Emanuel Revici, MD:Efforts to Publish the Clinical Findings of a Pioneer in

Lipid-Based Cancer Therapy - Part 2by Marcus A. Cohen

This second part of a four-part seriesabout the late Emanuel Revici, MD,recounts efforts to circulate his clinicalinsights and results through peer-reviewed literature and presentationsat medical conferences. Part 1, brieflychronicling his life and summarizing hisscientific diseoveriea, appeared in theAug/Sept. issue.

Revici's publishing history began inParis on the eve of World War IL Itcontinued until the end of the war inMexico City, where US physiciansvisiting the medical facility he hadopened witnessed the results of hislipidic treatment for cancer. Most of thehistory took place in New York City,after Revici moved to the US in 1946and a year later founded the Instituteof Applied Biology, which specialized inclinical cancer research. Revici's 50-yearstruggle to publish exemplifies theproblems most originators of non-standard approaches to cancerexperience in seeking mainstreamunderstanding and acceptance of theirtherapy.

Publications, 19309 & 1940s: EmanuelRevici's medical research commandedattention during his years in France{1936-41). Between 1937 and 1938, thesub-director of the Pasteur Institutedeposited five papers by the Romanian-bom physician in the National Academyof Sciences, a prestigious way ofregistering scientific innovations.^These papers summarized observationshe had made about the influence oflipids in pathological pain and cancer.

In 1943, a year after establishing hisInstitute in Mexico City, Revici soughtto acquaint visiting US physicians withhis findings, hoping they would assistin publishing them in peer- reviewedEnglish-language journals. Hisassociate and friend Gaston Merry, in apersonal letter dated 9/5/45, aired hissuspicion that the US doctors hadintended to publish Revici's findingsas'their own.

Perhaps with that aim in mind, thesephysicians took a glancing swipe atRevici. The Journal of the American

Medical Association (JAMA), on 8/18/45,printed a letter signed by them underthe heading, "A Mexican Treatment ForCancer - A Warning." The letter, notreferring to Revici by name, disparagedboth his theories and results.

"What seems to be behind the paper,"Merry wrote, "is the desire to work alongthe ideas of Revici and to claim thepaternity of some of his ideas. A hint isgiven by an article published in CancerResearch on page 480 of the Augustnumber and called 'The Effects of 3-4Benzpyrene on the Auto Oxidation ofUnsaturated Fatty Acids.' It is signedby G.C. Meuller and H.P. Rusch,'thelatter being the doctor from Wisconsinwho came at the end of 1943 to spendabout 5 weeks here and who came againat the end of 1944.

"His article," continued Merry, "is thereproduction of an experiment made inParis, the conclusions of which havingbeen published at two or threeoccasions. When Dr. Rusch was here inDecember 1943, I was present to theconversations as an interpreter andRevici candidly discussed his findingsat length, mentioning specifically thelinoleic and linolenic acids which arealso the ones used by Dr. Rusch whotook plenty of notes during theconversations.... As you know, accordingto Revici's classification, 3-4 Benzpyreneis one of the first bodies to be-consideredas Lipobase. Dr. Rusch does not go sofar as to talk about Lipobases andLipoacids-but his method is a closereproduction of the techniquementioned by our friend. I am afraidthat - all the notes taken 18 months agoand later will serve as subjects forpublications which so far could not bemade from here."

Merry ended: "I guess the best thingwould be to liquidate what we have hereand have Revici working in a Laboratoryin the States with the proper help torepeat all his experiments in support ofhis theory and especially the suitablecollaboration for writing up thepublications. It is a great handicap forhim that his English is too poor forwriting the necessary articles. This is

what we asked for when the Texas andWisconsin gang came here but theyacted deaf "̂

From the moment Revici co-established the IAB in Brooklyn, NewYork, in 1947, the Institute reported onits investigational programs.Summaries of Revici's findings prior tothe opening of the IAB appeared inbooklet form, printed and bound in bluepaper covers, with each booklet devotedto a single subject. Itemizations of newor ongoing studies periodicallycirculated as mimeographed type-scripts.

