tion were made? These are some of the questions that occur to me as a layman in this field.

On the other hand, if we have to reconcile ourselves to living in the shadow of many of these major diseases for some time to come, the question that we would like to ask is how we can provide protection against the economic consequences of these diseases.

I could go on for quite some time giving you my thoughts on this subject of health on which I feel very strongly. However, time is short and we have arranged for a large number of witnesses to be heard.

The 15 days of hearings which we have scheduled so far are perhaps the equivalent of some 45 days of hearings while the Congress is in session. Now that the House is in recess, we will not be interrupted through floor calls or through conflicting committee meetings. Furthermore, we expect to hold hearings, mornings, afternoons, and if necessary during the evening. Therefore, we expect to do a great deal more work in 1 day than we would be able to do at times when the House is in session.

Before calling on the witnesses this morning, I want to express my appreciation for the splendid cooperation that we have received on the part of the men and women in the private and public organizations who have given so generously of their time in preparing for this inquiry and who are here today to participate in our hearings. Last but not least, I want to thank the members of this committee who have interrupted important duties in their own districts in order to attend our hearings this morning.

The hearing this morning relates to heart disease.

The committee has set aside today to inquire just where we are, where we are going, and what additional measures must be taken, particularly in the way of research, that will hasten relief from the burden of heart disease.

As husbands and fathers, individuals ourselves, we members of the committee have a deep personal interest, for we have seen heart disease strike among our families and friends.

As members of the committee itself, we are gravely concerned with heart disease because of the staggering number of our people whom it kills or incapacitates and because of our committee's responsibilities in the field of health.

In the matter of especial knowledge of heart disease, we are laymen. But we are keenly conscious of our legislative responsibilities for the Nation's health, and we want to search out the important facts about heart disease.

What is its true significance? What about the gloomy statistics? What is being done today? What is not being done that could be done? What are the prospects, not for the far-off future, but for the, immediate years ahead? What are the resources? What has been accomplished in the past few years?

Heart disease is like an enemy loose within our country. It seems timely, when we are attacked by this disease as never before, to present to the American public the facts, to inform them about the current efforts to control heart disease, and to learn what can be done to improve these efforts.

If we can find ways to strengthen the research attack on heart disease, we must do so. If we can curtail the economic losses to

families and to our whole economy, we must do so. If we can take measures to relieve more human suffering than at present, we must do so.

Judging by the response with which the announcement of this inquiry has been received by the agencies, both private and public, most active in the heart field, I am encouraged to believe that much has been done and can be done toward these aims.

This is the purpose of our hearing, and an outstanding group of individuals active in the heart field has come to assist in this inquiry. The committee has endeavored to provide a plan that will guide our discussion, which I will place in the record at this time for the benefit of those who read the testimony, together with a list of witnesses who are scheduled to appear.

(The matter referred to is as follows:)

HEART DISEASE

AGENDA

1. Purpose of the inquiry: Statement by committee chairman.

2. Where are we today with regard to heart disease compared to several years ago?

The significance of heart disease.

Rheumatic heart disease: what is is, its importance, what we know today in the way of prevention and treatment, where we stand in research, where we stand in application of knowledge.

High blood pressure and hypertensive heart disease: what it is, its importance, what we know today in the way of prevention and treatment, where we stand in research, where we stand in application of knowledge.

Hardening of the arteries and arteriosclerotic heart disease: what it is, its importance, what we know today in the way of prevention and treatment, where we stand in research, where we stand in application knowledge.

Other types of heart disease.

By private or voluntary organizations on the community, State, and funds are being employed in the attack on heart disease? What are the cooperative relationships? How is coordination achieved?

By private or voluntary organizations on the community, State, and
National levels.

By public agencies on the community, State, and National levels.

4. What are the goals, the weak spots, the obstacles to progress, the needs? In research.

In the application of knowledge.

5. What are recommendations for strengthening the nationwide attack on

heart disease?

In research.

In research facilities.

In research training.

In medical education and teaching and training.

In community services.

In public education.

PARTICIPANTS

Dr. Irving S. Wright, past president, American Heart Association; professor of clinical, medicine, Cornell University Medical School.

