NATIONAL HEART INSTITUTE FRIDAY, APRIL 9, 1948 UNITED STATES SENATE, COMMITTEE ON LABOR AND PUBLIC WELFARE, SUBCOMMITTEE ON HEALTH, Washington, D. C. The subcommittee met, pursuant to adjournment, at 10 a.m., in the committee room of the Committee on Labor and Public Welfare, United States Capitol Building, Senator H. Alexander Smith (chairman of the subcommittee) presiding. Present: Senators Smith (presiding), Donnell, and Pepper. I regret to have to announce that because of emergency matters that have come up since yesterday, Senator Donnell and I will be called away this morning at 10 o'clock and I will then have to recess the hearing until 1 o'clock this afternoon. General Donovan is here this morning. I understand he wishes to get away, so we will ask him to come on as the first witness. We are glad to have you with us, General. I think you are familiar with the subject before us, and we will ask you to go ahead in your own way with your testimony. STATEMENT OF WILLIAM J. DONOVAN, NEW YORK, N. Y. General DONOVAN. Mr. Chairman and gentlemen, I feel deeply honored at being called upon to testify before your committee on the proposed legislation, S. 2215, which seeks to establish a National Heart Institute. As a citizen who has been privileged to serve his country when, twice within a generation, its freedoms were threatened, I appreciate this opportunity to join the ranks of those seeking to preserve our Nation from the inroads of heart and circulatory diseases. It is a well-accepted military precept that the security of our country is based upon a vigorous and healthy youth. The force of that truth was brought home with telling impact on the American people during the last war, when, out of approximately 17,000,000 men between 18 and 35 years of age, examined by selective service and the armed forces, about 5,000,000 were rejected at the time of examination, and another million and a half discharged from the services-all because they were men who lacked the physical and mental stamina required. Men between the ages of 18 and 35 should be fairly robust; certainly, they expect to be healthier than other age segments of the population. Yet about 40 percent of them were in such poor condition that they could not fulfill one of the primary duties of citizenship. 103 Col. Leonard G. Rowntree, an eminent physician and Chief of the Medical Division of the Selective Service System, testifying before a Senate committee investigating health conditions, properly stated the deplorable situation when he said: We are just completing the creation of the greatest fighting force the Nation has ever seen. Instead of finding a rugged, virile manhood, we have found a great many of what we call the five D's: defects, deficiencies, disabilities, diseases, and disorders, and the number of these has been appalling. The country is ailing. Just another pertinent fact. Of the number rejected by selective service, more than 317,000 were for cardiovascular defects; that is, for diseases of the heart or circulation. Offhand, that figure might not seem a startling one, but to appreciate it to the fullest significance it might be well to note that those rejections ran higher than our total battle casualties during the 4 years of World War II. Medical records show that heart disease is the leading fatal disease among children between the ages of 5 and 19; and rheumatic fever and heart disease cause almost five times as many deaths as infantile paralysis, whooping cough, diphtheria, scarlet fever, measles, and meningitis combined. One out of every 5 children suffering from rheumatic fever and rheumatic heart disease dies within 10 years, and four out of five are left with some permanent heart defect. Small wonder that our youth has not proven to be as robust as we would have them in order to perform their civic duties. More pathetic is the realization that many of those untimely deaths could be prevented with proper care and increased scientific knowledge. It is incredible that a nation which could spend more than a quarter of a billion dollars a day to fight a military war permits a common enemy within its midst to victimize and murder almost 600,000 of its citizens every year. With all the sincerity that I can muster I say to you gentlemen the destruction of our youth by heart and circulatory diseases is a disaster of national scope. I can readily visualize the reaction of Congress if an enemy dropped an atomic bomb on a city, say the size of Buffalo or Milwaukee, and wiped out its entire population. I am certain that the reaction of Americans everywhere would be to spare no expense in rallying their forces for the defeat of that enemy. Despite the fact that heart disease kills that many of our citizens every year, we have not mobilized our national scientific and medical talent in an all-out effort to eradicate the No. 1 killer of Americans. By virtue of a failure to coordinate our medical and scientific talents in a national effort to combat this terrible scourge, some 9,000,000 Americans are presently disabled in varying degrees by heart disease. In other words, our failure. to take action againct this national menace is tantamount to creating a huge army of displaced persons within our own national confines. Congress has not hesitated to give aid to foreign DP's, and I ask your honorable committee how much longer will we wait before we give aid and succor to our own? The question has been asked, "How do the American people feel about Government expenditures for such purposes as a National Heart Institute?" The answer to that question was found by research associates in a pilot poll conducted by them in 1947. In reply 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?" 