STANHOPE :3AYNE-J'ONES k�t "· . ·�� final, edited transcripte of tape recorded talks wit}y arlan Be Phill ps Volume II l .. 363 National Library of Medicine Bethesda, Mar;rland 1967 l We 1 v.!.fa~~d.z_talked about the PilR~S,a wha~ ~•ve_l_!.u~d,a, ~ t should set s2inni!!_g the year_s--wel;l,,.t,, tq,e jumpin,g j_~cks years, the year_s of go:I;,~~ house to house and the ciz:_cUI11stances which gave ~s_!.,_to thato Fr~at I ~ seen in the papers, it has had a shaQi3 .eJ.fect on nu, an<;!.!..t~ink agz illumif!8t1on ,lO__!! can give ~hat Qeriod will~1e_lpful t.~ a biograeher~ ~~_r~searcher:s who wantf to understand _xou bett,!'.Z:_because .zou're here to hele exp~ain_it. If zou'lLtake !e back to those years--house to house to house and the circumstances which gave rise to thato I'm not sure that I can do it chronologically straight-unless you tell me from your search on this where I went after my father's death and the seque~ce from then on. Does~t matter? No-except that I think you began this proces~ in the home of Dr. Jos~h Jones, Yes 0 Well, I have very faint recollections of that, except that while I was in the house, I used to be in and out of his office which was an annex built on the sde of the house and in which he saw patients. I would help him some time there. I would answer the door> sick people coming to the door. This was a big house on Washington Avenae and Camp Street, right opposite e the fire enginl\,•• Are the fire engines in those papers? -Yes. Well, I had ear];f impressions of horrible wounds and injuries to people 2 there. I can remember one evening a man who had his cheek missing. You could see his teeth and blood. He had been tending the back end of a lumber truck. The two-by-fours were flapping, and two of them caught the side of his face. I had a number of experiences like that in that house. Also the house was full of the most strange things. My grandfather collected Egyptian Mummies. He had great interest in snakes, poisonous snakes, and he had a great many specimens of snakes in all sorts of containers, both in his office and outside in another building that he put up, a little wooden shacko He collected Indian remains. He had all sorts or remains that he had dug up in the Harp\th River Valley in Tennessee after the Civil War. He had cases and cases lining the halls with Indian relics, tomahawks, pipes, arrow heads, bows, everything that you could think of. s Then he got interested in models and specimens of rifies, swords, breat I\ plates, armor. He had a full suit of armor and great, big, two-handed swords. I can remember once in the side yard I put on a heavy breast plate that must have been used by one of CrGJRWell's Ironsiders and got my friends to hit me with a two-handed sword. It knocked me down, I couldn't get the breast plate off and had to lie there on the ground. He also collected Aztec things--he had great carved heads of serpents \t,.i from Mexico around in the house ~ith these snake bite things projecting above them. He collected books galore--he had a remarkable libra+ich was later distributed. After his death it was sold for what little it would bring. It was bought by the man who was the librarian of Kings County Medical Society ,S in Brooklyn, and i t ~ mostly there now. They didn't identify the sources of u. their books. They just put them on the shelves, and yo~ can't find Joseph Jones books in there any moreo He collected these Indian skeletons and bones of all kinds, and they went 3 e ultimately to the Museum of th}\ American Indian in New York City. Mr. Heye bought them. Well, now all this--lim sure all this had an effect on me, for arousing interest in the first place in the medical things that I talked about and in e, the second place in archA_ology, or paleopathology as they call it mostly. Recently there was a conference on paleopathology at the National Research Council of the National Academy here in Washington--two years ago-organized by Dro Saul Jarcho. He invited me to discuss a paper. I got up and said that I had no right to be there, that I l'Bd never dug up anything but maybe some dead rabbits, and that the only reason that I felt I could cite for being in this privileged position was an hereditary privilege from my grandfather. Now that conference indicated essentially a revival of interest in paleopathology in the United States, and a general society is now being formed 4 I can trace a great maey things back to the inf'luence of my grandfather-­ more than m:y father influenced me. My father did influence me in medicine be• cause he would take me into his--I would call it a sort of dispensary, or office in that home on Howard Avenue by Lee Circle. I can remember helping him wind bandages there. He had a kind of twisted, angular wire over a cigar bex1 and I would turn the crank on this thing, and the bandages would roll up. I got used to seeing him take care of some sick people in that place, but not very extensively. To me it was a very happy sort of a beginning. I ran arou~d with friends, and I was treated respectfully for a childo I can remember-I have a picture somewhere, and you may have seen it, of myself in Lord Fauntleroy's velvet clothes. Did you find it? ~s 1 I did. I eut it o~er there in the corner with the rest of the photographs. 4 Well, I fell in the gutter in that suit one day'. New Orleans had no drainage system in those times. Even when I grew up there were street gutters along the side. Whenever the rain came, the streets were nooded, and we used to go out am. swim in the streets. aow, they 1Te reduced the water table by about eight feet, and they have a huge pumping system that clears the city. \\{ Well, there ~ere lots of interesting things to do 0 At that time I would occasionally go over to Biloxi, Mississippi, where Mrs 0 'Denegre, my "Tante E11 1 had a place called "Malua", and play on the beach, go sailing, fishing. I would see m;,y brother and sister ever there more than I would sometimes in New Orleans• Was Dr. Jones something of a phemist? Yes, he was a Professor of Chemistry-~ Yes, I forgot to mention that. The house was just full of his chemical things, and he did some original work in chemistry. Apparently you did too in the gold fish pondo I wasn't doing chemistey in the gold fish poad. I ,ms a biolog~•+t that moment, trying to see whether a fish would survive under a flame that was twelve feet in diameter. It got out of hand. It was much bigger than I thought it would be• I think it was gasoline--or coal oil that I poured on the pond. My grandfather let me have rabbits in the back yard. I built rabbit pens, and the darn things would dig out fram under all the time. I had dogs, especially a little Fox Terrier that I was very fond of called "Vixen"• In that house they bad to punish me a good deal because I was unruly and pretty wild. I did a great many things that I don't look back on now with any pride, 5 but they did punish me a good deal. Two I remember--a series of frightening punishments. 'l'hey told me that if I continued to be bad like that, the moon would come down with a pair of ice tongs and put them around my ribe and take me away. Do you know what ice tongs are? Yes-the hooks. Yes, and the other punishment I remember aroused my sense of humor very much. One of m,- uncles decided that he would take me up ia the attic ef this big house and give me a whaling with a trunk strap. I started to run around the attic, and I can remember dodging behind these upright two-by-fours that 1 support a slightly sloping root 0 He d whale at me, and the leather thong would curl around one or these uprights, and he 1 d have to stop to untangle him.­ self and the leather. I remember all these punishments in more or less an amused fashion. My aunt, Mrs. Denegre, "Tante E", was a very modest person, and I can remember when she had to spank me, she said,"Stanhope, come over here, take down your pants, and bend over." Then she•d drape my buttocks with a towel and then spank meo How gentle. Also she used to spank me with a piece of silver which made me blush every I / time I would look at it, and I•Te seen plenty of them. It a a Kirk repousse. ,· If you get spanked with a ropousse of roses standing out against silver, you get a let of red. I think I had a great deal of corporal punishment. I guess so. But it had an amusing side. I can still laugh at it somewhat. One time 6 one of them was paddling me with a lady's slipper and the slipper broke while I was being spanked, new off and knocked something off a bureau. I thought it was a wcnderful joke. Another side of that life was that I had much time to :rqsel.f out oa the streets. The neighborhood where my~andfather lived was right on the verge ef Magazine Street, a block away, which is the verge of a hoodlum district. I had a great many street fights at that time, and I developed some cautiono I also had a knightly sense because one of my aunts gave me Howard Pyle's book, When Knighthood was in Flower, so I rememner this punishment that a street ruffian gave me. I went out on the street and challeaged him by putting a chip on my shoulder. ltd read that he had to knock a chip off my shoulder to start something. I put a chip on my shoulder, and he swung wideo He knocked the chip off, but on the way to knock the chip off, he broke my nose and knocked me down. ~ zou run free? On the street? Yes. I was not a part of a fang. I was different. I was~n a higher social status than the gang that was running. They would mostly persecute me. Was there just your grandfather, Dr. Joseph Jenes 1 in the house? No, there was m.y Aunt Susie am my Aunt Mamie, Mrs. Bringier. Susie Jones was there, and rrry Aunt Frances was living there and Hamilton Jones. It was a great big house in New Orleans. 7 All of them had a hand in these pu~ents? You said "they"• Yes, I think of them as a group. "They11 then includes all of them. I don't remember that there was any division among them regarding myself. Certainly I felt closest to my Aunt Susie, but I don 1 t remember playing one off against another. My Aunt Susie was a very lovel~erson who, I think, cared for me a great deal. 86d they also have fun with you? Can you remember pleasant times as distinct from the unpleasant? I think they had~ome fun chasing me around all over the place. "What will that boy do next1 11 That 1 s righto I could think of all sorts ef things to doo I might as well tell you while we're on this subject that I had some gun powder and I lit some of it on a window sill. All of the smoke from the gun powder blew back in the house and frightened everybody. It was on the second noor, so they locked me in a room, but in that room I discovered some shot gun shells and a magnifying glass. I can remember to this day working all day 0 I unloaded these shells and made a train of powder from the window ledge along down to the fire place on which I had quite a sizable bunch of powder by the end of the day 0 I sat there and waited until the sun came by the window and with the magnifying glass--I didn't know that it was going to set the thing on fire. I thought it was just an interesting scientific experiment, but I got the sun on the powder and shh--you know how it goeso It went all up again. 8 I got another spanking for that., but that was an achievement of the scientific method. I guess they let you out of that room. I 1 ve forgotten what happened nexto Were fire arms part of the order of the day? Did people generally have this? Did you do a bit of hunting, or no? Oh yeso ,ent hunting and so did my uncles go hunting. Firearms were around the place 0 like sppons and knive~o Yes. I don't know where I got those shells. I don•t remember a shot gun., but there was a box of shells in that room. L~uisiana was a great hunting country and still iso l:> My br1\.ther got to be a great shot. Was the family a family of readers~-apart from Dr. Jpseph Jones who collected books to whet his curiositz? When you say "the family"., are you talking about the Joneses? Yes 1 the Joooses. Not particularly. They read a good many things, but it was Joseph Jones who collected the books, and curiously enough., my recollection is that the books that he chiefly collected are the ones he wrote himself. He published 9 four huge volumes and did it at his own ~ense., and all of the upstairs, the ~t:t),.lt second floor., and part of the downstairs ~lined with book shelves containing these volumes--maybe thousands of themo Nobody bought them, and he didn't give them all awayo I had a good many sets., and there are a lot of them around stillo My Aunt Frances was a reader and an artist., and they had--all the ladies had, but particularly Frances and probably Mamie, a very liter~! friend in New Orleans called Grace King. De you know of her? My Aunt Frances illustrated one of Grace King's books. /New Orleans, The Place and the People (New York., 189Sl7. Grace King had a salon. She was a literary figure., and every week these ladies would meet., and they would discuss some very serious subjecto There were a number of these literary societies among the ladies in New Orleans called the Geographies, or the Blue Stockings. Mollie Moore Davis had a salon. She was the daughter of Jefferson Davis. Yes 1 that is described in one of the paper&--Mollie Davis' salon and the people who frequented it. All of that in there? Yes. But you indicate that some members of the Jones family gave it a kind of creative, artistic navor--Frances he Jones. Oh yes., Frances could draw very well -with pen and ink mostlyo And made potteryo She taught art at Newcomb College. Newcomb College was built just across the street from this house, a sort of huge, renaissance building with 10 other buildings. There was an artist and historian,, a potter named Mro ~llswort,!y Woodward--I think his name was. Well, I don't remember but Newcomb was built thereo Newcomb had an art department, and Frances Jones taught in it. They had a particular kind of pottery called Newcomb Pottery that they invented, so to speak-glazed and baked themselves. The place was full of myths and curious things. For instance, they had two iron lions on the stairway outside the steps of Newcomb College., and somebody told me that i:f I was lucky I would hear them roar some night. I spent many a night trying to hear those lions roar. They didn't• There was a marvelous fire engine right across the street with great big horses that would come plunging out, and that was a great thrill. The house was a great, big, rambling, ghost-like place, and I was very frightened at times in 1t--didn 1 t know what was behind the door 9 Well, they lived a pretty good life there. They had Negre servants all the time. They had a cook, maids, and a choachman. 1hey had an outhouse and a carriage and a horse. My grandfather would go to Tulane for classes in it, and to see his patientso That horse and buggy is in the inventory of his estate. It didn't amout1t to rmuch,. 0 Didn't you indicate that this house is no l~nger there? It's still thereo I have a beautiful picture of it, but it went to New Orleans with his papers. Its stt.11 there. It had a wonderful lot ef iron " work on balconies so that I could start on the ground level and put my tees in between iron roses and climb three stories. Yes. I think there is a picture in the papers of that house with the iron on the front. I don't remember that it was three storieso 11 It was two long stories and an attic, a fiat attic. Something I was going to tell you went right out of my head. Is this the house in which you were born? No 0 The house in which I was born was on Howard Avenu~near Lee Circle. 185 Howard Avenue. Yes, and my brother a rd sister were ~Jn there too. Also Joseph Jones was greatly interested in Confederate recerds and relics. After the Civil War, he became Surgeon General of the United Confederate Veterans, and he used to wear a grey uniform, mostly part time, not a regular military cut uniform, but it looked like one, and he was collecti~ great many records of the sick and wounded and the rosters of regiments and companieso A good many of them are published in the Southern Historical Journal. He had~de interests, didn't he? Oh yes• Terribly wide. He was a traveler in this country and then he went to Europe in 18711 and that's when he bought all the Jenners, three editioffi of Jenner 1 s great work on the small pox vaccination with cow pox, and those originals that he bought are still in the Brooklyn Kings County library. He came back at that time, and he was Health Officer of the State of Louisiana. He got out a great big book on the management and prevention of small pox, and in that work he put the 12 three original Jenner volumes including copies of the plates, just more or less in an order to his own fancyo Although he didn't change the text, he re­ organized i4somewhat, and Dr. Harvey Cushing has told me that this is the most ,'\ I '' j w' remarkable Jenner in existence, very r~/.Jrj-I wouldn't say bodlerized1 but it's 7tJ \ the kind of thing Joseph Jones would do, if he wanted too He 1 d put his own gloss op ito He was also deeply interested in malariao Oh yes. ~,m pretty sure that he saw the malaria parasite six years before the man that is credited with discovering it. It was published in 1876, in the Medical and Surgical Journal of Louisiana. It all appears in a murder caseo It was his testimon;y that he gave in a murder trial, Narcisse Arrieux, and ~,m sure that he saw it. I•m sure also that he saw the typhoid bacillus in intestinal lesions in Andersonville Prison in 1864, and that's a good many years before Eberth, the German, is credited with it 0 Was the house set up with a laboratory? Yes, he had two laboratories. One laboratory wa~n that office where he did urine tests and other tests. He could examine blood, and he was pretty good on blood. He was not shy about showing off his knowledge because in this trial the judge asked him 1 11 Will you name the diameters and dimensions of the red blood cells of all the vertebrates?" So he recites in this trial the size and shape and dimensions of alligator blood, elephant blood--any kind of blood because he had studied that with Joseph Leidy and published a Smithsonian monograph on it. Curiously enough his interest in snakes ran on to the end because the last paper he ever published appeared in the Journal of the American Medical Association, and the 13 title was "The Ophidians"o Now, people as a rule don't speak of snakes and alligators as ophidians, but he vould write that word--just like his charactero When you stayed at the home 1 he was pretty old at the time wasn't he? No, h+as born in 1833, and he died in 1896, so that he was sixty-three ;years old when he died. Speakine of the influence of my grandfather., I have found that as I have gone along, I do things, have done things, just as he did them. I wasn't aware of that until I read some of his letters, or his jourruµs, or in his books what he did about thingso I worked just about the way he worked and I would do things the way he wot!!i do them without knowing ito I think it's an atavistic trait come in there 0 Procedure -~~!E?_:r:_mines the e~0 Well, it had an influence on me in another way because it impressed me so much that I was doing things in the manner of my grandfather that I thought that I certainly could not outlive the life span that he had because he seemed a very old man to me. He was sixty-three. He died when he was sixty... three. I never expected to live beyond sixty-three. 11 m now seventy-eight. /' That could have a disast~rous effect because I•ve had an uncle, my Uncle -- Charlie, who was an engineer, a geologist--what do you call a man who goes arourrl looking for gold and minerals? A ~oE!,P_ectoro Prospector, and he went to Alaska at one time--I think around the gold rush time, and he got some gold. Thea he came back and settled down around 14 Los Angeles and was one of the early investers in the coal fields out there. Is that in the papers? Yes, i..!-..J..!. Mro Kaiser--the Kaiser plant is out there because of this fuelo Well, my Uncle Charlie was in a very low state the last years of his life. He apparently had no money, was in a boarding house and I had a letter somewhere from him te.lling me that he was sorry that he was living ro long, that he expected to die years before and had spent his money, and that now he had out­ lived his sustenance. We used to help himo Is this the U~e Charlieoooo He was with my father in West Virginia 9 :~ou ~~~t!..Zour father much after 1894? !Jo, I only have one recollection of him about that time, and that was down in that boarding house on Sto Charles Avenue, about four blocks above us. At least tha~ where he was in a small little bedroom in the back ell of the house on the second floor, and I remember seeing him once there, but I don't remember anything else. But he had been st¥ing at_y:our grf!_ndfather 1 s house 0 Well, if he did, I don 1 t rerember that. I suppose he was, but I dontt think he was at my grandfather 1 s house very long, was he? ~not ac~rdin~ to these paper...!,P 15 You describe a greai free lun~~nter that ~-kid can absorb in a house Sl:!,~!L!,s. zou:r:~andfathe_~~~th arrows and the like. It's like a series of steady ~o!_eries that you can go through. Yes, and all of it is still with me and had an influence on meo I•m sure that my grandfather, probably more than my father, 1nriuenced me to go into medicine because I went into the study of medicine without giving it a second thoughto I never had any doubts and I never had any agony such as some of my classmates atale had in trying to d~cide what profession they were going into. For me it was all settled by the stars long ago. That I s as good a way as .!:!.'Sl. I know of• Yes. ,!t mi~~..E_~Ve been a_tandem t~if!S too because you w~re with zour Dad in his office tooo Yes before. Se that Y2L~~U,~.ras in the air you breathed. Yes, that's certainly trueo What rel~tionship as of 18941 di!!you pave with the Bayne~ The B1L.z..~es are the other side_ of the famiq 1 the legal sideo I can't pin it down to the year exactly. I just say 18,2_4 1 which is the year of yo~other's death 0 Yes 4 Well, the one that I remember best is my "Tante E", Mrso Edith Denegre. 16 She married George Denegre, and she was the boss of that side of the family. She used to boast of the fact that she was know+s a young woman there as "she who must be obeyed", but she was a very ch~ing and lively person. She wasn't very well. She had some severe surgery shortly after her marriage, and she was never8-well, I would say she was a very vigorous invalid-if you know what I mean 0 She was an invalid, but she did everything that she wanted to do, and she hafeople doing a lot of things for her. She had a great determining influence on where I 1 d go and what I did and when. The next Bayne that I remember is my Uncle Thomas Levingston B~ne, and I remember him because he took me in to his house--he and his wife Gretchen took me in. They had three children already, so I was extra in that crowd. They lived first, !I. s I remember it, down on 610 Royal Street which is down I in the French Quarter near the Vieux Carre, in a great big house with one of these old court yards, funny creole things. My Aunt Gretchen was a Muller, no kin, of course, except through marriage. She came from a very fine family in Louisianai, the Governor Nichols family, and she was apparently a very lovely person and gay--maybe a bit of a faddist. I have a medical recollection of her. When I was down on Royal Street, she did something that has kept me from eating honey the rest of rrr:, life 0 Really? I was sick, and she thought I ought to have an emetic, so she made a soup, a tea out of violet leaves and put honey in ito As soon as I drank it, I threw up, and I cannot take al\r honey. That's a ch:a,ncy thing. 17 Isn't that a silly thing to put on the tape& I Not at all. It s the sort of thing that:, comes ~o ~ • Well, they used to go to Russellville, Tennessee, which is a little town in the mountains near Knoxville, every swmner. Several fummers we went there, and that was a very primitive place. Everybody seemed to get typhoid fever there. I didn't get it. That was a wonderful experience though to roam around in those marble bearing hills. I had a pretty free life because I was on the loose again. Then they came back to New Orleans--now, I'm up to about 1898. They came back to New Orleans and builit a house on 8th Street between St. Charlea and Prytania, right next door to George Denegre. The yards were continuous, and I lived in that house with my "Uncle TL", as I called him, Aunt Gretchen, and their three children, T. L. Bayne, William L. Bayne, and Edith, a daughter. I guess I was a good deal of a nuisance because I can remember being locked up in rooms again and shrieking so that they could hear me all over the block, batting en the walls, trying to get outQ This is lour mother's brother. Yes, and then I used to visit with my mother 1 s sister, Mrs. Vaught.. Did you run across her? Mrs. Vaught had a punishment that I think conditioned my inability to keep my check book. I would go down to th~aught's with my brother and sister, and Mrs. Vaught 1 s children would be playing in the yard. I would do something that 18 required my being locked up again, and this time they locked me in the back stairway. It was a long house with a long wooden stairway and a ld.nd of closed in part going from the first floor to the second nooro It had oe little cut window in the side ot the wall far higher than I could stand on any­ thing to reacho I could see out of ito 'fhey would give me a long sheet of paper, a yellow sheet, as I remember it, with figures •nit and tell me to add it up and if I could add it up right, I would get out. Instead of adding it up I used to rush up and down the stairs an4scream and beat on the wall. Then I would look at the figures on this yellow sheet and put down a number and stick it under the door. It would come back with my addition, my sum scratched out because I hadn't really added it up. Then I would have to go through this again. Meanwhile my brother and sister would be playing out in the yard., I could sae them and this little windotould 4~~ the sun come through toward afternoon. I never did l.et that column of figures added up. It got dark, and there wasn't any need to keep me there. l'hey could send me somewhere else., but ever since then if I sit down with a colwnn of figures in front of me, I just get the dithers 0 You want to reach for those stairs. No, I get the dithers and make~o many mistakes. r, m fascinated by mathe­ matic~. live taken course after course, and I got part way through into calculus onceo I thin~t's a beautiful subject. The thing that thrilled me d most one '\y was that I found that if you differentiate twice the equation of a falling body., you can cone out with a value of the force of gravity--just by monkeying with the figures, but I can not work the materials because I make so many transpositions without even knowing that I have done it. I cantt even see the mistakes. Are you that wa-,1 19 I can't see the mistakeso I get telephone numbers backwards. I don't trust myself at all when it comes to check books. To me 35 is just as valid as 53. I trace all these things back to this experience with the Vaughts. You see, the Baynes come in for disturbing my mathematical genius. Then I can remember another experience with the TL Baynes in 1898--there e were two wars about that t1,• One was the Spanish...A.merican War, briefly in 189i, and the other was the Boer War, and I can remember sitting--I was I climbing up on the back fence there on 8th Streetnd could see blue uniformed men going down to get on transports to go off to the Spanish-American War. That influenced me in a martial sense a great dealo In the Boer War they sold thousands of mules to the British, and these troops of mules with soldiers taking them down there influenc~d me a good dealo I always was in­ terested in Civil War relics and Civil War Museums and would hang around them. I had~lmost as strong a feeling from the beginning for military things as medicine. s Well 1 was there any continuity with the Jones ~de of the family while you were with the TL Baynes? Yes, I'd go off to see them sometimes. Oh, one period in there I actually lived•-I'm not sure of the date--wi.th my Aunt Mamie. She 1 s Mrs. Bringier, and they had a plantation up in Ascension Parish, Louisiana, about sixty mile5 north of New Orleans, a plantation called "Tezcuco"o I went there several swmners, certainly one swnmer, and I had very severe malaria in that place. My Uncle Trist was a mystical sort of a figure who was in and out of the house with a shot gun, accompanied by two dogs, two pointers, or two large 20 setters. He shot quail all through thereo There was sugar. It was a sugar plantation. The Mississippi River was about a half a mile from the front door where these paddle wheel steamers, old show-boat-type things would go by against the sky. There were great, big oak trees there, so that I could build a house way up in an oak tree, and nobody could find meo The grass, flowers growing--it was a good ante-~ellum house. Now that happened in a couple of years, but not for the whole yearo You can probably find the dates in some paper down thereo She's mentioned in this 1900 problem of schooling. This was a convenience in a way to allow you to get out of New Orleans for the summer ti.me, or whenever it was 0 In some of these episodes with the Joneses in ways that I never understood I would be transferred back temporarily to the Baynes. I recall this very mucho I was playing with my brother and sister at Mrs. Denegre 1 s house at Prytania and 8th Streets when a little cart drove up with a Negro on it, pulled by a horse, I guess, and on it was a little trunk and a little white iron bed, and they brought the bed and trunk into the house. I changed houses by that metamorphosis. Nobody asked me. Don't think that I•m recitine this with any particular grief because I just took it as it came. Part of the order of existence. I wasn't embittered. I was bad in many ways, as you would call it, but I 1011'1!'1 21 don't think I was on the verge of juvenile delinquency which is supposed to happea in a case like this. Well, you know, having a elace where you were secure--you had a hero kind of attitude toward Dro Joseph Jones, and by comparison everione else must haV!_ paled just a little bit. They didn't have-you know, the accumulated things that he had around to keep you occupied, keep you intrigued. Oh, going back to the things that Joseph Jones had----he had brass cannon, and we used to load those cannons with gun powder and nails and fire them off in the backyard--anything. A wonderful time£ Then the other thing that comes in about this is my going to Dixon Academy. Did you find anything about that? Just a brief mention of it 0 Well, Dixon Academy was a boy's school at Covington, Louisiana which is R across Lake Pontchatrain, behind northwestern New Orleans. Mr. William Dixon \ who ran the school was the son of the Pre0ident of Newcomb College. My Jones family knew the Dixons very well and somehow or other I got to Dixon Academy in the period--! would say 1900 to 19051 somewhere in there. It's hazy to me now, but that was a boy's school in which they had pretty good standards. I was there, and I played baseballo I got tremendously interested in water moccasins. I used to go out with a little leather Kodak box--you remember those square boxes?-cm my side and wander around in the swamps. i'hey had a very strange river that went back of that school. I could smell a moccasin a long time before I got there. Then ltd find this creature dozing on a log, or a branch over the stream. I had a forked stick, and ltd go put it over his 22 neck and put him in the box--you know, these are very poisonoll8, big mouth snakes--and bring them back to schoolo I had twenty moccasins in the cellar of that school and the principal didn 1 t know ito I was feeding those moccasins on newly hatched chicks that belonged to the principal of the schoolo I didn't think that it was stealing chickens. I just thought that I was being good to moccasinso These creatures didn't frighten me any, and I•s fascinated with them. I caught black snakes and king snakes. They had coral snakes too, but I didn 1 t catch many of them 0 They are the deadliest 1 aren't they? The moccasin is a pretty bad one too. What did you do with them in the cellar? They all got loose. One night they all got loose. Oh man! I had them. ltd just go down and look at them and talk to them 0 Was it ever discovered? I guess it was. Oh yes. I had plenty of extra tasks at Dixon because of various behavioro Then another thing that I never doubted was that I was going to Yale. My grandfather, Thomas Lo Bayne, was in the class of 1847 at Yale. My Uncle Hugh Bayne was in the class of 1892 1 and I had been brought up on Uale, so I was ,J always sure that I was going there, but nobody gave me any directions for the mapping of my course of studyo At Dixon Academy I took a little bit of everything. I studied history. I got pretty far in Greek. In Latin I got 23 up as far as reading a part ef Virgil 0 I had French. It was a pretty good schooling, but it was not very well organized. In 1905, Mr. Denegre had a hand in sending me--no, I had gotten by that time, around. 19051 back under the nominal control of the Denegreso I wasn't livi*ith them. I was off at this boarding school, and it was about that time, 19011 or 1902 1 that I came back from Dixon Academy one Christmas and found that Mrs. Denegre and Mr. Denegre had hyphenated me. They didn't ask me about that either. I didn't care. It didn't seem to make much difference to me, but later I found that I had to be known as Bayne-Jones, and it had a tre­ mendous influence immediately on my life and has ever since been influential. In the first place, when I was Jones, I sat in the middle of the alphabet, in the middle of the classroom and inconspicuously. When I got to be Bayne-Jones, I was in the Bs and sat in the front row, so that I was questioned much more than Iwas when I was in the comfortable mediocrity of the Js. I began to study more. That's wonderful. To continue with this hyphen--I became self-conscious of my name, and I don't believe people as a rule are self-conscious of their names. I had to explain, and I still do, that my name is Bayne-Jones and listed under B. It still is a nuisance because people come to Washington and look me up in the telephone book undar J and think I•ve moved. I•ve missed a good many .friendly calls that way. In addition, I•ve had an account at the American Security and Trust Company for going on twel~ years, or more, and every time they change the tellers I have to explain to them that my card is under B, so I go and present e a ch1ck and they look it up under J and they say,"I'm sorry, but you have no 24 I\ money ~ere. 11 Well, I've had a deposit there for twelve years, and I have to explain m:y name' over and over and over again. I It has the advantage--well, its got two advantages. One is that it helps me to sort out my friends. There was a great chemist named Bence.Jones, and people who misname me and call me Dr o Bence..J ones, I know right away that they are chemists. There was a great poet and artist named Burne-Jones and when people call me Burne-Jones, I always turn on the literary parlance, or whatever you want to call it. I can tell their backgrounds by the fact that they mistake mine. The other thing is that I•m quite sure that it has been a reason why I have been elected president of at least three scientific societies because people 0 think I•m Jones--J, and they think that the list put out by the nfinating committee is in order of preference; whereas the nominating committee is putting out a list alphabetically and people tend to check off the first name on the list and being moved from the Js to the Bs I have been first on quite---well, practically all these lists, and I get all the votes. That's a facto It's an ill windo That's a good one. Tell me this--did they ever give you any rationale as to why this was done-­ the Baynes being Uncle George and "Ta11te E"? Yes, m:y opinion is that they hated the Joneses. They did? They hated the Joneses, thought it was disgraceful to be identified with 25 the Joneses, practically told me oo. That 1 s strange because there's nothing--well, she Wl'ites you very gentle and tender letterso Who? "Tante Euo Oh yes, sure. Thatmsn 1 t me. It was the Jones people that they didn't think well of--my fa.thero Also they thought that Bayne was a distinguished name, and Jones was just run of the mill. That's the feud aspects of thiso Yes, that's why I say-and I love both sides of the family-I•m a missing link between two families in a feudo They did this without consulting youo Yes, I came back from Dixon Academy and found that I had been hyphenated. Well, to finish out about this Dixon Academy and Yaleo My Uncle George through Yale friends had heard about the Thacher School which is in the Ojai Valley in California.o It was founded by Sherman Day ThachAr in the 90s some­ where, I think 0 It was an excellent school, forty boys and about ten masters, and we lived in good old California ranch buildings. Every boy had a horse, and you took care of him yourself, and you roamed all over the country in parties, up in tre mountains, camping--wonderfull They looked me over. I was going to Yale, and I had no orderly preparation for Yale, so I prepared really for Yale in one year out thereo At the end of that year I took nineteen en- 26 trance examinations for Yale, and I failed only Advanced Algebra-again my mathematics. We played baseball and rode horses. I don't know how they did it with me, but it was all done in a year out there. The reason I think it was easy for Mr. Denegre to send me to Thacher School in 1905, I guess, was that he was a very ireportant railroad attorney. He was the attorney for the Louisville~shville Railroad, and attorney for the Southern Pacific, and all of us travel~ed on passes in those days. I crone ,\ ' ' I home from Thacher School just for Chr,~t:mas week on a pass, and later I travelled to Yale on a pass, so havi~g a pass, it~as easy enough to do it that wayo Tell me eomethi!![__more about that scho~~-_people 1 teache3::_~- What about Dixon School? Was th~,!.~manz....e_~OJ?le t~~t-~ire ~gination there? Dixon didn't~ Mr. Dixon"-I forget his full name now--was a tall, austere man. He lived much to himself, though we saw him in classes and in the dining room, and then I think he would have certain evenings when he would read Dickens, or something, to the boys .. There was a chemist there whose name will come to me after a while--a big, hearty man who influenced us a good deal in sports--basketball and baseball. My professor of Greek ~vas a shy, little man, and he influenced my morals unfavorably because he was afraid-I being his only scholar, so that when the time for the examination came, he gave me a set of questions, and he also gave me a dictionary, a grammar, and a trot. He went out of the ~oom, locked me in the room again, so I got a high mark. Oh, marvelous--I like it. No, I don't remember the characters at Dixon 27 Academy that way very mucho Curiously my recollections are mostly earthy reoollections~-snakes. Yes~-w~1-11 that tra~es back to Grandfather Joneso In those days we had a good Many fist fights in Louisianao In the school? In Louisianao It was a ritualo See that knuckle? Well, I broke it on the side of the baseball pitcher's head one day. He was taller than I amM-he was six feet tall, and I reached up and hit him on the head. I broke my fist, and I couldn't tell him. He wouldn't stop, and he beat me for about a half an houro The ritual was interesting. This fight began because we were both in love with the postmistress who was about three times as old as each of us, .9.n:i I said to him one morning, "Did you say what I hP-ard you had said to that lady?" He said,"Goddam you, what is it to you? 11 So I had a £.!:!.tur~ Eveni~-~~ in my hand, and I was still a. knight, so I slapped him in the face with the Saturday Evening~• Nothing happened then but we arranged to meet abo11t a week later in the evening on the basket... ball field, and that 1 3 when I had this fist fj_?hto Another one showing you the ritual was at Biloxi a little latero I took a young lady riding. I borrowed my Uncle George's horse without asking him t, and took her riding. Sre had a horse and at Beavoir near Jefferson Davis' \ house her horse stumbled, and she fell over the neck of the horse. She was 28 riding my uncle's horse, and the horse started to go off down the bushy roado I looked at her, and I saw that I couldn't do very much, but there was my uncle's horse going off, so I dashed after and caught th~horse. When I came back she was sitting up and rather angry because I had shown no chivalry at all i+pite of being a southerner. She had a friend who was a powerful, young football player, and he challenged me to fight. I~~ to wait two weeks for that fight--worse than Cassius Clay's periods, but it was--well, we had secondso We exchanged insults, and you had to wait and calm down, and then you had to get all mad again. Was this a sought thiq,g--somethiri&, that you sought? What? Fights 0 That was in the ritual of the life of the boy in Louisiana at that time 4 What do you mean by sought? Was this the sort of thing _that you W«?.,~~d look for? Oh noo I was scared to deatho I think the others were too, but you had to do it 0 That was the mores 0 What about the Thacher Scho~l--since they preeared iou for Yale? They were awfully good, strong characterso Some we liked, and some we didn•t. Mr. Sherman Day Thacher was the headmaster, and every evening he would read to the boys gathered after supper in a big room. He was a bit remote, but 29 a stern disciplinarian. He had a brother, William Lo Thacher, who was a big man, a national tennis champion, and we admired him no endo He taught Latin. We had a very interesting professor of physics who taught us some physics and chemistry, a Mr. Avard L. Dodge. The way they got me along, the way Mr. Thacher brought me through all this Latin--he just gave me a trot, a translation. I would read it and remember it--that is, for a whileo In the light of subsequent things 1 how did the Ehysics and chemis_l:tz•ooo Physics and chemistry were elementary things at that timeo Was there a laboratory available? Yes, the school had a smal~ laboratory. I did at Yale mediocre work in chemistry and less good in physics. Physics required too much mathematics. 1 111 get into physics later when I finish up on telling you some more about getting ready for Hopkins• I think we 1 ve gone .~bo~t as far as we ought to go todazo You're gettin~ tired? Yes. Well 1 that wasn't so bad, was it? r I I I ' 30 I have been wonderi since the other h when we talked wetber ou had,.!!Y My recollectiea is tbat it seemed a little jumbled up to••• but I don•t know hew you ordered it. 1 I liked it. I transcribed it 1 and it s good. Is it? Yes 1 fer ~h~ eurpese we ori&~nally talke~ about, it's geed-the two camP!, ~~ ettect 1 but I wa,nt te.. JI.• .•ack••today and pick up some tllemes '!hich we may have overl,.20ked. They aaz .not figure, I don't know. Ia this thing recording now? Yes t of the inheritaaoe that ou u.s 1 and I wondered aaout yours in this pi'! aall erocess that y~~ _had-how much contiauity tnere was 1 how ;\!eortaat it was 1 how much it figured. I don't !!!!• Well, I think ratber early in my lite, perhapa aecause of this aoving around trom on.e doctrine to another, I got a feeling that there was a great di:f':f'eren.ce Ntweea what I later lear11ed to call religioa as distinct trma theology. Now, I weat through a Catholic pu.se--as a aatter or fact, I was christened a Catnolic. My mother was a Catholic, and sbe wu a Catholic aecause -, grandfather, Tno11&s Leviftgstoa Bayae, ••raced catholicisa, as they said, on the death aed of bis wite, and that was carried over to his childrea. My 31 brotner and sister were brought up ~atholic, but the Den.egre family that brought them up are very liberal Catholics. They are not oppressed by the regulations or the diocese, or the church, so I think I very early noticed a distinction between the inner deep feelings yeu might nave about the DJ,Ysteries ot the universe and some controlling influence. I never believed in a liVi.ng God, except when I was threatened with h.111. like that story I told you about the moon, so I had m> strict continu.ous theological, or ntligious upbringing by- a117body on1he Denegre, or Bayne side, 'but when I lived with_,. grandfather Joseph Jones, a very strong Presbyterian influence came to bear through Kr. Mal.lard, who was a mim.ater in the Presbyterian Church, and that was a long and painful experience tor me because I would have to go to church in the aornings-has it stopped? No 2 it's going fine. I would haTe to go to church in the mornings, and then ccae back to a big aid-dq Sundq dinner. Then I can remember sitting on the side porch with the older members ot rq family-whoever they were, and I cannot remember now-and I was required to give the gist of the sermon. That didn't lllake me love those Sunday ceremonies very auch as I might have done otherwise. It was a very severe sort or lesson because I was supposed to say something that fit in with what the minister had said. I couldn't just make it up. Then I passed over into the side of the fallily that was more interested in the Episcopal Church-that picture in Grace King's book of St. Paul's Church downtown. I went to that church for a while and sang in the choir there, but behaved so badly that they wouldn't let me come. I got in a fist fight in the choir. 32 As good a place.!~• That rather put a dalllper on my going very far in the Episcopalian Church, but I never studied any of those things to the extent that it would lead to confirmation. I never was confirmed, so here I am a baptized Catholic without confirmation in &OT church, and I have bad experience in the Catholic Church, the Presbyterian Church, the Episcopal Church, and the free sort ot Congre• gational Church at Yaleo I Right.. I think it• t12ical of the times for~e church to mean a ,1reat deal_ "' to families, but zou had this pin ball grocess--you know1 ~nd Sundaz with the Joneses 5 have been severe, a daz of rest1 8: day of sood clothes, a daz: sittigg on the porch, not exploring the waz iou were wont to, That must have made it very depressing, That I can understand,_ and then to be 2!9Sed ~:tt to liberal Catholiciftla and from there.a nirtation with the §I?iscopal Church is a varietz or religious experiences that_ other people don~t have. They have this deadening 1 unitary sense, most et the ti11&. They go almost au~aati;_call_z and _go through a process which leads to contirmation which they never reall_:,: understand. To jump ahead, I found b,r the tiae I went to rtsit Mr. Andrew Dickson White in 19061 I tbink, a very satisfying, huge, two volume treatise that he'd written called The Warfare of Science with Theolosz. Do y-ou know that? - Yes. He got bis PhD in Germaey on that book, and there's a great deal in that that inf'luenced ae a good deal--satisfied things that I was wondering about. Tied things up? 33 r·1 I Yes, it distingu~~ed between the scientific things that I was interested i \...' in and the cburch 1 a opposition to scientific advances 0 I appreciated ver:, early that the church was always taking a position--well, science would move ahead, and the church -nuli try t.o catch up. One that iapressed •e then was the contrOTeray over lightning rods on steeples. Lightning is a bolt or Jupiter, but it also ccaes out of the hand of Jehovah, God of the Jews, and Lightning rods were a profanation of a church at one ti.llle. Now they have thea everywhere. The astronomical problems that were settled by- Galileo and people like that interested •e veey 1at1ch. Vas there added religious st.udz at either Dixon, or Tt>;acher? No, there were prayers. There was a routine kind of prayer which, I aust conteas, you attended while thinking of saething else. They-w aren't prayed vith any fervor, as I r 8Dl8aber o It was an exercise. Part or the order of the <iaz and not oppressiv~• There is another church that I belonged to that didn't. affect my religious feeling ■, but when I went to England to join the British battalion in World War r, they asked me when they were making oat my dog tags, what church I be• longed to. I aaid,"Epiecop&l Church•" They didn't know what it was, so they said,"Oh, you mean the Church of England." I went through World War I with a C of E tag around 1lr/' neck. Marvelo.usl We talked zesterc!91 in soae sel'18e 1 about security. May I say one aore thing about this religion? Surely. r I 1 d like to conve7 a sense of reverence for something, but I think it's childish, juvenile stutt--the furor that is going on now as to whether God is d.eado I never thought he was living, and yet I h,ave a respect for scnething, though I don•t know what it 18. I don't believe in aey life after death, and I don't belien in all this that I used to recite about the resurrection of the bodT. Those are pepsonised things that one absorbs-yea, but 12u at least had a !~riet71 so that z:ou could gossibl.y discern distinctions and raise probleu about it. It was good that you had the talk with Andrew D. White, one of the accidents of soing to Thacher School in a !!l• You were talking about security? I was talking about securi tz in teras of what we said last time. It would seem to • that the ,sense of security was rel.ated to the cax;t with the white iron bedstead and the trunk-everywhere 7011 went that went with zou. Whether i ~ went, in accordaace with a request to you, or whether you knew about it--at least they are things that remained constant. That only plQ'sicall7 appeared once in my experience. - Oh? The cart, the bed, and the trunk only appeared once. I see. But if you are aaking a figure ot apeech out of it•••• 0. I was thinking of t~e~ as your lares and pan.ftctes, known thin&!• 35 Probably every tillle I did change there was smething, but this change I remember because he drove up to the front gate. Yes 9 I was also thinking about eating habi~s being bounced around f'r• place \_o place.t, How were zou as an eater? I know about the honez1 but food. I had ftO tads about food. I ate what was there. Only' one or two things I just don•t care tor, and these are beets and turnips, but I don't know wb.)" that is. They haYe a consistency- that ukes me gag. I ate anything, and as far aa eating fish on Fridqa, I would expect that, but I like fish anywq1 and this Catholic side of •7 family--! don•t know which member-raked up a Papal Bull that one of the Popes had issued on Lake Garda in maybe the 15th Century-. He didn't have aft1' fish that Friday so he issued a Bull and declared that teal duck was fish, so those Catholics in that group would eat teal duck, or arq duck on Friday. I It was comforting to have that.rationale, wasn•,t? Yes, and when I learned that it was all a matter or protein, they ate eggs on Friday-that's not too far frODl a chicken. No-not too tar. What about sleeping habits siace you had a succession of roans-I mean nothin_g that you could. really call your own with apy continuitzo Well, I was fortunate in most places in getting a little roClll, or a piece of a room-often I had a little room. to Jll1"Sel.f, and I don't recall ao;y trouble sleeping anywhere at all. I wondered about this because you were a young kid-six to twelve, or thirteen, 36 1 before going off to Dixon Academ,z:1 and the requirement imposed upon you was one of alllost continual adjustment--zou know, facing soaething new1 so I wondered about sleeping habits and eating. No, I don't recall any problems like that. I don't recall any problems of adjustment particularly. Maybe I was too shallow a person to be bothered by them. But you did have the sense in joinirl§ the various families where there were children, of being something on the outside. Yes. Yes, and I wondered whether that had any carry over--like bei9S locked in that back ro01'l1 that back stairway. That's not an easy experience to absorb. It didn't leaTe any long scars. It just made ae mad--that's allo All of these people--and I,a taking advantage of a certain snobbishness which c0111es fra111 having looked through the war time letters-I get the impression, and I & be wro:o,; 1 but I got the illlpression from the war till!.e letters that as of that particular period people began to aean more to you. 1·he choice between working in the laboratory in the rear and working with the troops was dismissed completely ahlost. You had to be with the trooe• The letters ha111e-the first real notiom of •l•d like to be once again at Biloxi. 1 Mississippi"' when you knew that everyone was aoing to be gathered there. I don't know1 and this may not be so1 but it appears frm the correseondence that people qua people began to mean more to zou later than in this early period1 and in this early period I wondered whether thez aeant agzthing at all-reople. 31 r Aa I look back on it, and I think I still have some of the saae feeling l about people, they were\mstent beings, but I was rather aloof from thea. I think the kind of a life that I was leading, going from one place to the other1 ude me a bit secretive and want to withdraw from them. I think I avoided ex­ posing myself to either criticisa, or contentions, nr to the opinion of strangers. I had a sort of life to IU1'Belf, and I think it still contimes. SUre--like describing the hut you can build in a tree where you can't be found. Yeso Or 1 for example, the collection of water moccasins. You could go down and look at them. These were friends to a kid1 friends that you could talk to where 0 ou either didn't or wouldn't risk conversation withs eone else. For you these wre 1 as I sq, friend.so I think that's followed ae through 1lllJ' lite because even though I know hundreds of men I don't have aey particular close friends. I wondered about that, There couldn't have been very auch in terms of loca! neighborhood trienda in this early J>!riod because you weren't there long enough to put down roots. . I was just speaking of .,- associates •n Yale, or medical school and others. I still have long associations that are ot an affectionate and frank kind, but they're not what you would call an intimacy- particularly. Yes--well 1 the onl.J one I•ve run on to, and this was at Thacher School 1 was Andrew D White II who formed an attachment for and had respect for you. The letters he wrote to you are filled with humorous allusions and guest.ions of )8 a rea1 1 quizzical minded fellow which showed certainly respect tor you1 regard tor you as a kind or guidtn aw&• Well, that alway-a surprised me at the time, and when I have thought about it, because he having been brought up in a highly intelligent and literate family, almost an American aristocracy in a sense, that was different from the kind of aristocracy that I was talking about in.,- family which could match his, but he had a grandfather who had been, as Mr. 'White was, an Ambassador to Germany, a great collector of books, a president of a university, and a man who had traYelled all over Europe and had taken this grandson, Andrew D. II with him, and so Andrew D. n to me was a highly cultivated and educated young fellow-way- beyond what I was at the time, so much so that when I first got to know bila, I just thought he was artitically poliehed. You know how a country boy would think about a city boy? - Yes. But how he happened to find scnething congenial in me was astonishing to me because we were very different. Well 1 in looking toward Yale--we got you prepared at Thacher School. Yale is a great distance awaz trom New Orleans, cert.a.inly a distance aw& from the Thacher School. You had people in the Bazne family who had been there and gave zou1 I assume, a kind of orientation toward what you might expect at Yale. They gave me more than an orientation. They gave me a feeling that that was a part or the natural lite of one who was related to TL Bayne and Hugh Bay-ne. You see, I saw sy Uncle Hugh Teey often during that period when he would Yisit New Orleans. Then he married Helen Cheney frm Hartford, the Cheney Silk 39 people, and he brought her to New Orleans to a house he built on Harmo0,1 Street, r where 'lflY' sister went later after my Uncle Hugh and his wife had gone. Hugh Bayne was in New Orleane, and he talked a great deal about Yale. He was a highly social person. He belonged to the Delta Kappa Epsilon fraternity, and I used to hear a great deal about that. He talked about torch light pu-ades. He could sing. He could play the piano. My- Uncle TL Bayne Jr. was a very ! neny, little football player at Yale in the clus of 1 88, but he didn't make the grade, an.d I learned about Yale from hi.Ill. I learned a great deal from Hugh Bayne who was a very attractive person. My- mother was devoted to Hugh Bayne, and I think I carried o•er some of her feeling without knowing it. I don't mow whether you Calle across the last scene down there in the house when she was dying. She begged Hugh to stand bf the foot of the bed and whistle tunes that she knew. Oh yes. And he did, and that'• sort of a sentimental thing~hat is carried along l in the memory that makes the Yale connection feel warm too, but Hugh Bayne was a romanticist about Yale. There was nothing else but Yale. I don't think I thougpt of any other college. My grandfather had been there, and I tell the ' true, but he used story about my grandfather TL Bayne--! don't believe its to say that he wanted to get to Yale so bad in 1847, t.hat he walked all the I wq from Mobile to New Haven to get to Yale. Thats a traditional story, but it is an ecample of what I aean about the desire to go to the place. Then I went to Yale without knowing anybody which also is smething you 111.ght have thought about ahead of time. Going to Thacher School and going to I ~ 11 Yale where there were only about t~ Thacher School boys be~es myself, and 1 ' knowing nobody else, you were rather isolated as compared with the people who COIie from Andover, Exeter, and Hotchkiss. They come in by the dozens and were the big shots right away, so again I felt that I was quite isolated at Yale. It took me a good while to find peopleo I got to know some of the men in my class early who were not first ranking in the social life at Yale at the start­ some or them came along. My Uncle Hugh did a good deal. He introduced me to C. a good many- people. He had a pla~ then in Bronxville, New York, and he used to invite me and some others down for a week end, but when you come from a small out of the way school and go to a big populous place like Yale, and you know very tew people, you often walk around the streets and look at the lighted windows and hear people laugh, and you haven't got anything to laugh about. I You wonder what it a all about. Yes. How did the course work go at Yale? Well, it got better as I went along. When I went there, illlnediately, u soon as possible, I tried to do saething because Yale, they say, breeds guts, and you have to do some extracurricular work to justify the tradition ot manli• ness at Yale, so I started to heel the Yale News. By "heeling" you go out and try to get copy that will be publishedo It was very, very strenuous because you'd go to class, and then you'd start to work and try to find things for the !!!!.• Tbat would take all your evenings, and you had very little time to do a01 home work, so I didn't do too well in my first two years up there. In my sophomore year I remember I got a letter from Dean Henry P. 'Wright, and all it said was,"Sir: Your work in the following subjects is unsatisfactory", and he named everything I was taking, and he implied, I thought, that if I had taken any- more, they would be equally unsatisfactory. That's good. I stuck at the News, and it took ae three competitions. A canpetition lasts a halt a year, so a year and a half I spent trying to get on that paper. Then when I gc,t on the paper, I became managing editor, and things got much easier. I didn't have much else in the way of competitiTe things to do up there. That119.s enough. I was manager or the freshman track team a couple of 7ears running, and I tried for the crew-the freshman crew, but I weighed about a hundred and forty-eight then, maybe, and I was too light for the crew. That is one pkacerhere my name came in for advantage. The crew coach, Mr. John Kennedy, had been brought up in some kind or uncouth, muscular environ­ ment that was quite unfamilar with a hyphen. I used to get two practices. He had me on one list as Jones and on another one as Bayne, so I got two rowing t practices a day-. Then one day he called out for one s~l for Bayne to row number 5 and Jones to row number 7. He was a humorous Irisblllan, I guess, be­ cause he looked at me when I stepped out and answered for both names and said, "Well, I don't know what I can do, except put both of you in a pair by yourself." Then he dismissed me f'rom the squad. Well 1 the extracurr~cular activities becme important--zou know, it is "the thing~" I don't know wnx., ~xcee_ that it seems to be a kez to soc~~l things. Well, Yale grades on a four level, and I think for my first two 5ears I was running about two-fift,-. In my senior year I think my grade was up around three-thirty, or three-forty. Then wren I went to Hopkins--! don't remember 42 working too hard, but I graduated first in my class at Hopkins and was made Phi Beta Kappa, so that wiped out some of the earlier disgrace. Was there ay:--Yale had a good ,f~cultz in those daz.~• Oh yes, they had some very fine men--lfheeler in history and Swaner in economics. I guess zou took whatever was required or 1011.e It was a rather rigid curriculum in those days• They didn't have matV' optional courses as they do now, but I was more or less heading for medicine, and I was guided there to lice physics aftd chemistry. I went through organic \ chemistry- which was very hard for me and physics-oh, maybe two years or more. I studied some more Greek and some lllOre Latin. I studied French and history and English. The :English I liked very much. There were two great teachers there in n1y time-William Ly'ons Phelps and Chauncey Tinker who was the great Johnson scholar. Well, then not far from where I lived--I was rooming near the camp12S-•they I I had the old Peabody Museua. Its torn down now. Its built in a new place. 0 The Peabod;y Museum was just a mass of messed up collections of di~aurs, fish, pterodactyls. One thing they had was Marsh'3 Evolution of the Horse, and I rem.ember bow that just intrigued me to learn how this thing started with five toes and came out with a single hooto I thought it was wonderful. It is. But English--this ~ournalistic escaeade that you we~t into was ~aue­ thi!!S, new, wasn't it 1 or were you on the f!l!!r at Thacher? No. You were not. I think I went out for the Yale News just because it was a conspicuo11S thing to doo Maybe it was sanething that somebody told me I ought to do. I didn't do ao:,thing in any literary sense at Yale. There was a man, Professor John Berdan who had a couree in what he called "minor themes"• You had~o write a short descriptive thing, or scnething 1 and I scored a few on those, and then Professor Phelps formed a club called "the Pundits• which had very bright people, Wayland Williams, Lawrason Riggs, and others, and somehow or other they took me into that. That club met at Mr. Willin Lyons Phelp 1 s house, and they discussed Chaucer and all sorts of esotericfhings. I roomed with a very able literary young man named Howard Vincent 0'3rien. I spent two years rooming with him. Did you ever hear of him? O'Brien is mentioned scaewbere. - Yes. "Pat"' they called hill then, and he at that time had made two of the main Yale magazines, the Yale Liter& KagaziDE?,, and the Courant., as they call it. He was a vecy clever and facile writer. After graduation he became a member or the staff of the Chicago Dailz News, and he wrote for years a column called "All Things Considered.n He's about as close a friend as I ever had there 0 We ro0l'lled together in Durfee Hall one year and a place called Haughton Hall the other year, but we went rather different ways. Well, we were in the same fraternit7 together. That's Zeta Psi, but he went into Wolf's Head senior yeari, and I went into Skull and Bones which is als• something that I just thought I was going to get. I remember very well tap dq. I wasn't worried at all, and lo and behold, I got tapped. Subseguentq1 and there's correseondence about this, zour brother Bazne, his i!Of?hGlllore class took a jaundiced view toward what tap day had beeau•• Not only tap da1', but the senior societies. They changed tap da1' a great deal. The students revolted against it. For y-ears they just thought it waa a horrible, barbaric torture tor these people. For instance, President B~evster, president or Yale aow, Kingman Brevster--he was a brilliant student, the kind or maa whom you think would be chosen by- Slcull and Bones. Well, when tap day came in his class, he went down in the basement and sat on the toilet during tap d&y'. They couldn't find him• He was revolting. My brother went Skull and Bones, and ray brother was in the class with Dean Acheson-1915.....nnd Dean Acheson went Scroll and Keys. A nlllllber of others, men who have become rather prominent­ I forget all their naaes-~but they- worried me and my Uncle Hugh because they didn't. know what they were doing. The:, were revolting against the senior societies that had a good deal more to thea than appears on the outside. People make up fictions about what they do. Yea 9 Tap day ~asn't an odd day in your clue. No. w+ook it all vecy natural~ and expected it. I think I came through a curious kind of age up thereo We were quite conservative-at least the people I was with were, but I felt on the verge of change 0 Itve always thought that they-ear 19101 marked the end of an era and the beginning of some new things at Yaleo Plll sure that's se, if you analyze it 0 I never went into it too 4S deeply, but we didn't worry. I didn't worry-. Fortunately I didn't have to. I was standing out there under that tree and one of these senior Bones •en stepped up behind me. That was about five minutes before the bell rang so I didn' t W01"1'7.o This was, I think, importa~t to Hugh Bayne too. Hugh Bayne, yes. Well, I can say that having been in that senior societ7, Skull and Bones, I know that there is no packing. There is nothing said to an;ybody in advance. No older person dares to say anything to the people who ~ I I are ~ng the electionso 'I'bat snot true or the other societies up there to I ~ the s81'1le extent. I know it wasn't because we haTe the lists, but H~h Bayne wanted me, of course, very much to be in the Bones. My grandfather was in the Bones, and H11gfl Bayne was, and I•a sure he :must have done a good Rl&rJY purposefu introductions, but he never laid a finger on the process. I onll meant to indi~~te that he was pleased. Oh, well--he was not only please~, but if it hadn't happened, he probably would have been grieved. That's true, but he was pleased. Did you have-how about study habits in this period.a along toward junior and se~ior year? I studied quite bard. I wasn't very bright about it because I would study like the dickens with chemistry and physics. There was a boy in my class named Marsh nock Powers .from Cleveland, I thinko He would borrow my notebooks just be.fer e the examination, and he 1 d get an A, and I•d get a Co He was quick. 46 1 ~ou attended class and took notes wq,icb is a new process too. Yeso Listening to ill protessor 1 ;ettitlj down what is called "the aeat"• I changed those habits when I got to Hopkins. As I said, and this is not boasting, I •s the first in..,- class, but I don•t remember making any special ef'f'ort to study. I took soae noteso I read a great deal. I read much outside the textbooks o J I was disguated witn one of our pro.tessora who used to take Osler 1 s Sl!,tem of Medicine when it was one voluae, and he would stand up there I and read it to us. He ,, d sq,"Now, underline this sentence•" He'd go right through the pages, and you'd underline all the sentences. This was mechaaical., but in •Y senior year at Hopkins I came up with an intenae interest in the Negro question, and I spent practically aost of..,- class ti.Jlle reading books about the South and the Negroes. I•d sit there with an open notebook, but with this other book inside it, of course, turning the pages. I had no trouble in the medical school getting along, and I had some good friends-that is, of' the kind of friends I ha'4 ~d you get to know 11&& of the professors at Yale? At Yale? Yes-in the sense of teacher-student. Noo Thez were remo~? Either they were remote, or I waa: in a fish like stage at that ti.me--if !'! 47 you know what I mean--squirming out of the way of things, but I got to know Mr. Phelps somewhat, and I got to know President Arthur T. Hadley somewhat. He was a queer man, but very nice. I don't recall going out very much to aey- K. body's house. I had no part.i.cularly close relation to any membe1' of the faculty. That's almost par for the course 1 I think. Did any member of the facultz sti~ zou up1 kick open a window or two? Well, I think Tinker did. or course Tinker was a wonderful teacher or Saw.uel Johnson and the 18th Century, a very polished lecturer. Mr. Phelps aroused _,. interest in playa-Pinero, and Shaw and those things very much. Curiously enough, I didn•t see much of a medical side at all when I was there, or I don't remember. Well1 :medicine lay ue ahead1 and zou said the other f1& when we talked that so far as chemiatrz: and pbzsics were concerned, there was a certain amount of preparation toward medical school that you took more.seriously at Yale than zou did at Thacher and Dixon. I can add tm that French and German because we were supposed to be able to read French and Germano I could read German with a dictionary all righto How did you do in chemistry and p!!zsics? You indicated that you went through organic chemietrz, but how did you like laboratory work? Very 11.11ch. Ob, you recall sc:aething to me that I liked extremely well. I got along in chemistry well enough to be accepted b;r the great physiological chemist at Yale--Ruseell Chittenden. 48 Reallz? Yes, and I 1x> ok the course with Chittenden and Lafayette Bo Mendel over in the old Sheffield Building. You know, that's so identified with my medical work that I hardly consider it a part or Bf3' undergraduate work, but that laboratory was extreael7 interesting, and Mr. Chittenden was too, and we did a lot of interesting thing1. That's like getting familiar. Yeso Was it a well appointed laboratory? No. Oh, it was a tuabled down place. It wu the old Sheffield mansion, a living house that had been :made over on Hillhouse Avenue. I suppose the1 put laboratory benches in the old parlor and places. It was very- crowded, but that was all right. Its eemed fine t.o me, and we did all sorts of physiological and chemical things. Lafayette Mendel was an interesting person, but Mr. Chittenden was the lively one 0 Was he a critic? What? Was he a critic? Yes, he was a critic, and a tremendous worker. He was Dean, not founder, but :I Dean or the Sheffield Scientific School, and he was very ambit~ for that school to wipe the eye o f # College, so that there was a co~lict then in a 49 way. Now they're all merged.'I'hey 1 re in one university now• but Mr. Chittenden h was responsible for introducing to the Sheffield Scientific Se~ool a course that he called a "select course"• The men could go into that and not take any science at all• and they ~t through easier in their literary studies and in their studies in the humanities than the students over in Yale College across the street. This was called a "select course"• He was something of' an innOTator thepo When it came time to go 1 or to think of medical school the indication that I have is that lou studied Ol'18 year at Tulane, 1910-19110 I alwayB wanted to go to Johns Hopkins. I never thought of &01' other place s because it seemed ~o admirable to me because ef the people who were there and their ideas, but as I approached the time to go I surrendered to the wishes of Mrs. Denegre. My brother was at Yale, or coming to Yale. He was still at the Thacher School theno My sister had married an+ad moved out ot the Denegre house. Of course she was acroes the street. This is a true story. Mrs. Denegre had a little white poodle called "boucbe troue"• Do you know what that means? It aeans "st.op gap"• You see, a bouche is like a cork, and a troue is a hole, so they called the dog "bouche troue", and Mrs. Denegre wrote me that Marian had gone, that Bayne wasn't there, that she and Uncle George were loml.y, and that "bouche troue" wasn't enough, so "you 1e better come home." I didn't have the nerve to stand against that.o I went to New Orleans. I got into Tulaneo I don't know that the financial side had much to do with it, but I got a scholarship because of 'III3" grandfather Jones having been a professor there., and I imagine that relieved them of some expense. At that tine and all through Yale I was getting a ttousand dollars a 7ear from a fund I thought was inherited. I don•t know who put the money up, t,o tell you the truth., but I got a check for eighty-three dollars and thirty-three eents a month., and I lived on that--tuition and everything else. Well., anyhow I went to New Orleans in the fall of 19101 after I graduated from Yale, and I entered Tular20 As I look back on it now., Tulane was a rather raucous, rough time of country boys who had very little educationo They didn't have to have much more than a high school education to get into Tulane at that time. For instance., the first anatoay lesson rather shocked me, as it does most students. Alan Gregg wrote a bo~ for doctors, and he said, "Medical students certainly don't realize before they begin that their course of instruction is rather like a prize tight. Ttiey meet the cadaver first and shake hands with the adversary at the beginningo" Well, you en,tered medicine in those da7s through the dead house, and I had a different feeling about it. To go into those big dissecting rooms that smell bad and see all those bodies lying out there--for me, who had had some experi­ ence with medical things, it didn't look too well. It didn 1 t smell very nice. It was a bit or a shock., but some of those other b07S didn't mind it so much. I remember that two of us were on a cadaver to start the dissectiono YoQ were supposed to work out all the muscles and nerves very carefully., and this Georgia boy working on the lower part w1 th me took a big knife and went around the battocks of this cadaver and cut one side of it off like ah• and took it 51 0 to the profess~r• He was finished with his dissection in five minutes. Tba.t was typical. The other things I told you about 0 The tape recorder wasn't running then, so please put them downo I got to be president of that class pretty soon. 0ur histology course was quite interesting• but Professor Ining Hardesty who taught it was quite strict, and you had to draw pictures of microscopic sections, and you were supposed to ba.ve in your drawing exactly the number of nuclei that were in your section which was pretty hard to doe Then he had a coarse in neurology which is an extremely difficult course anyhow, but the boy-a thought that it was pu.t in there to spite th•, and they asked me as their president to go to the trustees to get Mr. Hardesty to take the course out of the curriculua. The Professor of Chemistry, Mro Abraham L. Mets, was a strong and vulgar and rather interesting chemist, but taught in a rather unorthodox manner. He- 1 what I said to you the other day-would put~ on the board and sq,"Here•s I I Mr. Sodimo He s blonde and debonaire, and he 1 s walking down the beach."' " Then he 1 d write 1,l and he 1 d sq, 11 This is Miss Chlorine, and she's green- eyed and avid. 11 Then be 1 d write 1cf on the board and sq,"Name their babyl" Sodium Chloride or salt. He would come into the lecture room--once lecturing on the naah points of oil he came into the lecture roem. carrying an oil lamp and pretending to stumble on the threshold ot the door, he threw the lamp on the floor, and it would go out. It wouldn't catch fireo It was a way that he could begin a lecture on the nash points of oil, e. very dramatic way to do it• Another time he lectured on copper, and he had all the copper ~es and everythiag else on hi,long laboratory table, and he went down along that table and with his big right hand he picked up chunks of stuff weighing ten to twenty pounds and hurled them at the students sitting in the amphitheater--big copper pots too. His beta noire was Jean Jacques Rousseau because Rousseau said that you would get poisoned it you made pickles in copper pots, and he would talk about toxicoloa. That 1 s a g1r>od way to teach• He started me in the first piece ot real research I did. I didn't succeed. He didn't belieTe that tryptophane, an amino acid, wow.d come from casein, so be bought me many gallons of millc, and I made the casein out ot the lni.lk by" 0 precipitating it with acid. Then I tried to hydr~lyse it to get tryptophane. I almost got it, but I didn't quite. This was all, new. The Professor of ~ysiology was an interesting person, an Englishman by the name of Gustav Mann aan at the time rq brother-in-law, Ralph Hopkins, "fllY sister's husband, was an Associate Professor in Physiology-, so I was pretty close to him. I was dissatisfied from tre tiae I went there. I studied very hard-I think now in a compensatory- fashion for things that I wasn't getting elsewhere-that is, I didn't care to work off energies, or anything b.r playing around. I didn •t go to dances, if I cou.ld help it. I didn •t know malJ1' people, and I can r•ember ence at Mardi Gras that first 7ear. I was upstairs in the attic. I had a rooa in the attic with a single 'bed, and the single bed was that Washington bad of which there is a picture in the files. I was studying anat011Y up there one eve rtng, and it was carnival time, and I should have gone to a ball, or saaething. Mrs. Denegre, 1q "Tante E", came u.p to the attic door and aaw 11e-I can remember it to this dq. She was about five feet one and rather plump, and she gave sort of a plu~_r and fell across the bed so that her 1111'11 little feet were sticking out over the edge. She was lying across the bed1 net very- comfortable, I guess, and she said,"You're the most unnatural member of this family that ever has existedl• This was because I wouldn • t go to a part7• Well, I didn't go to the party. I don•t remember how that ended, but at that time I began to read &aerson, anf read Elllerson 1 s essay called •self-reliance•, and he says in there that if 7ou are in the household of your parents, or close relatives, and don 1 t I agree with thea, 1 t s better to go and tell thea and get out than to try to stay there and make a go of ito I read that, and I stewed around for maybe a week, or two. I wanted all the more to go to Hopkins,, so one night I went down about nine o'clock frea the attic which was on the third noor to a library 0 down stairs where Mr. Oe~ge Denegre and Mrs. Denegre would sit in sort of opposite chairs and read booka. I came to the door with great trepidation., and then I told them that I wanted to go to Hopkins. Well, to rq amazement before I finished telling them I wanted to go to Hopkins, they agreed with my going. I didn't want to tell them that 1/wanted to go because I was afraid that I wouJd hurt th•, and they didn't want to tell me to go because they were N afraid that it would appear that the7 were puttiAg :me out of the house. Well., this opened the Sllbject up, and we were all together in no time 0 Then I wrote right away- to Dr. Welch, and you 1 ve seen the letter. I got an answer froa Dr. Welch which is one of the achievements or an;ybody in the world. Before you go on1 there are two things-zcu told me a fascinating story the other daz about a group of students who were about to tar and feather one of the professors. That was a man Maed Herbert H. Bullard. Bullard was a Canadian, and he ..... was a Professor of Osteology-. His idea was like Hardesty 1s with the nuclei. He would teach us about the bones in the ekeleton, and you had to know all the origins and insertions of the muscles, not 'nly C the big things on the bones, but~ the little roughnesses where the muscles coae and go. The students :'\. I ~ted that. It was too l'Brd really. It was just strict memorizing, and also the stuff is very variable because two bones are not exactly alike, but he would insist on thiso Well, I was president of the class when I got a call from somebody in the evening, •coae on up here to Audubon Park. They 1ve got Dr. Bullard on the levy of the Mississippi River. They 1 ve got him undressed, and they're going to put tar and feathers on b.iJao•· Well, I got up there in tile and stopped th•• They would have tarred and feathered himo That shows in sODle ways the flavor of the tillles and Tulane, the attitude thez would take. The other thing that intrigues me is that you said that even at Ya1e 1 or before to Yale Johns Ho ou. How did ou first hear about this place? Well, it's hard for ae to remember because it goes back into Joseph Jones and early- .Sayne themes. One of the admirable people at Hopkins was William Sydney Thayer, Professor of Medicine, a most charming and cultivated gentleman, who wrote one of the first papers on malaria in this country, sc:mewhere in the £1'6q5; -,sen , 1890s. Well, e was known to my family, to Mrs. Denegre, through .baltimore connections• 55 To digress a little. The family used to come up to Baltimore frequently e becaus~ Jzy" mother went to Emnittsburg, the Catholic seminary-that's a place tor monks, isn't it? She used to go to Emmettsburg1 the convent. It's right up here near Frederick, Maryland. rhey got to know a good many people in Baltiaore, including Dr. Thayer who became Professor of Medicine and also Dr. Lewellys F. Barker who becaae Professor of Medicine. Dr. Darker j;' married a Halsq, and her brother was rofeasor or Pharmacology at Tulane. In addition, the faaily connections that go through Baltimore included Cardinal Gibbons. Somehow or other I identif'ied him 'With Hopkins in a way as a great figure. Moat of the things in Baltimore took a part of Hopkins in my imagina­ tion, but I met Cardinal Gibbona. He forgave me for being a rather gauche sort of person when my aunt, my sister, my brother, and I called on the Cardinal in his palace on Charles Street. They kneeled down and kissed his ring. When he held out his hand to•• I think I reached out •1ust shook hands with him, I didn't kiss his ring. I was about twelve at that time, I guess. You see, we were in and out of Baltimore a good deal.t and Hopld.ns w a.a there. Now to go back to the reasons for starting with Dr. Thayer. When malaria was attributed to a parasite carried by a mosquito., that was a very exciting thing. That must have been around•-~ell 1 the mosquite that carried malaria was ffl.scovered in 1897 ..1900, and shortly after that various people tried to confirm, or disprove this, and one of these was Thayer. He would come to New Orleans, stay at our house, and go chasing mosquitoes. Everybody thought he was a damn fool to be chasing mosquitoes. They did. I didn't think so. I thought that was a good thing. He was so charming and so intere.ated in this biological ..... S6 1 process that I thought Hopkins must be a fine place. That's one of the things. Then I used to pass through ~altimore and see this superb building-you know, the central dome of the administration building of the Johns Hopkins Hospital. It was very impressive. In addition, I had an even earlier connection with Hopkins because when i'i'Jcs they were planning the hospital in the early~, the trustees invited five people in this country to sulnit plans for this hospital, and one or them was Joseph Jones. .A:-nother was John Shaw Billings. I .forget who the others were, but there is a book in this library with those five plans in it, and my grandfather, after being prodded by the trustees, said1 "I 1m very bus.,, but J. here's what •ve done", !lrtd he sent them drawings of the hospital. They were very like Billing's plan too, ,o you see, I knew about Hopkins froa the plans ' that he had made about it, alld we'd talk about the place. It a hard fer me to (I separate my recollections of '111¥ fine experience there with the anticipations I had about the place because they have all merged as one now9 I don't knew where one began and the other ended. Did zou work with Thaz!r in New Orleans? No. I can't sq that I worked with him. I knew what he was doingo What I meant.was did you go along with him? I may have 0 Mosquito _catchin,gt You didn't have to go faro 'I'bey were all in the houses. Everybody- had a . ctstern then. r ! ! 57 The reason I aske~ ·'-bo0;t J ~hns Ho,ekins was becau.se I know from the papers that it has had a lo and I wanted ut it down. I think we've 0 gone just about an hour-just abo~t e~ugh. I think so. I could follow up on this Tulane story with the Chicago story, if you want0 When I got through talking with Mrs. Denegre and my Uncle George about going to Hopkins, I immediately wrote to Dr. Welcho I soon got an answer saying that I had been accepted for the secend year class, if I could meet the re­ quir•ents. Well, therequir•ents for entering Hopkins were even higher than the things I would have in my head after I 1 d finished the year at Tulane. The requirements also included more of physics than I had had, so I found out that I could take a swmner course at Chicago to make up this difference. I went to Chicago, and I have somewhere some of the recor~ left-I lived in a little t-1 . ro0111 in a side street near the University i~ a room so small that my bed waa across the door. I had to push the bed out of the way when I opened the door and push the bed back across the door when I got in. I think I lived there-­ I have food bills that I saw not long ago, around six dolla:rrs a week, and my roOlll was around two dollars a week0 I took a full course in bacteriology. I took a course in physiology with Dr. Carlsouo He was a great physiologisto I took a certain amount of physics, and I read a great dealo I had good enough :marks and finished all the stuff A up necessar,- to get in Hopkins; in fact, I did more tt_r1 enough, but I almost didn't get into Hopkins because after I finished at Chicago I took a little time off. Somehow or other I picked up some books on architecture and I got very interested in reading about architecture. Then I woke up one day--this had only taken me a few days-to realize that the Admissions Colllllittee meeting which was whatever examination they'd give at Hopkins had been held and finished before I even started for Baltimore9 This is a ridiculous story I•m l going to tell you, but its the truth and characteristic of the Hopkins peopleo I went on down to .baltimore, and I was the enly candidate that appeared that day at a meeting in the Dean'• Office. The Dean then was a man we called "Bull" Willia.as, a great, big Professor of Obstetrics, a wonderful man, J. Whitridge Williams. Dro Williams, Dr. Willia:a H. Welch, Dr. w. Ho Howell, who became Dean, and Dr. Franklin P. Mall, the great anatomist, were sitting there, and I appeared in that room with a derby hat in m:, hand. One of them said., A "Won1 t you h\e a seat?" I put the hat down on a chair, and then smething distracted my attention, and so they said1 "Well, sit down." I sat down, but I sat on my derby hat--right when I wanted to make a good impression. I think: it you did that nowadays, they 1 d throw you out arxl say, "You're so duab you can't come in ft~s school," butt hey all acted as if I hadn't sat •n Dr9" hat, Ii nd I did too, until finally Dr. Mall turned to me and said,"You can get up oft your hat now. That's not a sacrifice demanded of the ne°T'1yte here." Tbat 1 a aarvelous. Did they-this was a verbal questionin,g that they put you ~hrough? They didn't ask 118 much• They just wanted to talk to you 0 As a matter of fact, that system of a liberal attitude toward a candidate is chacteristic ot the place., or at least it l s been 1111' fortune to have had it extended to me. $9 For instance, when I went before Dr. Wil]~h Halsted in the end for oral examina• I C tion in su.rgeey--Y1\u know, he was a great surgeon-he talked to me about North Carolina. 