terms as the triumph of a renegade cell and its successors over the confining and conservative rules the body imposes. This is a very super- ficial biologic insight ...
BOOK REVIEWS
Cancer and Vitamin C. A Discussion of the Nature, Causes, Prevention, and Treatment of Cancer with Special Reference to the Value of Vitamin C. Ewan Cameron and Linus Pauling. 238 pp. The Linus Pauling Institute of Science and Medicine, Menlo Park, California; McLeod Publishing, Don Mills, Ont., 1979. $12.95. ISBN 0-39350000-4 This book is written or the general public. It sets out to describe the nature of cancer and to present methods of management. Although no opportunity is missed to suggest a role for vitamin C in treatment, the importance of the care of the whole patient by general support and diet is properly stressed. However, any validity the book might appear to have is undermined in several ways. It is replete with errors, such as a description of the use of radioactive chromium in treating polycythemia. There are three references in a single paragraph to the interaction of nitrates and food to form nitrosamines. This leads me to believe that Dr. Linus Pauling, a Nobel Laureate in chemistry, is listed as coauthor for reasons that are not purely scientific. It is unlikely Pauling would have missed the crucial difference between nitrites and nitrates. The classification of the lymphomas is both British and out of date, so it will not help the understanding of a North American patient or physician. The assumption that lymphatic spread invariably precedes the hematogenous dissemination of a cancer is likewise incorrect and might mislead patients struggling to understand their disease. Burkett's lymphoma is wrongly stated to be 768
certainly caused by the combination of an insect-bone virus and chronic malarial infestation. Advances being made in the treatment of the leukemias and lymphomas are recognized in the text. However, it is incorrectly stated that there l.as been no progress in treating the malignant diseases. Not only does this mislead the public but also it provides the wrong conceptual framework in which to discuss the merits of treating cancer with a new method, such as the large doses of vitamin C the authors propose. Cameron sees cancer in atavistic terms as the triumph of a renegade cell and its successors over the confining and conservative rules the body imposes. This is a very superficial biologic insight. We treat cancer as we might treat an invading army, with fire and brimstone, only because of a lack of understanding. Greater knowledge may well reveal cancer, like most other diseases, to be a failure of regulation by the body of the wayward offspring of its cells. All of these considerations detract from the central thesis of the book, which is that vitamin C is a potent and underused remedy for cancer. Much anecdotal and uncontrolled evidence is given to support this thesis. The authors deny the validity of trials that have shown otherwise, arguing that vitamin C could not overcome the harmful effects on the immune and other responses already caused by conventional treatments. This issue appears not to have been addressed in the animal studies of more conventional workers, although, as the authors point out, man is one of the few species (guinea pigs included) in-
CMA JOURNAL/OCTOBER 18, 1980/VOL. 123
capable of synthesizing vitamin C. The book is written in what one of my colleagues describes as "medspeak". The authors inflict phrases such as "the situation was inoperable" not only on their colleague. but also on the public. Cameron is clearly a concerned and compassionate physician, and his work is disinterested in the best meaning of that word, However, the scientific validity of his hypothesis remains unproved and he does not write popular science like Pulitzer prizewinner Carl Sagan or Thomas Lewis. I can only regret that he has not used his considerable energies in the laboratory and seminar room to arrive at some answers to questions he poses about the role of vitamin C in the treatment of cancer. This book can do little more than mislead and widen still further the gulf in understanding between medicine and science on one hand and the public on the other. BRIAN LENTLE, MD, FRCP(C]
Cross Cancer Institute Edmonton, Alta.
The Development of Modern Medicine. An Interpretation of the Social and Scientific Factors Involved. Richard Harrison Shryock. 473 pp. The University of Wisconsin Press, Madison, Wisconsin, reprinted 1980. $7.50, paperbound; $17.50, clothbound. ISBN 0-29907534-6, paperbound; ISBN 0-29907530-3, clothbound When it was first published in 1936, "The Development of Modern Medicine" helped establish a trend in the writing of medical history that has steadily grown. Before this time, the history of medicine consisted of biographies of great phy-
