APPARENT CONTRADICTION IN FINDINGS

Mr. LAIRD. Doctor, I wanted to follow through on this question of the chairman, Mr. Mahon.

I happen to represent the largest milk and cheese producing district in the country and I wondered if you were familiar with the studies which the National Institutes of Health are making at the present time and the new system of recording cholesterol. These studies do not corroborate some of the testimony which you have given us this morning.

Mr. FLOOD. Mr. Laird is from Wisconsin, Skipper.

General HEATON. I presume so, yes, sir. What I was giving you this morning was the data given me by the Chief of Medicine of Walter Reed Hospital. I know that blood cholesterol reading is not a true reflection of the lipid metabolism. It is difficult to understand why, up in your area, there is not any particular rise in the instance of coronary artery diseases. Yet you remember I referred to Norway. That is authenticated and documented.

Mind you, I was talking about an older age group when I was talking about animal fats.

Mr. LAIRD. I wondered if this testimony that you are giving us is conclusive.

General HEATON. No, sir. Nothing is conclusive in medicine.
Mr. LAIRD. That is all.

Mr. ANDREWS. Mr. Mahon.

Mr. MAHON. Your discussion is very stimulating and interesting, Doctor, especially in view of your reputation and high standard and recognition in your profession. We are glad to have you with us. Mr. LIPSCOMB. Will you yield?

Mr. ANDREWS. Mr. Lipscomb.

DEFINITION OF "MIDDLE AGE”

Mr. LIPSCOMB. What do you classify as "middle age," General? General HEATON. In the medical profession we figure we are not dry behind the ears until we get 55, but we don't consider ourselves old at 55. I would say middle age would start around from 45 on. I say that because for our physical examinations, from 45 on, we routinely do a very thorough X-ray of the chest, an electrocardiogram and a prostatic examination, figuring that examining for a prostate you also will feel a cancer of the colon.

Seventy-two percent of all large intestinal cancers can be felt with the finger and going on the assumption that most cancers and these other cardiovascular disabilities start around middle age, we examine more thoroughly at age 45 and for the prostate at 40 years of age.

OPERATION OF HOSPITAL, DISPENSARIES AND DENTAL SERVICE UNITS

Mr. FORD. General, I suggest we put in the record the justification sheets, 407 and 408, which show, I think, some very important data from the point of view of the budget which we are considering here. Mr. ANDREWS. Without objection, they will be inserted in the record at this point.

(The material requested follows:)

JUSTIFICATION OF FUNDS REQUESTED

The fund requirement is based on an analysis of hospital and dispensary operations in terms of inpatient care, outpatient care, and dental services. A comparison of the workload and staffing ratios for the 3 fiscal years is as follows:

Overseas: Data are not available to show the staffing in overseas medical facilities in terms of inpatient, outpatient, and dental care. The following, however, shows the workload and civilians utilized in hospital and dispensary operations overseas:

Mr. FORD. Could you give us some information about the trend in-I think it is the ineffective rate-is that the phrase you used? General HEATON. Noneffective rate.

Mr. FORD. What is the situation today?
General HEATON. It is very good.

The noneffective rate from 1957 was 13.5. You know what it is, of course.

Mr. FORD. Would you define it, please?

General HEATON. A noneffective rate is the number of troops per1,000 per average day who are excused from duty on account of disease or injury; 13.5 in 1957, 1960 it is 11.8 per thousand men excused from duty.

That, in turn, reflects a very marked increase in the effectiveness of the inpatient treatment techniques.

In other words, we are getting them in and we are getting them out faster. In that period of time we have had a marked decline in patient stay.

Mr. FORD. Could you have somebody from your staff put in the record this figure for each of the last 5 fiscal years and what yourforecast is for 1962 fiscal year?

General HEATON. Yes, sir.

Mr. FORD. The figures should result in a fine commendation foryour office or the Office of the Surgeon General. But it also is important to us on the committee in that it reflects itself in more people being available for the commanders in the field or elsewhere. General HEATON. That is right.

Mr. FORD. Have you ever had your office figure out what this im-provement means in the availability of troops? How many more people are available per year as a result to the people in the field? General HEATON. That is the line commander. That is what he looks at, the noneffective rate.

You would be interested in this. We are speaking of disease against battle casualties in World War II. It was 4 to 1. On any given day in World War II there were over 300,000 men out.

Mr. FORD. In other words, for every five men in a unit

General HEATON. There were 4 diseases to 1 battle casualty, but that is 21 divisions that were out with sickness or injury.

Mr. FORD. Let's relate that to the current situation. You have got 870,000 men in the Army. You are down to 11.8 per 1,000 men. Two years ago it was 13.5. How many more people in this year are available for combat duty every day than there were 2 years ago because of the work of your office?

General HEATON. 1,480.

Mr. FORD. You do not have to figure it out here, but that is the way I think we have to take advantage in our day-to-day operations from the point of view of the field commanders.

General HEATON. Yes, sir.

Mr. FORD. It is fine for the people who are sick fewer days, et cetera, but we have to look at it from the other side as well. Let's work something else if you can, honestly and legitimately, that would be reflected in this way.

67438-61-pt. 2- 6

ARMY NONEFFECTIVE RATES, 1956-61

Mr. FLOOD. On those first charts you asked for, is it possible for you to obtain a like chart from the British and the French?

General HEATON. Yes, sir. We can go to the British Surgeon General and the French Surgeon General.

Mr. ANDREWS. Would you like those in the record?

Mr. FLOOD. Yes; along with the American figures.

Mr. ANDREWS. Without objection insert those in the record at this point.

(The information requested follows:)

For comparative purposes the U.S. Army noneffective rates excluding quarters cases (patients excused from duty but not hospitalized) are given below:

1956

1957

1958

11.7 1959
11.6 1960
10.5

10.2 10.1

The figures received pertaining to the French Army differ so greatly from the United States and British experience, being many times the United States and British rates, that it seems clear that some basic difference in method of computation exists. For this reason, we are unable to provide comparable noneffective rates for the French Army.

OPERATING AND OCCUPIED BEDS

Mr. FORD. Do you have any information about your percentage of hospital beds occupied? Didn't we get information like that in the past for the record?

Mr. FOGELBERG. Between 70 and 80 percent.

Mr. FORD. When we used to have panel hearings we would get into these details in greater depth. Let us go back and get some of those charts brought up to date, if you would, and insert it in the record. Mr. FOGELBERG. Yes, sir. I will be glad to, Mr. Ford.

(The information is as follows:)

Operating beds and occupied beds in U.S. Army hospitals in continental United

Average beds occupied by active-duty Army patients in all hospitals, worldwide