0 When I got a license by examination, so to speak, in C~nnecticut after I had moved back to Yale in the 30s, they- called you up to Hartford for 9l"l-'eJ __cu examination. 'I'hey even asked Harvey Cushing to cme up there, but when I got ky' • in before this austere board, they just aaked mefi>1nion about things. They didn't quiz me on the facts. I could make up anything. At Hopkins I had done so much work that it was very- fortunate. I had this physiology with Carlson, so that excused me-Dr. Howell who was Professor or Physiology said that I needn 1 t take any more. Yous ee, I was entering the second year at Hopkina. I did this work at Chicago so that I wouldn 1 t lose a year. Dr. Howell excused me from physiology, but permitted me to put all that 0 time in his lab~ratoey working on a problem, so I worked on the extraction of prothrmbin from blood platelets. It•s a part of th• coagulation of blood in which Dr. Howell made such a great name for hiaselt. Well, I spent a year-all or the tillle that I could put in-in a little room in his laboratory-. It was vonderf'u1, and he g ~ me an ideal which I think Itve lived u.p too When I got through, I wrote the paper tor publication in the Allerican Journal or Physioloa, and I put bis name first. Naturally-he outlined the problem. He guided every step, and it was really-well, he should be first as senior '( author. When he went o~er the manuscrip~ , he changed it a great deal, or edited it, and he took his name off'. Now, that is what a lot of' prof'essors don't do. When they- have a student taking a degree, a Ph D, or whatnot, I know some of them just insist on putting their names on all the publications. Leo F. Rettger was one like that at Yale 0 I don•t know whether your teachers 60 did that--you know, before y-ou make a thesis, you often have a number of papers. Well, Dr 0 Howell did this, and that paper was pub~\iedo That 1 s 'tq first I publication in 19ll {.'Jo .American Journal of Physiology 74-79 (April, 191227. - Moo I wanted to take a course with Professor Walter Jones. He was the Pro• lessor of Biochemistry, a very- brilliant and able man. I wanted to take his course in biochemistry. I went to see him, and he said, "Have you had an;:, bio­ chemistry?• Is aid, "Yes., sir. I had course work with Dr. Chittenden.• He aaid,"uet the hell ou.t of here! I can't teach you &DY' biocheai.str;r., if you've worked with Chittenden", and he wouldn't let me come in and audit hie courseo Was~his Ajax Carlson at Chicye? Yeso What sort of fellow was he? He was a great big Swede, I think-or Norwegian, a big, rawbone man about r six teat twe, str.aong as the deuce, chewing a pipe stem all the time and very .,/ incisi'Ye in everything he said, firm in his opinion, opinionated, a big voice, and he was a leader• A eied piper. How was he with st.ud«:nts? Oh, they liked him, admired hi.a so mucho He was so honest. There wasn I t any fa➔bout hilR. I 61 ~ut the University of Chicago is the first ti.Ile that bacteriology is mentioned• I took a course there in bacteriology with--well, his name will come to me later on {"Professor Norman MacLeod HarriiJo It was a nice interesting course. He was a Canadian man who was a quiet, shy sort of person, taught a routine bacteriology course, but I didn't get into bacteriology because of I thato I'll take that up with you later. It s a curious thingo I went. back " there to Chicago in 1928, as a visiting Professor in Bacteriology, and I will tell you about how that resulted in 111' being offered a protessorship and why I didn't take it. Let'• call a halt todgz-all right? 62 Thursd&, April 141 1966 A-54 1 N. L. Me Last ti.Jlle w• got you through the period of ijerest1 but dissatisfaction at Tulane, the break thro4Sh in communicaticm between. l~urself and Uncle George and "Tante E" about Hopkins, and there was no problea--sud.denly you were all singing the same song. We took you to Chicago by' way of underscoriy Dr. Welch's letter to :zo1u "It you meet the requirements"• Well1 you did more than aeet the reguireaents. This waa because I wanted to go into the secol'ld year without losing a yearo Righte Then there was this fascinating aside into architecture that all but eliminated the adlllission day meeting. Yes, it distracted meo I forgot the data. But at &l\Y even~, rou finally got to Hopkins, spoiled a derby' hat1 but were very gentg: received. I guess the preparation for eoing and staying at Hopkins, studying at Hopkins--as you indicated la.st time--had been in your mind a lo,!$_ Oh yeso J,.J Well, here you are, You're there. Baltimore L is an old friend to you. Hera you are with ~ontinuity 1 and I•d like you to talk about the city1 the atmosphere, the general shaJ>! of things 1 what was available to you in terms of' facilities, laboratories, people, equipnent1 librarz, and so on as of this earticular time because you must have luxuriated in it all. There was more present than Marsh's Evolution ef t.he Hors•. 63 1 I 0 Well, the first thing you have t'f\ do when you go to a new town, er a aew school is find a place to live. I don't remember how I went to the house where Dr. Welch lived, 807 st. Paul Street, but I did have some kind of a letter either to him., er to the housekeepe~ of that house that made it possible for ae to get a room there. When I entered the second year class at Johns Hopkins, I got a room in the house where Dr. Welch lived, and I eccupied that room on the third fioor just over his bed room for the next three years. This was a great, wonderful thing for me because I place Dr. Welch with the great people ef the world. I admired him enormously, and he was always very good to me in not a condescending fashion, but curio1181Y enough with his gentility and his great knowledge or people, he treated this incOl'ling student. as a colleague. The lact, who kept the house was Miss Mary Sinnons, a tall, thin, austere sort of person with a ■ost kindly heart, but an imperious demeanor, a.nd as soon as I got the room and she was giving me a latch key to the door, she said to ae, "You~ man, if you come back to this house any night and you can•t get this key in the lock, if you are rich, you can go to your olubo If you're poor, you go to the statiel'll" Pretty austere.. Miss Sillmons, I think, also managed Dro Welch who was a bachelor, in a sCll18wh.at similar kindly and strict manner. Dr. Welch was a bon vivant, and be gave elegant dinners at the Maryland Club, some of which he took me to1 and I remember once seeing Miss Silunons, the day after Dr. WeJc h had been at one of these dinners, and she told me that Dr. Welch came home about JBid-night and didn't. have his ke7. He rang the bel~)and she said,"I went to the door te tell bbl what I thought about this, but he was so sweeto He put in my arms 64 all the noral decoratiom frDll the center table of his dinner party and went upstairs as quickly as he cou1d." That showe, I think, Dr. Welch's character and his tact--and for a bachelor-­ bow to appeal to the ladies. It also shows something of Miss Simmons• dis­ ciplinarianism. Did :you warm t• hia? Were you en rapport with him? Vi.th Dr. Welch? Oh yeso I talked to Dr. Welch quite freely, but most respectfully' all the ti.Jle because he was the molder of tlle HopkillS medical school, the great feunder of all the modern foundation support of 1tedical education. He knew Mr. Frederick T. Gates very well who was the man who influenced Mr. Rockefeller to give the money. Let me continue with Dr. Welch just a little on saae minor anecdotes. All 0 the people that visited the Jl8dical school from abr\ad, people of any conse" quenoe I wcu1d call on Dr o Welch, and he entertained most of them at the Mary­ land Club, wonderful dinners. He took me to everal, but I happened to see one night as I went by his door how he was preparing for the dinner 0 He had a man fron South Africa, and I noticed that Dro Welch while putting on his tuxedo, had propped on his bureau the Enclyclopedia Britannica. I think I may have gone by enough to see what he was doing. It wast.urned to the article on Seuth Africao I went up stairs and read that article too before the dinnero At the dinner, this foreign distinguished gentleman was sitting between me and Dr. Welch, and Dro Welch began on that article with paragraph one and said --- 65 soae things. I caught on to what; Dro Welch was doing., so in the next pause., or ••, I picked up paragraph two., and Dr. Welch looked at me in a curious wq. Well, we went on through that whole article thatwayo That 1 s a marvelo\18 techniqueo Well, Dr. Welch would do that. He would thoroughly prepare f'or anything he did, and it wasn• t false. It was false on my- part, but he could haTe done it without preparing, bllt that was one of his characteristics 0 He had a most 11&rVelou.s meaory, al.most cc:aplete recall., and he kept on developing it by in• eisting on holding you while he recited in detail what ne•d just reado He ' would read a scientific article and start to talk to you about it. You couldn't stop him. until he told you everything that was in that article 0 He would sometimes repeat ito I remember how long that particular quality continued. Dro Welch died in 1934, April 301 1934, I think:• He was in his 85th year. He was born in 18501 and he was dying of a cancer in the BradJ' Urological Institute. I thiak he spent a good part of a year d11ng there 6-"ctual.ly 14 monthi/, but he was reading scientific papers all the tiM in the journals which ve brought him, and one of them C112 Proceedings Royal Society of London, Series B 384.-k06 (March 2, 1933')], as I remember distinctly'., bad the first account of El.ford {crradacof/ filters which are collodion filters with very fine pores, so fine that you can Masure the size of viruses that pass through and those that don't• Thatw as the first time that they began to get at the size of viruses like poliomyelitis e virus and others., Ir emember sitting by the sid~ of Dr. Welch's bed the day or so before he died, and he :mcited the whole of that article on Elferd filterso That's the way he waso 66 He founded one of the first medical histor7 clubs that I knew anything about. I s11ppose the influence of Dr. William Osler was there too, but the Johns Hopkins Medical History Club aet at least once a :aontb under the aegis of Dr. Osler, who had gone before I got there, and Dr. Howard Kelley, Dr. Thayer., and always Dro Welch. Dr. Welch knew medic~ histoey just as he knew anything else, and of course the final accc:nplishment or bis varied and wonderful life was when he was made the secom director of what is called the Welch Library at Hopkina, the great medical, historical and general scientific medical library. When Dr. Harvey Cushing wouldn't take the job, Dr. Welch took this on--oh, in his 80th year, I believe. He went abroad and bought a lot or books in his characteristic fashion. He just bought books and greatly exceeded the provision that had been made for his purchases--he was a very mild sort of an emperor to hiuelfo He was a very big, portly man with a very- large abdominal section, very handsome, dignified, pleasant voiced, kindly-no end or energy- as tar as I could tello He could go all the t:iJle. Was h~ ne9:.~ and tidz? Yes 1 he was neat and tiey-1 but he didn't have anybody' particulayly taking care or bis clotheso He was neat and tidy' as far as his clothes go. He was very untidy' as tar as his correspondence and bis books went. He had a syst• or allowing letters to accumulate on bis desk until they got to a certain depth, and then he 1 d put down a layer or newspapers over those and start again. He did. ondence was hand written. All or bis correspondence was hand written. I talked a year or so ago to 67 Dro Allan Mo Chesney who wae a class ahead of me and became Dean of the Johns Hopkins Medical School some years ago, and he wrete the history- of the J ob.ns Hopkins Hospital and Medical School. He went back over all these files of the Dean's Office, and they hardly found any-thing by Dr. Welch typewritten. He did all his Dean's work and his Foundatienwork in long hand. That's great organization to keep in mind an idea. That's tidy 0 Let ae ask you if you're doing any collateral reading in connection with this? I•a trzing to. Well, there's a wonderful paper by Dro Harvey Cushing called "The Doctors Welch of Norfolk" libich characterizes this wonderful Welch doctor tal'lily. Dr 0 Cushing was tomed by' Dr. Welch in a way too and admired him treaendously". Did he have hUllor? Yes in a way. Well, you dido. 1 t make any jokes with Dr. Welch. I uooerstand that1 but did he have humor? He had a twinkle. A twinkle. Wasn't overly serious-just well organized in terms of his interest. Yes, he wasn't frivolous. Well1 the picture of him depositing the center piece with Miss Si.Jnmons comi!!S - hcmeo 68 He had a sense of humor--certainly'. Was he accessible to you in the house? I never tried to associate with him in that way. To me, he was an 01,mpian figure. As a matter of fact, I'll confess one thing I did. I put my bed on the third fioor over where I knew his bed was on the second, hoping that some dre8118 would come up and influence•• You indicated that he could talk with awone high or lw without them gaining the feeling t~\ be was condescendingo Yes. That's a rare gift1 isn•t it. Dr. Wlelch was very fluent in German. Of' course hew ent to Germat\Y from Bellevue Hospital up ia New York before he went to Hopkins. Then he went to Oerm.atV" almost year after year. He was a close associate of Robert Koch, of Cohllhe:La, ef Ehrlich, Pasteur, He knew a1~ people who were making the bacteriological era which had begun a bit before his time, but which was caning in to what he called "the most miraculous decade in the history of medieine"­ that is, the period from about 1870 to 18801 1885, and he was a part of that. He was making discoveries of bis own in bacteriology at that time. He was one et the men who introduced medical bacteriology into the United States. He had .... a wonderful scientific mind, great judgment. ~ople consulted him on all sorts of things, and hiB colleagues at school accepted his authority very easily, even very, very individualistic people like Franklin Po Mall, Professer cf Anatomy--y-ou may have come across him in some of this stuff. Dr. Mall was a tall, sharp spoken man of great intelligence, a Professor of Anatomy, and a man who, really before Dr. Welch, had a vision of the full time system of medicine 0 He preceded Dr. Welch., but Dr. Mall had everybody e rather frightened because he would say such sharp things in a ~ntle manner. I can rem.ember when I was trying to draw a picture of a brain that had been given to me up in his anatomy- course, and it was still covered by the meninges, the dura :mater which is a thick piece of fibrous stuff which was almost opaque from the fixative. I was trying to draw the convolutions of the cerebral part of the brain. Dr. Mall watched me nfor a while, and he said, "I think if you would remove that opaque obstruction, you'd be able to see it better." That I s the way he I d talk to you 0 Like pulling the stopper. He was a man who, as I say, frightened you somewhat, but very intelligent, and he had with him a marvelous Associate Professor named Florence R. Sabin who got to be a great expert on the formation of blood. I had the good fortune to work a little bit in her laboratory for a fh ort time-ahe went while I was at Hopkins to the Rockefeller Institute 0 I think s be was the first woman to be en the faculty of a medical school 9 It was in the time of Dro Welch and Dr. Mall that women were admitted to the Hopkins Medical School. The~leren 1 \ admitted at first, but the place got in financial difficulty, and Miss Mary E. Garrett said that she'd give them five hundred thousand dollars if they would admit women on the same footing as men, and they did. How was Dr. Welch in class? Dra Welch in class was superb. He didn't recite the textbook on anything 0 70 He just talked about his experiences and his knowledge. He had first hand know­ ledge of just abou.t everything that he was going to talk about in pathology-. His i.Jlmediate,successor was George H. Whipple first, and he was followed by Milton c. Winternitz--both ot whom had tremendous influence on ay doings. Winternitz was succeeded by William Go MacCallwn who was a brilliant man, but these men all lectured tram what they knew. They didn•t recite the book back at you. They supposed you knew it. Dro Welch? - Yes. 0 It's the same thing. They just t~11ght Dr. Welch was one oft he seven wonders of the world. they liked him, but there was no familiarity. They wer~ there for business4 They were there for business, but even if there wasn't any business, there was an aura about hill that influenced0 Did 1..ou ,have .~he feeling, .in compari;_son to Tu_!ane 1 that Hoekins, _wa~ a erof'ession&l school? Oh 7es o or course its students were all very much more earnest than they were at Tulane, :much better informed. They all had BA degrees from their colleges. 'J:hey all were ambitious, wanted to live up to high standards. They didn 1 t want to get by on any easy way. They admired their professors which is veey different 0 71 As far as the physical. plant went at the time, I thought it was palatial, but I know now that it wasn't. It was built at a time when modern apparatus, modern appliances, modern fixtures had 't cme in very much. There were great high ceilings everywhere, not too warm rooms in the winter. Then, yeu know, the whole place got into trouble when the Baltimore and Ohio Railroad failed. They lost a great deal of money at the time, but you see, it was in 1910, that Abraham Fl.exner wrote his great report on the medical schools of the country, and I think that Abrahaa Fl.exner thought that there was no other school in the u country that could te1\.ch the Johns Hopkins. Dr. Welch had a good deal ot influence on the F1exners. It was Abraham nexner•s brother, Simon Flexner, who becue the director of the Rockefeller Institute after his work in pathology at Pennsylvania. He came from Louisville, Kentucky to work in Dr. Welch's laboratory. Dr. Welch knew both Abraham and Simon Fl.exner from the time they were much younger-you see, Dr. Welch lived a long time. He was born in 1850, 9nd we're talking now for me around 1911--at that time Dr. Welch was sixty-oneo The rest of the things on the equipment side, it was a period when most of tbe investigators made their own apparatus. You blew your own glass anfade all sorts of things, could repair instruments. You couldn't repair microscopes and instruments like that, but y-ou could do a lot of llinor stuff, snd Dro Welch's own laboratory was very simple. He wasn I t deing research any more when I caae there, but I could tell f'rca the pa.st that all he had was some bacteriological apparatus, some culture tubes. He of course presided over the pathology tthe Clinical-Pathological Conference,j/, the great autopsy occasions where he would- 72 I-i,uppese he might have introduced the system in which the pathologist and the professor of one of the clinical departments meet over a case, a body that's been autopsied, and the professor tells what he thought about the disease, what the consequences were and the processes, and then the pathologist, who has the ls last word and has the great advantage of having seen everything, A_ sually tells I him where he was wrong--the clinical pathological conference. ,.. a very Its lively' and interesting meeting because these men don't try to put on any false front. They go at it. How was Dr• Welch in those conferences? He was very good. He wa1'1••• He didn 1 t do what some pathologists de in those conferences. He•s a gentleman and dealt with the clinical professor as if' he was a gtntleman too. Some pathologists that I have known use that occasion to vilify and ridicule the other man. They shouldn't because, as I sa;y1 they've got the look-in on what actually was there. The other fellow was just guessing--bad to guess. It ca'! be a little frightening, I think it could be pretty fri~htenigg with~ fellow whom you mentioned and whom I met scme years ago-Wtnternitz. Where did you meet Winternitz? It was h•l_!. in Washingto'!:~e? he was down here on the Hoover Commission. He died about five years ago. 0 It was soae time before that. He was down here working on the HOAVer Commission, • R I think it was 1 to revise the stru,_cture of government, and I saw him briefiy1 ~ he had th~ reputation or running a pretty brutal conference. Th~t may be 1 73 , ' ' ' overstatedo Well, I worked under Dr 0 Winternitz a couple of years down there. Winternitz never hurt me, but he was awful rough on Salle peopleo Yes, I guess it's one thing when you have the final say. You 1re--.ell1 it's like having an ace in the hole. Talking about the apparatus--you take this thing here, the chloride deter­ minations in the urine. That piece or apparatus that is shown in there is 0 nothing but a graduated cylinder--just stock in the lab)\rator.,1 and you put it together and make something out of it,. This eaper is 1913. ["Simplified Methods for Quantitative Estimation ef Chlorides in the Urine"' 12 .Arch Internal Med 90-111, (191327 This was during my third year. Yes. Who was Dr. Guthrie? He was the Professor of Clinical Microscopy which is a subject in the school where you examine blood, saears, urine, sputua--all the excretions, plus make cultures. Clinical microscopy was a favorite subject with ws. It was a _,,. rather exci;tiag sort of work--ha.ving • ~ peculiar things that people get out of their bodies and tun trying to find out what they were and guessing. lnyde G. Guthrie was a beau brumm.ell, a good sized fellow with shining red hair, immaculate clothes, and I would say now, a Madison Avenue manner, but we didn 1 t know that in those days. He had as an associate a more interesting and able person named William L. Moss, and Moss discovered the blood groups while I was there. That was a great excitement. Guthrie let me come into his ahop, his laboratory, to do whlt I wanted to do. I usually' eame in after class and usually worked until late at night. The interest in this particular paper was that it appears to have been an effort to test the accuracy and simplify the tests doctors could make. That would work• A use,ful service. An effort to draw some relationship between what went en in rds. In Hopkins they encouraged you to de what they call an "arbeit". They carried that over from their German experience. Every student was supposed to be able to have art arbeit-you worked on some problem. A great many et them didn't work on a probl•, but if you showed any inclinatien to do so, you were encouraged. You didn 1 t have a grant to work on. There were very small funds in the departments, and you had to fidget around and get your apparatus as you ceuldo It you had a piece of work that required the use of dogs, or other animals, ;you probably wouldn't get very far with the supply because it was too costl7. In this particular problem--tbe accuracz of these tests and measurements--in settinc it up did you talk to Protesser Guthrie u to how it would be design'?2, or did ,he turn zo11 loose? As I recall, they turned me loose-you see, there's no statistical study in that paper. It is not as I would do it newo I would figure out how much I had to do to get a significant result and do scme other stud7 or the problem. That and this one-I forget what this one is-but they were all episodic with r I 75 ... Theydlappened to be something that I was interested in at the time • Yes 1 that's the nature of these eari, papers. This one is that abscess of the liver. L9Bloomfield, A., and Bayne-Jones, s.,"A Case of Abscess of the Liver due to a Streptothrix" 26 Johns Hopkins Hosp Bulletin 230-233 (191Sl7. That v as because I happened to see a patient who had a mosi peculiar fungus-like thing-there's a picture or it there. I was partly- interested in that kind of a thing then because, as I recall, Aldo C~ellafti. was talking about those things. Was he mentioned? No 1 but that doesn't mean that he was not there. No, Castellani Calle to Tulane somewhere around a 7ear er two later as a Professor, a ay-cologist. He became the chi.et surgeon for Mussolini in the in­ vasien of Ethiopia. This apparently was a specific case that came into the hospital-here's its historz:--and presented a problem. This probably-well, Arthur Bloemf'ield was the resident physician then, and he was a highly cultivated doctor who went out to California--literary, in­ telligent, a good teacher, and he ran the laboratory. In the Hospital there was a laboratory for bacteriology, and he ~~bably put me on that job, or else I I found it and worked it up with hiao Its ,.. of no consequence. Well 1 it does show what comes ner the transoa as you grow-:-the same with this ~ • CPleural Eosinophilia"· 27 Johna Hopkins Hosp Bulletin 12-16 (1916'fl. Well, that one I worked up myself because the eosinophile cells were 76 supposed to have possibly an iron component. These are these cells with the red staining granules. Not only did I find them in the pleural fluid in the chest, but I studied all these cells. Then I tried to incubate those cells, I think, with hydrogen sulphide, a.nd they got black so I thought there was some iron. in them. This again is the pursuit of interest. This one on "Eventration of the Diaphragm" ["17 Arch Internal Med 221-237 (191627, was an episode too because I had a patient with his intestines up in his chest because they were going through a hole in bis diaphragm. Yeu read about diaphragmatic hernia. I then went to the library an4ooked up evetry ease I could find anywhere, and IlilS greatly helped in this kind of work by- the Surgeon General's Index Medicuso Then I got the x-ray1,. See these drawings. There was a very- interesting man at Hopkins by the name of Max Br8del. He was brought to the Hopkins from Germany by---maybe Dr. ~arker, and he founded medical illustration in this court, ry of a special type 0 He was a very good draftsman. He had a technique for drawing things on a chalk board with charcoal. You rubbed it arour.d and came out with a .full brain, or something else, but Max--well, didn't Max sign this drawing? Yes 1 he di'!o Well, Max Bredel was a musician and a rather considerable artist, not adically trained, but very quick ~ catch on to what was under the skin. He had a place outside Baltimore which later en in my life, in the time of pro­ hibition, was one of the great beer stubas in town because Max Br6del was a great brewer. Max Br8del's friend was Mencken-Ho L. Mencken, and he was out 77 there eTery Saturday n:ighto Brlde1 and Mencken wou1d play a double on the piano, and weld get out there and sing and drink Max Bredel 1 s beer. He drew those pictures, and he drew some more here too. This paper called "Roentgenography of the Lungs" [""waters, A.Ao,Bayne...Jones, s., and Rowntree, Lo 0 0 ,"Roentgenography of the Lungs. Roentgenographie Studies in Living Animals after Intratracheal Injections of Iodoform Em.u1sion" 19 Arch Internal Med 538•549 (191t)l, has a title that I know now causes a thing to be lost-yo11 see, all that aeans ia x-ra:, of the lungs, but then the subtitle says that we used injectione of iodotora oil, and look at the date on that. It's 1917. I was an instructor in Pathology and Bacteriology. Waters was the x-ray man. I was the animal man, and Rowntree was the braino Dr. Rowntree is the man who wrote that book I shewed you, but nowadays to Tisualize the air passages, that 1 s what the1 use, an opaque substance in the X•T.'&y and this is one of the first papers eTer on that subject, but the iodof'ora we used killed :most ot those dop, so we didn't. use it on patients. Was Rowntree at Hopki~? Rowntree was Professor of Pharmacology"' At Hopldf!!.? He was assistant to Dr. John J • Abel-Leonard o. Rowntree. He was a good pharnacologist, and he did a great deal with the dyes that were used to de­ termine the hydrogen-ion concentration coming out about this ti•• Well, here I am just before going into the war. Yes, l917=though this paper Jl!igh~ relate to work done in 1916 0 r I !I' If! 1!' r I 78 One of the great satisfactions of the arbeit is that you really came in contact with an erudite professor who was kindl.y--inrother werds, it was a little like browsing in a library. You browse on personality when you're con­ nected with this work. I In another sense, its an unplanned thing--interest has to develop, and it is interest that projects you into the midst of work like this. Suddenlz you're in the llidst of it-you know1 and the fringe benefits are the fact that zou do get a chance to talk with a first rate group of P!ople. This first oru,, the beginning, with William H. Howell--he was a remarkable man. I gather you took to medicine like a duck to water. I guess so. I took te aedicina with. a great interest in patients, a great interest in the processes, and a great desire to make further contributions to knowledge about them, but I never did practice aedieineo I always thought that I would go back to New Orleans after leaving Hopkins and be like my grandfather. I would be answering a tinkle bell like he did. The houses in those days had a pull handle on the front door with a wire going to a bell back in the hall, and that bell was a kind of cow bell on. a coil spring. You 1 d pul-1 that handle, and the bell jangled. I thought that's the way I would spend the rest of lllY life after leaving Hopkins, but the accidents-I suppose I can go into them now--ot having an internship in medicine after I graduated and then being asked to be an assistant resident in pathology which I accepted, ~hanged all that. Dr. Welch and Dr. Osler by writing and all made it perfectly plain that you couldn't have a fundamental understanding of morbid processes without 79 1 having a fair experience in pathology, so I went £rem medicine to pathology, from an internship in medicine to an assistant residency in pathology, and that got me so interested that it began to turn my life in that direction. Another thing happened that comes from Dr. Winternitz, and it influenced A me very much. Winternitz was in charge of the Pi\thology Department this year or 1915--I guess it wasJ yes, the fall of 1915. Winternitz had built a labora­ tory for bacteriology on the fifth noor of the Pathology Building, and he didn't have anybody to put in there to run it, and he said to me,"Why don 1 t you take a shot at this?• Well, I had never had anything but an ordinarJ' course in bacteriology up to that time, so they sent me to work with Dro Hans Zinsser, so my lite really began to change. I went to Columbia, P & S Medical School, which was over on 59th Street, back near the Roosevelt Hospital in those days. I went to Dro Zinsser 1 s Department and was c ~ d beyond resistance by his characteristics-­ his vivid personality and energy, ideas, a ranging mind. I woriced there through 1915 and 1916, I guess, and then went back in late 1916, to take charge of that fifth fioor laboratory. I got set up and started to work and then World War I cuae along early in 1917, but Dr. Zinsser was a most charming, fascinati~g person0 He was a musician. When he was in trouble about a scientific problea, he'd put the problem down and go and get the fiddle and go fiddling around, fiddling in the laboratory, pla)'"ing his violin9 He alse was a vivid lecturer who was himself' writing textbooks so that he didn't have to repeat anything at all. Do you want me to ctr;' on w1 th Zinsaer? No 1 I don•t. l,ve got to turn this reel over becauae we're practically at the end.1 and when I turn it over1 I want zou to take me first down to Panama. All 80 right? Where's that marvelous little drawing or the Schistosoma mansoni you ma.de the other day? Well 1 here we are, I think you're entitled to your own views. "Historz", what­ e.ver else it may be 1 is intensely subjective, and when we trz to make something objective out or it 1 we're making something that was not before you. Yeu know how we•re called ueon to make decisions on the basis or inadequate evidence all the time. So the stoq can't really be the way historians write about it-all nice and neat, I wanted you to &9 back because in 1912 1 there's a digressien maybe 1 or opportunity is probably a better word-you didn't have to return to New Orleans. You received an opportunity to go to Panama and this 1 in part 0 certainly 1 was the consequence of a rec~lll!lend&tion from Dr. Welch and also the \ tact that a relative of yours was there, General Gorgas. My going to Panama eaae through my- relative whO.ll'l I called "Uncle Willie", but he was my cousin, Colonel William Crawford Gorgas who was the Chief Sani• tary Officer of the Panama Canal Zone. I don't remember 'When I had seen hi.JI before I went to Panama, but there was some preliminary talk with him before the letter from Dr. Welch. I probably asked Dr. Welch to write to Colonel Gorgas and told him something about it, but-let's see, Colonel Gorgas had been Sanitary Officer of Panama since 1904. He went there right after he finished cleaning up yellow fever in Cuba, after Walter Reed's work, and in two years he finished yellow fever in Panama. There wasn't any more yellow fever--in­ digenous yellow fever. I saw some yellow fever down there that drifted in from ~uayaquil and Ecuador and in the Panama Hospital, but there was no yellow fever arising in Panama in 1912. There was lots of malaria, lots of intestinal parasites, typhoid fever and skin diseases, so I went down there in June, and 81 I stayed down there, I think, until nearly October. You became an expert--and very easily when landing on the dock1 and that's worth telling. I became an expert by accidentally reading, as I usually did1 anything that was printed that came in my way, and on the dock at Colon while I was waiting for the Custan•s Inspectors to finish with my baggage, I saw a rather tattered pa.m.phlet of a few pages on the noor, picked it up and read it. It was an article by Dr. Lewis B. Bates on Schistosoma mansoni which is an in­ testinal nuke that gets in the veins in the lower part of the bowel. The female lays its sharply spined eggs there, and they work their way through the tissue ~nd cause a great deal of trouble. I read this paper which told about the egg and about the life history of the worm just to pass the time. Well, I went that afternoon from Colon to Panama and was sent to a billet in the bachelor's quarters, rather in the dark, and I spent that night scratching and tossing around. The next morning I found that I had been lying on a blood streaked sheet which was the habitat of bed bugs and h~ been used by other people who had left an almost dark greasy pillow. I had to get up early to go to the Negro ward at Ancon which was a very big ward, about ninety patients in it, Negro laborers, and Dr. w. E. Deeks, the chief medical officer, assigned me right away to examining feces in a small roc:m in a little out ex­ tension of the second floor of the building under a tin roof. By that time in Panama at thataeason the sun is pretty high and pretty hot, although it was not yet probably eight o'clock, and this was a stinking place with two hundred 0 and fifty s~e specimens accumulated there. I started to examine them ut'lder the microscope. You take a little bit of this material, put it on a slide and 82 look at it under th+icroscope. About the third or fourth specimen I remember that I saw, had in it a perfectly beautiful, as I thought, lateral spined egg with a miracidium in the center. I recognized it at once as fitting the picture in that pamphlet that I had read at Colon by having accidentally picked it off the floor. Thinking that as I could recognize it as the egg of the Schistosoma mansoni, it must be a comm.on thing. If I could tell what it was, I supposetverybody would know it, so I wrote it on the diagnostic book which at that time went on down to the ward where they were having rounds, and Dr. Deeks and others saw it and came rushing up to this room and said,"What did you do with that specimen?" I said,"! threw it out because I had finished with it."' They said,"Why do you think it's Schistosoma mansoni?" Well, I told them, and I told them all about the worm. 'rbey were amazed and unbelieving, so I had to find the specimen. We looked at it again, and there were these eggs in anything you picked up out of it. Some of them didn'~ know what it was so they sent it down to Dr. Samuel T. Darling who was the Chief' Pathologist of the medical establishment on the Canal Zone, ,1nd he said, "Certainly that•s~hat it is." It came back. It was confirmed, and so the attitude of Dr. Deeks and others changed from one of contempt to respect, and llfls given a white coat and a stethoscope and allowed to come down and be a doctor. That's a marvelous storz. How long was the tour? Just for the summer. Just for the summer. 8.3 I couldn't spend any more time 0 Was it straight ward 1!!~cine? You've indicated sanitation. Oh, I went out with Colonel Gorgas~n malaria control occasionally and saw ditching and draining and larvicidal work and some mosquito control work. It wasn't just seeing patients by any means. I saw th+ana.l. A\.t that time there was no water in the canal. fhey were still digging at Balbea, the last encl of it. I saw accidents on the canal. I saw machinery working. I knew Colonel David DuBose Gaillard who built the Gatun Dam locks. I used to wander around with Colonel Gorgas at that time. He and I and a boy named a. Huntington Williams who afterwards becae the health officer or Baltimore, nearly drawned in the-well, it mir:ht have been the Mirafiores River. It wasn't the Chagres River. We started out-General Gorgas, Williams, and I down an old railroad embankment where the railroad had been moved off. This embankment had become covered with brambles, and the water of the Gatun Lake was rising all around us, a picturesque thing. There were iguanas up on the low branches of trees half covered withi&ter1 and there were great big tarantulas on the tops of the sticks that were up in the water. We went down through that, and the water kept getting deeper and deeper. We were going from a place called Frijoles te Mira­ fiores, and weforget about the fact that ther+ad bee+ bridge through a culvert there. This was a muddy kind of water. We got to walking with the water about breast high holding our wa~ches and cameras overhead. Of course, we had on heavy shees, and all of a sudden we stepped off into about forty feet of water, and we went down and up and down. I was gasping areund. I was still holding on to lflY' watch and m;r camera while drowning. Colonel Gorgas said,"You fHl, let them gol" 84 I did. Then we started out to swim to what we could see were the small I leaves of the top branches of trees that were then all submergedo Wed get te ft a tree and put down our feet, md there was nothing to rest •n• We were ~tting pretty tired. After we did find a place to rest, we were in three separate trees. Colonel Gorgas was in one tree. I was in another, and Williams was in still another. This was muddy water, and the point was to find out where that embankment was, so we explored around and finally Colonel Gorgas was the one who found ito He apparently had been able to swim acros+he river and let bis feet down on this embankment. He called us in, and we got back, but it was a strenuous time. We had taken off our shoes by that time, and this embankment was covered with brambles which rather tore our feet up by the time we got back. I only mention this because it was such a close risk of a life of a man whe really was a figure who contributed enormously to the welfare of the world, and that'• Crawford Gorgas. He probably not only made the Panama Canal possible -they never could have dug that canal without his sanitation of it, but he had a great belief in the value of the tropics to the white man. He said that when the pilgrims discovered .America, they opened up a valuable territory for the white man, but that what sanitation was doing down there was opening up not only an enormous territory, but one that was richer and could be better suited to the life of the white mano He firmly believed that the life of the white man would benefit enormously by the control of communicable diseases in the tropics which is pretty true. He also had an.other belief which later got cenfou'l<ied, and that was the belief that once a thing is extinct, it won't cane back. He would talk to me and sa7,"The dinosaur became extinct, and they aren't an;y more, and if w•"--not I; he didn't talk about himself much--"make this yellow fever virus agent 8$ extinct, it will never COlll8 back4 " That was his belief--eradication and finish with it, but he didn't know at that time about jungle yellow fever. The yellow fever was prevalent in the monkeys in the tree tops. There •s no way to get them to come down for treatment 9 Well, they are getting at it now. In a case where a disease is transmitted by an insect, you have a greater power over it than you have;~~ diseases th.at sre transmitted directly from hUDlan being to hwu.n being because you can destroy the insect, the breeding of the insect and get rid of it entirelyo That would break the chain. Righto ·£here's no such transmission in irrl'l.uenza, for example, and you mre a horrible time. lellow fever had been eradicated in the United States and fra tanama, and there's a great eradication program to get rid of all of the Aedes aemti now, and I think they 1ll do ito ~his was sort of a chance experience at preventive medicine 1 llB.sn 1 t it? Oh yes 0 ~as the Hopkins oriented along Feventive medicine lines? Through Dr. Welch later oo-I .forgot to tell you that one thing that nattered me into going into bacteriology was that Winternitz couldn't find any­ body very well to take the position, and it was vacant. A rather able man, Willia w. Ford, had been the Professor of Bacteriology there for years, and 86 he wasn't doing so well at this time. He dropped out, or was pushed out--I don't know which, and Winternitz wanted me to take Dr. Ford 1 s place, and here I was only two 7ears out of school, with never any- training in this subject, being ~-'~ nattered by being effered the position that a professor~ vacating. sure that appealed to my vani t7 in some respects and my sense of power too, though I don't know. It could. In any eveat, I took Dro Ford's place. Dr. Ford wasn•t interested in preventive medicine too much. He was kind of a basic minded biologist who thought that anything that had, we'll sq, a aedical implication, could be applied, was not sufficiently' remote to be worthy of being called basic 0 Well, that 1 s not true at all. I changed that course right awa7. For instance, when Dr. Ford wanted to study the formatioa or spores in the bacteria, he 1 d go out and get some innocuous spore bearing orgaa-­ isa from the soil and have the student work •n that. When I took the course, I put the etwiente right to work oa. anthrax. Anthrax has the same biological processes as spore formation, but it produces a fatal disease, an extraordinarily A interesting disease in cattle and man. The anth~ spores in the ground were of great interest to Pasteur--all the fields got contaminated largely by tlle spores 00111.ing up from the buried cattle. The spores were brought up by worms digging up and pushing the dirt up--well, if you take a medical student and teach him spore formation on an organi.Dl that is medically significant, there's a burst of interest that doesn't •ccur when you take something remote from the soil. It was the same thing with the capsules on bacteria-the pne~ococcua has a wonderful capsule which is extraordinarily important in all its reactions and what it does. So does some slime forming organism .f'rom milk. When Dr. Ferd would get areund to studying capsules, he would get this thing out ot milk that 87 had no medical significance at all. I took the capsulated pneaococcUB of all types, and we 1 d study the capsule and study something about pneumonia. Well, you can do that in medical teaching. You can teach the basic process at the same time•••• That you're involved in something vital to medicirie. Yes, with the practical. Lasked you if"-you know, about the preventive medicine that you saw in the sumer of 1912. You must have returned just filled with ite No, I don 1t recall that particularly because I had known before 1912 1 a lot about preventive medicine and had associations with it. I told you about Thayer coming down looking for malaria. Well, at that time malaria was being prevented. By cousin Willie Gorgas had done it in Havana. I know about Walter Reed aniellow fever• When I was at Chicago my main textbook-and other books in bacteriology and immunology later on--was ~orge Miller sternbergo He was the founder of preventive medicine, and all of that for years had been going through ➔•ad before I went to Panama. Panama was just sort or a fie 1d ex­ cursion into things that I was prettywell familiar with. Also Dr. Welch had a very deep interest in preventive medicine. In 19161 I guess-April of 1916, he founded the School of Hygiene and Public Health at Hopkinso I used to sit with him. in an old building over across town in Hopkins University where he had an office and talkro him abo~t the founding of that school. I know he was deeply interested and searching. Some of the things he worked on early like the Welch bacillus were important from the point of view of preventive medicine. He didn't realize that the Welch bacillus was 88 so important in causing gas gangrene in wounds in soldiers and what it formed 0 He fouro. the Welch bacillus by-well, he did an autopq on a Negro woman once and found the vessels in her uterus just full of air instead of clotted blood after death, and he got the organism out of that. The second time he got the organism out of dead dogs found noating in sewers in Baltimore. He actually didn't know that the Welch bacillus fomed a spore. He didn't know a good deal about it, but it bad great epidemiological significance with regard to woum infection. This he appreciated. Then Dr. Welch also knew the great founders of pre­ ventive medicine. He knew Pettenkofer, Pasteur, Robert Koch. Se it was in the air. Yes. In talking about Hopkins, you didn•, mention the surgical sideo The surgical side was interesting to me, but not attractive. The great surgical professer that I admired very much was William Halsted. He reminded a me of~silisk•-if you knew what I meano He had e;yes that you couldn't aee almost, and he had a very dignified and cultured manner. Hew as beautifully dressed. He was a roan who had his shoes made in London, and he used to send ~ his shirts to Paris tD be laundered. I was once o~ twice to his house to dinner, and he had a superb service, servants, table linen and silver and old furniture. Halsted was the great founder of the developments after Joseph Lister in surgery. He was a very skillful operator• and he had a most delicate 89 manner or handling tissue so that he didn't crush anything. He was also re­ ~ponsible for introducing rubber gloves into the operation. Up to that time they were operating barehanded. I don't know much about surgery. Despite this long contirm.ed interest in medicine, I went through what a good maey people do, I guesso Wnen I was in the Charity Hospital in New Orleans when I was a student at Tulane, they took me in to see an op:,ration, and they brought a woman in on a stretcher and started to cut the bandages off her abdomen with a pair of scissors. I hit the floor in a dead faint right away, and I didn't 6l ee the operation. Then when I came up to Baltim<me and was in the high stands, the sort of pipe like fabricated iJ stands that yoA rolled around the autopsy table--I was up on the top shelf, and I nearly fell off becauae I got sick at my stomach. I remember once in Dro Halsted 1 s clinic, I was up in the amphitheater there, and he was operating, and I also got nauseated. I don't know whether that had aeything to do with it, but I never}l!B.s interested in surgery. Most medical students go through a phase like that. work at all service? Dr. Theodore Janeway was another great character. When-well, there was a succession of professors who followed Osler. First there wa~ Barker, and Dro .l:Sarker, Lewell,-s F. Barker, had written papers in favor of the full time plan, but when he got down there, he decided that he didn't want to give up his practiceo He had his office outside. Dr. ~arker was about six feet three with long, long fingers and a long nose, very precise, and the most extraordin­ ary teacher. He knew everything, but he knew it because he boned up before his clinics. There is a man over there now who is a professor in his eighties, and 90 he used to think my enthusiasms f'or Dro Barker indicated that I didn't have any critical sense because what I admired in Dr 0 Barker was that his teaching was just as precise and effective as you could want. He would draw you out in con­ versation too. He was good. Now Dro Barker was succeeded by Dr 0 Thayer for a while, and then we come to Janeway. Dr 0 Janeway was persuaded to leave a practice in New York, come down there and become a full time professor. I think he was disillusioned and didn't care too auch about it, but he stuck it out, but what I liked about Dro Janeway so much was his absolute honesty and forthrightness, although I started off in a bad way with him, and, I 1 11 tell you about that. \ ! When I was an i~rn in medicine, Dro J;)arker wu the Chief Physician outside of his being professor, and he used to telephone me before he'd. make the rounds on the ward and say,"What have you got 011 the ward?" Ird tell hilno Well, the next morning he 1 d come in, ani I•a. be standing at the door with all the histories in my arm. We had quite a ceremony when the professor visited--the nurse was there with a basket of pencils, knee jerk hammers and stethoscopes and whatnot. Well, Dro Barker would come through the door or the ward and say,"What have you got?" He'd do this as if he hadn't telephoned me, and I would tell him and then he'd think it over and say,"Well, suppose we see this case with alca.ptonuria"­ we111 say, some rare disease, and we 1d go and see him. ~d lead him to the bed, and they always pull down the covers, 11ake a physical examination, think about it ~r a while. He went through all of that, and then he gave the most superb lecture on alcaptonuria, but he boned it up the night before• Dr. Janeway was just the epposite. He was a rather sparse, dark haired man With the kind of 110ustacbe that Hemmingway had when he was ..runger-you J 91 know, falling down over the sides of the mouth, and he had a way of making \ ward rounds that was veey different. Heed come to the ward and never ask you the nieht before what you had~ He'd ask you in the morning. He didn't ask you for a dia~ais. He:d just say1 11 Suppose we see that man over there.n Then hefd get his historyo The intern would give a a:umnary of the history, and then Dro Janeway would start to examirie the man1 start to work out the problem. Well., you could see the ago~ the man was going through. He'd walk around the bed. He would just struggle. You'd see him struggling out loud te get at the 111Bteries an+he unraveling because it's veey- bard just looking en the outside ef a patient to know what I s going on on the inside• Dam righto He impressed me as a very honest man whe didn I t, want to be prompted. But again I had a bad start with him. I inherited Ward F from a big, tall .fellow named Wilber a. Carlyle who had been the intern there the year before. This is 1914, .J:,m talking about now., and Carlyle left me thirty-five patients who were very sick on the ward and about six people in the back room. We used to put them in a little back room when they either weren't sick, or they were convalescent. I had five of thoseo Then I remember five very sick typhoid patients. Some were bleeding--well., theyw ere awfully sick. I worked all night long to get up oa the histories and do what I could for those people on the ward. Dre Janeway took that ward his first round., and he came to the door-­ I remember it very wello He said., "I don 1 t want to see any of those people in there. I know you've worked hard on themo I,m sure you have1 and there 1 s nothing in particular, but have you got any people in the back room?" I s aid,'1Yes, sirci'' 92 Well, we all trooped back there, and he said,"! can always tell whether I•ve got a good intern or not by the nll1llber of unrecognized pleural effusions Do you know what I mean?-fluid in the chest. Well, lo and behold, there was one man there in a bed, and Dr. Janeway had him sit up, and he percussed him. He listened to him f'or a moment, and he turned to me, and he hissed at me--the man had a pleural effusiono ti I hadn 1 t examined him eve,. I worked all night on those sick people. Well, he didn't bear any grudge against me. It aust hav+aken a while f'or him to get over that initial experience. Maybe he was pleased that he could find j{ a bad intern by going th~ough his usual pattern of behavior. Did you trade medical services, or did zou.... I stayed on medicine the whole time. You trade wards. You move from ward to ward. There was the octagon ward where this fellow wkth the diaphragm was, I thinko Then I was on Ward F-the male ward with all those acute patients. J. Most of thea were West Virginian miners. 'd go and sit around by their beds and talk to them a bit, but I was ver:, immature looking. My life suffered, or at least ~1ve been handicapped by- having practically invisible white hair and a childish looking face, so that when I'd come in, these poor fellows from West Virginia would say,"We came down here to see a doctor, not a child&" That's good for one's morale 1 isn 1 t it? Well, they'r• awfully lonely people, and they exist by themselves. I think 93 a patient sick on the ward is somebo~ to be nursed very- carefully not in a sentimental manner, but enough to let them know that you're their friend 0 You had notions of returning to New Orleans to practice. Did the exF!rience at Hopkins--well 1 you had other things inf rent of you too. You had access to laboratori9s of professors who were large in their fields and who were open to suggestion and would allow you to work1 and you got that attitude. You could see 1 happily with your triE down to Panama, something of the whole question of sanitation which is design et1ineering that goes way bezynd just practice. N You must have confreAted a much more difficult choice when you see it all laid out and try to grab a small holding on the slopes of Parnassus instead of getting shooting rights over the whole of the mountain. How did you feel about the choice? As usual I didn't go through any agony ef decision. After I said to Winternitz that I would like to have this job, thatllil.s that, and when I went with Hans Zinseer that convinced me all the more that it was an interesting and fine field. Zinsaer was a fine man. I came back without any question of going to New Orleans any more. Well, let's stop for today1 and we'll go back to Zinsser next timeo All right. 94 Fridaz, April 151 1966 A-54 1 N. L. M. As I indicated before we turned this on1 I wanted to go back to Chicago because I bumped into the name of a man there with whom you apparently wprked in the laboratory, Fred M. Drennanq Yes, Fred Drennan was an assistant to Dr. Carlsoa in physiology, aver:, large, tall man. He was an instructor close to you in the class work, helped very much on all the animal experine ntation. His letter here-and he has a fascinating handwriting which is different every ~- Yes it is, isn 1 t it• He wrote you: "I have received your notebook o.K. and Itm glad you saved your- self just as much time and effcrt as po.~~ble on those last hundred e~~z:.~~E:..~~•" You m~~t have done quite a bit cf work. - - Later in this letter he writes: "I saw haps by now she !01!-Z. have some expl-anation_C?_f your results withn--r can't make this word out 0 "I gave you my ~est efforts the morning we were ,doing the .work. Don't worry toca.!.ucq ~bout ito Just leave it to some res!_arch mat!.t, and he'll ge.t a masters ou~ (!f.~tJ!~idea and not know anything ab,oAt it eithez:•"- It~ a witty~ote 1 but.zou must have been working pretty clos~ wit~o Yes, Drennan was very close to us in the class all the time. Was he good from the point or view of standar~? Oh yes 0 95 11 That 1 s a good thi~ to lea~~• I didn't do any research in that physiology course that I remember of any consequence, 3.nd this Fe.r1·~r is a distant relative from New Orleanso She comes from a family or the Farra.rs, Judge Farrar remotely related to the Denegres, and one of the Farrars in this family married Dr. Joseph Goldberger who worked out all the problems of pelagra. She was in Chicago that summer. I forget which one of themW!l.s--there were about six Farrar girls. You ~pen~ ar_earentlz Rot a little .~i~. in t~e laborator.z. Oh yes-long hours in the laboratory with difficult experiments. ~this Drennan 1 s design of £:xperiments 1 ,or were those related tC?. the class work? I think they were related to the class work, but this is a long time ago. It 1 s •••• Well 1 1t 1 s 1911. Fifty-five years ago. Yes. I wanted you to mention him. You mentioned a man in talki!!,~ zester~l and couldn't remember his name. Drennan waa Carlson's assistant. I couldn't remember the bacteri.ologisto His name is Harris• Later at Johns Hopk!_l!s--thinkin_s over what we said about the school zesterdaz-­ there are some things ~hat occurred to me that you might w~~t to comment about 0 96 l One or them is the whole concept of paM.ent care--you know.t.. .'lille organization or r~ources for eatient care and how~~ t~at figured_, the standarcyi that they had with r!.-!E_ect to it at Johns Hopkins at that tim~• Well, it's difficult for me to sort out the impressions I had as a student and intern at Johns Hopkins from the impressions I have from experience later on in being responsible for medical care, but I admired the medical care so much and wanted to have the benefit of it so much that I started te substitute on the hospital wards in my second year"-just about the time I went down to Panama.. Whenever I had the chance to substitute for an intrern I would take his place and take care of patients. We thought the medical care at Johns Hopkin, was superior to anything else in the country, although we didn't have experience in other places to serve as a basis for compariso0,4 It was extremely thorough. Dr. Thayer, Dr. Darker, Dr. Adolph Meyer., Dr. Theodore Janewa.y--all those men were not only conscientious, but they were scholars all the timeo Their patient to them was a problem, really a research problem--I'm talking about the element of medical care that begins with the study of the patient and the effort to arrive at a proper diagnosis. Nothing was spared by them either in the taking of the history, or the using of such apparatus as they had available. For the benefit of the medical care and the patient, on the laboratory side, they had excellent biochemical laboratories in the medical departrnent, and I know only about the medical de­ partment. Although I had someacperience occasionally on surgery or obstetrics, or gynecology, it's medicine I•m talking about mostly. At that time two things 97 were developing that had a great influence on medical care--one was x-ray. They had a great man in x-rny there named Frederick H. Baetjer. He was one of the earlier x-ra:y men. He died of x-ra.y cancer of the skin later on. Hopkins was building up a fine Department of Radiology at that time. In addition, they had one of the first electro-cardiograph apparatus. A man named Douglass. Hirschf'elder-I think he wrote the first book on that subject in this country. We were able to study patients with electro-cardiography in new ways. All the specialties at the Hopkins were extremely well done-as well as the general medicine. Dr. Hugh Hampton Young was the great urologist at tha time, a fashionable urologist as so many of them get to be, and his main patient was "Diamond Jim" Brady. "Diamond Jim" Brady gave Dr. Young the money for the Urological Depart­ ment, a building, hospital beds and laboratory. The superintendent of Hopkins Hospital when I was there, Dr o Winford Ho Smith, was a very careful :man, a dictatorial disciplinarian with very high standards, I thought; indeed, his standards were so high that he ~uspected most of us or being crooks. I must admit that toward the end of an internship, every year when the interns would be changine:, a certain number of thermometers, stethoscopes, knee jerk hammers, and other things disappeared from the ward baskets, and Dre Smith practically wanted to frisk us as we went out, but that was only a part of his high ethical standards in general 6 He was skeptical of the characters he had to deal with, but he insisted on the best you could do for patients. It was a very rational therapeutic school, althoueh they did some rather severe things that we got rid of after a while. When I started, the way of treating typhoid fever was to put the patient in a tub of ioe water and hold 98 him do1rn in it., and that was very, very severe and hard on the patient. That therapy disappeared while I was down there. The other thing that they were h doing which you migAt not think is good patient care, but was done with the best scientific appreciation of the possibilities, was treating syphilis ef A the central nervous system by giving the patient salv~rsaa, then bleeding the patient in about a half an hour and collecting the ser\llll which contained some A salv~rsan that had been in the body but perhaps got changed by the body, and then doing a puncture of the spinal canal and putting the serum in the patient's spinal canal system. That caused the most terrific reactions, headaches, and all sorts of thing. To compare whatwas then done at the Hopkins with the N moder)\ medical care of patients, we would find nothing different in the idea and the point of view of wanting to do the best, but, of course, they didn't have what you saw in that open heart surgeryo But the drive was there for patient careo Oh yeso ~twas erie_!lted along thos,ines and seve~. Yes, it derived from the Oslerian concept of teaching at the bedside 0 They understood that the best element :i.n patient care was to have medical students around because it put the doctors on their toes and kept up the i~tereat., but that also came from the French School of Louis and other people who introduced bed-side teaching. Incidentalq1 in the light of the experience, the initial experience zou had 1!1-th Dro Janewaz after you 1,d been up all night ereparin_g those cases, Dr. Janeway later recommends zou to Dr!. Warfield T. Longcope for a. position in 99 Bellevue on some medical service there, so zour initial impresion was erase~• I didn't mean to imply that Dr. Janeway carried any grud.gs. He never dido That horrible sound he made--he was laughing through his nose, or something ,J like that. He didn't rub it 1A to meo &ne other item that ltve been,thinki!,!S about since lesterciaz and where in­ fectious disease is concerned is t.his whole epidemiological approach and wheth:£, this was rt of the resentation at Joh Ho kinsl I have to think of that to try to separate it :from what I did later-I don't recall it being so strongly brought forward on the general medical service, although, as Is aid1 I had a ward full of typhoid patients, and in considering them we tried to find out the source of their infection, and you'd read and talk about the contamination of water from privys. Where the epidemiological, er preventive medicine point of view came in most strongly was in pediatrics, and pe~c~~rics is still th_Leader in clinical preventive ~edicine in many ways. I I & . I think I got an impression then that I c~ied through later on that made "' me oppose the establis~Jllent of a separate department of prevef\tive medicine at Rochester because I couldn't see how you could deal with the actual current H situation in a patieat without undorst~ding or looking at the origino Just th+rdinary- course of the study of a case imolved knowledge of the preventiono For instance, you talk about heart conditions, heart diseases, you have to think of whether the patient has had streptococcal infections before and if so, how did he get them and how were they spreado Syphilis of th+eart, for exam.pie, and this process takes you back into infections diseases that on the h surface ~as nothing to do with the he~rt. I can recall that kind of preventive epidemiological mixture with the ordinary day to day observation of a patient, 100 1 but there was im course that I took at that time that was a kind of epidemio- i ' logical course that they would give now with statistical investugation, of dealing with communities. We had practically no experience in community health service, or the conditions in which people lived in communities, except in obstetrics. Fourth year in obstetrics we were sent out to deliver children in the poor quarters of Baltimore, under the supervision of one of the instructors, or assistant professors, on the obstetrical eervice. In my case one llight the instructor didn't get there in time--did I tell you this? The instructor didn't get to the place where I was in time. It was down en Wolfe streeto A Jewish woman gave birth to a baby before my supervisor got thereo This was the first time ltd ever had to deliver a woman, but fortunately she had had previously a number of children, and it was quite easy. I was cleaning up and getting ready to go, and to my astonishment she gave birth to another child, so she had twins, and I didn't know ito My instructor didn't come even then, but I had these two babies and fixed everything up, tied the cord and cut it off and cleaned things. You have to make post-partum visits which I did with a little black bag, and this lady said that she wanted to name one of those children after me. One was a husky child, and the other one was a wizened little thingo I deliberately said,"Well, name this baby after me" because I--to tell you the truth--didn't think that it would survive, and I didn't want the burden or the baby, so they named this child Stanhope Bayne Saltzburg. Lo and behold, the husky baby died, and Stanhope ~ayne Saltzburg survived through a very weak infancy, but was able to come along. I clothed and 101 fed that child more or less until I got to Rochester, and then I lost track of him. His mother was one of these white women who do the ironing in a Chinese laundry-you know, you see white women ironing for a chinaman. They were very poor people down on Wolfe Street, so I learned something about the social back­ ground of childbearing at least among the poor. I used to go down there fairly often. Patient care got an extension--! have that down here. I found that in a letter home dated 1917 1 when you were abroad and were concerned about the boy. Oh did I really? I was going to ask you about it because "patient care" does go way beyond the hospital. Of courseo In this particular instance, she named this bap;y after yo~o Who did I write that to? This was to your "Tante E".....October 5, 1917-•and you wanted her to send them some clothes-shoes was the recommended item. I must admit that my motives in undertaking it were noto••• These things happen--that'e the interesting thingo They un.fold1 and you have to play it by ear. I put it down that you got involved in patient care way beyond the hospital room. Oh yes. They had a great deal of that in New York which I•U tell you 102 about 1a ter. One other item at Johns Hoekins is in e_art a public health ~atter1 but deeper th.an that. It ' s the sense of public service which I think was pretty strong in Dr. Welch. Maybe it 1 s stronger in terms of that develoeuent in t.he Rocke­ feller Foundation to help through financial aid zoung doctors to becorr~ better and better at what they were doing. Maybe that 1 s part of what I mean, but the sense of public service was pretty strong at Johns Hopkins, wasn't i~? Yes, I think it was, but when I was there we were so closely concerned with the individual in the faculty that I didn I t think very ra rd., or much., a.baiit the outside relationships. Of course, Dr. Welch did, and many, many things you can ascribe to him in the way of pu'c.:il.ic serviceo He led legislative efforts. He was head of the Board of Health. He was President of the American Medical Aseeciation. He fought the antivivisectionists. He was the guide of all sorts of good movements. Somewhere along the line while at Hopkins you get involved in something which is available to you in term.~ of degree-a master's degree. There were some requirements~-an awlication and an essay. Did you file an essay? No., I had done work, and I forget what it was. It was about 1917, and I ~anted a ~aster of science. I think they gave me a master cf arts. It's based on some of the things that are published there., and they may have been in manuscript form at the time. I remember writing to the graduate school that handles that degree and asking them. I had ata~d this work without any I thought of using it for a degree, but I asked the graduate school whether they would accept it. I didn't have to take any subsidiary courses for this. 103 No. This was sClllething which I think was available for someone who had done individual work. I think it was about 1915, 19161 wasn't it? 1915. In any event, you can begin something for one purpose, and it lends d itself to another purpose, and it helps. They had this availableo We talke~ about publications 1ester9&1 and I know froa my own experience that when you publish something, yeu wonder, apart from the close intiaates that you may I have 1 whether its ever read. I pointed out to you earlier, before we turned the machine on1 a letter that came to you from Saint Thomas Hospital, Dr. Leonard Dudgeon, fran which it was clear that someone had read one of your articles. I Well, Dr. Dudgeon I didn't know personally, but I knew of him.He s a " pathologist of distinction, and I don't take a~credit for his having read my paper. It must have been on a subject in which he was interested and when you find such a subject appearing as a title on a list of publications in a catalogue 0 or an index, you don't read th~ articleo You turn ~ver to see whether the man has noticed your work. This is happening still. A lot of these histories of the medical department in World War II that we have been publishing--the first thing that anybody" does who gets a volwne is look in the index to see if his name is mentionedo It's a natural human thing. j•ve forgotten-I know Qf Dudgeon--it had to de with immunology. 104 But if you've never had this experience before, this was a way in which you got N it quite early--you know, the !otion that someone has read ito i What uas the year of that? This is 1916. I mentioned to you before we turned the taP! on that there were a nUJ11ber of societies that were soci;ll in nature, and one of them was a Medical History Club1 a Dr, Nichols, and I asked you then, and ask you now1 whether t\ this was something to do 1 sanething tc share. I find that you attended tAese meetings. I was always interested in medical history, and so was my grandfather Joseph Jones, and he collected a lot of it. I have read a good da3l of medical history, but no student could go through Hopkins without getting enthusiastic about medical history from. these meetings of the Johns Hopkins Medical Society. It was a monthly affair, presided over usually by Dr, Welch, and they were very fine meetings. I don't remember who Dr. Nichols was. You say he was in Washington? It may not have been, but this Philip Ro1 writes about the University Club, 15th and I Street-that's where his meeting is going to be held1 but it does in­ dicate the existence of a club that extended pretty far if you went to Washington to attend it 0 What year is that? Oh dear--it looks like 1913. Well, I was just starting then. 105 Yes, 19130 There's a Bulletin of the History of Medicine still being published at Hopkins. Right. I don't mean the Johns Hopkins Bulletin which had a wonderful lot of his­ torical articles, but there was actually an Institute of Medical History there. Yes, but they were deep in thiso (£ Oh no, it was part of the atmosphere you breatho " Well 1 you've indicated that you read outside the textbooks anyway. Yes, I dido So you knew your way to the librarz--you liked to browse. Oh 7es. The library we had at that time available to us was the collection of books in one of the ends of the main building. The Administration Building of the Hopkins. The library occupied on the first floor a.bout four large rooms with stacks, and then down in the basement there were a series of spaces filled with stacks. Somehow or other they let me go down in there without any surveillanceo I wandered down the stacks. I never have stolen any books, so maybe they didn't mind. It is a temptation sometimeo It sure is. Well 1 sometime in 19161 and there 1 s a letter here from Dro Welch, March 81 1916: "!'Te written Zinsser tonight abo11t your desire to work with him." Dr. Welch encouraged this as distinct from working with Noguchi"who is engaged on some special problem and cannot undertake to give trainingo II Apparently lo6 this was, in part, I suspect a Rockefeller Foundation thing 0 No, this was getting me ready to take over the fifth nocro I did have a fellowship-a Rockefeller Fellowship, seven hundred dollars a year. Right. This plus the thousand that I got from my patrimony, or wherever it came from, but I didn't work with Dr. Zinsser on the fellowship. I a~ready had ito You alre~dz had the fello~shi£o They were arranging for me to get training--Dr. Welch was writing to help me get training to carry on the bacteriological and imn;.unological job in the Department of Pathology at Hopkins. There's no~hing prior to 1916..l._~~ol!t Zi~~ser--zou.r desire to work with h~o This is my introduction to Zinsser, but I didn't know Dr. Zinss9r before thiso I knew of him. He was a great le~der. He was about ten years older than I was, and before this period he had been a Professor mt Stanford, and he went from Stanford to Columbia P & S School of Medicine about 1913, or 1914-I w forget ~hat the date was, but h£> had done work that interested me very much in immunologyo He was one of the first people to introduce physical chemistry into the study of immune reactions. He hims2lf was not a physical chemist, but he ma~aged to have an enthusiasm for it, and he really was one that could do that. He was at that time more thought of as an immunologist than as a bacteriologist, though he was a good bacteriol~gist. I wonderlJ:.d about tha,bec~e he~had be~~ Stanforc, but in ,:l_:.9151 he was ~ 107 member of the Red Cross Typhus Commis~ion in Serb~. That's righto So it wa~ a ques~~~f ~here he was going to light. Offourse 1 typus fever is what he became the great expert in• RightL but then, as I understand ~ta you moved ue to ,New York for purposes of either taking a.oourse 1 or working with himo It was not taking a course. I had all the courses that were necessary in the ordinary sense of taking a courseo As a matter of fact, when I got there €. Dro Zinsser took me to s,rinars, used me as an instructor and then immediately-- I wou.ldn.&t say he gave me a problem, but he arranged for me to start to work on some research, and I published a paper out of that research on the coexistence of antigen and antibody in the same serum, and that is a sort of physical chemical equili.briwn problem L"Equilibria in Preoipitin Reactions. The Co­ existence of a Single Free Antigen and its Antibody in the Same Serum" 25 ~ Experimental Medicine 837-853 (June, 1917)7. I gave that paper at the Association of Immunologists in Washington, and I was taken to pieces by a very distinguished man who is still living and still worldng at the ~ockefeller Institute, and that 1 a Dro Eugene L. Opie. Oh gosh zes, ~u~ did he reall)y; take 1ou to pieces? As I remember, and he'~ right, he said,"You just think there's one antigen in egg albumeno YQu have orystalli~ed that, and you think you have a totally pure thing, but as a matter of fact, there are probably three or four antigenic substances. You get ri.d of one, and you can do another reaction and get some 108 1 more which you think is just the original one remaining in the fluid." I I think hes right about that, but I know also that there is-well, later I its been shown that there is an equilibrium as there is in most things. You get the compound form of the tw-.0 substances that are present, ~nd then there is al~a,s a little of each left that is not united, or they might be united but A1f" not in a precipit'f? form. I remember that meeting down there, and I was very politely put in my place by an intelligent, able, and experienced man. Do you know Dr. Opie? He drifted bz me just once, but I•ve heard cODD11ents abo~t _himo Dr 0 Opie is getting on to be ninety years old, and he's still working in the laboratory. As a matter of fact, years later when I was the Director of the Childs Fund--we started the Childs Fund, and we'll talk about it another time--we started and got other peop~interested in making provision for ttthe elder statesmen of medical science", as we called them, and at that time we made an appropriation for a stipend for Dr. Opie at tre Rockefeller Institute. (\ \ The Rockefeller Institute had a policy that they wouldn't accept any o u ~ l funds, but I went to see Dr. Fl.exner-I think it was Flexner at that time, or it might have bean Herbert s. Gasser, and they agreed to take Dr. Opie in and. let this money come in for his benefit, so all those things happen, and nobody seems to carry on any grouch about them. Par for the course. But this work--workin~ with Zinsser on a oroblem like this-- how clear as he? I ot the im ression from readin thj_s last n:i. hto ••• Last night? Did you come back here? _!!0 0 I was thinking about it last _night because I had i:,~ad it yesterday aft~.- ..... 109 noon, but this eaEer was an effo~t somehow or other to pull loose eieees of in­ formation that had et to be reall formulated into scae kind fa floor a basis upon which you could operate, tha~ there was a lot of work that had been done thatwanted a kind of rationale. Yeso And that this was an aim in that directiono Yes, because the suppositien up to this ti.Ile was that these immune reactions were completed affairs, that equilibrium existso We know it exists in many chemical reactions and especially colloidal reactions which are shown in that paper. That work is not far from Dr. Zinsser•s type of work out at Stanford. I think that~e probably talked to me about it and said that this was an un­ solved problem. I don't believe that his name is on that papero No. The only thing that is on it is that it is aided bz a grant fran the Rockefeller Institute for Medical Research. He got that 0 I didn't get it. It was something that he had in his de­ partment. Yes, but it does show, I think, the fact that when you were a Rock~feller Fellow in Pathology, an assistant resident and pathologist, and instructor in pathology -~it shows as of this time a fou~dation which was interested in sustaining you~ eeople 1 bright young_P!ople at the source of development, a laboratoiz, as I distinct from lettins them go out and practice~ Here its an effort to increase their educational ex rience an effort· o sustain scientific research. In that d.az you apgarently had the foundation as you now have the NIH. 110 1 I don 1 t recall any dealing with the Rockefeller Instituteo ~,m sure that grant came to Dr. Zinsser's Department. How did you find him as a person? live read his sonnets, and thez 1 re marvelous. Isn't th1t last one effective? Yes it is. You indicated that he played m~sico He played the violin--he called it a fiddleo To clarify? Oh--it did something for him. He liked music. He liked to listen to it. He liked to play it. I don't think he played the piano, but he played the violin pretty well. In the laboratory when he played the violin, it was to relieTe tensions, and I suppose he thought while he was doing it. He ' d walk up and down sometimes in stressful situations and play the fiddle. 11 m sure he played it at home too. I don't know whether he had two violins, or carried one oack and forth. Was he a particularly intense fellow? Very--look at his face in his pictures. He was a romantic, intense person in his scientific work and outside of it too. His going off on expeditions was smething innate in him. He was a great horseman even up to the end of his life. He rode dangerous horses--he had horses at his place up near Boston that would jump fences and throw him around against the rocks. In the Spanish­ American War, 1898 1 when he was about twenty years old, he joined squadron A of the New York National Guard Cavalry, and he went into the Spanish-American 111 C War as a ~avalryman. He got a sabre at that time which he rattled occasionally. One very amusing but partially serious thing that happened was that he kad a controversy with Dr. /jfomer F.J Swift at the Rockefeller Institute. He was a great expert on rheumatic !ever later on--"Speedy" Swift, naturally, we called him. I forget his full name. Well, he and Zinsser didn't agree, and Dr. Swift said so in print. Dr. Zinsser got very wrought up, and to settle the matter he challenged Dr. Swift to a duel with sabres. He was a ve:r:z sensitive man. Then he got interested ir typhus and went off on that Serbian expedition. That WlS a wonderful thing which was done. Dr. Harry Plotz wae along too, and so was Burt S0 Wolbach, and they did wonderful work. That started Dr, Zinsser on typhus, and he kept it up to the end of his life. He was a little reckless with typhus rickettsia occasionally, and I have a feeling that he might have gotten a laboratory infection at one time or another. 1 •m not sure, but he got sick in the course of his work. Did he think epidemiologically? Oh yes, he was a leader in epidemiology. I mean even as of the time you went with him 1 after Serbia 1 after the Commission went over there and that frightful mass probl9lllo That was after Worlrl War I 1 w asn •t it? No--just before. Well, in World War I Dro Zinsser--I know this because I 112 got it all in my history downstairs--he was head of the Division of Laboratories and Infectious Diseases in the A. E. F. at one time. He also beca.J&e what was called Sanitary Inspector of the First Corps and the Sanitary Inspector of the Second Army. He was intensely interested in sanitation and epidemiology. What he says about a sanitary inspector in essence is this--a sanitary inspector has 0 got to know not ~nly sanitation, but also be familiar with epidemiological methods and laboratory methcds. He could uRe them both as ready, powerful tools, and his writings about, epidemiology in World War I areFreat. I got to be Sanitary Inspector of the Third Army, the Army of Occupation in Germ.any. General Robert L. Bullard was the General in command of the Seci,nd Arrriy, and General Joseph T. Dickman was in command of the Third Amy,, Somehow or other they may have got to talking, but anyhow there came up from the Second Army a manuscriot, of Dr. Zinsser, a rather famous paper called "Sanitation or a Field Arltfyo" They gave it to me and said1 "Hereta your Bibleo" I read it, and I found that the field army he was writing about, the Second Army in the field, in the Meuse Argonne, was different from the Army of Occupation that I was in which was settled, living in houses,1 so I dtidn 1 t use his p~per much. Just about a !ew weeks 3go I -was putting it into a chapter in this history that Itn ~-riting about World War II. Well, Zin~ser was an epidemi.• ologist of great note and very enthusiastic. He understood it too. Aesociationa--the things you absorb--working with him 2 this kind of thinki~o Did he want followers? He had devoted people with him. One of my still unsettled questions I think of usually with regret. He wanted me to come veey much to Harvard on his staff and at that time--this was 1923•-I was at Hopkins with the prospect that 113 I might become a professor there of a separate department. I had some un­ certainty about going to Harvard, EJ.nd I told Zinsser I wouldn 1 t go, but he had devoted people working around him all the time. Among them is a Nobel Prize winner whom you may know, John F. Enders, who cultivated t'he polio virus in monkey kidney cells. He was a PhD in English, and he came to Dr. Zineser one day and said that he wanted to work in bacteriologyo Zineser liked him and took him in. He did that with Monroe D. Eaton who found this Eaton agent for atypical pneumonia. He had any number of people coming through his work--P..euben Ottenberg. They wrote a book together--Zinsser and Ottenberg. The Hiss and Zinsser relationship was very close. Everybody was-well, he attracted you. Did he like independent minds? Yes he did. He taught in a Socratic manner as well as an authoritative one. He and I had very close relations, even though I didn 1t go with him, and our relations became very much more so when it came to this textbook. Do you want me to talk about the book review and the textbook now? No 1 we'll come to that. You've got many more resources by that time. But what I was thinking about--in 1916, you'd never met him before--a handsome fellow, an articulate man 2 forcefu.1 1 high pressure, and1 you know1 you can be warped by this kind of iant 0 I wondered what his attitude was towar tudents or younger people who came to him. Would he look for the independence of mind? I•m sure hefdo I can't recall anything that he interposed either to studies, or ordinary conversation~ A very nice thing happened right away in his laboratory, and it does in some others--instead of going out to lunch some pro­ fessors in a department have a little gas stove in the back1 and they fry eggs 114 and sit around for an hour eating fried eggs, or drinking coffee. He had one or those. Very niceo Sit at the bench and eat 0 Sit at the bench and eat. The same thing happened to me at Hopkins. You haven't mentioned it, and that's Nu Sigma Nu. Do you want to talk about that? Yes. That's this letter. I Well, its bigger than that. Nu Sigma Nu is a national medical fraternity, alld I happened to be pledged to it down at Tulane, so when I went to Hopkins I became a member of the local chapter. ! 