Senator HRUSKA. May I ask the witness: Are you familiar with this speech? Did you ever read it?

Dr. HUSSEY. No, sir; I have not. This is the first I have heard of it.

Senator HRUSKA. Have you ever heard of it before now

Dr. HUSSEY. No, sir.

Mr. FLURRY. I would like to quote from the bottom of page 71, in Dr. Lull's address:

The consideration of advertising has been taken out of the jurisdiction of the council. Advertising in AMA publications is in the hands of an advertising committee. No consideration of advertising elsewhere is being undertaken. The former official rules of the council have been superseded entirely and without wishing to bore you, I would like to read what are called the new principles and not rules.

And then he sets forth the new principles and not rules.

Was there any effect of this change, in taking advertising out of the jurisdiction of the council and placing it in the hands of an advertising committee, on the amount of revenues received by AMA from advertising?

Dr. HUSSEY. I would like Dr. Howard to answer your question. Dr. HOWARD. I will start by saying this:

That the American Medical Association traditionally today and throughout its history has had the most rigid advertising acceptance standards of any medical, scientific journal in this country.

This is true today; it was true in 1955 and in 1950. I have been with the association for 13 years. I have some familiarity. I am about to put into the record certain standards so that the record will be perfectly clear. The fact is that the council on drugs had a considerable relationship to the acceptance of specific advertising copy, and its relationship to that was reduced, not eliminated, but reduced, in order to improve the council on drugs program.

It was felt strongly by the board of trustees at that time, as well as Dr. Lull and myself, that the council on drugs was dedicating its efforts to too great a degree to one subject; advertising copy and its acceptability, and to too little an extent to the overall, broader question of developing a sound, good program of drug education for the entire profession, and of publishing expeditiously and early through our scientific journals complete information on new drugs as they appeared and as soon as they appeared.

In other words, we felt then the emphasis of the council was circumscribed to the consideration of advertising copy. I think the council since has agreed, although there was some adverse reaction from the council in 1954 and 1955 as its program was going through this transition, to the idea of being dedicated to a broader program of educational information, and the production of appropriate articles from the Journal.

May I put into the record at this point, Mr. Chairman, the present principles governing advertising in the AMA scientific publications, if it is not already in the record.

Senator KEFAUVER. That will be made exhibit 4. Do you have copies of it? We would like to see copies now, if you have them. (Exhibit 4 may be found on p. 95.)

73753 0-61-pt. 1- -7

Dr. HOWARD. I can give you this more here.

copy now. I think we have a few

Senator KEFAUVER. The point is to understand the time element; in 1905 the council on pharmacy and chemistry, later called the council on drugs, was established, and no advertising went into the J.A.M.A., the Journal of the American Medical Association, in connection with advertising of drugs unless it was reviewed and approved by the council.

In 1954 or 1955, advertising was taken substantially out of the council's hands and placed with an internal committee. What is that committee called?

Dr. HOWARD. At that time it was called the committee on advertising. At the present time it is the advertising evaluation department.

Senator KEFAUVER. Who is the head of this committee on advertising?

Dr. HOWARD. There is no committee on advertising today. The staff member who is in charge of what we call the advertising evaluation department is Dr. John Ballin, a pharmacologist. He works under the supervision of Dr. John Youmans, who is director of the division of scientific activities. He recently received the top citation of the U.S. Army for his work as Director of Research in the Surgeon General's Office.

Senator KEFAUVER. Who is the immediate head?

Dr. HOWARD. I beg your pardon?

Senator KEFAUVER. Who is the immediate head of the staff that has to deal with advertising since the council was

Dr. HOWARD. Dr. John Ballin is the present head of the advertising evaluation department.

Senator KEFAUVER. He is a pharmacologist?

Dr. HOWARD. He is a Ph. D. pharmacologist.
Senator KEFAUVER. Not a physician?

Dr. HOWARD. That is correct.

Senator KEFAUVER. And Dr. Youmans is just a staff supervisor? Dr. HOWARD. He is the director of the division of scientific activity of which this activity is a part.