For example, a "Report on theResearch Conducted at the Institute ofApplied Biology," issued 10/15/48 by theCancer Research and HospitalFoundation (the lAB's funding arm),listed over 20 different experiments."The fixation of oxygen, sulfur andselenium in unsaturated fatty acids"was the second experiment in thisitemization. The 21st was "Theinfluence of lipids in healing of tissueinjured by radium emanation."'"

Revici's research on radiation injuryhad blipped onto the US Navy's radarscreen 18 months earlier. A letter froma Colonel Thomas G. Cassady, dated justfour days before the IAB report,confirmed the Navy's interest: (Militaryscientists were testing nuclear weaponson isolated atolls in the Pacific Oceanin the late 1940s, seeking to protectservicemen on the battlefront fromlethal radioactive fallout.)

"I have had several conversations,"Cassady wrote, "at the Naval MedicalResearch Center at Bethesda, MD,regarding Dr. Revici.... About a year-and-a-half ago...they had conversationswith the Doctor. They were interestedin his research work and offered himcertain facilities.... As well as I could,in my layman's language, I told them ofhis further research in the matter inquestion. They will see him again as itis their policy to leave no stone unturnedin seeking relief or a possible cure forthe type of injury in which the Doctorhas made some progress.""

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Emanuel Revici, MD

Twice in the late 194O's, the Officeof Naval Intelligence cleared Revici towork on this top-secret project. Twice hedeclined, preferring to work on radiationprimarily in relation to the broadproblem of cancer.

Publications and Presentations,1950s: Between July 1950 and June1951, three papers about Revici'sfindings on lipids and radiation came tothe attention of the clinical researchcommunity. Robert Ravich, a colleagueat the IAB (fresh out of the College ofPhysicians & Surgeons, ColumbiaUniversity), read a paper by Revici atthe Sixth Annual Congress of Radiologyin London on July 26,1950. Titled, "TheInfluence of Irradiation UponUnsaturated Fatty Acids," tbis paperdwelt on abnormally-conjugated lipids,wbich clearly fit Samuelsson'sdescription of leukotrienes published in1987.** Revici didn't use tbe terms"leukotrienes" or "prostaglandins" bere,but in later publications he indicatedthe role these substances play ininflammation, and he attributed thehigh bioactivity of prostaglandins to a"twin formation...which appearsthrough the cyclization of aracbidonicacid."

Dr. Ravich presented another paperby Revici {co-authored by Ravicb) beforetbe American Association for tbeAdvancement of Science in Cincinnatiin December 1950. It bore tbe title, "TbeEffect of n-Butanol in Sodium SaltSolutions Upon Sbock and tbe Survivalof Mice Exposed to Severe ThermalBurns."^^ Waldemar Kaempffert, asenior science writer for The New YorkTimes, devoted a column to Ravicb'spresentation in the March 4,1951 issueof the Times, stressing the potentialvalue of Revici's findings on radiationinjury should American cities be hit byA-bombs.'^

"Fall-out" from a paper delivered byLeonard Goldman, MD, at a meeting ofthe AMA in Atlantic City, New Jersey,in June 1951 marked the firstdocumented instance of mainstreamopposition to independent clinicianstrying to follow Revici's line of research.Notice of Goldman's study, titled the"Use of Lipids to Enhance tbe Effect ofRoentgen Therapy in tbe Treatment ofPain from Advanced Cancer,"''' made itsway into a dossier tbat tbe American

Cancer Society (ACS) maintained onRevici. Tbe dossier was labeled,"Summary of information contained inthe American Cancer Society, Inc.'s filesconcerning tbe Institute of AppliedBiology and Dr. Emanuel Revici, as wellas other persons concerned in thematter."'^ Here's an entry about amemorandum from Dr. B. AubreySchneider of the ACS, who bad heardGoldman's paper, to Dr. CharlesCameron, scientific director of tbenational ACS: "In bis memorandum toDr. Cameron, Dr. Scbneider adds tbatin a private conversation with Dr.George Cooper, Director of the VirginiaDivision of the Society, be indicated tbatbe was going to try out tbe Lipid therapyon some cases now under bis care at tbeUniversity of Virginia Hospital. A copyof Dr. Goldman's paper is in tbe files."