1ve forgotten what chapter i+s• They had a house at 518 North Broadway. I didn't live in that house. I lived in the house at 807 St. Paul Street. The Nu Sigma Nu house, at that time, a. single brick house with marble steps that are characteristic of Baltimore houses, was located on Broadway facing the Johns Hopkins Hospital, right across from it, and it has about twenty men living in there. It got rather crowded. I didn't want to live there because it was noisy at night. I studied at night, and I would rather not live there, but I ate noon meals there and those wore almost better than the classes. There were three classes, ~econd, third, and fourth year men in each group of about ten, and they all ate together in the same dining room. The men in the fourth year class seemed to know everything so they start.ed quizzing everybcdy else and quizzes lead to arguments. I think I learned more from those quizzes and arguments than I did from some of rrr., teachers. Just self-education, or mutual education in a group like that is very valuable. When I finished at Hopkins and was still around there, we decided to buy 11, the house next door and join those two houses. Somehow or other I undertook to raise the money for it• I got a thousand dollars, we' 11 s ay, from Dr• Barker, and a thousand dollars from Dr. Young, some from Paul Clough and others. We took a mortgage and bought that house, and that was a burden for me and a worry until I left the place. I actually went so far as to ask those people to whom 0 we'd given notes to tear them up because we c~uldn 1t pay it. The expense in- creased, and the members didn't have any money. I think that the professors who were members of that chapter who had taken those notes to start, never ex­ pected that we would be able to redeem them, so this must have been what this gentleman was talking about when he wrote about doing so much for the chapter. A'fter I left, Dr. Paul Clough took it on, and he worried with it maybe ten years. What happened in the end I don't know, There's some question when you finished worldry; with Zinsser 1 the publication of that paP!'.r--was the intent to return to Baltimore? Yes, I was going back to the fifth noor of pathology- in the fall. Yes 1 but then in 1917 1 which is the following year 1 Dr. Zinsser wants you to u return as assistant professor with him1 and he writes yoj two letters on the I\ same day, I•m in Hopkins at that time, aren't I? Yes 1 but Zinsser writes that he'd had permission from Dro MacCallum to talk to you ~bout getting youo Dr 0 Maccallum had apparently gone ~own to Hopkins from I P & S because it s Dr O MacCallum who wrl. tes you that while you I re going away to the Army1 Dr• Ford will probably helpo When did the Winternitz idea develop? 116 I graduated in 1914, and I spent the year 1914-1915 in pathology and Winternitz was there then., Did you see a paper here on the "Blood Vessels of the Heart Valves"? ['"21 Am Journal of Anatomy 449-1.;.63 (May., 1917)7. Yes 1 that's here. 0 I did that under Winternitz. Dr., Welch was not c~nvinced. w"hat year is this? Publication is 1917. Well., they don't say when they received it. This is Br6delfs worko I injected these hearts and you see the vessels around the edge of the valve and around the chordGe tendineae. Then I showed BrMel twenty or thirty of those specimens., and he made a kind of a schematic drawing putt~ng a lot of pieces together. - Yes. Well, that was done under Winternitz, and I think that was in the year 1915. You see., what happened while I was with Zinsser., I got called into active p duty. The 1\ershing Mexican expedition was on then, and the 5th Maryland Regi• ment from the Maryland Nationa.l Guard, an infantry regiment, was called out. They aRafflllbled in a field near the race track at Laurelli Maryland, and I was called down there. I forget how long I stayed., I stayed at least two weeks or so, anc. I got what turned out to be infectious hepatitis thereo Having no eed a terre", or whatever you want to call it, to put my foct on in Baltimore., 117 I went on back to New York to the ,room I had on 57th Street near 3rd Avenue, and from there I had to go over to the Hospital. I went to the Presbyterian Hospital where Dochez took me and put me in a bed. He 1 a worth a word here--Alphonse R. Dochez. Alphonse Dochez was an intelligent, polished, court1~ gentlemant quiet spoken, a man I rather revered for his scientific ability. He was high up on the Rockefeller staff at that time. He was a close friend of a man we called "Fessn @swald T;/ Avery who at the moment was probably close on the discovery of what new turns out to be DNA. H,called it the transforming factor, but Dochez and Avery were so close together that you'd think they were entwined. They were De.mon and Pythias. I didn't know Avery very well, but I did get to know Dochez. His taking care of me at the hospital was mostly a remote sort of thing. He was giving me purgatives because they thought that maybe that would loosen the plug of mucous and let the jauncli.ce go by, but it didn't and I was jaundiced for a long time; in fact, I got kind of green and you r,.,el quite weak. I got over that, and I went back to Hopkins after thatli6s over. Then it was getting on toward 19170 Well 1 you joined the reserve in 19,5. Yes, I was a lieutenant-I think at the instigation of M'J "Uncle Willieo" Yeso Was that a time when you had two weeks on maneuvers during the summer? Not necessarily--unless you wanted to take it 0 Training at Carlisle Barracks is where they sent you~ Yes, but the first time you remember being on active duty is with the 5th 118 Yes, tha.t•n the first ti:w.F; I remember. I may have gone to the Carlisle ~arracks before then, but I don't remember ito That 1 s almost a normal thing in the reserve 9 Well 1 I think w e•ve gone as far as we ought to go today. I may have a few more things about Zinsser next time~ Then we ought to go into•••• We ought to get to that textbook business. We ought to get to leaving scientific work for the time being completely with the ad.vent of war. All right? 119 Tuesday, April 19 1 1966 A-.54 1 N. L. Mo The documentation about the first world W~r is _£rettz_g_ood 9 All of the lotters that you wr~te home, so far as rtknow1 hav~~een 2reserv~d and thes~ two diaries which are l~g_elz. daz by daz_ -~ccou x s ..-;rou kn«>!!t.~to whe1:_~ zou we_r.!,, the thr:,e 1 ~he.•~oi:,~_of _t~3s lou fell heir to 1 or _ran into. Now we 1ve a l ~ got ~e..!!...l!u into the .!!~,. I have in addition to those diaries some other items I haven't brought out to you, great, big books of all the maps of our positio~ that we were in thro11ghout the war with ·ihe British and the Americans and a lot of photographs of the battle fields. You mean you've been ho~<!,!.ng out onl!!!? I didn't know you wa.nted that id.rd of thing. ~~ar~~-wella handwriting being what it_:l;_s, I can't make out some the en­ tries. You'd like me to bring that stuff in? I sure would. You make some drawi?_gs in .the diaries, and I•ve bee~ over this - area. 11,,e got all the battlefield maps of the whole thing. It would be very good if' you would bring them in. I don't know that I will turn those in here to the library. I don't think they want them, but you can seeo They were ver:, useful to me not long ago for 120 agrand-nephew that I have. He borrowed them, and 'e kept them for three months ~ just going over them because he 1 d been with his father on the battlefields last year. They went around, found old helmets and things like that. I would underst!~q-~his period better because I look upon the maes as a visual guide. I'll bring them in then because there are pictures of some of that mud in Flanders with shell holes in it. I can remember lying there as if I was a kid swimming in a pond. You know how the water jWlps up with rain dreps? That's how the ground was doing. People wouldn't believe this 1 but when you talk about wading around ankl;~ dee2 in m.~d-I know what that is. Wel:,t.,_ how did the call :tor active service come? Well, as I was about to tell you-in my background there is either a llilitary gene or a military tradition. One of rq ancestors, Major John Jones was aide te Brigadier Lachlen McIntosh--! think that is his name--at the seige of SavaMah during the Revolutionary War. Hew as killed there on October 9, 1779. Then there was m:, grandfather Jones in the Confederate military service wandering all over the battlefields of the South. My grandfather Bayne was a major in the Washington Artillery and was wounded at Shiloh. The father of General Gorgae was General Josiah Gorgas, Chief of Ordnance of the Confederacy. My uncle Hamilton Jon.es went in:to the Spanish-American War as a military ,._ batatalion ._, doctor, so that with the things that were in my grandfatherts collectien-~rms and things at the house-I was brought up to be rather accus­ tomed to the military side. The war--the first world war affected me rather deeply. I can remember when 121 it first broke out. I was sitting on the porch in Biloxi when the news cu,.e in, and it just disturbed us no end for a further reas••• If you were brought up in New Orleans, you were brought up in a Napoleonic tradition. The Denegre family-­ my nrante E" and all of those just thought that Napoleon was a second Alexander the Great and even a second Solon. Be was the greatest law giver and the greatest military leader in the world. You have no idea of the vividness of the Napoleonic songs and traditions that were in my youth as I grew up. So it wasn't strange to be wanting to be with the mili~~y in some way, but to get dowa to 1917. I was back in the laboratory in Baltimore, having been away for that time with Zineser and with the experience with the 5th Maryland Regiaerrli .fer a short time, the Marylalld Infantry. I had come back to Balttmore early in 1917, to begin work in the 5th Floor Laboratory o It seems to me that shortly after the declaration of war which I thiRk was about April 16, or 17, 1917, I talked to Dr. Welch about the future, and Dr. Welch told me that he wanted me to sta7 in Balti.llore on the staff on active duty and train bacteriologists for the An,q. I agreed verbally to thato What was in ~heart I really don 1 t know at this moment, but I came over _,, to Washington to see my kinjs:man, "Uncle Willie", as I called him, General Gorgas , the Surgeoa General. I was at that time a Captain in the Medical Reserve Corps, and I went into General Gorgas• Office which was in the old State and Navy Building down here on Pennsylvania Avenue, and before I said anything to him at all, he said,"Oh, Stan, I•m so glad to see you. Lord Balfour was in here a tew minutes ago, and he said that tbey 1 re desperately short of doctors for British troops and battalions. I know you've got a uniform, and it you can J. get it out and get packed, '11 get you on a boat in five days.• I never told hia what Dr. Welch sent me over there for. Now, th.at'• when 122 the decision was made. I went over there intending to ask General Gorgas to put me on active duty and to assign me to teach bacteriology at the Hopkins in Baltimore, and when he talked to me that way, I didn't tell him. Now, why I didn't tell him, I don 1 t know. Something in me may have said,"This is what I want to do", but also nI would have been a little ashamed to have 'What the French call an "embuscade" job--tucked away safely. Did Dr• Welch unders~? Dr. Welch never made a~ coaplaint about ito He, I'm sure, understood. H• himself' never hadcaa,y military experience. He didn't upbraid me, or make any complaint that I raembero What his private opinion was I don't know 0 You were set to go and sailed almost 1.Jnmediateq. Yes, I sailed early in May. I forget the date. The 8th of May, and I was on a ship called the "Orduna" with the Cleveland Voluntary Hospital outfit under the command of Major Harry L. Gilchrist who later became a general and head of the Chemical Corps. On that ship were scme very interesting medical people. The great surgeon Dr. George Crile was the chief medical officer of it, and there were several other men whose names I could dig out, but I don't recall them at the moment. They got to be ve-ry interesting companions, but we were-well, there were five of ua unattached to that Cleveland Unit on that ship going overo We were the forerunners ot a thing called the "Lost Battalionu. They were altogether perhaps a hundred or more doctors like my'Self that were sent over to be attached to British outfits, and there is a 123 book published that is in this library on "The Lost Battalion"• We got over there, and we went around for a day or two with the Cleveland Unit in London and then mostly on our own we met, or had a conference with Sir Alfred Keogh, the Surgeon General. They made a great deal of us. It was hard to pass aqywhere without having to drink some liquor. Everybody was pressing "refreshments•, as they called tha, on you, and even we five with the Cleveland Unit were received by King George and Queen Mary in the garden at Bucld.nghu. I met a captain one night there at a club, and I met him again in France. He turned out to be a captain of a British canpaay in France that I got assigned toci Is this Ca tain Lindsa ou in the cen er of a room at some ban uet and elayed the star spangled banner? Maybe it was. It was N. t. Lindsay. Well, do you want me to go on to France? You had a note to Sir Allred Keogh1 and I think that when you had the con­ ference with him1 he call;ed you aside a~d told you that .Ile was writing a special letter for you. Now1 I don•t know whether the others in the ~roup of fin had the same thought in mind about their service as you did. You waated to be with a battalion, or at least you expressed that idea. Well, Sir Alfred Keogh sent me first to the 69th Field .Ambulance in ~ranee near Messine Ridge. At that conference-well, it didn't progress very well. We were sitting around the table, and there was present a Lieutenant Everett D. Plass who was the Chief Obstetrician from the Medical College in Iowa City, and Sir Alfred Keogh said,"Now, gentlemen, I want to place you where you can 124 employ your specialties and do some interesting work as well as serve the soldiers in this war", and he said to Plass, "What is your specialty?" Plass said that he was an obstetrician, and that set the Surgeoa General back. He said,"We don't have much of that in the Aray- 0 " I think he stopped asking questions at that point. I really do 0 Actually orders were slow in coming because zou went to the Base Hospital #4 with the Cleveland Unit_for a tille 1 up arourrl Rouen. Yes, I weat tnere just as a rider on the Cleveland Unit for food and clothing, and I stayed with them until the orders came for me to go to the 69th Field Ambulance. We had sane maneuvering type of exercise there. I remem­ ber that we had what was called in those days a bangelore torpedo which is a very long metal rod with explosive in it. You were to shove it under the barbed wire and then blow a hole through it. Coae on--tell ae about itl I hate to say anything about a great surgeon who bas done good work and has passed on, but Dr. Crile rather shocked us. He had a theory of the p~o­ genetie origin of shock. He meant that the more highly organized your nervous system was, the more apt you were to have shell shock, and his serious purpose was to reduce shell sllock in. soldiers 0 He began to invent double wall helmets with padding inside of them to take the shock away, ear muffs. He invented dugout doors which, of course, never could be placed and if they were placed, they wouldn 1 t stay there. He sent us down into Rouen one day to collect all Te varieties of animals and plants that we could. We had~ome out later leading chickens, dogs, frogs, violets, and God knows what. I think I had to pass in 125 front of the crouched British soldiers waiting for this explosion to go off leading an eel. The explosion went off, and the creatures were blown up into the air. A lot of them didn't mind it very~uch, except the dog~t t few of the dogs came down out of the air and lay panting on the ground, and Dr. Crile said,"Yousee what I told you? There's the highest organized animal we have. and he's got typical shell shock." Arthur Bo Eisenbrey-I think is the man's name-he and I took some of those dogs behind a building and did an autopsy. We found that their mesenteric arteries had been cut by little fragments of this torpedo that went through. They were dying of hemorrhage, but the professor was satisfied that it was shock. Well, I didn 1 t stay there too long. There hadn't been much work on the problem of shall shock, had there? It was a fumblin,g_ beginning--this collection of bugs 1 animalso Is that in there? Yes 1 There was another offer made to you about this same time frm a Dro Charles F. Hoover--! think it is Hoover--to establish a laboratory for the study of trench fever with the Cleveland Unit. Maybe. Trench fever was just beginning about that time to be recognized. It was supposedly a typhus-like disease and probably might have been carried by lice. They never really worked it out thoroughly. They thotlf;ht they had found a rickettsial-like organism which they called Wonlhynica. They thought that ....._________ - ~ 126 1 trench fever came from one of those Balkan states. I had it-I'• sure--at a very uncomfortable time. I 1m jumping way ahead. In 1918 1 when I was with the Americans, we moved up to the Marne River--we'd had a little rest with the 26th Division back of Verdun--and on up the Meuse River on the right hand side of the bank. We had to IJarch at nir,ht and rest in the day time under the trees. Well, the doctor didn I t have much rest because he sp:,mt the day fixing blisters on the .feet. At that time I had fever every day for a while and this charac­ teristic red swelling in front of the shin bone, very painful legs, and a little erruption. I think it lasted about ten days. You eve the teaperatures in this diary:, and theY; were quite high. Did I put all that in there? Yes 8 There's one camnent in June of 1917--the simple statement, that you avoided being made a member of the Johns Hopkins Unit. Were they near the Cleveland Unit? Yes, those units were cClllieg out. I was with troops, and I liked troops, and I didn't want to gets ent off to the hospital laboratory. That was the only reason. All my friends were in the Johns Hopkins Unit., but i.f I had gone there, the same thing would have happened as happened to me when they eent me to Dijon in 1918. Did you get to that? They wanted to put me in the laboratory and do Wasserman reactions, and I didn't want that. - Yes. I got on well with troops, and as I said, I didn't care very much about the outccme of my life in the war, so it didn't matter, except that I didn't want to stay in the laboratory. 127 You ha~ a succession of talks with a colonel who wouldn•t talk to you at first­ Qolonel Russell. You got a telephone call the night you finally got a chance to talk with him1 and he said that he was going to move y:ou to a battalion, ~ut that the first thing you had to do was go to a gas school, which is a brand new tmi _yo Was that Colonel Frederick Russell? I believe so. He became a brigadier general, a very eminent man. He introduced typhoid vaccine in the United States Army about the ti.Ille of the Spanish-American War, about 1900, I think it was, a brusque man. I had no real personal association with Colonel Russello e Except that you wanted to get on to troops. You spnt a good bit of time in '\ . Rouen. The Cleveland Unit really didn't have a place for you, although they !!!:..• _affable, as were the British who were being replaced by members of the Cleveland Unit, but _you wanted to set on to the busiaess of being a medical officer with a battalion, out with the troops, so y:ou went in and knocked at his door. He didn't give you the time of day the first time 1 but late that night, your eceived a telephone call1 and the first thing you had to do was go to a gas school. That was reasonable. Everybody had to go+to the gas school. That's new and novel. You haven't indicated any ex)?!rience with gas. No, I didn't have any experience with gas, and I did have a new experience with the h«rrible type of gas mask that you had to use at that time. It was a 128 rubber contraption and it covered your whole face with a clip on your nose like a clothes pin and a respirator that hung on your front like a knapsack on your backo I think they did expose us to some gas. Mostly it was a drill for putting on a mask and behaving. I don't know what,. risk we took. I doubt if ve took any, although I do recall that there was some man about that time who 0 showed that a human being could walk around in hydr\cyanic acid gas that was killing dogs right around him. But then you went on a train ride and finally a Ford car ride to the 23rd gtvision--a replacement camp. The British 23rd Division--! still belong to the Officers Association of the 23rd British Division, get a letter every year to caae over to London to dinner. I don't remember anythi~ about the train ride, or where we went, but the 23rd Division is what I got into, and I think I went to the 69th Field Ambulance first. The British were at that time just about to blow up Messines Hill south of Ypres. Well, that was a very fine ambulance company, very strict discipline, and fine people--Scots. I 111 get the name of the colonel in charge of it after a while, but ~'ve forgotten it at the moment. The only ones I have here are a Captain w. Go Johnston, a Captain H. Ro Macintyre, and a Colonel Hammerton. Colonel a. H. L. Hammerton is his name. I said replacement camp. You did join the 69th Field Ambulance and then for a time you were sent off to the 70th1'wherever you were needed. . A replacement in that senseo 129 Yes, b\lt tbo•e weren't •ery long in any- one place. No--actu.a!,;l;z until zou got attacne..d tp the lltb. Sherwood. Foresters. e. Yes, the 11th Sherwood Forest.era which suited ae no end becaus~ when I grew up, one of the things tut we w,ed to do at l\oae w u play Robin Hood, and I w as Friar Tuck JUB:, times. God-that'• a p:eat legac_z1 It was natural. They must ba~e been scaetbingl The Sherwood Foresters were Yorkshire, a Lancashire battalion with very broad accents. I sooa got to know the ujor in charge at that tiae-Colonel Charles E. Hu.dsoa, snd I st\lek very close to nilll. He adaitted tlle doctor to his headquarter•, and I was with tne c0111Und1ng o.f'.ficer all the tille, practi• call.7 troa the t1ae I joined th•, but it wasn''i loag before tit.at battal1oa nat oa up into the liaea at Dickebu•ch-I tllink: that was the place. Yes--nere the first gas attacks began. Dickebw,c~? Yea, it was-just outside of Dickebusch. I remsber tne first e gas attack was s~l gas. I raember the queer, whistling, wobbly sound of e tlM sh~ll ccaing over with very little explosion. We had working partiee out just beyoad a little eabaruaae11t where the road wen.t across a sort of ma.rally' K place. There must have beea two lumdfied men working out there that night bringing up elephant iron, aand bags, all sorts of thing. This shell gas cae over, and aobodf mew what to do about 1t.\It didn't se• to be especiall)" 1.30 poisonous, b~t it wasn't more than about ten minutes before we toud that it was a lachryraatory gas. It just caused awtul infia:mmation of the e7es, and I had man;r en l)'ing out there. I ude a mistake. There were no instruetioas as to what to do, but I had some cocaine solution, and I found if I put it in \he qes, they got rid of their pain for a wbile, but it caae oa wor•• when tu cocaine wore off. Then ia that same plae• we had phoagene shell gas attacka, and in tae sae place at various ti.Iles we nad austard ga ■, so I aaw th• all about that tiae, but I didn't have any- trotible with gas. Tllis lacnrymator7 st.rt didn't SNm to get ia yq e7es. I dida't pq auca attention to the proper va:r to handle a 1aa aaak because it waa so alltfocatiag and se obscuring ot tae visioa tbat I ued to P'lt the clips oa .,- aose and the respirator end in my mouth and let the rest or the mask tall dGWn so I could •••o Pbosgeae is horrible. Not lo11g after the soldier breathes pbosgene he collapses and starts to ~•d a bloody l pink frothy' st1lf'f all over llis tac•• I ha➔nat later oa in 1918 with tae Aaerioau. This was in JuJ.y1 and there were a successi~~ ,of attacks with gas 1 but this i~ soaethinS nev. These were the .f'irat gas attacks. You're in t~eneh warfare, aad ,this is the Ypres sector where the sal;ient was, and t~z were changi91 ground all the time1 swapping ground., and never w1 th a chance to clean it UPo There,ere dead horses, dead men, feces everywhere. Is there an anecdote I( in there about how the English soft speech c~ accmplish what the American 131 speech won't? I No. You told me this the ~ther <!!f• It s a :marvelous story. I wish you•d put. it in with the language 1 however riP! it maz ~ from the American [>Oint of I can• t ue those curse worda. I was walking with Colon.el. Hudson one nigh.t along the bank just north of Zillebeke with about seven hundred men, I think, ~nd there were tour British three inch guns tiring across tbe road, across this embankllent, and we couldn't pass. We were due up front to make the relief, and e. Colonel Hudson went up to the British gun"J\r, and he said,"! say, old thing, 0 would you mind stop firing oft that silly "N-d piece until I get my men by?" The gunnar said,"Righto", and they stopped firing these four guns--I gueae. We went by o Well, about a year later on the banks of the Meuse near Sunoneux, there were split trail, long hundred and fitt7-r1ves tiring straight froa the river bank up across the road going over the neighboring bills-I aean the shells did, and the major I was walking with went up to the gunner and used the aost vile profanity, called hill all sorts or naaes and asked bill. how he thought he could get his 103rd Infantry b;r at that ti.lie with these guns firing across the road. It111s a very sharp squabble, and the gunner told the in!'antey major that he could sit down on his behind in the mud there and wait with his aen because he had orders to fire two hours, and he was going to tire two hours. The7 got each other so mad, and that 1s where the war had to stop. There is a difference in the approach. Oh yea-sett speech got it all the tiaeo What sort of resources did you haYe as battalion medical officer? What did yo11 132 have to relz on? With the British? - Yes. I started with a prett7 good little medical chest, but 7ou can't carry a'Q1thing that is at all weight7, so I took out ot the chest bandages, scissor9, I suppose SOJ18 bottles ot iodine. I didn't take any anesthetic, took a few pilla--someti:aes we had some pills that we used to give tor diarrhea--I forget what they were, a tew things like that and put thea in a gunny sack and carried them on my back. I had three or tour very devoted aide men with me in rq little battalion aedical place, and they had gunn;, sacks on their baca, so we didn't carry mu.ch. We also carried as mao;y Thoaas splint• as we could, tied 0 up together and hanging arer ~ur shoulders. You know what a Thmaas splint is tor--broken legs. Tne stretch.era wre carried by other people. We had about eight stretcher bearers most ot the time, but stretcher bearers got awfully' worn out in the aud, and the7 couldn't make more than one trip anywhere, so we had to impress all sorts or people into ser-rl.ce. It wasn't long before the doctor persuaded the cOIIIDlanding ot.fi.cer to let hiJll have the bando I think I broke up three bands in the course or that time because as soo+• a stretcher bearer gets back with a patient he general.17 joins th+uttit he's with in the back area. If a bands11a11 gets back there, the outfit behind wants a band, and tbey keep hill. Did iou omate troa an aide stat.i~n? I didn't do much operating at all. I just did first aide stutr. I did the best I could, cleaning out pieces and things, putting bandages on and 133 stopping bleeding. I didn•t. put any heaV7 tourniquets on because I knew that is forgotten in tiae, arid the limb becmes possibly' gangrenous. You tad so 11&D7 things that you couldn't, really handle, and tbe aide stations weren't. built as aide stations. I reaember one we occupied quite a wb:Ue. 'l'bere vas a thing called tbe Hooge Menin Road r11nning trOll Ypres te Kenin and just at the beginning et the Battle of' Paeschendaele ve went up through there, and there was e an old cul.Ten under the road and a l i t ~ tunnel d'1g into the shoul.dera of' the road. Tbat11A8 the aide atation, and it was tull of blood, people dJ'ing on the fioor, hot and smell.7, but you saw aoae braTe thin.gs there. I reaellber an Auetralian one night who cue in holding his toreara in bis hand, and it was attached to bis upper arm by just a tew shreds. It was bleeding very auch. I asked hi• bow he got that, and he said, "l stopped a five point nine with tq elbow." Well, a f'iTe point nine shell is a good sized sbello I cut his ara otf with scissors and bandaged it up and got bill awa7. You see things that you can't do anything about. In the saae Battle or Pa■ schendaele we had oar aide station in what remained of a sort or a mound on which a race track grandstand bad been built. There was a t11nnel in that-very- narrow. The most room I had, as I r•eaber it now, was as aach space as the top of a s11&ll table. The ~oor was coTered. with wounded. I r eaeaber some wounds like this-a ■an brought in with tbe whole ot the front of bis skull lifted up. You could see his I brain. Then it ccaes around tour o clock int.be aorning, and tnat 1 a the time rou could get people out vi.th stret.cher bearers. That's a very hard tille tor V the aedical officer. That's the tiae you•~• got to act like God Alllight7 and decide who ia going to get out atld 1181'be live and who is going to star there and di•• The rule with me alld ■oat of the medical otticera was to use your l 134 stretcher bearer• to take out the people who had the best chance or sUrYival. You go through this. You. can be close to a aan who is moaning, in great pain, horribly' wounded, and begging to be taken out, and you have to decide that 7ou•re going to take sOlllebodJ' elseo That happens over and oYer again. As a matter of f'act, to jU11p way- ahead, i+s now a part or the official poliey ot the civil def'ense medical organization and the .Aaerican 1"edical I Association in thi1 count.17. Its alaost a rnolution in medical thinking with A regard to who youfre going to take care ot. Suppose you bave an atollic boab, the rule nc>w is t.bat yo11 don't waste y-our tiae on people who are sure to die. You try to do soaething .f'or those who are likely' to snrvi"Ye, and that is in print. I That a a great cbange in Mdical attitude and thoughto You confronted ~ t f!licl as a matter of ~eceseitl though1 didn't you? In the war? Ies 1 There vu ~ya limited mmaber of people zou bai who could take eeople - back. Oh 7••• !ow close were the general hospitals to the line? Oh--it wasn't general hospitals that you took thea back to. The general hospital would be back a hunired miles or ■or•• These were the small station hospitals, little tent.a, aaybe tive miles back, but 70u didn't know alway-s what it was. I bad an experience one Bight that sounds like General Patton, but it had au effect on this man. It was also in the Battle or Passchenclaele which was a horrible slaughter. We were be7onci the Hooge-Meoin Road, geing to what's 135 called--I think it's Polygon• De Zonnebeke 1 an old race course, all shelled up, mud to 7our .+4, and one of the stretcher bearers with me was naaed Corporal Tongue-did 7ou run across his name? - No. Corporal Tongue was about six feet three, a strong man, and a shell burst very close 0 Corporal Tongue who was a stretcber bearer lay down on the ground and started to shiver and c-q aad wanted to be taken back. Somehow or other I vu able to pull that man up to his teet and when I let. hiDl go, he tell dewn againo I pulled him up again and slapped h1a in tae face as bard as I could, and he .tell down again. Then I kicked bim on the bott• of his shoes, didn I t !I l kick hi.a on his flesh. I kept badgering hill until he deci~ that he couldn't I get back. He got 11p slowly and put hi• weight aad ara around ..,- neck with his weight bearing on ae--I guess a couple or hundred pounds in the aud1 and we went on up to the Polygone De Zonnebeke where the battle was Tery thick. That ■an never left ■e troa that tiae on. It I'd seat. bbl back, he would have been a shall shocked pqchiatric casualty. He beca■e s:, batman. He I d bring me tea at four o'clock in the morning when I had to get up for sick call. He carried ray latrine around, a little box. I think that that 1s good treatment ma7be. In Korea they tried to do a great deal of rehabilitation right up near the sound ot the guns still--at the front. Well, those things in after thought enter into your general philosophy of medicine and what the principles should be, but at, that moment, I was just thinking of survivalo I wasn't going to send this 11an back with the tew stretcher bearers tbat I bad when he wasn•t even hurto other things tba.t happened in a battle like that were very unexpected and dis- turbing 1 but can be worked out. I remember a big captain up there ~this '"'' 136 I Zonnebeke region. I was wandering around in the night, and I found this officer separated from his men, lying on his stOllach with his face in his hands, just blubbering. He 1d lost control of hiD1Selt, and he was no more in command or his eapanJ'. I just sat down and talked to him a while. He didn't get sent backo You certainlz had no experience for bombardment. Betore~bi.s? I don't kn.ow that there is an.y :wy: to prepare lourself for what it really iso No. lven in this Battle of Passchendaele I must have spent half to three quarters or an hour one dq being shot at point blank with a cannon. Did you find that in there? It was a German cannon, a small cannon across the Gheluvelt River about four or five hundred yards frOll us. I was in a dugout pill box the door ot which then faced the Germans. One of us was foolish enough to put•- sandbags around that door, and•• soo,. a tew sandbags ftre up, they started shooting at us, and these shells would wbiz by. Several of them hit just above the door. Son:i of them hit below the door. Some hit the side ot the dooro This little pill box was about six feet in one dimension and about eight feet long. There were about five or six of us in there. We crowded against the back wall for a while, thinking that11Ls a sate place to be. Some- body' would say,•Ttiat ,..•s fooliehl If it hits the back wall, it will spread and get us all." 0 We cr1i..wded up to the front wal.l and then they'd think they'd get it on the long back shot, but fortunately- none of those shells came in. Also I was in a kind of a shelf near the roof of that heaV7 German pill box one night and the 137 ,I shell hit the corner of it and the top of the roof started coming down on me. !bis was an area that had just been taken frca the Geraans. Yes, in the Battle of Passchendaele. Yes, the door was fine so long as you were on the other side 1 but their do,2£_ beca11e &I!, open door toward them when th& retreated. Yes. I got a Military Cross in that battle when I was with Colonel Hudson. The Sherwood Foresters were going up to take over in the line. They had been on resene, or at least in the second line until that ti.Ile, and believe it, or not, we were having tea--about halt past fov with a battle going on. There vu an aw:f'ul bang, and the dirt tell down a little cement stairway into the dugout, and a soldier came down rather alamed and said that a lot or aen were . I hurt outside. Colonel Hudson looked at me and aaid,"Well, Doc, I guess its s up to you," so I crawled up through the dirt on the ~tairway and went out, and there were wounded men there. There was a lot of babardaent. I don't think I got back for a couple of dal'•, but that••r- I got a Military Cross. Just incredible things happen. I didn't believe I could be hit. Really? I stood on that mud talk~ to an officer and a shell came and the man next to me was gone. The sae thing happened to meo N The shell goes dewn into the gro~d and it bursts, and it has a kind ot a 138 ,I full fan shaped explosion. You can be between those scatters. Yes, you can, but that's very much or a chance. I think after a while you get ' to the point where you can tell from the sound where it s going to land-you ... know 1 yeu get a sense aa to whether you should dive to the ground, or some cover. That wae a hypothetical bit or comfort because when you hear the sound or I a shell, its gone by you • . les 1 but pqchologi.calq it was helpful. ' a big howitzer shell that has gone wa1 up It's gone by you•-unless it.a ... in tile air and is ccming down. We used. to hear-the big German naval guna were otr Dunkirk, the Belgian coast, aoo they would fire on Dickebusch, twenty Jliles or more. You could see their flashes and hear the guns. Was there much mortar fire here? 1 oer'lain amount. or aortar fire, not a good deal or it. They had another thing--instead of a aortar, it was like a garbage can, a root and a half in diUleter, and it swirled up on top or the trench with two or three explosions. They didn't have the same kind of modern mortars that we have. Those zou couldn't hear 0 Tell me something about what you can learn fros what the human body can take from the Sherwood Foresters, from all the things they were subjected to-clilu.te 1 everything else. It is incredible what the body can take-cold and wet, hung17., full of lice, dirty. Bobody is going to pat J'OU on the head or hold your hands. There's no use weeping. Fa~ue--you get so tired that you don't know you're tired. 139 ,./ These men--a lot of th•J well, in 1917, the war had been going on since 1914; and a lot of men were approaching forty. 'f:pey were that age group. Taey weren't the priae young fellows who bad started, and they could take ito I was well and quite strong at that tilae. I don't remember very much. M,' feet didn't. get sore• I got plenty of lice. Didn't we, At some point the Sherwood. Foresters were pulled out of the line, and they were directed to the Italian eueaign. f•a not sure why. This wasn't after Caporetto1 was it? I guess it was. Yes, it was the Caporetto retreat. that had happened and the break through on the Isonzo front. The Austrians had broken through, and they had the Italians I on the run. They were stopped at the Pi.ave River. Thats as far as they got. "' e At this junture-they were entrained, and you were too. You mentioned another \ man1 another Aaerican by the name of Long. Yes, Lester L. Long is a physician out in Seattle, I think. He was with the Koylies, the King'• Own Light Infantry, s.nd that outfit was also in the 23rd Division. The 23rd Division felt that it was a pretty spic and span out­ fit. It belonged in the loth Corps, I think, bad a caamander named Lt. General Morland, and in one place in nanders we ware reviewed by the Crown Prince tc1ward. But technically we--the United States--vasn•t at war with Austria. lo, that bot~red me a little technically because I wanted to go with the Sherwood Foresters. I didn't care whether they went to Italy, or Africa-I wanted to stay with thea, but they did go to Italy with the British 23rd 140 / Division to oppose the Austrians, and I found out that it wasn't proper for ae to go with them because the United States had not <',et declared war on Austria., as it that would make any difference in the outcome o.tr,he var., whether I was there or not. After I bad gotten to Italy and eTerybody was quiet about this, no diplomatic episode occurred., we did declare war, so I was legalised. This vu a different kind or warfare than the nat1 country tzye ot warfare in nanders. Very different. The whole coantry was rocky. The Piave Riveras low. It was just a maas of boulders. The fielda were bard, and after a while we were sort ot in mountain valleys. In the first place, we were in softer ground, a hill called Mountebelluno, just north of Venice, but the shells that hit these ro~ks scattered like everything., and the Austriana apparenUy had huge mortarsw­ maybe thirteen inch, soaething like that, and they'd tire the• over the moun­ tains, and they'd c•e straight down the valley and throw rocks all around • .!~ was setting along toward winter too 0 It was getting quite cold, and the Italian haoitations were quite cold. They have a little fire place in the llli.ddle of scae room. It's open hearth., and you stand around, but before this Italian experience was OTer it snowed, and it was quite cold. They kept us on the aove all the ¥-1.me• We kept warm at night, but we bad •rches, rou+rcbee, exercises and the docter had to tag-Jalong too. After you detraineda there must have been a ■arch of a hundred and forty some miles. Yes, there was a :march f'roa Mantua to the Piave River. It waa a very long, 141 / hard aarch. The British had no--well, they apparently never had an officer like Major Munson who developed the Munson last for the American soldier•s too\. The British shoe excoriated your heel in no timeo It hurt the instep, the joint of the big toe. It would pinch the toes, and every one of these men had blisters in no time, ae auch so that al.Jllost all during that march I fixed feet most every might for aost or the night• I was a aounted officer, so I was allowed te put soldiers with blistered feet on two things-I could load my aedical cart with soldiers, and I could put a couple or soldiers on my horse. I could let th• take turns, but the British were very strict against stragglers. The British marching discipline was wonderful, and these mounted officers would really ride a aan down if he tell out. We went down these battalion roads in formation, looking good, eTerything shiny, and on the other side of the road coming out ot the line were thousands and thousands of ragged Italians. You remember the scenes in H•ingwq's Farewell to Arms? It was exactly the same thing. These aen would go b1 and pick a field bare. The7 were just like locusts. They would go and take Italian houses and mess thea all up, put feces on the floors. As a matter of fact, they had some way-I don't know whether they evacuated themselves into their hands, but you would find these lumps of feces sticking to the ceiling, so they'd throw it up on the ceiling. An;y-how, it was a pretty disorganised and unkempt lot. ;rbey ought to have been good soldiers. I think they were andemined up there in the Austrian Alps b7 propaganda. Part of the propaganda which I picked up and which impressed me was coaing frc:a the clergy. I think that the Vatican clergy saw an opportuu:itJ to let Austria come through there and bolster the power or the Pope. That's what we supposed. Anyhow, there was a shortage of­ well, at least the rations weren't given out to these men up in the •ountains. 142 ,/ S011.ething disorganized them a great deal. I never knew the whole thing, but there was supposedly propaganda frm the cleruo The Austrians bad some good generals at tha.t tiae. They did. There's one thing that we've voverlook~dL and that is that lou went ~hrough_ this area in France before; it? ract1 zou were there ir>; 19081 1th.en you ~ook a tour with the familzo Yes, I,d been to France twice before this, and it seemed like the country I had seen. Tbat appears in the correspondence home 1 while you.'re not able to convey what the town is because or censorship1 you do indicate to them that this is something 0 that the have seen or ou described the nowers or s0118thin familiar. Yu &~~ a chance while still in France to go to Pariso What was Paris like in those days? How unreal was it with reference to the war? I wasn't in Paris twenty-four hours. That's right. You JOt r•~~• I went to Paris, and I went to the Hotel Maurice which is a spiffy place, got a roca, and I took about three baths in the afternoon. Then I think I went and called on 7lrJ' Uncle Hugh Bayne who was in the Judge Advocate General's Office somewhere down in an office there. I think that it was this ti•• We went out () to dinner and on the way out-I think it was the same evening--! th~ught I'd better go and report to the British Military Office there. I did go and report, and they said,"Oh1 we're looking for you," and I had to go back the next day. Yes 1 thel had received o~ders to go~o Italy. Yes, well, I didn't know whether they were going. They •de me go back to Abbeville~ as I remember. Abbeville was on the SOJUle River somewhere. You did get ~chance !inallz after this perio4 ~n the northern part or !tag t~ go to Rome. To Roae, yes-ten days. Rome in that tiae was a very social and pleasant place, good restaurants. I was tagging around a little with Colonel Hudson who ie had an entre in the British Embassy down. there. We met a good many people, snd ' I did sight s eeing. I believe we got that leave extended a little bit. Yes 1 b~t t~en I ynnk by t~e tiae you. got back-well, you had orders to rejoin the .Aaeri can Forces, 'ftlere'e one thing about ,sanitation. You aean where Colonel Ro Jo Blackham gave me the devil? -Yes. I don't remeaber that very well. I remember some meeting. Everybody had a lot or diarrhea., but Is aid soaething which, if I vagu.el.y recall it, :made him think that I was too careless or both the chlorination of water and eanitation. I think there was a dinner, and the c0111111ent you aak.!, in the, diary is that "no 2ne seemed .triendlz." This :ias a dinner .for--I eess .the 69th Field .Ambulance. Not in Italy. Well 1 it was some organization in Italy that was over all the medical peopl~• Yes, well, Colonel Blackball was called the ADMS1 the Assistant Deputy tor Medical Se"ices, a staff' officer, and he lind in a nice Italian villa. I \lSed / to see him occasionally. He lived in regal splendor, had been serving a long time in India, and he had wonderful sort of Maharaja clothes that he could sit in the evening in, but Colonel Blackha didn't carry- ao,thing after the war against ae because I had a certain amount of correspondence with him; in .fact, I saw him once, and he wrote several books which, by the way, xeminds me that I meant to bring you sOlllee Ther,!, ia a large aaount .or diarrhea during this period. This f• December. 0 Yes-\n the banks of the Piave. It was more than diarrhea. It was d,Ysenteey. It was bloody dysentery• How eftectiTe were the Br~tish lab~ratoriea? Did they have laboratories t~ study these proble1!!,? Not that I know of• \ They were studying thea, but I never saw them. A lot or good work was done in England and various places, but we didn't have •IV' laboratory support out there. I remember on.e man standing up to be sent off u a replacement. When the Sherwood Foresters would get orders to send ten men to another outfit, you'd pick out the worst actors that you could, line them up. I remember that this man standing there fainted, and the Sergeant Major •s pretty rough with him. I came up, and thi• soldier looked sick to ••• I pulled his pants down, and he had bad dysentery. We all had a certain amount of diarrhea, but there actually was dysentery. I don't know what organism it was, but the British must have round out. You~• some cownt about the shipping of your trunk for w,g_iaer clotnes:::zo~ coul4,?!!t lug this stuf'.f', aroum. It vu in a back area., and when yo111Bnt troa 14$ / France to Italy a~d .1:n Deceaber in the 11ountains .it got cold. What about ~ccess to clothiDJ• I don't remember any suffering about that. I had a heav,- trench coat, and it seems that it was in tbat region where we had a Christmas party with scae hot rum punch, and the padre was there. He and I left about mid-night, and we bad to go arouni a narrow ledge ot rock, a nd I .fell off and slept in the snow all night. Is that in there too? Is it? No 1 sir1 it isn't• I aust nave been a little mixed up. I Its ... S'!1'J!ri~ing what you can~~• Yea., I had a heavy trench coat. Where I got it I don• t know, but we had s no shortage of blanketll. We J\ent them up on quarte:raaster trucks. I wondered about ~ueelles 1 even :medical supplies. I had no shi»rtages. There is S0118 1n~cation in the diaq ~h~t on o~e oc~sion the aedical supelies were destrozed. By shell tire. Yes. But there was an enormoua llllitation on what you could doo Oh yes. You didn't d.o anything, ez:eept try to keep the trenches a bit clean, tey to keep the latrines coTered1 dig new ones, but it is no fun digging a latrine in the rocky- banks of the PiaTe River, although the Italians could lh6 / do it. When we got there, as I remember, they had full head nigh deep trenches right through the rock. That is commented !'n in the di!,12-that they •ust have been good workers, ~though you didn 1 t get that iapression!,_s you watched them retreat. Mo, they were protected, and they were used to doing that kind or work. There were soae labor battalions attached to tm British in Flanders. ilw&y11 labor battalions. Ttie7 would dig trenches, and tbe7 would put up barbed wire. The uin protection the7 bad was what we called "elephant iron", whici+-- a halt beat corrugated iron that 7ou'd put up and crawl under. It. wouldn't. stand &IV' bullets. !}l•n order• cayht up to zou. I had to wait. They said1 "You can't be ordered out ot here by an American order", and so they had to work that aroundo I think it took a couple of months to work that around, but all to the good. B;r that time I got up as far as the Asiago plateau. They s~rted an attack on that. Yes they dido That's where Colonel Hudson got the VC one rrl.ghto He stopped a Geraan potato masher with his teet, and it blew ott most or his teet, but you couldn't kill him. He lost his feet in that, or at least part of his teet. He bad cerebro•spinal meningitis, and he had a ruptured duodenal ulcer. - Godl You couldn't kill hiao He was reaqy; tor c!,11t7. Then you had a !airlr guick ride ""tt&ck to .... Dijon, I believeo You went first to Paris 1 then to ,Chamont1 and thel finally sent you to Dijon. I must have gone from Paris right on out without any stops. Chaumont was Pershil!IS• Well, you went to the wrong station in Paris and missed the trai!• Oh, did I? Got out there a little bit late. I don't know th~t yw ~ , or that your orde~~ !J?!Cified that lou were going to Join a laborat.or.z: ia France. I got there. I don't know wh7. Colonel J. Fo Siler was in charge. Dr. Zimsser was around there soaewhere. Wel1 1 your orders are dated ,Nov•ber 21st, but you didn't start to move until:, the .rollowi9S March. Yes, there was a long wait in there. Thert-s a Lt, Colonel ~lchrist. Yea, that's the s&Dl8 Gilchrist that brought over the Cleveland Unit, and be later becaae a general and the head of the Chemical Corps. Who is Uf!l eral Bradlez and Colonel Ireland? In 1917, when World War I started, ueneral Pershing wanted General Merritte w. Ireland to be his surgeon in the A. E. F. in France. Pershing started troa here, and he wanted to take Ireland as his surgeon, but General Gorga• wanted Colonel Alfred E. Bradle7 to be the surgeon in the .American Expeditionary- Force ,; because Colonel Bradley had been in London as a :medical military attache in the Eabassy far eoae years and was actually ever there. Ite s very i nt.eresting about policy and staff relations, and i've re oent.17 reviewed the papers~ eo I knov. General Gorgas recmaended that Bradley be made the Chief Surgeon of the .AJllerican Forces in France and to have the authority over those aedical establish­ ments in France equ.al to what the Surgeon ueneral had over the medical department heN. That v as the beginniag of a veey important difference in statf relation­ ships which extended very far anfnterested us throughout~ World Warn also. To answer your question about General Ireland.....Oeneral Ireland succeeded General Bradley along aboQt late 1917, and was the Chief Surgeon of the A. E. F. until, I think, March, 19180 General Bradley had to quit because he had an abscess of the lungs, and he wasn't very well aost of the time, but Pershing didn't want him. General Pershing and Ueneral Ireland were both very intelli­ gent and aggressive men, and General Pershing thought that no one stood between hi.Ill aixi the troops over there except the President of the United Statea, and he had the bitter row, as 70u r•eaber, with General Marsh who fas the Chief' of start, se ■uch so that General Marsh got out an order saying that the Chief of' Staff was the immediate commander of all these forces. General Pershing didn't pa7 an7 attention. to it. All that is written up in General James G. Harbord 1 s books and other things. They had a bitter tiae, but General Pershing was dealing constantly with the President at that tillle-it was Wilson, wasn't it? That set a tradition for the theater commander. Even the modern theater com• j under is like a viceroy, like a satrap, like an independent cmmnander--almost independent, and that extended down to uene~al Ireland, the Chief Surgeon, who made vast numbers of changes in medical organization, policy, administration, supply, hospitalization in France that were quite contrary to the published regulations and accepted things cf the Surgeon General, so it ma.de a split be­ tween the Surgeon ueneral and the Theater Surgeon that existed all through World War II also 0 General None.an T • Kirk and Ge t'l'lral Paul Hawley-Hawley was the Chier Surgeon of the ETO. They got together pretty well, but •ost of the surgeona over there were quite independent ot Washington-As much as they could be. Ireland then became Surgeon General in October, 1918, end was the Surgeon General of such renown-I think he held that office tor twenty-three years, greatly respected, brought out the great history of World War I. Have you seen th.at? Yes, What I was thinking of was that as or this tiae when he made the changes., lcu make them with reference to the scene you see in front of you. Who? I General Ireland, when h~ made the chanses, Its almost on the ground discretion as to what comes to zou and how you're soing to handle ito That's what he said-..tbis moving warfare in the field was ao different from the static barracks, post-like things that had been going on in this country­ that he had to make changes, and we bad over two million men over there which is terrific. I don't know whether rou saw tbem1 or merely mentioned the fact that tbez were-- - 11 150 I thit1lc l!?U saw a major I reported to a major I a.nd they s ent you on to Dijon where the laboratory was, where you talked with Colonel Siler, There was also a docior there from Hopldns--Hussey. Wasn't Hussey there? . h Yes, Raymond. s. Hussey was there. He was a pat~ologist, and he goes in and out ot my relations for m.aey years. He was with us in World War II in charge of the Artlf¥ Industrial Hygiene Laboratoey in ~altiaore. You also met Hans Zinsser. Oh yes. Zinsser was in the tide of glory, so to speak. Zinsser loved troops and liked movement, and he was a very illlportant man, had charge or a division of infectious disease and laboratories, and he was the Sanitary- Inspec .. tor of the 2nd Army at one tiae. First he was Sanital'1' Inspector of the 2rxi Corps--well, in one of the corps. He was a very able, imaginative person who did a lot for modernizing field sanitation. Do you remember the labc..Tatory installation they had at Dijon? Zinsser'l I was o~· there about :four or five days, and I didn't do any work. I moped around until one morning when I was sitting on a bench by the front door, and Colonel Siler came in, and he said, t'Wbat1 Are you still here?" I said,"Yes, sir.• I couldn't say I wasn't, and he said,•Get the hell out of herel The 26th Division is on the road, and if' you can find them, you can join them." 151 This was the New England Division9 Yes, that was the New England Division {J,he Yankee Divisio!Y"-f'r• Maine, Massachusetts, New Hampshire, Vel"llont, and that's all, I guess. A Captain Harry Martin is mentioned in the diarz. Oh 1 Captain Harey Martin was, I think, a regimental surgeonff the 101st Infantry. Is that right? God.1 how can I remember those thingsl !011 bad to report to himo Yes, I went from Dijon to Toule where the headquarters of the corps were located-whatever corps it vu that was up there-just as fast as I could go. Fortunately" Ias picked 11p by a Briagadier General John M. T. Finney and carried in a car up there. They didn 1 t know I w aa coai.ng because I had no orders, and the Coloael-I forget his name a1 the moment-said, "All right. You want to go with troops. They're up the line at a place called Montsec"•-whioh is a bare bill rising right out of the plain of the Woevre occupied by the Germans loolcing right down the throats er the .Americans in horrid sodden trenches. The region I•m talking about is near a town called Seicheprey. Did you ever hear of the Battle of Seichsprey? Well, Marti~as a vigorous, short statured man who was a good soldier 0 I 1.$2 d1dn 1 t have to see much of him. I was under him as battalion surgeon. He w.s the regimental surgeon. You arrived there on April 2nd1 but l!:)V orders are dated !J?ril 11th. That•s often the wa7. 'that's the difference between joining the 3rd Battalion, 101st Infantry as oeeoeed to the 11th Sherwood Foresters? Well, the difference was in the language, the habits, the food, a.nd as far as the experiences in the war went, they were very much the same as being around Ypres. We were in mud, and we were being shelled all the tiae, under ma.chine gun fire moat or the ti-.e, and under the observation of the Germans who had the high ground. I didn't know an;ybody. I had nobody like Colonel Hudsoa that I adaired so much to talk to and do anything with, and when you co• into a thing like that you pretty well catch on as to what you're supposed to do and go do it the best you can, but again, I did the same thiag I used to de with the British and I did it all the rest of the war, go out on my own and look things oYer. 0 I used to go out on patr~ls at night. I had an experience-~'• sure that f'rigttt ode it possible for ae to walk 0~111ter like one holy person dido I was out about a thousand yards in front of our lines. There was another man, and a party of Oeraana came in the dUBk with their rines and we lay down. They went by talking low in German, and after the:, went by-1 we lit out to get back to our trenches. There was a shell hole as big as a house, and I ran right across that without sinking, and when we got tc our lines, a man stuck his head up with his rifie and sa1d1 "Who goes there?" 1.$.3 1 It was something like that, but I was over the top and on him and knocked him down before he could do ~nything. You know1 it's surprising whatever it is will do to a person, what 1ou can do I given a set of circt111.stances. It s just incrediblel " Yes, if y-ou get acaredfnougho the hundred yards in nine nat1 or whatever it is1 somehow you call forth far more power under certain eircumstanees like those that you describedo Then there came this Battle of Seichepre7. The Germans about this time, I think, pushed the Americans out of Seicheprey and Seicheprey is a town lying on the lower slope of a very- long hill going out into a very- marshy plain over to this rMontsec and to another region called Bois Menieres • 'l'hey s ent me in there to the 102-1 Infantry because the doctor hall been evacuated. Well, I nnt in there, and I had been there for a 'While under a picturesque man named nMachine Gun" Parker. He was a New Englander, a very buccaneering ty-pe of man, talking all the time of what he could do with machine guns, but I don't know that he did particularly ■ucho Well, in that I took over a static position. Seicheprey was almost in no man•• land. It was rubble at that ti.Ile. We had posts all through there. I must have stayed there three weeks. We retook it rrm the Oeraa.ns in a counterattack starting early one morning, end that•• the first time I was ever tired on b7 our own guns. The artillery tired eight hundred yards short and killed a number ot the 102nd Infantry- boys who were trying to get to Seichepre7. Also wh'tle I was down in there, I used to wander around and talk to soldiers in trenches, and that was..,- first experience with an;ything hooiosexual. One soldier called me aside and said that he had to talk 1.54 to me and please not to let th&ll go througn with the order to assign hi.a to the battalion headquarters because he aaid,•The sergeant looks us over and picks us out and gets us in there and aolests us.• The sergeant was a fairy. I looked a little further into it, and I found that homosexual practices were fairly common in that particular outfit and I never saw anything as demoralizing. Everybody was suspicious. Apparently there is something about according the favors of a u.n to a man that acquires tar acre for the one who ~v•s it, a great deal or tavoritisa, and it was an unjust set or af.t'a~s. That got reported down to Chaumont and very strict orders came out about that, but it was a most disorganizing thing. Wasn't the 102nd overrun, in part? Yes, that was Seicheprey. Then tnez had to retake that area• Yes. That's when you went up in there. This was underneath the Geraanso Weren't -) they looking down on you. Yes. Here ia a place called Beaumont on a ridge, am then imagine this hill that goes down like that--Seicheprey would be here and Montsec there, but C- there'l8re woods 1'.ver here and deep trench••• That was the time that they were using cylinder gas. We stored a lot of it-great big gas cylinders like these carbon dioxide cylinders that you see going around on trucks here. A friend or mine, Captain Jermne P. Webster, was a gas officer, and he pulled up and left about twenty of these cylinders right outside or my aid post. It a shell 155 bad hit them, there would have been nothing left of us. Well, the cylinder gas is what started the Gemans on their chlorine attack on Ypres. They unloosed the chlorine in 1914, I guess. Rough business, but you had a long time cleaning up this place after you had taken it. Oh.,...., it wae horribly dirty. There were dead horses1 dead Germans and dead .Americana. It was soggy- dround, excrement all around. There was a period of training that zou. went through. I don 1 t know how long it lasted1 but it would seem that it ran from the latter part of April on into May. Yes, I suppose it did• Just cleaning up the place. There is a whole series of towns--Buconville, Bernecourt. Yes, I know that. That's dowu in the valley 0 I•11 bring you those maps. Then there was a phosgene attack. Was that the raid we put on? - Yes. They put on a raid against the Germ.ans one nighto I think the trenches were on Montsec, very deep trenches, and they had been used by the Germans a long time. It was our own phos~ene that got us. We crawled out there before mid-night and were all lying around. We had white brassards on our arms to 156 tell friend from foe, and I think there was a Major James F. Hickey-do I mention his name? I don't know why his name should come back to me after this time. He was in command, bu.the started running around in the dark saying 1 "Where on eai%th is my PC?" He got excited, lost his way, and lost his head so somebody else had to take over and get ready for this raid which was to start around four o 1 clock. They had the most wonderful artillery fire. They had what they called a box barrage, a tremendous barrage of all the guns sounding down parallel to each other on the aides, across fromr,ch other on the back to keep people frODl coming in and in front the fire moved in while these two lines were firing down the sides 0 So we went in behind that barrage. You don't need to get hit if you don't get too close. I think they had more artillery in that raid than they ever had at Gettysburg, and all we caught was one little German prisoner. I remember this man. He slid down the side of one of these deep trenches and tore the seat of his trousers out. That •barrassed him more than the war, but be was the only capture we made. It gave me an idea later on which I u.sed. We captured one night two hundred and some Germa.ns--about twent~ of us captured them. I didn't. I was with them. We had no means of guarding them all, so we took their belts and suspenders off of them, so that they had to walk through these woods and trenches holding up their trousers. They wouldn't let go or them. lbey were absolutely helpless& Well, we threw pbosgene over into the German side, but the wind was wrong. It was ott to the right, I think, and it all blew back on us. Pbosgene has a latent period. You don't know you 1Te got it right away. Its not very irri­ " tating. There was so much dust and noise and smoke that nobody could tell that there was any gas caning, but as they all went back, some of these men began 157 to get sick and voait. Some of them had this .frothy' stuff cardng fr011 their mouths. I went back with them., and I think I must have had several hundred cases of phosgene poison-these men lying out there with no antidotes and no knowledge as to what to do. I don't think any of them died. J.,• not sure. We got them all back to the hospital in ambulances. There was a decided shift in the windo Yes-it was off to the right hand side, if I remember. I thi because hereafter you ~et raised in po~ition. I became Regimental Surgeon of the 103rd Infantry. Which is a dit.f'erent thing than beigg with troogs. Well, I stqed with troops-is this thing still on? I•a going to turn .it orr. 158 Wednesda71 April 20 1 1966 A-54 1 N. L. Me There are a n\Dllber of ites which intrigue me--one ot whic4,I r~n onto in the ~~arz. Itve alread7aenti,,2.11ed it to you1 ~nd zou•ve indicate~ that fOU don't remember muc~ .&:.bo,ut it 1 but I wondered ~9:t:, r elationship you had to ~he sense of Al;SY ,discipline as it manifested itself in Any; law and the qs~ of court~• The British? With the British and the Americans. I had very little ·to do with the courts, except two court martials-the one that you mentioned with the British which I 1 ve forgotten, and one I'll tell you about later with an American which is quite interesting involving., as it did1 a soldier in a battle and the family potentates at home who had political power greater than the power of the cCl1'1Dlanding officer. All sorts of things arose. With the British, I adllired their discipline veey much even with this I! Sherwood Forsl\ter regiment made up of older men who had had practically no ndlitacy training. By this time in the war-it was the third year for Great Britain-the discipline was good and strict. they had representatives of what ve 1d call MPs, Militaey Police, on the ground among the soldiers and there were a good many prisoners all the ti.Ile in the battalion, soldiers under disciplinary punishments, or confinement. Curiously enough I used to sleep right next t+he prison, right next to the room where they put these prisoners, and I could listen to them talking and hear about some of their problems. 'I'hey were not at altutinous, but they still had a very independent spirit and would do petty things. They would steal fr011 the l.59 local civilians in the towns where we were billeted. The British soldiers I was with were never violent like some or the .Americans. In one or two ot the towns where I was with an American C011lpany1 or battalion, the Americans raped the French girls every now and again. I don't know of anything like that happening aaong the British. I think the British were older than the .Americans which may have kept them a little quiet. They would-the British soldiers would steal truit f'rom orchards, but they didn't steal anything very valuable. Some• times they would steal souvenirs-souvenirs were wanted by aost people. The discipline was administered in the British battalion largely by the second in c0111111and1 aa I remember. It might have been a personal thing in the 11th Sherwood Foresters. Tne COBllllanding officer was more of a liberal, scholarly type, literary- s • ~ t in his inclinations, whereas I think it was Colonel J. R. Halford, a big, tall aan, a wonderful horseman, ver,- stern and I very strict, and he was the one we associated with disciplinary :matters. Hes ... the one who would ride up and down the line when you were on the march and ride down stragglers. That's about all I can say about it. This co■E!,l"es in some reseect with the Allericanso Yes, the .Allericans were not so disciplined. The Aaericans tend to be still civilians. These were not regular troops in the American forces. They were the National Guard reg$lllents and the National Guard people. The 26th Division was made up of National Guard elements, the New England states. Tney had regular officers--so■e or th•, but some were not regular. The 26th DiTision was emnmanded bJ' General c. R. Edwards who was a great favorite among irregular soldiers in many ways. ' ~. sae people. His aolito was "stout hearts and discipline", but they were quite rhey wandered around and did~ t tale proper 160 care or their sanitation. You had to be after them all the ti•• fhey ,_ had good fighting esprit, but not good living esprit, but that ia characteristic, I believe, of .American youth in most places. They are not disciplined. Don't you tbink so? Yes, I don't know wily that iag except I think you !Ut your finger on it when that the are lar el civilian oriented an thout the sense or h tra~tio~ that th~ Britis~ w~¥d have~ You know1 t.be 11th Serwood Foresters \ meant something quite aeart from the men who were there. Yes. The 26th Division didn't have very high standing in Pershing's Anrq-. For instance, thej,secood Marines were better fighters and much better disci.plined and tops. The 1st Divisio~s a top division. The 32nd Division was also as was the •Rainbow" DiTision that McArthur had nade up very much like the 26th Division, but it had a auch better reputation at headquarters. It was felt by us that the 26th Division was being penalized because of an unfavorable reputation, penalized by being kept in the line. The 26th Division was kept in th• lin• fro• March until November /J.9lf/ with practically no tiae out at all and with many battle•• I r•e11ber one instance-this is by hearsay-General Ed.wards was indirectly repriunded by' the Commander-in-Chief. As you know, in the Arrtcy you're not nppesed to put two subjects in one letter. You can't. file two subjects in one ., 0 letter, but ueneral ""dwards WX1\te a letter to the headquarters commanding the 26th Division, hoping that they would get a divisional citation. In the same letter he asked tor ten thousand pairs of socks. He got a reply saying that he 11ustn•t put two subject.a in the sue letter, and the 26th Division didn't get an;y divisional citation. At about that time they sent up to command the 26th Division a Brigadier General F. E. Bamferd who was a Marine. He was a blustering disciplinarian, and we thought he tried to take it out on the soldiers in the Division. There was another Marine cG111DULnd.er in a battle 011Ce next to us named Colonel. a. J. Bearse. He was rather a law unto himself, but a strong disciplinarian that carried his men where he wanted them to go. We were in the Battle of st. Mihiel where we had to make an ~~• turn to the east-starting south and turning about thirty degrees east-the whole line was supposed to do this. Well, this Marine t ol-\ 11 ~IH>lf: ~ •\tal~a didn't turn and vent right straight through the wheeling 26th Division. That's what Colonel Bearss did. In another cue Colonel Bearsa vent orr with grea~ bravado to the German side and got pinned down in a fara boas•, and we bad to go and rescue him. Curious things were tied up with discipline in a way, and the disciplinarians, I thought, were not always well disciplined theaselTes. How representati.Te was the court martial that y:ou attended? Tb&t was an interesting thing. This was in the battle southeast ot Verdun N when the Meuse Argonne had started up north of Verd~• The 26th Division was on the nanlc and had to~• what I thought was a very nerve-wracking diversion­ ary attack. We attacked froa the hills down into the plain of the Woevre under severe fire with barrages and everything else with the knowledge that we weren't supposed to gain anything, but were just supposed to divert the attention or the Gemans--sta7, if youfould, and get back, if you could. Well, in that region-this is about October, I think• of 1918-there were great tunnels in the hills that we were on and fr• which we took orr. A sergeant vitb me one morning whe~we ware well into an attack was found biding in a tunnel, so I put ' 162 him under arrest for dissertion in the face of the enemy. I had no way or having him put in confinement. We were in the line and were fighting a daily sort of battle, but l:Ie became a sort of a ward of mine 0 I had to watch him and be more or less responsible, and whenever we moved, this man would stick along with -., with~be aedical section I had. That continued f'rom that moment until after the armist&ce. • I had no way of bringing his case to trial and no way of dismissing him on my own word. The chaplin began to intercede for him and other people. He and I got rather attached to each other in a f'riendly wa7. It was quite •barrassing and rather ridiculous. Finally they did t17 hill, and it was so long after the event that they- just dismissed hill, bat it tur"(ed out that a situation existed in this man's case that probably' existed in several ether Aaerican units, and this situation might have conditioned this man's sense of' independence sufficient to make him hide himself when the battle was beginning. He cue from a small town in Haine where his father was the chief' undertaker, and his father was fairly well-to-do. The commanding officer of the c011pan., in which this 11an was, was employ-ed occasion­ al17 by- the undertaker who had political power also, so that the officer in the company- couldn't control the enlisted aan because th.e enlisted man•s parents were ■ore powerful than the officer's peopleo This man came troa such a situation, and I imagine that existed in a good m&f\Y of those National Guard outfits where the hand reaches out frOJll the local cC11111.unit7 into the military­ situation protectively. That certainll was absent in the British, wasn't it? I never saw anything like it in the British. I think also that there was a caste system with the British. The officers are much more remote from the men 16.3 than .American officers are. Yes 1 but that can lend itself to a lot of mischief--you know1 it spreads. I mentioned one other interesting item before we turned the machine on; the nature of water supply in a static situation where you have trenches, dug in positions, prepared positions as you did in F1anders and in Italy 1 and then the changes that are demanded because the battle becomes fiuid 1 chase and run affair toward the end.1 E?!:rticularlz f'rca perhaps Septeaber 1918 on1 when there was this steady push. Now1 purification of water seeJIS like a simele problem, but it isn•to Well, as I recall in the trench situation, water came up either at night in C, water carts close to the line, or what they called petrA_l tins, five gallon gasoline tins, containers. They would be brought up strung around the necks of soldiers carrying them. Most of the water,a, I recall it in the trench situation, was chlorinated somewhere and brought to you. On the move when the fighting is in the open coun~, men will drink from streams and don't pay I any attention to purification. Occasionally, I suppose, you have a Lyster Bag and set it up, or local chlorination--you~ry that with tbe American troops all the time, but you often can't use it. I don't remember much difficulty with the water supply on the open warfare part because it was a rather short period tor us. We broke through--the 26th Division, or the 103rd Infantry I was with broke through Belleau Wood.a and went to the Veale River, but it was rather fighting alfhe way. Itlesn•t just a march, and we had no real open country in the St. Mihiel, or other regions. When zou 1ve picked up experience in terms of raids 2 no man's land.1 the possibility of casualties between fixed emplacements-what sort of demands did it make on 164 your crew, the people you had with you1 when you begin to have a acre fiuid Of?$!ration? Of course, zou have to play with what you have 1 but I wonder whether the experience led to any rethinking at some later time on the ldrd and qualitl of aid that you had. W.ell, it varies very- much on the terrain where you were. Let me go back to the st. Mihiel battle again. That started about two o I clock in the morning with a terrific heavy barrage going over, the sh~ falling on the Germans and close to Americans in a region that had been fought over since 1914, and it was all a aess of barbed wire, grass, and shell holes. When I started out and. could see something by- daylight, could see wounded in the middle of that mess, I really b drepped 'M1' medical supplies, except for a small paclca.ge of ~andageso I found a Germ.an wire cutter, and I went through that barbed wire on the ground and liberated people who had fallen and got entangled in the wire. I still have those wire cutters at.home and use them• They are very strong. Now, that was an open movement tor about two miles or more, and then by eTening we vere off the hill and down into the plain, and that'• where the lines sat for the rest or the time• They wiped out the salient and had lots of counterattacks, but they didn't go very rar. That•s a long battle line way oTer frc:,m Montfaucon way over nearly to Verdun, but aside from cutting out the salient, it didn't advance vecy much, nothing like the sweeps that Patton's Army made in World War II. They went thro\lgh that region also. Was there any eroblem in evacuation? Evacuation is, I would sq, easier on the move than it is in the fixed position. The fixed positions we were ~n were so much bombarded and had been so cut up with shelling that you really couldn't C:o a~ eTacuation until toward 165 day break, or maybe soae ti.Ile in the darke The terrain was very bad. It was very hard to move anything. No vehicles could move in there, whereas when you're in the open, stretcher bearers have firm ground under feet as a rule and carry- longer distancesJ Little ambulances can also come up very close; in fact, when we went through Belleau Woods, they had ambulances in Belleau Village which never would have \been, if' you had been fixed in a trench. These were lJ Ford amb~lances, little Ford vehicles•-! think they carried about four meno Did you remain at the St. Mihiel sector until the end? Quite early in Flander~ zou got nicked on the leg by a piece of shrapnel, spent shrapnel, which healed in a short ti.Ile with nc problera. In fact, I never reported it• Yes, except in a letter hOB181 but you went all through this ue until about e~even o'clock on that final day when again under baabardm.eat1 I think•-! don't r•ember1 bat somebody discovered sane casualties, or indicated that there were some out there. I don't know whether you knew that an armistice was comingo Well, new you 1Te jmnped ahead a month. I was just wondering in personal tel"lls-injuries and the possibilitl or injury. s You ge fra st. Mihiel up to this region southe\t of Verdun which is an ~ I:; indiscriminatt kind of region. Then we turned and marched throllgh Verdun, up '- " the east bank of the Meuse River about fifteen Jd.lea past Fort Veaux and sc:ae or those Verdun battle fields and stopped at a place called Samogneux. /' Saao9neaux is up over the hills that rise trlD the riTer. We finished the war u' there eaxctly in the place where the French first aet. the Germans in 1914-you 166 can see what a nu.id war it was, but it was relatively grown over with bushes, and it was hard ground. Lately it had not been knocked to pieces too auch. They had some .American little tanks-"wbippet tanks", they called them-that tried to come up through theN, and the Geraans mocked off all six o:t them, ~ stopped them right there. Our line from the Germans east of Saaogneux in the edge of the forest was probably thirt7 feet. You didn't dare stand up1 but at night there was an exchange of cigarettes for some things that the Germans might have-there was a little fraternizing going on• Then there was that rather heavy shelling frt111 twe directions-getting on now1 toward Armistice time, en the llth of Novem.ber-ve would get shells from behind, coaing froa the western side and shells calling froa the eastern side because there was a curve in the line there. As far as what happened on. the aorning of Arllistice day-7es, I knew there wae going to be an armistice abo~t a d81' ahead. Se did everybo~ else, but for some reason, f'or morale, or to impress the Germans, orders were given that although-they didn't say this in the orders, but I 111 say it-that although the high cc:nmand knew that there was going to be an armistice at eleven o I clock, they ordered the battalion units to go over the top at daybreak. They started a big batt'.e in that region early in the morning, a veey foggy morning. The ground is gullies and slopes and little valleys, and you recall that Irew ot some wounded in one of those places and started to go get thea. I got veey close to a German machine gun position and finished the war lying on my face and belly being shot at. Then after it wu over, t.hat night we had a Fourth of Jul.T celebration. In the first place-I may have it in the di&r7--a German with a beautiful baritone voice started to sing. Suddenly when the guu stopped, the silence was terrif'ic-oh, amazing silencel That night everybody who collld get his hands se r ! 167 on a Vere7 pistol, a Vere7 light pistol for barrage signals, started to shoot them otf 1 and there were beautiful fire works. Big nares would go oft, and the barrage signals were kind or a Fourth or Jul7 rocket affair that exploded in the air and then dropped a long tail of different colored burning nares, and it was a great celebration. How did you feel about this at 11:10? It 1 s very difficult for me to recall how I te~t aboat it. I felt elated that the allies had :f'orced the Germana to stop fighting. I was glad that I was still alive, but not hilarious about it. I was as dirty as I could be, as lousy as I could be 1 and I guess I thought mostly of J4Y own comfort. I had men to take care er• We had to find food, or reorganize, or get t~,ether again because we were pretty well scattered. Then we gathered up and marched all th• way back, a long way back to a place called Bazoilles which-I don 1 t know. It must be thirty, or forty miles. All of forty miles. I was still looking to get clean, and I hadn't had a bath since September as rar as I remember. The onl7 bath I got was on the banks of the Meuse when one night the sergeant and I went down there. We thought wetd jump in the river., and when we got out ve saw bales of clothes on the banks, urxlerclothes, and we put thea~n. It was an old, abandoned delousing station, and~hese underclothes were full ot louse eggs, and in a tew hours we hatched a million li~ that just dro"Ye us about crazy-. I didn't. ha"Ya any chance to change thea. My uniform was eut at the elbows. il~ough I was a captain, I had bare elbon and the euft ends or rq uniform were ragged. The inner seams of my pants were ripped. I had 168 them held together. I wove a little willow twig through t.hea to hold them to.. gether, and when I went back, got back with the battalion to the rear area, I found -.,self right in the JRidst of the Johns Hopkins Hospital Unit at a place called Bazoilles-"Btasiwtllien ..,. ./ we called it, and a:, old illlmacula.te friend, Cy Guthrie was in charge. Is that in the book? I No1 its not. Cy Guthrie was in charge. He was a major then, and I had another friend from Hopkins named Frank Evans who\•s a medical man from Pittsburgh, and they wouldn't let ae come into the officer's quarters I was so filthy. It•s cold and moonlight. They made me undress outside the bath section of the barracks, and Frank Evans then pulled me through the window into the shower bathe I got a little clean. I bought a uni.fora from Dr. Guthrie. Then I was in good shape. The battalionWls reconditioned too. Whe? The battalion ou were with. This is where the ceived British shoes. Oh yes. Well, they were very uncomfortable. ·rhen from that place we went t' on south in France to a place called MontigD3"-le""'-"fis where the division head- quarters was. From that point I got up from Regimental Surgeon to be Sanitary Inspector of the whole 23rd Division. By that time I got prcmoted to major. I•d been a captain when I entered the Arm:y in 19171 and I had receiTed no pro­ motion all that tillle 1 although I had jobs that called .for major 1 s rank. As a matter of fact, you get lost the way we were doing. I don't think I get any pay when I was with the British-for months, but I had a letter of credit that my Uncle George took out, and every time I got near a French bank I would draw out money from it with this letter of credit much to his surprise, I think, and maybe some inconvenience. The 26th Division Sanitary Inspecter was a very interesting and enlarging position because you had the power to go all through the division to see what was e;oing on, to try to see that the billets were clean and sanitary- measures were being properly observed• At one tiae down there, we were visited by President Woodrow Wilson, General Pershing, and Chief of Starr Tasker Bliss. That visit was very hard in some ways and very amusing in others. To get ready for it they hauled us eut in the road about daybreako It was sOlllle cold, wet morning, and we stood along the roadside that the President was coming down from about daybreak until he came, around 11:30. He had dinner, a noon dinner, in the big dining room in ~ a French hotel in this reso{ town. What .r •m leading to, I think, is indicative of the lack or tact~ or a political sense on the part of the Presidento We were all in the dining room, and we had taken a lot of trouble to get this dinner ready for him with the best rood we could findo He went through the dinner, and at the end or it we thou~-~ that the President would get up alld say that we were ~ 1get home soon. There was a long sort of pause after dinner. Tbe President and r\ General Bliss got up, walked across the dining room to the main door, and as Mr. Wi~n went through that door, not having said a word to us, he turned around am in °a ~ther high voice said,"Good b;re.