available and such expansion is no longer necessary. In the case of any such expansion of an existing institute, the Surgeon General may change the title thereof so as to reflect its new functions.

"ESTABLISHMENT OF NATIONAL ADVISORY COUNCILS

"SEC. 432. Upon the establishment of an institute pursuant to section 411, the Surgeon General shall also establish a national advisory council to advise, consult with, and make recommendations to the Surgeon General on matters relating to the activities of the institute. Any such council shall consist of the Surgeon General ex officio, and of twelve members appointed without regard to the civil service laws by the Surgeon General with the approval of the Administrator. The minimum of twelve appointed members shall be leaders in the field of fundamental sciences, medical sciences, education, or public affairs, and six of such twelve shall be selected from leading medical or scientific authorities who are outstanding in the study, diagnosis, or treatment of the disease or diseases to which the activities of the institute are directed. Each appointed member of the council shall hold office for a term of four years except that any member appointed to fill a vacancy occurring prior to the expiration of the term for which his predecessor was appointed shall be appointed for the remainder of such term and except that, of the members first appointed, three shall hold office for a term of three years, three shall hold office for a term of two years, and three shall hold office for a term of one year, as designated by the Surgeon General at the time of appointment. None of such twelve members shall be eligible for reappointment until a year has elapsed since the end of his preceding term. In lieu of appointment of an additional advisory council upon the establishment of every additional institute or upon expansion of the functions of an existing institute, the Surgeon General may expand the functions of an existing advisory council established under this Act so as to include functions with respect to the particular disease or diseases to which the activities of the new institute or the new activities of the existing institute are directed, where this will be in the interest of hastening discoveries for new treatments and cures for such disease or diseases. In the case of any such expansion of an existing council, the membership thereof representing persons outstanding in activities with which the council is concerned may be changed or increased so as to include some persons outstanding in the new activities. Such new council or expansion of an existing council may be terminated by the Surgeon General at or after the termination of the new institute or expansion of the existing institute which occasioned such new council or expansion of an existing council. In the case of any such expansion of an existing council, the Surgeon General may change the title thereof so as to reflect its new functions.

"FUNCTIONS OF THE COUNCILS

The Advisory Councils for arthritis and rheumatism, blindness, and neurological diseases and other diseases mentioned in this bill, and other diseases, appointed by the Surgeon General are authorized to

"(a) review research projects or programs submitted to or initiated by it relating to the study of the cause, prevention, or methods of diagnosis or treatment of the diseases mentioned in this Act, and certify approval to the Surgeon General, for prosecution under section 412, any such projects which it believes show promise of making valuable contributions to human knowledge with respect to the cause, prevention, or methods of diagnosis or treatment of these diseases; "(b) review applications from any university, hospital, laboratory, or other institution or agency, whether public or private, or from individuals, for grantsin-aid for research projects relating to these diseases and for construction research facilities, and certify to the Surgeon General its approval of grants-in-aid in the cases of such projects which show promise of making valuable contributions to human knowledge with respect to the cause, prevention, or methods of diagnosis or treatment of these diseases;

"(c) review applications from any public or other nonprofit institution for grants-in-aid for training, instruction, and traineeships in matters relating to the diagnosis, prevention, and treatment of these diseases, and certify to the Surgeon General its approval of such applications for grants-in-aid as it determines will best carry out the purposes of this Act;

"(d) collect information as to studies which are being carried on in the United States or any other country as to the cause, prevention, or methods of diagnosis or treatment of these diseases, by correspondence or by personal investigation of such studies, and with the approval of the Surgeon General make available such

information through appropriate publications for the benefit of health and welfare agencies and organizations (public or private), physicians, or any other scientists, and for the information of the general public;

"(e) recommend to the Surgeon General for acceptance conditional gifts pursuant to section 501 for carrying out the purposes of this part; and

"(f) advise, consult with, and make recommendations to the Surgeon General with respect to carrying out the provisions of this part;

"(g) upon the appointment of a national advisory council for an institute established under this part or the expansion of an existing institute pursuant to this part, such council shall assume the duties, functions, and powers of the National Advisory Health Council with respect to grants-in-aid for research and training projects relating to the disease or diseases to which the activities of the institute are directed."

NATIONAL ADVISORY COUNCILS

SEC. 3. (a) Subsection (b) of section 217 of the Public Health Service Act, as amended, is amended to read as follows:

"(b) The National Advisory Health Council shall advise, consult with, and make recommendations to, the Surgeon General on matters relating to health activities and functions of the Service. The Surgeon General is authorized to utilize the services of any member or members of the Council, and where appropriate, any member or members of the national advisory councils established under this Act on cancer, mental health, heart, dental, and other diseases, in connection with matters related to the work of the Service, for such periods, in addition to conference periods, as he may determine."

