the ordinary lobby, but from the standpoint of a sort of a stewardship to the public, and as the men from the National Cancer Institute and the Public Health Service sit on our board and sit with us on every move, so we and our people sit with them, and the problem becomes a problem of trying to spend the people's money the most intelligently in solving a problem of such grave importance as this.

I think that I will not take any more of your time, and I will be glad to answer any questions. I know this, that you will find there is nothing that you can do with $15,000,000 which will do more good in the world than to start this heart institute in the Public Health Service, or in the framework of the Public Health Act, exactly along the lines of the Cancer Institute.

Thank you very much. Especially thank you for letting me come early today.

The CHAIRMAN. We certainly appreciate your presence today, because you bring to us a wide experience in the practical side of this question which, together with the sympathetic nature that you have and the desire to be helpful to your fellow man, gives us an angle on it, and from the standpoint of a successful businessman, that is very helpful to the committee. We feel that you have made a very great contribution by the testimony that you have given to us today.

Mr. ADAMS. I would like you to know, sir, that of our 56 directors, I have written authority from all save 5 to back the testimony I have just given you. Half of them were doctors and half of them are quite distinguished laymen, and the other five did not have enough information to voice an opinion.

The CHAIRMAN. Are there any questions, gentlemen?

Mr. HESELTON. Do you see any conflict between the legislation proposed here and the proposals for the National Science Foundation? Mr. ADAMS. None. We have been greatly interested in the National Science Foundation bill in trying to help wherever we could in arriving at the right thing for the country. The Science Foundation bill is designed to take care of the forming of a fundamental policy for the Federal Government over a long period of time. It grows out of the experience that Dr. Bush and Dr. Richards and the others had during the war, and still others have used in other parts of the war effort. You can take the problem of cancer research alone. We have today not only the Public Health Service, but we have the veterans and we have the Navy and we have the Army and we have the Atomic Energy Commission, all working in the same field.

One of you gentlemen asked a question about the States. The State of California has just appropriated $250,000 for cancer research out there. It is going to be necessary that these programs be, I do not like the word "coordinated," but be reviewed, both the public programs and the private programs, for the purpose of coordination. And that is spelled out in the copy of the Science Foundation bill that I think Mr. Wolverton introduced, in a way that we think meets the problem. I do not mean to say that it is wrong for the Navy or the Army, on certainly the special problems involved, to be carrying on a part of this work. I am not saying that at all. I am saying that there are only a number of workers and institutions in the field, and that if we have this Science Foundation bill, as I understand it, we have

a chance for a review and a recommendation as to policy which should be useful in view of the great expenditures being made.

Mr. HESELTON. I had in mind more specifically the provisions, as I understand them, of H. R. 5087. This is section 3 (g) (1), for the establishment and maintenance of research fellowships, on page 3. As I recall the bill we had before us, or the bill the chairman has introduced as revised, there is also that provision, and I wonder if there was a duplication of that.

Mr. ADAMS. As I understand it, I do not think so, because if my conception is correct the Science Foundation would be that institution which would eventually take care of the problems of pure research, the acquiring of new knowledge; and the cancer group, for instance, would be devoting themselves largely to what we call applied research, the bringing together of the bits of pure knowledge and getting something done on them.

The Science Foundation would also be developing and stimulating, through its fellowships, a general raising of the level of scientific ability in the country. As I understand it, sir, that is what it would be. Mr. HESELTON. Thank you.

The CHAIRMAN. Are there any further questions?

Mr. LEA. As I understand it, from your testimony, there are two general phases of this problem. One is the attempt to better use the known methods of prevention and cure; and the other is the basic thing of developing further information that may develop an antidote or better methods of treatment?

Mr. ADAMS. That is correct.

Mr. LEA. Now, would you distinguish between the importance of these two methods of approach?

Mr. ADAMS. They are equally important, because you take the case of the incidence of cancer of the breast. In our best institutions, cancer of the breast, widely prevalent among women, can be cured completely in 78 percent of the cases now. The knowledge and the facilities and the technique is known in a few places in the country. In all of the rest of the country the death rate is quite high because the knowledge has not been spread. So it is important to save lives today, and in that field the American Cancer Society spends 60 percent of its funds locally, and 25 percent for research, and 15 percent for all of the rest of the things we do.

