The following excerpt is from Dr. Cowan’s book “Vaccines, Autoimmunity, and the Changing Nature of Childhood Illness,” and is reprinted with permission from the publisher.
Shaken by Dashiell’s death and what seemed like Memorial’s far too frequent failures to treat sarcoma successfully with its advanced—for the time—surgical techniques, Coley began to analyze hospital records. He wanted to better understand the rates of success and failure over time. And he wanted to understand the factors. The results, he discovered, were dismal. Very few of Memorial Hospital’s sarcoma patients ever actually recovered.
The overwhelming failure was what made the curious case of a German immigrant and dockworker stand out. Records showed that the man was admitted to Memorial Hospital in 1883 with a malignant tumor in his neck. He was later discharged, having neither undergone surgery nor showing any further evidence of a tumor in his neck. Fascinated, Coley sought the man out, found him alive and in good health, and asked about his experience. What Coley learned was that while in the hospital waiting for surgery, the man had contracted a virulent case of erysipelas, a grave and painful strep infection of the skin.
The History of Fever and the Role of the Immune System
Cases like this are typically attributed to “spontaneous remission for unknown reasons,” but Dr. Coley began to investigate the history of fever and the role of the immune system in treating cancer and other diseases. He discovered in the scientific literature that most so-called spontaneous remissions occurred in patients who had had a concurrent acute febrile illness. He also found a history of physicians using fever therapy in the treatment of their patients. And he learned that European doctors were injecting cancer patients with bacterial toxins to induce fevers. In 1891, Coley began to experiment.In the beginning, he simply injected patients with Streptococcus pyogenes, the strep bacteria that causes erysipelas. Among patients who contracted erysipelas as a result of the exposure, approximately 20 to 40 percent died from the infection. Roughly another 20 to 40 percent experienced no noticeable impact on the sarcoma. And roughly 40 percent experienced remission. These results are intriguing and significant, for two reasons: First, for the first time in modern medical history a nonsurgical therapy resulted in the durable remission of a significant number of patients with an otherwise incurable form of cancer. And, second, no matter how successful the therapy, a 20 to 40 percent mortality rate is too high a price to pay. Coley, emboldened, began looking for a better way.
After several years of experimentation, he was able to isolate the S. pyogenes endotoxin—part of the outer membrane of the cell wall in Gram-negative bacteria that elicits a strong immune response, including fever—and mix it with the endotoxin from Serratia marcescens.
Each of these endotoxins can provoke significant fevers on its own, but since Coley was using only the part of the bacteria that provokes the immune response, he surmised that there would be a greatly reduced risk of life-threatening infection compared to simply injecting patients with live bacteria. Dr. Coley injected this mixture—known as Coley’s Toxins—into patients at increasing doses, depending on their tolerance, provoking fevers of up to 105 degrees on a daily basis for a month. Amazingly, Coley’s gamble (with other people’s lives) paid off. The death rate plummeted, and the benefits of the fever therapy remained.
Coley treated nearly a thousand patients, mostly with inoperable sarcomas, and his toxins—eventually there were thirteen different formulations—were made available to physicians across Europe and North America from the pharmaceutical firm Parke Davis and Company. A 1945 study calculated a 60 percent cure rate among more than 300 cases of inoperable cancer. This is astonishing and, in fact, far surpasses anything modern oncology has to offer for stage 4 cancer patients.
For decades, Coley’s Toxins were used all over the United States and Europe in the treatment of a wide variety of cancers, but never without controversy, in part because Coley could never quite explain how his concoctions worked and in part because results were unpredictable. As early as 1894, Coley’s Toxins were criticized severely by the Journal of the American Medical Association, which declared, “There is no longer much question of the entire failure of the toxin injections as a cure for sarcoma and malignant growths.” And James Ewing, fanatically obsessed with radiation treatment, forbade Coley to use his treatment at Memorial Hospital.
Understanding the Nature of Disease
What does all of this have to do with the changing nature of childhood illness and vaccines? Broadly, it has to do with how we’re looking at health and disease.We (modern doctors) have forgotten (or never learned) that acute disease—disease that is typically self-limiting and usually accompanied by fever, rash, and pus—is the primary way the body rids itself of unwanted toxins or other substances. For example, if you get a splinter in your finger and do not remove it, your body may make pus to expel it. The pus is the therapy for the splinter, not the disease to be treated. The splinter, technically speaking, is the disease. If you think of the pus as the disease because it is an infection, you might take antibiotics, but the splinter remains. This mistreatment of acute disease is a fundamental mechanism for chronic disease. In order for a disease to become chronic, there needs to be an insult, often a toxic exposure, and then a suppression of the body’s attempt to detoxify.
These days, talking about “noxious influences” sounds naive, even childish. We are much more interested in genetics. We furiously attempt to characterize specific mutations occurring in the cells of a specific tumor. We spend billions of dollars a year doing research on DNA sequences in these distorted cells. We have been doing this work for about five decades, and yet there has been only minimal improvement in the prognosis for cancer patients.