• n That's all that he did. It was extraordinary that he should do thato It's just not understandable ia a political fi&ure. It was understandable to me afterwards. He was, I suppes9» an academic sort 170 ot man who may not have known how1 or may have been too proud to col'ldescend to jolly people along, but all of us were disappointed, except one reporter woman who went t\NUnd after the President had left and collected bis spoon and fork­ verined off of mess kits, and she was getting souvenirs of the utensils that the great had used• Were you bothered much by reporters ~urins the war? No, I doritt recall any except at this big party of high government officials coaing with the President• He came eff prettz lo_! t~~t fl!.J• Yes, we didn't feel much affection for hill• This bee ones a •~i ting period too 1 as•.tea what is going t.o happen next. Ther_!, are notes hme feari~ being JUde ert of the Army" of Occupation, hoping th.at it would not happen. I have that in MT writings? Letters to "Tante E" 1 • Well, we didn't know whether the 26th Division would be in the Army or Occupation. As a matter of fact1 they formed another new anny...the 3rd Ar,q was established and organized very lat...... h, early in November /_'f.91[1, about two weeks before the Arlllistiee, under General Dickman. They had no training, no experience with civil affairs, or occupation procedures. I think we knew the 3rd Arm.y had been put together, and I sllppose we were afraid that they would put the 26th Division in the Jrd Arw:/• They did pnfdirtsion in the 3rd Ano'- 171 no MW onea, but the 42ndt for instance, was put into the 3rd Army and stationed in the A.hr Valley. When I was Sanitary Inspector or the 26th Division, some high officer came and called on me one day when I was making an inspection and intimated that there was a position that they would like me to take at some head- ._. quartera--I 1ve forgotten. I didn't• I wanted to stay with the 26th DivisioA• Then orders came for me to go and beccae Sanitary- Inspector of the Anq' et Occapation which I did in "anuary of 1919• I think that I a the dat•-~arly in January. Janqarz 7th in th~ diarz 1"0rd~r•d to the Jrd AN on the Rhine as Sanitary I~• spect~~ er the A.7:;&." but this is a brand new thing 1 a brain new setting, I don 1 t know tl\&t •& existing regulations, or manuals related to the kinds of probl~ zou ~ould get into. You make certain chaggea in the organization-par~icul~lz with reference to the anq e2ideaiologista 8 one of .!fhich you were allowed, but zou thought that you needed two-one with the statistical branch, and one !&signed to the laboratory in the event an epidemiologist was needed. This is the first time that this comes out-that is 1 the use of an epidemiologist, the need for twe in the kind of organization zou had with the static occupation troops. It makes a lot of sens•• 0 I think that the idea ~f needing the tve in additien to the Sallital'7 In- specter is not to be credited to•• so much u to that very wise Colonel who was the Surgeon ef the ArTfl1' of Occupation, Colonel J. w. Grissinger. We set up an ~., office there in a fine building in Coblens. The Surgeon's Office was at head­ quarters, and lo and behold, the epidemiologist they sent to werk with the 0 Sanitary Inspector was rq senior, so to epeak, froa J°'fn• Hopkins, .,- admired friend Alan Chesney, a :much better man than I was. We set up an office in a e 172 big room-two rooms may'be, next to the Surgeon's Office, covered the wall with 0 the huge map or the ,J\°cupied area. We had daily, often hourly reports of what was happening in the occupied area. We got around a bit ourselves in car■, and we pinpointed every case of inf'ectious disease that was going on there. They .... had two outbreaks of influenza, and they had a considerable u4,ount of tn,hoid v fever among the divisions in the Ahr Valley. The innuenza was among the C. soldiers too, but the t1Phoid was mostly among the J\ivilians. We knew th&t1 and we knew about scarlet fever and the things happening in the A:l:ltlTo I think there were about two hundred and fifty tbousa nd men in that Arm7 of Occupatiol'l, occupying a great strip of land from the border of Luxembourg to l'I the south ba~k of the Rhine and then half of a bridge head extending over across the Rhine. The other half was occupied by the French. Well, Alan Chesnq and I had all these statistics and locatioos,and Colonel Grissinger just thought that was very fin•• All the visiting brass hats and everybod7 that came to Coblenz he'd bring into this map room of disease and show how much he knew about what was going on in the troops and civilians in the region. We had a good control over things. There was a wonderful liaison with the Civil Affairs • • There was a Civll Affairs Branch Headquarters separate froa the Arra-:y to deal with the civilian. health, and the man who was in charge or that had been the Health Officer of the City of New York. I forget his n&111e, but I knew him. I stay-ed there frOlll Januaey until soae day in June, 19191 and during the course of that tiae I had two personal experiences with Colonel Grissinger. One ~. or thea was somewhere {along in April, I suppese. Telegrams began to come in. f'r• Hopkins, one from Dr. Welch saying that I was needed back in Hopkins to teach. I don't know whether there is &DJ' or that in the book or not. No, you got this in the mail somewhere along the line. 17.3 r,i That's just.,- promotion. Well, Colonel Grissinger was aver, hoest, A straight-forward man, and this telegram. came in from Dr• Welch saying that I was needed at Hopkins to teach and to please let me out. Colonel Grissinger called me in his office, and he said,"Major, do you think you're really- needed at Hopkins to teach?" I said,"No, sir.• He said, "All right. Go back to ,-oar out.f'it." I couldn 1 t tell him that I thought I was needed to teach. lb.en at the end in June, when I did get released I went in to say goodbye to Colonel Grissinger, and I got the greatest accolade I ever received. After all those months of . ~· hard work be said,"Goodbye, major. You haven't giv• ae any trouble•" That's wonder.t'ul 1 This area in terms of its own sanitation, existing installa­ tions, went fro■ aore refined in the larger cities down to almost crude in the little villages. In the occupation area--y-es. And while a certain eercentage of the troops were housed in barracks1 a great many or tl'Em were housed in various l!rels of concentration of the population. Yes, in civilian houses• existins installatiol18. What sort othelp did - Yes and with the added burden, the t«x that thei•rt being there would be on you have-A::,m;y Engineers, and so •• on? The Army of Occupation had an engineer battalion to take care of the water supply, and thatw as under laboratory control. This other laboratory man you 174 mentioned came up there. I forget his name at the moment. Hew as in charge of the laboratory and most or their work was diagnostic work on some diseases like typhoid and constant supervision of water supply, but in that region the vege8 tables and fresh foods like that were a source of great anxiety because the Gernns fertilized that region with what we called "honey carts"• They would pump out the cesspools into these wagons--they looked like great big barrels, and they would drive them out in the fields and would spray the fields with all this decomposing excrement, get it all over the cabbages and the low vegetables. The other difficulty in Coblenz and other places was venereal disease, and the policy was still, and it always ia 1 under debate as to whether you try to control houses of prostitution and by exuiination say that certain women are not infected, or whether you try to prohibit it altogether. In Coblenz the authorities authorized certain houses to be accessible to the men, and you'd see lines, hundreds or men standing outside the doors of these houses of prosti­ tution waiting to get in. They had a fair amount of venereal disease, but not too much. What did zou do for infiuenza? You can•t d• anything for innuenza. Influenza--the 1918 epidemic of in­ nuenza was very much worse in the United States and in the cam~ of the recruits over here than it was in the more seasoned troops in France. There were two waves of infiuenza, one in March and one in the winter extending over to 1919. ~. What you tried to do was separate tta man, and to sleeping quarters you would try to get as much air in the place as possible. There was no drug that you could use. There was no vaccination at that time, but j•ve(recently looked over the statistics of the influenza in that region, and it was not very great. r 175 Ne1 except-you know, it was spotted on the horizon. Given the exP!rience •f 1918 1 and its possibilities. 1hether it was the more settled life 1 the more frequent baths, and bathing1 in• cidentlaly1 was set up too 1 again I suspect with the Arny Eniineers and their mobile bath. Yes, also these troops were getting seasoned by now. They were stronger and more resistent than the recruits. There were a number of telegrams--you mentioned telegrams. There was a telegram~­ ! guess this 1s in one of the letters-that indicated General Ireland through General Gorgas asking your release as soon as possible, and to that Colonel Grissinger replied not available. Another telegram came back to him asking when yeu would be available, and it was here that it was indicated that you were urgently needed by Johns Hop19-ns. You're in tbe Army or Occupation, the war is behind you1 you're probabg at sixes and sevens. You have a job to do to be sure 1 and it has its interest. Yeu 1 re going to work anyway at it1 but,ou want to pick up older things. I guess this is symptomatic~£ all troope 1 a desire to get home. Yes1 I wanted to get home, although Coblenz is a delightful city. We went to the opera almost every night. We had the officer's club. There's some :marvelous poetry in these records by "Speedl" Swift. Oh yes, that•s Dr. Swift of the Rockefeller Institute who is a great man on rhemn.atie fever. I lived in a billet that was a palace on the top noor of 176 the heuse of one of the members of the firm of Kuhn, Loeb and Seligman, big bankers-a very plush lite. A. far cry from dugout <!&.P• Yes., 'Ehat was the bank president. We were close to the bank:1 so)w e had American soldiers guarding the place. Tney were polite to us in there, but the futlly didntt associate with ue 4 The j~b1 in etf~ct_, had ,been done. Yes 0 There always was a great deal o:t boredom in the war just as much as at any time. I don't know of any situation where you 1re so bored day after dq--even in the line. It 1s a deadening thing, except when you get movinga and_there•s sound. That !•ehow ~xcited ~drenalin1 and yeu can li~e through it1 er at le~st z•~ can ~ove 1 but th~re are dazs and days of bored•• There is some i~dication of going back to Hopld..ns--you did Ke.1 s011e indication fr• t.~em that thez had ~~~ your eositi~'! for you. They told me when I le:tt that they would hold it open, and I had no anxiety about it at all. I took it for granted. !h~s was, reaf'firmedo I don't think lcm p;aMed on being gone r,or such. a long time perhaps, though I don•~ know 9 I don't r•ember that they ever calculated oa hew lo,ag I'd beo In a& event, yelU' return. from war to Hopkins in terms of the correspondence is like the silence ~:r ,Nev,.:;,lllber 11th-certain doubts about enthusiasim, fee~~n,1 ✓ 177 C strange and <:fistant--in a sense, the laborati\rz: itself wasn't the same laboratory. Fae~ had chan ed and moved on. You moved into 712 st. Paul Street waich was anzthing of those dazs 1, those ini~i~ d&zs 1 trzins to find your way back? Yes, I remember that it was a rather slow process getting out of the Arflr¥o I landed-I forget where I was. Newport News? Yes, &nd then I had toge to Fort Dix to get diSllli.ssed from the Arm.y which is a long way f'ro111 Newport Bews, and that took same ti111e. Everybedy is in a. rush to get out• and nobody seems to care very much about anybody else. Then I went back to Baltimore. It seemed very natural to get back to work gradually. I didn't have tow ai t, as I recall it, for anybody' t.o get out because I don I t belieTe that anybody was in my place in the laboratory at that moment. I be... lieve I had been promoted during the iast part--wnat--June, 1919, while I was still over there, to what they called their position of associate which is just under associate professor. The laboratory that I went into, I think• was in the Hunteria n Building across the street fram pathology where I had. been befere­ no, it wasn•t. Was it? This I don't know. No, no. It wu back in the pathology building, and then Dro Lloyd Felton and I started to de work there. We built a hydrogen-ion generator, and that generating hydrogen set that building on fire. I think it was in 1919 that that happened, and then we moved aeress the street. 178 Initially this 124riod--~ell 1 you lived with a Dr 2 Davi,2 M. Davis for a while. I Yes, I know him stillo He was a urologist. Hes ,. still living. He was waitin for a ho11se te be bui to move into a ho11se where I believe 1 he was going to live with qis sister, but he joined you at 712 st, Paul Stre~t• Then you met a Dr. P.A. Schule who back in the A.ray of Occupation was verz much ioterested~n refuse and left certain instructions to ~ollect it 1 and you not infrequentll_ gave instructions to burn ito I don't remember th&to But _he was at the Hopkins apparentlz. Then you movE:,d into the Baltimore .C!~­ zou seemed to have been at odd 1 s e~d• The Baltimore Club was a very nice place to be ino I think I must have stayed in the Baltilllore Club for a year or so. I had a room there. How did you reel about the laboratorz? Can you pick up things? Do you have to start fresh? There's evidence in t~e letters that you encountered difficulties making a pure culture again. I don•t remember. Well 1 l!~.~•d~n effect aone at right angles with laboratory work1 straight ben~b work1 and had gotten into adlllinistration1 san.itati~• All I recall is that when I t',ot back there, we just went back to work very busily-. We were studying cultures of all kinds and had a collection of in­ nuenza bacilli to work on. I'm a little uncertain now. Did Davison come in at this point? 179 Ies 1 sir. Wilburt Co Davison. I was in the fifth floor again, and he came up one day- and aeked if he could work in the laboratory-. He'd been a great friend of Dr. Osler in Oxford, became a good pediatrician in the Harriet Lane Home, and then he became the Dean of Duke University Medical School and was Dean there f•r twenty years or more. He worked with me for a while. Felton worked with ••• Dr. Thomas Rivers caae. I w•~~ to go into that next time--Felton and Rivers1 but MacCallum was the - head. Dr. MacCallua was the Professor of Pathology-. -Yes. At Hopkins they had never given bacteriology independent status in spite ef the fact that Dr. Welch was one of the greatest bacteriologists in the country. He was also Proteasor of Pathology-, and I think it was his feeling that bacteri­ ology and pathology- were so closely bound together intellectually- and b7 methfkia andfntereeta that he preferred. not to separate them. Dr. MacCallwn was bead of the combined bacteriology and pathology-pathology predcainated. His wasn't aD unfamiliar race 1 bat it wasn't a fallliliar fa~• • MacCallUJ1? No., I didn't know him until-well., I got to know hia dllI'ing the course of that year. 180 There's--well 1 this may be related to thE?, ,!'hole business of cOllil!S _out of the N pr a~d ~tting back to civilian thinss 1 but your correspondence during this time !~~pates that there is a certain quality about MacCallum that makes you feel I !ike an outsider in your own laborato17;. Its just possible that in 19191 this " was so. I think Dr. MacCallua would have done that even if there hadn't been an;, Val"o ~••11.z? Dr. MacCallUJI was a rather sharp, critical man who was deeply- interested in original ideas of his own. He was a top ranking pathologist, wrote the best 0 book in patholoa in the c~untry, still a classic in its wa7. I don't think he was very aucb interested~n bacteriology. I remember in this same building that he decided that he,,,ould take a lecture I was going to give en typhoid bacillus. I was awfull7 glad t• have him meet 1f17 class and talk, but he got up there-I remember very well, and he said,"Typhoid bacillus is a graa-negative, motile organism that ferments glucose Without producing gasn, and then he suddenl7 said,"Well, all that's perfectly dulll Let's talk about something else." Well, 7ou'll feel a little strange with a man who will treat ,-our subject that wq. Dr. MacCal.lum bad traveled, ana in India b.e had gotten interested in • leprosy, I think he got some flayed skin of cadavers that he brought back that were peculiar. He was a brilliant person. Dr. Felto sn't the easiest erson to work with. No. Felton was a high strung, enthusiastic man of strong opinion, very 181 well in.formed and rather an original investigater. We got to knew each ether pretty- well, but then we rather separated when I loaned hiJll s011e aoney-. I got te needing meney- and asked for it, and that was thought to be pressing things too much, so that rather separated. us. That was several years after thi•• I get the impression fran the correspodnence that ,he had the kind or personalitz on eccasion and that there were not a tev rows in the laboratory with one persen or another, and you'd hear it from both sides. That's not a very sood position to be in 1 or to find yourself. Well, Felton was very able, and he went on to Harvard and did some fine work. Verz good work-yes. During this period there is mention of tw• offers you d otJ,., receiTe• one is Dr. Richard Stro 11 staff at Geneva the International League ~ ~f'. Red Cross Societies. De ~u remember that? ' the correspondence. That 1 s strange because i~ figures •n He wanted me to com on his staff? which you talked about not a little in the cerrespondence. Curiously enough I was not iaterested enough to remember them. Yeu say in the letter that you're pulled in.that direction partly because of the difficult~es in the laboratorz1 but that you're going to s~..z, so opening year, the unsettled natw-e of 1919 1 into 19201 was apparently a difficult transition 182 iear all the waz around--people coming back either overworked because they had remained at Hopkins and hadn't been part of the war, or overworked because they had been in the war and were returning to Hopkins, and all the clash or tempera­ ment that you get out of a collectivity that is trying te find its waz into a momentum again. I think that•s probably a fair sUJIIJlary of what transpired, and it is reflected in differing ways in thE! dorrespondence. Let I s pick up the Bence-Jonas protein studies next timeM-that brings in H.B. Cross, n, w. Wilson, Tom Rivers, and I wondered, in your thinking about it 1 whether rou go back and pick up any of the items and ideas that you had with Zinsser to pursue. Rivers has 1nfiuenza1 and there were some experiments with cats-just where 1•u got the SUpPlY•••• We had cats up in the animal room on the top floor. That was over at the Hun~riaB Laboratory-. We moved out of the other building which had burned• I N Yes 1 there's the whole business of the fire 1A_ that laboratorr• I was.o Well, you won•t be here tomorrow. I wontt be here until Monday4 ~ell 1 we '11 put it off until Mond&• 183 Mondaz, April 251 1966 ,._,41 N. L, Me The first thing r,d like you to tell me something about today is this little beok that you brought in with you this morning on the Eclat Club1 a kind of continuation of the commraderie1 the spirit that some medical people had as, 9onsequence of their war experience. The little bock I brought you this morning was one of the original copies I tf the history of the Eclat Blub, meaning-a French word for shell burst"~ d 1obus was the burst of a shell. Eolat here doesn't mean ansr high society, or artificiality. The club was formed in France by a group of surgeons who wanted to continue after they got home their personal relationship and really, 1ericusl7, to do something about keeping alive the new knowledge they'd gained tra advances in surgery and the treatment of wounds that they had been able to make during the war o 'J.'hey wanted to keep up their personal relationship which had rapidly become cemented into lasting and unbreakable friendships, so in 1919, I believe, they had an organization meeting., and as they say in their preface to this book, this was perhaps the only society of its kind in America, that it stands for something choicer and finer than any other group, or organi­ zation of medical men in the country• .!.'hey add also that the key note of the club must be comradeship,"The rare type of fellowship that was bora abroad and is living alwqs at the home and hearts of the members" of this club. Well, that is said by men who had been through very tough experiences, and it is not just a soft sentimental touch. My impression was that they had elected within the first few years of their formation fortyfen. You ceunted the names in this book and have gotten the dates which have gone out o:f my head, but most of them-as I remember it-were 184 surgeons, except four., arid those four were what we call medical men-Dr. Hans Ziru,ser., Dr. Russel Wilder from the Mayo Clinic., and an extraordinarily fine man named Dr. Mauri~• Pincoffs, the ~rcfesser of Medicine at the University of Maryland, and myself• ' The club had sever al meetings a year-as I recall it., usually two, but as you say, sometimes three, and those meetings were divided into two parts. The morning sessien en the day of the meeting was usually a clinic in a hospital followed by discussion and talks., not set speeches, but people really telling about their experiences and discussing cases, conditions and ideas of medical education and training. In addition they discussed the possibilities chieny among surgeons for high appointments in medical schools. '!bey didn 1 t take any part in the politics of the appointment of professors, but these men who were members of this club were in high positions in their schools and could infiuence the selections of deans and particularly professors of surgery. I think for a number of years they were probably the most influential body in the country in exerting a disinterested influence on getting the best men available for these positions. The second phase of the meeting was a jamberee sort of thing done in high style. Limousines would pick us up at the hospitals, or medical schools and take us off to st'lllle place for an afternoon and evening meeting. One that I remember particularly was going fr0J11 Albaey to the Battlefield of Saratoga, passing on the way the house where General Grant had died of cancer of the throat. We went thoroughly over the Battlefield of Saratoga where Johney Burgoyne was playing his part as "Gentleman Jopnny", where he got really badly licked by the new sort of ArlJq that Washington had at that tiae. I think that the battle was in the fall of 1777. ls that right? I don't know. I have forgotten the date exactly, but anyhow, it was probably the crucial battle of the revolution because 185 if Burgoyne had been able to link up with Clinton in that part of !few York, there would not have been much .for Washington to do• ilse Wasbingtoa,s A.ray at that time was down to 7,00°or 8,000 men. The worst thing had been the maall pox .... in Continental Troops ia the eitrly part of 1777, so important that whea Washington was at Mo~ristown he decided to have the whole Arttt:f inneculated. Jennerian vaccination by- innoculation with ~ pex hadn't come in so~ as you knw, they- had a war of immunizing actively. It was a very interesting thing te have been done ca a Mss scale-the fi~ introduction of immunization on a I uss scale into the United States ArrJf1'o After that time, Washington had practically a small pex free Anq, and he had small pox free soldiers when he fought Burgoyne. I have later learned that a good many serioue historians et those ti.Jiles say that the doctors won the revolution. I can 1 t make any such clai.JR as that in the face or the character of George Washington, but they- had an enormou1 effect en the pr•tection ef the treopeo Well, after TI.siting the battlefield and learning something about the history of the times, we went en from there to the race track at Saratoga and spent an evening in the gaming rooms, a very good time. A very good dinner usually ended the meeting. Another tiae I recall was when the New York World 1 5 Fair was just beginning-­ not the last one, of course, but the one before that--when Grever- Whelan? Whelan met us and was our guide. It was an example of how these men could get anything they seemed to indicate they would want, and the afternoon of that meeting was spent at Theo~ore Recsevelt'e old house at•••• Cold Spring Harbor? 186 I Its near Cold Spring Harber, but it baa a name. The house-The Roosevelt house is on the hill up there /J,agaaore Hil!71 and he's buried there, but one of the members o4he Eclat Club was Dr. Richard Derby who by marriage was re­ lated to Theodore R~osevelt. We had a good talk at that time about affairs of the gevernment, Tisi ted the grave and then afterwards spent time in a very plush club there at the place at Oyster Bay. Tbat 1 s the kind o4hing that went on until abo~t three years ago. The club decided that after it had elected its forty some members, it wouldn't elect any more, and as the years went bJ', they would generally spend more time counting the ones that had passed on than looking for anything new. It got rather dismal, and so a rew years ago they decided not to hold any more meetings. They gave their silver cup to the ~ithsonian Institution, and~hey turned over the records ~ of the club to their most re~eftade and defective aember1 myselt, and I am now surviving as the Secretary of the Eclat Club. ~n personal terms, eomiy back frem the war 1 did you have any thoughts about ~'"\1 ~\\ the experience at all? Let me dilute what 1 •ve just saido 1 his is a period i ~ soeiet somehow sanctioned of behavier that would a ear to be or seemed to be 1 illogical in a stable societr-the destructiono F1anders Field, for example 1 is a staggering experience. But in personal term.s1 looking back on it 1 what do you carry away with you on the nature of warfare? I carried away a very distinct diehotmay, or schizophrenia, or whatever you want to call being able to live with two ideas about the same ._., thing. Warfare u and deatr~ction strict'q related to military effort seemed to me to be a very natural sort of a thing. I knew you couldn't get on without it, and I know that what 1 •m going to say is not peculiar te myself, but whereas you could see r i 187 soldiers blown up, churches knocked down, the productive fields all plowed to pieces by shells, water supplies ruined, roads cut to pieces, communications broken-all the things that would be catastrophes in civil lite-you could see all that without regarding them as catastrophes because they seemed-unless you got licked-a part of the expected events; whereas anything that touched a civilian close to you was very distressing. That happened fre'(Uently. I have seen soldiers go almost to pieces because a girl, ozja child was hurt in the street by falling debris, or something like that. Thtt 1 s the way I felt about civilian damage before I went to the war, and it was no different ai'terwardso If1ontt think I more than any •thers got any special callous, hardened feeling about the destructiveness of war for as long as it seemed to be connected with, as I sq, militar,y effort, but when it touched on ordinary civilians it was very painful. Certainly I can•t recall anything after I got back in the United States that I did, or any of my friends did, because they had been brutalized by war. Is there such in the letters? No 1 In.the letters while the war itselr is in process, there is sudden. enormous - - /4 expend;i~U;;I"• of energy in its service, expected, anticipated1 unquestioned. Tl!e letters are fill~~ with comments en the really heroic at~itude of men who have to ~stand fantastic ordeals and do it without complaining--~tts a tremendous lesso~ to learn1 ,if zou•.ve never t::a'! t~at experienc~• Do it with out caplaining-1t I s expected, and you expect it of yourself. I But the end result_is to leave _~he scene the moment itAs over. The enerq ~ is put r~rth becau~e of the requirements imposed upon a group of men 1 when th.at !:!._q_uirement is no longer imposed•••• 188 The energy is turned to getting back home. Right and immediately. Yes. Well, when you &et bB;.~k to Baltimore, as we indicated, I think, .to some exten.! last time a, the scene had changed1 and you were goi_ng back to work and I think !,,_lmost for the first time with scne continuity, in the Laboratory of Bacteriology in the DeE?!rtment of Pa.tholoQ; at Hopkins. Some old faces that had been i11Stru... mental i establishin this had disa eared fr• the sceae...-t•J.ilton Ca Win ,nitz is one. ad associations for a eriod of ears had D usumed the burden or the School f,,f Hygiene and Public Health and was removed from the scene. He was organizing at that time the Schgol of Hygiene and Public Healtho Yes 1 but i~2,rar a~ the Depart,ment of Patbelogz was concerned, th~7::son yo~ bad to deal with directlz was Dr. MacCallum with whom you had had some corre­ spondenc•..a~~ I suse,ect some SJl!&ll association. Gettif!& back to work was-I don 1 t know hw do ou feel about it? What was available to oul What did you - !ind? I got back to work with a great deal of ease and comfort because they had saTed my- job for 11e, and I had nothing t• worcy about. Actually I had been promoted in June of 1919., I think made an associate. I was aade an Associate in Pathology because bacteriology was included in the Department of Pathology. It had no separate budget that I recall and no separate status. ·:r1..e u reasons-well, there were two kinds of reasons. One was a philosophical reason, and the other 189 u ene was the will of the person in charge. .Dr. Welch alway-s tho~ght that bacteriology and pathology should be together with pathology dominant, and Dr. Winternitz at that time, and George H. Whipple befere h.illl.1 had the same idea. They didn't make any effort to change it• and Dr. MacCallum, I think had a stronger conviction than any or the~thers that the two should not be separated, so it didn't bother me any. 'rhey gave me everything I needed. I had a place to work in on the fifth noor again in the old Department of Pathology.f I was able to get new apparatus. We were able to start some new things. At that time Mansfield Clark ever in the Department of Agriculture in Washiagton--William Mansfield Clark had written very important papers on the biological effect ,r hydrogen-ion concentration, and that was an eye open.er. That's what they call a "parameter of reactions" that determines what's going to happen in so many of these chemical reactions, as well as reactions of living things like bacteria. Se Dr. Lloyd Felton and I built a hydrogen generator wbieh had grave comequences for the future of bacteriology at Johns Hopkins because one night it exploded and burned down the old pathology building. I think that was probably January 19201 or spmewhere around that time. gu1 te ,earlz. Jiq_ 11] I hadn't been back very long. I got back fran the war in July,~nd of June, and I think I got to Hopkins about a month later, somewhere in there. "' As far as what you said a while age, that my work before this time had been episedic ~lld after 1111 return it seemed to settle down with more constancy, it. did as far as the general field went-bacteriology at'Yi immunology fr•m then on were my main interests and concern, but it was extremely episodic work within the field, picking around one place, or another that seemed to be interesting 190 and being guided by theoey only for short distances. I never was good enough, •11-ntelligent enough, te¥,evelop arw particular theocy that guided my experi­ mental work. It was always vecy secondacy. I can say the same thing about l lJ Dr. Zinsser. You notice his papers~-he~s one min~te on physical chemistcy and the next minute on rickettsial diseases, and then he'll read another article and start on s•ething~lse. A*ot of people work that way-• !,he cepartaent--the bacteriolog laberatorz had functions to fulfill within th~ total con~ext or the hospital and t~~ school. Se 1 selection-you get soae interesting material from sources you didn't antici­ eate s~metim.es. Yes, bacteriology had a heavy obligation of teaching. The first class I had to teach was ninety students, and that's more than I ever had thereafter, and it came at a time when I knew far less than I did lat.er on, but ninety students to be taught in bacteriology is an enormous load of cookery. You have to make-we had to make all the media in which we grew the organisms, make all the solutions that we used1 make up stains and do hundreds of things in those days that you don't nowadays when you ean buy the stuff. Then all of that was hard work. Let me g• baek to this fireo What we went through is characteristic or the poverty of the Johns Hopkins am the willingness ef the people on the staff tfo any grade of manual labor to 0 keep it going. After the fire was put out, we had to --1\ve acress the street into a portien of the original administrative building of the medical school in which there was an auditorium and the Dean's Office. On another fioor above 191 was the Department of Physiology, and on the top floor was the Department ef Biochemistry under Walter J~nes. We carried-I remember how we took the residue of' the unburned laboratory equipnent out of the old building on Monument Street and across to the new. The elevators were out, so we had to really throw it down the stairway- frem one floor to the other, one landing to anothert and then carry it across the street. Thea we started to put together a bacteriology lab•ratery in the auditorium. Some old benches were brought in, and they had to be fixed up in a hurry with plumbing, little sinks with gas lines. This seems trivial, bit it did at.feet ..,- relations to the students. I was lying on my back in a dirty laberatory gown tinderneath one of those benches with a stillson wrench screwing up a gas line connection when I felt somebody kick me gently aore or less in the ribs. +tud.ent well dressed was standing over me, and he said to • , if' I remelllber,"What kill!. of a guy is this fellow Jones? What do you have to de to get in this department good specimens and good ne dia, good. stains?" In other words, he took ae for a janitor, or as we called them at Hopkins a •diener•, and he was ready to give me a tip so that he could get a pick of culture media and thin.gs. That indicated to me that the academic position carried no recognizable aura. ~~d you identify yourself? I didn't identify DlY'Self' until the next day when I appeared to give the intreductory lecture. He must have just died. I remember kidding hia about it, but it was very difficult te try to de any C work in the midst of a diserganized pl~e like that, but curiously enough, it 192 didn 1 t stop. We had our laboratory on the third floor of a building called the Hunterian Building• It vaa a relative]¥ new brick building down oa::l.r Street about a block and across the street fr• where we had been burned out. On the third noor, I think it was, abo'Ye the Hunterian Laboratory for l!abryology- where some very noted people, Warren Lewis and others, were working, we set up in the room up there, and I bad some very interesting associate• at that time. Felton was there, and then Dr. Thomas Rivers joined us, wh• bec811le famous as the greatest authority on viruses in the United States later on. Howard Cross was an assistant, and we had a nedia kitchen and about four roou for our laboratory up there. Rivers was the most noted one of the lot. He was a graduate of Johns Hopkins, was in a class originally' ahead of me, but graduated in the class after I did because be had developed what they thought was progressive muscular atrophy', and he we'nt ...... down to Panaaa taking a year oft when people thought he wouldn't survive. He lost most of the 11Usclas in bis harvis and in between the bones of his foreaffl, but he was alert, mentally very able. and he had had an opportunity during the war to be on a eG11111ission known as the Pneumonia Cemndssien that went through all the recruitment centers and camps studying influenza. He colleeted several hundred strains of infiuenza bacilli, what was called Pfeiffer's ~ bacillus at that time and what was thought to be the cause of influenza. T~is was years before the virus of infiuenza was discovered, and he also had good histories or the conditions of patients frGJll which the strains had come, and we were able--mostly Tom Rivers-to develop much new information about the in• nuenza bacillus in a good maey studies. I learned a great deal f'rcm bill about bacteriology. He knew much more than I did. I also learned something about personal dealings between men. Rivers was a very opinionated, high strung man of extraordinary independence who would just 193 not do anything, if anybo~ told him to do it• I don't mean he would combat it actively. He just couldn't take a suggestion. He got into a state with hia work where he was not making any progress. This was along about February, some~ where in 1920. I discussed this problem with him because I was head or the so• called department, er section, and I outlined some experiments I thought he might do to help to solve his questiens, but he didn't pay at'zy' attention to that. Finally he disappeared out of the laboratory. I knew where he was. He was in the Green Spring Valley, but I didn't communicate with him. I respected his privacy, but he came back of his own accord in March, and h+ame up to me and said,"I was sitting by the fire last night and I had some of th+est damn ideas I ever had in ray life", a.nd he told me almost verbatil1l what I had told him the month before. ' HeAs the kind of man--and I•ve met a good matV" and I have lear11ed hew to deal with them as a Dean and in other positions--who will not act on anything until it comes into his consciousness as something of his own. As long as it was smebody elsets suggestion, he wouldn't pay any attention to it, and after this-it did solve some of his problems, and he went on. It was also at that time that I had a further influence on River's li!•• I was chairman of the program committee of the Society of American Bacteriologists --this is getting on, I think, to 1922--and we decided that it was time to have a symposium on viruses, filterable viruses. Up to that time these filterable viruses had been known. They had actually been kno'Wlll since Beijerinck's work in 1898, on the tobacco JllB.Baic, and then foot and mouth disease had been found by Lerner to be due to a virus, but little was knowno At the Fhiladelphia meeting of the Society of American Bacteriologists the program canmittee arranged for a big symposium and the main speaker was Thomas M. Rivers. Tea wrote ae and told me afterwards that all the rest of his life bis iaterest was 194 in viruses. That symposimn was the turning point. I suppose giving him the 0 h~ner and job of being the main speaker on the subject made him go rather deeply into it. His ccrrespondence is very enlightening on that talk. Is that se? He has sOJlle thi s that he wants to sa he field of a general nature. He didn't want to get trapped in S£E:cificsci He wanted to fence in a field 1 or fence ia an area. He did"-:res, it was wonderful 0 I admired him so much for doing a thing like that. I never could have done it myselfo H,!)W painstaking and fussy was he at the bench? Hfas very accurate--alwqs1 the rest of his lifeo I would call it pains­ taking, but not fussy. In bacteriology- one of the great problems was to avoid contamination of your material with organisms. You cans ee how important that is now when they 11•e worrying about putting bacteria on the moon, or Marso The same thing was just as serious for us in those dqs/,. If you get a contaminated culture, you don•t know which of the things in it are doing what you think one J.i of tem might be doing. Handling viruses is even more difficult than cacteria ~ .s because you can 1 t see anything. Until recently with ti~sue cultures you don 1 t know, except by animal passage as a ruJa, what you're dealing with. Now with tissue culture you can tell whether you have a contamination. Even with all the care that Tom Rivers and other virologists exercised, they found out later that without their knowing it they were dealing with mixtures ef v1ruaes 0 195 I That s one of the studies that zou' had with n. ! Wright Wilson on the Bence..J cnes groteins. CSpecific immuno~~~al reactiona of Bence...Joues Proteins" I 18 Proceedings, Society for Experimental Bielogy and Medicine 220-222 (192127. That's not a viruso Th&t 1 s a che 1ical 0 1 But the question was dealing with mixtures. Oh yes. Well, that--I want to refresh my 111.emory about something in there. De 1ou want me to turn this machine oft? You might because I want to look in one of these books. Well, the Dence-Jones proteins are peculiar proteins that are in urine and in blood. They are soluble in wann conditions and precipitate out in cold. That's almost contrary to what other proteins do which nocculate when they're heated and stay in solutien when they're down to room temperature, or body temperature. That characteristic later, after my time, is found to be extremely important in certain diseases ef peopleo Well, I was always interested, even !rmn the work with DrQ Zinsser, in the fractions of antigenic substances, and 0 I had in Balti.Jllere access t~ several specimens of Bence...Jones protein. Some had been isolated from the urine of a peculiar disease called multiple myeloma and sane had been found in c,ther cond.itionso I think Dr. Edwin o. Jerdan had a crystaline Bence-Jones protein, so I collected these and used all the methods I could think about to see whether they were the same thing, or whether there were differences ainong them.t I did this by immunological means because the 196 immunological tests were far more sensitive than any chemical tests at that time. I had Do Wright Wilson, who was a biochemist with Walter Jones, and he helped me on the chemical side of it. We did the immunological work in rq laboratory in the Hunterian. Most of that work was specific precipitin reactions with absorbed serUJll and very interesting immunological reactions with the uterine horn of a guinea pig that had been :aade anaphlyactic hypersensitive several weks ahead with a small amount of protein. When you suspend one of the saooth muscle portions of the uterus of a sensitized guinea pig in salt solutien and put in a very little amount of the protein, it causes a violent contraction. You saw those graphs in tbere11 You can do that, and if you have the guinea pig sensitized to two Bence­ Jones proteins, you can get a reaction fran the second one after the reaction et the first one has been exhausted, and so on, so we published these papers on Bence-Jones protein much te the confusion of the world, so to speak, because it has allowed me to separate wry friend and emphasize my hyphen. When Bayne...Jones writes a scientific paper en Dence.Jones, then it gets all mixed up. known since then when peoile call me Bence-Jones that they have a scientific, probably immunological, or biochemical background, but there was a great artist and painter named Burne-Jenes and when people call me Burne-Jones I immediately try to fish out from 1lfY' past inadequate education. the cultural aspects of the humanities or Burne...Jone1. The impression I get from these studies is that it was an effort to fix more carefully the nature of that with which you are dealing. 197 The general philosophical point ef view is very- camon te bacteriology because almost the whole advancement. or the science depems on discri.llination. between microorganisms that look alike-I aean the fermentation reacti•u, the biochemical effects or them. I carried this a little further with some papers about the same time on the~omposition of the nucleic aci.d of the colon bacillus, f!on the Presence •f Nucleic Acid in ~acterian 33 Johns Hopkins Hospital Bulletin 151 (April,1922l7. At that time it was believed that the pentose CDlllponent and one of the nucleotides of plant nucleic acid were different from those components in animal nucleic acid,. and I wanted to see whether the colon bacillus was an:ilnal or plant. Most bacteria had been called plan.ts 0 It turned out that they are a little er both• but that was the time when the :marvelous developnents ef nucleic acid chemistry- had not really begun. The great experts N en ~ucleic acid in this country, Walter Jones and Pheebus Ao T. Levsne at the Rockefeller Institute, had a very definite schematic representatien of the d molecule of nucleic acid, and it got so fixed in ~•gma that it really stopped \J the ad'(9-nce ia the subject unti1 Avery and other people began to find out abeut DNA,. One feature of the papers •n JJ ence..J ones protein was some CCll!Dnunicatien fr!J4 Ludvig Hektoen wh• was at work on the same prebleJJo Well, Dro Ludvig Hektoen was almost comparable to Dr. Welch in pathology. He was the head of patholo~ out at the Univerisity of Chicage and the head of the Journal of Infectious Diseasee 1 I think• He helped in the Archives of Patholoq and had an institute, The McCormick Institute. Dr 0 Hektoen was a very wise and able man that I knew until his death. Do you want to go on with Dr 0 Hektoen? 198 The only thing that I have for him in this period is the Society ef Bacteriolosists. Yes, he wu president~ but I•m thinking about personal relations with Dro Hektoen which rather clouded the relationship in the latter years of his life with me-say, from 1932 ono In 1932, I lett the University ef Rochester 0 School of Medicine to go to Yale vi.a the National Research ~uncil1 and at that time the Associate Professor of Bacteriology when I was there, was a man named Konrad Birkhaug. You've probably run across him. ia these paperso Konrad Birkhaug was a Norwegian and so was Dr. Hektoen which may have had scaething to do with the event, but anyhow, when I left, Dro Birkhaug thought that he would succeed me, but there was much opposition to hiJR for various reasons in the faculty. He didn 1 t get the appointment, and he rather held me responsible for the failure of his appnintment to such a degree that it broke up our relation­ ship. I have never had any connection with him since then except one or twe letterso Dr. Hektoen at that time was concerned in the Unioa of University Pr•­ tessors, a group of professers1 an organization that is very jealous of tenure. Birkhaug was an Associate Professer, and there wasn't any job ahead ef him when he wasn't appointed at Rochester, so Dro Hektoen took a hand trying to bring pressure on the faaculty at Rochester and me too~ that Birkhaug be appointed. That was upsetting, bu~~n Dr. Hektoen and I knew each other at the National Research Council and at scientific meetings, and to my astonishment aboat 1941, he invited me to give the Hektoen lecture in Chicago in early 1942. Well, the war was getting hot about that time. I was slow in·getting fff1' manuscript done, and I was about to go eff to the war, disturbing factors which bothered Dr. Hektoen, so that we were never quite the same again1 which I regretted very 199 much. I wan~ ~ane back to ~l!_hole, problem -~r~.w.!. &et to Rochester because 1 t' .s 4 !B interesting one in terms of mana~ement~-it really is. What? The prob~e~ •t the associate professor, but in this period-well, here 1 s a !etter from ~eonard Colebrook, En1land in replz to a reguest ~h~t zou ma~e of him on the bacter~ology of actinom:zees. I published a paper on that, r"'Club Formation of Actinomyces Hominis in Glucose Broth with a Hote on B. actinomycetum-Comitans" 10 Journal of Bacteriology 569"576 (December,1925l70 Ies 1 a."4 .also a letter to Colonel Siler on the same _£rop1emo • ..! thought that t.hey J?ight hav~a.d s.~e_t:,hing to dofl:th class work1 an .exampleo Ne actinomyces in the lesion of the jaw of horses has the most beautiful ran-like clubs, a little sprig off,the growth ends ia a yellowish bulbous, miorescopic cluster •f clubs-they call it, and I just got interested te see whether the club would grow, or the stem would grew. I fixed up some little culture dishes, little culture cells, and I watched them for days-very slow growt,h, but the clubs didn't grow at all. As I remember, the little filament at the stem grew S011l8o I think I have a picture of it here, but I didn 1 t produce any disease with this specimen of actinomyces, but we always got them to show the class because tney are very beautiful things. There wa,s an unanticipated event in the cat colo~ which le~_to an interesting paper,[""Respiratory Infection and Septicemia of Cats due to the Hemolytic 200 Streptococcus" 31 Journal of Infectious Diseases 3-8 (December,192227'. They developed hemolytic septicemia probably transmitted through the respiratory traei, but I think that was an episodic descriptien of something that happeaed. Did we go deeply int• that? Te st4& twentz•five-they died within ~our days. There was another colorq: of _!!f'ty that were also studied at the_~~e on ~ch yeu and TOl'll Rivers wrote a paper1 taking ~wabs trom their throa..:!,L"'Infiuenza-like Bacilli Isolated from Cats" 37 Journal of Exerimental Medicine 131-138 (February,1923l7. We ought to get the credit for taking the swabs from the throats of the cats-it was pretty tough going. You can get chewed up. Yes, but this was something that haeeened which lent i__~elf to a stu~!.......!, weuld have thought in term~ f!! .the publicati;on tha~ the i.ocieti Psi: the Pre... ventioa of Crueltz._to Animals might have been en z•ur ~~~• We didn't hurt the cats. No 1 but the fact that you had twentl•five of them in a v;_arm room-:-.z•u kn!1!_o Well, the epidemic got started, ~r the epizootic, as they call them among an:i.Jllals. They are enormous. Great flocks of ehickens die all of a sudden of leukemia and fowl pox. .1 I In the early days wh~ they had Texas ~ever in the . J cattle, thousands ef cattle died, and 1n foot and mouth disease, the only way they could control that disease in this country was to kill all the cattle and bury them. That's still the chiet way of handling that. The antivivisection people are mostly concerned with degs and surgery, experiments that require some sort of an operation on the animal, or dismal, solitary confinements, or un- 201 sanitacy cages, neglect, but I don 1 t recall that the antivivisectionists ever made aDiY objection to the study of naturally occurring infections in great groups of animals. This 11111st have been a blow since afrl;mal resources were hard to come bz4 Oh yes. We didntt have much aeney for that 0 Is there anz mere ce1111ent about Wilsoa and the need for biochemistry-th&~ !!, in your thinking about bacteria, the need tor a hro~der team almost~-I won't S9' "team" a but .another eze and COllJ?!tence? Oh yes. Bacteriology and biochemistry gofhand in halVi just the way bio• chemistcy and physiology ge along with the study of &Di1 living organisms. Thatte a basic thing. Bacteriology in a sense is a living biochemistry in which you can manipulate the living, so to speak• You caa dish up life with a platinum. loop. It thrills you very much to think of that and to wonder what it is you're dealing with, so I was always interested in tr;ring to link biochemistry, ~ provide for bi•cheJBistry in the place wAere I was working. I did at Rochester, had people--! think the first Ph D degree given in~ department at Rochester was a biochemist. I had close relations with Dr. Joh~ R. Murlin in nutritien aad Dr. Walter R. Bloor in biochemistr,r particularly about fats. It seems very natural that the two, bacteriology and biochemistry, go together like building a house. Here •.s a letter from n. J • Davies fr~ .the .Univer.~i~ Qf lllinois with~ lo~ ot:, samples that he sent rou. Was this for course work? Let me see--1921. These are all very interesting ~ungi--Sporothrix.1 one 202 of them name~ after Schenck and Hektoen, Blastomy~e\i, and Streptothrix. These are yeast..like and fungus-like erganismso I apparently didn't have any, and I put things like these in the collection. Some of them I weuld stud¥, and some­ times publish something about, but usually n.etQ I notice in the cerrespondence 1 .and thi~ ~s general 1 that there is enormou~ shari5 ot strains you 1!9: have for purposes of class work. Yes, everybody did it, and it grew-well, each person collected a let of strains, and you had a culture collection in your own laboratory. Of course they had enormous duplicatiea &11 over the country. Out of that grew what is called the Natienal Type Culture Collection which is now a collection of thousands of strains of viruses, fungi, bacteria, and yeast. It~s housed here in Washington. After a long, desperate struggle to get funds for keeping it ' up, it's now ric~ supported by the National Institutes of Health, and its " callei the National Culture Collection. There was one in England. There's ene in the Pasteur Institute in ~aris. Colleotiog in those days was a characteristic thing. You kept your own rather extensi~ culture collection ' because you never knew when you'd want something., and you didn't have tiDle te wait for the mailo These things that Davies sent me I would study, and I had a notebook on my collection. I knew what to expect or them because variability-­ and this is something I• d like to say something about when we talk about Dr. Zinsser-in all these organisms is one of the features or their lives, and you have to know th•• This preparation fer class wo~k-later on at Rochester we'll get to it--2repara­ tio~ for classwork is the collection of samel8.!,? 203 Oh yes. Collecting specimens even took me into the end of Cuba rrea which Castr• came later. Yoe that's as ecial tri ou take I along in I sues~ its June of 1922 1 Dro Whipple comes into your lite1 and 7here 1 s an exchange of 'Views about a new department. Do l•u remember your talks with him? Whipple became a great Dean-what is the date ot the founding of the Rochester School of Medicine by Mr. George Eastman and the Rockefeller FeuRda• tion. It's about this time-19220 Yes, they had time to plan ahead before the .l!chool would be readyo Yes, long before 0 There wasn't an;ything out there for a scheol er meai.cine, except a f'ield t ~ was on quick sand near a cemetery out oa the bank er the Genesee RiTer. The story of the founding and the negotiations between Mr. George Eastman and Mr. Abrahaa F1exner have been well written up• particu1arly­ in bocks about Dr 0 Whipple• The University of Rochester had a ver1 intelligent and able president at that time, Rush Rhees, and at that time Dro Whipple, just before he went to the University or Rochester,•s the head of the Hooper Foundation of the University ef California Medical Scheol in San Franeisce. Dr. Rhees went out there and saw Whipple who didn't want to leave his jeb Gut there right away, if ever, and Dr. Rhees persuaded him to take on the deanship et the University of Rochester School of Medicine for an indefinite tera. Dr. Whipple went to Rochester about 1922 1 to plan for this schoel and te get a I faculty. He 1 s still there ia the labora\ory. He s now about 8$ years old, and he's been there a leng time-forty some years. a-. Rhees was very broadminded 204 and se was Dr. Whipple, and Dr. Whipple started abeut the ti.me that m wrote te me-does this have anything to do with the professorship? Well, he started to write to me about the professorship. I think it came ,,. about, or what helpf,ed ..,,,. to bring it to a head about this time was that Dro Whipple happened to come into the laboratory- one day when I was working on the bactericidal effect of ultra-violet light. That 1 s another man-V•n der Lingeno Yes, Jos. Van der Lingen• s!Jlu:ti Africa. I forgot to mention hbl 0 Yea-well, Van der Lingen was there visiting, and he and I worked together, but I think I have ••re papers than that one. Is there just one with Van der Lingen? This is the en• in 1922,L"The Bactericidal Action of Ultra-violet Light" 34 The Johns Hopkins Hosfital Bulletin 11-18 (January1 1925l7. Well, I had-Van der Lingen was rather a physicist, I think, and he helped me to get spark gaps, cadmiWll spark gaps, and other things that had a different spectrum in the ultra-violet, and I could, imitating other people who had done it before, spread bacteria en a culture plate., hold them up in r ront or the spark gap, and then incubate the plate. The organisms would grew except where they had been killed, so that you'd get the spectrum of the arc in tae growth of the bacteria. Well., I was working on that whea Dr. Whipple came into the 205' laboratory in Baltimore, and he was deeply interested for reasons I didn't under• stand very well at that time, bQt I think it had a rather influential effect tn his opinion ef me because he had by then become very close te Mr. Eastman, George Eastnan1 a most ru.arkable man who was interested, of course, in spec­ trographs and the spectra of various souraes of light, studying his films. He had a fine physical department, the Eastman Kodak Company, and Dr. Whipple said, "Certainly Mr. Eastman would be interested in this" and told him about it. I think that helped me to get an appointlnent. 0 The appoint.Jnent dragged on for quite a whileo I think that it-I forget when he offered it to me• There may have been an earlier contact than these papers1 but here's the letter in Juneo Well, this is soon after his being in Baltimore• .But then decision was delayed until Octobero ,They were geing to give you a de£artment•-that is 1 when they constructed the .school brand new, it was going to have not only the medical school, medical hospital, but the city health board tooo Dre Whipple apparently wrote me June 22, giving a budget of the department, 1aying that it would be a department, and telling me about the professorship and other conditions, but I didn't accept this until later in the year-I forget just when. October. 206 Yes-October of 1922. As I recall it, I asked Dr. Whipple to give me mere tim.e 0 He wanted the question of appointment settled sooner than October, and there :may be a letter in here from him agreeing to giving me more ti.me, but saying that he doesntt do it with any pleasure. Is that in here? Yes...-not to you, but to Dean Williamso I remember that expression somewhere ill here. Well, new the reas•n,f for that delay has nothing to do with Rochester. It had to do with Dr. MacCallume Dr. MacCallua practically' told me thaI if I didn't accept this Rochester appointment~ he would get the trustees and the faculty at Hopkins to make a separate department of bacteri~cgy- and make me the professor and bead of it• I have never known what happened, but the upshot after bis consultatien with Dr. Simon Fl.exner and I don't know who else-well, it just sort of died out• I remember I had a final talk with him in which he said that he had not succeeded in arranging this. I think it I had been better, or a more able person, that they would undoubtedly have made a department at that time and made me the head of it. I think it was the timing, This came in June 1 and there was to be one more meeting ot the trustees in JutE • That didn't give them sufficient time to ~anvae the possibility of developing a Department or Bacteriology. At Hopkins? Right• They wanted to meet this offer because they didn't want to lose yo~• That might have been so, but 1ff1' illpression was fran Dr. MacCallum--I don 1 t know that I have any evidence of it-that if I had rsall;r been good enough, they 207 1 wotild have taken some extraordinary action to hold me there. Nonetheless this is really a fantastic offer from the University of Rochester. I finally accepted the University of Rochester at that time and started to work on the plans. Dr. Whipple sent us the plans, the blueprints and sketchee that had been made up to that point, and all of us-the young faculty that was being appointed~-each man had a chance to draw his own floor plans within reason, a.nd I worked on that the latter part of 1922., and 192.31 until I went abroad 0 They thought that it would be geod for me to go abroad in 19231 for several months and come back and go to Rochester early in 19240 I was quite pleased with their ideas to include in the department provision for doing the work of the Rochester City Bureau of Health-1-hat is 1 the diagnostic bacteriology from specimens from sick people, er the whole of the immunology, the Wasserman tests, the pneU111ococcus type tests, everything that required immunological work and also the bacteriology of water and llilk which was a very large job. This was a conception of a VCl"J" great man in public health 'Whose !riendship I enjoyed all the time I was there and that is George w. Goler, a remarkable man, and one of the early public health figures in this country. He believed earnestly that the welfare of Rochester and the good of the citizens would be advanced by having the Strong Memorial Hospital, the University Hospital to be, connected ver7 organically with the Municipal Hospital, and they were built side by side, although they had separate administrative management to some extent. The work of the Rochester Health Bureau Laborateries had been down in some old buildings in the c~n"ter er Rochester by Professor Bharles W0 Dedge and somewhat under the guidance of Dr• J eseph Roby, but we planned to take them into rq department, the Department •f Bacteriology at the scheol., and in doing se we 208 drew plans for it, practically provided a cc:mmon media kitchen for the city work as -well as for our school work and researehe We~ enough certainly to I start two wings of this huge building, and the wings were about thirty-five feet wide and a hundred feet long, a.s I rem.ember. I had plenty of space. Dr. Goler managed to do something with his city financial people which was quite unusual. He gave me authority to hire and fire, f:O to speak. I could engage anybody and put them on the payroll without having the approval of the city politicians in any senseo The salaries didn't come under city review, except that they were reported to Dr. Goler and the supplies they used• Of course they used theusanda an~ousanda o! dollars worth •f supplies ef glao.,_ ware, culture media and whatnet, but those were all purchased by the medical school. A certain proportion of the total, based on the work without actual count of test tubes and petri dishes, was paid for by reimbursement to the school fr011 the city. That arrangement continued all the timeo There never was any trouble at all over the finances, or the administration. They let me alone in that respect, although I saw plenty or Dro Goler and Dr0 Edward w. Mulligan, a remarkable man, Mr. Eastman's physician Dro Joseph Roby, a number 1 of men that are characteristic or Rochester. It was what you'd call a civic~ minded place. They really did things in a highly idealistic, but very practical manner for the good of the community which impressed me very mucti. I liked to work with them all, b~t I 1m sure it had an influence on my future that rather took me out of line for advancement in research0 I think that is my OW1I fault, er a characteristic of my disposition. It gees back maybe to that childhood time when I toli you I was being inadvertently trained to be a Dean by •Y "Tante E"• Yeu can•t do this work in a population of a good many tens of thousands of people with 41 sorts of conditions requiring labera- 209 tory fllCaldnatio\without having to spend a lot o! t 4 n it and without being : I willing to put aPede your own. work to talk with people who call on the telephone about things of interest to them; namely, the doctors who send in the specimen and the people sometimes from whom the specimen originate d 1 to talk incessantly with the memters of your staff who have thousands of problems that you can help them solve, to watch the details of administration, to be responsible for proper supply, equipment, and materials, and te> have a general public relations activity; whereas if you want to do any really good solid research1 you better be the kind of person who says that he has n• concern with those affairs and sticks to his knitting of researcho Well, to me, I may have felt unconsciously that WIY' ability in investigation wasn't particularly good, and tha+he satis­ factions of doing the work that I have outlined were so great that I probably succumeed to the lure 0 We'Te gone ever an hour 2 Perhaps we 1 d better stop tt,dy:. Perhaps we'd better stop today. Goler is i.Jnportant1 but there 1 s a period fran • lJ22 to 19241 which involves a trie abroad.1 the examination Gf other laberatories, meeting doctors and other people in Paris and Belgium which is important. Yes, I went to the Pasteur Institute in Paris and saw the laboratory in Brussels. I Let s de that then 1 This biophysicist that you worked with 0 That was wholly " Van der Lingen? 210 Yes That was wholl new. Initiall the nature-I can see some traces bac to the work with Zinsser 1 that kind of continuum, but scne of the things were accidental, episodic. There are more specia1 cases that come up to pathology, but that 1 s the nature of the Job. Yourre there, and they excite interest at Hopkins. They r eguire study and the publication of a paper. they happen, but the mi ·ht be eff a line of develo ent. Then th ccident with the cats. 'Who biophysicist. Wbat year was that? This was 1922. He was a lecturer in bieptgsics at Johns Hopkins in the winter of 1921-1922 ..-"The Bacteriacid.al Action of Ultra-violet Light." I used to correspond with Van der Lingen after he went back te South Africa. Itns called a Depirtment of Pathology and Bacteriology at that time. I had forgotten that they had given it that name. It says: The work wa~ undertaken under the direction of Dr. Van der Lingen, who was Lecturer of Biophysics in the Johns Hopkins Medical School during the winter of 1921-1922. After his return to the University of Cape• town, South ~frica to take up his duties as Senior Lecturer in Applied Mathematics, I obtained the data on the absorption spectrum of a bac­ terial •ulsion, tho actiort of the inner ultr~let llght (390-30011:w) the temperature coefficient of the bactericid ion of light, and the effect of hydrogen..ion concentration." I see I did this after he 1 d goneo Yeu went on with the work. As I remember it, ne was interested in this, talked to,me about it1 and he was there for a while, but the note says that I went on with it after he left, and those things are the important th1.ngs in this paper. I think I have 211 a ~ture in here of the spark spectrum. There's the killing region. This is l the culture--see. There's the killing region around 200-300 mm. That 1 s the same thing--the spectral lines come out 9 ,! mq be, wrong 1 ~ as I re~is paper., :iz_understandini_was tha~ i~ was an effort to f_!x more precis~lz_where tee killing 1¥U_2:~5 we~~• Yes. I forgot how that began. Van der Lingen was not in m7 department. He was over, I think, with Dr. John Jo Abel, pharmacology, but ~'ve forgotten. There's the cat study". All right? Then ~tters get episo_die again0 r:~i:~xample 1 t~ere's wor~ there wi~l!-~ u " Department of ~atrics and Drr L~~Wilkins ["Indurated Ulcer' of the Tongue due to Odium Lactis" 26 American Jouz:nal of Dise!!_~ of ~~ 77-32 (July1 1923rJ, work with Dr~ Isaac R. Pels in the De,P!rtllent of Dermatology CElastic Tissue Simulating Mycelial Filaments in Skin Scrapings" 8 Archives of Dermatologr and Syphilology 37-43 (July, 1923'j]. Some of that work would come about this way. -'- 1 d be working, and these people would get interested in something, and they 1 d bring tbe stuff up to Y«y" reom 0 Sometimes you 1 d ge through thoasands of things like that. Is this still running? Sometimes you dontt do an.ything. Sometimes it makes a great difference. In each instaNce 1 I .~h1nk1 there was 111aterial t,hat could be worked 01!l___!_s,tec_!,f~ case which is mentio~. 212 That one with Pels is just clearing up a false observat.ioao A cu.rieus thing --the elastic tissue fibers in the skin branch and twist like fungus growth, and to make a diagnosis of a fungus lesion, or a crusted fungus lesion en the skin, you scrape it, and it shows that you can get things that look like fungi out of it• We had to de a differential stain, I think, to make it. Does Davison appear in there yet-Wilburt C" Davison? (' I !,es 1 this book co~~ns his,.E,aper,"Div~~ of the So Called Flexner Groue ot pz:sen~erz Bacilli", /)2 Journal or Experime~tal Medicine 651-663 (December, 192027. Davison brought that in. What year is that? - 1920. Well, Davison had been a Rhodes Scholar, a great, huge man, and while he was at Oxford, he learned some new wa:,sro differentiate dysentery and typhoid e. organisms. This was largely an outgrwwth of the war, and h~ brought the material to rrr:, laboratory with a note fra Dr. Osler, I tbink. That's not in this correspondence, is it? I think it probably was in his own pocket. This leads into bacteriophage, but that's what happened to me all the ti.Be. Bacteriology :is related somehow to nearly everything that sick people, doctors, and stn•ents are concerne• with, an• all the time people were bringing things te the labora­ tory, getting me to look at them. Sometimes it is easy to say what it is an• what it will••• Sometimes it is not easy. It's new, ani then you stuiy a little. That's rather scattery work. Let 1s call a halt to!_q1 arui. Itll see zou tOlllorrow. Are you f'inishe• w1 th this F.clat book? 213 Tues•&• April 261 1966 A-54 1 N. L. M. ~ince you have to go at three o 1 cloci, we'd best get at it. l wanted to go back to s<ae observations that lou may have with respect to this initial ex.. ,eerience you had with the teaching of students. A lo~_of other thi~s were at hand ab~ut which we commented somewhat yesterday, but how did you find teaching? Well, the formal teaching of bacteriology to medical students was the beginning of teaching of bacteriology in a formal manner, but at Hopkins youtre teaching all the time-even betore you graduate. I b.ad , as I told you, a substitute position as an intern almost from my second year on., and every intern has under hill a nua'ber of people callea clinical clerks who work ri etit along ~D'.e him and do a certain amount of the routine work. The clinical clerk examines the patient; the same as the intern does, and the intern discusses his patient with his clinical clerk. He is teaching right from the start. The method is there. You bd.tate your chief. As a aatter of fact, some of the imitations got to be so ingrained that you couldn't tell the resident from the e. chief surgeon scnetimes because of his manner and t~ way they emphasized one thing, or another. Teaching as such was no new experience to me when I went into the bacteri­ ology after the war. You see, after being an intern in medicine, I was an Assistant Resident in Pathology, and you're responsible for groups ot the class. I was teaching in pathology at that time. The only difference was the size of the class and the administration of the program for teaching. The subject really wasn't a new subject to•• You speak of efforts to keep ahead of the youngsters-well,~ never felt that particularly in any competitive sense. It•s 214 very stimulating to find some student who has picked up sanething and is ahead of you. My difficulty with the subject of bacteriology at that time, to tell rou the truth, was that I never md any real, broad basic training. I went for a while with Dr, Zinsser and worked on a research problem, as you know, and then that was broken up. Then the war broke up the next beginning, so I always felt that, unlike a good many other men that were in the line of teaching and re­ search, I had a lack or basic training which made it rather difficult, but perhaps a little more funo Teaching also involved the teaching of nurses. I taught a course in bacteriology for nurses right from the start which means--well, you don1 t talk down to them, but they don•t have the basic information that the medical st11dent had had from a college course. Most of those young people, yo11ng women, were frm high school, or else first, or second year in some college. They were an interesting group to teach. You had to simplify a good deal, but I didn't simplify too auch. You give them a fairly sound course, and then I had occasional teaching experiences with visiting groups of people, o~as a visiting lecturer, or I had a aeainar at some other aedical school. Was the fact that zou had ninetz students after the war a unique thi~? Yes, ninety students is much too much--too numerous. You can hardly get around to give much individual attention to a com.ploy that size. About fifty or sixty is a manageable lot, and besides with bacteriology culture media is so varied and the containers of it so numerous that you deal with things by the gross rather than in smaller lots, but teaching ninety students was a very severe sort or burdeno Fortunately I only had one year or thato It's a combined,lecture-~::i.boratory COl.!,,,\S_!? 21$ Yes, it was a combined lecture~laboratoey course. Usually I think we lectured too much. Mostly we had some lecture perhaps every morning. I•ve for" gotten what the schedule was, but I carried that through at Rochester too• We had a great maey lectures, but after a while, at least in my experience, being a teacher for a little while teaches the teacher how to get the students to I give their own lectures. Its a very interesting little socratic method perhaps ~ that you can apply. If you know what you want to bring out and face a class, you can ask questions and then ask another student what he thinks about that, and with a little suggestion and a)nnt every now and then, you bring out the whole lecture without haVing delivered it. As a matter of fact, the students give the lecture, if you manage the class with tact and kn-ow when to put in. the right word. Were you a--this may sound like a curve ball and I don't mean it to1 but it mq help you to 8.llplify the statement that you've ju.st made-were 7ou a book man with the course? Did you have a book1 a text on which you relied? Yes, we used Hiss and Zinsser. That Wis the basic text, but there was a famous old book before that by Sternberg, the great masterpiece of early bacteriology, a huge volume with a thousand or more pages, but we tried always to direct the attention of students to current literature and basic things that were not in textbooks. We tried to get them to read some of the originals. If they could read French or German, so much the better. The spirit of the teaching at Hopkins was to avoid the didactic textbook in most things, if possible, but I think I told you once before that we had one resident in medicine that taught us by having us sit down and open Osler 1 s Principles and Practice of Medicine, and he would read it and say,"Now, underline this sentence.'' 216 That didn 1t arouse au.ch enthuium. You have an aversion to that aeeroach even at this late d&te 1 so I would assume in talking about teaching, you would have avoided that sort of thing as one does the J?lagu.e o Y••• In sane places I think the teachers are so respectful ot the textbook n~ and so tillid that thq don't dare goA.beyoad the covers ot that book, but at tb.e Hopkins right f'rca the start a spirit of independent inquiry is en.. couraged in the entering students as well u in the teachers theuelves. Did YoU get ■ueh challenge tram the students? It• a bard tor me to recall, but you always feel a challengeo You want to sff them light up with excitement er the knowledge that study and discussion brought to their view, and very often you find highly thoughtful, original Minded you·1g mea that are able to sustain substantial discussion, but they vary all the way fra people who don't. do anytbiug at all to people who are very bright and run ahead. I think this is also a eriod-I aentioned tlld.s to zou before we t~ed the machine oa.-when you got married. Yes, I got aarried June 251 19210 Curiously enough, I always get the 21 and the 25 lllixed up, sot.hat I have to go back and thirik about ite The lady I was fortunate enough to ru.rry was froa an old Baltimore family". AJl1ong her ancestors were Robert Saith who was the Secolld Secretary- of the Navy aud General Sa■uel Sllith who won the battle of Baltillore. She was living at that t i • with her great uncle, Mr. John Donnell Sllith1 who had 217 become a world renowned-where did you pick up his name? He was a botanist. Do you know of him? He was a botanist. I,11 come back to thato She was in ~altimore all the time I was in medical school, but I never called on her. She was living in the house with Mr. John Donnell Smith, a great big house at 50S Park Avenue. She was living there. I never ~alled at that house until after World War I, because I had heard so ma ry fine things about D Mr. Jxhn Donnel.I Smith as I grew up that I thought he must be dead. I never heard anybody praised by the members of my family in such a manner unless he had passed on. The connection in here is curious. Mr. Johns Donnell Smith was in the c}.ass of 1847, at Yale with rq grandfather, Thomas Levingston Bayne. They were class­ mates. They went to tbe Civil War at the same tiaeo Mr. Bayne was in tb.e Louisiana Washington Artillery- and got wounded at Shiloh, and Mr. John Donne~ S1llith, although eoming from a town that was divided between the South and the D North-Baltillf(• was a double allegiance town--went into the An.fry of Northern Virginia and served under Jackson and General Lee as an Artillery Captain. Richmond fell in 1865, and my grandfather was there connected with the Ordnance Department under General Josiah Gorgas-that 1 s my grandfather Bayne--and his wife was about to have a baby'. When Richmond fell, s. Wo Smith, the father of John Donnell SJli.th, brought her to his house in Baltimore, a.nd she had her baby in Baltimore. The family connection was very close, and it was just kind of stupidity on my part, or some 1:mpreasien I had made, that I 6_idn 1 t call there. Nannie Moore Saith, as the future Mrs. Bayne..Jones was named, had been trained as an expert X•ray technician and had worked with Dr. Lewellys F o Barker. 218 She was drawn into service in the war, went abroad, not with the Hopkins Unit, but with another hospital unit which, curiously enough, was at Bazoilles1 so I passed very close there in 1918, but didn't know that she was in that place. This went on. It was only in 1921, that I happened to meet her on a little sail boat in the Baltimore harbor. No, that must have been 1920, or 1919-~I forget y which. In &lliY e'\ntf, we were married in 1921, and soon set up house keeping in a little ~Tided house en Park .Avenue with very- little to live on at that time. ~d you meet and set to know the uncle? Yes, I got to know Mr. SJlli. th. r,u tell you how he got to be a botanist. It's very remarkable that he did so aucho After the Civil War he did not knew quite what to do with hiaelf. He f'elt unhappy in Baltimore because Maryland had not seceded• Finally he took himaelt off to Guatemala, Nicaragua and Honduras, and he made a fundamental, basic, systematic collection of the nora ,t these countries. He had his house when I saw it full ofases ot his herbarium. Later on I saw lots of the .folders of' his herbariua at Kew Gardens in London. He described all these plants in Latin and published several small books on them and very accurate observations. They to]d ae at Kew Gardens that his herbarium folders never contained mixtures of plants. They were all parts ef the same thinfc::, and thatts vecy unusual because the immature stages of them are hard to recognize, so the basic descriptions of the nora of guata.ala, Nicaragua, and Homuras are those o.f John Donnelt Smith in the 1870s, early 1880s. I think he named two hundred and fifty species, but Itm not sure. It's a terrific lot of things. I never could talk to hi.Ill much about botaD3" because I was interested in function and what the plants did, bow they developed and propagated themselves. He was altogether interested in the vination of leaves 219 and the way the leaf cUte ett the stem and all th• morpho~ogical details 0 He vu net interested in function at all. That 1 s inter~sti~o Yes, I went tbrough the Victorian standards and requirement.s of his domain. When we got around to it, I iemember going to see Captain Jehn Donnell Smith in his study, and I asked him if I could have the h~nor o:f the hand ot his grand,.. neic• in 11&rriage-a very solaa.n eccasion. He thought it ever for a while and said all right. Be aPJ! are occuioulg in the corr•aeondence• Yes, he used to coae up from Park Avenue•-they lived •n Park Avenue and Hamilton. Street, I tbink-an;ywq one of tbe cross streets, and we lived at eight buad.recl and soae number further up L,'S'21~ Park Avenu!7. He'd walk up to our little apartaent and s011eti.Jllea have supper with us, sit and talk. Mrs. Bayne...Jcnes was very, veey fond of hilno We talked about the offer from the University or Reohester last time and the e etf~t made to see whether Johns Hopkins weuld break through and create a separate department for 'ba,ftericlPf,?jY as had already been done at P & S an':!, I think1 at Califcrnia. In arv event, they didn't do s0 1 se you had this Rochester possibility before you of really growing up witb a brand new department, to Sba,P,,!l and mold it the way zou wanted to without any vested interests standing in your way1 but befere going there, I think from Julz1 l92)-though1 I think1 you accepted the offer in October ef 1922-there was no plant in bei!!Sa as I under­ stand it 1 at Roc~ster at the time 1 and they were verz much interested in gathering a faculty that would.sit in judgment en its growth. Well, plan for its growth, not a judg,nent on its growth. 220 In short, they were looking ahead, but !ran July 1 1923 1 on you take a trip abroad. As I think I told you, therets one letter f'ran England. Your only cOlllDlent is a general comment,"! have beenEBeing lots :of' doctors, soae sick people and many bacteria.• The letter doesn't allow you to risk a& specifics. I wonder whether any occur to you now. This is a safari in a field of which you'd grown enamored. Well, the arrangement for going abroad at that time originated with Dr. Whipple and President Rhees at Rochester. they saw a period where there would not be any need for me as an active member\ of the faculty. There wasntt &IV school then, and there wasn't any teaching. I worked hard on my sectien of the plan.s in the early part lif 192.3, and they thought that it would be very good for me, as they did for other oncming members of the faculty1 to go abroad and see what I could see in that time. That, of course, was in the Hopkins tradition also because Dro Welch went abroad nearly every year. Dr. Halsted and Dr, Osler went abroad. That was the thing to do. As a matter of tact, it was quite nat~ral for one caning from New Orleans to go abroad, because the young men of New Orleans went by sea to Paris and London a great deal before the Civil ,, \ War, and the New Orleans Medical and Surgical Journal is full of intere~ing observations of these visitors on the European clinics and laboratories, so much so that trips abroad continued after the war. During the Reconstruction when the iron curtain came down between the North and the South, men were still going out of New Orleans, so that some of the members of my family--my grandfather Jones went to LoMon and Paris in 1871, and so it was natural to want to go abroad to see these people anfhe things that they were doingo le_ It is astonishing to me how I had entre without being known. I must have \ had some wonderful letters that don't show up 0 I probably delivered them to 221 the authorities, but I saw the chief people in the bacteriological laboratories at least in London, Paris, and Brussels--those are the chief ones--ox.tord, and good people in Edinburgh, so I must have had good introductions troa Dr. Welch and others because I was a totally unknown person at that time. The expenses of the trip were paid for by Rochester which began to provide for my expenses even before m::, formal appointmen,which was areund about October, wasn't it? I couldn't have afforded that trip on my own small income, but we went over on a-I think it was a second class passage we may have taken to get over on, one of the big boats, and in Paris-we went straight to Paris, and Nan and I got a place in a pension in Passy where they spoke only French which helped us to learn a little French. I should know ~ore French than I do, but I prevent~d myself from learning lrench, I think, because I soon found out-~ Uncle George Denegre who spoke French nuently and rq "Tante E", his wife, spoke French, and one day at the dinner table when the three of us were together, they started talking French. I uooerstood every word of it, and they were talking about me, so I didn't let 0 on that I understeod. I never shlwed any capacity in the French language, but r\ K I learned a great deal about myself. I could J\ead French, and I acquired a suf'ticient accent so that it wasn1 t altogether neglected, but I had no facility v with it. It I s curi~s though, that if you have a littJ.e basic :material at that age or earlier, you can rather develop it in the situation. I talked French with these people in the pension and on~he Metro, and I had introductions that admitted me to the Pasteur Institute. I saw Emile Roux • who was the great man early on diptheria, a great, tall, ascetic figure like a prelate of the inquisition almost, and with him was A. Besredka. I met Besredka in the laboratory. Besredka was an immunologist of considerable interest to 222 Dr. Zinsser and others 0 The chief friend I malle there was at Garsche outside of Paris where Gaston Ramon was the man in charge. Ramon thenwas about in his¥ifties, and he had charge of the making of diptheria toxin and antitoxin at Garsche • He discovered a method of titrating diptheria toxin by mixirg the toxin and the antitoxic sera in a proper proportion. There was a flocculation, and you could tell the strength of the toxin against the known strength of the antitoxin, or yo~ could reverse that and titrate the antitoxin, if you knew what the strength was of the toxin you had. This method had to go in and out between animal testing and test tube testing. Well, I learned the method, and wh a:i I came back to this country-, I went up to the State Serum Laboratory in Albany, a year or so, ROing from Rtchester to Albany, and I got Dr. A. Bo 'Wadsworth, the chief, and his assistant, Mary Kirkbride, to set me up in -:.\ 1 boratory and give me unknowns fraa their big supply of tmns and antitoxins because they were making diptheria toxin and antitoxin for New York State at that time. This method worked out so well that I published a paper or so on the titration of toxin and antitoxin by the - nocculation method, /"The Titration of Diphtheria Toxin and Antitoxin by Ramon's Flocculation Method" 9 Journal of Immuno.!!a 481-504 (November~l924); and "The Titration of Toxins and Antitoxins by the Flocculation Met~ Chapter 54 ,!!!! Newer Knowledge of Bacterioloi,! and Immunol;ogz: ( Chicage, 1928) 759-7'Tfl• The point of it t~ particular value to me was that this remarkable Dro Gaston Ramon becaa my close friend, and he credited me with introducing his method in the United States. There was nothing original on my part, except that I had good facilities and~ lot of things to work with. Ramon wis coming into international notice at that time so that ever since 1923, until he died a few years ag9"M I had some papers of his. I don't know whether I left them in the file here, 223 but he kept sending me his publications, particularl1 after he got a prize or two from Rome, or Paris, and he began to write a great deal about his own importance. I found one of those-a historz.