important contribution in this regard was the progressive legislation passed by the 85th Congress providing grants for the construction of facilities to conduct research into the causes of and possible cures for crippling and killing diseases. In addition to the need for medical research, there is an equally great need for more well-trained personnel in medicine, dentistry, nursing, medical technology, physical therapy, occupational therapy, medical social work, and other health fields. In order to meet the ever-increasing demand for such personnel one of the fundamental requirements is the improvement and expansion of the medical educational facilities of this country. The American Congress of Physical Medicine and Rehabilitation wishes to express its support of H. R. 6874 and H. R. 6875 introduced by Representatives Harris and Wolverton. The Harris and Wolverton bills' provisions for 5-year grants to assist in the construction of medical and dental educational and research facilities would provide another progressive contribution by the Congress for improving the health and welfare of the people. Consequently, the American Congress of Physical Medicine and Rehabilitation urges your committee to act favorably on this important legislation. Sincerely, GLENN GULLICKSON, Jr., M. D., Chairman, Committee on Legislation. ILLINOIS COLLEGE OF CHIROPODY AND FOOT SURGERY, Hon. JOHN BELL WILLIAMS, Chicago, Ill., April 22, 1958. Chairman, Health and Science Subcommittee, House Commerce Committee, House Office Building, Washington, D. C. DEAR SIR: I am dean of the Illinois College of Chiropody and Foot Surgery in Chicago and president of the American Association of Chiropody-Podiatry Colleges. The purpose of this writing is to indicate why we feel that our schools should be included in bills providing for means of expansion of research and teaching facilities in medical and dental schools. I refer specifically to the following bills: H. R. 6874, H. R. 6875, and H. R. 7841. I am presenting this information as president of the American Association of Chiropody-Podiatry Colleges. The profession of chiropody-podiatry has developed because of the demand for the care of the human foot. It does not have the history of having gone through a cult stage. Even though the profession functioned on more or less a superficial basis in its early history, it has always been considered a legitimate branch of the healing arts. Whereas 40 years ago the chiropodist-podiatrist offered primarily a palliative service, the profession has developed to the point where medical and surgical care is now provided. The official definition of the profession as adopted by the house of delegates of the American Podiatry Association reads, "ChiropodyPodiatry is that specialty of medical practice which includes the diagnosis and/or medical, surgical, mechanical, physical, and adjunctive treatment of the diseases, injuries, and defects of the human foot." We feel that the service of the chiropodist-podiatrist contributes much to the health and welfare of the Nation. About 80 percent of the population suffers from foot disabilities at a given time, and over the period of a lifetime almost 100 percent requires attention. Certain occupations require feet with 100 percent functional ability. Some industries provide chiropodical services for their employees. Defense services have provided billets for commissioned chiropodists. The care of children's feet presents a vital problem. More research is required in the prophylactic care of children's feet as well as in the rehabilitation of children who suffer from crippling diseases. The aged also present a problem which is well recognized by both our State and Federal Governments. It is well known that aging can frequently be postponed by the maintenance of adequate locomotion. Chiropody-podiatry is a profession as highly specialized as is dentistry in the field of health service. Chiropodists-podiatrists are licensed in all of the States and the District of Columbia to diagnose and treat the human foot. Currently there are about 8,000 chiropodists-podiatrists practicing in the United States. There are six colleges of chiropody-podiatry located as follows: California College of Chiropody, San Francisco, Calif. Chicago College of Chiropody and Pedic Surgery, Chicago, Ill. Ohio College of Chiropody, Cleveland, Ohio. Temple University, School of Chiropody, Philadelphia, Pa. The present enrollment in all colleges of chiropody-podiatry at the present time is about 635. It is anticipated that this enrollment will increase to about 1,000 by 1961. All of the colleges are incorporated not for profit and at least two have been in existence since 1912. The six colleges are accredited by the council on education of the American Podiatry Association. The Educational Directory, part 3, published by the Office of Education of the United States Department of Health, Education, and Welfare, lists the council on education as the accrediting agency and the six schools as institutions of higher education. All of the colleges have public clinics affiliated with them. Some of these clinics handle as many as 50,000 patient visits per year. During World War II these clinics were classed as essential to public health. None of the colleges have adequate resources for teaching and research. The primary source of income in all instances is from tuition fees and clinical service. Aside from these sources some support is available from alumni groups. The annual expenses of the colleges range between $50,000 and $150,000 per year. Each of the schools is dependent to a great extent upon free or virtually free faculty services offered by physicians and chiropodists of the community. On surveying the needs of the six colleges it appears that about $1,520,000 is necessary to expand the physical plants of all schools to the capacity they are capable of filling. About $470,000 is necessary to bring the physical plants up to desired standards currently. We feel that chiropody-podiatry offers a health service that is essential. Further research regarding the health of the human foot is imperative. The extent and quality of the health service offered by the chiropodist-podiatrist is limited only by lack of funds for teaching and research facilities. Respectfully submitted. DONALD V. ANDERSON, B. A., D. Sc., President, American Association of Chiropody-Podiatry Colleges. Hon. JOHN BELL WILLIAMS, AMERICAN HOSPITAL ASSOCIATION. WASHINGTON SERVICE BUREAU. Chairman, Subcommittee on Health