Dr. WHITE. Man needs it more than woman-the help, I mean. Senator RANDOLPH. Of course, it has been said that man has sight and woman has insight, so there is a very significant difference.

Yes; there are some 3 million or more women of voting age than there are men of voting age in the United States. I had not thought to delve into that subject matter, but it is certainly very important.

Dr. White, you have spoken about the prevalence of certain types of diseases among certain peoples of the world. And I have noted your contrasts. I wonder if you will make available, for the record, or have those who accompany you in this cause supply the rate of mortality among the peoples of the earth, perhaps by countries. are constantly apprised of the serious situation in reference to diseases of the heart and cancer and other maladies by which men and women are afflicted; as we think in terms of international research in medicine, of the situation as it now exists in reference to the length of the life of the people in the various areas of the world, such information would be enlightening.

Dr. WHITE. That could be easily supplied.
Senator RANDOLPH. Thank you.

(The information referred to follows:)

Life expectancy at birth, selected countries (males)1

Life expectancy at birth, selected countries (females)1

The CHAIRMAN. Senator Williams.

Senator WILLIAMS. I just wondered what other international societies there are similar to the Cardiology Foundation, Doctor. Are there other societies?

Dr. WHITE. Oh, yes. There are many international societies. One of the oldest, that I visited many years ago, when I was starting my studies in Europe, in 1913, was the International Society of Physiology. The Russians were very important leaders off and on through those years. Pavlov was one of the leading physiologists. And, of course, he is a great hero in Soviet Russia today. And there are others, too. The International Society of Geographic Pathology, the International Society of Cancer. Each special field, now, has its international counterpart. And these it is important to recognize as private groups, which could be supplemented by these Institutes of Health in this country and through the public health activities of other countries. And I would like to add that when in Brussels we had this Congress last September, and we spoke of the advantages we had had in the last 10 years, both through Congress and the Public Health Service and privately, of linking the layman with the doctor in this campaign-this was new to the rest of the world. They are willing to accept it; but they want to know how best to do it. So this 10-year experience, which we had no realization about ourselves 10 years ago, when I came down first in 1948 to testify-I was a green

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horn, and a little loath to come to Washington. But the challenge was there, and it has, I must say, been a most gratifying experience.

But that is not true of most of the world, yet. So we have that help to afford them. And they want it, I am sure. In Australia I went from one city to another, and the mayor had a reception. And he would invite to this reception 50 prominent citizens in industry, in the professions, in the arts, in government, and so on, as well as scientists, to come to this reception. And then I would present our 10-year experience; it was actually easier to enlist the laymen than it was the doctors, but they also finally agreed that it would be a good idea. They have established this joint effort of laymen and doctors in initiating these programs, which I think will be extended all through the world.

Senator JAVITS. I just came in. I am terribly sorry to miss your testimony. If I ask something which has been testified to before, just tell me, and I will withdraw it.

But I wonder whether anyone questioned you about what I considered to be the very interesting discussions between our colleague, Senator Humphrey, and Khrushchev about this subject, and to what extent you thought this would allow of a contribution from the doctors and scientists with experience behind the Iron Curtain, and whether you thought from your experience they would cooperate or whether anything of value would be obtained, or whether this would facilitate it. Perhaps you will give us a brief statement of your opinion on that general subject.

Dr. WHITE. I was disappointed that there was not more information, at the time of Senator Humphrey's visit, about the fact that he went largely on a medical mission. Some of his conversation was on the medical cooperation between our countries, in the fields particularly of cancer and heart disease. A fair amount of the conversation had to do with that, but it was lost somewhere in the shuffle. Yet it is very encouraging to think that this was the point on which they both agreed wholeheartedly, so far as I have been able to find out. And I know the private physicians, that is, the doctors privately interested in the field of heart disease and other diseases, too, whom we met, either in Moscow or in this country, are really very anxious to cooperate with So if the Government will back them through this sort of an agreement, it will be extremely helpful.

Senator JAVITS. Have you been there yourself, in the Soviet Union? Dr. WHITE. I was there in 1956 with Dr. Rusk and others.

Senator JAVITS. We will have Dr. Rusk and will have a chance to question him; but I wonder whether you found that their-whatever you call it technically-their knowledge of the art, which is the best term I know for it-is of such a character that they could make a contribution to an international consortium of the great minds of the world on this subject.

Dr. WHITE. Oh, yes; a very able people, I am sure. And we feltand Dr. Rusk can add to this-that there was sincere effort in working with us among the doctors we met. They recognized that they had a lot to learn, as well as have we.

In 1950, they sent, as I said, no physicians to our congress, the first World Heart Congress, in Paris; none in 1950; and the statement was that they were not interested in the subject. But when I went there

in 1956, I made ward rounds at one of their big hospitals and found they had just as much heart disease as we have. Half of their cases in those medical wards were cardiovascular. And in 1958, 11 Soviet physicians came from Moscow to Brussels to attend the third congress. Senator JAVITS. So apparently Marx' doctrine has not lessened the tensions which produce heart disease.