Dr. T. Duckett Jones, medical director, Helen Hay Whitney Foundation, New York City.

Dr. Robert W. Wilkins, vice president, American Heart Association.

Dr. E. Cowles Andrus, Johns Hopkins University, president-elect, American Heart Association.

Dr. Edward J. McCormick, Toledo, Ohio; president, American Medical Association.

Dr. James Watt, director, National Heart Institute.

Dr. Robert W. Berliner, chairman, committee of laboratory chiefs, National Heart Institute.

R. O. Betts, executive director, American Heart Association.

Dr. Jean Jones Perdue, member, board of directors, Miami Heart Institute, and practicing physician.

The CHAIRMAN. You gentlemen, and our distinguished lady, have already been supplied with a copy of this guide, so to speak, and we assume that your testimony will have regard to it.

The committee is honored to have with us this morning representatives of the American Heart Association, the National Heart Institute, the American Medical Association, and other outstanding authorities in heart diseases.

Dr. Irving Wright, of the Cornell Medical School, and former president of the American Heart Association, we are honored to have with us this morning. I understand that he and his associates in the American Heart Association and colleagues of the National Heart Institute are prepared to assist the committee in evaluating the problems this disease presents to the American people.

Doctor, I want you to proceed at this point, to take over as it were. In the past the usual procedure of this congressional committee has been for the chairman to call the different witnesses who are to appear. However, for the purpose of these hearings we have adopted a different course. Dr. Wright has been selected by those who are interested in this subject to act, so to speak, as the leader of the discussion. The discussion will, therefore, naturally, take on something of the appearance of a symposium.

We hope in this way to make it extremely informative and informal and to gain the greatest possible amount of information. We want Dr. Wright to proceed just as he sees fit.

I would suggest that Dr. Wright introduce those who are present and who will testify in the hearing.

For the assistance of the reporter we have asked the different doctors to have their names prominently displayed upon their person so that the reporter may know who is speaking.

I have some doubt, however, as I look at your tagging, about whether it will be possible for him to read their names.

The reporter shakes his head in accordance with the statement I am making. Therefore, I would suggest, as an assistance to him, and in order that the record may be complete, that when a doctor speaks either in answer to a question by Dr. Wright or by anyone else or makes any statement that he preface it with giving his name, and in the first instance when you speak not only give his name, but give his identity with the heart activity and where he is located so that his testimony will take on added significance and importance because of the position that he occupies in this regard.

Now, Dr. Wright, will you please proceed. Before you do so I will ask the members of the committee if they have any comments that they wish to make at this time or suggestions. If not, then, Dr. Wright, will you take over?

Dr. WRIGHT. Thank you, sir.

I wish, first of all, to express the grateful appreciation of the representatives of the American Heart Association, the National Heart Institute, and others who are here to contribute to this symposium

testimony, for your generosity in inviting us and also for the very splendid manner in which you have proposed that we may proceed. I think and hope that we will be able to make a real contribution. I know that the members who are here assembled have come sometimes at some inconvenience because of the great importance of the problem as you have outlined it.

I am going to ask each of them—-may they stand when they identify themselves so that everyone can see who they are?

The CHAIRMAN. I think that would be well, and before you proceed may I read a letter which has just come to my attention from Oveta Culp Hobby, who is Secretary of the Department of Health, Education and Welfare, dated September 30:

DEAR MR. WOLVERTON: Your September 18 letter, informing me of the committee hearings scheduled to begin October 1, and inviting me to send a special representative of my office to attend the hearings, is much appreciated.

The Assistant Secretary of the Department, Mr. Russell Larmon, responsible for legislation and congressional relations, is asking Mr. Donald Counihan, congressional liaison officer, to maintain continuing contact with the committee. In addition, Dr. Chester S. Keefer, Special Assistant to the Secretary for Health and Medical Affairs or his assistant, Mr. M. Allen Pond, plans to attend some of the committee hearings.

If through Mr. Counihan's services or in any other manner we can be helpful to you and the members of your committee and its staff, I hope you will let us know.

Sincerely yours,

OVETA CULP HOBBY, Secretary.

That leads me to inquire whether there are other representatives of the departments of government present today who would like to have their names made a part of the record.

