts about pathogenic problems are not even formulated as yet. When the medical scientist has tried to transform the new data into effective therapeutic procedures, he has failed. And the failure has made more evident how much we need basic physiopathological knowledge before we are able to take advantage of detailed data.
Meanwhile, normal development of cancer research has been hindered, side-tracked from its logical course. While thousands of scientists with almost unlimited funds at their disposal are presently using the most advanced methods for the acquisition of details, almost no attempts are being made to resolve basic problems, although the cancer investigator is continuously obliged to realize the dearth of fundamental knowledge.
If we attempt to analyze this abnormal situation further, we can find indications that it may have its origin also in a distortion of the proper relationship between the two factors that, together, make for progress in research-ideas and experiment.
The experimental approach provides precise information about particular phenomena under defined conditions. The analytical method tries to investigate reality by recognizing the proper place of the various constituents of a whole, the parts being identified as such by the experimental findings. On the other hand, the conceptual method not only provides an inkling of what the completed whole will eventually look like, but also attempts to predict the properties and the relationship of the component parts.
In dealing with a highly refined and complicated subject, the analytical method by itself appears inadequate. For example, in atomic physics, the results of experiments are expressed by numbers giving the values of certain physical quantities that have been measured. In order to complete the analysis, we must simultaneously determine the numerical values of certain quantities defining the material bodies, the objects of the experiments. This is prohibitive so far as canonical coordinates by Heisenberg's uncertainty principles are concerned. With experimental knowledge somewhat curtailed, theory at present must attempt explanation.
In other areas as well, experiments present only limited numerical values pertaining to some physical quantities. Were we able to measure all quantities, we could analytically reconstruct the entire theme of the physical reality. However, when some quantities cannot be simultaneously determined, this direct reconstruction is not possible and experiments merely give an indirect approach to what we regard as "reality."
If the inadequacy of the analytical approach by itself is evident in the highly positive disciplines, such as in the physical sciences, it is even more so in biology. As Bohr and others have intimated, the conditions of uncertainty seem to be much more pronounced in biology than in physical science. The fact that experiments in biology give only fragmentary and unrelated results is not surprising; the need for a synthetic theoretical method in this field is clear.
In medicine, which is applied biology, the need for the conceptual approach is especially profound. It is true that this approach, as the sole approach, has shown its inherent weakness in the past. There was a time in the development of medicine when available data were so scarce and unreliable, and the need for ideas to provide some sort of guidance was so great, that the worker resorted to broad imagination, using it to replace almost entirely any other form of investigation.
Largely as a reaction to the high proportion of "speculations" prevalent in the early years, the experimental approach in medicine came to be emphasized. Claude Bernard, who almost single-handedly was responsible for this, tried to give experimentation its rightful role. However, in ensuing decades, the relationship between theory and experimentation has been progressively distorted. An unrestrained exaggeration of the role of the experiment, the erroneous view that pure facts represent the aim of research, has led to an entirely unbalanced approach. Not only have almost any data obtained by research been considered intrinsically interesting, but obtaining them has become the sole purpose of much research. In scientific papers today, experimental data must be reported as such; any allusion to theoretical meaning is considered undesirable. Generations of scientists have been schooled to believe in the intrinsic value of the experiment. As they have applied this belief to research in biology, and as they have made unlimited use of new methods taken from other disciplines with no ideological requirement for their use, we have had more and more data and fewer ideas. Today, with great astonishment, some scientists are at last beginning to recognize not only that data alone do not generate ideas, but that science cannot progress without theory.
Ideas and experiments are integral parts of all scientific research. A balance between them is needed to assure progress. It must be understood that the function of experimentation is to guide our thinking, to help build up new concepts, and to prove their accuracy in accordance with reality. Certainly, fundamental concepts must not be mere "speculations." They should be accepted only after confirmation through experimentation. Experimentation is the necessary link between mental concept and reality. To the attempts to consider any unresolved fundamental problems in biology, one has to try to bring a rightful balance between conceptual views and experimentation.
