rate. Next to the veterinarian are the male members of farm families, dairy families The female members and children, who are drinking the same milk, many times raw, do not have anything like the infection rate that the male members of the household have that are in contact with the cattle. Mr. FOGARTY. Do you have any idea of the number of deaths that occurred in the calendar year 1950 due to that? Dr. ANDREWS. No, sir; but we can supply those data for you. (The information requested is as follows:) The most recent available information on deaths from brucellosis is as follows: Mr. FOGARTY. You say in the justifications: Treatment of viral and rickettsial infections by specific drugs required accurate diagnosis. Therefore practicing physicians are utilizing, through the State laboratories, this type of laboratory service more than ever before. So this service has been developed by you, but is available throughout the country to all physicians. Dr. ANDREWS. It is available to physicians through State laboratories. We do not like to deal with the physicians directly because we want to be sure the State laboratories themselves are in position to render this service, if possible. Mr. FOGARTY. Do they render that service to local physicians? Dr. ANDREWS. They do. And if they cannot, then they refer it to us and we refer the reports back through the State health laboratories so that they are informed. POLIOMYELITIS Mr. FOGARTY. What is the biggest problem you are faced with at the present time? Dr. ANDREWS. I would say it is probably poliomyelitis, in the mind of the public at least. That is the most important communicable disease problem right now. It strikes terror in the hearts of the parents from one end of this Nation to the other. The actual number of deaths caused by it are not as considerable as by other diseases, but the crippling and deformity of children is something that makes a big appeal to us for the parents. Mr. FOGARTY. Is multiple sclerosis a communicable disease? Mr. FOGARTY. You do not know whether it is or not, do you? Dr. ANDREWs. That is right. Mr. FOGARTY. Are there any further questions? Mr. SCHWABE. But you do consider poliomyelitis, commonly known as polio, do you not, as a communicable disease? Dr. ANDREWS. There is no doubt about that, sir. It is transmitted experimentally from person to person or from a person to certain animals. Mr. SCHWABE. And the treatment, of course, is generally recognized as isolation and is considered important on that account? Dr. ANDREWS. In stages of it; that is right. Mr. SCHWABE. So far as the cause of the disease is concerned, other than the communicability of it, there is very little known; is that not true? Dr. ANDREWS. It is known that different strains of the virus have different clinical characteristics, different immunological characteristics. That much is known. And there have been some measurements of particle sizes, the size of the particles of virus. But as to the most important methods of communication of disease from one individual to another, and as to what measures can best be taken to prevent that spread, we are still working on that. Mr. SCHWABE. And very much in the dark, so far, are you not? Dr. ANDREWS. Not as much as we were. Mr. SCHWABE. It is no respecter of persons, is it? Dr. ANDREWS. No. Mr. SCHWABE. Apparently it is no respecter of persons in various stages of life. Dr. ANDREWS. That is true. Mr. SCHWABE. And the poor and the rich and the humble and those who live in luxury and affluence seem to contact it almost as readily as the others. Dr. ANDREWs. Fully as much so. Mr. SCHWABE. And just why that is we do not know; is that right? Dr. ANDREWs. That is true. IMPORTANCE OF PUBLIC HEALTH TO THE EMERGENCY Mr. FOGARTY. Do you feel, Doctor, that your work in the field of public health is just as important, or more important, in view of the emergency that we might be facing? Dr. ANDREWS. I think it will get progressively more important with the urgencies of the emergency. The urgency of saving physical effectiveness, to me, is of prime concern, not only to the producers of the Nation, but to the medical attendants of the Nation. I am referring to the unnecessary use of doctors and nurses and pharmacists and such people and their facilities in cases of disease, which can be prevented. It is much cheaper in the long run to prevent them than it is to take care of them after they are caused. We are having these shortages which are demanding more and more skills. It seems to me that the sensible thing to do is to redouble, if anything, our preventive efforts now in order to save more of these other skills and liberate them for other purposes. FEDERAL FUNDS FOR RESEARCH Mr. FOGARTY. I agree with you a hundred percent. But there are some people that do not believe in the expenditure of Federal funds for research. In fact, they claim nothing has ever been accomplished by any Federal funds that have been appropriated. Dr. ANDREWS. I think there has been eloquent testimony by Dr. Scheele on that. Mr. FOGARTY. I know. But there are still some that contend it is just like throwing money away. Dr. SCHEELE. Mr. Chairman, if I may add one word of explanation, in the range of research that has to be done, there are methods that have to be taken into consideration in these fundamental problems. Very often these people attack the programs saying that they only give employment to people. What they want is not a research program on poliomyelitis for 1 year or 10 years, or 20 years, but to see a solution of the polio problem. I think it is that which makes them skeptical of spending research money. It is because it is money spent and yet we do not know the answers. Yet the fact is-and folks outside say it—that we are getting more knowledge faster through the range of the millions and trillions of medical problems that exist than we ever had in the history of our country or the world before. We are getting results faster; we are beginning to make a greater impact on more diseases more quickly now than we ever did before. But we still have great dark areas, great gaps, and in some instances we are closing in many little fundamentals and pieces of this tremendous puzzle, but still we do not have that final crucial one within our grasp. CONTROL OF SOME DISEASES Mr. FOGARTY. But in the field of typhus and yellow fever and malaria and smallpox, you have conquered those fields, have you not? Dr. SCHEELE. Pretty well. Mr. FOGARTY. You are able to control them and, in many cases, prevent them. Dr. SCHEELE. That is correct. Mr. FOGARTY. That was accomplished through research, was it not? Dr. SCHEELE. In some of these cases we have not eradicated them forever, so to speak. In other words, if we slow down our approach in our areas that would potentially breed mosquitoes, for instance, our use of DDT and that sort of thing, we might find these things coming back. We also have another problem which worries us a great deal. We have discovered that the housefly tends to become rather immune to DDT. At least, something is happening there in some instances and it can happen that an area not affected today can be affected later. So we necessarily cannot be complacent and say that DDT is the answer to all of our problems and we can rest on our laurels now and stop. We have to keep looking for betterments; keep studying problems. Mr. FOGARTY. Then there are sometimes some side effects that develop from some of these new things such as DDT; is that not so? Dr. SCHEELE. Sometimes we start using these things and we have no tangible evidence of their harmful effects and we later awaken to the fact that we have been having some very slow effects from things we have been using. In that case one might ask why we ever started using it. Unfortunately, when one discovers a thing as wonderful as DDT, unless it is openly bad, we just cannot afford not to use it since it becomes such a vital thing in our farming and agricultural program and in control of these diseases. You just have to use it and find safeguards and improvements. Mr. BUSBEY. A good illustration of that, Doctor, would be, I think, in your research on arthritis, would it not? When they first brought out this ACTH we only found out through experience that originally they had been giving it in too large a dose and cutting down the dose resulted in more effective treatment. Dr. SCHEELE. Yes, sir. We still are not really sure as to what the long-range effects of even that low a dosage will finally be. Mr. FOGARTY. If there is nothing further for the record, the committee will be in recess until tomorrow morning. THURSDAY, FEBRUARY 22, 1951. VENEREAL DISEASES WITNESSES DR. T. J. BAUER, CHIEF, DIVISION OF VENEREAL DISEASES A. ELLIOTT THOMPSON, BUDGET AND FISCAL OFFICER, BUREAU OF STATE SERVICES DR. LEONARD A. SCHEELE, SURGEON GENERAL M. A. STEPHENS, BUDGET OFFICER, FEDERAL SECURITY AGENCY |