November 22, 2002

Collins outlines 20th century scientific discoveries at Dean’s Lecture Series

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Dr. Robert Collins, center, talks with Dr. Bonnie Miller and Dean Steven Gabbe before the lecture last week in Light Hall. (photo by Dana Johnson)

Collins outlines 20th century scientific discoveries at Dean’s Lecture Series

A physician who made two of the most important health discoveries of the 20th century had no formal training in research, but used common sense, vast clinical experience, and a Ford Jubilee station wagon to make discoveries that fundamentally altered our understanding of cancer and American dietary practices.

The important scientific discoveries of Dr. Denis Burkitt were among those discussed at last week’s Dean’s Lecture Series by Dr. Robert D. Collins, John L. Shapiro Professor of Pathology. The title of Collins’ lecture was Fibre Man, a name given to Burkitt.

“Denis Burkitt likened his role in these discoveries to building a platform in which a rocket was launched by others,” Collins said. “He claimed he was not very smart or well trained, but he was able to put a nail in a platform here and a plank there. He said the really smart people built and launched the rocket. The truth is he was a clinical scientist of the highest order.”

In the 1950s Burkitt began studying a form of lymphoma that affected children in Uganda. The children had fast-growing malignant tumors of the facial bones. The lymphoma, which came to be known as Burkitt’s lymphoma, is the most common cancer in children in Africa; the first human cancer cured by chemotherapy; the first human cancer for which a viral cause was proven; and the cancer that led to fundamental discoveries about how all cancers arise from pre-existing cells.

When Burkitt saw two children within a short amount of time with jaw tumors, he got a research grant for $75 and had leaflets printed with photographs of one of the children. They were sent to physicians across Africa, asking if they had seen similar malformations. Burkitt found that others had, in locations 10 degrees north and south of the equator, and got a second grant, for $1,500, which he used to purchase a Ford Jubilee Wagon.

Burkitt, accompanied by two medical missionaries, doubling as mechanics, set out on a 10,000-mile, 70-day trip that took them to 57 hospitals in 12 countries. They found the tumors were found in children in areas where the temperature was above 60 degrees Fahrenheit and rainfall was greater than 20 inches, the same distribution as malaria. Burkitt’s first reports on the tumors were met with little interest, but in 1961 and 1962, he published reports on the geographic distribution of this malignant lymphoma in Cancer and Nature. Soon afterward, Anthony Epstein attended one of Burkitt’s lectures and asked for a tissue sample. Three years later, he and his assistants Bert Achong and Yvonne Barr made electron micrographs of the virus now known as the Epstein-Barr virus.

Burkitt’s other important observation, published in 1974 in The Journal of the American Medical Association, changed the dietary practices of millions of people across the world. It presented evidence that the consumption of refined carbohydrates and low consumption of dietary fiber is a major cause of many Western diseases, such as ischemic heart disease, diverticulosis and cancer of the colon. Subsequent studies have failed to show a relationship between fiber in the diet and colon cancer.

“The message in his paper that refined food causes disease was not well received by the medical establishment or the food industry,” Collins said. “But the paper changed the management of diverticulosis overnight, from low roughage to high roughage. It also emphasized there are geographic and regional differences in disease.”

Burkitt was extremely interested in preventing disease, stating on many occasions: “Diseases are like water flowing out of the tap, filling the sink and flooding the floor. Most physicians are floor moppers, unwilling or uninterested in turning off the tap.”

“Speaking as a floor mopper, that seems a trifle harsh,” Collins told the packed lecture hall. “But there is the missionary speaking to us again. He is correct. We do not emphasize prevention of disease adequately.”