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From the Townsend Letter
October 2004

 

Emanuel Revici, MD: Efforts to Publish the Clinical Findings of a Pioneer in Lipid-Based Cancer Therapy Part 2
by Marcus A. Cohen

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Part 1 of this article originally appeared in our August/September 2004 issue.
Part 2 was in print in October 2004.
Part 3 is an online publication only, August 2006.

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.

Emanuel Revici MDIn 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

Publications, 1960s
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.

Part 1, Part 2, Part 3

Notes
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.

Marcus A. Cohen
Health Trends
8 East 96th St., 1C
New York, New York 10128 USA
212-427-0707
Fax: 212-348-8288
marcusacohen@aol.com


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