Senator KEFAUVER. Is he an M.D.?

Dr. HOWARD. He is an M.D., one of the world's foremost nutritionists.

Senator KEFAUVER. So the council of drugs, which formerly passed on advertising, has been removed from the picture, and it has been placed in the hands of

Dr. HOWARD. No, sir.

Senator KEFAUVER (continuing). The hands of the staff, is that correct?

Dr. HOWARD. No, sir; that is not true. The council on drugs has a most intimate relationship to our principles and to our activities in connection with the accepting of advertising policy in our entire advertising program. As I have already said, our present policies, as they have been developed, are the most rigid known in this country; approximately 85 percent, I believe and I would have to check this figure with our people who deal with this every day-approximately

85 percent of all advertisements submitted are rejected; as a matter of fact, for general and other scientific publications.

I would say this clearly for the record: That the advertising policies pursued by the staff with the 200 or 300 consultants who are used is more liberal in relation to the acceptance of certain mixtures than would be true if the council on drugs were given total and final authority.

The council on drugs, as a whole, disagrees with the acceptance by the AMA of certain advertising copy in the mixture field, and the board of trustees and Dr. Hussey may wish to comment on this. The board of trustees recently has had conversations with the council on drugs with respect to this single item of controversy and question within the association.

As a matter of fact, the board of trustees took an action recently, as requested by the council on drugs, that there shall be a gradual elimination from all scientific advertising in our journals of mixtures except for certain mixtures in the ointment and other fields that are appropriate; that there will be a gradual elimination over the next 2 or 3 years as our drug information program is expanded concurrently of certain mixtures to which the council on drugs has traditionally, and today, objected.

Senator KEFAUVER. The council on drugs was more strict on what kind of advertising can be in the J.A.M.A. than the committee that you have set up, and the council on drugs had authority to approve or reject specific ads. That has been changed?

Dr. HOWARD. The council on drugs, sir, is a powerful council within the American Medical Association, and if it disagrees with the adver tising practices that are carried on by the staff, it has every authority to go directly to the board of trustees, of which it is an advisory committee, and protest.

As I have said, to be completely candid about this whole program, the council on drugs has protested the acceptance of certain ads, particularly of the mixture type. The board of trustees recently has reacted to the specific recommendations of the council on drugs that our advertising standards, already the most rigid in the Nation, be made even more rigid with respect to mixtures.

Senator KEFAUVER. The point I am trying to get at is that prior to 1955 the say-so and the final authority was in the council on drugs. They may have some advisory capacity at the present time, but their passing on it and having the final say-so has now been taken out of their hands.

Dr. HOWARD. That is not true, sir. Dr. Ballin, in carrying on its activities under the staff supervision of Dr. Youmans, is constantly, daily, cognizant of the opinions of the council on drugs; is continuously checking with Dr. Spring, who acts in the same division of scientific activities as the secretary of the council on drugs.

The two of them frequently look at advertising copy to make certain that it is acceptable to the council on drugs. They exercise a continuing effect and impact on what we do with respect to advertising copy because we are aware of the fact that if we accept certain advertising copy to which the council on drugs objects, it will make its feelings known, and very strongly.

I repeat: We know that the council on drugs-it has made its statements clear and its recommendations to the board-disagrees with the acceptance of certain mixtures in the scientific journals of the association, and that recommendation has been received by the board and acted upon-as a matter of fact, last month.

Senator HRUSKA. Dr. Howard, what is the basis for your policy? Do you have a statement of principles or a statement of standards? Dr. HOWARD. Yes, sir. There it is, right there.

Senator HRUSKA. Mr. Chairman, did I understand that was to be printed in the record?

Senator KEFAUVER. That has been made exhibit 4 to the record. Senator HRUSKA. Will it be printed in the record at this point? I believe it ought to be. In that way it will be intelligible to any reader or anyone who wants to analyze the record.

Senator KEFAUVER. Very well, we will direct that it be printed at this point.

(Exhibit 4 follows:)