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ternal tissues of the eye, and it certainly affects the retina, causing night blindness. We know that the lack of some of the B vitamins will affect the tissues of the eye. Vitamin C will affect the tissues of the eye. Vitamin C, or ascorbic acid, seems important to the metabolism of the eye, but we lack fundamental knowledge; we lack knowledge of vitamin C or ascorbic acid. What is it doing to the fluid of the eye, or the lens? There seems to be some connection, but so far we are actually groping in the dark, even though we know a good deal about the eye. We know that there are certain conditions, particularly of the cornea, produced by nutritional deficiencies.
Mr. HESELTON. Do you know whether or not the Atomic Energy Commission in its medical section concerns itself with the problem of blindness?
Dr. FOOTE. I do know that the Atomic Energy Commission is concerned about cataracts caused by radiation. Cataracts can be caused by a great many things, and by some things we do not know about. A number of individuals have had cataracts caused by radiation in Hiroshima and Nagasaki and they have been studied by the Atomic Energy Commission, and they have sponsored some very basic research in this field. I do not know to what extent they are studying other problems in relation to the eye.
Mr. HESELTON. Were they successful at all in providing any kind of a successful treatment?
Dr. FOOTE. Well, the treatment for cataract is the removal of the lens, and that can be done regardless of the cause of the cataract; nevertheless, there are complications. I think that they have learned as a result of their research-and here again I am talking from memory-a good deal about the doses of radiation that will produce a cataract. I am not sure what practical significance can be attached to this, though, because those exposed to radiation in sufficient dosage will actually be killed very shortly. Among those who survived within a given area, I think in Hiroshima, over a 100 did develop cataracts. I think the problem on that point is to keep them from setting off such an explosion in the first place in this country.
Mr. PRIEST. I think perhaps my first question should go to Miss Gruber. I believe you mentioned the total of public funds spent last year was $148 million.
Miss GRUBER. Public and private.
Mr. PRIEST. How much was public?
Miss GRUBER. $98 million.
Mr. PRIEST. Does that include payments by Social Security?
Miss GRUBER. Yes.
Mr. PRIEST. Did it include vocational rehabilitation?
Miss GRUBER. Yes.
Mr. PRIEST. $98 million of public funds. Do you have that also broken down as to State and Federal?
Miss GRUBER. The separation between State and Federal?
Mr. PRIEST. Yes.
Miss GRUBER. That is a difficult thing to do.
Mr. PRIEST. It is matching.
Miss GRUBER. Yes.
Mr. PRIEST. I realize that.
Does that include payments for veterans?
Miss GRUBER. No. The blinded veterans represent one segment of the population not included, the blind population not included.
Mr. PRIEST. I was just thinking of the disparity in expenditure of public funds, $98 million in social security payments and other rehabilitation programs, which is not any too much, but compared to less than $500,000 for the fiscal year for research, it seems to me like we need to recognize the importance of putting a little more to that $500,000 for research rather than stacking it at the top end. That is not deploring the fact it is there, because I think it ought to be, and even that, I think, is not enough, but the wide gap between the two figures impresses me a great deal, and I think it should begin more and more to impress the Congress and the Appropriations Committee and the Bureau of the Budget and all others who are in any way responsible for this sort of program.
Mr. HESELTON. Just as a matter for the complete record, I believe there are some additional allowances on income tax in the case of blindness.
Miss GRUBER. Yes.
Mr. HESELTON. Also, there was a recent law permitting an exemption up to $50 a month on the earnings of the blind people. Miss GRUBER. Yes.
Mr. HESELTON. It is almost impossible to compute those.
Miss GRUBER. Mr. Walker has some figures to indicate the amount of money involved in the $600 exemption on the income tax.
Mr. WALKER. I think you will find that the Treasury Department estimates that on the number of blind people paying Federal income tax, allowing this deduction, the Federal Government loses approximately $300,000 in tax due to the exemption.
