Science

The Issels affair

Bernard Dixon

In a week's time, almost exactly two years after the date originally scheduled, Hodder and Stoughton will publish Issels — The Biography of a Doctor by Gordon Thomas.

This account of Dr Josef Issels and

his Ringberg Clinic in Bavaria will doubtless be widely reviewed and will stimulate anew a controversy that reached an earlier crescendo in 1970 when the Olympic athlete

Lillian Board, dying of cancer,

became a patient at the Clinic. Careful comparison of the final and

original version of the book (review copies were first circulated in 1973) indicates the nature of the legal difficulties that have delayed publication.

My intention here is not to review, the book. It is to discuss the light which the Issels affair has thrown upon the tension between science and art in medicine, and between orthodoxy and hetero doxy. Towards the end of 1970, it will be remembered, BBC television screened the film Go Climb a Mountain which it had made about Issels and his work. The film was relatively noncommital concerning the high cure rates allegedly being achieved in treating cancer at the Clinic, but it did report fully the unusual therapeutic techniques employed. Based on the idea of boosting every possible facet of the body's own defences, these included dental extractions, mysterious "sera," and large quantities of herb tea. The programme provoked widespread public concern,

because it implied that cancer victims in Britain were being denied valuable expertise. Pressure grew for some sort of official action.

As a result, a high-powered team of cancer research specialists was dispatched to Bavaria • to investigate. The British Medical'

Journal pro-tested. "To carry out their study, these exceedingly busy

people had to interrupt their work in the laboratory and at the bedside for some weeks," it fumed. "Popular clamour for a will-'o-the-wisp has occupied the time of people who are much more likely to bring benefits to sufferers from cancer if let to get on with their work. In a microcosm, this whole unhappy episode exemplified how not to Influence research."

In the event, when the committee produced its report, there was no unambiguous evidence of a hither to unknown "magic cure" for cancer. This conclusion was inevi

table because Dr Issels did not keep his patients' records in the normal form, which would have made it possible to compare his results with those obtained on statistically matched patients treated elsewhere by conventional methods.

Most members of the committee, and objective orthodoxy, thus adjudged the mission a failure. Yet, taking a wide view, valuable lessons were learned about patient care, about measures to boost morale, and about the whole psychological context of potentially fatal illness.

It is all too easy, from a strictly scientific standpoint, to dismiss such factors as of trivial importance compared with the vital techniques of drug treatment, radiation, and surgery. Anyone who has witnessed a friend or relative dying of cancer will surely not see things that way.

"Let it be said that the patient with advanced malignant disease is more or less guaranteed a dignified form of death with continued nelp under the state service," wrote Clifford Brewer, senior consultant surgeon at Liverpool Royal Informary, in the Times shortly after the Issels furore broke out. It was precisely because it shook up that sort of complacency that the controversy was so worthwhile — whatever, in strictly scientific terms, were the findings of the British investigators.

"We have heard a great deal too much of Dr Issels," wrote Professor Sir David Smithers recently in New Scientist (April 17) reviewing Issels' own book Cancer — A Second Opinion (also from Hodder and Stoughton). True. The final verdict seems to be that Issels has no magic cure. His writings contain gibberish. And his fame must have raised many hopes that were cerlaM tobe disappointed. But there is more to be said about Issels and the Issels affair than that.

Dr Bernard Dixon, who writes this column fortnightly, is editor of New Scientist.