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FEBRUARY 2026 TABLEHOPPING

POLITICS IN MEDICINE GOES WAY WAY BACK

I am sure you want to believe that medicine is all science based and free from personal bias and undue influence but it’s just not so. It’s not so today and it was not so years ago and this article will relate a pivotal exchange that influenced the practice of medicine for decades which unfortunately was based on social influence not science.

Let me set the scene. In the early 1900s there were two competing schools of thought in terms of cancer care. One school was led by Dr William Coley, a surgeon who believed that cancer was a systemic problem and could be treated by stimulating the immune system. He did this by injecting patients with a serum made from bacterial toxins. The body’s immune system would respond to this threat and if sufficiently activated the immune system would also attack the cancer. This was the beginning of immunotherapy. In 1891, while reviewing hospital records, Dr. William Coley discovered the case of “Patient Stein,” whose terminal sarcoma vanished following a severe bout of erysipelas (a streptococcal skin infection). Coley hypothesized that the massive immune response triggered by the infection had an “off-target” effect, destroying the cancer cells alongside the bacteria. It wasn’t called immunotherapy back then but that’s what it was.

Dr Coley began developing “Coley’s Toxins,” a mixture of Streptococcus pyogenes and Serratia marcescens. To work, the toxins had to induce a high fever, often reaching 104 or 105 degrees Fahrenheit. In an era before antibiotics or advanced monitoring, this was very risky. Yet, for many patients with “inoperable” tumors, it was the only hope. Dr Coley’s records showed remarkable long-term remissions—cures that were systemic, meaning they prevented the cancer from returning in other parts of the body. If the doctor was timid and gave only a moderate amount of the toxin the treatment did not work. You essentially had to risk bringing the patient to the possible point of dying to stimulate the immune system sufficiently to treat the cancer. Some patients receiving the treatment did indeed die. So, it was risky but it could CURE cancer.

In the opposite corner was Dr. James Ewing, known at the time as the “Napoleon of Cancer,” . He sought to bring order, classification, and industrial precision to the field of cancer diagnosis and treatment. He was the Chief Pathologist and eventual Director of Memorial Hospital. He favored the use of radiation therapy . Radiation offered something Coley’s Toxins could not: immediate, visible evidence of success. A tumor treated with radiation would shrink almost instantly. This “local control” was seductive to physicians and patients alike. Furthermore, radiation could be measured in “doses” and standardized across different hospitals, fitting the emerging model of the “scientific” hospital.The problem was that no one was ever cured of the cancer it just kept their cancer at bay for a time. Coley had CURES but the treatment was dangerous. Ewing wasn’t curing anybody but any doctor could buy a machine to see results quickly although there were admittedly NO CURES.

When one of the close personal friends of John D Rockefeller Jr died of a rapidly progressive bone cancer he took an interest and proceeded to fund what is now the American Cancer Society. Even his money was not limitless so he had to decide between the two schools of therapy…Immune treatment versus radiation therapy. To resolve this issue they had a grand round where the two opposing camps could present their findings. So there they were…these two prominent physicians standing in the auditorium facing their many colleagues who were attending the debate. Dr Coley presented his CURES to the audience…actual patients he had treated who were completely cured of their cancer. Dr Ewing presented his treated patients to the audience whose lives were prolonged by the radiation therapy. Doctors in the audience had referred these patients to treating physicians so they knew the cases well.

The culmination of the debate occurred when Dr Ewing, the pathologist, remarked that the cures were so remarkable that it called into question if they really had cancer to begin with. He was suggesting that these patients never had cancer in the first place so there was no cure.! Pretty strong assertion to be made in front of the assembled physicians. It called into question everything about the therapy except how potentially dangerous it was. It could have ended the debate right there.

But, the surgeon Dr Coley, had a comeback that ended the debate then and there. He pointed out that the pathologist who had initially determined that the patients had cancer was none other than Dr Ewing himself.! If he was doubting the diagnosis he was doubting his own work ! That should have settled it for the debate. One side, the immunotherapy side , had CURES and radiation therapy did not. Now , here’s the part about science being side tracked. Even though Dr Coley had the proven better approach…Dr Ewing was a better shmoozer, a better politician and better at dealing with the Rockefeller’s and convinced them his approach was safer and more standardized. Rockefeller backed him instead of Dr Coley. Dr Ewing utilized his administrative power to systematically marginalize Dr Coley. Dr Ewing eventually forbade the use of Coley’s Toxins within the hospital’s walls, labeling the treatment as unscientific. By the 1930s, the “Pillars of Cancer Treatment” were firmly established as surgery and radiation. With the backing of the Rockefeller fortune, Dr Ewing purchased then-precious radium and established Memorial as a “Radium Hospital.”. Immunotherapy, despite its early promise of systemic cures, was relegated to the status of “quackery.”

Today we have finally returned to stimulating the immune system to treat cancer. For 80 years this approach to treatment was minimized In the last few years oncology has seen a stunning reversal of Dr Ewing’s victory. The development of checkpoint inhibitors and CAR-T cell therapies has validated Dr Coley’s core premise: the immune system is the most powerful anti-cancer tool we possess. Today’s Memorial Sloan Kettering Cancer Center now views Dr Coley as a visionary. Scorned years ago…a hero now.

Time and again new ideas have been brought up in medicine and immediately shot down by the powers that be.. The discovery that a bug called h pylori could be the cause of stomach ulcers…the two physicians were derided and laughed at until they eventually won a nobel prize. A reformulation of the way to make the polio vaccine that did not involve monkey kidneys with their dangerous comtaminants…delayed by a decade by the doctors who financially profited from the current system. Our FDA saying ivermectin would not treat Covid and deriding its use and then trying to deny it .

Unfortunately the practice of medicine is not cut and dried, settled science etc. LIke any science ..the basic tenets need to be challenged and revised as new insights are formed. As long as politics and money are involved this will never be a straightforward process. Are science and medicine advanced by forcing practitioners to adhere to “guidelines” or should these highly educated physicians use their own reasoning, experience and observations to best treat their patients as they see fit. Outcomes not outrage should determine how we treat patients. Keep your mind as open as your mouth. Do your own research. Don’t be afraid to ask your doctor questions. Don’t trust anything you read without doing your own research. Do focus on your basic health issues with diet and exercise rather than relying on medicines that treat your symptoms but actually do very little to change your outcomes. Until next month…get well and stay well.

JT BARRY MD