Mr. LEA. The available method of doing something is by the use of the known methods of treatment, looking toward prevention and cure? Mr. ADAMS. That is right.

Mr. LEA. But beyond that would be discovery of a basic remedy, is not that true?

Mr. ADAMS. It will certainly never be a remedy, but for example in the field of leukemia, which is for all practical purposes completely incurable today-it becomes chronic sometimes, but you might as well call it incurable-we have new leads and new hopes for specifics there. Those leads and hopes will be utterly useless in the case of the malignant cell in the breast or in the prostate. But we have other leads in that case there. There is no simple cure because we are not dealing with a single disease. We are dealing with growth gone wrong, with life itself out of balance. But there are leads all of the way along, and great progress is being made.

Mr. LEA. Well I take it that the hope for effective advancement in basic research must necessarily depend upon a very limited group of highly skilled men. Would you be fairly safe to conclude that?

Mr. ADAMS. Let us put it this way. One great scientist, given able, well-trained technicians, say five of them, can multiply himself 10 times. So that it is a problem of surrounding that great scientist with facilities and opportunity and bringing in to him, as we are doing at the University of Chicago where Mr. Furmey, for example, who is deeply interested in this problem. He comes in with Dr. Huggens, and the two backgrounds meet, and their two assistants, working with them make great progress.

Mr. LEA. You feel that this legislation before us would provide that class of concentrated work?

Mr. ADAMS. Yes; I do.

Mr. LEA. To which we must look for real progress in basic studies? Mr. ADAMS. Yes. I think that we said 2 years ago to your committee that we would ultimately reach the point where the Federal funds for research on cancer would arrive at certainly $20,000,000 a year that could be intelligently, usefully, and properly spent, and inch by inch that is coming.

Now, the heart thing has been helped greatly by the stimulation of our efforts in the institutions to bring scientists of the other disciplines outside of medicine, the physicists, the chemists, the biochemists, men like Dr. Tuve who invented the proximity fuse, and Dr. Harvey. And that is terribly important in the field of one of the great problems here. It is because those men have been interested in the medical field that you can now go ahead with the heart field in confidence that a program of this sort can rapidly get under way and intelligently. Mr. LEA. I take it that under that plan, the Public Health Service would be primarily an administrative agency rather than a research agency?

Mr. ADAMS. I think the same principle applies, that the Congress, as I understand it, has appropriated funds for enlarging the hospital and clinical facilities in Maryland. There is a relatively small amount of the $15,000,000-I believe it is $600,000-for use there. That should be larger as time goes on; $600,000 is proposed to be spent in that facility within the walls of the work there in Maryland. That is very important, and it is important because the people who are responsible for carrying out research policy in the Public Health Service need to be in it with their sleeves rolled up. They need to be in the muck of it, and they need to have an understanding of it, and I do not recommend that we concentrate all of the research over here in Maryland, and I am sure that Dr. Scheele would not advise that, but they need a research institute there which will stimulate the whole thing, just as we have done in agriculture and some other

areas.

Mr. LEA. Could you cite a little more concretely the purposes for which you think our dollars should be spent to secure the best results? Mr. ADAMS. In connection with heart, you mean?

Mr. LEA. Yes.

Mr. ADAMS. Yes, sir.

This is an approximation of the appropriation needed for the National Heart Institute bill which has been suggested in cooperation.

by the American Heart Association and by the United States Public Health Service. There are $550,000 for research within the National Institue of Health in Maryland. There is $3,000,000, which are controlled grants for the purpose of working on the problem we first discussed, of the control with the knowledge we now have, and specialist trainees, 200 of them, $1,000,000. Assistance to medical schools for improved teaching, which is most important, $1,750,000. And strangely enough, I can remember when the medical schools would not take appropriations from us in connection with cancer. They were too busy. Research grants-in-aid to universities and hospitals, available for 2 years and the pressure is not on there to spend it within the fiscal year, which would not be right-that is $3,750,000. Now, for facilities, $3,500,000; for research fellowships, and this is developing the people who can do the work, 100 of them, guaranteed for 2 years, the cost is $1,000,000; administrative center, $250,000; study of the epidemiology of heart, $100,000; for demonstrations, $119,000; technical development, $57,000; and survey of research and clinical facilities, which is most important, $125,000. It is certainly a modest program for beginning to attack the problem which shall carry one out of three of us out of here on a stretcher sometime.