~f hi• work. He was a most interesting man, and of course that stable~like laboratory r', I at Gar~Cje has a room on the second noor where Pasteur died, and it was a moving thing for me to go out there and see ita !!toe thez on the de'!'._elol?":".nt of'. "9.uif!8n!? They were low on the development of equipment. A laboratory in those days was like a poorly equipped kitchen compared with what you find in laboratories nowadays with all the high speed centrifuges, the refrigerators, the extraordinary I~ microscopes, and the many things that you can have. They were using their ~its and their fingers mere than they used their hieJ'). class laboratory glassware and so forth. Well, I think I stayed in Paris longest of an;y place on this trip. I got a great deal out of it that still stay-a with me. Particularly the association with men of original, scientific integrity and imagination is an influence you crave, and you can never escape it if you wanted to. It is bound to affect your lifeo I forgot where we went next. I think the next thing I did was to ~o up myself frCIDl ~aris to the North. I went to Brussels ~st. , Oh yes--Mrs. Bayne- Jones was with me at Brussels. I had a letter, two letters, a letter I think from Zinsser to Dr. Jules Bord.et who was the great illll'lunologist, about in the same rank as Erlich who founded immunology, and I met Dr. Bordet in his laboratory, 224 He had written some great books which I think infiu.enced Dr, Zinsser as much as any writings of the tille. or course Erlich's books were alsofuntiuential. I happened to know a brilliant scientist and an able writer named Paul de Kruif. Do you know who I mean? - Yes. I think that de Kruit had written Microbe Hunters at that time. Also he bad gotten in tro\lble at the Rockefeller Institute by saying tbiags that Dr. Fl.exaer didn't like. De Kruit was in Paris, and he gave me a letter to Jules Bo~det•s assistant, Andre Gratia• which I kept tor a long time because it was the best opener or contidenee that I have ever had. De Krill just told C. him, "This is B..J • Give him. soae '1(:"'et de lapi~ and you can tell bia aeything." Do y-ou knw what cive~ de laJ>!'! is? e. It's rabbit cooked up in a brown gravy- with }{_hiYes and wineo I got to know this man quite well., and he took me areund. Mrs. Bayne-Jones and I took a trip out into the battle fields or Ypres before we departed frem that region, and they were still very rough-shell holes and barbed wire and quite interesting. Unbelievable• Then I went to-well, she went somewhere., and I went on North to .Berlin on a train. Fra Berlin, as I recall it, I went on to Warnem8.nde where I t.oek a ferry to Copenhagen, Demark. There was a very great un there named Theodore Madsen, a pupil or the great physical chemist a~nolgoist, Arrhenius, wh• was equal to Bordet and Erlich. Madsen was the head ot the Serum Institute at 22, Copenhagen. I visited there, saw him and a nuaber of his assistants, and got to learn about various fungi and serological reactions, particularl,7 ot toxin and antitoxin, coaplement tfxation, and so forth. That was a ti.lie that I saw some amazing financial changes. The German financial situatien had gone to pieces, so that when I got off the train on the platfem in ~erlin1 the newspaper was ottered to ae for seven llill1on marlrs•-ene little sheet. You can see what the debasement et the currency was. My dinner in the dining car was a billien and something marks. I was sitting in a c-.. pa•ent with three Gel'lllana en the way u.p that night, and we got to talking a little about these things-tortu.nately they could speak English, and somehcnr or ether it came out that I bad a tew dollars in.,- pocket. One of these men gave ae four billion marks for a one dollar bill. That tiU equal to tw hundred. and sixty aillion dollars in the old style, so I learned scae econolllics from that part ot the trip. That certainly' was a way to cancel all your debts by paying et:t in this debased paper money• I•a Anterested again in eg,uipaent. How was the Copenhagen laboratoiz? Thatllls fine, ene ot the better ones• It111sn 1 t any better than what we bad in the United states, but it waa well equipped so far as glassware is concerned and incubat•rso In these ~ s bacteriological equipment was neither very ornate nor intricate. Yeu could make most ot it yourself. From Cc>penhagen I went acress ner into Sweden, to Stockbolm, because there I had a Mend-eh shucks, I was going to sq his name, but it will coae back to me in a minute--who had Visited ae in Baltillore and also was well known as a bacteriologist. He took me around to the Karolinsky" Institute which rea1ly had an effect on me because there were several men there ot illportance who were 226 working on the variations of bacteria. They were getting away from the aono­ morphic ideas ot Robert Koch which Dr• Zinsser held to very closely--se did Dr. Welcb...-and since seeing that these organisms had a life cycle maybe, and a great series of fol'IIS where one was as valid as the other, but Koch and the A doctrinaire people said that those were either contami~nts, or degenerative phases, and they threw them out. That--well, I saw enough there to be conviD.Ced and get interested in the subject, and I met ••re people who had interest in bacterial variation. One of those was de Kruif who described what are called rough and SllOOth coloDi.es et bacteria. At that tille, it read froa the textbook, the ordinary- descriptien was that a colOI\Y' of a certain organi8Jl8 would be round, Slllooth, and glistening. On the ••• plate, very often, you saw crinkly little colonies that were rough and wrinkled, and often you didn't see them at all, even th•ugh theywere there. I don't know--you can be totally blind to what's in fr•nt of yo~, if you don't think it belongs, but these rough colonies were a T&riant ot the organism. The '.J..' saooth was a variant too. bey did have different properties of path•genicity and ditferemt serological eftecte. At that time the rough and s110oth variations tf bac teriolog were coaing •n, and I 111 tell you aore about it when I get to London. I saw men who had been at. this kind or work for ,-ears, and it opened -, eyes a great deal, so auch so that later on in Rochester in 19321 when I went to work with Dr. Zinaaer •n the revised edition of the textbook which I rewrete practically., I introduced a great deal of bacterial Tariatien in that reVision. that Dr. Zinsser never countenanced bef'ore 4 Now, it• s the common, ordinary thing, but I was iapressed psychologically that actually those colol73' f'orms could bl right in front of .., and I didn't even1Be them, and when I did see them.. I discarded them for a ntlllber of years witheut looking•~ further. I had a good 227 --7 and interesting tiJlle in Stockholll. Can you think of the man in Stockhobl? I I think i\s in the correSJ!ondence. Le~ me turn this reel; .over and take a look. All right? My bacteriologist friend at Hopkins, whom I had seen befere, 188 Hildring Bergstrand wbe also was a man who was interested in those early days in bacterial variatien. I•a leaving oat all the cultural side of this trip, like Swedish antiquities and a place called sla(;nsing _, where they recenstructed t.he old habitations et the Swedes in the early Christian era, cabins, and people (i_ dressed. in the costlDlfla et the pople et the tiae. Sweden at that tiae (1923) was in the stage or aedern architecture." Their City Hal.llGS a aost startling place--violent colors, ebel1J" colUlllns against 7ellow backgrou!lda, and disterted illages en the walls. What they call "the modern phase• was ccaing in then. Did you l'M\ ve a Sui de tor thi;,s sort of t hi'!i,? No, I didn't have a guide. I had one guide for the first nsit, but that was long after a long dinner part,-, and Bergstram took ae there at eleven t 1 elock at night to the Karolinsky- Institute. 'lilese Swedish dinner parties are remarkable things. The one l•a thinking about now started at tour o'clock in the atterrtoon, and this is not an exaggeration. I think we ate a meter or eel in centimeter slices, and between each slice of eel you had a drink of aquavit and yeu had t• •lee a speech, or soaebod.7 made a speech, so it lasted a long ti:ae., All the tiae I was collecting in my- head informatien about these things. I dentt. believe I ha~ e an:., diaries, or notebooks or the tripo I haven •t round •&• I don't think I kept not••• Let's go on to England. I forgot how I got 228 there, but in England Nan and I were together, and we traveled areund a little. b The chief trips we made were one t• Edinburgh and one t~ Oxf'erd. The one t• Edinburgh was parU,- sight seeing and partly because I heard that a taaous doctor named Dr. Byram Bramwell had specimens ot Bence...Jones protein. I vent to call on hi.a, and I tound hint in this beautitul Ad.alls house. He gave M a 'rial et this protein which I brought back and worked en at sae ti.Ile or anotbero '\ ·. Fdiftburgh was a charaing and interesting city, but rather n~-gray stones, high building•, aore or less crevded. There was ene good w~k up •n to the hill called Arthur 1 • Seat, and there•• a good 'ri.ew fr• ap there. I think it was getting on toward tall when we got there becauae it was getting kind ot chilly, and the hotel was cold• Then we cue on. back-I think we caae back that tilleJ I 111 sq we did go to Ox!'erd first-yes, and at Oxford I ran across a man whose name I have forgotten, but who was an officer in one of the British Ambulance Companies I served with during the var. He was working in tile laboratory 011 aev aethoda ot agglutination reactions tor the identificatien ot t7Phoid and paratyphoid which is a great group et Yariable bacteria that was being worked out chiefiT 'tv Dr. Joseph Ao Arlcllright. Arkwright was faaous for that new serological work where you could do something with this group that had not been done ve rr much before-that is t1P• th••• They gave them letters-type A, B, c, and so .forth and V-1-there are lots ef ditf'erent names, but that'-s important because 7ou could link the t,-pe to particular infections and outbreaks. A lot of basic irlformation was cOlling out about the nature of the constitution or these organisma. Well, J. '• sorry I don't r••ber the name of this friend of aine. I Will later probabl.7. He had a motorcycle with a side ear. and he took me en one trip to Blenheim Castle or the Marlboroughs which is a aarvelous big thing. Nan and 229 I wandered ar•und and saw beautiful things at Oxford, Bodlean, the theater, the kb stai\glass windows, Christ Church, Magdelin College, Balliol, lot• et things. It was satisfying having read a great deal about ito It was a romantic structure that tit. in with rGJ11&ntic notions or early reading or those tiaes. Then we went on to London, or got to London at one time or another, or aaybe several tilles. How I knew where people were, or whet.her I went to Institutions just ••, I don't know, but I vent to st. Barthelaewts Hospital I remember, and there I met an•ther gentleman who was very far advanced on bacterial variat.ion. HaTe ,-.u got st.. Bartbol011eW1 s down there? Was it a Dr. T. Joeke•? It aq have been Joekes-oo. Thia was a tall-I 1ve forgotten bis name. I could have looked up so• et this. Tbey were very kind and showed•• their laboratories whichvere like all the other laboratories, but there was a good deal of interesting talk. Then I aet Leonard Colebreok who was also interested in the typhoid group together with some of the anaerobic spore bearing organisu taat had caused a let ot trouble in the war-tetanus and gae gangrene type Baeillas welchio Tben over at anether hospital across the river I met Dr. P. Fildea. I didn't run acres s his name. Fildes was there, and he vu very- tar advatlCed in the bacteriology- er tetanus. He was separating tetanus bacilli into toxin forming and non-toxin 0 tol'lling, and studying ant1t,r1n, but FUdes coaes back into my- lite again with biologicoJ. warfare because later on he was head of the Portland Laboratory where the British went so tar with bacteriological warfare, particularly with anthrax. 230 Have 7ou run across any or that yet? To anticipate it-I won 1 t go into the st•r;r-as World War II was caing along in 1939, Secretary ot War Henry L. Stiason got aroused b7 newspaper accounts that the Germana were using bacteriological warfare and that a good deal had been published en the subject, so he called•• advisor:, cOlllai.ttee, and even before th• war he invited ae down here te sit with General Jaaes s. Sillm.ons, Merrit P. Sarlea, E. F• Fred., and Captain Charle• s. Stephenson who was later an Adlliral, and we were the tirst biological warfare cOJllllittee tor the War Department. We collected a lot et inforaatien, but ~,u cme to that later beca11Se that amounts to soaething in World War II. Was Dr, Fildes thinking in tel'IIIS or variability at that time too? Ob yes, the7 all were. It was new and exciting, and it was sanething that you had to pay attention to. Who else have you got on that list? I had Arkwright, but at the Lister Institute. ' Arkwright was at tbe Lister Institute• and I tWnk he had an influeace on the Oxford Laberator,-. I went to the Lister Institute and got soae cultures 0 eut ot their collection to bring ~e too. I think tha:i accounts for the correspondence. Then there 's Professor George Nu.ttal at Cambridgeo You pronounce him Nuttal. He was the great parasitolegisto - Yes. 231 He had been on the staff of Dr. Welch's department at Hopkins in the 1880s, and Nuttal wrote great books on parasitology, the protozoa, and ether things. He was a very learned man. I didn't get to know hill, but parasitolea alwqs fascinated•• We used the word "beautiful" about these creatures, and they are. They're larger than bacteria.I. You can see auch aore about thea and converse with the• in a different aanner than you can a little obscure m:1.croorganisa. They have coaplicated lite cycles, and they dof all sorts of extraordinary things. I didn't see much of Dr. Nuttal. I kn.ow he was close to Osler. He was at Caabridge, I think, and I didn't get much to Cambridge, and curiously I don't know+1mch about Cambridge. Cambridge I associate with at•ic physics, all the aew things or quanta, and quite a difference from the Oxferd develop1ent. Oxford I usociaetd with literature and biology-, and Cq,.bridge I associate with ph7sics and athematics. There 1s correspondence with Clifford Go Dobell 0 Clifford Dobell was at the hospital et the British Medical Research Council at Hampstead, something like that, and Dobell was a most perspicacious, precise and exquisite literary scientist as well as being a parasitologist ot unequalled facility in handling these organiSJll8 and separating them. He wrote a great treatise en the amebae. He was able to separate them. He had five varieties, and his books were the authoritative books on Ameba histoq,tiea which was the cause of dysenter.r and the ether endamoebae and the varieties fh&t exist there, but his great enthusia81l in lite was the study of the writings~! the man who discovered the bacteria and the protezoa and that is Anton van Leeuwenhoek--do yeu know him? - Iese 232 Debell wrote a great book called Leeuwenhoek and His Little Animal.Be He had published that. Clifferd Bobell with all bis impatience had leamed to read 16th Century- Latin and, more astonishing yet, he could read the Dutch script of Leeuwenhoek who wrote tremendous letters to the Secretary of the Roy-al Society. That's where his original descriptions in tne late 1600s and early 1700s cui.e tut. Leeuwenhoek drew the first picture of bacteria which I copied, aDd. every­ bodf else has copied in books they write. Leeuwenhoek developed bis own lenses and his owa llicroscope1 but he didn 1 t have a tubular microscope. ' take a Hetltd little glass bead, a spherical. bead, and aount it, and then he would put bis little drop of water en the point of a pin, anfmtehov er ether focus on it, see what be could see, and through magnification-you know, you can get a magnifi­ catioa through a spherical thing. 11 was quite wonderful what he dido He dis• covered. the bacteria. He discovered fungio He scraped teeth and, of course, it rou scrape your teeth, 1ou can find anything. He drew muscle fibers that no one had seen and really, I think he put in the link that was aiesing when Harvey described the circulation of the blood because Leeuwenhoek discevered capillaries, the little, fine vessels that exist between the Teins and the arteries. That dis~ove17 is attributed to Ma14,Js.us, but I think that Leeuwenhoek--and bis I pictures are about the same ti.lie in the 1600s•-i• just u important, as Malpigbius, se Leeuwenhoek exists en the eOTer ot the Journal •f Bacteriologz. I'• looking to see it 1ou have one here. There he is--ae 1 s our great saint. Debell was collectillfj and stud,!ng this man. Yes, Debell collected al~his eriginal things, translated thea from the original Dutch, geat books. He was associated with a hospital under this Medical Research Ceuncil. 233 Yes, bit Debellwaantt working on patients at the hospital; he was working tn the ameba. This National Institute for Medical Research that I suspect•••• The BritiS1National Institute fer Medical Research? I don't know whether it's called "~ational•-British Medical Research Institute. I don't know, but that was a great center of their national effort in medicine 0 I went there particularl.1'. It was concerned with..,- own field, bacteri•lcg, ay-cology and imunology. I went eut to Mill Hill and aaw people working on Tarious things, and they were all wary nice. I caae back te 1 t again. in World War II in con... nection w1 th typhus. The British &lpire-India1 Sinaapore1 Australia-there was an Il'lBtitute ef H7giene and Tropical Medicine in Lol'lden, I think. There had been an Institute of Hygiene and Tropical Medic::1.ne in Londen for 7ears and years. It had been a great center of interest in that subject0 And there are divisions or teaching in the London Medic&}. School dev1ted C, to this-a School or Tr,J\pical Medicine. -, I know of our own interest intro ical medicine but its also a s ur for the develops.eat •f the Academy of Tropical Medicine in 193.k, after this trip. nt thought it might have hele_ed1 though I don't know. Oh well, when that came up, it was a natural interest and advance there0 - Sure. 234 I was a founding member rL the .American Academy of Trepical Medicine that h started right here in WasAintgon, started through the efforts of the Dean of George Washingtea School of 11e<li.cine, Earl B. McKinley, but you don't wan\ that now. No1 As yeu think about this who)e trip-this lunch counter I where you had a £hance to saaple the experience of other men--it must have stretched rou. Oh yes, i+as enormousl.7 interesting and alwa)"8 a part et the whole piece. I didn •t teel &l'J1'•--Well, it it were a lunch counter, it was kind of a Laz1 Swsan lunch counter, that just went arouoo.. There vasntt &111' beginning, or end. ~ I wu thinking of l.ter developaenta at the Uni'Yersitz of Rochester for the I\ Department et Bacterioloq. Oll yes, it bad antenoraou.s effect because it opened your mind, and 1ou bad a vision of what. people were doingo I want to talk to zou about the Uni:Yersitl of Rochester, but I think we'd better stop novo Yes, don't get into tt because that's a loUE story, and 1 •ve got to go. 235 Thursdaza April 28 1 1966 B-9 1 N. L. Me Betere I turned this on1 I gave you something of !,Y intereet teday. I guess 0 we can break it dowa into two t!fice. One is the town or Rechester itselt, \ 'L 1923-1924-wnat was in the air? How would you eharacteri•• this town? Tb:l.s has \ a.lot te do with what happened, The other topic is this group or men pictured here that were breyht together even while the school of medicine was being developed and whe prticipated1 in t.el"JIS or whatever it is they brou~ht with thea in experience and insight and. abilitz, in its developnent1 so that t.here•s really the town and this new mutatien1 a new aedical scheol. Rochester is one of the older towns in Northern New York. Of course, \ having been interested in Indian remains fram ray Grandfather Jones time, I found when I got to Rechester that it was the hoae land et the Seneca Indians. It was tull of Indian relics and Indian lore• Rochester began in the 17th Century- when the French moved in from Canada and began te settle. Then along about--maybe the aiddle ot the 18th Century, or teward the closing of that century it began to get iato the hams of Allerican people-English people first who began to build up a tow as so man;y cf those places were originally started en the sites, or on the locations or watertalls 0 Tb.ey used right awq the power from three waterfalls that are in the city. The Genesee River passes through Rochester, and they built mills. They raised grain in that region, and they began te grind wheat and ether tbings. It began as rather a center or ingenious economical 0 exploitation er the resources ot the country both in power and in Pz:1\ducts. Then perhaps in the early" 19th Century, 18121 or thereabouts, or even lat.er., Gel'llans began to meve in there. They had a treaendowr effect en the devel•pment 236 ot the industries in Rochester and en the cultural outlook or the peoplee I•• sure they- did. Rochester became net only a great 111.lling center, it also became a great transportation center when the Erie Canal went through there and the r-1lroads began to go through, but there alse developed fr• the earl)"' ti.a, through these Geraans particularly specialized industriea, Bosch and Leab is an example. Rochester becUte a great center for the manufacture ot lenses and 111.croacopes, e1e glasses, all sorts or special things, and when I say in this letter that you have here, that I .found Rochester right away a fine place in which to live, the .fact that it was a cluster ot specialized industries with extremely interesting people of a scholarly bent at the heads ot these industries made it ve'rJ' pleasant, and easy to get along with scienti:f'ic work in the llidst et a community that appreeiateci net only the 1.mmediate scientific applications, 0 but also the huaanitarian and cultural sideo R~chester developed, and still u had when I was there, a big clothing ind.1'.stry, lots of specialised 11achinery~ relati11ely 81118ll machinery, but there was a wonderful plant for ma.king sterilizers, the Castle Company. Then in the early 1880s, Mr. Eastman moved into that region. About the same year I vas born, I think he either invellted the Kodak, or began ta build the Kodak plant, and that became the main industry of Rochester under Mr. Eastman who was there certa~nly frem the early 1880s unt1+ his death in 1932. You can't understand the developaent of Rochester unless you understand the effect Mr. F.astaan had on it, not only by his enormous philanthropical. gifts, 'but bis interests in the cultural life of the city. He gave large sUJBS of money to institutions in Rochester and te the Massachusetts Institute of Technology where tor years he was known as "Mr. Saith" before his name ,,.as disclosed as the giver e.r huge sUll8 to M.r.T. It is said that he gave away altogether about a hundred I I'/, Ii w 237 lllilllon\nollars, and in doing se, he built the Eastman School of Music, as it was called, to which he brought as a director, Heward Hanson, an origiul com­ poser or medern music, and Mr. Eastman had visiting conducters there-Eugene Goosens, I think, was one name, and there were a number of others. Mr. Eastman fostered a Technological Institute in Rochester and built there also one of his early dental clinics. He scmebow or other got interested in dentistry­ through a very remarkable practicing dentist and a political dentist of great power named Harvey Jo Burkhart. I think one of Mr. Eastmants firs\ dental clinics was the Dental Clinic or Rochester4 The fact tmt the Dental Clinic of Rochester was there before the medical school was thought of had a great deal et innuence on the medllcal school which was called from the start the Universit ef Rochester School of Medicine and Dentistr.,. ~'11 come back to that side of it later because a very double jointed name like thatw as the basis of a split in ideas between Dr. Whipple and Dr• Burkbar\ and even people in the city. It was also the occasion ot some dirtsi•n Within 011r .faculty. 0 Also in Rochester there were verr tine men ot br~ad interest. Mr. Eastman'= physician was Dr. Ed.ward w. Mulligan, a big, gaunt man who rather terrified people until you got to know him. He was a great power in the town and watched ever what went on at the hospitals, what the Ci"tj Health Department was doing. He•s the medical conscience of the place most inconspieuou.sly. He was supported by a close tiiiend of his named JoseJh Roby-. There were other physician in the town that I got te know who were high minded men of considerable ability. Dr. Albert Kaiser. Albert Kaiser was one of the best. of the lot. He was a pediatrician with a great public spirit that so many pediatricians have, and I think he became Health 238 Officer of Rochester after Dr. Goler 1 s death, though I•a net sure about that. Then a layman in the trustees was Mr. Edward Minor, a very weal.thy man, who was a book collector and whose chief interest was in all the original and early • works en yellow revero He collected not onl.7 in that r•eld but other books. For instance, he gave me an original edition of Beaumooita classic en the gastric juices, the Alexis 81; 0 Martin experiments, and Mr. Minor aftd Mrs. Minor had aroups or triellis areund the• and Dr•••• Sawyer_? No. I mentioned his name a moment age. Mulligan-Mrs. Mulligan had a great big house, and they used to have a real, old, Victorian type or salon. i Once a week people would cae there for tea about four <I,, clock, and yeu 1 d have a talk en some sensible subject, or soae significant subject. It was not just chit.chat. They really- put on a kind or salon that sone times I had seen in New Orleans with Grace King and soae or the ethers 0 Always there were good things going on in Rechester in music and lectures., snd the town was rtsited by a great many people. I suppese Mr. Eastman's connectiotts were all ever the world, so it was surprising to me, and to all or us, I think., to find in the upper border or New York, a rather isol™~••••L:Ehe phone rani7 0 You were cowntins ~n the•& the town_was erganised-aA■ultiflicity 'I-( ~u~~ Tereina in ~rms o,! iqte,teata, clubs and so on. I+asn 1 t exactly an erganizatien of the towR. It was something natural and indigeneu in the spirit that they had and which brought them tegether. They had a great ••03' clubs. The sense I got was that they were seriously- interested, without being aushy about it, in c0111111.unit7 welfare, and perhaps m;r appreciation 239 et that element in the population probably derived, in the tirat instance, f roa Dr. Goler, the health efficer, and Dr. Rhees, the President ef the University, ~nd then Mr. Eastman, but I onl;y got to know Mr. Eastman somewhat auch later. Dr 1 Oeler is worth a vignette. Dr. Goler was ene et the first rtgoreus health etticers in the United St.ates, in rq opinion, and he belongs in the categories ef George c. Shattuck and Charles V• Chapin-these aen vhe were innovaters and absolutely independent et politics, courageeus, thoughtful., energetic, tireless in doing what they tho11ght was the right thing to do and willing te both accept and suggest aew ideas and new undertakings. Dro Goler survived practically all the political change• in Recbeater over a period or 11aybe torty years betore i get there. They couldn't get rid er him because he always had suppert for anything that was going en. He had soae very severe ti.Ms to deal with in the earlier day's.-an epidemic et sull pex• an epidellic ef fatal scarlet feTer. He had te ua all sorta of iaproviaat.ions to build 1,1p his health tlepartaent and under small appropriatiou. I don't think he ever got tr011 the cit1 ver:, auch mone1 for his work 0 When I got there, he had a small laboratory, but big ideas about that laberator1 and abeut hospitalization. It was his conception that the new aedical school, if it could and waated to, could combine with the Cit:r in activities of aedical care so tar as hospitalization is concerned, by having a Municipal Hospital on the grouads with the Strong Memorial Hospital. They had different administrative supervision, or different superintendents. In the case of the Rochester Health Bureau Laboratories, he 11a11 glad to turn it all gyer to the medical school, and it caae into ay Laboratory or Bacteriology right trOll the start. Did I talk about this once before? 240 rl Well, nr. Goler just gave me bis complete confidence and made such arrange­ ments that it was possible for me to engage people to work in the laooratories and to discharge them, if I thought it necessary. As a matter or tact, I don't recall a07 changes in personnel. S1ae of those people who came in to work with me remained_,. friends after I left Rochester. I saw one of thea aot long ago who used to aake aedia-Mrso Josephine Mikletisch. Tbe qualifications of these people were lett torr judgment and in the asaesDent I was never bothered with Civil Service forms and the rigamarole that often goes with a municipal enter­ prise., and that Laboratory grew to be T&'f7 large. It took 1 n all the health examinations of a laboratory nature from excretions, blood cultures, and throat cttltures, surve;ys or all kinds !or bacterial infect.ion, the water and ailk supervision and lots of aiscellaneou examinations. How did you take to th~ laborato!Z largely staffed with women technicians? This was novel. Yes, the;, were WOilen techDiciana. Miss Hester A. Austin was head~sero- ~ logical work where • were doing Wasserman tests b;y the thousands• A aan was in charge or the water and milk, and his wife worked with hi•• We had man., woaen ... 011 the start all the w~ through. They were good. Tbere 1 a just thi~ cmment in one of the letters-"What do zou think of woaen !orkers in the laboratorz!• Yeu inherited a aealth bureau-a four female health bureau. I took the■ on, and Miss Austin was one of the■, i'• sure. llbo 1 s that letter to? !!!.!,_ is to z:our sister• 241 They worked just the way aen would work, and they worked just the way a physician would work. We didn I t have-as I recall 1t, we never had a tiae punch card syst•• They eaae early and stayed late. Did the 22ssibi.lity ot increasing the Public Health Laboratorz •~cur not to bz... e,ss Alba&:, but so that zou wouldn't have to send SJ?!C.~ens Oft to Alba9(1 Miss Austin1 I believe, was sent down to the Laborator,: at ilb•2(• For training. So that she could do this work locally• That was the poliq or the Albany State Laboratory. They bad no ambition to take O'f'er the jobs tor the aunicpalitieso The only difficult:, that I reaa• ber in developing that work troa a pllblic relations side wu that sme doctors with vested iaterests in laboratories, either their own, or group laboratories, had a feeling that the school was doing this tree tor the city and not charging the patient anything, and that this was interfering with the emoluments that pb;rsiciane had a right to expect. That didn't bother us very auch because the Monroe Count:, Medical Society was one or the best, aost liberal minded of a117 that I•Te known about, except perhaps the Medical Society of Maryland in Balti- 1 aore. They didn't intertererth us the way the New York Bounty Medical Society tried. to interfere with the New York Hospital and the Cornell Medical School vhea I went down there. At Rochester~ I think the physicians bad the same ~ general point of view that f've been trying to attribute to the citizens ot the town who were not in medicine. This grew to beaver:, large practice, so to speak, because there were many- thousands of speciaens, and behind every speci­ men there is a patient, as a rule, and that patient is anxious to know what it is all about, what is found, and the doctors are pressing to get answers be­ cause their actions in treating the patient depended a good deal on what the laboratory found. In reporting the fin.dings to the doctors, and sanetimes to the people, occasionally you have to do a little missionary education because theT don 1 t always understand. For example, I told a doctor one da7 that the specillen or sputum that he'd sent to me contained a pneumococcus. He said, "It can 1 t be• My patient hasn•t got pneumonia.• Well, bis patient had pnewnococcal laryngitis, and of course that comes from the larynx up into the sputum. Just because there wasn 1 t aey pneumonia he thought we must be wrong. That sort of thing happened over and OTer again. Every now and then they had an outbreak of a disease thatw as puzzling. One \:ime I remember scarlet fever was troublesClllle1 but what put the great burden on w, 1 which I did not work out properly, was an outbreak of what we now know u psittacosis. It was called parrot fever at that tiae. Tbe people who had these little love birds and kissed them got intected with what we know now is a virus, but when I worked on it, and these people in pet shops were getting this disease and the people in the town were getting it, I fennd what had been re­ ported before, a paratTphoid organism. I didn't go any- further than that, but 111' friend, Dr. Rivers at the Rockefeller Institute, really worked out psittacosis virus. This letter indicates that you no sooner brought the Public Health Laboratories into the general bacteriology laboratories, than you had a di@theria outbreak in one school--this is the sort ot thing that would come in-and a typhoid outbreak in a state hospital. This was the kind cf thing that would COllle in•-sudden likeo Oh yes, you ha1o be readT to do almost anything. At that ti.Ile tularemia I\ was a cODDD.on disease in rabbits in the region. T~eJBia is communicable from the rabbit pus, if you get it on your bands. Every Saturday" I can recall hunters would go 011t, and then thq 1 d hear about tularemia, and they knew that I was around, or that 1lf¥ laboratory would tell them whether these rabbits were safe to handle. Sometimes by' late Saturdq" afternoon 11£3' laboratory table was just stacked with dead rabbits-a lot of work to do• Another area that the Health Bureau Laboratory took me into was medicolegal work. I got to know the Chief of Police. Andrew J. Kavanaugh. tavanaugh was a fair haired, big Irishman with a tenor type or a voice. He had no means at all for identifying spots that 111.gh t be blood, and if they were blood, whether huaan blood or~ni.mal blood, so I used to work with hill and work out his cases for him. I did a good m&rJY' until I had soae experiences with the legal frenzy and to ae reprehensible behavior of district attorneys prosecuting some suspect and who in lfl1' opinion were not after the truth, but were after winning a caee. They would take me on the stand, and both the prosecutor and the defense would make life so miserable that I didn't want to do it after a vhile. Do you want an annecdote about that? I sure do 0 Once at Canandaigua I was an expert witness on the examination of some blood and hair that had been scraped off the fend.er of an autaobile that h&d killed a man. The district attorney got very excited about it. I was sitting at a little table underneath the judge's stand almost, and this lawyer gave me 0 the best example 1{ legal frenzy that could be turned en and off that I•ve ever 244 1een. He started pacing around the room shaking his hand at the jury saying that "this cruel bootlegger here"-be had no business saying "beotlegger" because he didn't know it-"has killed a boy who is the only support or an aging mother." He kept getting closer and closer to me. We had been talld.ng about these blood stains, and the defense witness was on the stand. I was sitting below. He kept getting closer and closer to me, crying before the jury and of course poisoning their minds. As he passed my table, he said to me, "What is that word that I •a trying to think about?" It was all or a sudden...-like that. As he cue around again, I said, "Hemosiderin crystals." He shook his finger at the witness on the stand for the accused and said, "What are hemosiderin crystals?", and then he made a big fuss about thato Arter a while at that, I told Chief Kavanaugh I didn I t want to do any more, but that I would help him in any way I could, I found out th.en another thing r about law;yers; they have a pattJern-that ...,,. is, these criminal lawyers have a pattern, so one day the chi.et asked me to help him out. He~d had a lot or sooty clothes that had been pulled out frm a chimney nue in a room where a man had been killed, and there was a question as to whether there was human blood on them or not. I told the chief that I was not going to do -idie work, but that if he would send s011ebody- up froa his laboratories, I would try- to help him find out, e so he sent up to me an expert on PJ\troleua products. This man knew nothing about exDining blood stains, but I knew the lawyer whotes going to defend this accused person, end I•a been--excuse me again. /J,he phone rang agai!Y We ware in the llidst of that•••• Turn this off a minute. 245 We were in the midst of a trial. He sent this petroleUll chemist up, and, aa I say, I knew the pattern that the defending lawyer would take in cross---examining this expert witness. So we piled the dirty and bloody clothes on a table in the middle of my laboratory, and I walked all around the room for two or three hours telling this man what to do in the order in which I thought he'd be quizzed. It tu.rued out to be human blood, and there are lots of thin~s you have toro to be sure that :you're not getting contaminations as you ba,.,d~1 ""' '\ /' l it. About a week later this man went on tbe stand and qualified as an expert, and then the defense law:yer took after him. He caae off with very great success, and he told JU atterwards,"Doctor, it was just like turning over the leaves of my notebogk•" This was an utterly untutored i•unologist who o~ bad to be told how to answer the questions of a lawyer, if you could guess what he was going to ask ahead of tiae. Well, I didn't do that any more., but I would help b:y indirect ways. n Did you meet Calvin Goddard? Oh yes, I know Calvin Goddard frOJIJ. a long tiae. How does he come into this at Rochester? The Scientific Crime Detection Labo:rato!7• He was in Chicago. s I knew Goddard f'r011 a long timeo He was a great ballistics expert. He 1& the one who solved the Valentine aurders. He was a colonel in the Army; as a 246 aatter of fact, he was the head of the Army Historical Unit just after Colonel Joseph H. McNinch. Calvin Goddard died a rev 79ars ago. I knew him before. He didn't come into this particular situation. They otfered-w8ll1 you didn't want to participate any more1 but there was an Association ~f the Chiefs or Policeo \ I was a aember or the International Association of the Chiets of Police. I carried a ticket tor a long timeo When they explained to you at Johns Hopkins that 1ou would have at Rochester a rich variety of source aaterial1 you never ant.icieted this sort or thing1 ~~d No, I never anticipated that I would be into this, be doing work in this tor the police, but its a routint 1-.unological exercise to be able to dis- ('! tinguish-as a matter of fact, I go back to Joseph Jones again because his description or the aalarial parasite, 18761 is published in the account ot a aurder trial in Louisiana, near Donaldsonville, a man named Narcisse Arrieux was killed b)T being hit on the head by those big weights that are used in a grocery store, and he bled on the mahogalV table there and on his clot~. M7 1 grandfather, the Health Officer for Louisiana, Joseph Jones, was sent pieces ot sliTers or bloody wood and pieces of wool cloth cut frcm the shirt of a Negro who had been suspected of the aurder1 and he said in his report that this was not only hUJ1an blood, and he described why be knew that it was hllllan blood, not troa imnunologieal tests, but the 'blood corpuscles were alike in size and shape as those he had seen in Philadelphia. He had. written a big monograph on the aallllalian corpuscles. He said further that it was also the blood of a man suffering fra intel"Jli.ttent fever, and he described what undoubtedly, in -ay opinion, are malaria parasites in those red cells, so again I go back to my grandparental influence. This kind of thing was all in iae same line. How did Goler feel about the service-the Public Health Laboratory in this kind of operation? Dr. Goler was in favor of doing this kind of thing. In fact, he left ae alone. He not only didntt question it, but he didn't tr.y to protect me from ~ myself which I wish soMbody had doneo You get into all J\onts of things. You see, the populace call bacteria "bugs", and one of the jobs I had to do was go into an apartment, where tor some reason or other, there was a sudden develop­ ment o! little bits of beetles, little bits oft hings, the size of pepper graina, thousands and thousands of them that caae out of the woodwork and dropped into the bath tub and on the bed. There was a young couple in there. So knowing tha1; ,) I I was a baeter1Aj~gis1; I aust know all about "bugs" and they called ae in. ;,J v Another was a ease or a woman who didn't care ~ery llUCh tor her husband so she got two horned toads--y-ou know, these little, drT frogs trem Arizona, and she had one on each shoulder ~11 the time so that she could not be embraced. I was called in to take those monsters away. I kept them in the laboratory for a while. There is more than aeets the eye ia bacteriology-. Indeed there is One of the conse uences of th introduction of the Publie Health Laboratory was the development. of the New York State Association of Public Health Laboratories. Yes. Well, I knew Dr. A. B. Wadsworth, the bead of the laboratory, and I knew Miss Mary Kirkbride, his first assistant, and I told you that after I eaae 248 back from abroad in 19241 the first thing I did was to go over and work on the Ramon test in that laboratory. I knew that Dr. Wadsworth had been thinking for acme time that they ought to have soae meeting or organization of the people who had laboratories in Syracuse, Alban;r, aside from the state laboratoey~ Buffalo, Rochester, and a good many hospitals had good laboratories. This grew up into an organization and they had at least one meeting a year in Albany-. This association is still going after all that tiae. I had an invitation to the aeeting that went on last week. .i,m an emeritus member of it now. Did~•t the_y have perioqic difficuli!,es before t.h,e ~tate legis!atur....the nBattle of Albany; or 1932'~--:the medical;_ ,,~OJamittee. You mean, the antivivisectionists? Yes, they had a very violent period of antivivisection agitation in New York. Was it 1932? I thought it was a little earlier. Somehow or other I was ll&de chairman of the medical cOllllllittee to oppose these people. They hac:\ a big hearing in Albany- to which I went. I went C. thn:ough the usual e:f':f'or1i as Dr. Wel\1 did. He led opposition to the antivivi• section group in Washington in the early 1900so There was much more than the hearing in .Albany because it was neoeasary to find out who were important in ~ controlling the vo)es of the memb~s of the legislature, the S8 nate and the House. Tha ~llls the first time I had e ver seen the operation of a local political ring under a man who was a good citizen, but not really very much educated, and this was the Republican Party of Monroe County. The head of that local political organization was a plumber, and I remElllber going down tofhe Genesee Hotel, I think~ to have a meeting to consider this vivisection problem. The room was all draped-a big room draped with heavy brown curtains• You muld see the people who were moving behind the arras. Here was this plumber 249 sitting at a big desk, and the legislators were sitting around on little, fii.lllsy, pionic...type chairs. I came in to that., and somehow or other explained to this man that guinea pigs were needed, tor example, to titrate, or find the strength f"\ \ or diphtheria toxin. He slJ:i-r didn't know that he was going to say this, but he said,noh, I understand that. M., child was saved by antitoxin. You say that it was measured against guinea pigs?" I said,"Yes," and told hi.a a little about it, so he turned to these legis­ lators, and he practically' said1 "Well, boys, we're going to support this Docl" That 1e what they did. Then the next one--the movement got into a little trouble in the Senate, I tbink1 in Albany, and we round that there was a man in Buffalo whow as a fancier of certain kinds of dogs, and through that there was an approach to him 0 He infiuenced a vote or two, so we came out all right, but that agitation, as you know, is going on at present, and fortunately I haven't had to bother with it any more 0 P,eveloRi'!i ana.ssociation in a sense puts a noor of stan~ds for the operation !~J?_ubl~c health laboratories 0 The Public Health Laboratories weren't. in this antivivisectionist thing. This was state wide medical schools and everything else• The eorres,eo(!dence shows, that it c~e.s from all directi<?ns-1es 1 but part of the growing knowledge in the state is through the develo@ent or associations--fran. Wadsworth to William H1 Park to J 1 K. Wilson on soil bacteriologz-all these 2eople and others were verz much interested in a,tloor for standards in their laboratoq tor laborato!Z, service, and as a corollary to that the mce~sity for experimental an:1.m.a1;s. . I know that the volume of work in the Public Health Laboratories was ~us,t ,\remendous. 250 Yes, the volume grew a grNt deal-vent ltp into the thousands and thousands of tests. What the test is is still to be determined becau.ae you say that you're goirg to do one "test for syphilis and one blood specimen, but you llight have to ~1L. call this specimen make six, or eight •nipulations of the specimen. Some peort!r' tests, and some people put down all the things they do, but we gave them specimens and then when it was a very difficult procedure., y-ou could separate the tests. The work is far aore than the thousands of instances that are in. the reports. ~es 1 did the immunological man~~ eoae out of this kind of wor}c'l The one I showed you? The one eublished by a colll'!.it\ee--eh1 I don't have i~ here which is one ot the bad reasons for not lea'Yin that room bu tests, I suesso ,'°'\ \ Everybody- has a manual. I br~Et~t you the one I used for my class. There are published manuals, but the published manuals are rather compromise editions. n They try~o suit everybody, whereas taost of the cooks have soae way of doing it that they prefer, so you generally write your own manual with the minor varia. tions either changed to fit a situation, or to fit in with supply, or to fit in with ?&oney1 or to fit in with your preferences. There are always a couple of ways of¥o1ng something. I was thiD;~'!I At a small publicatiol! which I•ll sb~w you tomorrow, 0 I don't £~ember its precise name 1 but later Dr. James A• Kenne'!l•••o s Jim Kennedy? Jim Kenned): tried; te get a rertsien accepted, but it was an effort to standard- 2Sl ize tasts 1 ~nd share them senerallp. That was going on all the time too because new tests w~ being devised _LI /)I_· and new variations were ccning out,. -,; s customary to s;~ ar•und speciaens that are unknown and let another man try to see what answer he gets. Stamardization goes on all the time. I want to tell you about Mr. Eastman's health service for the employees at Kodak1 but I don 1 t know whether you want to go into that now or not. other ~bi!!is about the Pll.blic Health ~aboratori-there are a lottor I ho l•ve bro ht it alo • Here's the ori inal. statf and the waz in which it grew. This is 1932--this is near the en~ fes 1 the origj'!&1, stat~ is listed. at the toe• Oh yeao Miss Myers married the man who got to be in charge of the water and the milk. Some of these were visitors 9 I called myself the "Zieg.t'ield of Laboratory Technicians" because I looked for intelligence, health, strength and affability in these people. They were all good looking girlso They were strong and well, and there wre a great rmany :marriages in this group. They don't show up here as Mrs, but marriage became so COlll1llon in our aaiable surroundings that ot the ladies vho visited for a few weeks, one of them wrote me she had been there for two week• and hadn't been married yet. Did •&; euzzles t~t led to scieati.t'ic exelora~ioa grow out ~f, the Public Health Laboratories? Oh yea, ve published papers eccasionall.y• Mrs. Priscilla Cummings got to 252 be an expert on streptococci in connection with pediatric troubles. I think that there were a good many- minor papers-I forget them now• I don•t remember titles, but I know that there were a good m&I\Y publications, and these people I would give papers--a lot of themweren t published-at the meetings of the laboratory association. ~ere you. able to intrigue, invite, otherwis,e corral doctors in the commu.nitz to come in .and work in \he lab~rato,r,z? I don't think I eared to try to do that. I had lots of relations with doctors, bttt--well, probably it I told the truth, I didn't want them t• be around in that capacity-0 Itvas runni I used to go to their meetings in the Monroe County Medical Seciety. I knew practically all of thea•u• I Let a turn to•••• Are you watching the tiJlle1 because they told me that Dyer /jJr. Rolla DyeiJ would be there until three o•clock. I !ou want ~o go u:esta1rs?. It s ten minutes to "t:~ree. We'll stop and coae baek to this toaerrow. 2$3 Friday1 April 291 1966 B-9, N. L. M. - Well•••• I want to get you an ash try. That was on the machineo In a speech You g11Ve at a ••~ting of t be City Club in Rochester in January 23., 19601 you indicated that soon after you arrived in Roeh~ster 8 you became co_~~ nected informally with the development under Dr. Willia A. Sawyer of the medical service for the employees of the Eastman Kodak C'8pan,.y, and th~t t¥s service was ■ore than a routine establishment for industrial aedicine 1 ,As another illustration of the public-ainded nature of the people in.Rochester, this is a good example, I thought that perh&es you'd tell ae somethi~ of this deve102:1ent under Dr. sawzer. It stemmed really- fro■ the influence of Mro Eastman because Mr. Eastman early' set up two thjngs of unusual character at that tille for the benefit of bis eiaplo7ees. He gave them a share in the profits of the COlllpal'JY', and they would get sort of dividends on the incraase in the value of the product.a, and he had aver,. loyal group of soae ten thousand employ-ees out there at the plant. I don't think he ever had a strike. Tbat 1 s part of his social mindedness, so to speak, and at the same time, he set up on the advice possibly or Dro Goler, possibly of Dr. Roby', or Dr. Kaiser, a medical health service tor his employees. He had in charge of that aedical service a Dr. Sawyer whose first name I have forgotten. Willia Savz:er. Willia Sawyer was about 'lfY' age, and we had ■ar:\1 common interests in the in.fectiou that were prevalent, the respiratory- infections and whatnot among those people. They were cared for by Sawy-er in dispensaries and some home visits in the manner or, say, the British Health Service, or later dq health service for population.." of' people. They didn I t have to pay, and they-were watched very carefully- not only when they were sick, but in applications or preventive aedicine, in sanitation. The conditions under which they were working were carefully regulated so that their health wouldn't be damaged any more than was :maybe unavoidable in same cases, when the:,-vere exposed to either f'waes, or t.eaperatures, or conditions of confinement which I•u mention im~nute which were part of the process of manufacture• This was a very enlightened medical C service. It included also preventive, prophylatic deJitistry and was quite in " line with Mr. Eastman's ideas of a dental clinic, of doing things for groups of people. Mr. Eastman didn't seem to concern hillsel! directly with individuals. He was an aloof man, and bis philanthrop:,- was institutional, or adjusted to groups and populations rather than for individuals, but he understood that the individ- a ,; uals composed the groAps, and, of course, he cared for theJllo This was a broad... minded, social under!aking and very well done, I thought. When I mentioned confinement, Illl.s thinking at that mauent of the men and women llbo had to work all day long, or at least an eight hour day, in practically total darkness in rooms that were not noisy and rather oppressively quiet. I w,ed to think it was a sort ot solitary confinement, except that there were many people there. 11 m talking abou.t the rooms in which, for instance, all the sensitised photographic printing paper was made. They handle that in the opea to package it, but it was in roans dilllly lighted with deep red colored lamps. They managed that so that those people didn't become annoyed by their isolation and were not hurt by it in any way that I could see. I think Dre Sawyer used to remove them if he saw any-thing like claustrophobia, or the sense of isolation evertald.ng themo That was part of the work , and of course Eastaan pbotegraphic products involved the use of maD7 poisonous things like the silftr salts that they used in the eaulsions. At the same time out there at the Kodak plant a great many- people were developing the Eastman organic chemical production. They had an enormus laboratory for making and synthesizing organic chemicals, indeed, one of the aen, Dr. Hans Clark, who was in charge of that work for a while was the greatest erganic chemist in the countey,. He became Professor ot Organic & Chemistry at Columbia and later at Yale, so that it was a ve,r interesting :manufacturing plant full of experiaents in social undertakings alld a concern tor people. 1h1& is the first tiae you met Marion FolsOllo I suppese so. I don 1 t remember the first tiae I met Mr. Folsoao He was a Director ot the Eastman Kodak Coapa"1', not a truatee of Rochester University at 1 that time, I don't think. I got to like Mr. Y.arion Folsom from. the sta~. He a very quiet and reserved. Although born in Georgia he vu rather a Mew Englander type. He was absolutely forthright and thoughtful, didn't say auch, but what be said meant a great deal. I knew Mr. Folaoa in bis office. I didn't haYe any social, or personal contact with him to speak of at that ti.Ile. As a matter or fact, even when he waa Secretary of Health, Education, and Welfare in Washington, I never sav hi1'll outside of the office. For soae reasoa, or other I don't know, he rather lived a secluded life both in Rochester and here. This was again another exaaple_o~_what forward think;ing men would do in that - town. 2$6 teso Symptomatic of tb.e placeo Yes, this was cbaracteristie of it. Wella so 1uch or what a school is and becoaes is related to the 111&1.l who heads it up, He gives it saaehw1 or in some way an ataospbere1 a tone, and this 9ri9s us to the President, Dr. Rush Rhees. I don 1t know how you want to talk about hillo He was the leader here 1 a somewhat older man than those in this grouE,, but with a lar19 exeerience. The book you let me read CJohn R. Slater, Rhees of Rochester (llew York, 1946) 30!!,7 is a good one in the sense that it explores the essence of a man without coaing to a conelusioa1 and so anz illwnina­ tion you can give about llil1l would be helpf\11 becaw,e aft.er all, he did largeg set the tone. I think tb.at 1 a the way to express it. Dr. Bhees was ene of th• wisest educational adainistraters that I ever met. He 1d been president of the University of Rochester for perhaps fifteen, or twenty ;rears when this school began, and he had liberalised a rather narrow institution. Rochester was founded, I think, in about 16501 and the UniTersity had salle rather restrictive Methodist type of influence on it. Dr• Rhees had auch broader experiences and uplifted the place and liberalized it. In addition, he had very- close association with Mr. George Eastman. H+as proud ot the Eastman Kodak Com.paa;y and was no doubt in­ nuenced by' Mr. Eastman's large ideas. Typically, like a good maDi)" in Rochester, be wu devoted to his city and the best things, alld when you spoke of his being a leader in the medical schoolts develoi:aent, yeu used the expression •set the toneu which I think is a very good one. 2$7 Dr. Rhees did not pretend to know anything specifically scientific about medicine, or pathology, as I recall it. He could talk with you about what- 7ou. wanted to do and bow you were going to teach, the philosophical aspects or it, but he didn't bother at the start to have au.ch to sq about the actual effects of actions that were done. However, he was responsible for taking fire at the idea suggested perhaps by Mr. Eastman and perhaps by hiase1t-I don•t reall7 know the origin of the project tor the school, but Dr. Rhees took the leader­ ship, had the first dealing with Mr. Abrab.aa Flexner and was a sharp bargainer because he got out of Abraham Flexner and the Rockefeller Foundation a million or so more than Mr. Flexner intended to give. Mr. Eastman wanted his money matched also, se that they had a pretty strong line up against any withholding. They bad to overcame parochialism in medical educational ideas at the time. There was a medical school at Buffalo, one at Syracuse, and all the great \ ..dical centers at New York, and why on eart~start another medical school in Rochester in the middle of that? Cornell had a medical school with a caap11s in New York, two hundred or more ffliles aw,q frcn the c&.11pus in Ithaca. '"' was T~1e a point that Dr. Rhees, Mro Eastanan, and even the rest or us had to examine, and either accept, or oppose 0 I wondered~self•-~ put another medical school up in that. place where there was no particular outstanding clinical facilities? It was not a medical center. It had a population which looked to us at first so well paid from their employment that there would net be occasion for a great deal or indigent patronage ot the hospital and school. Indigent patronage is a verr important thing for material, if' I may use a crude tena, 0 from which young aedical students and young ~tors are trained. I don't mean an;y careless, looee experimentation but until later, as it was at New York, it A w'5 not possible to examine the pay patient, so to speak, in the presence of 258 / groups of people as you could exaaine the indigent. Rochester looked to some ot us as a place where there wouldn't be the usual amount of opportunity for seeing disease among people who could be studied very thorougbl;y without. any objection on their part. Dr. Rhees settled hat to his own satiBfaction. He must have been very persuasi'Ye because he persuaded Dr. Whipple to come on as Dean at a tille when Dr., Whipple was well set at~he University of California as a Dean am as the head or the Hooper Fourdation and didn I t want to touch this Rochester j c,b at firs\. Dr. Rhees went out there and detel"lllined to stay until he succeeded in persuading Dr 0 Whipple to come to Recbester as Dean, and in persuading him he gave him life tenure in the job, so to speak1 and imperial power over his faculty and school that tew deans have enjoyed. Dr. Whipple exercised that power in a Tery thoughtful, but undoubtedly f'ira manner. Dr. Rhees was very close to the school. He had a part in the building plans. He sanctioned what was pleasing to Mr. East.man as it was to the parsimonious New Hampshire product- where was Whipple troa? Veraont or New Hampshire? New Hampshire• New Hampshire product that Dr. Whipple waa in approving the plans of the \l building, the style of the b~ilding and all of which it was made1 so that it turned out to be a stru.cture that we called "early penitentiary style• of architecture. It was very bare. The.re was hardly any plaster anywhere intit, but sanded brick walls inside• Ther~ bare cement noors which were finally oiled with linseed oil. All the money was spent 011 equipnent and rooa to work in which was wise, but aesthetics were not respected especially. Mr. Eastman lik;that. The rest of us thought it was a little bit erade at first, but you I\ 259 1 I ,f s0011 appr,ciate the ad)\antages you have .f'rom working in a pl,ace where there was really money :tor the work. Well, Dr 0 Rhees kept in touch nth all ot that. We used to talk With him about plans, f'loor plans even-not in relation to the scientific work going on i n - • but in rolation to living •+rld.ng in the quart.ens• Then Dre Rhees was the presiding officer most of the time at the !acult7 meetings. The f'acult7 waa called "The AdTisory- Board" which is a tera which I think Dr. Whipple gave 1t1 instead or giving it a more executive type of title. We got along very well in the Advisory Board, talked about the plans of the place., the educational outlook and the indep:i ndent projects that we were going to uniertake. I think that most of us knew more medical schools than ve had come from. All of us had been to scientific meetings. I don't recall that we ever vent ar•und the countcy looking at other medical schools to see what could be done 4 We knew enough, and ve kne+ore or less what we wanted to try to d•• Dr. Rhees encouraged the individual expressions of the members of this Advisor7 Board. He was a man or great tact., and I remember-well, I think the best eXUtple of his tactfulness caae up about the second -year of our progress in the school. We all had budgets tor our departments. I think 111.ne was about twent7 thousand dolla.rs a 7ear. Some were more 1 but Dr. Whipple didn•t let the heads of the departments spend that budgeted money- without bis approval. We used to have to go down to bis office and talk to his secret&1'7 about our wish to bu71 we'll sa71 a hundred test tubes. Every little amount had to be passed on by the Dean 1's 0:f':f'ice0 It got so tightly controlled that several members of the facult7 including myselt used to meet on the enclosed fire stairs and talk these things over. We worked ourselves almost to a revolutionary pitcho We said that it- 260 couldntt have our budgets, the school couldnlt have the Dean almost. So we were going " have a show down faculty meeting in front of Dr• Whipple and Dr. Rhee•• Dr. Rhees had talked to Ille and others about ito He knew what was afoot, so that day he said, "Now, gentlemen, we are met to see whether we can devise some plan by which the Deants Office can be relieved of a great dealf of administrative work in dealing with the purchase of supplies, animals, and things like that for the di!feren\ departa.ents. H-.ve you any suggestions?•: r:, SomebAdy said immediatel;r1 "Yes, give us control of our budgets.• Dr. Whipple probably knew that he had to give way too. Dr 0 Rhees said, "That 1 s a very interesting idea. Let's see if it's acceptable to the Dean." " He asked him, and so we got our budgets through that business, but we were ready to blow the place up almost. Dr Rhees did a hundred things like that. Hel&s a very approachable man-not exactly jocular, or familiar, but dignified. ~•. knew what was. going or, Yes, he knew what was going on in the school. He knew what was going en in the politics of the town. He knew what was going on in the field of edncatien in the coun.tey. He was, I think, a very wise man. Thatts a very nice __!nnecdote-I was goi!J, to saz shrewd_, but that was ~he mar; to get the bes.t ,out of. a grou2,o Yes, his tiJRing was good. I don't know that aey of us pufhiwl wise to it, but he knew something was brewing 0 Well, another ld.ai of thing that he and Whipple and the rest of theJn did is illustrated by a very- small point 0 There were firm and rigid, convincing opinions on large matters of education, ,telll say, or of activities of one kind 261 or another, but not too much concern with the smaller :matters. Dr 0 Whipple was quite willing to watch things and take actions according to the wq they were turning out ot their ow+ccord. An example of this, and Itve always thought. a good one, waa when that place was built there were grass plots between big wings ot the building and ara~nd the wings and the corners. A natural desire of a e builder would be to go and lay pavnt mt walks by soae arbitrary scheae right " away, out Dr. Whipple didn't put down those walks right away. He let it ga te see which. paths would be stcnped down by students and others, and then he laid a walk there. That's a good way- to doe That went on through the school a good deal in our relations with the students and others. Instead of trying to force them to do something that would haw been silly, it was so much more interesting and permanent to let them have some e :xpressien and then build en that. What role 1 if' arv:,. did Dr 1 Rhees Pl& in the _2evelopur1t of the Departaent of Bacteriology;? Dr. Rhees was bappy to have the Health Bureau Laboratory work done there 0 He could ha'Ye aade that more difficult by saying that one of' his professors ought not to give half er ure of his tiae to the serVice of the City because Dr. Rhees waa like & good m.a.117 other universit7 officials whe veey wisely sq that ordinary service, either in the care of patients, or in the laboratory services, is not a tunctien of the universit7, not a predominant function, but he didn't oppose at all the developments that went •n in the Department of Bacteriology with the Health Bureau Laborator7. 262 He was interested in the sides of bacteriology that had to do with people rather than il'l the biology er bacteria. I used to make vaccines to tey to pre• irent Dr. Rhees and Mr. Eastman trom having colds; make swabs ot their throati,, grow the organisms a+ke a vaccine out or'r1t• Dr. Rhees was iatereated in the human applications ot the subject. He was interested in the q#-ty ot the work er the students, and we discussed the progress the classes were aakiag at ti.Iles. He was net a man who was just impressed by ABCD marks. He was after intellectual content. It was a very hapP)"., pleasant., easy relation. On the S!b~ect or colds 1 I have an ,t!,XChay• ot . correspondence you had wi\h . Dr, Rhees about a chlorine aeplicater1 a Mr. Turner 1 I believe. Turner? You used this aeparatus in the laboratorz f~r the treataent of dogs.s~fferins ~th distemper, a saall group of puppies. There was in existence this aeea~ust and there wa~ the question of what to do about it1 but in writiDj to zou Dr. Rhees asked ou te investi ate Dr R S Diehl an at the University o_f Minnesota on the stud.!,Dt ood.y: with reference to cold.so Wallace and Tiernan were the manllf'acturers or chlorinating apparatus for the water BllPPlY' by which they put anhy"dreus chlorine gas into the water and had now meters and controls. There was a phase--some tille iD the middle ,-. 1920s, I think-or preventing respiratory intections by the inh.alJation __, of chlorine gas. Dr. Diehl was the Dean of the University- of Minneseta Medical School at Minneapolis. I don't knew whether he published, but be was the one who a eemed to give a. boost to the subject.. Then there were some extraordinary i' \ claims for it-a miJtculou cure of colds, so much so that Mr. Eastman became I 263 ' interested and so did Dr. Rhees. I tr•ed it out on those dogs with distemper. Distemper is now known to be a virus disease with a secondary bacterial in­ fection, and I don't think that apparatus did those dogs any good.o They got an apparatus to try on Mr. Eastman, but I don't know that• ever went that rar. What you were to do was to put your head in a sack and breathe chlorine, but I don't think that I had to go through that 0 It didn 1 t last very long. I was never convinced of ito ~ Your letter was to that effect, that you were not co~i'9\ed. Diehl did publish an article 111 the AMA Journal. You reviewed that article and sent Dr. Rhees a COP;[ of it. Mz reason for bringing it up was to find out from you soaething of !!i;s scientific interests, and this episode would disclose interest. He had scientific interests, but this~as a popular thing. Mr. Eastman was interested, and Wallace and Tiernan were a Rochester firm, and they were exploiting it. A number ot things that people want to exploit have bacterio• logical elements in them• and the problem in the laboratory- is not just to be d•i~ service work all the time for manufacturers. For instance, the Castle Ccapany would like endless experiments on sterilization pressures and tempera­ tures, soae or which I did. Eastman Kodak Company every now and then got bold D of a compound thatllB.s clai.Jled to have strAng bacteriacid.al properties, and I made some tests for them. An anQlogy is the Chief of Police-they all want help on something, and you scatter yourself to pieces on it, but Dr. Rhees in this case, was, as I recall, not interested in it from a scientific view point, but from the public hurrah about it. It was a situation in a Id.nor way like 264 this krebiozen cancer cure that has been raising the devil with people the last tew 7eara. Even Tierna.n in his letter, and Dr. Rhees quotes his lflltter to yeu1 said to Dre Rhees,"I would auch rather have the truth about the treatment and there.fore got be led int• undue expense and waste of time in pursuing a matter vbicb did not hold ~ut any prc:aisea" Se Dr. Rhees wanted your jug.gment t~ e9lere the Minnesota experience which you dida so that he waa interesteq enough te cliab on toe or that article and ask yotll' judgment about it1 to be in a position to be more helpful to Mr. Tiernan. I gather that was what the correspondence was about. Qt, does show interest. I asked about the role he played in the develop­ ment of the Department of Bacteriology;. There are some-I don't know exactly. Well 1 let me sg: that these things are ripped out of context. They al,l happened at ~he s~• time, and dealing with the• individu.allz is wholly unreal_, but in 1929a there is an offer to you from Chicage1 and it has certain con. sequences in the development ot tm departme'!t• Shook the tre•• Didn 1 t it§ Well 1 let 1 s go to Chicag• because this will bait1 in part, Rhees• response. De you remember this? Yes. I think in 1928, I was invi t.ed to be a rtsitiog protesser at Chicago. Was11't it 1928? Either the invitation was in the 8J2ri3 of 19291 or the tall of 1928--I•m not - sure. It was a sUIUller semester at Chicageo 26.$ It mu.st have been 1929!- Yes. This is ito The correspondence begins in October or 1922• Yes, it was the SUJllller of 19291 that I was a 'Yi.siting pref••••r at the University of Cbicage0 I went out there, lived near the utdversity, and lectured on basic, notHRedical bacteriology. I ran the class. It wasn't aedical bacteriolegy, but general bacteriology-, bacteriology or soil1 111t_., ataosphere, and metabolism of bacteria, variations, all the basic scientific side or bacteria without particular relation to pathogenic action. I carried that on 0 all that SUJ111er and returned to R~chester at the elld of that sumer in 1929. As a side issue before I forget this-I would like to put in here scaetbing abo11t another activity I had out there. I had been working i+y own laboratory in Rochester on the heat production by bacteria. I built a differential aicro­ ealorimeter, a very sensitive thing. I got it so I could measure heat, I think, from one microorganism, and I published a paper on that heat produ.ction by bacteria, ["Bacterial Calori.lletry II Relation of Heat Production to Phases of Growth of Bacteria" 17 Journal o! Bacteriology 123-140 (Februa17,1929l7. I did the experiaent in the course of a day, we 111 say, and then I made an • • pirical equation and extrapolated to what the expected result would be in torty...eight hours and so forth. Then I did experi.Ja.ents at these tiJnea"fi and 1 they came out very close to the expected result from calculations, and so I wrote the paper. A man replied in the Journal of Bacteriology and said that I was all wrong, {ji. c. Wetzel,"A Note on the Application of Buchanan's Formula to Heat Production in Bacterial Cultures" 18 Journal of Bacteriology ll7 (192927. The 266 way he explained my error was to have his paper be composed of about three pages of integral equations. Well, I ha+ad a little calculus, but I•ve already ex­ plained that I cannot understand profound mathematics, so on the side at Chicago I used to study mathematics from Friday evening until the next Monday morning, like old King David, looked up in my apartment-I had a little two room. apartment..-trying to get enough mathematics to understand what this man 0 had said about my being wr~ng. I had made the mistake-I got an instructcr in ma.thematics trom a section A that was dealing with imagi~ry kinds of things. They would give the equation tor a circle, say that it represented a square, and go on frcm there. This mathematics instructor couldn't see what I wanted exactly. I think maybe mathe" maticians now do it better. I wanted him to tell me how to take experimental data and put it into equations. How to handle that sort of thing was the problelllt but he gave me a great deal of work to doo The thing that broke me down was that he gave me-I remember this problem. "At half past four in the after­ noon when the sun is thirty-rive degrees above the horizon, yoa throw a baseball into the air at two hundred feet a second"-that•a too fast, but take that-"and the shadow ef the baseball falls on the hemispherical dome of a nearby observa­ tory-. Plot the path ot the shadow when the ball has fallen for one half second. Plot the path of the shadow and the rate of the progress of the shadow across this hemispherical surface." That didn 1 t help me 9 lsntt it? That was no compliment to me that he did that 0 It was ridi­ culing me. This mathematician that I bad could solve that problem in a few 267 Jlloments because au{the verbiage covers up a fn well known phy'sioal equations that he bas. He knew just what to apply,. I didn't get te ever understand the paper that said I was wreng. I kept on working en that subject. Dr. Whipple didn 1 t interfere• but I 111 sure very often he would wonder, and so did som.e of my f"riends, why I would be interested in heat production b;r cultures. Well, it I s a fundamental thing. Curiousl;r it turned out to be of interest in other wars. Another professor in ,~ the Roches~~ group was studying the heat generated by illlpulses in the nerve. C. l Take a siatic nerve out of" an animal, use very delicate measurements and see \ what heat. is produced, and then ;you get sODle idea or the enera involved. He was not a bacteriologist, and he didn't take any care to keep his preparations sterile, so I showed him that all he was measuring was the heat produced by the e contaminating organiPtS that were growing en the surface or the nerve. Baf{teri• ology entered into a whole lot or things like that. Well, 11 11 at Chicage 0 I finishflid the coursef and 1 •m back in Rochester. 1 I hadn't been there veey long before President Robert M0 Hutchins who used to be the Secretary of Yale University, a very vivid sort ot a person, invited me to come back to Chicago to see hill. and Mr. Benton, I think, who was the Vice Chan... cellor, to talk about a possible positien in bacteriology. So when I weu to Chicago, I went to see Chancellor Hutchins and Mr. Frederic Woodward. In the course or a few hours they offered me the Professorsbip of Bacteriology because Professor E. o. Jordan was about to reach the age of retirement. Well, I knew a good many- of the younger men in Dr 0 Jerdan 1 s department like r. So Falk and rq triern L. o. Taliaterre, who was the head of parasitology-, and others. The;r assured ae that they would welcome me if I came there as Professor of Bacteri" ology, and I was on the point of saying ;res, that I would be honored-well, I 268 was honored anyhow-and that I would be pleased to have them consider me for appointment by submitting my name to their trustees. About five o'clock-Ir emember now-•I went to see Dr. Jordan again in his backrooa in the Rickette Laborator.y. We ralked in a friendly manner because Dre Jordan, a most respected man, had taught me bacteriology way back when I I' was getting r ~ to go to Hopkins. He had written a famous textbook, and he was known the world over for his work on the preservation of food products­ particularly meats, and in the course of the talk, he suddenl.7 said that he wanted me to know that the authorities ot the University or Chicago wanted to keep him on as the titular head of the departaent, even though he 1d have another professor with all the responsibilities "because", he said,"of my extensive and great infiuence with the rood packing industry." 0 He was a great consultant for Armour, Libby, and a whf\le lot of others who had had problems in sterilizing hams, saussages and canned stuff of all kinds. Well, I knew right away that that wouldn't be well for him or for me. I was very respectful and fond of Dr. Jordan, but I could see only- treuble in an arrangement like that whe~e men of my--I won't say aggress1Te1 but pressing qualities, would get to work under his superior status and have the responsibility for the teaching and runniD& of the departaent. That would be a ver.y unpleasant thing for both of use '-:here's one thing that you_ might clarity. This offer wasn't in cennection with ·- a medical school. No. It was the University Department or Bacteriology, but itas near the Chicago University Medical School. They're all out there in a cluster, and there are subsidiary laberatories in the hospital, and medical students were taught 269 some of it in Jordan's department. The whole parasitology was there too. As a 11&tter of fact, the laboratory in which Dr• Jordan's laboratory d.epartaent was housed was the Ricketts Laboratory. That's named after Dr. Heward Tayler s Ricketts who discovered the minute microorganism that causes typh'¥\ fever. The I e. aioroorgan:isms got to be named after hill. That~s wb1fe the tera "rickettsia" ccaes in. Well1 as you saw it at the time would this have afforded you greater oeeortunitz for your own research? Yes, I would be head of a bigger department. I wonld have a much bigger budget. I would have a different position in the acadeaic world, so to speak, bT being the head of a famous well supported department in a famous university that was far older than the few years of Rochester. I was very tempted to do it until this caae up. The offer to me, I forget the amount, but it was con• siderabl.7 greater-I think I was getting eight thousand dollars a year from Rochester, and this would have given ae a great deal more. I came back and told Dr• Whipple and Dr• Rhees about it. lfot much was said, but they were glad that I did not take it. As I said, i+hoek the tree in two ways. I needed additional stat.t members notably a protozoologist and parasitologist, and I asked for Dr. OliTer R. McCoy. I got him right away with a good salary, equipment and everything, but the thing that amazed me, snd I found out without asking tor it, is that 111' sal&l'7 was increased. I round that out by neticing first that my bank book wouldn't balance. There was more money in the bank than I could account for. I didn't say an;ything about it because I know I•m not good at arithmetic. I thought that I would wait another month. The next month the balance was even 270 larger. The bank had accumulated this excess. What they'd done at the school was increase JfC';f salary without telling me-that is, the university paid it into ay bank acceunt. They also offered you an assistaat to take q_are of the Health Bureau activities-­ Dr• Kennectz• Kenne~ was a pupil of Zinaser. The tworsitions I wanted, I gaess, were the parasitologist and the assistant in the Health Bureau and in teachingo Jim Kennedy was enoraously helpfal• ... Then there was-well1 f'• looking at a aeaorandwa concerning the proEosal made to you by the University of Chicago, and this is on University of Rochester stationerz1 their effor~s too••• What part of Rochester? This is titled Intramural Correspondence. Apparently zou went back and talked t• President Rhees. Is that ay memorandum? No. I think this was sent to f!Ut It sqs at the bottca1 "This statemen~ to be r~viewed gy President Rhees." There are three items listed and one of them is a fellowship fund which will pull you into greater contact with the ~niversitz ot Rochester. Earlier when I asked about Dr. Rhees uestion with ou in 1928 about curriculua chan es for the under about studies in biolos,1 and in 19301 this matter comes to a head 0 I gave courses in bacteriology to the undergraduat.s at the University. 271 Right. But you set up a_'Whole separate section under Ralph P. Titsler. Yes, Titsler is in the Department o:r Agriculture here in Washington now. He was their bacteriologist. This proposal from. Chicago ude this particular idea jell plus these ether two. Another person w1 th whom yeu bad to deal directly1 and this may bring us t• th~ people in this photogra_eh with greater earticularitz1 was the Dean.a Dean Whieele. You've indi~ted something about the Dean. He bargained pretty bard vitb President Rhees to shield himself from unnecessa intrusions · ivic functions. He actually said that he would have little to do with them, and President Rhees sa1d,"We 1l l let the public relations ot the University take care of it." I wondered in choosing a gr~~or young people-and he was a young fellow him• selt--this tacult that sat in on the rowth and develo ent of th dical school, the hospitals, the relationships between the ••~cal school a_!!d th~ various hospitals which were there. This is worth a word. They 1 ve bad SOJI! continuity in your own life,. I•m thinking of so■e in particular who may not be important, I don't know, but in surgery...John Morton. I John Morton is still up there. Hes e an extraordinarily good surgeon. In the infiuences on the establishment of the school, the influence of Jehns Hopkins was possibly the predominant one. 'l'hey used to sa:y that we were starting up another little Johns Hopkins there because Whipple and I, George w. Corner­ was Morton Hopkins? I think so. l< Yes, and Karl Mo Wilson in obstetrics were all from Hopkins, but we didn't 272 consciously imitate the Johns Hopkins. It was bred in us by that time, and you didn't ha•e to think about it. It was like walking. Dr. Whipple was the leader or the administration or the school. There wasn't any question of that, but there was quite a good deal of independence in the heads of departments• We e. used to work together a good deal. There was perf',\ctly wonderful teaching you could d8 in the beginning with a group like this. In a small class and with time, I can remember things like this-I had opportunities that I never had aay­ where else. In taking the subject of diphtheria-I believe it's in the second 79ar-I could take the students to see a case, a child with diphtheria and a aembrane in the throat. We could study that bacteriologically and stu~ diphtheria toxin which causes certain kinds of paralysis. There were people in that hospital who had post diphtheritic paralysis er the uvula, the swQ].lowing apparatus, and some other things. At the same time there was a death from diphtheria, and Dr. Whipple did the autopsy, so right there in the place there was unequalled opportunity because we were all working together and had common interests in subjects, presentation, and students to take everything frCllll the bacteriology te the final anatomical autopsy in diphtheria. The same thing was done in tuberculosis. Right near the hospital there was the Monroe County Tuberculosis Sani.tar111Dl or Institution. There was a good deal of tuberculosis aong people in the dispensary, people who were sick with various formsr1>f tuberculosis, and there were the autopsies of tubercalosis. We could take tuberculosis from prevention ef tuberculosis right on through to the final obsequy. That didn't happen after a while. The place got too big1 classes got too big, work in departments too big. Everybody was too much occupied, although we never lost fellowship among the faculty. The only difficulty I ever had was With 27.3 one of the professers who was at Rochester before we Calle in, Professor John R. Murlin, who is a biochemist, not a medical m.an, a nutritionist. Dr. Walter R. Bloor was a great biochemist that they brought in, and he took a position that perhaps Dr. Murlin wanted to have. Dro Murlin came from a different origin than the rest of us and had different points of view. There was areurrl him at that nutrition department sort of a fence, dirt,erence of news and difference of behavior. How did they react to the general title of the school-Schoel of Medicine and Dentistry? That was a compromise, but veey interestingly managed by Dr• Whipple. " Dentistey was put in the title ob~ously because of Mr. Eastman's long interest in dentistey. It caused a separation in the faculty until we saw that they weren't going tQ run a dental school eut there, a fact which made a more sharp difference with Mr. Eastman's great pbilanthropical, dental adviser, the man who ran the Eastaan Dental Clinic, Dr. Harvey J. Burkhart. Dr. Whipplets idea was that the medical school would take a few highly qualified dentists and let them work for M.D.s, or even let a man work for a Ph.D. in the dental field, even though he wasn't a dentist. At Yale later there was such a scheme, and sometimes we tried it at Rochester by which a dentist would go back into say the second year ot the medical school and work for an M.D., so that he could be a dentist and an M.D. There was never even any effort made at Rechester to set up a school of practicing dentistry with chairs, drills and fillings. That disturbed Dr. Burkhart, ante never wu reconciled to it, but again this bacteri­ ological link which fits in with 1fl¥ hyphen, as I told you in the beginn1n.g1 let me be pretty close to Dr. Burkhart and the dental clinic. I had a little 274 aection •f a laboratory down there at the Eastman Dental Clinic. I taught dental hygienists, these women who scrape teeth, and I taugh~ aae of the dental 1rijerns that were there. I used to make a great man;y cultures and things, and I got en very well with them. Dr. Philip Jaz. Jay came to work with • • He was a dentist from Detreit 1 and he did very good work on what's called Bacillus acidophilus which is an organism that gets into the cracks in your teeth and produces an acid from sugars and things and was supposed to have caused dental caries. Philip Jay worked with ae1 and I had other people in the laboratory who were interested in various sides of dentistry, but Whipple's wisdom in setting up this dental fellowship prograa and the post graduate work was enormously successful. I think I gave 7ou a book en the careers or these people who have~een there o They have becoa• deans et dental schools, leaders in dental education, and they represent a great con­ tribution to both medicine and dentistryo So far as students in the school, the Nquir•enta for entrance were so hi&!¼ that dental students in these earl s after the school was o n. I don't blame thea because there ~~~~';; C any etrerings in dentistry ill the 0 school. !hey would have had to go thr~ as medical students straight. The requirements were fairly high, s.nd one or the best requiraents was the required interviews with all the applicants. At least three of us would interview every applicant. So far as developments in the Deertment •f Bacteriologz-as work increased, provisi•• for an assistant to do the autopsy bacteriology was made quite early...... 