of the men engaged in cancer research are doing their very level best right now, but the results are not forthcoming. We have therefore to look again at the whole extent of the problem, to decide what kind of war this is. If we attack the problem by sending repeated "punitive expeditions" into the cancer problem, we will get the same kind of prolonged warfare that we have had in our whole history with punitive expeditions they do not settle anything. This expedition into cancer is as much a challenge to science as the Nazi challenge was to the social sciences. If we had attacked the Nazi problem with a punitive expedition, we would have gotten nowheres. So large was our effort that the enormous research of the atomic bomb was only one phase of that warfare.

In attacking the cancer problem we are attacking a basic life problem. The result of that investigation will undoubtedly revolutionize our whole conception of medicine; it certainly will revolutionize physiology, it will revolutionize chemistry, it will revolutionize physics, it will revolutionize the whole system of training a man; and beyond that, it may even reach to the social sciences, because in the last issue of science was a plea from one of our leading scientific men, asking for scientific training of the character that produced the physicists who solved the atomic bomb, to come forward and solve the social-science problems, along lines of mathematics; so that if we are serious about attaining a solution to the cancer problem, we must lay down a strategy competent to solve it, and that strategy involve fundamentally the recruiting of perhaps 50,000 young men throughout the medical schools over a period of 10 years, who will be adequately trained to create an Army precisely the way we created an army to tackle the Nazi problem in social sciences. These men who have done the work up till today have to be retained as teachers, and young blood has to be developed, and we have to produce even a different type of man from the teachers we have today, because we have to produce men who are so well rounded that they can stand with their feet in biology, in medicine, in cemistry, and physics; but we haven't got those men today; but we have the teachers to make those men, and we have the young men who are anxious to become so well trained.

I spoke recently at the Bronx High School of Science to a graduating class. A number of those boys want to be doctors, and I outlined to them the broadening of medical education that is required; and the enthusiasm of some of those boys for a place where they can become expert physicists, biochemists, and physicians was exhilarating to see. This $100,000,000 donation to the cancer warfare is the first material step of any magnitude. It should be looked upon as the first step. I hope that it will be followed by a mustering of sufficient wealth and sufficient power, in brain power, to really wage an offensive war. Senator PEPPER. How much money, now, do you think we should

make available?

Dr. RUSKIN. You have now asked for $100,000,000.

Senator PEPPER. I would like everybody to consider that anything that is in this bill is in the nature of an original suggestion, so that you will feel perfectly free to suggest the alteration of any phase of it in any way that you think would be helpful. If $100,000,000 is made available and continued available-if that is not enough, or if it should be $100,000,000 a year, or if we should authorize $100,000,000,

and appropriate from time to time so much as the directive agency might say could be used properly, and so on, I want to know your individual idea as to how much money we should make available, how it should be made available-that is, in a lump sum or so much a year-and, in the third place, what should be the form of the agency, and the character of the agency that should direct this research.

Dr. RUSKIN. I would, to my mind, say that $100,000,000 a year would begin to approach the requirements, and there should be left open additional possibility for expansion of funds, just as a campaign in warfare is calculated to a certain number of men, and if something shows fruitful, to follow up that particular campaign. Now, you would need about $100,000,000 a year, at the first few years, practically, to broaden the basic science in medical teaching alone. You would require probably $10,000,000 for each of 10 of our major medical schools, to provide adequate facilities for training men in physics, chemistry, and biology, beyond the facilities at present available.

It should be looked upon also in the light of flood-control-that is, flood-control relief continues until the flood is stemmed, and the recent allocation of $300,000,000 for flood control certainly does not come so close to the people of this country as the requirements for cancer; so that I would consider $100,000,000 a fair beginning of a serious warfare.

Senator PEPPER. Then, what about the organization that should direct the research?

