Kapronczay Károly szerk.: Orvostörténeti közlemények 230-233. (Budapest, 2015)
KÖZLEMÉNYEK - Elek Gábor—Müller Miklós: Bauer Ervin és a rákkutatás
ELEK, Gábor- MÜLLER, Miklós: Ervin Bauer and Cancer Research 89 sis of the malignant growth was based at that time on morphology, the unusual variability of cellular and tissue structures. Although Borst noted that the nucleo-plasmatic ratio is shifted in favour of nucleus in cancer cells, leading histologists of the twenties of the last century stressed the lack of any absolutely specific feature of the microscopic picture of the cancer cell. The specificity of cancer is biological: a cancer cell is an irreversibly altered abnormal cell, the growth of which exceeds, and is uncoordinated with, that of normal cells of the organism (Borst 1923 655; Lubarsch 1922). Many concepts have been proposed to explain this irreversible alteration. According to Boveri chromosomal abnormalities were the basis of carcinogenesis; most malignancies, however, did not show chromosome breaks, mitotic aberrations or other deviations. Cohn- heim originated carcinomas from dystopic embryonic cells but his theory left the essence of the malignant transformation open. Ribbert stated that undifferentiated juvenile cells escaping from the control of the organism during regeneration started the malignant process. The ‘chronic irritation’ theory seemed the most comprehensive one: it attempted to elucidate the various types of chemical carcinogenesis. In a broader sense of this concept even the regeneration theory or the effect of parasites could be grouped here (see Baló 1962 229, 237; Borst 1923 656-659, 667-680). The therapy of course could not be causal, although in large sanitary establishments special hospital wards were organised for cancer patients. These also included research centres (for example in the Charité of Berlin under the leadership of Blumenthal, see Winan 1993 340-341). In addition to surgery the main approach of cancer treatment was the so-called non-specific therapy (Weichardt 1925), i.e. the parenteral administration of materials foreign to the body, most often proteins, bacteria, tissue homogenates. Therefore another name of such treatment was protein therapy. Its non-specific nature differentiated this method from immunotherapy. Treatment required great experience because the doses were not established. The Arndt-Schulz golden rule was the guiding principle: ''small stimuli fan the vital activity, medium ones promote it, strong ones are inhibitory and the strongest ones eliminate it ’ (Handovsky 1925). The purpose of the therapy was to augment the self-curative power of the organism. Fichera, later director of the Milan Oncological Institute, used normal human tissue homogenate for cancer therapy from 1910 (see Baló 1962 243). He established in animal experiments that lymphoid organs (lymph nodes, spleen, bone marrow) were more curative than other tissues. Their effect developed immediately but it was not long lasting, nor was it preventive or specific. It did not have the characteristics of immunity (Fichera 1914a). The therapy of Blumenthal was virtually similar; at the same time he tried to explain the small benign influences by immunological notions. He used the suspensions of homologous tumours for therapy (squamous-cell carcinoma homogenate for keratinised cancer, adenocarcinoma homogenate for glandular malignancies, etc., see Blumenthal 1914b). He was annoyed that he gained a reputation as a “non-specific” therapist. The mechanism of non-specific therapy was not fully understood (Weichardt 1924). Clinical observations indicated that certain chronic inflammations might favourably influence the process of the cancer disease (Schmidt, R. 1910). Although the concept of the reticuloendothelial system (RES) already has been outlined (Aschoff 1924 108-111), its defensive role in the organism was not yet experimentally proved; therefore an interpretation of the non-specific therapy acceptable today was not yet possible. Fichera was conscious of the difference