The exaggerated importance attributed to experimentation in biological science, its use even as a substitute for ideas, has led recently to a massive attempt to solve the therapeutic problem of cancer by indiscriminate screening of chemical agents. Here, empiricism has been brought to its culmination. After tests of tens of thousands of agents, many workers are now beginning to realize that the results are almost worthless for cancer therapy in humans, that seemingly promising agents have an effectiveness limited to the conditions present in the actual animal experiments. By its impressive magnitude, the failure of indiscriminate screening, of empiricism epitomized, has begun to impel many workers to change their idea as to what must be done if the cancer problem is to be solved. A first result of this change has been a new and, this time, unbiased evaluation of just where we stand in our assault on the cancer problem. Every day more scientists are making the evaluation in their reports to the medical profession and to the public with a candidness which, only a few years ago, very few would have employed.
The Present State of the Cancer Problem
Surgery in cancer can be considered to have arrived now at or near its maximum efficiency. Thanks to progress in operative techniques, and to advances in pre- and post-operative care, ultra-radical surgery is available today. The propensity of cancer to spread far from its original site has made such surgery obligatory in many cases if there is to be an effort to eliminate all malignant cells. Yet ultra-radical surgery has not sufficiently increased the cure rate to justify horrifying mutilations, especially when the face is involved. With few exceptions, surgical procedures do not prevent the patient from dying of cancer sooner or later. The so-called five-year-cure-rate represents, to say the least, an unrealistic appraisal. Many authors consider that even the rate of five-year survival is not improved by surgical procedures, and the ultimate fate of these five-year survivors, with few exceptions, is still disastrous. Most of the "cured" cases still die from cancer.
Other recently discovered facts have increased skepticism about the value of surgery in cancer. The polycentric origin of cancer, especially in cases where the lesions are far apart--considered by some workers to be true even in malignant melanoma, for instance - would greatly limit the value of surgery as a means of eliminating all cancerous cells. It is recognized that to operate on a lymphoma is useless. Furthermore, it is known today that cancer cells are present in the circulating blood. Surgical manipulation has been found to induce a flow of these cells into the blood even from relatively small primary tumors.
In view of all this, cancer cannot be considered to be a condition for which surgery is a major hope. Surgery represents only an expedient - to be tried so long as nothing better can be offered. It is probable that in the future it will be reserved, in cancer treatment, for the correction of mechanical complications, such as intestinal or other duct occlusion.
Unfortunately, radiation has not been much more successful in its long range results. In order to control cancer, it is necessary that radiation destroy all the cancer cells present in the organism while producing minimal damage to normal tissue. It appears that such high selectivity of action cannot be obtained. The lack of it may be implicit in the nature of the effects achieved by radiation. A study of the biological effects of radiation, which is to be presented later in this monograph, has shown that an important part of the action of radiation is to induce changes in certain constituents of the body, principally fatty acids. These changes are largely responsible for the favorable effects of radiation but they also are largely responsible for the undesired effects. It is the nature of these changes which limits qualitatively the capacity of radiation to influence cancerous processes, and makes it dubious that progress in technique can ever greatly improve the qualitatively insufficient effectiveness of radiation. Clinical results to date provide confirmation of this pessimistic view. The recent use of extremely high voltage radiation, of radioactive cobalt, and of other radioactive particles has not greatly improved results over those obtained with older forms of radiation twenty years ago, except for reducing some harmful immediate skin and systemic effects. Now, as earlier, with few exceptions, the benefits of radiation are no more than temporary. Long lasting good effects still are limited to only a few radio-sensitive tumors.
The resort to isotopes, in which the scientific world has put so much hope and millions of dollars, also has proved greatly disappointing. Of the thousands of cases of various kinds of cancer in which isotope therapy has been tried, only a very limited number of cancers of the thyroid have responded. Not only because of its continuing failures, but because of its inherent qualitative inadequacy, radiation does not appear, any more than surgery, to represent the solution for the problem of cancer.
With surgery and radiation therapy incapable of resolving the problem, more and more research workers have turned their efforts in other directions. The existence of some cases of spontaneous remission has led many investigators to believe that immunological procedures related to cancer would be able to resolve these problems. Unfortunately the existing knowledge in this specific field is too meager to permit more than some tentative investigations, usually only repetitions of similar researches made many years ago with limited success. Fruitful development of this approach would have to follow the normal pathway, starting with more knowledge of the complex immunological processes intervening in cancer.