Dr. RUSKIN. I think the organization that should direct this research should follow pretty closely along the lines that we followed in fighting the Nazi social problem. That is, we had a standing army. We had an organization; and we have to use that organization, because that organization represents the keymen in the country today, who have their hand in it. Those are the generals who have been trained in organization; but they should make a radical step to markedly enlarge the whole organizational and scientific staff, so as to avoid trying to wage a great offensive warfare with the same small standing army that they had at the beginning. If they do, they are bound to run into difficulties.

Senator PEPPER. The Army was directed, at the top, by a civilian Commander in Chief; underneath him, the Joint Chiefs of Staff; then, the Chief of Staff of the Army; the Secretary of War, and so on; but you might say the President, the Joint Chiefs of Staff, and the Chief of Staff were the directing heads; and then the staff that the Chief of Staff recruited you might say was the way the Army was run. Now, how would you suggest that this great "Army" be run?

Dr. RUSKIN. I would suggest that the same system be followedthat the President be the Commander in Chief of this fund.

Senator PEPPER. Who would be the Chief Staff?

Dr. RUSKIN. And the Chief of Staff can be appointed by the President, either through the National Research Council, or through the Surgeon General, or through the newly appointed person to direct this.

Senator PEPPER. What is your own recommendation?

Dr. RUSKIN. My own recommendation is that as great latitude as possible be placed in the hands of the President, himself.

Senator PEPPER. Thank you very much, Dr. Ruskin. You certainly have a magnificent approach to the subject, and I thank you for coming here.

Dr. RUSKIN. Thank you for the privilege.

Senator PEPPER. Dr. Stanhope Bayne-Jones, director of the Jane Coffin Childs Memorial Fund for Medical Research, of New Haven.

STATEMENT BY DR. STANHOPE BAYNE-JONES, DIRECTOR, JANE COFFIN CHILDS MEMORIAL FUND FOR MEDICAL RESEARCH, NEW HAVEN, CONN.

Senator PEPPER. Doctor, as you heard me say, we are meeting earlier this morning than we had anticipated, and I do want to get the detailed statement you have. If you could summarize it and make such oral comment as you would like to make, if you feel you can cover the subject that way, and file your statement, without any injustice to you, we would be glad if you would do it; but we will allow ourselves to be governed entirely by your pleasure.

Dr. BAYNE-JONES. Thank you, sir. I have handed to the reporter a written statement.

Senator PEPPER. Fine.

(Dr. Bayne-Jones presented for the record the following statement :)

FORMAL STATEMENT OF STANHOPE BAYNE-JONES, M. D.

It was a pleasure to receive from Senator Pepper a telegram inviting me, as director of the board of scientific advisers of the Jane Coffin Childs Memorial Fund for Medical Research, to appear and to testify at this hearing on the cancer research bill, S. 1875, which he introduced in the Senate of the United States on February 27, 1946, and which is identical with the bill H. R. 4502, introduced in the House of Representatives by Mr. Neely on October 25, 1945. Since the winter of 1945, I have heard and read many discussions of the bill. It has been discussed at meetings of the board of scientific advisers and board of managers of the Jane Coffin Childs Memorial Fund for Medical Research. I am glad to have the opportunity of expressing my own views and some general opinions of the Jane Coffin Childs Memorial Fund for Medical Research on the question of the extensive support of cancer research by the Federal Government, as contemplated in this bill.

At the start I wish to make it plain that in presenting this statement I do so as a private citizen and as a representative of the Jane Coffin Childs Memorial Fund for Medical Research. Having been relieved from active duty in the Medical Corps of the Army of the United States on May 16, 1946, I am now on terminal leave as a brigadier general. I beg to have it understood that I am not speaking as an Army officer, and that my statement is in no way concerned or connected with War Department policy.