I have the names presented to me of the following:

Dr. R. Keith Cannan, Division of Medical Sciences, National Research Council, Washington, D. C.; Dr. Stella L. Deignan, BioSciences Information Exchange, National Research Council, Washington, D. C.; Dr. Philip S. Owen, Division of Medical Sciences, National Research Council, Washington, D. C.; Dr. D. E. Price, Assistant Surgeon General, Public Health Service, Washington, D. C.; Dr. H. Burr Steinbach, Assistant Director for Biological and Medical Sciences, National Science Foundation, Washington, D. C., and Dr. C. J. Van Slyke, Associate Director, National Institutes of Health, Washington, D. C.

Now, if there are any others present than those whose names I have read I will be pleased to have you stand and identify yourself and give your name and position so that it may be made a part of the record.

Very well, Dr. Wright, you may now proceed in your own way. Dr. WRIGHT. I am going to ask Dr. T. D. Jones to stand first and identify himself.

Dr. JONES. I am Dr. T. Duckett Jones, vice president and medical director of the Helen Hay Whitney Foundation, vice president of the American Heart Association and a member of the advisory committee of the National Heart Institute called the National Advisory Heart Council.

Dr. WRIGHT. Dr. Perdue.

Dr. PERDUE. I am Dr. Jean Jones Perdue, of Miami Beach, Fla., a member of the board of directors of the Miami Heart Institute, a

member of the board of directors of the Miami Heart Association and a practicing physician in Miami Beach, Fla.

Dr. WRIGHT. Dr. Yeager.

Dr. YEAGER. Dr. J. F. Yeager, Chief of the Grants and Training Branch of the National Heart Institute located out at Bethesda, Md. Dr. WRIGHT. Dr. Berliner.

Dr. BERLINER. Dr. Robert W. Berliner, chairman of the Committee of Laboratory Chiefs of the National Heart Institute.

Dr. WRIGHT. Dr. Robert Wilkins.

Dr. WILKINS. Dr. Robert W. Wilkins, associate professor of medicine, Boston University School of Medicine, director of the cardiovascular research laboratories at the Evans Memorial Hospital, Boston, and vice president of the American Heart Association. Dr. WRIGHT. Dr. Andrus.

Dr. ANDRUS. Dr. E. Cowles Andrus. I am president-elect of the American Heart Association, associate professor of medicine, Johns Hopkins University, and physician in charge of the adult cardiac clinic at Johns Hopkins Hospital.

Dr. WRIGHT. Dr. Watt.

Dr. Watt. Dr. James Watt, director of the National Heart Institute, Bethesda.

Dr. WRIGHT. These individuals will speak on matters of policy in reference to the organizations which they represent and on matters concerned with research or medical opinions. They will be asked to speak as private individuals.

The CHAIRMAN. I would like to also make mention of the fact that the following members of the committee staff are present:

Dr. Stevenson, Dr. Stockburger, Dr. Borchardt, and our special counsel, Mr. John B. Teeter, executive director of the Damon Runyon Cancer Fund, who has assisted us in bringing together this symposium.

Dr. WRIGHT. Before I proceed I should like to ask whether there are individuals who have been asked to testify who have not identified themselves thus far?

STATEMENT OF DR. IRVING S. WRIGHT, PAST PRESIDENT OF THE AMERICAN HEART ASSOCIATION AND PROFESSOR OF CLINICAL MEDICINE AT THE CORNELL UNIVERSITY MEDICAL SCHOOL

I should first like to make a statement regarding the significance of heart disease as it affects the American people. Perhaps we should preface this by pointing out that heart disease is not a single disease, but it is a term which is commonly used to include many diseases, some of which I will mention.

Of these the three outstanding causes of death and prolonged illness are arteriosclerotic heart disease, hypertensive heart disease, and rheumatic heart disease.

Id addition, howover, there is a long list of other diseases which are capable of affecting the heart and the blood vessels in the body, and we include in this problem all of the blood vessels from the head to the toe, so to speak. These other diseases include problems of congenital defects either of the heart or of the blood vessels, syphilis, diphtheria, viruses, pulmonary diseases which secondarily put strain on the heart and affect the heart, tuberculosis, diabetes, excessive activ