Mr. LEA. What concern should be used in grants of aid to universities?

Mr. ADAMS. I think several of the bills provide for a Cancer Commission, which I believe would work very well. That Cancer Commission should be in a position of advising and recommending to the Surgeon General, and they should be given sufficient responsibilities so that you will find outstanding citizens willing to take that position. They cannot be administrative officers, obviously.

Mr. LEA. Would that distribution be on a geographical basis?
Mr. ADAMS. It should never be.

Mr. LEA. On the merits?

Mr. ADAMS. It should be on the merits of the individual, because unfortunately science is not located geographically.

Mr. LEA. That is all.

Mr. O'HARA. Mr. Adams, I have been troubled upon these programs, as I was on the Science Foundation bill, with the question of what deterrent, if any, effect, upon scientists the Government's getting into this sort of program has. Do they particularly resent it?

Mr. ADAMS. Well, we had an opportunity of meeting with as great a group of scientists as this country has ever brought together, in the opening of this Institute only 2 weeks ago. That is at Memorial Hospital in New York, just a few weeks ago, the one Mr. Alfred Sloan gave the money to build, and which is the top cancer institute at this time in the world.

Now, the men who were there were men like Dr. Compton of MIT, who headed one panel of distinguished scientists, and Dr. Conant. I know the views of Dr. Bush, Dr. Richards of the University of Pennsylvania, who ran the Government's medical program during the war and of the Academy of Science, and of leading industrial research men like Howard Pew, and Kettering, and they are all agreed today that this program, properly balanced at it has been, is the greatest stimulus to science the world has ever seen.

Now, it was quite difficult for some of those men to view the acceptance of Government grants in their institutions at all in the beginning, but looking at the world in which we believe, and at the cost of running universities and the cost of these institutes, they must be there. The private funds are not going to be available in sufficient amount. With Government funds and private funds, with the public properly educated by the voluntary health agencies, to come along together, the job will be well and economically done and science will be well served. I believe you will find that is the general opinion.

Mr. O'HARA. The reason I mention that is that I have heard doctors themselves say that dollars are not going to solve the scientific problems involved. We have these appeals of various kinds. Right now almost every store you go into has the little cancer bottle, or whatever it is, there; and it was illustrated, I think, in last night's paper, that a young doctor out at the Universiy of Minnesota, which happens to be my State, had arrived at some terrific development of that disease. But on the other hand, I do agree with you, Mr. Adams, that if we work upon the theory that we did with the atomic bomb, and I think that is a great illustration-the Germans had just as great physicists as we had, and they were being told by the Government what they had to do-and our people were asked to come in on a basis of "Will you do this?" Now, is that not true of this program?

Mr. ADAMS. That is 100 percent true. In our committee of scientists, the Committee on Growth, we have 110 of the leading scientists of this country. They are the top men in their profession. And for 3 years they have acted without pay, with great personal sacrifice, endless hours, to help work out this cancer program; and have done the same thing whenever requested, the same group of men, with Dr. Scheele and the Government's side of the problem.

Mr. O'HARA. This is probably gratuitous, but I have talked to some of the scientists who have been engaged in some of the work which the Army and Navy are doing, and I find that there is one thing that they do resent, and some of them are the top men in this country, and that is being told, "You have to do this" and "you have to make your scientific development along this line."

Now, maybe it has to be done, but I just say to you in these programs, we had better be a little careful.

Mr. ADAMS. Mr. O'Hara, I think that men like Dr. Bush and Dr. Richards and Dr. Conant and Dr. Compton, with whom we have constantly consulted, certainly have warned us about that problem.

Now, there are two theories of research, and both are right, and without them we shall never succeed in any field. The first is the pure research. You turn a scientist loose and let him do as he pleases, and he may turn up something or not. As the old professor of mathematics said at the University in Dudlin, "Here is to the science of mathematics, and may it never be a damn bit of use to anybody." That is necessary. That is the type of work which Dr. Einstein did, and is completely necessary, and that was the first field in which we put money.

But beyond that, as pure science develops leads, then the techniques of industrial research and of coordinated research, such as we had in the war on malaria, or as Dr. Bittner is doing in your own university, he is doing a part of a program, and in another university another part is done, and it is an organized planned thing, and he is very happy about it. They are both necessary in the work.