Goldman had reported on tbepalliative effects of Revici's tberapy. Henext proposed a trial of its tberapeuticeffects, requesting approval from tbeInstitutional Review Board (IRB) atQueens General Hospital, where beserved as a resident. Anotber entry fromthe ACS dossier on Revici picked up thestory: "Early in January Dr. Cameronreceived a phone call from Dr. AlfredAngrist, Pathologist at Queens GeneralHospital. Dr. Cameron prepared amemorandum which is in tbe files. Dr.Angrist felt tbat Dr. Revici exertedstrong psycbotherapeutic influences onpatients, and discussed his personalfeelings, as Chairman of the HospitalCommittee on Research andPublications, witb regard to hospitalapproval of a paper on tbe Revicitreatment by Dr, Goldman, Because ofDr. Angrist's strong 'anti' feelings, an adboc committee bad been appointed toconsider the particular paper, and Dr.Angrist felt tbat tbe committee'smembersbip bad been stacked. At hisrequest. Dr. Cameron suggested Drs.Gellborn, Bodansky, and Scboenbacbas'additional committee members."^^

Minutes from meetings of the IAB'sboard of directors in 1952 relate that the"restacked" IRB at Queens Generaldenied Goldman approval. In 1986, Dr.Goldman addressed tbe Regents of theState of New York, in a written pleasupporting Revici's struggle with tbeOPMC to remain in practice. He notedbis early interest in Revici's treatment,and - for the first time publicly ~ bedisclosed tbat his studies on lipidtberapy bad cost him bis residencyprivileges.

While the ACS and associatedelements in mainstream medicine werehelping to clip Dr. Goldman's wingsbehind tbe scenes. The New York Timesprinted a feature on the IAB in itsDecember 2, 1952 issue,'^ The writer,William L. Laurence, was probably tbemost distinguished science reporter atthat time; the US bad broken tbe newsof tbe A-bombing of Hiroshima andNagasaki under his byline. The firsttbree paragraphs of Laurence's reporton the IAB ran: "Animal experimentsand tests on patients in advanced stagesof cancer were described last night byleaders in medicine as lending 'strongsupport' to a new concept of malignantdisease that may lead to a radically newapproach to its ultimate control.

"The progress reports on the newmethods, developed at tbe Institute ofApplied Biology, Brooklyn, werepresented at tbe fiftb annual dinner ofthe Cancer Research and HospitalFoundation at the Waldorf-AstoriaHotel. More than 400 leaders inmedicine and other professions, as wellas leaders in industry and civic affairs,were present.

"One of tbe reports was prepared byDr, John Masterson of Brooklyn, formerpresident of the Medical Society of tbeState of New York and a member of tbeHouse of Delegates of the AmericanMedical Association. He is nowattending tbe AMA meeting at Denverand tbe report was read in bis absence.Otber reports were presented by Dr.Jobn M. Galbraitb, past president of theNassau County Medical Society; Dr.Emauel Revici, scientific director of theInst i tute; and Dr. Robert Ravicb,assistant director."

Laurence's last paragrapb, noting:"Prof. Jacques Maritain of tbe Instituteof Advanced Study at Princeton, NewJersey, one of the world's leadingpbilospbers, is a director of the CancerResearch and Hospital Foundation, anon-profit organization to raise fundsfor the cancer research program of theBrooklyn Institution."'^

By tbe mid-1950s, at least one ofRevici's associates believed a distinctpattern bad become discernible in thereception of papers submitted to peer-reviewed journals by tbe IAB. In a letterto one of the Institute's cbief funders,dated 11/12/55, Robert Ravicb recountedthe publication history of an article hehad co-authored with Revici, titled,"Antibemorrhagic Action of n-Butanolin Advanced Cancer" (Angiology,December 6, 1953).'«

TOWNSEND LETTER for DOCTORS & PATIENTS - OCTOBER 2004

Bear in mind that butanol - thehigher sterol Revici gave to controlbleeding in Resistance fighters insouthern France - worked so well, it setthe Nazi's on its developer's trail; ineffect, it amounted to his "ticket" out ofEurope. (See Part 1 for details.)

In the US after the war, Revici haddeveloped butanol for cancer patientstoo ill to stem internal hemorrhagessurgically. Injected intravenously, itsped through the blood system to thesite of a severed artery or vein,permanently constricting the muscletissue circling the vessel at the rupturepoint. The Revici-Ravich paper reportedon two small series of patients, onegroup injected with butanol and theother, control arm, not given Revici'santihemorrhagic agent. (Revicidiscovered the mechanism of actionafter publication.)

