circulation. The number of doctors in the United States specializing in cardiology is very small, utterly inadequate to provide 9,000,000 people suffering from heart and arterial diseases with adequate advice and information on how to take care of themselves. The creation of a National Heart Institute such as is provided for in S. 2215 with the establishment of a National Heart Council, consisting of 12 appointed members who shall be leaders in the fields of fundamental sciences, medical science, education, and public affairs, would help to change a disturbing national health condition for the better. S. 2215 does this in a sound, long-range manner which cannot help but receive tremendous public support in its program for meeting the challenge of the No. 1 killer of our people.

I might say, Mr. Chairman, as I close, that last year I took the leadership in the Appropriations Committee, at the instance of Senator Pepper and some others in this body, in putting in an amount of $500,000, which was the first direct appropriation for heart research, and was a step in that direction.

Generally speaking, I am for economy in this country. Probably no one in Congress is more strongly for it, but I think that in the interest of the economy of the country it is a sound program for us to spend a reasonable amount of money for research into heart ailments and other similar things that are undermining the health of this country and which I think present a real challenge to the Nation at this time.

I might ask, in closing, if I may, to have printed here as part of your record a statement by Senator James E. Murray, of Montana, who is one of the sponsors of the bill and who has asked me to present his statement to you and ask that it be incorporated in the record. Senator SMITH. It may be incorporated.

(The statement submitted by Senator Murray follows:

STATEMENT OF HON. JAMES E. MURRAY, A UNITED STATES SENATOR FROM THE STATE OF MONTANA

If, in time of war, we can provide funds, coordinate research and mobilize science in order the better to kill men, then surely we can, in time of peace, do those same things in order that men may live. And in so doing, we shall come far closer to the genius of America, to the heartfelt desires of the American people.

I am sure that my congressional colleagues join with me in this understanding. Consequently, I know I need not present a lengthy explanation of why I am glad to join with Senators Bridges, Ives. and Pepper in cosponsoring the National Heart Act.

This is a time when press and screen and radio are filled with talk of party strife and interparty struggle for preferment. But when more than 1 in 3 of our people die from a disease which disables over 7,000,000 Americans annually, which recognizes no class lines and ignores State boundaries, I know that we in the Congress will forget political lines and, disregarding partisanship, join together in insisting that the Nation's scientific resources be mobilized in counterattack against a common enemy. We have done a similar job with respect to cancer. We can do as well with respect to the even more devastating diseases of the heart and circulatory system.

I anticipate little or no controversy over this bill. Expert witnesses are prepared to testify as to the need for action and what we can hope to achieve. They can speak too of the experience in related fields which proves the soundness of the procedures set forth in this bill. My only concern is with the possibility that we might not act swiftly enough to asure the passage of the measure in this session of the Congress. Therefore, writing from Montana where in recent days I have had opportunity to discuss the bill with people in every walk of life, I want to assure my colleagues that the need for such a bill is everywhere recognized and action on it eagerly looked for. Should there be disagreements on any details of the bill I am sure they can be quickly resolved, and I am prepared to accept any changes found desirable by the bill's cosponsors.

Senators Bridges and Ives, Senator Pepper and myself, representatives of both great parties, are in agreement on the National Heart Act. Scores of people prominent in medicine, in business, in labor, agriculture, and the arts-of all political persuasions-are in agreement in urging its passage. And, insofar as they are aware of it, the people favor it-58,000,000 of them will die of heart disease unless effective action is taken and taken soon. In support of this contention, I submit for the record and as attached to this statement, a wire urging the passage of this bill and signed by outstanding leaders in every field of activity together with a fact sheet setting forth inescapable reasons compelling us to action.

I urge that S. 2215 be reported on favorably and promptly in order that the Senate may act upon it before the pressure of time and of other momentous issues endangers its passage. This is one health bill that is noncontroversial, badly needed, and widely supported. I know my colleagues are as anxious as I that it shall not be said that the Eightieth Congress adjourned without passing any major health legislation of importance to millions of our people. Let it not be said that anyone played politics with the people's health. Let us quickly give the Senate an opportunity to vote for this bipartisan measure. (The telegram and the fact sheet submitted by Senator Murray are as follows:)

Hon. JAMES E. MURRAY,

United States Senate:

NEW YORK, N. Y., March 19, 1948.

Day in and day out, men and women in their prime of life are struck by the No. 1 killer of mankind-heart disease. A constant increase in the death rate due to disease of the heart and arteries makes it imperative that pending legislation in your committee get an immediate hearing. Fifty-eight million living Americans, doomed to die from heart disease, are pleading for action.