and Science, House of Representatives, Washington, D. C. DEAR CHAIRMAN WILLIAMS: The hospitals of the country are greatly interested in the bills before your committee providing for Federal assistance in the construction of medical-school facilities. We wish to commend you and your committee for your deep concern in the provision of good medical care to the people of the country. Hospitals are an essential part of the education of physicians. They are the training centers for physicians, particularly following their completion of medical school, through internships, residencies, and various programs of postgraduate medical education. Hospitals provide the vital link between the medical school and the advanced preparation of physicians and, therefore, have a very direct interest both in the number and quality of physicians graduated from the medical schools. Moreover, hospitals as the hub of the practice of medical care are the means through which the advancements of medical science and research are brought to patients. The costs of medical education are great. In the case of medical schools, the cost is several times greater than the tuition charged. Many schools have assumed heavy financial burdens to educate the physicians of this Nation, and this burden has increased in the past decade. Medical science has opened up new horizons requiring substantial changes in the character and curriculum requisite to a modern medical education. New fields of knowledge have required new and additional research and laboratory facilities. Because so may of our medical schools are already bearing tremendous financial loads, they are unable to bear the additional costs of providing these new facilities. Today the physical plants of many medical schools are inadequate and outdated, and these schools lack funds to modernize their plants. The continued increase in our population, the growing proportion of the aged, the constant advances in medical science, and the gradual improvement in the methods of financing health care, are among the factors making for ever-increasing demands on the available supply of physicians. The education of physicians is a matter of national interest and concern. Physicians serve in many agencies of Government, particularly the Armed Forces, the Veterans' Administration, and the Public Health Service. Medical-school students come from every State in the Union and following graduation they start their practice in every State. Therefore, we believe the Federal Government has a direct concern with the needs of medical schools. We hope, therefore, that this committee and the Congress will take favorable action on legislation authorizing grants for medical-school facilities to assist in providing adequate numbers of well-trained physicians to serve the American people. Sincerely yours, KENNETH WILLIAMSON, Associate Director, American Hospital Association AMERICAN HOSPITAL ASSOCIATION, Hon. JOHN BELL WILLIAMS, WASHINGTON SERVICE BUREAU, Chairman, Subcommittee on Health and Science, Interstate and Foreign Commerce Committee, House of Representatives, Washington, D. C. DEAR CONGRESSMAN WILLIAMS: The American Hospital Association is vitally interested in the health research facilities program and its extension at this session of Congress for a further 3-year period together with an increase of $90 million in its authorization. Throughout the Second Annual Report of the Surgeon General of the Public Health Service, summarizing the activities of this program, are stated the kinds of health research facilities that are being helped. The list is most impressive. Not only has this program aided in the construction of new research facilities, but it has also made grants for equipment to institutions which had completed laboratories but lacked equipment. The test in evaluating each application has been whether the research contemplated in the applicant's facility could lead to better health for the American people. The extent of the need for additional health research facilities throughout the Nation is fully documented in this report. In brief, it reveals that as of midJanuary 1958, 364 applications requesting over $147 million have been filed. To this figure, on the basis of letters of intent, may be added 73 potential applicants asking for over $29 million. (See appendixes I and II, Surgeon General's Second Annual Report). Together, these figures total over $176 million, or almost 2 times the present authorization of $90 million. Worthy of note is the added fact that the project sponsors are meeting a far larger share of the total cost than the dollar-for-dollar matching requirement in the law. The urgency of need is best realized from the speed with which the program got underway. Within 66 days after this program came into being, the first 7 awards were made. In the 15 months following, 96 construction awards were made from 1957 fiscal funds. Of these, as of December 31, 1957, 9 projects had been completed; 20 were three-fourths or more completed; 19 were at least half completed; 18 were at least one-fourth completed; and the remaining 30 were under contract or in an advanced planning stage. As was evident in the enactment of this legislation, Congress had a real awareness of the Nation's needs for the improvement and expansion of facilities in which to conduct health research. All that was lacking were sufficient funds with which to meet such needs and in part these funds have, through the leadership of Congress, been provided through this program. The American Hospital Association is deeply concerned lest this Congress adjourn without extending the life of the health research facilities program. As we understand it, efforts to merge this eminently successful program with one to provide grants for the construction of medical and dental teaching facilities seem unsuccessful. We further understand this circumstance has been brought about because of unresolved difficulties concerning the latter. The American Hospital Association has supported a program of Federal grants for medical-school construction. We continue to do so. We believe a desirable and effective program can be worked out. As far as we know, no controversy exists concerning the health research facilities program. Consequently it would be unfortunate indeed in the best interest of the Nation's great need for health-research facilities to hamper the progress, if not endanger the life of this essential program because of the problems unresolved concerning Federal participation in