27S 1927-Dr1 William L. Bradford. De you rem.ember that? Bradford was attached to the laboratory1 and he worked in autOP81' bacteri­ ology tor a while. Arter that, he began to be the 11&in usiatant to Dre Samuel w. Clausen in pediatrics, and he finally became Pro teaser in Pediatric•• That was another phase or collaborative work that I was able to help a little bite In one ef these wings toward the end of the late 1920e and early 1930.1 I was able te provide a separate laboratoey room-one for aedicine, ene fer svgery1 and one for pediatrics,. Theyw,re all tofether. We were all together, and th• Health Bureau Laboratory was around there, so tha"f it got to be quite a varied and interesting place. Bradford was working on rheUJ11atic fever at tilaes and. endocarditis, curious organisms, but the good thing was to have all the people interested in bacteriology oa the same nocr. You couldn't walk around without meeting another bacteriologist and that extended also to radiology- with the physical side-Dr. Warren. Dr. Stafford Warren. Yes, he later became Dean of the University of California Medical Scheol at Los Angeles and aedical director of the At•mi• Energy- CmranissioD during the building of the bomb. At Rochester he was interested in the heat treatment of gonococcal infections. The idea was that if' they knew what teaperature would kill the gonococcus and artifically by electrical shortlll.ves, probably raise the temperature of the body t• an abnormal fever, the idea was that you would kill the gonococcus in that way. The same thing was used fer syphilis infecticnso That required bacteriological backing, so I developed a relation with the radiology- department in that way-. They had a person who became quite distinguished in that line-in the study of the gonococcus. I think his name was Carpenter. 276 c, M1 Carpenter, isn't it? But as the work increased this provision for assistantships allowed the Department of Bacteriology to have contact with and so on which was ood• You didn't run into a difficulties in establishing the assistantships? Ne1 the salaries weren1 t very bigh1 and the place was attractive. There were lets of other benefits fra the life there, the character of the youn~ C.) faculty that attracted people 0 I don't recall aey-body declining anything. No 1 Y,2u had a succession of peoele ~o really have gone on-Dr 1 John., § 0 Cunningl:!,am, Dr. Ricilard P. Howard, Dr. Donald s._Ma.rti!!,t These were assistants for a year in J!!.,tOJ?SY bac_tel~_ologz. They've a.ll had interesting careers. When the_z se~ u,2 th;e D!_ntal Research _Fello1!,sh~~--o.,gr_am _ __wa_s_tha __t_a_t_t__a_ch;;..e_d_t.•_t_h_e D.eE&.~~~nt of .B~cteriol•Q:? Noo Basil B. Bibby-did he come in? Yes, Basil Bibby is still highly infiuential ia the dental educational field. I think Bibby was attached--well, that was centered in Dr. Bloor 1 s de­ partment, biocheJ11.istry. That didn't matter. No, eocce:e_t that there are publications of pagers _by Dz:._ -~ilip J &• Jay was on my statf, and Bibby worked with me too 0 He did a good deal of bacteriology. He was an Australian. 277 Yes. What was the bllt'geoning interest in parasitology thai· you had? That was a life-long interest with me. I told you about my grandfather and the malarial parasites. I had seen worms and parasites in my earlier days in 0 New Orleans, and I was very much interested in then thr~ugh my medical course. I had t~e *lling experiences in parasitology clinically" in Panama when I was down there with Ueneral Gorgas, and it was a subject which at that time was not well developed in medical schools. I think that one had to do a good deal with parasites, protozoan parasites, but no formal provision had been made for it, and I didn't do it at first when I went to Rochester. After Chicago I saw the lack of it because I had a close association in Chicago with a great parasitolo­ gist, Taliaterre1 and it seemed very natural to have a department that I soon didn't call bacteriology an;,r more. I called it Microbiology. Thatts a term that has taken over a good deal. Now they have more Professors of Microbiology than they do of bacteriology, but that isn't broad enough. It is, in a way-1 but it embraces immunology also 0 They all ~o togethero Also having Dr. Oliver Rt McCoy set up continuing relationship with the Gorg~~ Laboratory in Panama. Yesa I don't know how long I've been a director of the Gorgas Memorial Institute, but it's been a long time• The Gorgas Memorial Institute it's called. I wasn 1 t a director of the laboratory, but the Gorgas Memorial Insti­ tute is a going concern still. I think McCoy was a consultant to the laborat~rz~ Yes 1 and McCoy then went over into the Rockefeller Foundation which had great interest in tropical medicine. Now, parasitology takes you into tropical medicine more rapidly than bacteriology does, because of malaria, tilariasis, and all the worms. The other day off the tape we talked about the Academy of Tropical Medicine, and this is en the way toward itL This is 1930& and its development is in 19341 so pz_ 19341 there is pressure foz:_,a group 1 and this is £artly due to interest and also possibly how to finance research in tropica~ medicin~• It's still the trouble right now. So far as the deeartment itself is concerned1 I asked you yest.erdaz, and I my have confused the issue about the .i::elationship between the Departaent ot Bacteriology and local physicians as to whether they possibly were illV'ited ii, We were talkil!l at the time about the Public Health Laboratories.,_ and I don't think that was possible, but does the name Dr. Paul Wo Beaven•••• Yes, Dr. Paul Beaven was a pediatrician in town, and he came to work there some ti.Ile. He and I published a pape1tegether en a peculiar acid fast organism that wasn't a tubercle bacillus, but it produced a sort of pneumeniafn an:iltals, u C9M7c0bacterium (Sp.?), Ryan Strain, Isolated from Pleural Ex~ate" 49 Journal of Infectious Diseases 399-419 (193127. It was in the sputWB of a child, and I don't think ~,ve ever found them. againo He used to come in and actually do work on animals and cultures, but with all friendliness, his lite at that time just showed how hard it would be for a practicing physician to do this work. He would come in, get everything out, start to work, the phone would ring, and be 1 d have to go. They didn't have any time for it 0 Some phy'sicians can do ito The Jllaft who could adjust lite to let his research go on without interference from anything is George Whipple. By George, I never saw anybod7~-maybe Albert 279 Sabin is the same kind, but Dr. Whipple laid it down at the start. that be wu going ahead with his work on the blood forming factors, the work that led to his getting a Nobel 1'5Jrze, though he never had that in his mind. in the beginning. All that work on pigments, hemoglobin, and blood formation went right on through with the most laberious quantitatiTe experiments with every little factor, and yet he had imagination in it too~ but it seemed to me just like grinding, grinding, grinding. He was not diverted. On the other hand, Dr. Whipple bad plenty of play in him. He knew how te enjoy some of the finest things in life, aside from his very interesting fnily. Do you want to talk about him? - Yes. Dr 9 Whipple managed to take helidays into the wild.a. He was a great I fisherman. He d go up fishing for salaon in Nova Scotia. Every year he'd go "" out in the West.. He was a great trout tishennan, and he 1 d fish in t.he trout streUlB in the West. In addition, he was a bunter better than Nilllrod and being a paraim.oniou.s persoa, he made every pellet in his shot gun count. He never missed. Hetd kill all the clay pigeons, and he never missed a bird~ He formed a hunt club of Morton, my-self, Williaa s. McCann, and Warren. Dr. Whipple and Skff Warren, men about the same size, over six feet, never could miss anything. They could shoot pheasants and shoot do~bles, hit one going North and turn u around and hit another one going So~th. I bad the privilege of hunting with these people, I think, largely because th+aw allowed three birds per person., and it they bad somebody in the crowd who couldn't hit a bird, those three birds would be divided. That would let Warran and Whipple kill a bird and a half' more. Did you see among my medals the medal they gave me? They gave me a brass medal at the end for faithful attendance and ability in finding game, and this e. medal is stenciled with the ~tters Dr. Whipple used for his anemia d~gs. , Well, we also had a little poker club which met once a week. We d play ~ for small stakes ard drink a little beer which was very pleasant. Whipple enjoyed those things. He was a great photographer. He had an enormous collec­ tion of pictures. He was always snapping something, and although he seemed austere and strict in his admi.nistratiYe things, he was quite a natural human being. I!,• yeu rem•ber Ler& Garnsey? Yeu had exclusive right to hunt on his ;eatch of ground near Cayuga Lake about ten Dli};,es from Seneca Falls. It was apparentlz :hro~h Garnsey. IncideJ?-tally you wrote a marvelous letter about this. May I read it? 0 The arduous sho~ting day■ are upon us, and I am stift and sore from walking all da7 in snow and rain carrying a shot gun which never hits anything. Wege pheasant hunting on four days of each 7ear, the last two Thursda7s in October and the first two Saturdays in Noveabero One forced march is therefore, still ahead of me. I like it i~pite or the J)a:in that comes from unaccustomed walking from aaylight to ~unset, and i~pite of the po•r showing I make. At least I think I like it, though my hunting instinct is better developed for bugs than for birds• Who is that to-Marian? Yea 1 your sister. I Well, those were strenueus da7s. Wed get up before daybreak, drive about ... thirt7 miles and tramp around in the wet all da.7, and as I say, they put me down in the bushes to scare up the bird.so Then you'd get home in the evening and you could hardly move. one 281 along--Frank Lovejoy. Mr 0 Lovejoy was a director of Kodak, but I never saw auch of bia0 In the hunt club? I don't think so, but my bacteriology came to the fore in that connection tooo It was prohibitien in those times, and years before I had started to collect yeast. I pushed it along a little further then. I thought it Jlight have aoae practical benefit. I collected all the beer yeast of the world­ L6venbrau, Pabst--all the yeast, so I became the faculty brewer, and in the basement of my heuse I brewed beer in forty gallon kegs and made win.e. I dis• covered t~at there was aore to beer than just the teraentation. It never got high alcoholic content, but it was easy to make. I got on a side issue to stQdy hops, and people don't realize what hops are. Hops contain golden y-ellow, resineua, little globules in among the dried flowers. They contain an alkaloid called lupulin, and lupulin belongs in the aorphine family. I didn't. know that, but I thought that this gave the beer a naver. I went and got the hops, and just picked hops that had the most of these gold.en droplets in the■• I remember the first brew that I had or that. At our little poker part1, it put ,,- everybody to sleep, particularly Nathaniel w. Faµono ....., He went first.• Itia surprised that the brewing industry doesn't make more o! that. Back in the Department there were fellows. There were the Fleischman fellowa.....Uarold w. Pierce and Dr. Sara E. Branh~• This is a relationship that goes outside the Universit(l These fellowships were not settled in my department, but those people worked there. Pierce was a biocheai.st very much interested in the intestinal flora, 282 particularly the bacterial nora of the large intestine. It was the smelliest piece of work that ever came into the laboratory. Poor Harold Pierce developed an extreme degree or arthritis, but he got his degree doing that., and his degree was largely based on a bacteriological study or the i~stinal contents. He be• CSffl.8 a professor at Vermont. 0 Sara Branham was in the department fA_r a while as a visitor, I think1 and she was interested in the meidngococcus. She became a great authority on the meningococcus and went from Rochester down here to the laboratories of the National Institute of Health where she stayed until she died, still working on the meningococcus. I indicated that these were F1eisehman Fellowsa ~nd you indicated that that was some relationship that sprang up between the medical school. I think this was a gran~. I don 1 t remember that it even had that name attached• Well 1 there was an A.M,A. Fellow-Dr. Georges Knaysi. Well, Georges Knaysi was really in the Department of Agricultural Bacteri• ology at Cornell, and his son is still an eminent person down there, but he was very interested, and convinced me that a bacterium had a nucleus. It was not supposed to, 'because it was so small that you couldn't see it. Now, with the electren microscope they see the nucleus of the bacterium. Knaysi was not very close to us. It seems to me that he was a commuter. His real place or work was Cornell 0 revision.was made for him in the labors.to riod of time. 283 Maybe he was on part sabbatical-wanted to pick up some other information. I think s•• In anz event, these people at one tiae3 nr another were at work in the laboratory. Then there were a series of Rockefeller Fellows who came1 I guess, under their international pro&ram-Dr. Istvan Bezi from Budapest. Dr, Altredo Reda fr01t the University of Fhilippinea. Yes, he worked on the cholera organism. Dr 1 Armand Frappier f'roa Montreal and Dr• Masao Nishi• from Tokyo. Nishio was a good friend, a rather polite mano We invited hill to dinner ene night at cur house. He was a bit late, and I found out arterwarda that he had torgetten about it, had eaten a full dinner out at the Streng Memorial Hospital and then hurriedly came in and ate another dinner with us without letting on. strange. A very polite Japanese 0 I gather initiallz that Mr. Flexner•s notion was to build a new beacoa for a new conce~ in medicine by the Universiti of Rochester School ct' Medicine and Dentistry-you know, there were no vested interests in the waz, and you coul_£ shape it trom the beginning. Then I guess their international pregram--ma.yb• Alan Gregg. 284 No, Gregg was just head of the medical section in the Reckefeller Foundation. Russell might have been th9 head of ito F1 F. Russell. In any event, you had a succession of these who came into the laboratory. Then there was~ se9eial student. Do yeu remember R. Gordon Douglas? u Yes, indeed, I do. Doiglas wu sent up to work with me .from Cornell /~~\l\D\~~ l.. _> University New York Hospital(Center in 19311 I think, or 1932 1 somewhere like A that because he was to be Assistant Professor of Obstetrics down there,. and they weren't. ready for him, so he spent a year with me1 and he did a nice piece of work. Vas it mercurochrome that he worked on? In any event., that started a triemlship that still exists o Douglas succeeded Dr• Henricua J. Stander u th• Protessor of Obstetrics and made a marvelous record at the New York Hospital, reduced infant, newborn mortality down to almost nothing 9 If he lost one woman a year from obstetrical reasons, he was shocked. He had a beautiful ,'\ I record. They lost some wo~n who had strokes., and things like that. I don't think they opened the S~rong Memorial Hospital until April la 19281 but you'd been in permanent quarters from 1925. Yes, we started in the dog house up there. Whipple built a little structure tw• stories high1 a hundred feet by a hundred feet, in which there was storage of all sorts of things, the heating planti a roan for me, a room for Bloor, a roca for Whipple., and many rooms for his dogs. I don't remember whether McCann1 or the others, worked in there or not, but that's where I worked for a couple ct years. Then you moved over into the•••• 285 The Main Building. The main building 1 but by the time they opened the hospital, yeu must have had quite a large develoeent. Yeu had-what was it? I had finally four wings of that building on the second noor en the Northeast side1 and those wings were about thirty~five feet wide and a hundred feet long# so there was plenty or space• I think we've erobably gone as long as we ought to go today. 286 Monday1 May 21 1966 A..60 2 N. L. Me Will it pick up+,ur voices? Yes, our voices will be all right 9 1 •m just afraid that there ma1 be an obli­ sato--sort of a choir outside 1 As I indicated8 I want you to go back, While we've sketched in the variety of experience that you had at Rochester, we didn 1 t deal directly wit~ the department, its teaching aspects and research aspects as the relate to ourself Dr Birkhau and Dr Kenned I know that is highly arbitrary, The papers indicate that Dr. Kennedy came by way of Dr. Zinseer 1 and I knew that as of this time 1 as of 19.31 1 you either had just reviewed the 7th edition, or there was correspondence cOlli.ng on about the 8th l / ~ edition, We_re going to set these pur!e as though they had no other contud.~nts. I wondered about the Department of Bacteriolegy1 where you had a chance to develop without any existing vested interest in the deeartment. You could build it the way you waated to. The search 1 I suspect, initially was fer an assistant in the department when you think in terms of students, This takes us all the way back again to 1925. In thinking about your department, fresh, brand spanking new1 and you wanted to continue with your own work1 the search was for aid and assistants with respect to that laboratory and students. What­ how do you search for an assistant? What was the process in 1925? ,;1 It 1 s hard t• recall all the de~ils, but I can sq that my attitude tDlrard the department was formed by the actual obligations to the school and to the cit7. That determined a great deal•-the obligations to the school and the hospital are to provide teaching for a second ,-ear class in bacteriology, t• offer some support to the department of pathology in getting at the causes of 287 the lesions that are disclosed tv autopsy-, and to gift support to the clinical departments, either adViso:J support or actual facilities and assistance in working on their bacteriological problems. Then, of course, there is the large obligation toserve the Health Bureau of the City or Rochester. Those were very- large and pressing obligations which took precedence over at least my own work because, to tell you the truth, I have always put rq ' . efforts on my own investigat~ns on a secondary- relationship to these institu- tional obligations. That llligh' be due to lack of comprehension of the subject$ but I think it ala• was due to the fact that I did two things. One is that I found a great satisfaction in administrative work that led to results of a practical nature in the disclosure of' the causes of conditions and in the dis­ elesure ot the nature of mieroorganiSlllS and provided a satisfaction that re• peated failures with the research undertakings denied me. I think that's been I true of what I•ve done right along. It s far easier to be a Dean, I think, ,.. than it is to be a crackerjack inTestigator. Some aen could do both like (I Dr. Whipple. Nothing deterred him fro his investigations. A man like Albert '\ Sabin, who is famous now for oral vaccination against poliomyelitis, is unde- terred by an.y outside events from his laboratory and investigative work. Well, I never had either that courage, or that drive, or that confidence ia myself to ~ut that kind of work ahead of the administrat-i.ve work• Then another thing I did was that I felt toward the people that I was able to attract to the department that they should have quite a wide range er freedom in what they wanted to do. Some people who are heads of departments make all their people work on the same general line of problems. I suppose if I had a real clear conception of the general problem that ought to have been worked oa, er that I would want to work on, I would have in the first place sought people who were interested in that subject and were willing to do the work without any 288 compunction, or simply say, as some heads of departments say, "No, I will not support you, if you don't work on this phase of the problemo" There were two men who were important in this for me--Konrad Birkilaug and later James ~ennedy. Birkhaug was a prima donna in investigation who worked very hard and with a good deal of imagination. He got into a little difficulty h at the Hopkins because his imaginatien persuaded him sometimes t~at things that had not happened actually had happened. He was working on a serum for strepto­ coccal infection by producing abscesses in a donkey, a. s Ir emember, and the result of that in relation to erysipelas. He had some difficulty having his work accepted at the Hopkins. I don't know 'Whether that comes out in these papers or not. I theught that he was correct in his observations mostly, and although I didn't know him very well, when he came up for a position with me in the laboratory I was very glad to have him because hew as an extremely in­ teresting and able person, a very attractive man, a raconteur of the first order, a pianist, enormously energetic. Artis+nd sculptor. Yes, he had many--he was a sort or Benvenuto Cellini in a way. Well, when he came, he had a laboratory room quite as large as mine, a big room, and all the supplies, animals, and anything tila t we could give him, and he was allowed to go his own way- 9 Se and I talked over his problems all the time, and I could make some suggestions that helped along, but he was an investigator in his own right and pursued his problems very easnestly and got some ary interesting results. He was an ex,ellent teacher, had great clarity of expression., and worked very ha1n lectures and the preparation for his class 0 Laboratory preparation for bacteriology is an arduous task for each day's work, and Konrad would do it 289 extremely well. He would arouse the interests of the students. He gave very finished and very fine lectures, 'llmost too finished., not just repeating text­ books, but they were precise and orderly and not as exciting as some disorderly presentations are where more argument can come about. Well, he worked there and had a great many outside interests. He got along among the bacteriologists. Well, the time came when I was about to go in 19321 when they began to talk about my successor. I was not on any committee that had to do with choosing my successor, but I felt that I could not recommend Birkhaug, to the degree that he wanted to be recommended. His name, of course, was on the list, but I didn't push his candidacy any. That caused him to have a grievance against me. 0 Dr. Helctoen also took part in that sort of personal contrA_versy, and so did the university professors union, as we called it1 the Associatien of American ~ University Professors. It went on in a rather tense atmosphere of ull,l\ertainty for weeks and weeks, and finally they chose Dro George Packer Berry to be my successor. What was the nature of the misgivings? Was it the relationship to other depa:r:,~­ ments? Let me say Itm not so sure, and Itm ~aling with a record here ~ow that will be heard in the case ,r the character of another man, and 1 •d rather be careful about ite You can just say that he didn't impress them su.fficne1'tly ' . favorably to be appointed the pretessor. I can think of many possible explana" tions, but I think it would be better not to put it on the tape, if you would agree,. The record is fairly extensi!•, but when the successor was finallz chosen1 t~ presentation was made ~hat that successor ought to have a tree field il!, which 290 to oeer~te• It se~d reasonable !'raa the ~chool 1 $ point o~ v!,~• That was reasonable from many points or view. Kost of the f'acult:r in that <. grad~ turn in their resignations when a new chief is coming on. Usually tbey•re not accepted, bnt everybody feels that he ought+to have a free hand. Also fie f!&:pers indicate that it wu quite a problea in tb.e s~h'?_ol 1 dealing 12:,1:,h this-1=,bat is 1 I 'tl!ink it wu good that President Rush Rhees wal! there, a!d C!! han~d it f'roa the Pres\dent•• Office on a b~sis wl\ieh. eoul4 have been accept­ !!~le1 ~cept tor th.e raye or characteristics tbat B1r~8:'11 had whei:e he coul;d !'!1sread ~ phrase,a, or corrver.t: t.he raeaniy of a rphrase into that certainly ~ intended by R~sb Rhees, althou.e,-let'• face it. The J?_roblea was there, ~ad it beca11e a di lcaatic tbi an inside ublic relations robl• whie d1:tticult. Well, it got so unbapw in our relationship that the triendship broke ott . then and never was renewed. He weat abroad after a while. I th~nk he was a prisoner of jhe Germat'l8 in Norway. He caae back to this countq after the war. In 1947, be caae to work in New York Cit7 on BCO, and he wrote me a letter about that. tille wanting t.o let b7gones be bygones~ and I replied1 and it may be in the folder there, th.at I just didn't see &01' wa.,- to do it. I have forgotten what I said. Wella in 19391 a~ the Waldorf Aatoria at the Co!!i!:ess of Mic~~biolog1s~~•••• There was &PJ?&rently a scene down in the bas•ent1 or saaewhere1 ~d be apologises tor that _in a letter \n wbieb he is quite contrite, .not \1! ~epig 291 with the us~al_ ~lavor !'f bis correspond.enc~• Is the scene with me? Yes. He comments to the e.t:fect that he had just been looking through a J?!Cka.g~ ~r eersonal correspond&~~ vtdch the Gestapo bad returned to b1ll and tbat he o e ca111 cross sae n tes that OQ sent bill in 1932-c es or vbich are in here ~nd these had to do with the action o~,the 2resident1 very good letters--alld he • that the mewed hill dee cid.ed to write Oll a few words to express 111' sincere regrets about !'l bad behavior }ovar<is nu both at the J?!!:ti9i ot our waz- in 12321 and still worse towa,rd yw1 B.J. 1 at our meetig 1a the basement. ot tbe Waldort Astoria Ho~el on the:t Thursdaz even.1911 Se,etamber 7, 1939a. st the otticial bang.uet of the Microbi_ological Congress. It was s,tuP!~ verr stupid or•• and I tail to f!J¥1 aiv: excuse tor ng; bad manners." I have no recollection ot what he's talking about there. The c0111111ent I made before we turaed this on was that the characteristics of the man were such .that i!!Juries were &1:-ost imagined,_ and an e!fort to steer care­ Wll through ¥,s charac~ris,~~• was a verz difficult one for tbe University or Roc~st.er 1 and it becaae more dit~icult for you because zo'! '!8re his chief. You u9derstood th_.! Ro~hester eoint or view, and also 12u bent o•er baclcwards­ tpa~•• wrogu zou. didn't bef!d over 'b~c;)twar~. You die! it ~orul.l.z bec9:uee that's ~~ way yoa are-zou wrote to I don't know how a&ttf places ~~r suita~le eositions tor him-four arqwaz that I can think o,r I so zou. recognized the dif!iculti~'! from gis point.of view1 b'¼,~ thel'! was also_~be school to consider, and if he didn't have the ~••or which in the judgment or bis pe'!!:s wo~2 carry on1 oi: ~•~elop the Departaeat or Bacteriolof2: in relation to the other erts of th! school there wasn't a alternative. The difficult did continue for ti.lie as a continuin,g troub~esoae s,e,ot 1 ! suspect, froa his poiat of new. He went_to the Pas~ur ~nstitute1 There are long ~etters not to zou1 but to Miss Cree_g_~~• Yes 1 q,-e~t.s on hie expenditurea 1 what it is he ba• left. Thi;s call be the sop to a pi:,sonal cerberu _!• distinct tr.,oa what is tactuallz cor,rect. Tbis I don't lau,w. I doa1t haTe && COlllleBt on ita except that t.hese are the J?!e!ra 1 bu~ tbis is the first tia you'd Hen in a tict;Lish seot lik~ this that. I can. ttu;f!k .. I haftn 1 t ran across another one like this in the tiles. Wo, I never haTe had a siailar oneo I 1Te had fist fights, arguaents, but nothing like this, and thi• was very proloncedo ~d this et:f'ect bis wor~ while zou were there? llo, u I recall• this was ju.st sort of before I was~oing awa:,-aay-be f'rom January to June., 19321 soaething like that. It increased in in;tensity from t1!9 mem•t he receiffd the letter from the presi~ dent. He sort, of read into it more than.was intended. The stu.de to him~• favorable I gather. Yes, he was very attractiYe to students, a liYely person, esselltially friendly, but apparently this cut bill so deep tb&t he suttered trait. The other fellow~• was in the departaellt caae as an assistant. He caae 1 aa I I u.4de,ratand the corres2o~~~ace 1 through Dr. Ziuaer a 01:.fice-n;:,., Kennedz:• " 293 As I remember., I wrote to Dr. Zinuer and asked him if he could help me :find soaebody' who would be willing to be a very hard working assistant, and as I recall it, Dr• Zinsser said that most of the men who were trained by- b:1a had already- been placed. and that the7 were ■uch in denand which is the truth. Hia was a popular laboratory tor training people and a great source of s11ppl7 of young men who ware wanted at other places, but he recOlilllended Jim Kenneq to me, and I liked hill when I saw hiao We had a trank talk about the kind of wort that he would be asked to do, and as I look back on hill now, he was ■ost unselfish. There wasn't arv-ttiing he wouldn't do, it you asked hi■ too I won't say that he was a slave, but he aade hilnselt so helpful and anticipated so :many- tiresome tasks that he used up all his tiae in that. I don't believe that he did any­ original research work the time that he was there. How long was he with me-two years? You said 1931. Then when the successor was appointed, Dr. ~erry, he did not ask hill to stay-, and Jim. Kennedy then went down to be head ot the Health Departaent Labora• t.ory- at Louisville, Kentuck'T• First 1¥' vent to Georda. Well, I 1ve forgotteB, but he's still down at Lollisville. That was an ending o.f an association. We have corresponded a little bit since then, butµ haven't seen him since those Rochester da79. I hear about hi•, but we haven't exchanged any letters for a long ti.Ile. !here 1 s one atuc\f that he had been doing in Zinsser•a 1 aboratoq with scaeone !lae up there at Harvard, and thq were P!!'bli~hing a paper which was quite 294 critical of a Dr. Coca. Dr. Arthur F. Coca-yes, I knev bill Yery vell. He vas an allergist and bad scae veey peculiar notions about leukocyte counts and different conditioas. Coca himself was a pianist subject to 111.graine headaches and dizzy spells, and I rem•ber oDCe he came to see me at "'1 house and i•ediateq had to lie down on the sota. Nothing could be done until the next day almost because the poor un was suffering so auch. Coca was connected, I think, too with the Lederle Compaff1' at Pearl River, jut North ot Kev Ierk and vu a man of rather strange characterietics and peculiar ideas, but a bright persoa 11ho had a respectable standing among bmmnologists, but rather a crank. ~ I think the subject was the ditfe~ent~ation in the types of blood, or blood groul?!• Yes, well he vas interested in blood groups. He was early in blood t7Pingo He was om of the original iDYestigatora on studies or transference of sensi­ tivity bys erua !rm one individual into another, and he put thea--he called tbea atopil'lS-put thats er\11l into the other individual and the spot where you put the ser1J11l becOll8s aensitiYe to the thing that the 11&11 vu sensitive to, whatever it be, pollen, or something else. Dr, Kennedy and for the moment I can't remember who the other person•s, the senior member. Reuben Ottenburg. Well, probably the senior member would be responsible £or that because I I 29.S can't think: or Jill's attacking an;rbo<:11'• _!g the writing ob:t3,ections were ra},sed. You kr>.Ol!J you've said before that when zou write a paper, S(!l8one else will read it and what thez will look for is the .anner in which their own work is treates, or whether it is treated. Tnat 1 s right. A rent Dr Coca's work vu treated in this st and no reated in a manner 1 ,, 1 in which be tho~t it deserved, and it raised again a kind of peripheral nego• tiatins problem in order to set words that would convey what the authorfs ._, in­ tended and not to be too •••• I have a vague recollection that Dr4 Coca and Dr, Zinsser were at outs with one another in Hew York.- Bef'ore Zinaser went to Harvard, be knew Coca in New York, but Coca was important. He was one ot the early men who started blood banks which are Tery- good0 ilter you removed yourself froa Rochester1 I think on :our recom.endation1 Dre Kenne& was placed in charp of the public haalth asP!cts of the laborato:Z as its adai19-strator1 and he continued there 1 out apparentg couldn 1 t-eomehow, or SOllleway-Dr. Berrz vu wholly diff'erent.1 and rou know how those thi91s start. I don 1 t believe that r,. doing any- injustice to Jill Kennedy by saying that he didn't haYe the capacity to deal with public and general probleu ot the city Health Bureau 1aboratories. He could do technical work of a high order, but the rest ot the relationships were beyond hill. You knowa when you leave a poet-zou saw Rochester trca baby up through ~addling clothes into a burgeoning thing. You bad more material to deal wit!i and the relationships that zou had were open both ways. I can 1 t think of any:• thing in the P!Rers that would indicate that you had an;r difficulties along the line so far as the management of that laboratory is concerned Vis-a-vis all the needs and demands that were placed on you whether they came .frcm the school, er the hospital, ,or other laboratories, or other departments. You apparently had time to do this and it 1 s in keepi5 with your views that this is the serv-ice, R,Ut anz views with respect to zour successor-I don't know that zou !292ressed any. By this tiae the world had chagged.1 and new things were on, but on the nOlllination of a successor which is going to alter the nature of this laboratoa:-­ it removes one variable and substitutes another, and ever@ing and everybody is changed in the process. I didn't go to Washington for a year before I resigned frcn Rochester. You were tbere in 1932. That was a leave of absence frcn Yale ijniversity. I had already accepted the Yale position, and I went down and had been appointed chairman or the Division or Medical Science ot the Nat~onal Research Council. Let ae put on another reel. All I can sq 1• that I cannot recall any- disagreement, or disfavor, or disorder in the relations I had in the school that caused me to leaTe ito As I ranember 1 I bad a vague sense that it was time tot°ve on. It wasn't that this particular move in 1932 1 was financially- advantageoU8 to me. Tbat•sn•t the reason that I left at that timeo Although I bad a prospect at Yale of getting a larger salary than I bad at Rochester, I•s sorry to go. You always have ld.xed feelings about things like that, and when you try to think them over 297 later on, you may make up your mind that one thing was the cause ot it and another thing was a cause of it· another tilleo Do you want me to go on with the Research Council? No 1 This is roughly 19311 and we ought to go back to June of 19301 wben 1ou bad a visit from a classmate-Professor French. Isn't he a classmate? Yes, Robert French-sure. I believe, to Truabll.l. Celleg••••• To be a Master at Yale 0 Yes 1 dates back to June of 1930e Robert French was Maater of Jonathan Edwards College when the residential colleges were being built and opened up at Yale. What do you want ae to say about that phase of itt He aeeu to have been acting on his own behalf to interest you in coming as a Master of a college in the new educational developments at Yale• I forget whether he talked to Winternitz first, or vb.ether Dr. Winternitz talked to bill first. Robert French was a Professor ot English in Yale College and probably hardly knew that there was a Yale Medical School in existence there because Yale College was very selt•centered and didn't care too much, or very much, tor its protessi~Aal schools, and indeed, to Rebert French the very language of aedicine was a jargon that offended bis ears. I used to sit down with hia and make hia work out these words etymologically'• and he bad to admit that they- were the most beautiful explicit words that he could find. He was a student ot Chaucer, and these medical words are much better than Chaucer's words, some of thea. He was a dear friend o.f mine, a ■ember or the Bones Club I was in, a.nd we were close together all the rest or the time we were at Yale and before I came to Yale--1 mean, before I caae there as a Master and then right on up to the time or his death. Professor French ae811l8 to nave beera very au.ch interested in baTing you come there as a Master representing science. Perhaps some notion as to the new educational s,xst• which waa being installed at Yale is worth a word because when Presid.:.nt Jaaes R. Angell writes to you1 and I think at the behest of French1 seldc.n have I seen such carte blanch• in a letter. Is that Angell'• letter? This is a COPf of his letter-zes. Do you remember thi~ one? I••• The residential colleges were a graft ot the Oxford..Cambridge system on to American Institutions, a aodel ot these buldings even, and the system was what they thought. the English colleges were. Mr. Charles Seymour who was provost at Yale, bad been abroad and was a tallow ot a college at Caabridge., I think, and bad adllired th• very aucho Actually the college pla n was started because money- was available. Mr. &!wards. Hark•sa offered 1 ale the aoney- to set up colleges, and Mr. Angell and Seymour turned it down.. The aoney went to Harvard and the Harvard residential houses aa they were called, were built with a gift ot about twenty ■Ulion and were in operation when the Yale college plan was coming along, so that the Harvard example helped Yale to accept the gift when it 299 wu renewed. Yale set about in that time to build these extraordinaey Gothic college house buildings. Several or the colleges are built ia good Georgian brick, but one ot th• has Georgian brick on the inside of the court while the whole frontage on the street is Gothic-the same building. It was a qnthetic thing, and the new buildings--the new things that have been done by Saarinen and others for the new colleges-show that they weren't permanent~ enamored of that kind of GC>thic obscurity. The plan or the colleges was to have about seventy, eighty, a hundred student;s living there in the college quadrangles and taking their •al• there, but the colleges had no ■oney and no faculty except attached fellows, had no set adllinistrative duties, except to keep watch over the behavior of the st.11dents living within the confines of that particular college. These colleges were not like the English colleges in that:mspect because all the English colleges have endowments and financial aanagement. or their own and actually h&Te curric'11ar •ttera that they s11pemee. these colleges were to have con... sultative arrangements between student and faculty. . lt0 a been changed a good deal since then and in recent years, which I won't go into1 except to sq they•ve got assistant deana living in the colleges now, and the colleges are taking on aore and 11Cre tormal activities in the education ot students. Eaeb college bad a tiae c01111011 room, tine dining hall, a.nd all of us tried to build up libraries. Web.ad s-.e ■oney to buy- books, and each college developed. a library along the lines ot interest ■ostly of the Master. One phase of ■oney that came in there which was very u.setul and excellent for both student and faculty to support wae what was called a Bursary System. Mro Harkness and soae others had lett money to give about 1900 dollars a year to each college and with that the college could eaploy1 or arrange for the eaployment ot students, provided they did not assign them to menial tasks like waiting on table, things like that, so we developed a syst• by which students becaae research assistants / and literary assistants to members of tbe faculty most~.~ It workeJd very well. Now to go back to myself-you say I have a "ca.rte blanche" there from Mr. Angell. With all due respect to Mr. Angell who was a friend of mine and who passed on sc:ae time ago, I doubt if he knew what he was writ.inc. I think he said in that letter that he wanted ae t.bere to represent science in the colleges and that I would find-I think he says thia-conditions tor my work as favorable as I would :find anywhere else. Doesn't heaa;y that? "We feel eguallf certain that we can proaise you opportunities tor fruitful work in your own line tbat zou would recosnise as fully aeetiy your requirements.• That 1 s pretty vague. That 1 a pretty vague, and tbatta pretty big• - Yes. I don•t believe I took that toofseriously; in fact, I never pressed it very far after I got tbere• 1~11 have to go back to the background of tbat to explain _,. own behavior and his. In the first place I had no illusions about my repre­ senting science in the colleges. I was a non-mathematical biologist, as I have explained before, and Yale vu faaous for people like Benjaain Silliman in chemistry', and Willard Gibbs with the phase rule and pbTsics on a high plane, mathematics or great intricacy and power, so I bad no false ideas about lff1' representing science in the place. I could represent a point ot view of respect for the experiaental approach to problems and, in essence, the so-called e experimental met.hod. The scientific point ff view was probably common to all those other disciplines. Although you might not have a capacity to work in 301 astrono~ because you happen to be a bacteriologist, you can have a high regard for astronOJl1'• They talk the same language when it comes to assessing observa­ tions and looking tor the things you would undertake to test a theory- and maybe alter your hypothesis according to the new findings. All that was common to both. Before I got to Yale and before I talked with Dro Winternitz, I had been dealing with the bacteriophage claiu of Dr. Felix d 1Herelle, the great dis• coverer of bacteriophage, who !Vas brougllt to Yale trcn some place in the region of the Caspian Sea-I think be had a laboratory out. there through the Pasteur Institute. He not onl:y -.ade this extraordinary- observation of the ability of this virus like Mterial to get inside or a bacterial cell and reproduce+ itself in emorao\18 numbers and destroy the cell, a most amazing phenemenon that turned out to be one of the most illportant discoveries biologically of the present ~e because it takes into the stQdy of sell-replicating material--Buch as DNA. Tbat•s what the bacteriophage puts out into the cell. Well, anyhow, the Council on Pharmacy and Chemiatry of the .Aaerican Medical Association ot which council I was a aember, spent a lot of time examining the claims of Dr. d 1Herelle-so--called bacteriophage therapeutic claims and tpreTen­ tiYe claw. He had a rather extraordinary notion that health could be con• • tagtous because it bacteriophage destroya aicroorgani.sms and you can put the bacteriophage in the ai~~ and get it in your body, and it is in your body1 ~ occurs in ghe intestine all the ti.Ile and in secretions, you could infect people with sc:aething that would preserve thei~ health. Then he thought. it was an extraordinarily valuable agent tor the treatment ot the urinary tracl infections .<; because it disolves colon bacilli and proteus bacilli. He made scae extraordin­ \ arr claills tor its ability- to cure disease. I used to talk to Dr. Winternits 302 about that before I had a?'J1' notions of going to Yale and before I had a full appreciation or the position of Dr. d'lierelle at Yale. Dr. d 1Rerel1e had an Associate Professor's position in the Department ot Bacterioloa in the Yale Medical School, and there were two full professors 0 there also-Leo Rettger and George H. Smith. Ge~rge Saith, the head of the departaent on the medical side~ was the great admirer of d 1Herelle and had biJll close in his laboratory in close association. Dr. Leo Rettger was a general bacteriologist, aore interested in the production of sour milk because he thought he had an organisa that wow.d produce long life like the Bulgarians had-Bacillus aciflophilue it was called. He made acidophilus llilk and drank it and sold it. Then he was interested in the biological characteristics or bacteria, all the sides of bacteriology that do not necessaril.7 have aay con• metion with medicine. Well, to fit me into that laboratory they had to find space which had not been provided whc Mr. Angell wrote his letter, and I managed, with Dr. Winternitz's help, or Dr. Wintern1tz 1 a influence, to get three fair sized rooms and an office in a wing across troa Dre Smith and Dr. Rettger in the same building. These rocms were unfitted forl:aeteriology, and no pro­ vision had been 11&de for equipment. I was given so■e equipnent in the place, and at that tiae Dr. Winternits secured the resignation of Dr. d 1Herelle, snd I inherited a good deal of his bacteriological equipaent. Al.so I was able to btq" some for m;rselt, but I was ott there, rather isolated in a sense ostra• cized, and I bad no assistant at that ti.lie. l.ater Dr. Monroe Eaton came .from Dr. Zinsser'• place-Monroe D. Eaten is a veq able, originat.1i-nvestigator, and he did a great deal of good work there on diphtheria toxin and tetanus toxin. Both Monroe Eaton and I taaght graduate students. Well, that was not like what Kr. Angell had written ae. I really suffered trom having been in the position, or been put in the position, or maybe I worked 1111self into the position, ot displacing Dr. d 1 jerelle from a place where be was congenially located and admired. Anyhow, I got to work there and started some research or my own on tetanus toxin, its method of transmission by nerves, and scae general metabolic studies oa bacteria. Then I began d,oing the odd sort or things that I had always been doing, working with the department to study­ organ:l.SJIS in various lesions--! did surgical bacteriology-, autopsy bacteriology, and I a asisted the pediatrics department in saae things. I didn't have anything aucb to do with medicine beeaue the head o:f medicine, Dr. Francis o. Blake, was hiaaelf an expert bactriologist and interested deeply in infectious diseases. low, going back OD the college side, I have vrittea this in a report long ago to Yale-not to their liking-but I r oand soon that this plan of having a Master of a college subject to acadeaic camlittee aeetings and so forth and subject to consultation at any tiae by ar.rr student in the place, and in a place that was run with a sort of bo! scout type of idea or association between young men and the professor, so to speak, wouldn't work :for a man Who had to work in the laborator7. This is actually what I went through• I would plan an experiment that wow.d take from eight to ten hours-that's rather a normal 0 working day in a laboratory. I would no so.J't1er get over in tne laboratory than I•d get a call to come over to a aeeting in the President's Office, or soae racult7, or you 1 d have(a11 sorta of eventa in the college tor which you were responsible, social events, athletic events. Each college had te&IIS. Each college had a recreation prograa for which the Master was responsible, ~nd our house was tull of students ~ the time. Mrs. Bayne"'"'1ones was extraordinary in the grace and constancy with which she watched after the needs ot the students and provided all sorts of entertainment, and company for thea. She bad a very ~ ~I great ability remembering their names on first hearing them which I never could do. Smetimes there would be fifty of them in the Master 1 s parlor, and she'd introduce everybody. I don't see how she did it, but it was wonderful. Well, that went on tor aoae tille, and this I caa tell truthfully-I won't say any man, but particularly one like JIITSelt, who has always been impressed by the institutional obligations, will go down under that arrange~\ent that I b.ave just described. You soon realize that you can't work ten hours in a laboratory en a aet of experiments. Ieu cu.t the protocols and the plans down to eight hours, and then you cut thea down, or at least I cut thea darn to six hours. 'ftien I tried to devise things which I could work in a tew hours a day and pick th• up on another day, and soaetilles 7ou woudn't get back to them en the next day". Tbe laboratory was clear acroaa town tor one thing. Ultiaately therystea de• teated itself as far aa having science in the college goes• I talked to them about this, but I think you can 1Ulderstand what I•a trying to sq-particularly a man constructed as I am would give way under that arrangement. I have always thought that if I really had had the faith in -.y ability to do important re.. search, I nuld n1 t haft gone down under it, l'a sure. The combination of these circwastances resulted in.,- almost doing nething in~he laboratory of my own, but I did eTerything I could to see that Monroe Eaten had all the supplies that he wanted, and he could work all day and all nighte That's the way it went from the tiae I was there until 19351 when I became a Dean. !he correseondence ~~out the originaJ. e,osition,is 9uite protraeted.-tha~ is1 lou !.~r• still in Rochester, ~nd Professor French who headed one or the coµeges was ver aucb interest a in bavi ou ccae as a head •fa colle e rais~ a whole series of-wella quoting .• sen.te.nce rrom ~ • A~ell to Provost: Se2our,"The .nature of requireaents"• One et these was appointment as Professor of Bacteriology in the Yale Medical School. That they di<l. A laberatory ~oru,i~ting of•••a aepointment on the facultz of the aedical school. That they dido Yes 1 ~~e initial eguieent. of .the laberatoiz to be ,2rovided outs~de of the ~udget o,f the laberatorza ~~ then aae budjetarz secretarial eenice 0 The :,_eac1l!gg and adai.niatrat!,Te du.ties were left prettz basz because th!l bad to !!&it until facts hit zou in the face 1 but apparently they were very such inter­ ~~ted for their purposes to meet zour requirements as best th!l.~ould because l,r . 1)/ the wanted science to in the new educational stem which overlooked \ as iou•ve ;eointed out1 your necessities for doing some work, This is long and prot:eae~d;• Did it start in 1931? It s~arted1 as I understand it trma the correspondeqce-the first idea ii! ,2l"Oached t:,o you on a visit bf Professor French in June, 1930-he s2s later that your ccaiog to 'lal.e as Kaster 1eea back to a conversation he had vi tb l'?!! in June of ~930•+ It all seemed very attractive and very- exciting and new. But theoa-I gather that the college wasn 1 t reacb; to receive zou in 1931. The college buildings in which Trumbull College is located are reorganized and renovated buildings of the Sterling Memorial Quadrangle. The money from Trumbull College came from Mr. Sterling's girt of land that was down by Green­ wich, Connecticut. It was not as richly and easily set up as Pierson, Jonqthan 306 Edwards I and all those new colleges • Mrs• Bayne~ ones and I worked at Rochester even with the helpto.r Mr. Eastman on revising the plans for the Master's House at Trumbull College which was sandwiched in between three great, tall, five story, stone doraitories. We did set a house in there that was a very fine house, but it wasn't ready in 19321 and I accepted this appointment u chair11an of the Divisi•n et Medical Science of the National Research Ceuncil for one year. Shall I go on with that? Yes becauae u leave Rochester- ou wontinued there for a riod of t:illle until thel settled the replaceaent 1 •l!?! through June of 19.31. Does that sound right'? Then you went off to Washington, though your aePointment begins at Yale as of that period• Yeu were on whatever it is-sa.bbatical1 er leave or absence, In asr event,a there was agreement with Yale that you do this. The Reaearch Ceuncil has to do with kud.wig Hektoen1 doesn't it? Yes. The National Research C•uncil is r division, or a subordinate part et the Nat.tonal Acadeay or Science•, and it was aet up in 1915, by the National Academy- and modified in 1919 1 in accordance with an order of President Wilson who wanted to bring to the aid of the government special scie~tific research on probleas of importance to the government in aey way at all, and the National Research Comcil was set up as such, and it contained a number of sub-divisions, like~ Dinsion of Biology and Cheaist17, a Division ot Engineering, a Division 307 et Medical Sciences, and I was chairman or the Division or Medical SCiences. Dr. Hektoen was the chairman ot the National Research Council as a 'Whole tor a While. Then Dr. Hewell succeeded him-William H. Howell. At that tiae1 the council suddenly got poor, so that the salary they bad agreed to pay me was cut in half'. Tbat 1 s a fine ae11017l Ia that right? - Yes. So we caae down here and got a. little apartaent ner on Foggy Bottea, and I had, I thought, a Teey busy- tiae with important things, but when I saw what happened in World War II, when the National Research Council and the Medical D.1.Tision 11Nre dealing in mll•ons ot dollars, the small budgets that were con­ sidered at the ti.lie I was the chair11&n were just "chicken teed" as Dr. Winternitz told ae later• .Although it was "chicken feed", I like to tell what happened with• and Dr. Hewell 9 I remarkable Russian-American scientist named Selman Waksman--do you know who he was? New Jersez--a.gricultural 1 soilo~•• Strepttay'cin. This is the Division of Medical Sciences. One day when I was sitting in my eff'ice a short, dark, busby headed man with rather heavy ,1 / features am. a kindled eye CU1e in and said that he wanted a grant of twe~- , five hundred dollars to help hi.a !'ind oat what kept the streptococci in the soil in balance with the tungu eleaents. He was interested in the ecology of the organiSJ1 in the soil which is a profound ecological problem. The relation- 308 ships of organi8118 in the soil, in tbe air, in bodies is intricate and extremely interesting. Arry one of then,. has an effect on the others, and they generally seem to be in balance. If they aren't., then out goes the other, but what had that to do with medicine? Well, it did interest ae because I could see from sae put interests that this was in a biological liae that I wou1d. like to see worked on, so I took h1a down the ball to see Dr. Howell, and Dr. Hwell was a very broad--einded aan. Be had been the Professor ot Physiology with wbom I had worked at Hopkins in the early tiaes, and he thought that WakS11an 1 s idea wu very interestingr,oo, so he approved giving Selman Waksman a grant to study why the streptococci and the fuDgUB forms were in balance. Out of that cute s\reptomycin because strepto­ nvcin is a product or the streptotheyx, a fungus that gron in the soil. You never know what will happen sse tiaes. Waksman 011t of that developed. a great remed7 for tubercu1osis, a drug that is als• important in the treatment ef t7Phoid fever. Enonnous royalties f r • it built his :a:1.crobiological research laboratory at Rutgers. Waa this the nature of the job-to sift possible support? lea, we bad a grant-in-aid prograa. We had a number of things, but not aucb aoney, not like nevadq"s. Thia is an earlier daz, and in terms of zour own exJ?!l'ience it is related, in ez:ta te hor to support research. the Leprosy Found.atien and later the Child's Fund. This is the first experience that lou*d had. lea, with either giving a grant, or refusing one. Right• 309 We had a little money in the Research Council for •king gra~ts. Did you also work at this time with Lafayette Mendel in the American Medical Association COJDdttee-chemistrz and pharmacy. Net Lafayette Mendel so much. He was professor of biochemistry at Yale, but the bead ot the Camittee en Pharmac7 and Chemistey was Dr. Torvald Sollaon, the pharmacologist fro• Cleveland, trcn. Westera Reaerve, I knew Dr. Mende1f,and I worked under hilll as a student when I wu an. und.ergradu.te at Yale, and I had known bia otr and. on all the tiae• Did the National Research Council task and the American Medical Association- ?•re thez parallel? The7 1 re not. They had no connection. Did 7!U wear two caes? I was a Jl8Jlber or a cClllli.ttee-a review Caaittee on Pharmacy and Cbeaistry, and I was a aaaber ot other ccanitteee, but it had no organic connection with the National Research Ceuncil. Wer. efforts made for legialation in tel"IIS ef further a•pport in this period on the National Research Council? No, the legislation that changed and was responsible for the aod.ern develop­ aeat or the National. Research Ceuncil didn't come about until after World WarII., 310 when President Roosevelt and Vannevar Bush set up the national defense research agencies. The National Research C•uncil in this period did have sone legislative base, didn't it? Yes. By actions or the National Academ;r of Sciences in respome to letters and an Executive Order of President WoedrowWilson, during the period 1918-1919. It didn't, have &01' new legislation. It got its funds very largely- from granting organizatiens. For instance, one of the things we were studying while C I vu there was under Dro Williaa Charles White, a sear,t tor a substitute for morphine. It w as supported by pharmaceutical people and by some philanthropic foundations. Another thing of very great illportance was a Comnittee on Sex-­ all the biology- of endocrines and hormone• that eme from organs of internal secretion, sex ergUIS and so forth. Another big project that we had soaething \ to do with, and that I carried forward again at Yale, was Dr. Yerkes study" ef the behaTior of big apes, the chimpanzee in Florida. The studies on looking tor a substitute tor morphine were quit• interesting, but turned into a whole lot of routine testing--the chemists could make compounds so much faster than the pharmacologists could test them out in anilnals that it just built up on the shelves an enormous supply of material. I enjoyed that year. That is also the year I helped Dro Zinseer revise his book. Yes 1 I think it 1 s probablz t:ille to go back and pick bi.a up too 2 We said initially that•• many; of these things operate at the saae time that it is hard t• get the flavor or reaction as between one and anether. Do you want to start on the book? 311 You wrote a review of the 7th edition which is an interesting renew. I don't know how tou read1 but your notes indicate that you did almost an atuopsy on that 7th edition. I told Dr. Zinsser that I was going to do this because Morris Fishbein invited me to do this',) I gaTe Dro Zinsser an outline of what I was going to say. The substance of what Illls going to say about the 7th edi.tionwas that it was the 'best book for teaching that I had ever put my bands on because, as I wrote ia the r enev, it had an overt error on each page, a slightly concealed error on each page, and a Tery- subtle error on each page. Yeu give the book to students, and a lot ot thea hand you back just what's on the pageo Yeu know that man is not thinking, is not bothered by the error. J.11other student is a little bit upset and confused, and he asks sOllle q~estions. A third student will see all the errors, will work out the answers himself, and will have nothing more to do with the book. He is then emancipated from the tyrano;y or the printed page, and he's a good man. I put all that in the review and told Dr. Zineser that it was going to be about like that, but be had forgotten that I was going to write the review• He had gone to Algiers to be with bis friend Nicolle to work on typhus. Nicolle? Yes, Charles Jules Henri Nicolle--he was very fond or Nicolle. Nicolle's picture and profile and R,cketts are on the Typhus CainissionMedal now. Well, this renew was published while Dr 0 Zinaser was away. It was published in the Journal ot Inteetious Diseases, I think:1 which was put out by the .American Medical Associatien, and when Dr. Zi.nsser got back to this country, he got furious and thought his eneaies in Chicago were after hi:ae He 312 0 wrote a.n indignant letter t.o Dr. Marris Fishbein, the editor of the Journal ¥, ~ ~er!can Medical Asso~_!at!!t:_and other publications, and Fishbein referred it to Dr. Hektoen, and Dr. Hektoen told Dr. Zinaser that I had written it, so t, when Dr. Zinaser heard that frcm Dr. Hektoen he wrote me,"Oh, since you did it1 it doesn't JUtter. It's too trivial•" He knew his book eught to be retised, and he tried over and over again to 1 get somebociT to help him. He asked me two or three times, and I said that I had too 11uch to do and that I couldn't.• I succumbed as usual. I was in his laborator, in Boston one day up at Harvard, and he got a telephone eall--it was from scaebody down soaewbere in the Seuth, I think_, ., aying that he was aerey that ne couldn't undertake to be co-author with h:iJB in revising the book, so Dr. Zinsaer started walking around the room, saying, "What on earth. a I going to do? How am I going to do this? It you don't help me, I don't know what Irm going to do•" So I said,"All right, I would•" I really' undertook a piece of work then. I was then chairman of tbe Division of Medical Sciences of the Natienal Research Council, and I suppose I didn't know what a labor this would be• I had a full time job at the National Research Council building, and I persuaded the librarian of the Surgeon Generalts Library, which was the forerunner of the National Library of Medicine, the old building down on 7th and Independence Avenue, to give me a corner back in the stacks, a table, and stack privileges, so I could run down there at all sor1:.e or odd mOlllents and in the evenings sometimes and work on the notes and things fer this book. I was living right across the street froa t.he Navy- Hospital. Back or \hat was the Hygienic Laboratory, the tererunner ot t.he National In. stitutea of Health, and Dr. George w. McCoy was the head ot that and a friend or mine, and he gave me tree run of this libral"Y', so with those two libraries 313 and putting in all the tillle I could find anywhere, I managed to write in long hand in that year, I think, more werds tnan are in the Bible. I think I wrote seven hundred thousand words in long hand wbichlllS a great labor. I found tbat the book really needed a thorough overhauling to bring in the modern ideas about bacterial variation, the morphological variations as well as the cultural variations, and th• host variations. Tbat had not been in Dre Zinsser'• thinking very much to that time becawse he was strictly a mono­ morphist, as we call them, a pupil of Robert Koch who thought that a bacillus was a rod, and a coccus was a sphere, and that a ~here could net be a rod and i a rod could not be a sphere. Well, there are all sorts of transitions between those two 0 One could be one one tiJlle and another time the other one 0 The power of the language is so great, and I'll give you an example at that time. There were two important organiSJIS. One is called Bacillus abortu.s which causes u abertion in cattle and ~n.dulent fever in humans. It ltl8 discovered by B. Bang in Norway., or Denmark. It's a vecy serious infection tor humans as well as cattle., a long chronic thing., abscesses and troubles. A very similar kind of a disease, Malta fever, is produced by an organiaa known as Micrococcus meli­ t.ensis, discovered in the Island of Malta, and these two diseases were treated T separately- and described separate~. The organias were described separately because a coccus couldn't be a bacillus, and a bacillus couldn't be a coccus. They are as close together as brother and sister. £hey have cross immune re­ actions. They have many- cult11ral reactions in c011mon. J:hey bel•ng on the same stea and atter they were put together by Alice Evall81 Karl Meyer and others about this tillle /J..n the 193oi7 it waa a great clarif'ioation. Well, that was going on, and it runs through the revision or this book in many- w ay-s. The same with diphtheria bacillus, tetanus-eTeryone or them varies just like human beings. 314 Well, Dr. Zinsser worked hard on this revisien too, and I worked as hard as I could with very little sleep, aided i~-we.kef'ulness by giving myself light potations of stuff that caused intense indigestion.. and that disturbed me so auch that I could sit up and work--mostly- hard boiled eggs. Then I didn't want t• have &111' differel\Ce w:lt,h rq dear friend, Dr. Zin.seer, who was high ~ strung. I told you this ariJ(ecdote. Shall I put it in here? v - Yea. Abeut the carben copies? Put it in. I il'l'Tented soae fictitious bacteriologists and would type off a letter with a carbon cow and send it to Dr. Zinsser. I would say that this man bad written to me and said,"Y•a•r• re'Yising this boek, aad. I want you to notice that i the definition of' the diphtheria antitexin unit, for •~ple, is entirely in~ correct." I would send that to Dr. Zinsser1 things like that, and Dr. Zinsser had a great big black pencil. I signed these letter like J.P. Squill, Keulcu.k, Iowa, and it would coae back to ae with a big pencil mark on it,"Squill is an ass." I'd write him another one and finall;r break hina down. We never had any disagreements, er fw,a about ito Was he open t• conviction en Yariabilitl? Oh ;res, he took it up strengly after that, and he worked on variable • organisas, the Rtckettsia of typhus. He contributed, I think, the best chapters in that book. A chapter on tuberculosis, a chapter on typhus fever, and most 315 of the chapter on encephalitis have a touch ot the master that Ii.user was in that phase or it. Most of this is carrie'n bz eorreseondenc_!• Yes, we didn't see each other very mucho I would take manuscript to meet him either in Boston, or New York scne week~nds, and he 1 d drop in. Was he a P!rson who diSJ>!tohed business this way? Oh yes, he wu a very facile person., clear headed. This was done in a year, and I think that 8th edition-whal is the~date on that? 1933. It was about a thousand pages, and I added a chapter on the history or bacteriology- that hadn't been vecy good in the previous work. As tar as using the nom de plwu, Dr. Zinsser ceuld understand that because he wrete sonnets and other things and signed it Rudolph Schmidt. Nobody knew who that was. He never told. Ira not sure I know yet, 'but I think his aot.her was Schmidt. I don't know. I don't knn either. But you saw it in those sonnets, or in As I Remember. - Yes. Every nw and then he 1 d fall into that third person, that tictitiol.18 character. The 2!2!rs are .tilled with claritz about the nature ot the contract, due reiard ,316 to the Hiss family. He 1 s verz ~entle aDout this in not wantiD;i to•••• Yeu mean, when he divided reyalties 'With 11e? We did all right on that 8th editioa. I don't knew whet.her the acceunts are in these papers or not. { May'be I had them in another book. That edition sold tor eight dollars a coPT, and we sold for•y theusand copies, I think, wt I don't believe the royal ties were fitt7-fitt7. Were they? - Mo. He had two-thirds. ~tner ebtained in t8rJl!S of the contract with zou was fitt,z-tittz. There was an initial period in which someone else had written a section. Jo, ,soaeone u;e there at Harvard, and initi!YZ hE:, was sharing soaething with bill, /Jznest Ee 'fysse'iJ• !)le initial ersoa va~ _Phili,? Ho His•• I•s• Bias. The tiae caM when I wanted te tu.rm it over tof8nd T• Saith and Norman Fo Conant. Did you notice tne dedi.catien in tbat? Look at tnat1 Ye11 1 d think I was dead. It puts ae along with Hiss and Z1Maer beth or whoa are dead, and I'• next. Is this going en there too? !•s--:-"Te> the memo17 et•" Som.e of ,the caments received alter publ1ca¥,oa aN 9,,,nte illuminating. A l~~ of J?!Ople noticed that the book had been real]J 317 r,evi!ed1 and yeu were revising this righ;t up to the aoment or publication, as l_he galleys cw in and new work ca11e in1 Io11 wanted to make sure. people '!ould send you thisa and you wanted to make sure that this new vieWJ2oint wa:'! incoreorated in the textbook. That's an endless kind of thing1 isn't it? ,.,,. Yea it is. Yeu start to revise in ene place and the doain~o falls down I,;, sOJ1ewhere el••• We had te watch that. In the war this book was sold to the Arwfr• There are copies in all the laboratories in the Arrq• I was en the book selection coanittee for the Surgeon ueneral....General Hugh Morgan and I and ~\ several ethers, and after a while-I don't tmnk I WU really atraici of "con- nict of interest" because there wasn't an;r book like it. They could net have ~ 0 avoided it. •• not saying that b"asttu.117, but there wasn't any other text• book like this at that tiae-tull of practical directions as well as philosoph­ ical discussion. Just teward the end of the war, I got Appleton and Company to figure out just hew much of my ro7alties bad COJ119 f'roa the books that were purchased by~he !rs¥, and I sent then a sizable check to the treasurer of' the United States. It didn't do the Surgeon veneral any good. It gees into the Treasury when you pay- back the government. I felt good about it• The other moral preblent I had with th+ook during the var came through my adllinistration of the Army Epidemiological Board. I was in closest cont.act with all the original main investigaters of infectious disease and bacteriolo­ gists in the United States tor four 7ears. I knew what Dr. Sabin, Dr. Rivers, Dochez, Avery-all the new things that were in their lli.nds and what they were doing. Teward the end of the war Appleton wanted ae to put out another revisien, a book, and I didn't see how I could do that without disclosing what I knew trom the unpublished. reports of these other workers, my colleagues, so I 0 decided I wouldn't do that. I could have had a sco~p• I had the run of that .318 • all in the tiles. Its I told Mrs. Zinsser about it, and she didn't object particularly-, and Dr. Smith and Dr. Conaut at Duke took it on, and they put out a good edition. Siace then it 1 s now reached the 12th edition. !,his is a period also for purposes o~ understandig and writing1 of real.;tz clbabigg •n toe ot the field. When _zou put pencil to e_aper1 zou begin te dis• ~over what~~ is you don't know. Oh yes. And roaaing tbreugb the Surseon l.ie~eral'• Lilrag aq~ the Hygienic Laboratorz aar have atterded l!U f!\U' first over all Vi••• By that tiae I didn't have to roaa too muche I knew pretty well who was doing what and where they were being published. In that field there vere excellent indexes, j~nals, abstracts of bacteriology, chemical abstracts and Index Medicus. But it bad been a fast moving field from about the early 1920s. Oh yes-all the virus work came in. I want to tell you something abo11t Berry and the biolegical slant that1e were talking about a few minutes ago. I hope in your transcription of this you can bring it in in the proper piace. Berey had discovered something very close to what Avery, Colin MacLeod, and Maclyn Mtcarty had called a transforming factor•-that is1 they had found that they cold grow a pneumococcus type 2 in a pneumococcus type 3 :medium where the type .3 had grown, and the quality of the type .3 would go over into the type 2 form and rema.in--acquired characteristics. Well, now we know that that is a transference fr• these nucleic acids. Berry had done the same thing with 319 a virus that causes papillomas and a viscous kind of degeneration of cells. He 0 transformed tbe viruses by letting them w'J(k together in an infected ani1'lal. He was interested in that fundamental thing too, so he wasn't just clinical. Oh no--a.pything ~hat I said that would im.pg that, ~nd this was off the tape 1 was in error. Although he assWRed the burden of the adainistraUen of the Deert- o ment of Bacteri~loq at Rochester, he continued with bis researches.in the virus field. Oh yes, and nets been a Tery fine Dean at Harvard• W'ell1 I think that we've gone as far as we ought to so today., 320 We.dnesdaz, Maz 4, 1966 A...6o 1 N. L. M. I 1 ve alreadz indicated that mz interest todg; is to go back from tbe vantye e,oint of Rechester all the way into tbe 1220a and deal with your work in the ~ield of bacteriology. I eee certain thiqgs which when I mentioned them1 ltm sur!&, weren't in yeur aind at the tiDle you did them1 but taken iosether they lend ~euelves to a kind of organization which mg be whollz ~n,;:eal1 but it looks that waz: to souone like melt wh• pes through the papers. Sme of ~l!~~~~ have alrea27 talked about--the earlz episodic ':!&•a but_ th~e is a growing awareness on your ert fer the need tor a b¥ie in parasitology: among other things. I don't know its origins. h ~ you'd caret• comm.ent en tbat1 and there ia this trip to Cuba which I think z•u eught to put in. Well, in Rochester there was very little "material", as we called it, in helmintholog and ~otozol•gye I11Cfections with protozea and he~nths occur I more in the southern tropical regions than they do in a salubrious, Fomewhat ~hern region like Rochester~ but it was necessary, even without that current supply of material tra the inhabitants in the district, to teach students about the existence aad characteristics of these organisms. Students need to be broadly educated no matter where they are and they need to be specifically educated if they g• inte cert.ain regions where these organisms occu.r in greater abundance. There was ne collection of slides of protozoa and the eggs of in- . I t.estinal worms in Rochester, and its necessary to have a collection of slides ... that can be used over and over again that contain stained malarial parasites, stained Uleb&e, stained babesia1 stained spirilla. You need to have bottles 0 and jars of feces suspended in formaldehyde sfi.lution into which you can dip and and take out a drop and look at the eggs of a parasite, or a worm. These didn't 321 exiat in Rochester. I think through JllY friend Dro Harbert Charles Clark1 Director. ot the Gorgas Memorial Laboratory who roamed around the Caribbean and knew that part or the country- very well from Panama to all the Islands I I got an invitation to go down to Cuba in the region under the control or the United Fruit tompaey. Dr. Clark was the scientific adTiaer and medical :aanager 1 really, or the United Fruit Can.paey in the tropice. The United Fruit Company- was liberally interested in supporting studies on parasites because it kept their own laborers well1 and it added to the increase in knowledge• They had some very fine people on their etatr. I wae invited to go to the United Fruit Company establishments in the eastera end ot Cuba, in Orient• Province, which has the mountains in it from which Castre later ca:me 0 To get to Oriente Province I went through Havana because Havana still re• membered Walter Reefnd William Crawford Gorga■ o There were still living people in Havana who had worked with the Reed Yellow Fever Canmiseion in various wqs1 notably Aristides Agramonte who was very- cordial and var:, nice to••• There was also., •• I recall it1 a Dr. w. Ho Hotfllann in the Carlos Finlay Laboratory. Carlos Finlay wu the great old man cf the region who long before the discovery-, er the proof that the Aedea aegypti mosquito--or the Oulex basciatws, as Finlay called it-was the insect vector ct yellow fever virus., Finlay felt quite sure that that as the mosquito that carried the disease, but he never could prove it 0 He couldn't prove it becauee there were certain things that had to be observed before you could prove a successful experiment. There 1s alwa79 a period or about twelTe days between the time when a mosquito bites a patient and when it1 s infectious. That period was noticed by Heney R. Carter in the South ot the United States. He thought that there was some important biological reason for the lag between the first case ot yellow feTer in a canmunity and the 322 other cases, and that peried of lag until the next case is the tilae for the nrus to multiply- in the mesquite and get up into the salivary- glands where it ' can be inJected into the next person. Also Finlay didn't know that there were certain periods in the infected indiVidua~s when the virus can be obtained f'rm. the blood and other perieds when the individual is still very sick, that you can't get any virus at all. I don't think you can get it before the third day, and it only lasts for a short tia•• il I Those things Wal"tft Reed and bis associates proved. Walt.•r Reed was spurred en to de this work beeauae in a sort of casual reaark Walter Reed'• attentien to the virus p•ssibility had been areuaed by Dr. Welch who aentioned the work of Litner on foot and aeuth disease at that ti.Jae. Be teld Walter Reed in eaeence that \he reason yeu don't find anything that you can see in the yellow fever bloed is that the agent may be a filterable nru, and that was what reall.7 turned the trick. Well, I went to Cuba with a great load ot paraphernalia for the collection ot speci.llens to bring them back for the teaching of my class. This paraphernalia was largely s•e metal boxes full ef bottles containing ten percent formaldeby-de • solution, so attractavely put up that the Custom's Officer in Havana thought I was trying to sllllggle drugs into the country-, and I llad a ha.rd time getting through. He finally let me through. He didn•t tab the paraphernalia away from me. I saw Agramonte and s•e other people in Havana for the tew days I was e there. One et the advanta~s of that meeting was that Dr. Hoffmann gave me some egg• of the Aedes mosqu.ite that they bad carried on tra the days of Carl•• Finlay. I was interested ia having these eggs, though I didn't know what to do 0 with th•• I dried them en a piece ~f paper, and I put them in an envelope and carried them back te Rochester. After these mosquito eggs had been for sOJH months in the ice bex in Rochester, I thought ..f'd bring them out, put th-. in 323 s•e water, and see what would happen. Lo and behold, they developed iato .full fiedged mosquitoes. I could watch the whole stage fr• the larva to the pupa te the adult. I kept a colony of these mosquitoes going for three years, or ao: stu~ng the bionomics in an amateurish way/. It was quite interestiAg• " At that time I had this stop motion picture camera with a micrescope going and I photographed the whole life cy-cle of that mosquito frem the egg, the batching, the larva~ stage and the like; in fact, I got so that I could tell whe the changes were going to occur, when the larva was going to change into a pupa• I could dip hill out l-..,i th a little dropper-er when a pupa was g•ing to give ott a nympho It changes color and activity. That tila, I think, was the firs\ action picture of a full life cycle of an insect of this ldcroscepic sise. I didn't de anything aore with it, except publish it, and it got into the Eastman Kodak teaching film series with a little descriptive manv.al that I drew up for it. These wre colored filllls? No, black and white. I .fed those mosquitoes en m;yself for about three years. I had them in long tall jars with water and grass in there, and I covered tbe jar with a silk stockine provided by my secretary. I would cut ihe .feet off of the stocking and fitt7 or sixty mosquitoes would light and have a good feed. I could draw ..,- arm out without killing them against the silk. There is in the teacher's •nu.al that went with the film 1 slides or iactures that indicated wheri they were feeding. Was this you? Yea. I den•t believe that an;ybody else cared to do that. I don't believe 324 I I tried te get anybody. Its not comfortable, but it deesnft hurt teo much. t\ Well, to go back to Cuba. I Theres just one thin,g~-Dr, Hef.fmann speaks here in his letter of transmission A exper1m8nta. You 111Ust have talked to him about it, There•• some guestion about Atrica. F0 F. Russell had made a collection of Allerican and African eggs about this time also. That 1 s the International Rockefeller Foundation group. Dro Hoffmann writes: "I always planned to make trunsmissionexperiments.... 11 Hef:t'll.ann was planning this? - Yes. I He s ratB:lr mixed up in here because he 1 s trying te do transmission experi• ... aents with the different spirochetes and to observe the development in the mos• quit•• He says that it is easy to do. This is in the period when yellow fever got off the track with Hideyo Noguchi. Do you want to go into that? Well, Noguchi, the supposedly great genius, was at the Rcckefell er In­ stitute about this ti.Jle-or a little sonner, sometimet before. ~ forget the dates, but it was earlier than this date in Hotflllann 1 s letter. Noguchi had gone into ~uayaquil after having studied the disease known as Weil 1 s Disease, called hemorrhagic jaundice, and in ~\uay~ quil he innoculated into guinea pigs some blood froa a p1trson suppesed to have yellow fever, and he found this organism, abeptospira which he called Leptospira icteroh•orrhagiae in the blood of the guinea pig. This spiral, a spirochetal erganism, is an extraord.inary-1.y lovely I\ ' thing to l ~ at, bright, shining under the dark field, and it spins. It has two nicely ~urved ends, curved in epposite directions. Noguchi thought that 32$ was surely' the cause of yellow fever, and it was heralded all over the world as the cause ot 7ellow fever. Hoffmann here is speaking of transmitting ~epto­ seira icte~des by mosquitoes, but he sa7s,"I aust sa7 that I do not believe that the Leptospira icteroides is a specific germ." There was a lot of skeptiein of Noguchi's findings, but Noguchi had such strong backing frOll Fl.exner and was such a world renowned figure& He was in the height of fame-based ver1 largely on incorrect work and curiousl7 unrepeatable \ observations-and was the great authority on yellow fever, on polio, and s~d... fiy fevers. People began to attack bill. Russell uy have been looking for soae of these things in Africa, but the other aen-Adrian Stokes was one or the i.JRportant ones opposing Noguchi and I> curiously enough, although I didnft know auch about it, never believed in Noguchits doing this. Noguchi made a vacciae with leptospira against yellow fever. My dear associate and assistan.,t, Howard Cross, was drafted troa the laboratory in Baltimore to the Rockefeller group studying yellow tever in Vera Cru~. ihey vaccinated him, and he hadn•t been in Vera Cruz for two weeks-wellt 1+ little over two weeks he died of 7ellow fever. That happened before I went to Rochester. There was much skepticism or Noguchi'• work, bat Noguchi didn't give in, although the criticism mounted, and people 0 were not able to confira his work. Some wise d~ctor in Ecquador said that Noguchi was dealing only 'With Weilts hsease, this hemorrhagic jaundice, but that ccnnent made no impression on people. Then Noguchi went back to the Gold Coast in Africa, and there he tried to repeat bis own work. He couldn't do it1 and there he died or 1ellow fever. The supposition is that he killed himself. Everything toppled down about that time on Noguchi' s head. 'l'bis happened a little earlier than this work of Hor.tmann, but Hottmann is naturall7 skeptical, as a lot of us were. 326 You did~•t intend to obtain eggs this waz? This was an accident. Hoffmann said,"Do you want scne eggs?n ~ I was interested in everything that would gn. I had never cultivated a A. mosquito, so to speak., and I was ver:, interested ins eeing all the forms and transitioaa. Y•u keet the colon;,; aliYe for thre~ :,ears. Yes, at least three 7eara. Now do you want to go on to Oriente Province? - Yes. I went out in Oriente PrOTince, and they gave me a laboratory in a building. They let ae roam the area to collect what I could, and I studied them as I collected thea0 There was a Yery interesting man there named Dr 0 Eugene Ro Whitmore who was studying Black Water .F'ever which is a disease I got interested in in Panama, a ocmplication of malaria0 I had a very interesting sort of a laboratoey in a building-only a table and a ndoroscope. kl friendly chameleon used to coae and sit on the window screen and stay with me while I was working at the laboratory-good companional:dp. I would then go out in the cou~try with wry little bottles of formaldehyde and collect feces. Then with slides I would collect blood. I got all types or malaria parasite-the quartan form wu to be found in the laborers there fr• Canton, and they have curiously enough very abundant infection with an intestinal worm called Clonorchis sinensis. I got a lot of rare speci.llens, hook wors,Lrichuris, etc. All the wol"IDS were there • and T&r'J' nice collecting. I think I st.a7ed there about a aonthe I came back with ay- tin boxes and all 327 rJ' bottles .full. Id idn 1 t want to risk any- more custom 1 s trouble. When I wen1 through Santiago on the wq back I was offered no end of Tery good rua, but I wouldn 1 t take any because if I brought it in, the custoats fellow in New York would confiscate all WJ' stuff if I tried to bring in any rumo That was a grea1 disappointment because the Cust011S Officer in Nev York-I remember now I had a these boxes and bettles, and the Oust• Inspector said,"I 1m not going to look at those things. I know how hard you b079 have to work down there in th.at heat I think TOU can go right through without any inspection." I was held up for possible drug peddling going in, and I innocently kept myself from bringing back a117 ra on r,r return, but I had a fine collection for the teaching of a class. I wondered whether there was in existence at t'!;i• tille &D,Y re§ulatioas governiOJ the introduction of th11 aaterialo No, they were all dead. There are very strict regulations now. We had a great deal to do with it in the Jr,q. We brou.ght in infectious material from the Pacific region. 'l'here are rules. You have to get permission. The Public Health SerTice has rules about bringing in those things. There are soae items 7ou can't bring in. You can•t bring in foot an+outh disease, or some of those ot.her violent diseases of animals, but jwnping ahead when we worked on biologicaJ warfare, • had some Yery secret stations where they had special pel'llission, like an island in the st. Lawrence River, or an island off Montauk Point, where 1'0ll could do soae experimental work with live aaterial that they wouldn't allow ill the continental United States. Thia also illustrates the field trip approach too-that is 1 the relatiomhip of the field,to the laboratorz and the necessitz for going to the fielde 328 I Oh yes-the Whole thing is one piece of fabric. Its got different designs on it, but it's all connected with the strands• I don•t know that field work today is done to the same extent that it was then-­ like zour .~~p to Cuba• Oh yes. Field work is-well, with the Typhus Comd.ssion we had an enormous aaount of field work, even epidemic and aurine t1phus and--do 1ou mean for a professor to go to a place? - Yes. Unless be ha• a prejeet, he doesn't do much. These colleetions-well1 everybody' was collecting, and I suppose every decent school has a good collection. You. have to have boxes and boxes of the 88118 thing 110 that you can-well., the ideal i• provide every student with a box of maybe thirty, or forty slides, and then you have an endless amo11nt of material in ~ugs for worms and eggs, but they 1 re all dead. The results of this trie::I know it aided you in Rochester ultimately in tel'lll8 or parasitoloa. 0 I was always interested in parasitology, as I told you before, thr"11gh my- grandfather and his early observations in malaria, the fact that malaria was c011111on in New Orleans. I had seen parasites back as early as I can remember, so it seemed a natural part. 'nlis was an effort to increase the resources of my department, teaching a vital subject. Ultimately you broupt in a man to work in this field. 329 Oliver R. McCoy-. lfhere did you find him? I'll have to look up the papers for the origin of thato I aay have met McCoy- at a meeting, or-wasntt McCoy connected with the Hopkins before he cam to Rochester? I think so. I think that w as tbe connection.