The Jane' Coffin Childs Memorial Fund for Medical Research was established at Yale University in June 1937 through deeds of gift from Mr. Starling W. Childs and Miss Alice S. Coffin as a memorial to the late Jane Coffin Childs. The purpose of the fund is primarily for medical research into the causes and origins and treatment of cancer. The deeds of gift provide also that in case the board of managers and the board of scientific advisers should decide at any time that the causes, origins, and treatment of cancer had been sufficiently determined, the fund, in accordance with specified procedures, could be devoted to research into some other unsolved problem of medicine or into some other field of science.

These broad purposes and this long and sound view of the future are set forth, with other historical and organizational material, in a pamphlet attached to this statement.

(The pamphlet referred to is entitled "The Jane Coffin Childs Memorial Fund for Medical Research, The Deed of Gift, Bylaws, and Other Official Documents. New Haven, Conn., 1938." It is placed on file with the clerk of the committee.)

I believe that the activities and experience of this fund in cancer research are pertinent to the discussion of this bill, S. 1875.

Since the summer of 1937 the fund has been in constant operation. It has functioned by making grants-in-aid to Yale University and to other institutions in this country and abroad for the support of work of experimental investigators. The fund's activities are not confined to Yale University. From the start the fund has taken the view that the problem of cancer is essentially a part of the broad problem of growth. The investigations it has supported have been both basic researches and specific researches on cancer. It has supported work on the characteristics of malignancy; in chemistry (including histochemistry, immunochemistry, and chemotherapy); in genetics; hormones; viruses, lymphoid tumors and leukemia; and work on gastric cancer. The fund has sponsored lectures and conferences, and contributes to the support of the journal, Cancer Research. The fund maintains a fellowship program along liberal lines. The grants of the fund have been made for periods from 1 to 3 years, with renewals which in some instances have provided continuous support for 10 years. Important scientific results have been produced from these investigations. From these and other investigations under other auspices during this period there has been a notable advance in the attack on problems of cancer. the causes, origins, and treatment of cancer remain to be determined.

But all

In dealing with the program of the fund, the board of scientific advisers and board of managers are constantly aware of the vastness and difficulties of the problems. These problems are administrative and economic as well as scientific. Coordination of research, while leaving a maximum degree of freedom to the investigator, is regarded as essential. This fund, however, has not coordinated its entire program, although there is more informal coordination than appears on the surface. There is little formal coordination between the activities of this fund and other agencies is the field, although there is a fair amount of exchange of information and some joint effort. Although the fund has supported certain projects continuously since its start, it has not and cannot provide life-tenure or assure long tenure for investigators in cancer. This is a characteristic of most of the agencies in the field. Careers in cancer research in this country, on the basis of assured long-term support. are rare. Provision for such careers is essential. Basic investigations of cancer start from, or lead to, dependence upon knowledge of the biochemistry, metabolism, and physiology of normal growth of animals, plants, and microorganisms, in which latter group one may provisionally include viruses, although viruses may be shown ultimately to be related to genes and enzymes. The investigator of cancer is constantly impeded by lack of knowledge of these normal processes. In 1942 more was known about the nucleus of the atom than is now known about the nucleus of the cell.

It is obvious that advance of knowledge in the basic field of normal growth will provide for advances in understanding of malignant growth and will yield knowledge that can be applied to the prevention and cure of cancer. The transfer of experimental results obtained in lower animals to conditions in human beings is extraordinarily difficult. This emphasizes constantly the urgent need of more basic study of cancer as it occurs naturally in man. This indicates that new fields of clinical cancer research must be opened up and developed if the problem is to be attacked where it is of gravest concern to mankind. These are vast problems. The experience of this fund indicates that very large, coordinated, and long-term support is needed to attack them. Private agencies have played a great role in all the advances in knowledge and power òver cancer thus far. They will continue to have a highly important function in our society. The problems, however, and the requirements for the attack on them transcend the capacities of existing private foundations. No one can predict when a brilliant discovery may be made or older knowledge newly interpreted under existing conditions. It is believed, however, that the Federal Government is the only agency large enough to finance and carry through this attack on the whole problem.