the construction of medical and dental teaching facilities. We therefore respectfully urge your subcommittee to take whatever action may be necessary to extend the life and increase the authorization for the health research facilities program in this session. Sincerely yours, KENNETH WILLIAMSON, Associate Director, American Hospital Association. Hon. JOHN BELL WILLIAMS, CHICAGO ILL., May 7, 1958. Chairman, Health, Science Subcommittee, Interstate and Foreign Commerce Committee, United States House of Representatives, Washington, D. C.: National Society for Crippled Children and Adults, Inc. executive committee met April 26, approved endorsement of H. R. 11913. Requested that I advise you although too late for committee meeting. PAUL DIETRICH, President, National Society for Crippled Children and Adults, Inc. STATEMENT BY FREDERICK G. KILGOUR, LIBRARIAN, YALE MEDICAL LIBRARY, NEW HAVEN, CONN., FOR THE AMERICAN LIBRARY ASSOCIATION Mr. Chairman, gentlemen of the committee, my name is Frederick G. Kilgour. I am librarian of the Yale Medical Library and lecturer in the history of science in Yale University. The American Library Association has asked me to present to you its views on the bills now under consideration by your subcommittee to amend the Public Health Service Act to authorize grants for research and teaching facilities for existing and new medical, dental, and public-health schools. The association is deeply concerned with assuring increasing library contributions to the national welfare and security. Surely our resources in health contribute more to the national security and prosperity than do any other resource. The association believes that these bills will effectively stimulate the equipping and construction of health libraries as a section of health research and teaching facilities. Since the majority of libraries having a function of supplying information to health research programs also supply information for teaching programs, these amending bills will not only provide support and stimulation to teaching activities but will also increase the support of research over and above that made possible by the present Public Health Service Act. Libraries are a vital and integral part of health research and teaching activities. An investigator must have available to him an effective library so that he can keep abreast of new discoveries and developments in fields of interest to him. In developing a research program, he must also be able to find in a library whether or not something has been tried before, and if it has, whether or not it worked. Needless to say, health libraries used in this way obviate a tremendous amount of unnecessary expenditure of time and money by supplying information that prevents unnecessary duplication of research activities. Just as a library is an integral part of a research facility so is it essential for a teaching facility. The major function of an educational institution is to impart knowledge imaginatively. A library's principal aim is to make avail able to students knowledge that is useful to them. For a medical student, for instance, useful knowledge is that knowledge which will enable him to evolve new knowledge and to increase the effectiveness of the prevention and cure of disease. A health education institution without a library would be an ineffective school indeed. Education and research cannot be separated into two compartments. The research worker must continue to learn to keep abreast of developments in his field. Similarly many health teaching programs involve research activities. It might be possible to segregate research and educational use of a health library, but it would be ridiculous to do so for many reasons. Not the least of these reasons would be an enormous waste of money to duplicate facilities. One of the reasons that the American Library Association supports these amendments to the Public Health Service Act is that they make possible an efficient library facility which the present act, confined to research facilities, does not allow. The association, therefore, supports the intent of this present legislation and requests your committee, Mr. Chairman, to make a favorable report on these proposals to amend the Public Health Service Act. JOSEPH C. O'MAHONEY, CHEYENNE, Wyo., April 14, 1958. United States Senate Building, Washington, D. C. DEAR JOE: This past weekend I attended a conference and seminar in Denver, Colo., held by the podiatrists of the Western States. We were informed that there were three measures pending before Congress, H. R. 7841, H. R. 6874, H. R. 6875, these bills have to do with medical schools and it has been brought to our attention that the podiatry-chiropody professions have been excluded from these measures. We are sure that this is an oversight on the part of those responsible for this legislation. I am informed that members of the American Podiatry Association will appear at a hearing before the committee considering these three measures and I would like to request that you use your influence to see that the accredited colleges of our profession be included with the medical and dental schools. It is my understanding that these bills are up for a hearing on April 19. Would you be so kind as to inform me as to the progress of this legislation and anything that you can do in behalf of my profession will be greatly appreciated by the podiatrists of Wyoming. Thanking you in advance for your kind consideration in this matter as I know how busy you are, but this means a great deal to us, I remain, Gratefully yours, LOUIS A. CATELLIER, D. S. C. NEW YORK, N. Y., April 21, 1958. Hon. JOHN BELL WILLIAMS, Chairman, Health Science Subcommittee, Interstate and Foreign Commerce Committee, House of Representatives, Washington, D. C.: We urge your favorable consideration of H. R. 11913 to insure passage of the bill authorizing 3-year extension of research facilities construction program for medical schools. These construction funds are important to the success of our research program. SYLVIA LAWRY, Executive Director, National Multiple Sclerosis Society. Hon. JOHN BELL WILLIAMS, CLEVELAND, OHIO, April 22, 1958. Chairman, Health Science Subcommittee, Interstate and Foreign Commerce Committee, House of Representatives, Washington, D. C.: Having long been interested in the matter of health research facilities and especially interested in the sensory and blinding diseases field, we urge that H. R. 11913 be favorably considered. Because of inadequate existing facilities |