-the School of Hygiene• or smething like that. He was a very bright young man, a very nice person, and we were very glad that he was willing to c011e. He had a deep interest in trichinosis at one time and the general infection of animalso Trichinosis occurs in the United States--people eating raw pork. It occurs very often in places where meat in• spection was not sufficient to prevent the consumption of infected pig meat, but I don't remember the details of how McCoy cq1e, unless the papers are in the departmental tiles. It 1 s not ia_J;he epera 1 and tha.t 1a WN: I ,•ked., ~he question, save that he did a !ot of work once be was set up and established in the laberatory. He published a lot of papers. Oh yes. Am I think it was also a wa I) tact with tlle Gorgas M•orial. Inatitute-thr)rugh K McCoz who was • ~ made a consultant. Through MoC,too, but as I say, I was always connected with the Gorgas Memorial Institute. 3.30 Yes 1 surely. I wonder wpether this Cuban trip and subsequent developments in parasitology are 1 in part, some of the seeds for the developnent of the Academy or Tropical Diseases too. I':a:. sure it was. As I say-, I have always been interested in tropical diseases because of my origins in New Orleans, 1f1Y grandfather's interest and tb occurrence there of both malaria and yellow fever. I was in the last yellow fever epidemic i~ew Orleans. In 1905, I•• on my- way to the Thacher School when the yellow fever broke out that summer. That was, I think the last yellow fever epidemic in New Orleans, but to get to the Thacher School I had to go through a very rigorous series of quarantine procedures because people were as alarmed of yellow fever then as they were back in the 1870s. Then /J.n 1905-190; the Texans set up a guard on the Louisiana border so that no trains, nor an;ybod; could get through there. '1'beytci stone them, or shoot them. I was put on a tr&in in New Orleans and the doors of the day coach on which I was on my way te u North Carolina were nailed sh~t, and screens nailed over the windows 0 I didn't p get out of that coach until I got up to Saphire, or somewhere in North Carolina where I had to w ait a period befere I coal: f!P on. I hadf• wait in quarantine to see if I had yellow fever. Then to get on to the Thacher School I had to go around by' Chicago and down through Sante Fe 1 New Mexico and Pasadena and on to the town on the coast north of Pasadena-I 1Te forgotten what it is now @anta BarbariJ, to Ojai. It was a long, round about trip 0 Well, I never forgot that sor,of live experience with yellow fever. Then too, it was very- natural for me to talk to people about tropical diseases wherever I met aeybod.y interested. When I came here in the National Research ~ Council in 1932 1 I met D)'o Earl B. McKinley who was the Dean of the Gorge . Washington Universkt;r School of Medicine. \ He had been in Puerto Rico, and he ru 331 " definite interests in tropical medicine. He started a move which became the Academy of Tropical Medicine. The idea was that we were going to collect twenty million dollars and have a great tropical ••dicine establishment in the United states, but it never got to that pointo We got a charter, and I think I was a charter member of the organization--about 1933 1 liB.sn 1t it? I aa an emeritus member still of the Aaerican Association of Tropical Medicine, and I know a good uny people living--and many others who have gone on too--who are experts in ' t~~ field. I think, if 1 rm not mistaken, that the National Research Council sponsored a survey of tropical diseases back in those days. May-be so, but aore recently still the National Research Council-I have a big book downstairs--had a commission thro11gh the Amy- Epidemiological Board and others to do something about tropical medicine in this country. After World Warn, most of the medical schools and the universities dropped their courses t) in tr/\pical medicine and weren't producing people who knew about it. It looked as if Tropical Medicine was in a parlous state. I don't think you want to go into that now. No 1 except that one~-well 1 in P!!'ta the basis for McKinl&'s drive for an ·1 ' assoc~ation was this sur?;ci that he had made as of that time. The one we made was in the late 1940s, in the 1950a. I have a huge copy of it downstairs CTropical Health 1 A Report on a Study of Needs and Resources (Washington, 1962), 540,J Itll bring it up tomorrow, or I'll go get it now, if you want me to. No1 I was just thinking of tropical medicine in those times. Yoar own interest 332 dates back quite deeplz, but other people were becoming interested too1 not merely for collections; in part1 tor collections of material-you know. Groups met--the American Association of Bacteriologists. The American Association of Tropical Medicine was existing then too, and nearly all aedical societies in the S.utb b.ad papers presented on some disease of a tropical, parasitic nature, and the American Medical Association, I thiak:1 had a section on it. They do now. This is a phase ot your own interest that is constant • .1.aet'a go back to your own laborato17, som.e over~Tiews as to what you wre up too 0ne is this themo­ chemical investigation or 1.Bllaunologi.cal reactions, a study you did 1920•1922 1 but you didn I t publish this E! per until zou got to Rochester C"Heat from Reactions Between Antigens and Antibodies: Special Reference to Diphtheria Toxin and Antitoxin" 22 Proceedings Society for ExJ>!rimental Biology and Medicine 2h6-248 (192,l.7. I finished the work at Rochester that I dared to publish. I finished it in. about 19231 19241 I think, in the laboratory, in the animal house that was there. As I recall, it was tetanus toxin a.nd antitoxin that I was llixing to see whether heat was produced. It did produce heat. The deeper interest in it was not simply observation of the production of the heat, but it was partly to see whether a differential •icrocalorimeter would work in such a situation. The deeper scientific partfwas that I had an idea that if I could measure the heat of the toxin...antitoxin reaction I could determine the molecular weight of tetanus toxin. I wrote a paper on it and gave a molecular weight that is much too low. I think that was the deep interest that I had in the probl.ea. This is adapti!}g a piece of equipment to measurement-that is 1 Hill'u• 333 Yes, Ae v. Hill•s differential microcalorimeter, and the interesting thing about that piece of equipment was that you had a means of aea11uring the heat in undeterminable mixtures in such a way that everything balances out, except the reaction that youtre interested in, the reaction of the growth of bacteria, or the reaction between the toxin and antitoxin. You have two naskso Everything in them is the same, except one of them will have the reaction which you're interested in. The differential part of the process simply means that whatever happens in these two nasks is related to the reaction in which you're inter­ ested. Everything else balances out. Well, all sorts of things happened with that apparatus. I built the one I used which was rather difficult, and I learned so much that I can•t call bacteriology. I learned all about specific heat. I learned about conductivity of heat, about temperature aeasurements1 but the most fundamental thing I ebserved, I didn't pay any attention to--I found out that Faraday and others had done it. I had a very sensitive galvanometer which is an apparatus to measure electrical currents, a very fine instrUJllent, and I bad it attached to a long tbin wire. It11t.s up on the wall, and I had a wire coming down to the ealorillleter on ury- laboratory table. I just casually picked up one or these wires one day, and I walked around the table where it was, twirling the wire a little bit, like a rope that you skip. I walked froa North to South-or East to West, it doesn't matter-and while I did that, I happened to notice the mirror .r of this galvanometer waslmnecting a little bit to one direction as I walked around, w e 1 ll say, :t'rma North to Southo When I came back, it was denecting in the other direction. I was quite excited about that becftuse I thought maybe my galvanometer was wrong, or else I was electrical, or a0111ething 0 It turned out that what I was aetual:J.y- doing was cutting the lines of magnetic 334 terce on the earth with a copper wire. This ie an electrical motor, so I dis• covered, incidentally' to a study of bacteria, the very fundamental thing that Faraday and others had disceveredJ that by whirling a coil in a magnetic field, you get a current, a aodern generater. Yo~ never know when these things will turn up. I was a good many y-ears too late on that one. Part of the joy1 I suspect, or working in a laboratory are the surprises that you bUJtp into--arentt they? Yes. ~t you changed frm this tetanus toxin antitoxin study to the study or growirte bacteria itself. Part of the rationale in the article is the w!l in which e&siologists generally have been using this approach and have been overlooki!!S the bacterial aspects 1 C•Bacterial CaloriMtey. I. General Considerations. Description of Differential Microcalorimeter" 17 Journal of Bacteriologz 10.5-122 (February, 1929)7. I dentt think that was any major thing in my case. I saw the application of that. The physiologists had been overlooking bacteria in everything they did to such an extent thafY friend in Baltimore, .l~nt Clark, thought he had dis­ cOTered what \urned out to be insulin, until I sb"f\wed bill that he had a colon bacillus in his perfusion fiuid• He had a big perfusion apparatus there in the laboratory-, with a heart, a pumping heart, a perfused heart attached to a pancreas in this machine. Be would perfuse it, pump a salt solution through there. He put 801118 sugar, glucose, in salt solution, and it went through the pancreas anfnto the heart, and the glucose got used up. Well, or all the foods that are delectable to the colen bacillus is glucee•• Admont Clark didn't 33, realize that he had a contaminated, wonderfully- vigorous culture of colon bacillus in his material that was using its glucose up. He thought that it was the internal secretion of the pancreas working through the heart muscle that was using the sugar. Actually though, he was ahead ot Sir Frederick Go Banting and Charles H. Best, and if he could have carried that through clean before his death1 which occurred about that time, he would have been ahead of Banting and Best in the discover7 ot insulin. Is that going in here-all those voices? I don't think this..will pick it. t.U?• Well1 physiologiatll didn't know much about bacteria. Tney couldn't see them even when the7're there by th+illions, when the material theywere working with got turpid. I\&8 interested in the heat productien of bacteria because ~ there had been ma'!\ observations en heat productioA• A. great law of what's called thel'llogenesis is that bales of hay ferment and catch fire from the heat produced b;y the bacteria. Evecybody knows that fermentation in jars of preserves is what makes a thing warm. to the touch. These are very old observations. As I recall it, Otte Mererhof, who was a great phy'siologist theorized on the heat production of bacteria as a measure of the metabolism af the organism. This is the saae as human being heat production which is going on all the}1me, keeps our body temperature what it is, and is related to your metabolism. Nobody had really studied the relationship of heat production to the growth curve of bacteria, so I thought that I 1 d try to do it b7 getting a very sensitive method of measuring temperature, C"Bacterial Calorimetry. II. Relationship of Heat Production to Phases of Growth of Bacteria" 17 Journal cf Bacterio~o&l 123-140 (Februar.,, 1929)]. At thesaae tiae I had to devise a means ot counting the .336 the nW11ber of bacteria present and relating the heat production to the growth curve. I think I had charts in that paper. I haven't seen them for a long time. That paper shows, I think, that the younger cultures or a bacteria-when they're in a veey active growth, logarithllic phase-produce more heat than afterwards, though they continue to produce heat. I studied heat production in yeas\. The yeast baa a budding phase, and the cycle or heat production is more variable in yeast. It waxes and wanes, goes up and down. Well, that worked-that differential microcalorimeter• I did that work when--1929? --------- A little bit earliero I should haw gone en with it, 1f had been a good ch-•t, or a good biological chemist.. Itve often thought of the things I eught to have done. Thi~ is a.whole series.of papers, one in particu;tar with a wanan-Rhees. That 1 s Dr. Rush Rheea•s daughter. CHenrietta Rheeif. She _got a 111&ster 1 s degree• She got a master's degree out of rat bite tevero But orked •n this a r. You had eneral considerations as to what ou were goiag to do and the first publication was this growt.h curve business• Later !~ere apJ>E?•~!d a note oq the application or Buchanan's formula, a formula that lou used 1~.the p!J>er• Calculating growth rate. Righ~-this note was on the applica~ion of that formula to beat production in ~c.te,r;ial culture bz N. c. Wetzel; .w~o didn't particularlz care for the i,athe- 337 matics of zour J>!l>8~· Ari Well, I had to get same help 0 Buchan' s formul.a has an integral in it, u \ I remember, and I wasn't any good at calculus. I•ve forgotten who helped•• ~is cr~ticism was helpful, illuminating in terms of the formula used1 but there were three asP!cts ~f this p:r:eble• which you. set asi~ in the original stud,1 with Henrietta f!hees 1 and tp!!Z are the measurement of the sizes of bacteria, C•arowth in Size of Micro-organisms Measured from Motion Pictures. I. Yeast, Saechar~es cerevisiae" l Journal of Celluar and COJa,.P,arative Physiolog 387-407 (June, 1932)J •Growth in Size of Micro..Organiams Measured from Motion Pictures. II. Bacillus megatherium" !!!2• 409~27 (June, 1932); •Growth in Size ef Micro-OrganiSlllS Meuured froa Motien Pictures. III. Bacterium. coli" 2 Journal of Cellul~r and Co2rative P~siolD.Jl 329-348 (December, 1932)7- the determination of the~r sur~ace area 1 ~ad chemical studies of t~eir metabolism. These were s~b•eguentlz deTeloeed, They show a deeper concern fer _bacteria ~s bacteria quite •Eart from.their •eelication, ~11nical utilitz-a growi3 C~11!:ern with bacteria. Well, just the aeasurement of the heat of bacteria-I mould have carried it further. For instance, the amount or the calories liberated by, say, the decomposition of a gram of glucose by yeast might be different frOlll the saae thing done by bacteria, but I didn't get down to it 0 If the heat liberated is different, it meaas that the basic chemical reaction is different. It would mean that the bacteria would have a different cycle going through the decompo­ sition of glucose. I!' I had tackled it at that-rime, I would have come out with some simple business that would have been entirely wrong because now the cycle er carbohydrate metaboliSlll in a body is more comJ+p,icated than the orbits or the ;0 338 heave nl7 spheres. It 's t•rrific ... •1 I The last ea,per z:ou J?Ublis~ is on carbocydrates 1 and I think it s in this " stre.am. I .mentionsd the facters that you set aside 1 measurement of the sizes. The ...e,roblem is__how do you measure the size 1 and that bri!!f?s in another aachine. Yes, the sizes were measured with this ti.Ille lapse photographic motion l1 picture apparatw, that Clifton T'ttle and I devised, ["•An Apparatus for Motion Photomicrograpb;r of the Growth •f Bacteria" 14 ~urnal of Bact~riolosz 157-170 (Septaber, 1927)7. It reall7 was a delicate apparatus because you could work at veey high magnification. I think we let this :machine go all day and all night with an oil inlllersion lens and with very little change in the focus. I had the whole apparatus enclosed in a carefully regulated temperature-con1f~lled bu: so that the arms and metals ot the microscope didntt expand, or contract and move the focus. I had five, or six thousand feet of film that all got burned up in my Masterts House fire at Yale in 1933. I lost them all-all my­ books and everything else wu burned up in that fire--just before we moved into the Master 1 a House• Betore that, tortunatei,-, Dr 0 Edward F. Adolph, the Associate Professor of Phym.olog71 at Rochester, was a biologist, a mathematician., and interested in the growth ot human beings as well as all growing things. He saw these motion pictures of growing bacteria and yeast, and we set about to measure theme What we did vu to project the illage on a acreen a➔ust measure the length and the breadth with a caliper. We had long tables of those measurements. Then there 1 s the forlllula-.frQIJl the length and the breadth you can calculate the volume and the surface• We did it with the bacteria, the yeast, the spore formation, L"Cytological Changes During the Formation of the Endospore in Bacillus aega~ 339 tharium" 25 Journal of Bacterioloa 261"274 (March, l933'i], with bacteriophage and megatherium !"Changes in the Shape and Size of BacteriUlll coli and Bacillus megatherium under the influence of Bacteriophage - A Motion Photanicrographic Analysis ef the Mechanism of Ly-sis" 57 Journal et Experimental Medici!?,• 279"304 (February-, 1933270 That's where, if I hadn•t stopped about that time, I night have gone en to genetics beca\lae tllia paper om megatheriua with bacteriophage was accepted finally by the Journal of Experimental Medicine just before I was going down te Washington with the National Research Council. Dr. Peyton Reas wu the editor, and be saw these peculiar fol11lS in the pictures and asked me why I hadn't gone on to follow thas e foms to see whether there was a genetic factor that was detel'lllining the variation. Well, I was finished with it by then, and had no more chance. Yes 1 life got a little ccmplexo Tbere was a series of papers on the growth and !he sise-bacteria1 zeast1 aegatheriUJla colon, endospereo That 1 a a verz inter• !•ting series because the publicatiens contained slides to illustrate, and a Visual representation is se much better. Yeso These papers are still being noticed. Eveey now and then I find some~ bedy reviewing the growth er microorganisms that cites these papers. The last one I buaeed intoa a copy of which I don't have here-I couldn't find it 1 Itm not sazing that it isn 1t here, It might be in some file I have zet to come te--and this was .~he effect of carbohydrates on bacterial ~rowth and t~e deve+oeent of infection-1936, L"The Effect er Carbohydrates on Dacterial Growth, and the Development of Infections" 12 Bulletin of the New York Academy of Medicine 278-284 (1936l7. .340 That's a very s11l8ll thing. That was at the New York Academy of Medicine. Dr. Herman Mosenthal invited me to do that. He was interested in diabetes, and people w1 th diabetes and high blood sugar have endless boils• They can beat Job with their boils. The question presented was is high blood sugar related to susceptibility to bacterial, particularly staphylococcal, irifection? My con• clusion was that it wasn't, but I don't know that I ever did any serious work en the problem. I know that zour own time was cut to pieces in terms of other work. As zou put ita one ti.Ma zou were sucked into the abyss of administration and awaz from the laberatory1 but it see.ms to me that this series of papers does lend itself to a kind of corttinulDl. I don't knew that I used the word "sucked into"• I think I just consciousl,y· stepped into it because, as I told you, I got satisfactions out of that kind of work that I thought !Cd never get out of research work,. I wondered what relationship there was between the work that you did at th! ben,2h and the judgments that yeu ~•rcised at the National Research Counc,!_l;-•-a& at all? Ob oonstantly'of Otherwise, you coul.dn 1t deal with the problems of research projects, as we call them, when you're a director of a fund granting organiza­ tion. You either have to know what the man is talking ab~11t frtn the first, or you have to tm.w how to find out about it. The more basic experience you have1 the less you have to look up. I wondered also about the time zou spent as referee on the Council of Pharmacy and Chemistg; ot the .American Medical Association. 341 That was all educational. Yeu don't get paid in a job like that, but you get a lot of information that is bound to be useful in similar situations. I wonder if it added anything in terms of your t~nkins about bacteria? It did because the kinds or things I did on the Council of Pharmacy and Chemistr,- often had to do with chemotherapy, like the chemotherapy of urinary V tract infectiens, like bacteriophage, ~accinea, things like that. It was all toe;ether. ·rhe Council on Pharmacy and Chemistry didn't put me en the problem of the chemistry of drugs because IliUnit a chemist. The letter I had reference to before we turned this machine on--I can•t put & hands en it at the moment--is an indication that future development is in chemotherau-that is 1 as of the time of the latter in zour thinking. 0 Yes, but, curiously enoug~ chemotherapy 'J\t bacteria at that tilae into the 1920s was thought to be a hopeless businesso You wouldn't be able to find any drug that could kill a bacterium without killing the host. All or this is before antibiotics, before the sulphonamides. It was almost a dead end. The great therapeutic advance came at the time when Erlich developed salvursan, the silver bullet, where he put the arsenic in eombination with an orgard.c radioalo That looked like a great burst, the chemical cure of syphilis, and the thought was that a great many other thin.gs were going to be cured by newly discovered drugs, but the hopes were dashedo There was quite a period in there-from 1910 until later in the 1920s1 or maybe even later in the 1930e-when the sulphonamides and penicillin cmne in, antibiotics and the sulphur drugs, much to the amazement or everybody• II, I did have a connection at the Co\ncil or Pharmacy and Chemistry with claims 342 with antiseptic substances. One of them was mercurochrome !rom the Abbott Laboratories. Mercurochrome was of sufficient interest to persuade us to work on it at Rochester. I got a grant from the Abbott Laborateries, and Birkhaug worked on mercurochrome. Douglas also worked on mercurochrane. Everybody was always testing things to see whether they would have a07 effect, but we didn 1 \ have anything like the huge screening prograaa that are being used now for cancer chemotherapy, testing everything, whether there is any reyme, or reason for testing it or not, to see whether it will do anythingo You make comments in letters I have read to other professors at Yale about the difficulties inherent in the whole process of purification, the kind of prebl81J'l Eaton 'bwnE47d into in an effort to purify toxins. Monroe Eatea. came there with some interest in purification of toxins, but I was interested too, and I did everything I could to favor amii support his work en attempts to purify the diphtheria toxin and tetanus toxin. The influence on Eaton, and on me teo, oae from a remarkable man whe was en Dr. Zinsser 1 s staff, J0 Howard Mueller. Howard Mueller was a Ph D chemist in Zinsser 1 s medical, bacteriological laboratory, and his line of work had been to purify the factors in peptone solutions and bacterial media that were responsible for stiumlating growth. He found copper compounds of great importance for stimulating growth. He was up in Zinsser 1 a laboratery trying to purify growt~ factore in bacterio­ logical •dia. Eateft was Ulere, and I was in and out of that laboratory, so it was a subject in which we were interested. Eaton did very good work on the diphtheria toxin and the tetanus toxin. There are twe other items about this tille--one of them is this research studlJ Gonococcus and Gonococcal Infections. 343 This was undertaken as a result ef connections formed during the war time with preventive medicine in the Office of the Surgeen General, the Public Health 1 Service, and the Allericaa Social Hygiene Aseociatieu. We d been talking about gonococcal infections very- seriously ever since the venereal disease problem came into our field of preventive ••dicine during the war. At that tille, the genoceccal. inf'ections were very- prevalent.. Later in World War II they found penicillin and the sulphonamides would take care of venereal disease•• There had always been a relation between the Social Hygiene Association and the Army Medical Service with venereal disease, and this published study is a part of the result cf that asRociation. Who supported this? Don't they acknowledge a grant here? Well, we had a grant t+o this work. It was necessary to bring tojther the knowledge or gonococcal infection, and this is not a laboratory study in any sense. Thie is a literary- study. Right...& research study into the literature. Yes. We tried to assess the statements we made, and they were full of controversial points. This report has got f• big bibliography. If I could close that orr. Ir I de that, will it hear? It won't cut off? Ne 1 it won't cut it off. Do you want me to turn it oft? I was going to say something illproper. In the 1920e-Tom Parran•••• Is that otr? No. Tom Parran {1Jr. Thomas Parran, Surgeon Ueneral, UoSo Public Health Se'Z'Vicy 344 was very much interested in venereal disease. He took several trips to Denmark to assess their experience and approach toward the problem. I don't remember whether he went further than Demark-England& I beliew-and then he set up a ,ooperatiTe Clinical Group outside of the Public Health Service with support froa the Mazo Clinic, or some friend of the Mayo Clinic, to furn the collation of materials, studies. One of the laboratories was at Johns Hopkins, Th.ere were others. I think tnere were five or six other laboratories in:volved in this cooperative stud{ working in this field, with case histories and the like. It was a continuing problea1 and it mq; well have been the Social Hygiem Associ­ ation that supported this pulling together of information. Yes, the Social Hygiene Association-we had most of our meetings down in the officeo Walter Clarke was medical director,rr director of the medical activities of the American Social Hygiene Association and secretary of this committe••t I see here that the National Research Council gave a thousand dollars for the support c£ tthis work. I think thatw as a big sum. in those days. We started to meet ill New York in --1933, and we had most of our meetings in the effices of the American Social Hygieoe Association. It had very high purp•ses. t I never "-.ar•d very much for the point of view of either Dr. William F. Snow, or Dr. Walter Clarke in these matters because they were sentimental, emotional and not really scientific, and this was an attempt to bring scientific thinking into their affairs, and if you'll turn that off I I'll tell you what I saido What interested me was that with all the other things you were doing 1 like the I revision of linsser s book•••• I 1 d finished the r eVision. This is 19330 But the galleys were coming ino 345 Yes, and I was Master ef Trumbull College. I becaae Dean of the School of Medicine at Yale in 1935, so this overlapped a good aany things. Putting this report togethe+as hard work and took a let of time. In the course of it I got German aeaslea, and I didn't know I had it. I wae working late at night and didntt, observe 'lff3' bod7 particularly even in the shower bath. I developed this rash which I hadn't seen. I only noticed that I wasn't quite right whea I first put_,., head •n the pillow, and I bad the usual enlarged pesterior auricular glands. When you have German measles, the lymphnedes enlarge back of your ears. Ir em.ember I had one meeting with this committee in New York. I had to attend it, and 1ffY eyes--I had a sort of conjunctivitis. I had no particular rash DA my face. I went down to the American Social Hygiene Association's Offices and sat way over in a corner by a window while we md this meeting. After the meeting some one said to •,"You must have had an awful party last night1 You look as if you'd been on a binge for a week•" All my high purpose and the sacrifice of my comfort to attend a meeting, and I was accused of having a hangover. lJ There's one other piece lf business I want to get in here that occurs about this I\ time-this book and the circumstances under which it was don•• This book you're showing me is the subject and author Index of the volumes of the Jou.."'tlal or Bacteriologz trca volume 1, 1916, to volume 301 in 1935. Inter~sting to nete en the title page is not only my name, but it acknowledges the assistance of Mr. Autin E. Andersen who was a bursary student. I told you about that bursary &id program in the collegee. This wor~w as done in 1936 and 1937, published in 1937, and it 1 s all the listings of everything, a very useful index. I dontt really know now why I did it, except that it's the kind of a 346 chore I would do. It was extremely hard. l,d never made an index before,. and I told Y'GU I got in trouble because although I knew that you should have only one entry- on a three by' five card, I got so tired making these entries-I think there are ten tbousand 1 them in here, or something like that. I ma.de the index of the revised 8th edition of the textbook which is a very long index. I got se tired doing this index that I put several entries on a single card and gave myself more trouble than I would have had, if I hadn't done that foolish thing. May I say one thing about this? Yeu make an index of a number of volume8 or a scientific journal like this, and you think a great deal about the subjects \ . th.at you put on the pap~• • educational to a great extent4 Its ' 1;ou indicated to me 1 I ~ink1 walldns ~hro~q the stacks downstai..!!_~at this was done everp.J!i.S at ,T:r:,1.1;!b..fil_Coll;e§•• This was done mostly in the evenings. I think I worked en it1 as I would a thing like this, at odd moments in the day time, Sundays, but it wae done much at night in my office at Trumbull College. The Master's Office was in a little stone extension of the main Master's House, and students could see me working there. The Masterwas available by the mores of the system., as well as in my j~ \ case by my own personal interest in these young men, to the stud~~ who wanted te talk. They were able to tap on my window pane, coae in a.nd sit for hours 1 til ore •r tu in the morning 0 I learned some very astonishing case histories of young people growing up. Some of them you could help 0 I thi;,nk we•-ve gone as far as we ought to go_tod&• 347 Yesterdaz we tried to put lour scientific work in sane perspective,,,t,, some orga~­ zation. It was quite ~rbitrarz from mz point _o,f, '!i,ew1 except that looking back on it1 it seemed to lend itself to organizatien. There's one other problem '!h,ich appeared in a little study zou published on i:,ai~.}>ite fever which was ~ ~f' rare, or was, in fact 1 rare. It had certain contiouing vitalitz. subs!,9,uentlz at Iale 1 ane!; this is the earlz ~ork with Dr. Edward G9 Nugent's patient at Roch~ster. I thought we might take that ue ferst todg ("Rat Bite Fever, Report of a Case with Delllonstration of the Causitive Organism and Its Uses in the Treatment of Paresis" 27 New York State Journal of Medicine lll3-lll6 (October. 1927)7. This is another problem that I got into because something happened to turn the organism up in my laberatory 0 It w asn•t a deliberate search for the organism of rat bite fever. It began with the study of the blood of a patient of Dr. Edward G. Nugent in 1926. I think Dr. Nugent had a suspicion that it was rat bite fever, but be didn't find it 0 We didn 1 t find the organism in the patientt3 blood either. It 1 s difficult to find in the blood of a human being. I innoculated, inj? cted blood into a guinea pig, and ten days, or so, later when the pig was sick, a drop or its blood under the dark field of the microscope showed this little bit of a spiral organism of very active motion with three or tour coils of spirals in its body characteristic of the o!rm of an erganism ,v known as SpirillUIR nun~; in other words Spirochaeta mers~s muris, the organism of rate bite fever. Natural~ I tried to cultivate it and study it, but I neve~w as able to cultivate it, or grow it in artificial medil.llllo The question was how to prove 348 .: that this organism was the ~ause or rat bite fever in human beings. At that time the treatment or syphilis or the central nervous system by inducing another fever, a febrile disease, in the patiert. was a cOllillOn practice. They did this by the injection of erganl.111111 into himan beings. The;y di+t by giving such things as eaulsiou ot typhoid bacilli to produce a fever. We didntt undertake to do that in a patient, unleas you had some means of curing the patient of the artificially produced disease. Well, rat bite fever in the huaan being is easily cured by injections of the antisyphilitic drug arsphenamin.e; u a matter of fact, patierrt.s develop a rash all over the body. They get sore 919•• Tneydtvelop a huge chancre-like ulcer at the point or innoculation, but when you give ars­ phenamine, it wipes it all ott the patient just as i.f' you did it with a sponge, so we felt perfectly safe with this man to WhOlll we gave artificially induced rat bite fever. He developed all the symptODls and all the pathological con• ditionso That was an experiment which fulfilled Kochis postulates. We had an organism that you could get out or a patient, and when you put it back into a patie~, you reproduced the disease and got the organisa backo That was the subject of the paper that was published on it first. Later I published a long review of all the literature I could find on rat bite fever, L"Rat Bite Fever in the United State•" 3 International Clinics {41st. Series} 235-253 (September,193127. It I e known as "Sodoku" in J apaa, or India. It occurs more frequently in Japan than it did in the United States, and l,ll surprised that it doesn't eccur more aaong the Negrees who liTe in rat infested slum•• Thia organim had an interesting connection with .,- beginning at Yale. llftlen a new professor coaes in, they hoe a aeeting or the faculty-I suppose in many places they do the saae-and the incoaing professor gives a lecture, or a 349 talk, or a demonstration on sometbi~ in which he i~currently' interested. I put on a demonstration on rat bite spirochetes, spirillum in the blood in the ampi­ theater at Yale sofpeople could look at it in the dark field 0 I talked about it, and in the audience was th,pewerful Professor ef .Medicine, my friend, Francis o. Blake, who had already published a paper on a very variable strepto­ coccus, Streptobacillus JIQnilif'ormis, as the cause of rat bite fever. )!•ntien or it is in here, I thif!k• Blan thought it was a streptothrµ, but this is a very pleomorphic strepto­ coccws. Have I got the name of it in there? Number 7-~his is the larger study. He published, I think, in 19241 a case which had come up in Bosten, or which appeared to have c aae up in Bosto,~• He published in the Journal of Experimental Medicine a paper on the •1tiology of Rat Bite Fever" in 1916. Yes 2 in 1916. The organism which he thought caused rat bite fever was this pleomorphic-like streptococcws-like organisa. Well, how could the same disease be produced by a spirillua and also by a steptococcus? These organisms are not at all related, but the disease or rat bite fever has some similarities wilth a type or arthritia that Dr. Blake and others were studying. The organiSlll that he had never pro- ,.,. duced a skin er·.... ~ption, or the ulcer, chancre-like lesion, and the disease was not subject to cure by arspbenamine, so it obviously was different. It was very 1nterest11Ul: that two ditterent organisms ware obtainable from people, different people, who had the story of being bittea by a rat. 350 There I was just entering the school and having something that was contrary to the finding of the much more distinguished Professor of Medicine. It was a controversial point, but we never bothered to argue about it too much, and it has turned out that both are right. The SpirillWll minWJ that I had produces the typical rat bite ffl'ler, and this other organism, streptotnry.x, or Streptobacillus moniliformis produces a somewhat similar disea••• but different, and the twe are A 11 running {leong now j11st about in that state. I was carried awq by inter,~ in showing this organism. I can•t remeni>er that I intentionally put on a show that would be critical of the finding of the Professor of Medicine. What was the problem connected with its isolation and cultivation? It j11st won't grew. We tried everything. Henrietta Rhees has a swmna.17 et all that in her Master's thesis. Nothing we could do would make it grow, and nobodf yet has grown it outside the body• I suppose it would grow in the embryo­ nated chicken egg•-the one that they grow "Ii.ruses and other things in with cells, bu.t I didn't carey it over into that media. I didn't go on with the work in rate bite fever after those demonstrations. You went and while we said some thi s abeut Trumbull College and being Master of a college. and you have paid tribute to the enom~us sensitintz with which Mrs. B.J handled vorki91 with youngsters, being ! Master and a scientist must have pulled you in two directions. What is there about bei Master of a coll•• the work r the colle e the work or the Council of Masters-that kind of associatien witb the Masters of the different colleges presents a varied and interesting lot certainly in tems of their lett,t.~ Well, the colleges, of course, are under the administration of the 351 President and the Corporation of Yale in the usual way, and they had attached to them members of the facalt y. All the Masters were members of the faculty ot professional rank, and they had very greatly differing interests--Professor French in English, a Chaucer expert; Arnold Whitridge, Professor of English too; the Professor of Classics Clare Mendel; an engineering socialegist Eliett Dunlap Smith; a very attractive Rhodes scholar, athlete, an a:mateur writer, and English teacher, Allan Valentine; and a Professor of Art and a noted etcher in bis own right, Emerson Tuttle. I think that's about all the Masters. They were authorized to r orm a Ceuncil of Masters wnich met and discussed many of tne problems of the colleges. We met once a month anyhow and gave advice on appointments, the development of the bursar, system, rules for behavior in the colleges, the fostering of the dining halls of the colleges in competition with the dining rooms of the fraternities; in fact, some of the fraternities had to go out ot business because of the college growth. We had hundreds of problems that were discussed• and to me it was extreme}J' interesting because I hadn't, as a rule, talked with protesors of English, or history, or the classics. I envied them very much--these men in classics and literature-in the relation to their work and behavior in the college plan. I had toge{ across town to the medical school and bang around on a cement floor in a laboratory all day as best I could, while the Professor ot Greek, we'll say, could lie on the couch in his college and read Haer and be doing the work of the college. He didn't have to go out. He was always available. I was available to the students at ver:, difficult hours, either earl1 in the morning, or when I got back after five e 1 clock trmn work, er after dinner. I told about the building up of the labraries. I bad a special problem in Trumbull College because this was not a Harkness college. It was a poorer 352 college. It didn't have as much money back of it-the residue of the Sterling Fund. It was housed in rather cramped quarters in a way, in older dormitories next to the huge Yale Library en film Street. The people wh• had set it up had had to fit the college into existing student rooms and buildings; whereas the newer colleges could be planned by the Masters, and they had much better common rooms, dining rooms and living quarters than were available at Trumbull College. Fer instance, there were a ftUlllber of fellows attached to each college-fifteen e of thJ\1'1, or about. that, frem economics, history, classics, chemistry, covering the whole academic field, and these fellows, meabers of the faculty, were supposed to have offices, or did haft offices in the college to which students could COJle for counseling en their cour•e~ or anything they wanted to talk about. In the newer colleges the Masters had an opportunity to include in the new building the study rooma and the cmfortable quarter• for the fellows, attractive quarters, whereas when I got to TrUllbnll College there was n• such ro• for anz,one. I had to go and persuade Mr. Farnum, the all-powerful treasurer •! Yale University, to put up some University money to fit about twelve student bedrooas for fellows' etudies. Of course, that took away dormitory income and didn't add to my popularity with the financial managers of the institution, but we did get them after a while. Always Trumbull College, I think, suffered somewhat fran a lack of financial support and suffered from the kind of quarters it had as compared with the other colleges, but we got on pret~ well• . .. I enjoyed it, and I didn't enJey ito It was very hard work, and I was not in sympathy with the general, what I call, "bey scout" aetion of many of the Masters and the ladies, the wives of the Mastera, whe had plenty of time te engage in personal, social and aausing, or serious, relationships with students in their colleges. Sme of themdeveloped1 real,ly, such a motherly cemplex that 353 they would remind you of female birds, or hens taking a nock er chickens around. I thought the colleges ought to be more like the English colleges and let these men find their own way through life at that time-tal~to tnem about their problems, but not to have too paternalistic an attitude toward them which is what I did. Well, fortunately the entering class that was assi~ned to Truabull College really contained many brilliant men-the class off936o There were people in that class that have made distinct names for themselves in literature and in polities. They were great in athletics in Ia1.e. The great Larey Kelly was a member. I adllired them very- much. I had rather personal experiences with all of thea. Somehow or other they would find me working in rq office in the back et the college and would cane in and tell 11e the mosl remarkable stories abeut their parents, their love affairs, their financial situatien, and the pressure the~w ere under. I sav so9e very fine things. For instance, a great tackle on the Yale team lost Me •~er aae his rather at one time in his sophomore year, I think. They were poer, and he came to me once and said, "Sae Yale alumni have Ti.sited me. They wanted to give me an alumni scholarship. What do you think about it? 11 I said,"It sounds to me like a football scholarship because they-.nt you i) i to play football on the YfJ&.e teamo I don 1 t. think a self-respecting man would ! take a thing like tbato" That fitted in with his thoughts about it, and this huge fellow spent his sUJIDler en scaffolding en his back, on ladders, or whatnet, with a drill drilling holes through concrete noors in buildings to put in electrical wiring and sturr. In college he wu a bursary student, and he did this kind of drilling work during the SUlllller. You saw things like that among the students that were very .354 affecting. I remember one man whese mother lost her mind, as we 1 d say in common par., lance. SM had psychiatric trouble and was put in an institution down in Mary... land. Thie boy would g• down to that town and stand on a cerner for hours waiting until his aether passed in a compaey w1 th one of these custodial efficials of' the psychiatric hospital, just to see her. She didn't recognize ~ , but he would do that. d, You found that they'd come ia a 1tell you about curieus situatiena that had eccurred-a boy who had grown up in a small town and had coae to Yale was engaged t• a girl who in a small town was his\~ual, but he soen outgrew bis fianae, and tbiB kind of student would have a great probl-. His eyes were open, and he saw a scope of' the universe that he never would ha~e seen in a country town. The girl didn't satist,y him intellectually an,aore. This kind of 118.n would feel under a great obligation to aarry this girl that he'd promised to marry'. He 1 d been engaged to her, and hetd cut her off frem other opportunities t• get married because she was loyal to him. The problem you discuss with a 11an like that was hew injudicious it is to marry anybody out of pity for them. They 1 d understand that it wouldn't last. Tha.t 1 a the kind of thing that came to me a great deal as the Master~ probably because I was a doctor. 'l'heytd tell me lots of things about their physical troubles, er their family treubles. They wanted advic•• er in:f'ormation. I suppose i.t' I took the time, I could think of a hundred very personal stories that were told me in all seriousness and resulted in rather useful actien sane ti.Mo Some times you couldn't do an;ything. Well,, there was al so a great intellectual interest in the affairs ot the students in the college. They wrete and put on some plays of their own. At TrUlllbull, they established a magazine called the Trumbullian-do you have any 355 copies of that? There are a couple of issues in the files. - . w I liked Trumbull College because ~r its patron saint....Jona.than Trumbull of Lebanon, Connecticut, who was a vecy steadfast man in the revolutien, furnished the iron that George Washington could use t.o make cannon. The Trumbull home was up in Lebanon, and we used to have a pilgriJllage up there with the fellows, sometimes the students. He was sturdy and forthrieht-•Brother Jonathan", as he was called in the old days-and one of his sons was a great artist, John (\ 1 Trumbull, which was a s~t . development in the fudly, and one of the students at Trumbull Cellege wrote a tremendous thesis en John Trumbull the artist. All et it went aleng as part of a whole life of different people, different agee gathered together, and I don't recall a~ serieus difficulties either among the students, or in ttB relations between my fellows and the students. Our house was a vecy fine Masterts liouse. It was built especially by alteration and addition for our occupancy of ite We had help on the plana tran Mr. Eastman and others• It w as a ver7 expensive house, but it was a place that I entered teward the end of my being there with a shudder becausi knew that as soon as I got inside I would see it swarming with students sitting en the noor, sitting everywhere with nor egard fer the privac7 of myself, or Mrs. B87ne...Jones. Whenever they had a dance, or student festival or some kind, she would take in as ma~ of the girls as the boys brought there as it was possible for her to house, and we had to take care of the parents. We had a huge kitchen and ice ba:, and I think the students in these da7a ••nk a great. deal of milk, quarts and quarts of' milka So•tiaes they-is that book of hers in the files with the names of the people she saw? I didn1 know I brought that over. 356 These wre the dinners. It isn't cmplete. It stops after a while. She tore out a great many pages, but you can see that we had dinners and dinners and dinners. Entertain" ment b1 the Masters was part or the obligations. We had an academic guest suite in the college Masterts ~ouse, separated a little, in a wing, and you could lock the door, and this academic suite was always occupied by visiting members of the Corporation, the monthl1 meeting of the Yale Corporation. One of the members ot the Corporation was attached to each cellege, but in addition the Trumbull academic guest suite was used•• a sort of reaidence occasionally by a pro­ fessor Who had no other place to go like Mr. Allerdyce Nichols, the head of the School of Dr••, who stayed for menths. They didn't take their meals in the Master 1 s liouse. They went elsewhere-the college dining room usually, but the burden of taking care of the linen and keeping the place clean fell on the lady' or the Masterts liouse. To revert to this milk business-I'll tell you a trivial episede that I saw. As I said, the students were all drinking milk and especially when their parents were around. One boy wanted sane milk in our parlor, and we brought in a bottle of milk and a glass, and he tilted his glass an~et the milk run down slowly into it. I said,"Tbis don't foam like beer." He did that inf ront ot his mother. His habitual way of pouring beer into a glass caught up to hi.a on the milk, b11t theywere not rowdl', and there wasn't auch drinking. As a utter of fact, I went to student parties eccasionally at the Waldorf Astoria, or some ether place, a coming.,.ut party, er engagement party, and they had always two bars. They had a milk bar at one end or the dance floor and a liquor bar at the other. All the young people were at the milk bar, and their parents were at the liquor. 357 I got interested in a phase of those students at th.at time enough to talk with them about it• telling them that they seemed to be ~amed of their best instincts. There was a move, a beginning of civil disobedience, a beginning socialistic point of view. There was Mrs. Lindberg's Wave of the Future. De yeu know that book Mrs. Anne Morrow Lindberg wrote? It influenced them a great ... deal, and they wouldn 1t admit they were patriotic. They wouldn'i cmuntenance any talk about service to their country• They s eemed to be hard and disenchanted on things of that sort, but I knew underneath that they had a great sense of integrity and de'f'otion to the eountl'7 and to good things, and it all came out in ''\ wi<t War n. These were the men who fought the war--gloriously• I still have close connections with a number ef students who were in Trumbull College, and they will be life long connections. Well• I went through this as long as I thought I could take it, b11t I wu e getting into other things. At the same time I got to be Dean of th' Medical School, and I got to be Director or the Board of Scientific Advisers of the Childs Fund, and I was still trying to work in my laboratory. I had no end or committee connections outside or Yale, so in 1938, rjr esigned as the Master or e Trumbull College. Fortunat~ly we were able to move to TrUlllbull Street, and the University rented me the house they owned of great historic interest, the house er Benjamia Silliman, and we enjcyed that very much until I went to the war in Do these entries renect dinners in the Master's house? Yes. Formal dinners? Formal and infonnal. 358 There was a dining room in Trumbull _ColleGe for the students, •sn•t there? Yes, but these were in our ~ouse. We had a dining room that could seat comfortably twelve people, well-furnished. Some of it was the fine old furni• ture that Mrs. Bayne-Tones had fran her fud.l.y 1 and some of the furnishings or the Masterts house were taken fr<1n the great Garvin Collectiol.'lS of furniture in the Yale Art MllSellllo There are some fascinating names ,that ap,eear in here, but unrelated to scj_ence .... John Hersey was a student in the college. We tried very hard to keep Trumbullf•llege from being known as a pre•edical college. That nust have been hard. Yes, they always thougbt.-the students who elected that college thought. that they would be close to the Dean, and that this would help them get along in medicine-I mean that you could give them advice. You see, they were under­ graduates in the college. Theyw eren't in medicine, and it was hard to get into medical schools, and they thought that electing Trumbull College would be a good thing. Also I had a good maey medical people in the fellowts group 0 Dro Harvey Cushing was a fellow of great renown. Dro Winternitz was a fellow 0 The one who raised the greatest problem was a most interesting psychiatrists named Clements c. Fry. Dr. Fry was the psychiatrist for tne Yale student health organi• ~ation, and he had his fellow's room up on the fourth noor of the same buildi~ that housed the Masterts ~•use, a five story buildingo He used his sofa as a therapeutic, psychiatric coucb 1 and all the time disturbed and queer students were going up to Clem Fry1 s place to be treated, and it began to give the place .359 a rather shod~ name. Trumbull College didn't get to be known as a pre""ill8dical college. That was the trouble. Having a medical man supposed to represent science, or be broadly interested in science, and yet working in the medical scheol tended to restrict the interpretation, but I had excellent scientific people in the fellows-the great theoretical physicist named Henry Margenau, a botanist-biologist, Johns. Nicholas, and Charles H. Warren who was the Dean of the Sheffield Scientific Scbeol and who succeeded •• Nicholas succeetled Warren. There have been four Masters since they started. They had a fellewts meeting every- Thursday evening"­ all colleges did because thatts the evening when all the servants go out of the house. We would meet and go down to dinner in a body and sit at the head table, the Master's table, cae back and have a discussion about sauthing. ,s Hw did you enjoy the association with the other HaJxters? Very auch. Rebert French, the Master of J onatban F.dwards, was a long-time friend of mine from classmate da,-s at Yale. Alan Valentine and I used to play­ tenni+ogether. Arnold Whitridge was not so approachable. He comes fr• a group ef Victorian socialites of New York-rather snoety. Elli,t Dunlap &nith was a very interesting person, and he was an engineer with social ideas. At that time, engineering was being urged and taking stepa itself to be a broad social subject, not just applied work. The engineering courses were being broadened. Clare Mendel, the Professor or Classics, was still a close friend. He was a Navy- captain, a rather vigorous, opinionated man who married twiee. He could get mad, but it didn 1 t matter. Emerson Tuttle, the artist, was a highly cultivated man ill literature and other things, and he had a very fine college in Davenport Colle~•• Then a friend that I still have who is here in 360 Washington is Arnold and Mrs. Wolters. Arnold Welfers was a great authority on international affairs, and he 1s still here with the Johns Hopkins International Affairs. We aet in the Council of Masterts meetings, but we saw each other all A ot the tillle somewy, or another. ' this contact. I don•t know how much contact you had at the Univer~ity of Rochester aeart from the medical school and the DeP1rtment . of Bacteriology? Well, we had contact with a great many people in Rochester outside of the t,E"' / medical school because Mrs. Bayne-Jones got to~ soon one of Mr. East.manta rather constant associates. He had four ladies that used to go with bi.a and sit with him, talk with hilll always at his musicals and things-Mrso Whipple, and one or two others, and these ladies would bring their husbands into the association they had with Mr. Eastman. You met a great Inal\Y peopleo Mr. Eastman had a musicale at his house every Sunday, and you'd meet all sorts of people there. I knew a few people outside of the school in the University faculty-Dr. Rhees, Professor Charles w. Dodge was a close friend ef mine, the Professor of Biology, and a long time friend or Dr 9 Goler; in fact, Professor Dodge and Dr. Goler were among thesrly people who made diphtheria antitoxin. They got a horse and immunized him under the steps of F.dison Hall in the late 1890s, I guess. Professor Dodge was in the Health Bureau Laboratory and his specialty was to watch for the appearance of diatems in the drinking wata-. Diatoms are these beautiful, little, microscopic organisms of extraordinary color, shape, and size. 'l'bey vary a great deal in the water. Some of them come at certain times and give the water not only a curious color, but a most awful taste. One of the problems in water supply was toatch what happens in the reserYoirs-follow the J61 diat011S. What Ita getting at is hew precise Professor Dodge could be. He had a little bettle of black magnetic sand. It was sand that could be picked up by a magnet-little fine grains. He W!led to use this sand as the filter bed for his diatoms-made a little filter out of paper. J.'he diatoms would go throu~ the paper, but it you sprinlcled a certain amount of this sand in there, they would be caught in the sand. Then you could wash them out. He concentrated them in that wa7-put a quart of water through this thing. When he got through the filtration, he would take out his paper and let it dry". Then he would start picking up the sand grains with a magnet. He used this little bottle full of sand for thirt7 ;years, and I doubt if he lost two grains. I inherited the bottle from h11ll when I took over that part of the work, but the bottle got empty. The other Masters on the occasion of your retirement from Trumbull College, and incidentalJ,Y it hasntt been pointed out, and I think you ought te 1 that the nature ot the aepointment was lite t~. s The original Master were to be thereo " Yes. French stayed until he died. There was no term, except the retiring age-not lite tiae. You had to retire at age sixty--four optionally. Yes, I don't remember any time limit at all oa the appointment. Nicholas stayed there until retirement for age. Wbitridge lett. Emerson Tuttle died as Master. e Wolters left. Vallentine went to the University of Rochsaer to be president. u \ Mendel stayed until he retired. On the eccasion of l~ur retirement as Master of Truabull College 1 there was quite a good bit or eoetrl read bl some of the other Masters. 362 They gave me a fine dinner party at Whitridgers house, and some of this poetry is very clever. Yes 1 it is. I donft know whether any of it is in these files, or not? I Yes 1 its here--! guess there were six pieces from six different sources. They were so much cleverer than I was--it 1 s just. amazing. It was a good experience. Don't you think in terms of subs!9,uent things that happened to you at _Yale, that it was g cod oo have this initial experience with a variety of youngsters in the college settiDi? Oh yes, I think it was a very hmnanizing and soul enlarging experience. Anything that is as intricate and extensive as that is bow..(d to increase the comprehension of even a dope. You couldn't help but pick up some ins~ght into the nature-some of your early reports. I want to take that dinner boo.\<. back to her. You don•t want that. El:cept that 1 t does indicat• . _. ereseat, Well, you keep it, but put it back with "l1f3' papers. Why don't we leave it here in the files, and when we come to go through them we can decide then whether it's wise to leave it 1 or not. Well, it belongs to hero I didn't know that I had brought it up. 363 Maybe yon'd better take it then. I think before we can get into scientific work and changes at Yale, we ought to get into the conditions that yeu found in the medical school, its growth and developtent 1 the spur behind this growth and development, and sane of the difficulties that led to the deanship problem in 1935. That 1 s a. large order. u Let me turn this over ..-vetve ot about ten mi tes left on this side and I hate to get started on something and then have to stop and change reels. I believe we 1 ve had enough for today. .364 Mellday, May 9, 1966 A-60 1 N. L. M. I want to take advantage of your experience at Johns Hopkins and your experience at the University of Rochester to give some comparative insight for its own sake into the develoe,n~nts at Yale Medical School as background, in a way1 to under- • stand the rebirth and development of the 19,?_0s_ and into the 19.30s which would set some dimension for what it is you fell heir to 1 the kinds of problems y_ou fell heir to, so if you could draw on experience in three places bec!use they are different in. some respects.,_ and tell me 1 so far as you can r ecall 1 or have thought about it 2 or read about i!::, something of the background. of the emergence of Yale in the 20th Century, particularly after 1918. 0 Well, in my re~tllection and my feeling about these places, they are not so distinct as they would appear to you. I have had some connections with Yale, as I brou{!ht out earlier in our taik, since at least 1843, when my grandfather 0 went there and was in the same class with Mr. Johrlf D~nnell Smith who was a great uncle of the future Mrs. Bayne...Joneso In the intervening years of the last half of the 19th Century I bad some relatives in Yale most ef the time--my uncle Hugh Bayne, my uncle T. L. Bayne, a whole lot of cousins by marriage in the Che~ney family and a nU111ber of people from the South who continued to let their children go to Yale, although they were still remenbering the Civil War and Reconstruction, and Yale was not so popular in the South an;y m~re after the Civil War. Yale was a place I was familiar with from very early times., but the side ef Yale with which I l&S familiar was the academic and social side. I was there as an undergraduate fran 1906 to 19l0p taking preparatory work for medical school, but to tell you the truth, I paid very little attention to L'r I Yale Me~~cal School. At the time when I was in college, Yale Medical School was in a little old tumbled down building on York Street-one of the original n~I): C.ft L. 'S 1:.1-\UC\.. .,,) buildings almost, going back to the middle of the century. Yale(had been I\ ✓ .founded with some eclat in 1831, by Nathan R. Smith and some very fine physicians or that time. It had a respectable positien in the medicalfworld and history or the country, but no pa.rt.icular distinction. There's a great pamphlet on Yale ...-no, that's not it; that's later-by Dr. William Ho Welch, and you llight want t• get this and see it. It must be in the library here. In 1901, Yale University celebrated its bicentennial. It was rounded in 1701, and one of the chief speakers at the bicentennial celebration was Dr. Willia.a Welch. He wrote a history of the Yale Medical School which was published as a separate booklet in coMection with that bicentennial celebration. I know from talking to Dr. Welch and others, that he haf.o work very hard to fill the :f'i.fty or sixty pages of this pamphlet. Yale Medical School was a geod scheol, but not in a class with Hopkins, or Harvard, or Chicago, or Pennsylvania at this time we 1 re talking about, and I had never had much connection with the Yale Medical School. I had no thought of going there. I wanted to go to Hopkins as I have told you before, but I got sidetracked to New Orleans for one year. Nevertheless, I knew that the Dean at the Yale Medical School through the period from about 1910, a little arter 1910, up to 1919, and that's Dr. George Blumer, was a very fine, solid, upstanding man, conservative, careful, un.. breakable integrity and dull, but Dr. Blumer was a great professor of medicine. He wret.e good textbooks, ~ The was very much respected. I used to see Dr. Blumer occasionally when I went back to New Haven for one thing or another. As I say, Yale Medical School was a place outside m:r ordinary ramblings. I was very much more familiar with-\t,he academic and the social side of Yale College, and I make a distinction here between Yale College and Yale University. Although Timothy Dwight in the 1870s, or thereabouts, is supposed to have made ,366 the first steps toward creating a university at Yale, Yale College was then, and still is, the rather dominant elemen~ in the placeo One, who grew up as I did, thought about Yale College more than he did about Yale University, se when I went back there I had the saae feeling about having been there before that I had when I went to Hopkins. Hopkins was not a new place for me to go to as a student. I knew Dro Welch Dro Thayer, Dr. Barker, and a good many other people in the Hopkins and in Baltimore before I was a student, and I had an interest in the things that they were doing. Starting at Rochester was a new ventnret but as a matter of faet, it also aeemed rather like being inff'amiliar sarroundings because mes1 of the men on the new faculty were old friends of mine. It wasntt strange at all. We thought alike in a great man;y ways. We had cmmon experiences. At Rechester we had t• build up this medical school within a university that1&.s then about seventy years old, I think, and a conservative un:l.versity, c..,.ducatienal, placed in the middle of the town or Rochester, whereas the medical school was built eut on the banks of the Genessee River, about five miles out fran the center of the city• .! i Again, we were in an isolated location, just as I tel t ~'(,e Medical School was in an isola"fed location because it was quite across town from the University• Our problems in startins the medieal school at Rochester were surrourided by an inheritance of the traditions of medicine and the ideals of medicine and the usual thoughts that we all shared about the policies and procedures for con­ ducting medical education. All or theBe things were in our minds inc ommon, and I didn't feel as if it were a new building in the <Bsert, or anyttdng like that. For my part, at least at Rocnester, I began to feel very much at home among the u people. I suppese this was because Dr. Goler was so cordial and enthsiasticall.y supportive of the effort and so wise that it made rhe " transition quite easy-• 367 a~st cOlli.ng into a respective part of your family that you hadn't seen for a C O long time. I don 1 t knew ~wt~ characterize the situation :much more, but I would emphasize that I had a great continuity through them all• There wasntt any great break in either one, or the other. At Yale"-to take it up at the time I went back there in the thirties. Is that when you want to get into new? Some insight into its developuent since 1918 1 because I think it had taken a turn for the better, had it not? Yes, Dr. Winternitz, whe I think graduated from the Johns Hopkins in 1907, went to Yale University in 1917, I think, as the Proi"esser of Bacteriology and Pathology. He didn 1 t go there straight as the dean. I think it was for nearly twe years that he was in the Department of Bacteriology and Pathology, and Dr. Bllllller was still Deane Dr. Blumer conti. nued as Dean until 1919, and Dr. Winternits, if I remember correctly, became Dean in 1920, and he was Dean of Yale Medical School until 1935, fifteen ~ars of the most extraordinary develoJ:111ent of an:y established medical school in this country. It was a complete renovation of ideas, aspiratiens, metheds of teaching, research undertakings, and all in the social cast that was characteristic or Dr. Winternitz and character­ istic of Kr. Hutchins who was Secretary of the University and other supporting people who gave Dr. Winternitz unli.111ted, loyal support, although you would think that they would not have had much interest in the deliberately- socialistic phase et medical e ducation and medical care that he sponsored, and one or these men was the all powerful Treasurer ef the University-, a tall, gaunt, finn man namee Mr. Thomas Farnam. Dr. Winternitz seems to have set abeut right from the start to revolutienize 368 the teaching and service plans in the Yale Medical School even before he became Dean, but when he became Dean, he had a chance to bring }his huge and sweeping ideas into practical effect. He was able to get an enormous building program started. He built the Sterling Hall or Medicine which is this huge building Ll covering the better part or a large block. He b~lt a new powerhouse, built new animal quarters, built a better Department or Pathology, added wings to the eld, tumbling down New Haven Hospital~ and set up very soon what he called the Institute of Hwnan Relations. The best way- I can characterize that is to recall a diagram that Dro Winternitz gaff me which convl.noed me that what he was doing with huaan relations was jus"t to take the whole university into his ballliwick and giYe it another name. The diagram he drew for me about the time I had gone back there as a Professor and Master of Trumbull College was a five pointed star, The five pointed star represented the nucleus of the basic structure of the Institute of Human Relationst and at the point of each point of the star, he had a little circle, a little spheret and one of t h + labeled Yale Law School and another was labeled Yale DiVinity School, am another was labeled ¥a1e College, and the Yale Medical School came in there-in other words, what he did was to take all the big departments of the university and make them little appendages of the Institute of Human Relations. He nearly succeeded in getting that grouping established, until the people who had not only vested, but perfectly legitimate rights in the Divinity School a~he Law School as autonomous organizations almost with special functions and special oblieations, tur1ted against the plan, and enormous opposition~s aroused to the Institute of Human Relations in the university coamunity.-also this eppositien was aroused outside-who rather ridiculed this idea of having a thing called the Institute of Human Relations when it really was a power play to bring all the main 369 division of the university under one jurisdiction headed by Dr. Winternitz and maybe Hutchins. Well, by toe ti.lie I got there, the furor or the Institute or Human Relations •s rather quieting down. It quieted down rather quickly' because the Institute or Human Relations idea was promulgated largely by 1931• ancl I got there in 1933, and what it had become by that tiae was a Departaent chiefiy of Psychiatry am Psychology. They bad in one of the large wings ot the Sterling Hall or Medicine the Department or Psychiatry with patients in all stages or manic ex­ citement to great and dangerous depression showing Jlinor abnormalities of be• bavior to very serious abberatiens. Dr. Winternitz also had planned to introduce into the Yale Medical School foreign professors, and the Professor of Psychiatry was Eugen Kahn whom he brought ner troa Vienna, I think• Another importation was Dusser de Barenne a neuropbysiologis\, a 4eat, big strong duichllan. I don•t thinlr: either of those aen took root bere. Dusser de Barenne died or a heart attack just shortly after I finished being Dean. lahn lett, and he is now a Professor of Psychiatry SOllEIV~e in the Southo In 1lfl' opinion, when the7 transplant a foreign pro• tessor in new soil, he carries on a rather wilted existence. Nevertheless, Dro Winternitz started a vogue of haTing foreign protessora come in, and they 1-re bad one recentl7 at Yale who didn•t settle down too soon and probably' won•t stay very long. The other l'llembere ot the faculty that were in the medical school--! forget when they were attracted there, but I think Dr. Wiaternitz had much to do with getting the•• They- were very proaising young aen and had developed into excellent. authorities in their fields, like Dr. Grover Powers in pediatrics and Dr. Francie G0 Blake in aedioine 0 An indigenous Yankee of the country, Dr• Saauel HarYey, was there as Professor of Surgeey., md he vu a 370 remarkably stable philosopher in the medical school and a llB.11 or general relmvn at that tiae. The other 11en were good toe-Arthur H. Horse in obstetrics. The school, hG1ever, was suffering from lack of .tut'lds. It had no endowment to speak or. Its financial problems sc:aehow Dr. Winterm.tz bad managed temporari­ ly to solve, or at least he managed to get money to do the things h1wanted to do1 but it wasntt, resulting in much permanent resources in money. For example, a very great 11an who was on the faculty was Robert M. Yerkes, a great student ot higher prillates, cbiapansees at Orange Park, Florida, where he had his coloir,r of these anillala. He waa a psychologist, and he carried a huge ~ndertaking by yearly pleading with the Rockefeller Foundation to give hill whatever he needed I per year-36, or 40 thousand dollars. Thats eas ridiculous now it ,., s so small. I bad a little problem in connection with that work when I was the Dean, to get it retinanoed tor the last tiae, I tbink, on that saae source, the Rocke­ teller Fonndation through Yale• Dr. Wio.ternitz had succeeded in getting .trom the university and froa out• side sources enough to build these new buildings, to bring in aew people., and b;y persuasion and eloq11ence to ren.se the educational progrmn to a considerable extent. How etf'ecti.Ye wu the nexner Report in this rebirth and through the Flexnei:, Report the Rockefeller F•undation in the 1920s? The nexner Report was in 1910. Everybody was taai.liar w1 th it. The report indicated that Johns Hopkins was so tar ahead or ewrything else, that all any.. boc:IT could do was tr.rr,o catch up a little bit. I don't think the Flexner Re• port wu or a• particular benefit to Yale. Yale, as I said, ranked aaong the good schools, and the Rockefeller Foundation was interested in supporting 371 medical education to a great extent at that time. They don't do it any more t.o that same extent, but they did support a good deal at Yale--just at the present I I ~orget how DlUch, or when. There ere several •ther foundatieu that con- tributed to work going on in the place• The Anna Fuller Fund giving money tor growth studie1, the basic developaent of cancer research at Yale. Mr. Frederick P. Keppel vu interested in haVing bis foundatien-wbat was that? Carnegie. Yes, Carnegie gave SOil& money- tor dental educat.ion at Yale which we can talk about now or later. One ot Dre Winternitz•s ideas, tor example, was a very broa-1 idea that affected his etterta in connection with specialties and general education. " noires, or whatever you call the kind ot bea\t that He bad two ~te '.::, ~011 want to tight the ■oat, and one of these was the tenure ot professors. He thought that Ute tenure tor a professor was one or the aost inhibitory- things that a school could have. •You can•t get rid of them", he'd sq, and he wanted te get rid of SOile et the■• Ttiat•a been true ot ■oat adainistraters ot educa­ t.ional institutions. They have to obe7 the traditiou of tenw:"8, but they don 1 t want to alwqs. A aan is finished, and he stays on. The ether thing that Dr. Winterm.tz wanted te break down was the walls be­ tween departaeat.a. The departmentalization in a school•• extraordinary. The people in. surgeey want to build up surgeey as a cmplete little school with the emphasis on surgery-. ·~he sae in medicine, and the same in neurology-, er soae­ tbing else, am they all go abo\t their work with very- little ca1111u1Bication be• tween these sectioM. The one thing that was different at Yale, at the tiae I vent there, as cc:apared with Rochester at the start, 1118 that at Rochester we were all tree to associate and didn•t have too many other bllrdena or interests. .372 We could pool our efforts in education and research, but at Yale it was a series of rooms, so to speak, or c•partaents in which one departaent would live and not go through the door into the other. Winternits tried to break that up by forming what he c•illed study- units. For instance, he set. up the Atypical Orowt.h Study Unit which aeans that it would be broadly interested in the functions of growth and particularly- in the growth that is not t.y-pical. That's a long lot of words to aean cancer, or neoplastic growth. Ir 7•11 stu.q growth as they do now everJWbere, you can't just study the change in the length and breadth ot an erganisa. You've got to study the biolegical aetabolic procesaea, the whole physical cheai.cal situation, the eu,aes, even tae effects of cosmic radiation en th•• l'hey- are all a part or the ecoloa ot the uni.Tera•• Well, Wlnternits saw that, and he tried to bring together in the Aty-pical Growth study- Unit the pathologists who were seeing cancer in the autopsy-, the surgeons whe were seeing cancer on the operating table, and the medical people who were seeing cancer tbat1BSn 1 t being treated surgically, or cancer diagnosti­ call.1' in the patients as the7 caae along. The ph1'9icist could help with apparatu, and Winteraits even brought a pby'siciat over from the University- De• partaent or Phy-sics and gave bill an ottice in the aedical school so that this aan was alwqs available to discuss the pb7sical aspects ot probleaa, whether it be a question of apparatu, or whether it be cellular process••• iadiatien waa rather well deTeloped at the Yale Medical School aostly- trom the diagnostic I\ point of rlew. Radiation in relati•n to 'typical growth was well known ever since anybodT saw th+ancers that developed on the hands of the men who did the first x..ray- work. It was quite interesting at that tiae to see radiatien coming into the field. The s ae thing was happening in ch8JBi11try. It was a period when the sex hormones were very aucb to the tore, and, for exaaple, the Pro- 37.3 t88sor of Anatomy, Dr. Edgar Allen, was more of an expert on some of' the in.• ternal secretions, particularl7 sex estrogens, thfln he was on structural anata,or, and anatftl1' at about ~ t ti.Ile was doing what Dr. Winternitz would like very much to have it do-that is, go over into fields of biochemistry, or physiology-, to study processes as well as struetlll"e. Well, the Atypical Growth Study- Unit was formed and tunctioned, and, as I say, it brough~ into Yale a lot ot capeteace in th• field ot cancer. I can r eneaber the imij~•ion that group aade upon. Mr. Starling w. Childa when he and bis son came to visit the place. I think it turned their attention to Yale in a way- they hadn't appreciated before. The trou.ble vitb the atud;y' um.ts is that they go along very well for a f'ew yeare, and they becmae departments, and you nave to break their walls down. They get a little aoney, and the)" begin to have vested. interests, have interest in positions, interests in p~sical laboratory, space, and whatnot. Winternits bad ala• another group called the Nevological stud7 Unit. A characteristic of Dr. Wlnternits•s idea was that this should bring together the psychiatrist, the psyeholegist, the neurologist, the anatomist, an expert on nerve structure, the sub-department that Dr. Harold So Burr had on neuroanatcay -7011 saw his letter there-that kind of a1a is fine, but the only thing about it is that the7 nourish in a broad wa7, have a nourishing time in broad and liberal activit7 for a few 7ears, and then they get set. I suppese all living things do something like tbat. h This is p:e~t excit•ent though in t~ generati~n of ~ew ideas and novel approaches. I Oh yes, but it a extraordinar7 hew divisions in a school just occur either because of geographical accidents, or the inclinations of the peopleo Yale Medical School is divided structurally by Cedar Street which runs between the 374 hospital and the Departaent of Pathology- on the one side and the so-called basic science departments on the other--anatOIIIV', physiology chiefiy-and then the Institute ef Hwaan Relations. Now, people don't cross Cedar Street, although it's about thirt7 feet wide. That 1 s a fact. It was a greater chan in that school than the Colorado canyon. That's incredible isn't ito Yes, but it happens everywhere. It happened at Hopkins. There is something about the geographical separations that are very powerful. Te cross Cedar street 7ou had to put on a coat, or a bat, so•thing like that. It took time, and it caae UP-I aean this idea about having accessibilit7 as a pri.119 element in a plan came up when Dr. Cushing, Dr 0 Fulton and I were talking about a structure fer the Yale Medical Lilraey. W. 111 get to that rn IIOre detail later, b~t let ae put it in here 0 11 11 sa7 this-at one tiae Mr 0 Grosvenor Atterbury-, who was an architect.classmate ot Mr. Childs, had an idea that this library ought to be a beautiful aarble, mausoleum--as I called it-set up on a piece of land just beyond the Institute or Hunan Relations. Dr. Cushing and I felt very strongly the other way, that the library eu.gbt to be a place into which the students would fall unavoidably, so we put the libraey on the encl of one or the stems of the lliddle wing of the Sterling Ball of .tledicine, a beautiful little corridor going into a Y shaped extension, the biatorical aedical library on one side and the working libr81'J', or current libraey, on the other, and it was so easy -~ passing by there to walk in through the aoor that thousands went 1 ..,,R that never would have gone up otherwise, t•• sure. We fixed it like a trap. In the late l920s1 I think troa the Yale Faculty1 c-E A. Winslow and from the Yale Law Scht?Ola Walton Hamilton1 were involved ina studz, the Com.it.tee on 37S the Cost or t'.1.edical Care. Did that baTe its ramifications at Yale 1 oi: was that one or the new ideas that were abroad in the land also? Yes, it was a new idea ill the land. Dr. Winslow, Charles-Edward Amory Winslow-curiously I haven't mentioned hia so far. He was the bead of the De­ partment of Public Health, and Dr. Winslow was a noted man, very eloquent, a pro- 1\ li.fic writer, and a great powe~ in public health in the country. He was not a clinician, and he didn't have an;ytbing particularly to do with medical students. His budget came through the Dean•• Office in the medical acheol becaUBe he didn't have a school. He had a deparaent, although it was called the School of Public Health. Dr. Winslow was a man apart ia a vay, not on his own inclin.a• t.ion becaase he was a perfectly charming, hospitable person, bat because, I think, the other members of the faculty were either too busy, or too disinter­ ested to have auch aasociatien with the Department of Public Health. That Departaent et Public Health was an enlightened department. Dr. Winslow was a prophet ot the new ideas of social medicine and very iaportant in all sorts ot civic and other activities that are outside ot the ordinary medical field; as a matter of fact though~ he was a fellow of Trumbull College, and I got to know hill well• For instance, when he was in Trumbull College, he was very much iaterested in city planning, and. with him we got a Russian or two over. At that tiae it was a little bit bold for a aeaber of the faculty to have such guest.a, but they came over and talked about city planning. Dr. Winslow knew the chief city planners in Englami, and he and Ira Hiscock studied the city planning of' New Haven, but what good it did for that I don't, know because New Haven is an unplanned situation, if there everllla one. Yale University occupies moat ot the center of the taxable property of New Haven and makes a great trouble with the city officials and town and gown battles. 376 And especially when you headed into the early 1930s and the depression. I don't know much about that because I •s down here in Washington theno This study of the cost of medical care was fought by the regular aedical profession as they did so 11&rJT things of that kind. Xhey-tbe on, I have up ~ there on the c~st ot medical care, the financing of medical care, even as late as that, the late 1940s, was opposed by a good ttl\Nf et the medical people in the organized medical profession. The school had to make its way through inno• Yation into innovations by~ constant sort of a battle with the offices ot the Connecticat State Medical Society and the Bridgeport Medical Society, although 0 Dr. Winternitz had managed to make good friends of the main Pf\ers there, Creighton Barker, the Secretary of the Cennecticut State iedical Society, vu a strict AMA. type of man, but he was mostly friendly• Then Dr9 Winternit1 set up an advisory, consultative cc:adttee composed of the Dean, several members of the faculty, and the chief aedical officers ot the state-I mean physician effieers; not politically appointed officers"'4embers of the State Medical Society, the Bridgeport Medical Society, and so forth. They would meet three times a year and talk over the problell8 or the medical school as they bore en the practice ot •dicine in the State of Connecticut. It's rather sharp at tiaes because they want to protect the financial emolU11ents of the practicing physician, and they- are rabid on what the physician calls "the corporate Il'&Ctice of aedieine.• Yale and other places I 1Ye been do get into the corporate practice of medicine, it you want to strictly define it, and that's anathema to the AMA type of person. Waa Winternits behind the developaent of the full t1Jle &•tall at Yale? Ho, the full time-yes, he was back of it, but the full time system at Yale 377 was started at the Hopkins. The full time is in the nexner conception ot things. I was at the Hopkin., when, of course, that was going on. Dro Osler bad left. After he had left, he expressed indignation that aey professor would venture to talk about medicine who didn't have to fight in the arena in the battles with the patients and their families and all that sort of thing. Dr. Welch, however, was thoroughly full time froa the start, and Dr. Franklin P. Mall, Prof'esser of Anat0117 at the Hopkins was probably ahead of Dr. Welch in the concept et the -hu1 time systea. I was on a coamittee which Dr. Welch had set ap to periodically review things in the full ti.Ile syst•• I can•t remember exactly the last meeting, but the substance of it was that Dr. Welch called us down to Hopkins to discuss the full tiae system and at that time-and I think +as at Yale thenJ I was repre• senting Yale--tbe ful tiae systea vu not working well for tn reasons. One was that it wu aet up on a shoe string financially. It offered salaries to these great professors of medicine and surger:, that couldn't compare with the salaries that the7 cow.d get elsewhere, or couldn't compare with the salaries they shodd have to live the kind et lite they were supposed to live. That was one thing. The other thing bad about the full time system was that they e arJ.,-1 and maybe they do still to a certain extent, selected young men who were in. the beginning of their productive research period antad great promise in research. They brought them. in to be heads or departmeDts and loaded them so with adainis- r, '\ tratioa that they couldn't do any aore research. Administration, ~aching, public relations, faculty coalittee meetings, cOlllllittee meetings all ever the country in connection with educational and research foundations are incessant interruptions an+ke awq1 or exbau~ the energies, or the thoughts ot the people who haTe to do it• The Ml time system was reaU.,. breaking down because 378 it was ruining the people they thought were just the right ones to coae into it. Was this true of your experience at Rochester? How did Whipple regard the full time system? Hew as in favor of it., but again Rochester at the ti.lie I•a thinking about it, in the 1920s, was smaller, a.nd I don't know that the outside calls on the people were anything like what developed later in the 19.30s when ■ore and more organizations had foraed and more and more people were asked to be advisers. Well, an example is the growth of the National Institutes of Health. 