An enormous amount of cancer research in recent years has been directed toward chemotherapy. It is a fact that many agents and groups of agents have shown the capacity to influence tumor evolution. However, each has had limited usefulness. Results of treatment have been characterized by inconsistency. Even in seemingly susceptible types of cancers, results have been good in one case, poor in another and have varied even for the same patient at different times. The inability to explain and remedy these variations has discouraged many workers. Although it appears evident that the source of discrepancies resides in the patients themselves, the general tendency among researchers has been to try to resolve the problem by finding agents able to act independently of any differences which exist between subjects.
In despair at the lack of progress in this approach, many workers today are using the screening enterprise mentioned above as a kind of last resort. For this project, they have renounced the scientific concept that pharmacodynamic activity must serve as the basis on which an agent is to be tried in therapy. They have fastened into a purely empiric approach. Now, all available chemical substances - and many others which will be synthesized especially for the purpose - are to be screened indiscriminately, for their effects on animal tumors with no reason for this test other than that the agents are, or can be made, available. We will not dwell here on the assumption that routine technique is more likely than imaginative brain power to resolve the problem of cancer. The results of this screening to date have shown it to be an invalid procedure, as expected by most critical workers. With tens of thousands of substances already tested, the busy screeners are obliged to recognize that the approach itself is fundamentally erroneous. Experience has proved that an agent can be wonderfully effective against one tumor and still be entirely inactive in others. Of tens of thousands of agents tested, less than a hundred have shown effects on tumors in animals. None appears to have significant value when applied in humans.
These results have emphasized again the importance of factors other than the agent itself. One factor lies in the differences which exist between various tumors. Some of the other factors include variations between species, between individuals of the same species, between origins of tumors, between spontaneous and transplanted tumors, and even variations in any one individual at different times.
Faced with this situation, some workers have concluded that not one treatment but at least hundreds of different treatments must be found in order to cope with the huge variety of conditions. Taking cognizance of these considerations, it has seemed to us that a more realistic and logical approach is to try to understand the nature of the existing differences and to attempt to make the treatment adequate on the basis of that understanding. It has been this approach which has been followed in our research.
We have studied the problem of cancer for the last thirty years from an entirely different vantage point than that used by other workers. Attention has been focused on the physiopathological aspect of cancer, on the basic changes that occur in the different patients, with the ultimate aim of understanding the part played by these changes in the response of cancer to therapeutic attempts. This emphasis on the physiopathological aspect of cancer has been made possible by applying a more general overall idea of the nature of the disease.
This approach is based under various new concepts. They concern,
1) The role of the organization in the pathogenesis of the conditions.
2) A dualistic systematization of the manifestations related to normal and abnormal physiology.
3) The predominant intervention of certain constituents such as lipoids and chemical elements in the induction of the opposite manifestations.
4) The possibility to integrate the occurring processes into a system of defense mechanism against the noxious influence exerted by the environment.
Many general and special problems of physiopathology, some of them concerning cancer and other conditions, have been analyzed in this framework.
The application of this approach to therapy has resulted from a logical development of that approach. The recognition of the intervention of a variety of pathogenic factors, not only differing from one subject to the other, but even changing in the same subject during the evolution of the condition has emphasized the need for individualized therapy. As opposed to the tendency to overcome the differences existing between individual subjects through a standard therapy, the "guided therapy" utilizes the knowledge of the occurring different pathogenic particularities in order to correct them. A high degree of flexibility in the treatment has appeared necessary.
As part of this approach to therapy, has appeared the need for more complete knowledge of the existing differences and their interpretation in terms of the pathogenesis of the condition. The search for adequate analytical tests has thus represented the first task. The development of day-by-day analysis of the condition has been possible by choosing relatively simple but reliable procedures. The information they offered was used to determine the nature of the agents able to correct with a certain specificity, the encountered pathological conditions. These two parts, the recognition of the existing condition and the adequate agents, have concretized this approach.
These considerations explain also why the new developed "guided therapy" cannot be understood and correctly applied without a sufficient knowledge of its physiopathological and pharmacological basis. These same considerations have led us to present the research concerning this approach as a block, instead of fragmented communications. The form of a monograph has appeared consequently the best suited. In a further effort to achieve a cohesive presentation, we have separated from the text most of the technical and experimental data, and presented them as notes at the end of the text.
Dr Emanuel Revici wrote his book in 1961
and is now republished as
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