Sponsors of the National Heart Committee: Irene Dunne, Herbert Bayard Swope, Edgar Kobak, Justin Miller, Gardner Cowles, A. F. Whitney, Gerard Swope, Elmo Roper, Niles Trammel, James and Marian Jordan (Fibber McGee and Molly), David Dubinsky, Samuel Goldwyn, Siegfried Hartman, Alfred McCosker, Walter Reuther, Grantland Rice, Robert W. Woodruff, Walter S. Mack, Jr., Frank Stanton, Philip Murray, Carl Whitmore, James A. Farley, Mark Woods, William Green, Harry Emerson Fosdick, John Hay Whitney, Lowell Thomas, Lois Mattox Miller, Barry Bingham, Leonard Lyons, Matthew Woll, Alfred Howell, Dr. Irving Wright, Seymour Berkson, Mrs. Ted Thackrey, Dr. Henry Simms, Mrs. Peter Rathvon, Bernard F. Gimbel, Dr. Charles A. R. Connor, M. Lincoln Schuster, Joshua Loth Liebman, Mrs. Arthur Baer, Gov. James Cox, Mrs. Daniel Mahoney, Dr. Arlie Barnes, Miss Jessica Daves, Miss Eleanor Lambert, Miss Leonora Corbett, Daniel Mahoney, Dr. T. Duckett Jones, Mrs. Dorothy Norman, Mrs. Bernard Gimbel, Dr. Harry Goldblatt, Henry Luce, Mrs. Franklin D. Roosevelt, Dr. David D. Rutstein, Julius Ochs Adler, Joan Bennett, Walter Wanger, James

S. Adams, Dr. Paul White, Dr. Harold W. Dodds, Mrs. Harold Guinzberg, Harold Guinzberg, Dr. Howard Rusk, James Douglas, Paul Walter, Hugh K. Martin, Merrill Meigs, George W. Weber, Jr.

Executive Committee: Ted R. Gamble, Mrs. Anna M. Rosenberg, Emerson Foote, Mrs. Wendell Willkie, Gen. William J. Donovan, Mrs. Albert D. Lasker, Don Francisco, and Robert Coyne.

WHAT IS THE NEED FOR CONGRESSIONAL LEGISLATION AGAINST DISEASES OF THE HEART AND CIRCULATION?

1. How many people in our country die of diseases of the heart and circulation? (a) More than one out of three of our people now die from these diseases (1).

(b) 588,451 Americans died of these diseases in 1946 (1).

(c) 60,000,000 Americans now living will die of these diseases unless new treatments and cures are found (2).

2. How many of our people are disabled, in varying degrees, by diseases of the heart and circulation?

(a) About 9,000,000 (3), or about 1 in every 16 people.

3. Is there a National Heart Institute in the United States Public Health Service like the National Cancer Institute? No.

(a) There is no National Heart Institute and the United States Public Health Service has only $974,000 this year to spend for research on diseases of the heart and circulation (4).

(b) The National Cancer Institute in the United States Public Health Service has $14,000,000 of Federal funds this year to spend on cancer research, education, control, and other action against cancer (5), of which $7,544,000 is for research.

4. How much money is being spent in this country from all sources of research for new treatments and cures of diseases of the heart and circulation which cause one out of three deaths?

(a) Less than $3,000,000 a year of private and Government funds, or only $3.98 per death from these diseases, it is estimated (4) (6) (7).

(b) Our Government spends only $1.65 per death for the No. 1 killer of our people (8).

5. How does this compare with what the United States Government spends on research and control of plant and animal diseases?

(a) The United States Department of Agriculture has $29,866,200 this year to spend on research and control of plant and animal diseases (9). (b) This is about 10 times as much as the amount spent from all sources on diseases of the human heart and circulation.

6. How many beds for clinical research in diseases of the heart and circulation are there in the United States?

(a) Only about 200 beds in the whole country for the 9,000,000 sufferers (10).

(b) Only 909 special beds for convalescent cardiac patients, located in only 8 States, with 344 of the 909 beds in New York City (11). 7. How many doctors specialize in the field of heart disease?

(a) Only 199 doctors limit their practice to diseases of the heart; another 439 give special attention to this field (12). This makes a total of only 638 doctors out of a total of 135,942 effective physicians (13) who specialize in cardiology.

8. How would the creation of a National Heart Institute with large sums for research, medical education, facilities, and services help to change this situation?

(a) Such an institute would give grants-in-aid to qualified institutions for research into better treatments and cures.

(b) It would give similar grants for refresher courses for doctors, and for better teaching to medical students.

(c) It would give grants for construction of research facilities. (d) It would promote coordination of research of all work in these fields. (e) It would make available for prompt use new information in these fields.

(f) It would make grants-in-aid to States for prevention, treatment, and control of these diseases, and for training of personnel for State and local health work.

(g) All these would go a long way toward saving some of the almost 600,000 people who die from heart and arterial diseases every year, almost 25 percent of whom are under 60 years of age, and whose productive life could be extended for the betterment of our national economy and their own health and happiness.

9. How do the people of the United States feel about Government expenditures for such purposes?

(a) Eighty-three percent of the people polled by Research Associates in a pilot poll conducted in 1947 said "Yes" to the question "Do you think Congress should put aside $100,000,000 to be used in research on tuberculosis and diseases of the heart and arteries?" (14)

(b) Eighty percent of the people in the same poll said "Yes" to the question, "Would you be willing to pay more taxes for research and study to find new diagnoses and treatment of these diseases?"

10. Is there hope for better treatments and cures through research in these fields?

Yes; science has already made these important advances :

(a) Prevention of recurrences of attacks of acute rheumatic fever by the use of sulfa drugs.