Mr. PRIEST. Would that be added to your figure, or is that included in your figure?
Mr. WALKER. That is not included in our figure because that is an amount that is not spent. It just is not collected, so to speak. It is a grant, so to speak, a privilege, or an extra exemption due to the extra cost incident to blindness. That figure was not included in the amount of public funds that we listed as being spent.
Mr. PRIEST. That figure was $300,000?
Mr. WALKER. That is the Treasury's estimate as of yesterday afternoon about 4:30.
Mr. PRIEST. I will not prolong the questioning any further. I want to say for the record that Mr. Walker, who has just given us this figure, is from my hometown. I have known him for a great many years. He has been very active in Nashville and in Tennessee and other places through the years for the blind, and I personally appreciate the contribution he has made and I know there are many, many citizens in his hometown that appreciate the very fine record he has made in the work he is doing. I want to say that publicly for the record at this time.
The CHAIRMAN. We appreciate what you have said, Mr. Priest. We have had the benefit of the attendance of Mr. Walker here today. I can understand when he gave figures that were as current as 4:30 yesterday afternoon why you are so meticulous and so helpful to the committee.
Miss Weisenfeld, we will be glad to hear from you at this time.
STATEMENT OF MISS MILDRED WEISENFELD, EXECUTIVE DIRECTOR OF THE NATIONAL COUNCIL TO COMBAT BLINDNESS, NEW YORK CITY
Miss WEISENFELD. I would very much like to speak personally for the point of view I represent here today, but unfortunately, because I have lost most of my vision, I am unable to read notes, and in trying to check my notes for this hearing I found that the points I wanted to make might be far too pertinent to produce from my memory. As I have written out a statement in a fashion as I would speak to you, I wonder if you would permit my secretary, Miss Kay, to read it to this committee for me.
The CHAIRMAN. Your statement will be made a part of the record. Miss Kay may read your statement.
(The statement was read, as follows:)
STATEMENT BY MILDRED WEISENFELD
Mr. Chairman and members of the committee, my name is Mildred Weisenfeld; my position, executive director of the National Council to Combat Blindness, Inc., 30 West 59th Street, New York City. I am a founder of that organization and have been serving in the capacity of its executive director since its inception in 1946.
The National Council to Combat Blindness was established for the purpose of stimulating and financing research into blinding eye diseases and visual deficiencies. It was conceived to meet the crying need for more adequate attention and support to ophthalmic research. The great emphasis prior to that time had been placed almost entirely on the rehabilitation of persons already blind. Until the council came on the scene no voluntary agency existed with the primary function of educating the public to the need and potential of research in the prevention of blindness and the awarding of research grants and fellowships to medical colleges and eye centers for that purpose, this, despite the fact that blindness was a growing menace in our Nation, that it had doubled in the last two decades, and that while $125 million was being devoted annually for the care of people after sight had been lost, in contrast to this but a meager $400,000 was being spent in the same period on medical research-research which could prevent this tragedy from striking.
Gentlemen, it may interest you to know that the National Council to Combat Blindness was founded by a handful of persons ourselves faced with either partial or total blindness. We had been through the frustrations, 100 times over, of seeking medical help only to find that science was not equipped with adequate knowledge to reverse our blindness or even halt its progress. In the pursuit of personal assistance we found that we were but a few of an army of countless thousands confronted with the same hopelessness. We were shocked to learn that our foremost medical colleges and institutions barely had funds available for research to explore the causes, the treatments, and the cures of blinding eye diseases. They needed desperately equipment, manpower, and material in order to go forward and wage an effective attack against blindness.
It was startling to learn the following facts: That 300,000 men, women, and children in these United States alone are totally blind; that 300,000 more have visual defects so serious as to create partial or almost total disability. Some of this number will maintain a glimmer of vision through life, but for many of this group the verdict of ultimate blindness has been passed by their doctors and they wait with dread as they gradually watch their sight fade. There are others, some of whom may be in this very room or who will be reading these very pages, who harbor one of the many eye conditions at present in an incipient stage, and who are yet unaware of the danger that threatens. In addition, statistics disclose that a million persons are blinded in one eye; that there are probably 800.000 with undetected glaucoma (a dread disease of the eye which can result in blindness), and that the estimated 2 million sufferers from diabetes whose lives have been prolonged because of the various insulins are now each potential candidates for a disabling eye disease.