83 percent of the persons polled answered "Yes." Asked if they were willing to pay more taxes for the research and study that would find new diagnoses and treatments of these diseases, 80 percent of the people in the same poll said "Yes." In other words, the American people, as always, are willing to make the small necessary sacrifice it would take collectively to fight this horrible aggressor. The people are ready, gentlemen. They now await the action of Congress in this matter. We have but recently concluded a war on an unprecedented scale to protect the four freedoms. To bring that conflict to its successful fruition we spared no expense, we gave freely of our national treasure and manhood to preserve the right to live as freemen. With the threat of knowing that one out of every two of our citizens past the age of 45 will be a victim of heart disease, our people cannot really pursue their lives in freedom. It is unthinkable that we would keep a vigilant eye to protect the men and women of our Nation from the virulent infection of foreign sources while permitting domestic_killers to plunder and sap the strength of our people at home. Life, liberty, and the pursuit of happiness are a fundamental moral heritage of all Americans. If they are to be more than a hollow phrase, if they are to become a living fact, the heart of our Nation must beat with firmness, power, and a steady balance that will assure to even the least of us those historic American rights. Senator SMITH. I know, General, that we all agree with your general approach to this matter. The question we are discussing is the best way to deal with the situation. It is the question of set-up. I do not know whether you are prepared to comment on the exact terms of this bill, or whether you care to go beyond just the general approach. General DONOVAN. Í have read the bill over a number of times, Senator, and it seems to me a very sensible approach to the problem. Senator SMITH. It is similar to the cancer law. General DONOVAN. Yes, sir; and I am on the executive committee of the Cancer Institute, and I am familiar with that approach. Senator SMITH. Let me ask you a further question in that connection, a question that has come up in these hearings, and that is whether, in your judgment, if the Federal Government makes a substantial contribution to the cost of this program, it will cut off the private sources of contribution, and whether you think this would be desirable? General DONOVAN. No; I would think quite the contrary. Just on that question I happen to have here before me a memorandum on what is taking place in the drive on heart disease in New York today. They organized in that drive what they call a cardiac crusade, and as a result of it they have now had the number of gifts running 6 to 1 over 1947, and they have 10 times as many workers. So you can see there isn't any abandonment of private effort. Likewise in the cancer drive in New York, on that phase of it there is intense interest, despite the fact that, I think, you appropriated something like $14,000,000 for cancer. Senator SMITH. We appropriated $14,000,000, and the contributions were $12,000,000 last year, and I think they are trying to get them to 16 or 18 million this year. General DONOVAN. That is right. Senator SMITH. I just wanted to get the general opinion of the people who are in this movement, on whether they think it will impair the giving. The suggestion has been made to me that a better approach to this thing would be to revise the tax laws and give wider exemption to people who make gifts for such things. Do you agree with that? General DONOVAN. I do, yes, sir. Senator SMITH. We also have before us for consideration a bill to set up a National Science Research Foundation, and the question has arisen whether we had better incorporate this as a medical division of that Science Research Foundation or have it a separate bill. The questions are questions of administration, the best way to set it up. I don't think there is any dispute as to the great need for it and the great danger to our people from heart trouble. General DONOVAN. Yes, sir. I think that on the question of administration, which is a question I am always interested in, Senator, I think it is wise to have some degree of autonomy in these things, but to keep it under proper coordination, because in this you have got to have some freedom of selection, of flexibility in your research, and some competition in it. You can get it too closely held, and I think. that might impair its usefulness. Senator SMITH. We are interested in that, too, of course. It is very desirable. Another approach is that we might amend the Public Health Service Act with an over-all amendment to provide for such a set-up, an institute of this kind within the scope of the Public Health Act, which this bill contemplates, but it might require a revision of the whole act. So that the way we approach these problems should be uniform. For example, the Cancer Council set-up is the same kind of a set-up, dealing with the same kind of problems, and we might move on to other fields ultimately. General DONOVAN. No one knows better than you, Senator, the need to get a right kick-off. Senator SMITH. We are very grateful to you, General, for your testimony this morning. Senator DONNELL. I would like to ask the general a few questions. And, General, in the questions I will ask you I do not in any sense mean to minimize the importance of the study and treatment, nor necessarily to minimize the importance of this bill, but I do think there are some implications in your testimony that I would like to ask you particularly about. For instance, you have quoted Colonel Rowntree, who is, as you state, Chief of the Medical Division of the Selective Service System, and you mention in the quotation from him the language "The country is ailing." I think that, coming from Colonel Rowntree and yourself, a statement of that kind might prove very fearsome to the people of our country, and might possibly leave an impression that is not intended. May I ask you, General, is it not true that the health of this country is certainly as good as that of any of the other leading countries of the world at this time, and is it not true that, in fact, it is better? General DONOVAN. That could be true, and still what the colonel says be right. That is a relative matter. Senator DONNELL. Yes, but I am asking you, have you studied the statistics to see whether or not the facts show that this country is ailing more than any other country is ailing? |