(b) The surgical relief and, in certain instances, cure of congenital heart defects.

(c) The lowering of blood pressure and the relief of symptoms in some cases by surgical treatment of high blood pressure.

(d) The use of sulfa drugs, penicillin, and streptomycin in the prevention and treatment of a type of heart disease known as subacute bacterial endocarditis.

But, many new research leads are not being adequately followed for lack of funds, and—

(a) Diseases of the heart and circulation are still the No. 1 killer of our people.

(b) One person dies every minute of diseases of the heart and circulation (15).

(c) Diseases of the heart and circulation take a greater death toll than the five next leading causes of death combined (16).

(d) They cause more than 300 times as many deaths as infantile paralysis (17).

(e) One person in every 16 suffers from diseases of the heart and circulation (18).

(f) Nearly one out of every two deaths after the age of 45 is caused by heart diseases (19).

(g) It is no respecter of ages, and is the leading fatal disease among children from 5 to 19 years old (19).

REFERENCES

(1) National Office of Vital Statistics (1 out of 2.37 deaths in 1946; 1 out of 2.38 deaths in 1945.)

(2) Forty-two percent of the total deaths on 1946 were caused by diseases of the heart and circulation; 42 percent of 143,000,000 (estimated United States population) is 60,060,000.

(3) Dr. Rolla E. Dyer, director, National Institute of Health; estimate based on analysis of health of the Nation, 1940 (memorandum dated May 28, 1947). (4) Dr. Rolla E. Dyer, director, National Institute of Health (letter dated December 12, 1947).

(5) Dr. Leonard A. Scheele, director, National Cancer Institute (letter dated September 25, 1947).

(6) United States Public Health Service, $974,500 (see 4); nongovernmental agencies in United States, $615,000 (survey made in 1944 by Dr. H. M. Marvin, American Heart Association).

(7) Life insurance companies of United States (Dr. Francis Dieuaide, Life Insurance Medical Research Fund), $550,000; Whitney Foundation, $200,000; total $2,339,500.

(8) $974,500 for 588,451 deaths.

(9) United States Budget, fiscal year ending June 30, 1948.

(10) Fact brought out in hearings before Senators Bridges and Pepper on need for additional research funds for heart disease, by group of heart specialists, in Senate hearing April 24, 1947.

(11) Miss Margaret Matheson, executive secretary, New York Heart Association.

(12) American Medical Association, letter dated August 13, 1947.

(13) Journal of American Medical Association (vol. 121, p. 1163 (1943)): Total registered physicians, 1943: 179,039; difference represents those not prac ticing because of advanced age, physical disabilities, and other reasons.

(14) Pilot poll conducted by Research Associates, New York City, January 1947.

(15) Five hundred twenty-five thousand six hundred minutes in a year; 588,451 deaths.

(16) Cancer, 182,005; deaths associated with childbirth, 145,094 (1945); accidental, 98,003; nephritis, 81,701; pneumonia, iufluenza, 62,324.

(17) Three hundred times 1,845 (infantile paralysis deaths 1946) equals 553,500.

(18) Nine million sufferers; 143,000,000 population.

(19) New York Heart Campaign booklet Open Your Heart.

Senator BRIDGES. Thank you very much, gentlemen.

Senator SMITH. There is just one question I would like to ask you, Senator.

As you probably know, we are working now on the so-called National Science Foundation, which will provide for medical research, where we have tried to concentrate research in different fields cancer, heart, and so on-and I am just wondering whether, in the light of the possibility of that sort of legislation being passed, which will aim to provide research in the scientific field, you still think we should have a separate bill like S. 2215 to provide research in the field of diseases. of the heart? I am just trying to get the proper approach to the problem. I do not question the need for action. I agree with everything you say about the importance of having this work done, and I am just thinking in terms of the most effective set-up.

Senator BRIDGES. I would have to answer that, Mr. Chairman, by saying that was the approach which I considered and which my cosponsors and the various people in the country who are interested in this subject considered, but I think that the committee which you have the honor to head, after hearing all the evidence and considering all things together, will probably be better able to judge than I would, and you, in your wisdom, after you have heard all the evidence could better measure whether or not this should be done by the National Science Foundation, and I am certainly willing to abide by your judgment after hearing all the evidence.

Senator SMITH. I may say that there is at the present time on the statute books a similar statute to this, covering the field of cancer. The Cancer Institute is now functioning under the Public Health Service, and I imagine that if this bill were passed it would be analogous to the law which covers the field of cancer, and that research into heart conditions would occupy a place similar to cancer research.

Senator BRIDGES. I think that is right.

Senator SMITH. Arthritis has been called to my attention; polio has been called to my attention by people who are interested in those fields who think we should have separate legislation for each of them. Our problem, of course, is to coordinate our efforts in the most effective, practical way to get results. You agree with that, I take it? Senator BRIDGES. Absolutely.

Senator SMITH. We are very grateful to you, Senator, for your

statement.

Senator DONNELL. I have one or two questions, Senator. I notice in the bill there is reference to assistance to private agencies engaged in

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