Dr. WHITE. Well, I asked the question in the ward rounds. There was a woman with a peptic ulcer, and I stopped at each bed and examined any who had any heart disease. This woman was a secretary for Pravda. I asked this woman if her job had anything to do with her ulcer. Well, that broke the ice, because the whole ward roared with laughter. After that it was very nice.

Senator JAVITS. So you think we could get effective and useful cooperation, notwithstanding the cold war, in this medical area from Russia?

Dr. WHITE. It seems very probable.

Senator COOPER. The Soviets and the Chinese have laid great stress on their care of children. In your visits there, did you note any greater progress, progress on any greater scale, in the medical care of children?

Dr. WHITE. Greater than used to be there, without doubt.
Senator COOPER. Anything that compares with ours?

Dr. WHITE. I do not think so; but I think they have advanced a great deal, made great progress, so they are trying to catch up, and I believe that they are catching up, medically, in a rather few years, whereas we have been at it for a generation. But we have set the stage, you might say, for them, and they want very much to have the same standards in their work that we have.

Senator YARBOROUGH. Mr. Chairman, I have just one more question.

The CHAIRMAN. All right, sir.

Senator YARBOROUGH. Dr. White, the Nisei in California very generally are much taller in their second generations than their grandparents in Japan, often averaging an inch taller than any known ancestor in Japan. And in the southern part of Texas, our Latin citizens of Mexican descent have averaged out to something like an inch taller than any known ancestor in Mexico. Do you have an opinion as to whether that increased height of the second generation Americans of Japanese descent or of Mexican-Spanish descent is due to nutrition, or disease or absence of it, or other environmental factors, or a combination of them?

Dr. WHITE. That is a very important and interesting and intriguing question that has to be answered by further research; but it is true that in the animal kingdom, too, the smaller, apparently frailer individuals are more likely to live longer. So that overnutrition, which may have produced this increased stature, may not be wholly desirable; but we do not know yet. We perhaps are overnourishing our young. That is a very important study that will take years to find out.

The CHAIRMAN. Doctor, I realize you have to catch a plane. I do not want to delay you unduly. But let me ask you this question: You spoke of the joint effort of laymen and doctors that you have seen in these different organizations. You have also seen much joint

effort toward cooperation in these fields between Government and private organizations, have you not?

Dr. WHITE. Oh, yes; it has been wonderful. And the American Medical Association, I might add, was, I think, a little skeptical when I came down 10 years ago, down to Washington; but we have very good relations today.

The CHAIRMAN. That fear of government has rather been dissipated; has it not?

Dr. WHITE. Oh, yes, so far as I am concerned, and so far as I know. It has been a wonderful experience.

I appreciate this opportunity today, as well as in the past, to appear before you.

The CHAIRMAN. Doctor, in relation to the specific fields of research, you would also authorize the conduct of basic biological research; would you not?

Dr. WHITE. Oh, yes. The basic studies are just as important; so many people who are not making immediately practical application of research, but are working on techniques, chemical substances, and so forth internationally-that is also important.

The CHAIRMAN. Doctor, we are certainly very grateful to you for your presence here this morning. You and General Bradley both brought us very fine, challenging, and most helpful statements, and we are deeply grateful to you. We appreciate it very much.

If you or the general should have any further communications, we would be very happy to have them.

Dr. WHITE. Thank you.

(The prepared statement of Dr. Paul Dudley White follows:)

TESTIMONY BY DR. PAUL D. WHITE IN SUPPORT OF THE BILL TO ESTABLISH A NEW NATIONAL INSTITUTE FOR INTERNATIONAL MEDICAL RESEARCH IN THE U.S. PUBLIC HEALTH SERVICE

I am Dr. Paul Dudley White, of Boston and Harvard, past president of the American Heart Association and International Society of Cardiology, past executive director of the National Advisory Heart Council of the U.S. Public Health Service, and still active in the private practice of medicine, teaching, and research.

In the first place, I appreciate very much the opportunity to testify at this important hearing on the bill to establish a new National Institute for International Medical Research. I believe that I can testify most usefully by presenting my own experience in international medical activities since it is of this that I can speak with some authority. I hope that I shall not be regarded as either egotistical or egotistical in doing so. At the start I can say that one of the chief interests of my life has been in the field of international medical relationships and international medical research.

The year of 1913 to 1914 immediately prior to the First World War was my initiation into foreign medicine. I served at that time as an assistant in cardiovascular research to Thomas Lewis at the University College Hospital Medical School in London, Lewis was a pioneer in our newer knowledge of cardiovascular physiology and disease and for years after that initiation I continued to keep in touch with Lewis himself, with his own teacher, Sir James Mackenzie, and with medicine in Britain. Soon after that initiation in cardiovascular research came service as a medical officer in France, first with the British Expeditionary Force in 1916 and then with the American Expeditionary Force from 1917 to 1919. This afforded me an acquaintanceship with French medicine and physicians which has continued to date, as well as a reinforcement of my friendships with British cardiologists.

In 1919 a most fruitful experience as a member of the American Red Cross relief mission to eastern Macedonia and as an official visitor to the hospitals throughout Greece brought me into contact with the Greek medical profession