We knew that this was a challenge that had to be met, and thus embarked on cur important mission, encouraged in our firm conviction of the urgency of our undertaking by authorities in the ophthalmic field.
However, despite the fact that the National Council to Combat Blindness has been carrying on its fight for sight unrelentingly for 7 years, aggressively pioneering the cause for more adequate support to eye research and availing itself of almost every media through which to bring its message to public attention, the response on the part of the public has been negligible and wanting. We have only begun to scratch the surface. Those of us who conceived the idea of a national organization which would devote itself to collecting funds and distributing these funds for medical research did not anticipate the arduous effort it would entail to arouse public interest in this field of scientific research. The amount of public education necessary to stimulate voluntary contributions to research in eye diseases is vast. It is almost unbelievable to find how ill-advised the public is generally with regard to blindness. It is the common conception that the affliction of blindness is inevitable, hopelessly incurable, and due primarily to hereditary factors or injuries; that the only answer to the problem lies in rehabilitation of the blind and sympathy for them. The facts are that only 19 percent of blindness is hereditary and accidental; that the major cause of blindness is eye disease; that blindness is not hopeless; that our leading scientists are convinced that as much as 70 percent of blindness could be prevented with more adequate facilities, manpower, and research activity. And yet estimates from authoritative sources tell us that we, as a Nation, now spend upward of $125 million annually on rehabilitation, care, and welfare aid for the blind and that the amount expended in the same period for fundamental and clinical research to prevent blindness stands today at but a single million. This in face of the fact that blindness is steadily on the increase. It is ironic that while scientific advances have prolonged our life span, those latter years are burdened and marred by the ogre of blindness. Another contributing factor in the mounting incidence of blindness is that disease which is taking the sight of so many infants born prematurely. Here, while scientists have made it possible for these infants to survive, they have not been able to rescue them from a new and terrible eye disease which dooms these infants to lives of darkness.
The statistic which has been used is that someone in these United States loses his sight every 20 minutes, thus claiming 30,000 new victims annually. However in reading the Congressional Record of the hearings of the subcommittee of the Committee on Appropriations of the House of Representatives, April 15, 1953, I was astounded by the statement made by Derrick T. Vail, M. D., an outstanding member in the eye field and editor of the American Journal of Opthalmology. I quote in part:
** it has been predicted that, by 1955, 132,500 American citizens will have become blind."
If I am interpreting this statement correctly, the annual incidence of blindness in our Nation will have again doubled by 1955. Certainly this is a grim prospect and a frightening one.
Let us disregard for just a brief moment the economic deprivations and social frustrations blindness inflicts on the individual and let us look at the situation coldly and practically from the taxpayers' point of view. For the fiscal year of 1951, the total amount of Federal, State, and local expenditures for aid to the blind is estimated at approximately $55,000,000; while in the fiscal year 1953 this estimate is approximately $64,000,000 (reference United States budget for fiscal year ending June 30, 1954)—this represents an increase of $9 million over a period of but 2 or 3 years, and does not include the lost revenue to our Federal Government resulting from the annual tax exemption of $600 to each blind individual. It is further estimated that the cost to educate and maintain one blind baby through its lifetime is $100,000. Multiply this by the estimated 4,000 new young victims of retrolental fibroplasia (the disease which causes blindness in premature infants), and the cost of seeing these infants through their lives reaches the staggering figure of $400 million. When one considers Dr. Vail's prediction of 132,500 additional blind by 1955, the potential burden on the taxpayer is appalling. Indeed, gentlemen, the penalty we would have to pay, both in human suffering and burdensome taxation, would only be consistent with the injustice we commit by our lack of support to ophthalmic research.