Since 1937 the Jane Coffin Childs Memorial Fund for Medical Research has appropriated approximately $940,000 for the support of cancer research. Of this amount, about $124.000 has been canceled or refunded for various reasons, leaving approximately $820,000 in actual use over this 9- to 10-year period. For the year 1945-46 the total appropriation, exclusive of administrative expense, was $148,593.68, and is approaching that figure for the year 1946-47.

Looking back to 1937 these sums seem relatively large. In 1937, when Fortune published its notable article on Cancer-The Great Darkness the total funds

estimated as being available for support of cancer research in any year were under a million dollars. In that year greater sums became available. This fund was established. The National Cancer Act was passed and the National Cancer Institute and National Advisory Cancer Council were established, with Federal appropriations. Money for cancer research has increased since then. It is impossible to say how much is available now for this purpose. Some have estimated the amount to be $1,500,000 a year from all sources in 1945. Since then the American Cancer Society, on recommendation of the Committee on Growth of the National Research Council has appropriated awards of $900,000 for research and has made grants-in-aid approaching that full sum. These are notable increases but are still thought to be far short of what is needed for "a supreme endeavor to discover means of curing and preventing cancer."

The reorganized American Cancer Society now exemplifies the support which the people of this country wish to give to cancer research, and the prevention of cancer and the care of the cancer patient, through investigation and through lay and professional education. It typifies a democratic popular movement of great significance to the people of the country who are faced with a disease now in second place as a killing disease, responsible for some 175,000 deaths a year and upward of 500,000 cases of cancer a year. The society's fight against cancer is becoming greatly strengthened by popular contributions and effective direction, The society's research program is planned with high intelligence and has brought to bear on the problems brilliant investigators and wise administrators through the committee on growth and its distinguished panels. As a member of its board of directors of the American Cancer Society and as a member of some of its committees I know of the society's discussions of the bill H. R. 4502 and the stand it has taken in endorsing the principles of the bill in making available Federal funds for the support of cancer research, under conditions which would still permit the activities of private and popular agencies in the field. The Jane Coffin Childs Fund for Medical Research agrees with these general principles. Obviously, careful study and consultation is needed on policy and organization of the enlarged Federal support of cancer proposed in S. 1875.

Speaking as an individual and with general agreement of the fund I repre sent, I wish to record the following comments and recommendations:

1. The Jane Coffin Childs Memorial Fund for Medical Research is in favor of the purposes and principles of S. 1875, and the appropriation of Federal funds for research on the causes, origins, treatment, and prevention of cancer.

2. The boards of the funds have not reached conclusions on recommendations for policies and details of organization and administration of Federal support of cancer research under this bill. Therefore, the following personal opinions are presented:

(a) That this type of Federal support of cancer research be organized and administered as a distinct agency.

(b) That the direction of the agency be under a commission of high-ranking scientists and laymen appointed by the President on the basis of their competence, and without regard to other agency, geographical, or political representation.

(c) That in the management of Federal support of cancer research under this bill, support be given to qualified public and private laboratories, hospitals, universities, and institutions engaged in cancer research.

(d) That sufficient funds be provided to erect, equip, and staff new laboratories and institutes for cancer research in several places in this country.

(e) That provision be made for wise coordination and direction of research, leaving maximum possible freedom to investigators and their institutions, and preserving and fostering freedom of exchange of information. This should include use of and cooperative relations with the best existing institutions, societies, and organizations concerned with cancer research.

(f) That provision be made for use of funds in a continuous long-term support of cancer research, providing for adequate salaries and tenure, sufficient to attract and hold the best men and women in the field, and with provision for training men and women for work in this field.

Dr. BAYNE-JONES. Senator Pepper, I am speaking, in part, as the director of the board of scientific advisers of the Jane Coffin Childs Memorial Fund for Medical Research, and, in part, as an individual, because there are many phases of this problem that our boards have not yet discussed.