Ravich's letter started with anassertion: "I told you that the Instituteof Applied Biology had encountered amysterious form of censorship wheneverit attempted to have an articleconcerning cancer published in theregular channels. The following is a casehistory which... bears out mystatement."'^

Compacted, Ravich's case history ofthe butanol paper goes: rejection in 1951by Cancer (after a recommendation toaccept by the reviewer); rejection in1951 by the Journal of Laboratory andClinical Medicine and the Journal of theNational Cancer Institute; andrejections in 1953 in the originalsubmission and resubmission to theNew York State Journal of Medicine.

The editors cited various reasons.Consultants didn't think the paperrepresented a controlled clinicalexperiment (Cancer). The subject wasnot of sufficient interest to readers{Journal of Laboratory and ClinicalMedicine.) Not suitable for publicationhere: try a journal of a more generalnature (Journal of the American CancerInstitute). It was doubtful that n-Butanol had any relation to thecessation of hemorrhage in the patientsstudied (New York State Journal ofMedicine).

Dr. Ravich closed his letter withthese paragraphs: "On August 12, 1953the article was submitted to Angiology.It was accepted without comment andwas published on December 6, 1953.Angiology is a journal with very limitedcirculation, and not one that is likely tobe read by doctors interested in canceror by general practitioners who might

find the article of value. We havereceived requests for reprints from allover the country and the world and someinteresting comments and observations.

"The experience with this paperindicates beyond any question that theproblem of publishing our work oncancer is not a simple one. Why thisinvisible form of censorship is permitedto exist in scientific and medicalpublications and how it operates arequestions that I am not able to answer.But I do believe we are justified insaying on the basis of such experiencesthat the normal channels of publicationhave been closed to us and that we aretherefore forced to take any other waythat may be open, to get our findingsbefore the medical and scientific public."

Then Ravich added a postscript,dredging up a wider, deeper history ofattempts by Revici and the IAB topublish in the peer-reviewed literature:"Every paper we have submitted onsubjects outside the field of cancer hasbeen accepted; every one concerned withcancer has been rejected. When fourarticles were submitted by Dr. Revici bytitle alone, for presentation at theInternationa! Cancer Congress in Paris

Emanuel Revici, MD

in 1950, all of them were rejected. Onlyseven papers in all were rejected, andalmost a thousand read. I learned fromDr. Oberling that they had been rejectedbecause of the intervention of Dr.Rhoades [sic] and others in this countryon the program committee."'^

Dr. Charles Oberling, a Frenchacademic physician who relocated in theUS after WWII, was highly regarded byAmerican oncologists. He would haveknown the circumstances behind therejection of Revici's papers. Dr.Cornelius Rhodes, the first majorpostwar director of Memorial Hospitalin New York City (later. MemorialSloan-Kettering Cancer Center), hadheaded the Chemical Warfare divisionof the Office of Strategic Services (OSS),the predecessor of the CIA. Rhodes hadused his wartime post to experimentwith mustard gas - a chemical agentused in WWI - on human cancer. TheCongress Ravich referred to was theInternational Union Against Cancer,whose president and editor on different

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TOWNSEND LETTER lor DOCTORS B, PATIENTS - OCTOBER 2004

Emanuel Revici, MD

occasions was Prof. Joseph Maisin ofBelgium.

Through the 1950s and early 1960s,IAB papers slipped into medicaljournals,^" and The New York Timescovered a few of the IAB's researchadvances - where the papers or researchdidn't concern Revici's theories andtherapeutic applications in cancer.^'From time to time, research on lipidsand cancer not originating at the IABappeared in the scientific literature,focused on abnormal lipid metabolism- a prime Revici area of study. ̂ ^

Publications, 1960s: In 1961, D VanNostrand and Co. decided to distributea text by Revici under its imprint.Titled, Research in Physiopathology asBasis of Guided Chemotherapy, WithSpecial Application to Cancer, the bookhad been in various draft stages forseveral years: IAB newsletters voicednews of its progress in the late 1950s.Close to 800 pages in print, Revici'smonograph summed up his prolificfindings from the mid-1920s throughthe 1950s.