Gentlemen, as one representative of a group which has worked arduously and untiringly in the gathering of funds for eye research, I say to you today that the voluntary agency cannot alone meet the challenge of the research needs
in blinding eye diseases. The National Council to Combat Blindness, which is the agency primarily engaged in supporting such research, has over the past 4 years, in round figures, made grant-in-aid and fellowship awards totaling but $95,000. I refer you to the attached listings of these awards. I believe you will find these listings of interest upon examination, for it will reveal to you the meager sums which have been granted to some of the leading institutions of our land. I wish it had been practical for me to include with this statement the expressions of gratitude received by our organization from the recipient investigators and institutions for even this humble support, which does not begin to meet their requirements. It is a sad commentary and an injustice to the cause of eyesight when I must add to this statement that the $95,000 distributed by the council to the best of my knowledge, is the largest sum allocated in grants-in-aid and fellowship awards by any voluntary agency in this field. Our organization has had to deny in round figures $380,000 in requests for support which have reached us. These denied requests, however, hardly represent the need in the field since the very limited resources of the council are generally known to the profession, and scientists hesitate to file with the organization, knowing that their efforts to obtain meaningful support would of necessity have to fall by the wayside. For example, a survey undertaken by our organization, of 122 accredited medical colleges and eye centers in our Nation revealed that $61⁄2 million could be profitably employed in facilities, training, and teaching programs, and straight research. This need was based on the replies received from less than one-half of the institutions to which the questionnaire was sent.
The directors of the National Council to Combat Blindness recognized in 1949 the urgent need for Federal assistance to expedite a sound program in eye research, and consequently it was our agency which took the initiative in bringing this pressing need before Congress. I was privileged to appear as one of the witnesses representing the council before the subcommittee of the Committee on Interstate and Foreign Commerce to attest to the need for the establishment of the National Institute of Neurological Diseases and Blindness. On behalf of all these who have been associated with me in this work, both lay and professional, I want to take this opportunity to express profound gratitude to Congress for the establishment of this Institute which, despite the fact that it has operated on a budget far too small to meet the many and varied demands in the field of ophthalmic research, has nevertheless unlocked a door of opportunity to the scientist in the field of eye disease and stands as a symbol of new hope and promise to those faced with blindness.
Gentlemen, it is virtually impossible for me to convey to you fully the many hardships and difficulties encountered by a voluntary agency, committed to the pursuit of gathering funds for research to prevent blindness. It seems that the tangible aids, such as Braille books, Seeing Eye dogs, and other rehabilitation services to those already blind, have far more dramatic appeal to the "contributing public" than does the appeal for research funds to find the causes, the treatments, and the cures of blinding eye diseases. Thankfully, there are any number of agencies which care for people after blindness has struck, but do you not agree that the time is overdue when research to prevent this tragedy should receive at least equal attention? I feel confident that with unyielding perseverance, in time public recognition and support of this important branch of medical research will come. However, we must not wait for this public recognition; we cannot and dare not in view of the distressing facts and overwhelming need. Gentlemen, I cannot stress too strongly the inability of the voluntary agency at this stage to shoulder this grave responsibility singlehandedly.
I have had occasion recently to meet with the distinguished members of our scientific advisory board and can attest to their strong belief in the great potential that research holds for finding the solutions to the problems now producing blindness. I welcome this occasion to tell you of the enormous value they place on the contribution the National Institute of Neurological Diseases and Blindness has already made in stimulating research activity in this area of medical research by the financial assistance it has given to date. It is imperative that such support not be withdrawn. It must instead be increased. The research activity which it has inspired should not be inhibited. It must rather be encouraged, and extended. ACTH and cortisone is one demonstration of the miracle of research. In the September 1953 issue of Today's Health, an article appeared by Paul de Kruif, in which he discusses the amazing healing and curative effects resulting from research in these hormones.