(b) The heading of section 217 of such Act is amended to read as follows: "NATIONAL ADVISORY COUNCILS."

(c) Subsection (e) of section 208 of such Act is amended to read as follows: "(e) Members of the National Advisory Health Council and members of other national advisory councils established under this Act, other than ex officio members, while attending conferences or meetings of their respective councils or while otherwise serving at the request of the Surgeon General, shall be entitled to receive compensation at a rate to be fixed by the Administrator, but not exceeding $50 per diem, and shall also be entitled to receive an allowance for actual and necessary traveling and subsistence expenses while so serving away from their places of residence."

Effective October 1, 1949, subsection (a) of section 217 of such Act is amended to read as follows:

"(a) The National Advisory Health Council and the National Advisory Cancer, Mental Health, Heart, and Dental Research Councils shall each consist of the Surgeon General, who shall be chairman, the chief medical officer of the Veterans' Administration or his representative, a medical officer designated by the Secretary of Defense, who shall be ex officio members; and twelve members appointed without regard to the civil-service laws by the Surgeon General with the approval of the Administrator. The twelve appointed members of each such council shall be leaders in the fields of fundamental sciences, medical sciences, or public affairs, and six of such twelve shall be selected from leading medical or scientific authorities who, in the case of the National Advisory Health Council, are skilled in the sciences related to health, and in the case of the National Advisory Cancer Council, the National Advisory Mental Health Council, the National Advisory Heart Council, and the National Advisory Dental Research Council, are outstanding in the study, diagnosis, or treatment of cancer, psychiatric disorders, heart diseases, and dental diseases and conditions, respectively: Provided, That in the case of the National Advisory Dental Research Council, four of such six shall be dentists. Each appointed member of each such council shall hold office for a term of four years, except that any member appointed to fill a vacancy occurring prior to the expiration of the term for which his predecessor was appointed shall be appointed for the remainder of such term, and except that of the members first appointed, three shall hold office for a term of three years, three shall hold office for a term of two years, and three shall hold office for terms of one year, as designated by the Surgeon General at the time of appointment. None of such twelve members shall be eligible for reappointment until a year has elapsed since the end of his preceding term, except that the terms of persons serving on any such council prior to October 1, 1949, shall not be deemed 'preceding terms' for purposes of this sentence."

Effective October 1, 1949, subsections (c), (d), (f); and (g) of section 217 of such Act are repealed. The terms of all members of National advisory councils ap

pointed on or before September 30, 1949, pursuant to such subsections and subsection (a) of such section and serving on such date, shall expire on that date. Effective October 1, 1949, subsection (e) of section 217 of such Act is redesignated subsection "(c)".

GENERAL PROVISIONS

Sec. 4 (a) Section 406 of the Public Health Service Act is amended to read as follows:

"OTHER AUTHORITY

"Sec. 406. This title shall not be construed as limiting (a) the functions or authority of the Surgeon General or the Public Health Service under any other title of this Act, or of any officer or agency of the United States, relating to the study of the prevention, diagnosis, and treatment of any disease or diseases for which a separate institute is established under this Act; or (b) the expenditure of money therefor."

(b) Section 209 of such Act is amended by adding at the end thereof the following new subsection:

"(g) The Administrator is authorized to establish and fix the compensation for, within the Public Health Service, not more than thirty positions, in the professional and scientific service, each such position being established to effectuate those research and development activities of the Public Health Service which require the services of specially qualified scientific or professional personnel; Provided, That the rates of compensation for positions established pursuant to the provisions of this subsection shall not be less than $10,000 per annum nor more than $15,000 per annum, and shall be subject to the approval of the Civil Service Commission. Positions created pursuant to this subsection shall be included in the classified civil service of the United States, but appointments to such positions shall be made without competitive examination upon approval of the proposed appointee's qualifications by the Civil Service Commission or such officers or agents as it may designate for this purpose.'

Senator PEPPER. Mr. Chairman, the expectancy of life at the birth of people in the United States is now 66.7 years, based upon 1946 death rates. In the last 10 years the gain in life expectancy at birth has been about 2 years and since 1900, almost 17 years. This gain has been largely the result of greater knowledge of the causes and the control of infectious diseases. We have made tremendous progress in combatting tuberculosis and in lowering the mortality rate among infants and mothers during childbirth. We have established firm control over diseases such as pellagra.

In recent years we have made great gains in the health and medical sciences through research. We now have such things as penicillin, DDT, the various sulfa drugs, streptomycin, aureomycin, isotopes, and radio-active atoms, fluorides, and many of the other wonders which we have uncovered through prodigious and fruitful research.

In the field of heart research the Congress is about to provide some $30,000,000 for the next year; for cancer $37,000,000, for mental health about $15,000,000, for dental health in excess of $2,000,000. We have provided statutory authority for research in these fields, but Mr. Chairman, there are many other cripplers and killers of mankind about which we know and have done little or nothing.