When it undertook to bring outRevici's monograph, D. Van Nostrandhad been publishing scientific volumesfrom its main office in Princeton, NewJersey, since 1848. It had earned a solidreputation for quality. A letter from thepresident, Edward M. Crane, on June8, 1961, spoke of the publishing firm's"keen interest" in an "important andvaluable book."̂ ^

Earlier that Spring, in the March-April issue, Ca, a Journal for Clinicianshad come out with a feature on Revici'smethod of cancer control, characterizingit as "unproven." How Van Nostrandexpected to sell Revici's text after theACS publicly questioned theeffectiveness of his therapy is somethingof a mystery. Crane, D. Van Nostrand'spresident, in a telephone interview inthe late 1980s (conducted by the writer),said he thought there was room at thattime for another approach to cancer.

Revici had filled his book withexplanations of his theories, withreports of experiments on theirclininical application, as leads to followand independently prove or disprove theefficacy of his therapy. He viewed hismethod as a way to manage cancer thatdiffered in critical particulars fromstandard therapy: his treatments were

comparatively non-invasive, negligiblein toxicity, and individually-guided. Healso felt that the results of his treatmentwere equal or superior to the outcomesof treatments in common practice in asignificant percentage of cases,especially in cases resistant to otherapproaches.

In blacklisting Revici's method ofcancer control, the ACS aimed atkeeping patients from his therapy. Toan incalculable extent, the Societysucceeded. Tbere's no telling how manyof Revici's medical insights might haveproven of value, had clinicians been ableto get hold of his text, to familiarizethemselves with his method, to test histreatments in practice. Most important,had the ACS not discouraged sales of hisbook, there's no estimating the numberof patients who might have benefitedfrom tbe free circulation of his ideas.

Publication of Revici's mongrapb wasthe high point of his efforts todisseminate his findings in the US ~ forthat matter, in the world. It was also toprove the near terminal event in hisattempts to acquaint his peers with hisclinical research: a paper on the narcoticaddiction treatment Revici developed inthe early 1970s appeared by invitationin a government journal on addictionsin Quebec in 1973. (See part 3)

Correspondence:Marcus A. Coben, HealthTrends8 E. 96th St., ICNew York, New York 10128 USA212-427-0707 / Fax: 212-348-8288marcantonl@juno.com

References8. PersonnI 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), 1139112/28/381, 11417 14/25/38),11440(7/4/38).

9. Letter from Gaaton Merry to Col. Gustave Freeman,MD. 9/5/45.

10. Cancer Research and Hospital Foundation, Report onthe research conducted at the Institute of AppliedBiology, 10/15/48.

11. Letter from Col. ThomaHG. Caasady to Andre Girard,10/11/48.

12. Ravich RA and Revici E, The efFect of n-butanol insodium salt solutione upon shock and the survival ofmice exposed to severe thermal hums, paperpresented hefore the American Association for theAdvancement of Science. Cincinnati, Ohio, 12/50.

13. KaempfFert W, Burns are treated with n-butangl.rScience In Review"), The New York Ttmes. 3/4/51.

14. Goldman L, Use of lipids to enhance the effects pfRoentgen therapy in the treatment of pain fromadvanced cancer, paper delivered at the meeting ofthe American Medical Association at Atlantic City,NJ, in June 1951.

15. The ACS file on Revici and the IAB comes fromdocuments hequeathed by Fanny Holtzmann, Esq..to the American Jewish Archives, Hehrew University,Cincinnati. Ohio. Holtzmann. a celebrity lawyer withpowerful political connections, was a staunchsupporter of Revici's work at the IAB from the 1950auntil her death.

16. Identification of two of the three doctors added to thecommittee Angrist chaired at Queens General is not

certain. Bodansky is almost certainly OscarBodansky. Gellhorn is probably Alfred Gellhorn.Later. Bodanflky and Gellhorn were affiliated withmore prestigious institutions.