Our people still suffer and die of serious illnesses. We know 25,000,000 people every year have disabling and nondisabling chronic ailments. There are about 1,000,000 deaths yearly and over 1,000,000.000 days of disability every year resulting from chronic illnesses. The average number of deaths in 1945-47 from some of these leading illnesses about which we know so little and for which little or no provision has been made for reasearch, prevention, and treatment were:

Now let us turn to the disabling and crippling ailments:

2, 350

Number of sufferers 6, 850, 000 3,930, 000 1 330, 000

So, we see Mr. Chairman, that almost 13,000,000 persons are affected by these nine illnesses alone. What is more disconcerting is the fact that as many as 29,500,000 during the Christmas week of 1945 suffered from common colds.

I believe that the situation on arthritis and rheumatism will give some idea of the extent of the over-all research problem which we must meet. Of the 6,850,000 sufferers of arthrtiis or other forms of rheumatic diseases, more than 6,000,000 are subject to some chronic or recurrent pain even though they are able to perform their daily duties. About 1 of every 20 Americans is a victim of arthritis or rheumatic disease, yet there are only 200 free beds in the country allotted to the study and treatment of rheumatism. Only about 400 physicians are members of the American Rheumatism Association, a considerable number of whom do not devote their entire time to these diseases. What is more discouraging is the fact that only $200,000 a year is now being spent on rheumatism research, including the care of patients being studied and I divert there to remind the able chairman who has been such a pioneer in all of this field that that is back to about where we were with respect to hearts and cancer only

just a few years ago. An awakened Congress and country have now

pushed those figures up to where they are beginning to be respectable although mostly inadequate at the same time. But we still have to go back into these neglected fields and to pick up from the little progress we made and go ahead.

It has been estimated by reliable authority there is an estimated annual economic loss of about $750,000,000 in wages, relief allowances, and medical care because of rheumatism. About 97,200,000 workdays are lost each year in the United States. Rheumatism is more common among low income families. It is said that half of the workdays lost because of it occur in families of $1,000 or less income per year.

Mr. Chairman, we have had this matter up many times. Every dime spent in effective and competent research will yield, I am sure, at least 10 times the economic return to the country. So we are coming here in the interest of economy, but in the finest kind of economy, the saving not only of dollars but of the lives and health of our people as well. I wish we could develop a proper sense of

to go to some resort out in the dry countries and take life easy, and maybe they would get over it.

Dr. CECIL. That is right. I often tell my patients in New York that they should go out to Arizona, and they simply laugh.

Senator MURRAY. Or Montana. They have a number of these hot springs around the country like Hot Springs, Ark., and the hot springs out in the Western States that give some relief.

Dr. CECIL. It is not exactly a cure.

Senator MURRAY. It is great relief and especially if it is in a country where the climatic conditions are good. I suppose a person would get along better there than in the part of the country where they have these extreme changes of climatic conditions and so much humidity.

Dr. CECIL. But, you see, the arthritic runs an up and down career. He goes out to dry country and feels better, and then comes back after a few months and then he goes back where he was before. They have a tough time. They take these cures at great expense often and then find themselves right where they were before they took the cure.

Our cure is mostly palliative: rest, aspirin, all these various things, mostly to try to make life more bearable for them, but we do not cure many of them. Nature cures a few.

Senator MURRAY. As to the statistics, you said you intended to cover some of them or that some of them had been covered by the previous witnesses.

Dr. CECIL. Yes.

Senator MURRAY. You are in accord with their views that this would be a splendid investment for our Government, because it will save money in the long run and would be a very desirable program for the Congress to adopt?

Dr. CECIL. I feel so, very strongly, Senator, I really do.

Senator MURRAY. Of course, we are met often with objections with regard to the cost of some of these programs, and they are fearful about balancing our budget.

From the statements made here this morning, we appear to be spending more money on animal and plant diseases than we are on human diseases. It seems to me the Congress would be saving money and making a wise investment of this money to set up an institution for research that could possibly find the cause and cure of this disease. Dr. CECIL. There is one very prevalent form that occurs in old people. All of us get a certain amount of stiffening and rheumatism pains as we get old, but there is reason to believe a lot could be done for old people who get rheumatism, you might say, naturally. A lot could be done if we have a better understanding of the mechanism of aging and rheumatism.

Senator PEPPER. Thank you very much for your statement here, Doctor. We appreciate your statement today.

Next is Dr. Paul Holbrook.

STATEMENT OF DR. W. PAUL HOLBROOK, TUCSON, ARIZ.

Senator MURRAY. Your may state your full name, Doctor.

Dr. HOLBROOK. My name is W. Paul Holbrook, and my address is Tucson, Ariz. I am the president of the Arthritis and Rheumatism Foundation and chairman of the Research Committee of the American Rheumatism Association.