17. Laurence W, Cancer attacked by a new method. TheNew York Times. 12/2/52.

18. Revici E and Ravich A, Anti-hemorrhagic action of n-hutanol in advanced cancer. Angiology 1953;4:510-515.

19. Letter from Robert Ravicb, MD. to Mrs. Ethel Pratt,11/12/55.

20. The following list represents a selection of paperspublished in the peer review literature by Revici andhis colleagues at the IAB, The full list, 7 pages long,was compiled by the late Prof Harold Ladas, a patientof Revici. With his wife. Dr. Alice Ladas, Harold Ladasorganized and helped fund Revici's patients in theirsuccessful campaign to prevent the NY Health Dept.(OPMC)from revoking Revici's medical license in tbemid-1980s. An asterisk at the heginning of a citationsignals that Revici was a co-author

• *Blechmann M et al. The effect of unsaponifiahlefraction of lipids (sterols)on morphology and growthmetahoiism of mycobacterium tuberculosis var,hominis and var. bovis (BCG), The American Reviewof Respiratory Diseases. S9l3i <19fi4): 448-49.

• 'Blechmann M et at. Ring and lysis zones in culturesof tubercle bacilli in medium enriched withunsaponifiable lipid fractions. The American Reviewof Respiratory Diseases. 87(5i (1963).

• LeShan L, Psychological states as factors in thedevelopment of malignant disease: a critical review.JNat. Cancer Inat.. 22 11959); 1-18.

• LeShan L. Basic psychological orientation apparentlyassociated with malignant disease. PsychiatricQuarterly, 1961.

• LeShan L, The world of the patient in severe pain oflong duration, J. Chronic Diseases, 17 (1964): 119-26.

• Ravich R A, Relationship of colloids to the surfacetension of urine. Science, 117 119531: 561.

• Ravich R A, Pain - controlled and uncontrolled.Science. 118(30571(1953): 144-45.

• Revici E et al. Surface tension of urine in old age.Geriatrics, 9(8)(1954I: 386-89.

• Welt B, Head and neck pain: role of hiologicalimbalance in its pathogenesis and therapy, AMAArchives of Otolaryngology, 61:280-312, March 1955.

• Welt B, Vertigo: a further contrihution to therapybased upon its physiopatholot^cal aspect. Archives ofOlolaryngology, 63 (1956): 25-29.

A letter from Henry L. Williaine, MD, to BernardWelt, MD, 1/29/54. referred to an article Prof. Ladasdid not include in IAB bibliography. Williams was atthe Mayo Clinic. Rochester, Minnesota, Welt at theIAB. The full text of this short letter follows: "I readwith considerahie interest your article on a newtheoretical approach in vertigo which came out in theSeptember Archives [Archives ofOtnlaryngotogy. anAMA journal}. I have tried your method of therapyon some cases of vertigo and several witb headaches.They have given very good response.

"I have been asked by the Academy ofOphthalmology and Otolaryngology to organize asymposium on tbe treatment of headache to be givenin New York City for a two day period betweenSeptember nineteenth and twenty-fourth. This is tobe in the teaching section, a two hour session heingheld on each of the two days. The members of thepanel will discuss their treatment for t«n minutesapiece during the first hour. The second hour will hedevoted to the answering of questions from anyauditor present. Your therapy is extremely new andunusual and I would be very happy indeed if youwould agree to be a member of this panel."

21. Schmeck H M, Jr., Chemists study adrenal action.The New York Times, 9/19/59.

22. Letter from Fanny Holtzmann, esq.. to S.A. Logan,First national City Bank, 4/13/55. The pertinentparagraph reads: "In the current issue of CANCER,ofHcial organof the American Cancer Society iMarch,April 1955) there is an article by Dr. Marion Barclayet al, entitled "Lip-Proteins in Normal Women andin Women with Advanced Carcinoma of the Breast.'The title carries the unusual footnote "The authorswish to thank Dr. Cornelius P. Rbodes for suggestingthis problem and for his continuing support andinterest.' The article concludes that cancer patientshave abormal Lip-Protein metabolism "which isassociated with a severe defect in lipid metabolism.ThiB is precisely the premise from which Dr. Reviciset out on his biochemical explorations more thanthirty years ago.'

23. Letter from Edward M. Crane to Mrs. Sherman Pratt,6/8/61.

TOWNSEND LETTER for DOCTORS ft PATIENTS - OCTOBER 2004