'l'heir Councils are composed of teachers everywhere, and eveey day' there are Metings of great length, and ence you get on to one of these things, ene of these organi­ sations, and either do sC11ething helpful, or doa•t do anything disreputable, y-ou 1 re asked to go en againa It ju} builds up. Nowaday-s-well, I read a paper the other day- that ••bers of the faculty must at least spf~ a third of their tille a way from the school to be of any good to the school. That's incredible. At Yale then1 the full time system wu in operation only eartly. Oh, it waa in operation for the heads of departments-surgery, medicine, pediatl'ies, obstetrics, paJCbiatry, pb7siology, anatcay, patholou-4tbose, At Rochester we began to break down the full tille system as far (&S salaries go. We had to for the clinical meabers. We made what we called the modified full time system which I think is a good~lan, and I carried it out at Yale semewhat and much at Cornell in New York. The modified full tille system siapi, is this­ a man is allowed in private pract.ice to collect tees equal to his salary. It he gets ten thousand dollars a year, be can make another ten th•usand. It he 319 collects ■ore than ten thousand, the excess over ten thousand goes into some tund. Sae places put that money- in a fund to support their departments, some places turn it into the school, and sme places turn it into the university, if the central university manages to get hold of it first. The best plan, I think, is to turn it into a general fund for the whole benefit of the school. Se,ne departments make so au.ch aoney that they themselves become granting institutions within the school. I know of a department of surgery that supports a good n~wt of the departments of medicine and biochemistry, and other parte of a medical school, but if it's pooled and is under the control of a cOllllittee, or sane one person, as it waa in New York, it can be Wied tor the supplementat.ien ot salaries, to buy books, to have a research fund for venture investigations of people who haven't yet reached the stage where they can get money fr0■ a foundation, to carry malpractice insurance tor the interns and residents, and a whole lot of things 9 I think at Cornell we called it the "full tiae tees fund", but at Yale when I was the Dean there, and I don't ratember aey particular difficulty with this, I•a sure that professors, sane of them, collected money in addition to their salaries. B7 the tille you becoae Dean the emJ>b!sis is toward the modified full tiae syetemo Well1 z:ou know, ireat chans,es take place in the nation as a whole in 1929-the collapse, and I wonder what ef'fect this had. It maz: not have been felt initially, but Winternitz certainly felt a kind of retrencbaent3 even in the Jlidst of re• birth1 developlen.t and re•thinld.ng1 and it I s bard to balance that kind r£ act- I cert.a.inly to the satisfaction of everz:one, Its iapossiblet I would think that papessibilitz: would be part or the atmosphere, hostile or otherwise, to which you fell heir in teras of 193f. Part of this nation-wide calamity was to spur 380 new and exotic tho!!iht-you know1 how wild they were froa one extreme to another as to what to do• Well, you see, I was at Rochester when the depression began, and I felt it personally because I had trouble selling a house for half what I paid for it. I don't. think I could have sold it then, unless I threw in twenty-five gallons of the best wine I ever llade and an elm tree in my celler that had blown down and I cut up and stacked. You had to sweeten the pot with the best wine zyu ever made. Yes, it was good, and I persuaded somebody to pay half of what I paid for the house. Then I went tt> Washington shortly after that, and I was not in Yale at all during those pinching ti:aes. I didn't get to Yale until 19321 and when I got to Yale in 1932, I was auch concerned with getting TrWllbull College started anti my own laboratory, so I was not in the know as to what was going on 0 in the administration ot the scho~l very much. When I was there at that time .s I had ftO responsibilities as a department head. I taught some graduate who '\ were registered under Dr. Leo F. 'Rettger and worked with some of the clinical depart. nts, surgery and pediatrics. Medicine had a great department of bacteriology of its own. It was a distinguisb.ed department. James Trask was a great expert on streptococci in the country, and they were getting good grants trom the National Research Council and other places. I don't recall any particular hardship showingtn the surface at the time when I first went there in 1932. When I became Dean I had the pain of cutting fifty thousand dollars out of the first budget I had to handle, and that was a good big slice out of a Slllall budget. I dan't knew whether that is in IaT first report or not• 381 Ies-there'.s a thi!!G, called the "nuid research fund." The fluid research fund was about twenty-five thousand dollars a year which had been given by the Rockefeller Foundation. Tnat was modeled to what I used later on in this .full time fees f'und. at Cornell.v This money was put out in small grants to protessers, or instructors, or even a student maybe, in a i-. venture ~esearch. It .as administered by- our so-called Prudential Committee, and that's part of the Board of Permanent Officers, professors. It was about twenty-five thousand dollars a year which, of course, doesn't go very far in a s big place. The difficultJ there again is the tendency of people to con,,\'-der something done experimentally for support for a short time as permanent. It becomes an expected resource. The repeated requests for practically the same thing year after 1ear shows that they are eountingfon this as budgetary money. As a matter of tact, some of it did get into budgetary situatioos. It's very easy to do that, to emplo7 a research technician who turns out to be doing a lot et the departmental work. What was the occasion of ,the ofter t'?_ you or t~e ~ansbip? Out: or, what does thati grow? That's going to be a hard question for me to answer to you because I haven't answered it to myself yet. Now, I really think the attention of the faculty was focused en me because I was a new person and had no commitmsnts of a~ kind• I will leave out of consideration that they must have thought I was capable of being Dean. I took that for granted by their asking me without putting on any- side about it. As they looked over the people who were on the faculty who might be censidered for the deanship, they would find that all et thea had been there long enough to have aade a few enemies perhaps, or have made .382 a nWllber of epecial friends and perhaps had expressed th8ll8elves aboa.t policies and procedures that they couldn't turn away trODl, andfane quality a Dean should have without being weak about it is not only the quality of understanding all sorts of points of view, but a willingness to work out m&!\Y, many problems that come to the Dean from members of the faculty-. Some who had already' been members of the faculty- tor a number of ye8rs might not have been sotpatient with soae of the thoughts of their colleagues. What I•m Jlleaning to say is that I was rather feot tree. I imagine that's why I came up to their notieeo e Now, they were determined to mak/\ a change, and if I hadn't been Dean they would have attempted to have another ••ber of the faculty ma.de Dean~ but at Yale the prHess of appointing, or making a Dean as Olltlined in the bylaws at that tiae, was that the Beard of Perunent Officers ot the school eveey five years could make a nOJll:ination to the President of the Yale Corporation tor some• body to be Dean. That•a rather unusual in soae places because many- deans, once appointed, contime-well, Winternits continued fifteen y.ara, but he aame up every five ;rears. At Yale, the deanship comes up every :five ,-ears, or it did ur:rt.il lately. I think President Griswold broke that down. Well, Dr 0 Winternitzts tera as Dean was to end in 1935, so in 1934, the Beard of Permanent Otfieere began to think about it1 and they shoul.d have the nomination in, I think, to the President•s Office in probably December o:f l934e Well, to go back to.,- relatien to this situation. Suppose the facult,- had not wished to consider ae as a candidate tor the Dean, or their nomination, they­ would have had to pick somebody- else among their own ranks~ I f'eel quite sure that the President and the Corporation would not have accepted &!\Yother one there, and I know definitely that Dr. Winternitz would have fought another nomination very bitterly. J Jou can see what I aean bY" that because when I called en him to tell him that I was letting rq name go in, he said,"B..J, it it's you., 383 it's all right. It it had been somebody else, I would have fought tbeao" Then I think there• a a letter troa President Angell to me somewhere in these papers not only asking me what lfT point of view was about certain things in aedical education, but expressing the opinion also that the President and the &orporatien at Yale adllired Dr. Winternitz greatly and did not particularly care t• see a change. Mr. Angell and the Corporatien didn 1 t press that point. I didn't have to meet any unfavorable criticism from Woodbridge Hall. And th~re was no problem at all with reference to Dean W~nt~~Bitz-none. Oh no, ve had a •utuall.1' respectful relationship...-m.ore respect on..,. part, !•• sure, because I . regarded hill as a graat :man-and also an affectionate re• ~ lationship because he was neve~ cruel to me as he was cruel and harsh to some people. He never hurt ■e• It was a sticlg situation that came up in 1934. over this deanship? 41 Yea-lo¥ and continuing, ■ sure1 and it ca1!8 to a head at that time. Well, the traasitien occurred witheut any break in the school. It didn't ca11se a ripple• I think the eroblea wae comelicated somewhat bz problem• that had nothing to de with the deanshiP::the whele ata~sJ?here of the nation. That may haTe been.. Well 1 we 1Te gone a little oTer an heur. SupPese we st.op and pick it up again toaorrow. 384 I Yesterday we got zou inte the, ,deanship. I think that it s proeer to record that this perict,d of the emergence of this as a pessibility and its final settleaent !,s onl_z & utter or nine dazs at be1r~. The date of that is Janur.,, 193.So 'l'he date of the reselution of the C. faculty- when they- reAm111lended me. I tld_nlc the deciding question was the .tact t.~t they would reco11111eud you1 and that c9119s between December 12 1 and December 191 19341 it.series of meetings with ,he conp1ttee 4 certfin notices and i~erviews with Dr, Winternitz 1 a substitution of Dr1 Cushing in your place on the Coamittee on the Appointment of the Dean-­ all \his takes place in seve,n days 1 trom Dec•ber 12 to Dec9ber 191 1934. New, zou do see President Angell on December 26th tor a long afternoon's disc11Ssion ave it to ou te read the uestions which he raised on II anua:w;z 2 1 1932, and your r•el:l of January; 7th which is an overall.effort to sustain what h~ believed to be the.essenti¥ po1:tc~es of the l school, I thi;,nk it ,.. a iapertant to fence this in soaewhat because it is a point ef deearture and gives us some insight into President Angell and your relatien­ shie to hill. Do l!'! remember that? Yes. Presiden.t Angell wrote ae on Janu&17 21 and I have his letter be:t'•r• me now. He addressed it to me as the Master ot Trumbull College, and be said ii \ that h e • ~ to know.,- point of view about a number o:t' policies or Dr• Winternitz in the aedical schMl because the Corporation had greatly adJlired Dr. Winterrrl.tz, as many others had of course, and generally would not like to see any' radical change in his~olicies. Then he lists a number of matters that 385 he considered as especially important, and he asked me questions about them. I know now troa what this letter recalls and 1flll' handwritten netes in the 11&rgins of it that I round that I was really honestly in agreement with all of the policies that he was bringing up tor consideration. I pointed eut in ay reply that Dr. Winternitz and I were both trained at Johns Hopld.na1 that we had an illpresa en l18 that woul.d not be rubbed down in any kind ot association with other schools, that he in his wa:r was carrying out ideas that he had absorbed and breathed in at Hopkins, and that I had dene some­ what the same things at Rochester but only less vigorously and in a different manner troa his. I told President Angell that I would naturally go ahead with \ the kinds of ti~nga V that were going en in general like attaapt.ing to deal in.. dividuall.y with students. That was something that Dro Winternitz cared tor a great dea1, anirt was •-thing that was n-q characteristic of the early dayo at Rocbeater➔.cbing was individualized, the students were individualized. iv We bad to keep soae marking systea in Rochester and at !ale too, bu.t it was net anything that we paid aueh attention to, We didn't try to grade students by fractional points or grades suc+s sQlle people think are important. We looked fer the man•• charaeterist.ica and his maimer of work. Actuall7 Dr• Win'lerm.tz had been successful in net requiring attendance at classes; in fact, he rather urged the stl!ldente, it the7 didn't think well of a professor, not te beyeott his classes but to make protests. I felt the same wq about attending classes. I thought it weuld be a pity it the;y didn't ge to their classes because you never know when soae very useful remark will be aade. Perhaps in a long hour, or two or tiresaae and not very intelligent teacher student relationship some• thing will happen that will be •f the greatest importance, and it's better tor students to be there and not miss it. I would have gone ahead just about as 386 Dr. Winternitz had been doing in the cultivation of the developuent of the individual's responsibility anrs control of his own fate mere •or less. That was easy to answer in the same line of thought. that Dr. Winternlttz had had. Mr. Angell asked about my ideas en the integration of the several depart­ ments in order to foster the best teaching of the students and to foster, as I e could see it, a great man_y other advantage,us operations in a medical school in addition to those of teacbinr; and patient service. It was a perfectly faailiar operation to me. I had some of it at Hopkins, although I had relatively little opportunity to put it into effect there when I was beginning in bacteriology, and again after the war I was off in a side building, so to speak, after a fire, but at Rochester, as I think I said the other day, we had integrated teaching and joint departmental work right i"rOJll the start, and we could do it delight• fully because we were small and .free and not teo plagued by other responsibili­ ties. I had thought the same at Yale, although up to this mDment of being :made a Dean I hadn't had any special opportunit;r to do a~hing in the school along these lines. Ins etting up Trumbull College I had done •ore than soae of the masters in bringing to the group of fellows representatives of very diverse departments-­ we had physicists, mathe11&ticiana, artists, doctors, historians, and literary people. They were all sit.ting together. We met and knew about eur separate and joint endeavors and a good deal about the depart.meats that each man represented. That would have been a natural development, and I think that after I became Dean h we went along t~ese lines of helping to integrate departments. You can•t in- tegrate departments b.1 doing what I saw a lady' do in a stroet car with her two children. She plunked them down in the front seat of the car and coordinated their pleasure by bumping their heads together and cOManding them to enjoy it. 387 \ That doesn't work, and it certainly doesn't work with proftessors. It~s a matter et the spirit. Mr. Angell said that he waa interested in the effort te integrate ' the medi~ school as fully as possible into the general scientific and in• tellectual life or the university. The medical schoel yearned for that sort of thing. It was Dro Winternits 1 s great desire to knit it in so closely t.hat the university would be covered h7 the mesh or the knitting and weven into the aedical school. I explained his ideas on the centralized Institute of Human Relations which would take the wole universit7 under its aegis, but the medical -~--; schoel at Yale bad always been a little bit out efjline of the intellectual ~ activities of the uni.versit7 and yearned to be a part et thea more than the university would permit, or would have the infonnatien to all•, or invite. A good exaple of that--and it could cC!lle up later, the time of Hugh Long, when he was Dean in the 19SOe 1 the corporation actually passed a vote saying that the Yale Medical School was an integral part ef the university. That's between 1830 and 1950-it took over a hundred years to do that. I don 1 t believe I took up Mr. Angell en this point. The desire of the aedieal echeol was there, but the integration with the university depended en something foY"thcoJll:ing trOJ11 the university departments. Dre Winternitz had done this as I perhaps mentioned before in the cue or pby'sica. He brought a Professor of Physics ever and gave hiJll an office where he c•uld consult with the heads ef departaents in its school of medicine, and it qs a very- helpful arran.geaant. Mr. Angell ■ peaks of' the developnent through the Institute ef Human Relations of opportunities for voluntar.r group attack on basic human problems. That I didn't know veey ■uch about. I couldntt answer that very- well because I didn't know what the point ot view of the Institute or Human Relatione waa. I regarded it largel7 as a center tor psychology- and pS7Chiatry-. Mr. Angell was a psycholo• 388 gist and n.aturallJ" interested in that line, but I have forgotten what I answered about this. I probably dedged it by saying that I really didn't know, and in reviewint: it now I•• not sure that Mr. Angell indicates a genuine support ef the aoveaent in that rather vague question that he asked• I wondered hew knowledgeable he vu about medical school affairso Mr. Angell knew a great deal abeu:t it. Yeu can't be a geod psychologist the waa without knowing about orders and disorders in the central and way he • peripheral nervous system. He d been in a medical enTiroment t,hrough payebel•a ~ a good deal. He vu favorable to Mdical school activities in teaching and attended some or the faculty- meetings., though not as many as Mr. Seymour did, because when I got to be Dean, I made 1 t a point t• go over and escort the Presiderrt troa Woodbridge Hall to our facultyaeetings. After a while he came en his own. Mr. Angell speaks ot the conception ot the hospital and the institute as agencies through which the university illaediatel.7 touches and serves the com­ munity. Well, that' a a difficult thing to answer in the specific., though it'u easy- to auwer in general. Certai~ the ul11versi ty sheuld be in close, bamoni• ows contact with its canmu.nity and the goverment or its camunity. or course, I was very familiar with that sort ot thing trOlllacperience in Rechester with e, people like Dr. G\ler, Mr. Kasaan, the Rochester Health Bureau., and the Munici- pal Hospital. I would b.ave answered that, and I hope I answered it with re­ ference to the hospital and the medical school without saying what I thought the Institute ef Human Relati•ns might do in this connection. I wasn't knewledgeable enough with the Institute to say. I don't believe it had much of a purpose in that connection, except that one ve'rJ' remarkable professor in the Institute er Human Relations was Arnold .389 Gesell. He was a great student of child developaent and with a fn people he set up a clinic in which he could watch child development. He wrete those great books on the development or the child at different ages, and he did a goed deal with c0Dlllunit7 relations through child guidance and things like that. Se did another psychologist over there named Walter Re Miles who was a practical psychologist and got interested in aviati•n psychology- and the psychol~gical physiology of work effort and different activities. Alse in the Institute of Huaan Relations there was a remarkable man named Mark Ao May who was a sociolo­ gist and econamistJ as a matter of tact, Mark May succeeded to the bead et the Instit'llte aft.er aoae 7eara, after I had become Dean. Hew as a fellow or Trabull College too. Well, Mark May wae responsible in the years after 1935, er drawing in people fr• the Rockefeller Feundation enterprises, and one product er it, and I can't reaember the auther ef it at the :moaent, ["John Dollard_7was a rather famous book called Class and Caste in a Southern Town. That wuJ back in the middle 1930s and this book, I think, brings out in a veey clear way the kinds or things that William Faulkner spoke and wrete about later and William. Rodding Carter-just describing conditions ander which Negroes lived and white peeple on the wreng side or the railroad tracks as coapared to the others--that kind ef thing. The Institute was in sociological studies eutride ef New Haven aa 11ell as inside o! He+•••n. All ef this is ver7 good that Mr. Angell had in llind, <1nd. as Is ay-1 it didn't embarrass ae at all to answer it1 and I don 1 t think I made &ft1' excessive prollises, or said a~hing that w asn•t natural from experience. Your replY indicates that this was like JUllping oft the dock into a swollen stream the nature or which you. weren't quite sure of1 but th.at you could agree in principle with the prineiP!es he announcedo 390 Well, the jumping oft the spring board was that nine day sprint. I hadn't thought at all about being Dean er that school. I hadn't an;y ambition for it, and I hadn 1 t thought or ayselt as being an administrative officer of a great cencern like that. ou made some iJllnediate chan sin ,, the Dean's Oftice 1 the physical effice1 a less elaborate place in which you could function which, I gather, bu continued. Yes, Dr. Winternitz had constructecl ia the Sterling Hall ef Medicine a leng room with twe saaller rooms, ene at each end, lavishly f'1l'nished with oriental rugs and beautiful furniture from the Garvin Collection at the Art School. He set himself up with a sort of regal potentate I s envirot111.ent. It seemed unnatural to have a Dean of a hard working place like that in such rich and gergeeus sur­ roundings. None of us ever felt comfortable going in to see h1a in this Mussolini-like habitation, and he knew that from the ordina~1 chit-chat that gees on with people fr• time to time-someone would ask ijim how he was in ll1.s palace and whatnet, but when I caae to be Dean I couldn't bear to go int• those ... quarters, and I didn'} use them. at all. I imaediately got a roa across the hall, a slll&ll ro• that could be fixed up with sme plywood bookcases. mgot a good desk and got some pictures in there. It put me right next te the secretary­ and Miss Miriam K9 Dasey the head ef Adndssiens and right next to a remarkable and able person in the medical school, Miss Lettie Ge Bishop whe really ran the place, finances, knew everything and was very- sound in judgment. She must appear sonewhere in these records. She was a great person to help the Corporation, help '"'- Woedbridge Hall. She was good on pablicatiena. •nere was nothing she c~uldn 1t () do wello 391 Werenlt you lucq. Yes. She was strongtollinded., had her opinions, and they were always good• In terms of the school•••• This room I•m talking about is still the Dean•r Office. They haven't gone back. Mark May took Dr. Winternitz 1 s old office, but I think he let it get a little shabby so that he would feel better. That 1 s the sunshine of the place in a wq1 but :ou found in the administration of the school certain cOlllldttees in existence which seeaed to make for multi• plicity of talk about subjects, extension of time in which subjects would be taken u.p1 and there is a certain stremnl.ining that comes about so far as affairs of the school are concern.ed1 and I think the adjustaent was in keeping with the feeling that you had toward the chief's o.f' the departments, I think you eught to explain that. Itva forgotten the names of the CODllllittees, but we'll get to them in a minute. Committees get appointed and tend to perpetuate themselves. Every now and then you have to sweep them outo You do this in the government and anywhere elseo CODllllittees are appointed for a specific purpeee, a job, and when that's I ever they are reluctant to disband, but in an educational institutien its " natural to be changing ccamittees all the time. For instance, I imagine in the earl1 days that they had committees en the immaculate conception, but that's hardly in keeping with aodern notions of reproduction, and that has toge out. How long a cenunittee ef that kind stayed in depended on the parochial nature of the institution. There are committees that deal with admissions, curriculua1 " libraries, and ~ arious parts of the school. Some are useful, and some are not. 392 Some ought to be combined, and sane ought to be disbanded. The attitude of the person who is in a position to change the camuttees determines a great deal their continuation, or their stopping, although, as Ir ementber, I don't think that I disbanded any coD1tittees just by a tlash emotion about it. You generally talk it ever with the chairman of the committee, or sane of the members. Which ones were changed? The •~~ool was run, I think, by its Board er Permanent Officers. It was run by the Prudential COJ1111.ittee. Nominally it 1 s run by the Beard of Permanent Officers. This was the large committee. Yes, but the Prudential Committee is an old Connecticut naae for an execu­ tive committee, and it could do s•e things that didn•t have to go to the board, but most all things having to do with appointments, pranotions, educational e policy went to the B~ard or Permanent Officers. Budgets didn't• As I remember it, budgets went through the Prudential Committee. No-I'm not sure of that. Budgets were too confidential, and they went te the Dean and from the Dean•••• To the Treasurer. Yes, to the Treasurer. The reason Itm a little confused is that in 1955., I made a survey of Tulane University Medical School, and I put the budget ef every department. in 1q reporto When the report was done, the dean down there, when I asked hill what to do abeut copies, said,"Send me a tew0 " I asked him it I couldn 1 t send one to every head of a department, and he reluctantly consented, so at Tulane in 1955., eveey- head of a department got a 393 look at the budget of every other department, and it never caused aey trouble at all. Usually the1 think, "Well" if that man sees that 1 •m .favored by something, he'll crowd the Dean to favor him likewise", but it didn 1t happen. At Yale the budgets were not shared among the faculty members. ·:rhey didn't have anything to say. There had been two standigg conmi.ttees that were discontinued--one was the Standing Committee en the School of liecli;,cine and the other was a St~nciing C~­ mittee on the Biological ~ciences which did not meet and therefGre was d.iscon­ tiaued. That was revived I think later on. Yes 1 as a universitz matter as distinct from a school of medicine matte,:• I don't remember any activity of the COJlllllittee on the School ef Medicine. It didn't meet either, but it was put ue as somethiDJ to which the Prudenti~ CClllllllittee had to re.e,ort 1 and it aade for the delay and discussion of matters. We get rid of that 0 There were two other oe-ittees underneath the Prudential Committees-one on f2.11nical Subjects and one on Pz:e-clinical Subjects which was an arbitraq ~vision that z•~ didn t 1 find very satistzing1 ~nd I wondered whether there!!!. an.y effort to build a bridge. Did we keep those? 394 Well, there's a lot of interest in these fields, but I don't know that any or those depart.ments worked closely enough together to deserve a eanmittee en h cmunon probleu. They are all so diparate-elinical departlflents go their own way, \ have very different problems, different personnel and different points of view. Saae about the pre..clinical. The only ether c~ttee that is mentioned is the one on Public Health. Well, that was so because that was practically a school under tb.e medical school. Public Health was kept at a departmental status, although Dre Winslow would have liked to have it recognized as a school, but it had no endowment to speak of. It had the Lauder Fund which was a smaller rund, but its budget came through the Office of the Dean ef the school, and its appointments went through ~Prudential.Committee an+h• Board of Per,,anent otficera. It had certain ~9~bleas which didn't need to concern the other pre-clinical and clinical de• lu partments, and therefore a C"1mtittee on the Department of Public Health was a good thing. The others were the stucv; units that we mentioned the other day1 centers er in­ tellectual activity, and your view exeresaed here in the annual re_Rort is that the are serviceable but if the become fixed entities, yeu 1re for their disbandment. Well, they fostered intellectual activity by two or three mechanisms. One was to hold meetings or their groups at which members or the group would present their current w0rk, er have outside investigators invited into the aeeting. The other part of the work that the group did was supervise, or they could act in an advisory capacity ever the activities of units withim the group. The study 395 group llight have people from the Departments of Medicine and Pathology in it 1 and it 1 s geed to have some central place where they could peol their interests and not duplicate, or lese track of each other. Then they got some money after a while, these study units, and they began to make grants. _2ne thing haEP!ned1 I think1 to which lo~ tell heir by' w q of a yardstick, or a~ !._~i_g_ht into the conditions of the scbeo+, and this ~~s the rating bz the AMA 1a Ceuncil on Medical Education.and Hospitals whi~h was as ot conditions in 1934~ This indicated, I think:1 the conditien of the librarz, which is a subject I waat to come There was some liJllitation on this Council's access to sufficient material to warrant some ot the judjeents thel reached with reference to pediatrica 1 altheugh clinically that was bad, and that involTed the hespitalA a subject I would like to come to in a minute. That was in Dr. Winternitz's time. I don•t think I paid much attentien to that 0 Exceet that it is a guide 1 yardstick as of that aoaent, and I think in the ~ • Dean•~ Report zoa do indicate that thel didn't have access to Sllfficjeiat material t• warrant soae or the judgments they made. I think I probably left out of the report that they didn't have access to enough intelligence to deal with~oae of thea. 1 It s a signpost en the road. Thue c011111ittees of the .AMA are coapesed., as a rule, of v•rT conservative practitionera 0 ~ Yes 1 but they do issu scraps of e!P!r, and one is comP!~ed with .ret:erence to all 396 schools j_n the country, even if there are lillitations en the basis of their com­ parisons. Then there is a development which shows that soae thousht about the needs of the school an he hos ital was taken b the Dean 1 s Office ard this is the "John Schoolcraft Preliminary Survey of the Ne~ds or the School and the Hos ital" and he comes from Hamlin and Brllit18 an r anizatien that does this kind of ef~~ Do 7!U reaember tba t? Yeso You touch me on a tender spot. Reallz:? Yes, when ;rou bring that up. I had forgettea all about it because one tends to forget things that were unpleasant. Mr. ,'Jchooleraf't was a professional investigator working for a firm, Hamlin and Brwne, that did that all over the countr;r in schools. There was another one in New York called John Price Jones, and we gave it the name "What Price Jones" because the;r would charge a great deal, come around the school, talk t• all the heads of the departments and put in a report to the president that has already" been given to hill by- his dean. They don•t know al'J1'thing about the school and the;r have to get whatever the;r know tra the lucubrations of the people they interTiew, so the;r make these hurried surveys. This process is pushed on to the administrator of a place b;r the financial side, usuall;r, of the inetitutiens. I think John Schoolcraft came through Mr. Farnam 1 s Office, but again, to go to this Tulane survey, or before that one, I was at Cornell-New York Hespital. There were three strong moves by members ef the Board of Gevernors to import an outside investigator, a aanagement consultantf to go oTer R things. They can go over supply poblems am the housekeeping, but the;r don't "' know enou.gh to teucb any intellectual problems. 397 I•d better get a little water. Hold it a minute. There are some of Schoolcraft•s productions in these papers sanewhere. I havenlt found that ye~. "' One little pamphlet. Well, those people are good i~ certain fields of management, but they- are not good when it coaes to the accomplishments of a member of the faculty, what he sheuld be paid and how he should work. u !n terms of str;\cture-increases in the school structure, what is nieeaed1 in the reports here there is so• canment about the increased need for facilities­ library1 clinical beds and so en1 so that with all its limitations-you know1 it is at least again a peg which shows that there is scne effort to surv2 the needs. Well, responsible administrators are doing that all the time. This man's second hand stuff that he puts in his~eports is very illlpressive. I was thinkitlj of it in terms of what we do e.11 the time--make a survey of man.. eower1 and policz with respect to manpower is an eftert to make some basis for e.R the excise of judgment. We have increased the use of this process, made it \ better disciplined1 and this may be its beginning. Those in my experience have been prompted by some narrow..einded official who wants to reduce expenses. 0 Oh boyl The very op)'~i te comes eut. I soon had experience in this Dean's Office with one of the members ef the Yale Corporation who would read my reports and read other reports and write me long letters about everything that was wrong. I don't jnew whether any of those 398 are in the files, probably not. They1 re probably at Yale. Then another member 1 ·. or t h e ~ Corporation who was sure he knew all about mecical education and hospitals was my- friend Bishop Henry Knox Sherrill of Boston. Bishop Sherrill was on the Board of Managers of the Massachusetts veneral Hospital, and he was a guide, or infiuanced the opinion of members of the Corporation. The third one was Dr. Fred T. Murphy. He was on the Ford Hospital Board in Detroit. Dr. Murphy had been a surgeon in World War I, a very well-to--do man with relatively little practice and contact with medical schools, but he was the advisor ef the Yale Corporatien en medical school affairs, much to the detriment, I think, of the school in soae respects because he didn't try to keep u.p. He was friendly, but he didn't know the modern things that were going on that bad passed hill. He was one ef the self-perpetuating members of the Corperat.ion. Yale bas tw• sets of Cerporatien members-one are the original trustees, if you want to call th• that, members appointed originally', and they have elected their successors ever since 17011 and they are elected to retirement age at sixty-eight. The others are elected for teras of three to six years by the alumni, but Dr. Murphy e was one of the selt•perpatuating1 permanent members of the Corporation, s~ I learned from that a ru1e I hoped to prOlllote at other places, and that is to have a successien ef trustees more responsible for the affairs of an institution that is progressing through the years, all washed by changing waves, than this man who sits on the inside and doesn't know what is happening. It didn't take you long to run into dif'f'icult.ies in noating an idea then. Ne. Yeu have to have an idea to run against tbe difficulties. This matter of interoal work in New Haven is made more coaplex by developnentl?. iication for medical 399 education and research in the conceptions, if not the plans, for participation of the federal government and the states in making provision for medical care which comes out at this time. Tnere was a coamittee of phzsicians les, in part, by Dr John P. Peters thats entrenched interests in the medical associations, an e:f'fort to alter thinking, or to make some new assessment. This led to a Natienal Health Conference, the first of its ~nd, under Miss Josephine Roache in 19380 There was tbe first National Health Survey by the Public Health Service sponsored by funds fro• the WPA, so we had more to deal with, These were in the air. There was the Presidentrs Interdepartmental CCllllldttee 'Which fell heir to that body of material 'Which had earlier come before the President's COlllllittee en Economic Security1 but which had not beea worked rticularl health insurance schemes which trace back te Pref'esser Winslewts Committee •n the Cost of Medical care. Ail this was 5 creating problem to which one weul.d ha'Ye to adjus\ and which were way ber•nd the \ eower er a aedical acheol1 or a univereit1, to centrol1 and certainly indicated that the future was going to r eguire soaething in the way of development within the school. Well 1 if' you put those ideas in the context of 19351 as revealed bz these reports, the eaehasis is upon retrenchment. The first task zou had tc do was to cut fifty thousand dollars out of the budget which is the reverse or what seems to be needed. As I've indicated to you1 there I s a sudden in­ crease in gifts or all kinds1 rroa institutions, trom foundations, from individu- als 1 anonyaous and etherwise 1 which seeas to stem from re'Yisions of the tax law in 19341 and 19351 so tl1at for research purposes there are funds coming in sreater smu to the schoel1 but the school itself is retrenching which makes for probleas in certain areas I wa11t to come ta at some other time like nutrition, or the librarz1 or the aa:l.111&1 quarters, and so on. Tectg I think we may be able 400 to see locally the problems that aedical schools were going to face nationally by dealing with the New Haven Hospital and the New Haven Dispensary and its problems. This is the center of the medical school for educatienal and r•• search purposes, and the problems are just fantastic-incredible. It dees have a role in the educatienal process. Well, you can't conduct a school without ito You giTe a very good account of this in this report which l•d like to put in because it sWllS up the problElllle 1 et me read this: It is impossible to describe in a few paragraphs the most important of the intricate relations that bind together the University, the School of Medicine, at the New Haven Hospital and the New Haven Dispensary. A brief outline will have to suffice here 0 The attendant problems can only be mentioned, without full discussion or are than an indication er possible solutions. In the School-Hospital arrangements the two strongly directing influences are educational ideals and the conception of service to the community. The University is primarily interested in educatienal facilities gained by its alliance with the Hospital, but having under• taken to contribute to the support of a general hospital, particularly one which is in fact the municipal hospital of New Haven, cannot escape the obligation to provide a certain amount of medical care for the indigent sick of the district. Tne New Haven Hospital and New Haven Dispensary, having agreed to put their facilities at the disposal of the University for educational purposes, cannot conduct their affairs as a strictly business proposition•••• 1 It s open ende d--1ou k now. As institutions needing and deserving larger municipal support they suffer in the battle over taxes and charges which is going on between the University and the City, as is plainly shown in the previously quoted account of hearings before the Boarda>f Finance. Yau put in earlier the mazor 1s ccoment about the tax business, and I think the request tot.!!_• was for twenty t~ousand dollars, an increased approeriation for the D~nsary. This is just twenty thousand dollars. He weuldn't de it. 401 No1 he wouldn't do it 1 but this is the basis for the school. There is no dividing line between School and Hospital and Dispensary. This is a highly advantageous arrangement for the educational program •f the Schoolo If this coordination of affiliated institutions did not exist, the University could not have a first class four-year aedical school. Without it the University would retain its superb departments in the general field or biological sciemes, but the residue would net be worth considering as a tw•-,-ear medical school. That ;euts it •n tht!_ _lineo New,,1, the _T[~iversity had prot?lems. __Economic .t:act disc}-o~es _an annual appropriation from University funds somewhere in the neighborhood of four hundred thousand dollars a year 1 and a good bit of this is into this hoseital. Where do you go? The medical scheol had a relatively saall endowment, and expenses were going up all the time. There was always a deficit, and the University made up that deficit D7 taking from its general income, and that general income was largel7 the income derived from dining halls and dormitories. These were situated in the Sheffield Scientific School, or the Divinity School~ •r the Yale College, and te take that :~oney tor the medical school prevented the De­ partment of ClBsics, or history, or something else frem doing something else with it. They wanted it. Tbe University was, I would say, generous to the medical school considering the financial stringency of the time. It tinallz reached a point where the Corporation had to eut a limit en what they could do, fhey put a li~t ot a hundred thousand dollars. They wouldn't (O bezond that~ Tbez appoiated--meaning ne disrespect _to the previous superin­ tendent; I think he retired.....James A. Hamil ton. He was the director of the New Haven Hospital, and we brought him there. Hamilton was an able man. 402 Yes, he disclosed that the hospital was being run in an,t;fficient manner. I think you were invited te sit with the c011Jnittee on the hospit~. The Medical Board. To oversee its affairs. Tney even went se far as to raise the ward prices te five dellars a day-do f eu remember that? l\) Am the town sa that unless it was "ri.tal ~•rgency1 patients should go to the other two hospitals in the town. They would go under too. But herezou are. You run a medical school which requires this hospital for i\s educational purposes, and this is a big drain financially. It puts a premilllll en effort~ to get funds, some sort er endowment. . There is a fund raising coaaitt~e with Mr. Sp~mser Burger. Do you remember that? Mr. Spenser Burger was a very public spirited citizen of New Haven, and the President or the New Haven Hespital. Heras a rather well•te-do man, and he did succeed in raising some aeney, and he gave a goed deal of his own. He was a Mnuracturer or coraeta and some ether things, but as an aaide on yeur micropbene here, one Jdght mention the transiio~ essentiality of cersets. People thought at ene time that that was to be a permanentl7 safe investment. Brassieres had not coae in wnen they put up the corset bonds. Tne same thing happened when they put up the canal bonds. ~eople right here in Washingten u tlul,ght that canals would be a permanent form of transportation in this country, and they sold the bonds on a long tel'Jll basis. All these things cbang•• 403 I think there was an effort to extend the service of the school te an annual eostgraduate clinic for doctors, to inform,the Alumni and ph,ysiciam, generallz_ in the State of Connecticut that there were services available at this aedical center to which they could have access. This .worked pretty well-~that is 1 it ~ ) ; was a be imdn of a kind of ublic relations as to what was available at Y ae ,' either to infol'Jll pbzsicians generalll, or to help them in the new things which may have been coaing en. There are two sides to that relationship-the practitioners in a state around the aedical school--and one is good, and the other is discouraging. There are a number of enlightened physicians who support a modern progressive :medical school and hospital and are glad te use its facilities. There were also a great 11&ny ph7sicians, and therewere in the State of Connecticut, who didn't approve of the Yale program for aedical educatien. They wanted students to be turned eut who could do minor medical practice right away and certainly would have glib answers to all sorts of questions derivable frea manuals, one thing and anether-«emory-, people who are turned •ut or school with nothing but meJdriea of their work. Our ideal at Yale, Rochester and at Hopkins toolil.s to teach a •n method and ±o let him understand that every sick person is a preblem and not to care so much whether he learned what the leukocyte count in German measles is on the fifth day ot the diseaae, but to know that it is important to ~~ study the leukecytes. He can look up "What the figures would be, but he mu~ the principle of the thing. If you bring up students who have a research point or view on everything connected with medicine, they becOllle concerned with methods, procedure• of investigation, •➔hey don•t depend on a fallible ■8Jftocy 10 aueh. Lots of physicians in Connecticut thought that we ought to be turning out people who were very slick to pull out of their memories all of the tacts that they 404 might need. In addition I found that there was a desire ea the part of a lot ef the physicians im the state to have their sons admitted to the medical school. They put all sorls ef pressure on the Dean--all the way from pelicemen. The judges of the Supreme Court would come to the Dean's Office to get a son in, or help hia get in. That was all right, if the man's son wu an able candidate, but tragically enough, a lot ef these young men had been inhibited by the behavier •f their father 1 a medical practice. They had seen their fathers practicing successfully with tbia money-type approach that I mentioned. '.l.'hey were pragmatic, practical physicians who had little insight inte the precesses they were dealing with, s• that a student seeing a successful father with so little mental equip­ ment, so to speak, going ahead would be disinclined to do the hard work necessary te study medicine. Some students we admitted from such a parental environment, and they didn't do well because they had an example of success without effort. That's grill. Since YoU brought up the students-the.re was a comelete everhaul 0 et the adaissiens r cedure. There were a number of tests that were discarded. I think one er the things y&u did was to make admissions a functieri of a sub­ conmittee of the Prudential Cemmittee. Tb.e Colll'lit\ee •• Admissieu. We inteniewed every student admitted there. I saw them all, and ve divided thea aaeng the rest of tbe members ot the C911Dlittee oa Adaissio;s. The~ are.ve"r7 good tests that a student can take aef far as aptitude is concerned, but you can't be guided by them too closely. I think the preblea of the adaissioft of students is solved by an intricate syn- c, thesis of a lot ~f inforaatioR about the person, and in my case I wouldn I t put a value on each part of it. I did notice oae thing soon, and I think Dr. Blake L 405 and ethers had the same feeling, that the man who coaes to you--well, you always ask him why he wants to study aedicine. A great maey of them say that they want I t1•rve humanity and do something for their fellow man. Usually you find such a student hasn't the motivatien te surviYe the hardships of a medical cour••• He soon wearies ef his efforts when he finds that the only th111g that is supporting him is his hllllanitarian, or sentimental peint of view; whereas the onee who COile in and say that they want to study medicine because when I was a C yeungster I colle~ted butterniee, or shells, er got interested in frogs-in ether words, had a biologicli. approach-they have some permanent scientific, or at least some permanent bielogical interest, and this carries them along. Threugh this interest they increase their own internal resources. You never can tell for sure. They have pre4edical courses in chemistry and physics that were touched en, so to speak. The student as a rule had to do well in erdinary ehemistr.r, organic chemistry, and at least the first course in physics, but the Committee en Admissions got sorry tor the poor Dean who saw all tm students and began to let bim have a couple of what they called "Dean ts choices." I would be able to take one er two men that I theught ought to come, although they didn't have any competence in organic chemistry, or physics, er something else. One particular ene that I adaitted on tha,tasis had failed in organic chemistry and practically failed in physics, but he was a productive writer and scholar in Greek and the Classics, a very cultivated youngster froa Charleston, S•uth Carolina, and from a distinguished family of physicians. He graduated first in his class after four years in the medical school, although he would have been thrown. out en his preparation. The other thing abo11t students that we used as a guage for their capacity was their National Beards-whatts called the National Board ef Medical Examiners. 406 They give two sets cf examinations--ene at the end of the secend year, and the ether at the end of the fourth year. These are nationally accepted examinations so that it is advantageous for the students to take them and pass tbem because t if he passes the natienal boards, its easy for him to get reciprocity from the different states. He doesn't have to take State Board Examinations in every 1 state. Once he has passed these, he s eligible te pay the license fee in any other •tate that he :""nts~o go to. ;;_.erywhere he goes he haste pq the license fee. L'hey care mortbeut that than t.hey do about giving the examinations some­ times. These examinations by the National Board tock the place ef some examina~ tions in the Yale Schoel or Medicine, but not the rr omotion systell. Some schools prOl\ote their students--! mean by promotien frem first to second years and so forth•-on the aasis of their standing on the National Board Examinations, I but its fatal for an independent educational institutien to turn over its pro- moting system to an outside agency, so we kept it in our own hands and often advanced students wh~did not do well on the National Beards and held some back ~ ~) who did. It s;ilsetul thing to have. I used to be a member of the National J\ (\ N Board of Medical Examiaers. 'l'hey've been at it so lo~g that somebody has cedified all the questions that have ever been asked, so itls easy te bone up for it and prepare. Once having admitted a clase 1 and the report.a that 1ou write are very good on the classes-a. general ever viev--itts surprising the percentage of them that require assistance in going through school. NIA CNational Youth AdministrationJ is established in this eeried to helE them. There are efforts toward a kind of bursary fund in the medical school tc help them. A loan fund. 407 Ies 1 but the statistics that show this are quite revealing about the content of the classes. Well, we paid no att~ntion to the studentrs economic situation, it we had any means ef helping him by loans, or scholarships, or youth funds, of one thing or another. The Dean is in some very privileged positions in those relationships. I know at least two or three whe were admitted while I was there, and they had ne money- at all. I knew one or tw• well-to-do aen in the school, student.a, and teld them about these econ011icall.7 poor students, and they paid their way through, provided I didn't disclose the donor's naa•, and I never havee We had all sorta ef waya et trying to help them--even jobs, and these loan funds were very useful. A continuing source of difficulty that runs through these annual reports are the I poor fac•lities for heusing and dining that they hado Oh1 they- had squalid quarters areund the New Haven sl'tllll8 1 and the eating arrangements were poor, usually in a bas•ent of a tumbled down house. Dr. Winternitz wasn't able to do a~hing about it. I wasn't able to do anything about it, out it 1s been much improved in later years. Mre Harkness built a dormitory there. The men in the colleges across town lived much better, ate ;j much better, but they didn't alq]w medical students to go int• Yale Cellege ;v accoaodationa. On the whole theugh, they were very hard working, quite well disciplined students. Medical students go on a raapage nearly every spring somehow or other, and they did their bit, but it didn't UlOunt to muche I think what is or interest when zou tall heir to the deanship are the ramifica­ tions •f the preblems you confront. I was already familiar with a good maey of those things. I had been ob-- 408 serving Deans--knew Dr 0 Welch way back, and I had seen the other side of the Dean's Office handling similar problems, and then handling a big department at Rechester"•they were all there. I wanted you to put this in because next time 1 and we've gone about an hour, ,4 ~•d like to shew and illustrate with your help1 the need for a library and its development, even confronting retrenchment and subsequently the appearance of the wars ar as the buildi and its desi n is concerned. Another side I think1 because of retrenchment-there is attrition, not te say emasculation, of nutritien within the facult made necesaa arture or seme more favorable climes"-Foed and Drag Administration is one I remember 1 but this epens up a whole area that is not being covered by the schoel as sucho 1'he desire to meet that problem is in this Nutrition Institute which is a very in­ teresting storz. The other story which we will cane to subsequently, which is a successful one 1 but net within the sehoo1 1 is the Childs Furn. I think they will tend to illustrate that the preblem, in part, as a Dean was to beat the bushes for support soaehow somewaz. I don't think •beat the bushes" is the best phrase that yeu can use. Is that on? Yes 1 it's on. Let me turn it err. 409 Wednesday, May 111 1966 A.,6() 1 N• L. M. As I indicated to you earlier, ~oing through jhe recerds of Yale and your dean­ •hig, ~,. impressed by the nUJllber ef problems that come up for selutiea1 and these, I suseect 1 can be boiled down to who to obtain1 e9rsennel1 the student b•dza and then the actual needs 2 plaat needs, ideas needs fer the school and th• funds to sustain them. Some of these are succestul. Some of the ideas are nevel, aav in terms ef the time. One that you confronted, the Nutrit.ion Institute, is a complex problem because it involve• your continuation in the deanship. It 1 s arbitrarily selected becaase it is complex and because it dees involve a personal stog. The records disclose that zou didn't operate alene 1 but operated 1I 1 with knewledge and &pPrOJttl--which I would exeect 1 and this is another thing you I do. You eperate with due regard to the sensibilities of the instituti•n, You have that institutional senseo 'rhis is a strange stog1 and I wanted you to include it as an le of the sort of thi which iven this the Dean was confronted with-•what to do with an idea 1 hew to make it serve the e needs of the school and ultimatel decided en r unds that have 0 ~ode with the idea, or how tl slip the clutch and make it move. I don't know v, how far you want to go 1 but in terms of the records that remain some indication of your personal views with respect to this problem eught to be in the rec•rd• 1 \ Then we can parallel this with that other sto~\whtch runs right along with this o~-the developaent of the Childs Fund. This happened all at the same \ time. There's onlJ twenty-feur hours in a day 1 and I don't know how you did it all. There is attention to detail here which is also symptomatic of you-­ ferreting out the detail to be in a pesition te exercise your judgment, and it's disclosed in these a ers. The nutrition sto "s an idea bur eons somehow 410 within the University itself, the treasurer's department perhaps, in December of 1938 1 and you're very shortly involved in an exchange of views with the principals. Why don't you tell me what you remember of these events? My recollection of the beginning of this is very hazy. I'm not sure where the original id.ea about exploring a possible partnership with the food manu­ facturers came fr0111, but about the latter time of 1938, somehow or other I met with John Wesley Dunn who was the lawyer for what are called the Food Manu­ facturers. They don't manufacture food, but manufacture containers, the process­ ing of foods, cans. The President of American Can and groups of ~eople who were concerned with packaging meat, vegetables, and all sorts of things. We called them "food manufacturers", but as I say, they manufacture the containers and process the food. They don't make the food. There was abroad in the realm of ideas some perception of the current im­ portance of nutrition, nutritional research, and the need for further develop­ ments in teaching and training chemical nutrition people, dietitians, all sorts of people who could help improve the provision for and dispensing of foods. Nutrition seemed to be a proper thing to include among the activities of a school of medicine. It seems hardly arguable since the universities were much concerned with agriculture and the process of agriculture, notably Cornello Most universities had agricultural connectionso Personally nutrition was interesting to me from my connections with Joseph Goldberger and pellagra through family relationships. As I say, I have forgotten. how this all started, but it moved along very 0 fast. Mr. Dunn who was a very reticent, th\ughtful lawyer, very precise, pushed it along through his personal connections with Mr. Clarence Francis, the Presi­ dent of one of the large i~od manufacturing companies, a Yll'. James Ao Adams, and L 411 some others, and out of these preliminary talks, into which I soon brought the Treasurer of the University, Mr. George Day, we developed a proposal that would be submitted to the University. The essential features of this proposal were that the food manufacturers would agree to provide, under conditions always subject to the approval of the University, funds for a building, incOJlle for operation for a certain length or time, and funds for use for grants~in..aid. They would also agree to a governing board composed or members of the University~ distinguished public figures, and representatives of the industq. Certain officers would be appointed by this board and policies would be determined by the board all subject to the final approval of the University. The function of the Institute of Nutrition, as I recall it, was to be educational on a broad basis-for training in nutrition medical students, dietitians, nurses and actual food technologists. The service functions of the Institute would be those connected with making tests and special studies for the contributing industrial group. They would have an opportunity to have the work done at the Institute on problems of concern to their particular manufacturing process, and they would pay for the cost of that, for materials and for some of the salaries of some of the people who would be doing the work. In the proposed agreement was provision for a Professorship or Nutrition at Yale with the salary to can.e out or this industrially supplied fund. The proposal also contemplated the erection of a building, an extension to the south of the Sterling Hall of Kedicine in Cedar Street in which the Institute or Nutrition would be housed, just adjacent to the existing Department of Physio­ logical Chemistry, and that building would be paid for through the industrial contributions. Talk about this proposal between Mr. Dunn, Mr. Francis and 412 J117Self went on for quite a while-Mr. Day in and out of the talks--and got to a point where I was able to put down on a piece of paper a eummary of the proposal. This summary- or the proposal was submitted after preliminary talks to the President of the University for presentation to the Corporation, and I have a record of tha.t in these papers h.ere. I have given a aummaey, but I can say that as early as on May 29, 1939, President Seymour wrote to Mr. Charles Wesley Dunn referring to this outline of a proposal which Mr. Dunn and I had made and which I had approved, and saying for his part that he could assure Mr. Dunn that the University would ~hap~o enter into this type of arrangement, that he would be glad to proceed from this point with legal examination of the phraseology or a contract, so to speak, and with the final drawing up of papers for submission to the Yale Corporation and~he Food Manufacturers for adeption. I went ahead all through the spring of 1939, and into the summer and fall with a good many more talks and increasing enthusiasm for the fundamental ideas in the conceptionJ naaely, the partnership l::etween Industry and a University, between lale University and the Food Manufacturers, in an educational and re­ search under"taking of considerable 118.gnitude in a field that was obviously very i.Jlportant and easily predictable as one of the developing areas of scientific :aedica. and public health work not only in the United States, but in the world. It seemed to me to have great possibilities for the advancement of the University 1 , renown and the University's contribution to knowledge and service, and it seemed to ae to be practically of benefit to the University by the funds that would be brought in to erect a building that was needed, to provide a professorship that was needed, and to provide opportunities for the Universityta participation in an educational program. Most or those, in fact, all of those major issues that were of primary concern to the University could not be undertaken at this time because funds were not available in the University treasury. The food 413 manufacturers were enthusiastic about the plan because they saw benefits to their own industries properly, and they saw an opportunity for them to make--how can I say it-a patriotic contribution to the welfare of the country-, and I think they had the highest motives. Well, this carried along in the JRedical school with occasional reports by me to the Prudential Committee of the Yale Medical School and scae rather long talks with some of the professors about it. It led in the late fall of 1939, to the dra.f't.ing by Mr. Frederick H. "Fritz" Wiggin, the legal ad~~r of Yale i Uni.Tersity, of a draft of a contract, and that was done, I think, in December of 1939. After having worked over this with Mr. Dq and Mr. Wiggin it was sub.. ai.tted to Mr. Charles Seymour the President of the University for consideration at an oncoming meeting in December of the Yale Corporation. Mr. Seymour was prepared to subllit this proposed agreement to the Yale Corporation at the mid• December meeting, but as I understood it-I wasn't present at the JReeting, b~t I was told that Mr. SeJ'l1'1our hardly begal'l to speak about it when there was a very strong attack on the whole thing led by Mr. Det(n Acheson. I never knew his ["'Mr. Acheson•sJ reasons for doing ttiat, so I would only be making surJllises, if I should guess them now, but I have a written statement which he approved as a member of a subsequently appointed coan.ittee to consider this matter with me and in which he put the reasen on the very high ground or the preservation of the integrity and the independence of the University against possible corroding commercial interests. Well, Mr. SeYJRour, I understand, did not tell the Corporation about the letters or approval that he had given me in Kay for the activity I was carrying on, the work I was doing under letters in which he said that the Universit7 and he would be happy- to have this 11ndertaking prosper, so the Corporation at this meeting--smaewhere in llid...December, on a Saturday-immediately appointed a com• lllittee to consider the matter with me as Dean. They very courteously came over that Saturday afternoon to the Dean's Office which was in the School of Medicine. Considering the dignity and the eminence of the committee members their coming over to aeet with me was a great compliment and a respectful action. The com­ mittee was composed of Mr. Acheson, Mr. George Day, Dr. Murphy, Bishop Sherrill, and Judge Thomas D9 Thacher. They came into the Dean's Office, and we had a long meeting of about three hours or so. Their opinion was expressed really at the start and not changed by the long discussion, and that opinion was essentially as Itve outlined, that while Yale wclll.d be interestedfn this field as an acadellic undertaking, it was not interested in having a relatiom hip of the type proposed with the CC11111l8reial manufacturer•• They didn't draw QP a final report at tbis meeting, but the;y adopted some phraseology whiehlBS largely produced by -4. Bishop Sberrill1 saying exactly about what ••• already' said, saying that tb.e Corporation members could net allow the University, or any officer of it, to put the University in the position of having this kind of relationship with the commercial food manufacturers. That 1 s the way it was leit at the end of that meeting. The cOJllllittee then reported, I think, verbally to the President and maybe gave hill sane memorandum, but on December 10-well, the Corporation meeting was on December 9, 1939, so it was earlier than I indicated by my earlier remarks. Right after the ccnmittee had met with me, I wrote the President a note about the meeting and gave him not only a sunna1j of what had taken place, how Mr. Day and I had explained not only the proposed mission of the institute, the proposed governing of it, the proposed financing of it and including a frank expression of the plan tb.a.t provided for a temporary annual gift rather tb.a.n an outright gift, but we were talking in terms of' over a million dollars for the whole thing, but I a1so wrote 415 President Seymour that while I should deeply regret to see this undertaking fail, I ha.d a feeling that if the University adopted the point of view of this special col'III!littee, it was probable that I would noi· be able tr., go on as Dean 0 That's the way it was left for a number of days 1 until later on in the month when I had had one or two talks with Mr. Se;ymour. He went away for a Christmas vacation and came back-and at the end of that time I told President Seymour that the action of the special cOJRmittee, which obviously- had the approval of the Corporation, and his failure to support the approval that he had given me preViously, earlier in the spring, for proceeding with the negotia• tions made it impossible for me to go on with the deanship:::for another term. The reasen I could say that I was in a position to speak of another term was because the Corporation had already appointed me Dean for another term, be• ginning July 1st, 1940., t.o run until 1945. I felt that if I took this licking, I would be no good for my school and no good as an officer in the administration under Mr. Seymour because I can't conceive of a person, any person., so defeated after thinking that he had the approval of the highest officer in the University, going ahead and pretending to be a loyal supporter of his chief when he couldn't possibly be a loyal supporter under those conditions. Well, I did tell him that I would resign, and I thought I wrote a letter of resignation., but apparently it's not found in these papers. 1hey may be in the Deants papers up at New Haven. Mr. Seymour was apparently surprised at the action, and I know that he was very much upset. Everything that happ,,,ned after that, asking me to reconsider., er expressing any opinioa on my resignation was all highly favorable. It was a very unhappy situation in spite of the fact that these commendations were coming in on account of my past activities, including a Cl'.lllmenda.tion from 416 Mr. Seymour, but I went ahead after that and finished out my term as Dean, ending June 30 1 19u0e The timinf of this is important-in the sense that this matter of nutrition jells at a time when the colllilli ttee is appointed to s eek the reappointment of the Dean !n December of 1939. You did have some misgivings about the Dean's Office in terms of the load 1 the amount of work1 the need for assistants--wella at the same time you were trying to balance other work on 'which zouwere engaged; namely1 the Childs Fund. I didn 1 t in the Dean's eituation involve any consideration of the Childs Fund at this ti.Ile because I think that bad been more or less concluded before all this happened, but, you see, they start to consider the next Dean in December of the last academic year of his tenure as Dean. They had the usual :meetings in December, and they came up with a recommendation for my reappointment ~~r mean, the faculty of the medical school, the permanent officers. I wrote to the President expressing very great appreciation for that and for the indication that he had given me that the Corporation would approve the faculty 1 s recommendation, but I had some things in llind that were needed for the Dean's Office and for the school that I wanted to talk over with him and try to get settled before accepting the deanship. There was a group of questions that concerned administration, finance, and personnel. I wanted an assistant dean to help with the administration of the school. I hoped to get a salaried physician as a health efficer for the students, an associate dean, and more help for the executive secretary of the school. The executive secretary was Miss Bishop, and she was terifically overworked with what had to be done. There was always a need for supervisien and maintenance of the buildings. k T~ose big buildings were very hard to keep up to Yale standards. The Yale standards were 417 very high on building maintenance, but they couldn't be carried out even, I should sq, two-thirds with the then existing allowances for the Yale Medical School. It was too much, and yet they needed repair, and they needed alteration. Those were the things, and I had other questions of policyo When one is working in the position of a Dean he sees thousand of problems that he can•t solve, e either becaus~ he doesntt know what the answers could be, or should be, and usually in the case of a burgeoning aedical school like Yale at this time., the solutions depended upon the availability of funds, and they were short of funds. About those things I wanted to talk with the President, and I did have an I , opportunity to sp~ with hi.Ill around the middle of December. Most of those points he agreed to. He was quite willing to make those allowances, add ad.. ■inistrative assistance., nnd a paid position for the care of the health of the studentso Those were settled, at least they were settled by saying that they would. be granted. 0 I think the top paragraph here is what brA;ke the camel's back. Well, the paragraph-I said in the letter of December 10th to Mr. Seymour that the most serious problems were those related to the plans for the Institute of Nutrition which had been discussed last week wuth the Corporationts special committee, and I did tell the President-I read it here now-"The decision reached involves questions of my judgment and regard for the welfare of the University. It involves also the relation of the dean to the president and other efricers or the central administration and rq colleagues in the school and the outcome of further discussion or the comrdttee 1s action will have a profound effect on my standing and my fitness to serve the University usefully." Well, the outcome was even worse than the committee's formulatien of their 418 ideas because it was an absolutely closed issue after that• What intrigues me, and I don't know that zou have anzthing to add as to how thel got to this final vote. You've found in a file a handwritten note in my handwriting 11arked 11 A_ copy ot the Yale Corporation•• records of a vote taken on May 111 19401 voted on a recommendation of the CCIIIIJllittee on Educational Policy"--that was a new cOJIDli.ttee that had been foraed•-"that the establishment of a National Institute of Nutri­ tion be approved in principle, it being understood that Ya1e 1 s participatien in the institute should be conditioned upon approval et the Yale Corporation of the personnel of the institute'• board of directorstnd advisory committees an.d the plans for its erganization and functioning." This is a general statement of procedures and autherizations that were in the original planning, that all of this be approved by the University. This vote approved in principle and leaves out all the details that I have mentioned.­ the financing and methods of governing the institute and its functions and its ldssion, the building. This is a broad statement. But the sub-committee of the Corporation set li.Jllits for the discussion which had already been rejected as between the University and the food manufacturers. Yes, and they wanted me to go back and see the same manufacturers that had told me originally that those limits would not be acceptable. I couldn't do that. What I have thought since this happened was that it did come as a new sub­ ject to the Corporation at that time, although the President and the Treasurer knew what was going on, and Mr. Seymour in his letter to Mr. Dunn said that he 419 had not been able to bring this to the Corporation, that he had saved time by speaking to some of the members personally, and that he could now write to Mr. Dunn that we would be glad to do it. I think that was less impressive than if it t)ad been reviewed earlier by the Yale Corporation, and I have a feeling ~ that Mr. Acheson didn't know much about it before he came over tA the Dean's Office. It was a new thing. A great deal was lost iR tenns of its potential. I think a great deal was lost because nutrition has forged ahead as one of the most important subjects in wor\d economy--food for the population that is werwhelming the space of the earth is a major consideration now. There have been great advances in nutrition, and there are still great advances coming on. My interest continued because from 1950 on, or 1951 on, ltve been a member of an extraordinary committee called the Interdepart.mental CGIRlllittee on Nutrition fer ~ational Defense composed of members of the Army, the Navy, the Air Force, the State Department, the National Institutes of Health, the Public Health Service, the big agencies like AID, and with a far ranging program and studies of nutrition practically of thirty-five countries in the world so far, and it's done a lot of good, but I'll tell you about that later when you get around to it. The letters to you--they don't reach the question of the institute because the reasons he ecbool--I said 11 the school. 11 I don't know. In a event., what is reported in the press is the overall pressure of work and the desire you have to do certain specific things-like continue with the efforts to seek en­ dowment for the school, to continue to devote attention to the Childs Fund1 and to get back to work in bacterioloq which you'd left some time ago 2 but the 420 ort-therets a collection of letters here that are ·ust in• • Yerkes for exam le all the wa frea Florida. We haven't talked yet about his desperate plight, one of the problems, but I tJ showed you Emerson T~ttle 1 s letter. \ They were wonderful letters. 'fhey came from people who might have written quite contrarily, if you just take disagreements of opinion, but these vare very personal letterso I don't know the extent to which the school understood the basis for this. 1 et me.say that I would ex,e_ect that you;"!ould no~ discl~~e the deep per~~ ~uestions of reliabilitz and integrity which were inv~~~~_in the _non ~upport of a view which had all the appearances of being supported up _to a point. You had the rug ...e,1fil,ed ou_t f1:,~m un~ern1:}ath Y~• I don•t think after this happened I went around and talked about it at all. I don't think I made any def'eose. I don 1 t think I made aey defense with Mr. Seymour. I think I just said that this bas been done, and I can't take it. Right, _a~'!. t1l_E!~ -~ think it w~s dropped anq you went on. In(!.re~ble--lou know, -- what was the state of nutritioa at the school? The nutrition had been a subject of interest at Yale for a long time. Professor Chittenden shortly after the CiVil War became a leader in physiological chemistry in America. He had studied abroad in Germarv on the composition of d proteins, food stutf, and peptones, and he was himself a dietary fadist because "- he ate a little bit, but he almost neteherized, chewed a certain number of times. Mr. Chittenden was a Blllall man, sli~ht, not tall, with a pointed beard, glittering eyes, springy step, full of energy- and ambitions, led the Sheffield 421 Scientific School into the rank of an almost independent universit7 and greatly adllired hilll. He had with bl.JR men that a<>ftd over to tbe~dl.cal scbeol-tw• men with very deep interest in nutrition, Lafayette B. Mendel and Arthur Ho Smith. Then there was George Re Cowgill there also, so that there was a nucleus of nutritionists at Yale. Yale had a School or Nursing; that was on a high grade­ we'll talk about that later too, but the School of Nursing required a bachelor's degree for entrance, and the School of Nursing had very intelligent women con­ cerned with the nutritional state of patients, and they just weren't merely dietitians serving plates of souoo They wanted to know what was in the soup and how it was metabolized. Public Health naturally was interested in nutrition because of all the deficiencies that are consequent upen defective nutrition and the supply of food and types of food. The social conditions of people in relation to their diseases, er deficiencies were of considerable interest t• Dr. Winslow and to others who were stueyi.ng the cost of medical care and surveying the health of the people, so there was a very geod tradition of nutrition at Yale, but not a well endowed, or opulent effort. There was sOJ18thing to build o~ and much interes.t. As far as informing the faculty of the stages of these negotiations, I must tell you truthfully' that I didn't because the conversations bebreen Mr. Day, Mr 0 Wiggin, Mr. Dun.n., Mr. Francis, and myself were :fluid conversations. They weren't fixed. They weren't reaey. They probably wouldn1 t be ready for dis­ closure until a contract was agreed upon, and you find out in lite, or when you're Dean, or anything else, that when you broadly discuss uncertainties, you add to the uncertainties. I didn't feel at liberty to talk about some of these things in general, but they did know, the Prudential Committee did knew, and I 422 had one or two., as I recall it, very serious, sort of controversial talks about it with Dr. John P. Peters who himself lli~ht be considered in the nutritional field. His great study on body water was, in a sense, a nutritienal study, and he was interested in nutritional metaboliSDl, a very brilliant man. I would like to tell you about Jack Peters, but I rea~ don't want it on this recerd. 9.n}he part of 2eople who didn't understand the real basis for zour disinclina­ tion to continue ,with the deanshie how magy; brought pressure on lou to continue? They were eleased with zour deanship, ~,m sure 1 becaua~ their letters •••• Yes, you showed me one frcn Emerson Tuttle, if I can immodestly refer to it myself. President Seymour said somewhere in one of these letters that he thinks that my deanship was the happiest five ...-oh, hes aid, "I cannot remember any five years of a Dean's administration here more successful than yours." That 1 s an accolade. Well. when the school fa~ed a change abrupt as it was, without a kind of fore~ warning-I don•t know that you can have a forewarnin~• This is the normal. course of events, and if you decide for grounds that are rea~onable to Y;!U not to continue I suppose thel have to accept it. I was chosen, considered, and appointed in about nine days, or ten days, and the Lord giveth and the Lord taketh away in about the same time. I pesa you 1 re righ!:_. This didn't take auch more than nine da7s. No1 but the search for a new Dean•••• Yes, they started right away on that. They discussed it with Alan Gregg 423 who would have been a wonderful Dean, but Alan Gregg was not interested in school administration. He was the administrator of a great section ef medical education and medical research of t-he Rockefeller Foundation, and Alan Gregg, tall, eloquent speaker and writer and it-he was Tery wise and very attractive, and he didn tt want to be Dean, and I think he told them so. What they did- they coaproaised ~nd made Dr. Francis Blake, the Professor of Medicine, also a veey able man, the acting Dean for the year, and he remained Dean until-this was in 1940, and he was Dean at least until 19501 at least ten yearso Then Hugh Long took on as Dean. I Thats a~ interesting period, Do you have any sense of criticism of you~ deanship? You indicated to• ~he ,other day that in the develoP!ent. ef overall plans that iou weren't a elanner, You said this. I do•'t know that you had anz indic!_tion of this because ~•ve b~eed into all kinds of plans that were going on, aazye not an overall plan. I told you that there was criticisa of me tor being not the kind of planner that Winternitz was, for mcample, broad conceptiens or a whole mission, a whole scbeol. I had many plans for individual situaitions, and most of these came to me for dicussion fro• the heads or departments. I didn't teel that I was a messiah of aedicineo That•a a good waz to put 1t1 but then I think also the times did their b ~ condition this because the •phasia was on retrenchment. Yes, the times-well, it was rather dismal in some respects. Wetll get to toaorrow, if we can, the positive exploration of funding 1 the Childs Fund, ~t ran wallel to the nutrition study1 and it involved planni5 424 both with reference to pessibilities inherent in the school and beyond the school's control as an idea which is new aad novel tooo Let me say it befere I forget it. You say it was "planninge 1 " It was accidental. I To 1ou-it came over the transome to 1ou. Yes. But the manner it was established once it functioned was a plan of great si1tnificance so far as the school was concerned--it eventuated in a positive wa1, though the detail of its beginning may be quite accidental and indeed was. There are two ways that I think about planning. One is to sit down with a blank sheet of paper and draw out a scheae of urban development or whatnot. That's the architectural type of planning. That applies to intellectual planning too. Yeu could just say, as you would of a house, that you want s• many rooms for this, or that and say of a medical school that you want so many departments ef this and that and sit down and draw them up from nothing, but the kind of planning I was engaged in, and you have to in an institution like this, was to deal with the sections of it that are already- in existence. Mr. Angell told me ene day when I was talking about the future of the school,"B-J, you know, these great institutions have a moment'lllll of t~ir own, so it matters very little what anybody in a position of authority does with them." I think that's true 0 It is a wise comment. He didn't mean for me to lie down on the job. 42.5 Oh no. But there's SOlllething mysterious about an instituion. It has a life and vitality. His word was "momentum." It does continue in its direction, unless it's acted on by soaeacternal force. But in that period when you had to decide whether to be or not to be Dean-it was like jumping into a huge swellen streaa. Yes. And a good bit or the ataospher• and the Eroblems zou confronted as Dean related to a crisis OTer which you didn't have any control--the whole aense of retrench­ ment, the depression, and the new and novel ideas that were popping out of the ground 1 new organizations to challenge the older 1 staid, and more conservative or~anizations. Ideas of medical care and social elements in medicine were in a state of nux and argument at that timeo I guess we 1ve exhauste~ this. /J,~~ys f,eyhouef_) Let me read Gladys 1 s letter.(! see beret.hat Charlie was .... ~ 426 Thursdaz:1 Mal 12,1, 1966 A-60 1 N• L. M. I've alrea indicated that I would like ou to deal with he develo ents in the medical library at Yale today. Again1 putting this in a context-while it may be a little too logi,cal-~ 1Jll aware or the fascinating people who are in­ volved in the development of the library, but nonetheless there is a crzing f need in the Deans Reports about this facility, its role and function in a_ medical school and its condition 1s described as whol inade uate. That's not onll the judgment of the sc~ol itself1 but also oi the AMA Committee which came around to assess the school-well there's ust this enormou need viewed against this period of retrenchment in the l930s 0 What to do about it1 how~~ I get it started? It~s a hwnan storz too 1 quite apart frc:m the econofics 1 and there are a number of very .fascinating people involved-Dr. Cushing with whom you'd had some relationship all the waz back1 I believe, to Hopkins. Yes, I was there when he was there. Amd Dr. John F1 Fulton, a strange .fellew in his own way1 and any light you can shed on the marriage between the times 1 the need and the personalities here to develop what I have pictorially represented here as the historical library and the working librarz:. ~"'hat date do you want to take off from? 1 The earliest date you have is in the Report of 1935-19361 and it s that year •••• That early 1935-1936 Report, my first Dean's Report, points eut the in­ adequacies of the library. It was a very small collection housed in inadequate quarters, and it lacked money for acquisitions for new books and subscriptions 427 to journals. It had very little prospect at that time ot getting any increased resources either in funds, or collections. Everybody knew that something ought to be done about it, but they didn't know how to do it, er when it should be done, and, as I recall, the building up of the medical library was not in any high priority in any scaeme of fund raising. There were so many more urgent needs for professor•s salaries, staff salaries, or for the support of the working de• partments, that the libraey appeared a little bit off on the side and didn't arouse enough interest. You asked me where the library fit in to the functions of a medical school, and I take it you mean in the course of medical education. It has a bearing on every phase of the life and activities of a school of medicine that has any educational ideals, in the first place, a.nd any service ideals, in the second. It is a store house of •4i\he knowledge of the past, a place where 7ou can meet, or come in contact with, the thoughts of the past. It is also a meeting place I for the recent past as well as for the far past, or the distant past. Its a place in which docters and students can come into contact through the perusal of journaJs with the current thought of all sorts ot physicians and investigators of the time. Not only is it a repository of ideas and thoughts, but the very physical nature of books, illustrations, portraits, and diagrams and all the appurtenances of publication have in medicine, I think, as they do in any other professional activity, a stimulating value just of themselves. It's a wonderful thing to have a copy of Vesalius, we 111 say, the great anatcsy of Vesalius in your hand. That book had an enormous influence on one of the founders of the Yale Medical Historical Library; namely, Dro Cushing. He had a copy of the Fabrica. For me, thoughts about a library in a medical school went back as far--I link 428 i+gaiQ to ST gra..iJ:athar Jeseph Jo- who filled the hea,re with oeoia,, aostl;y bis own compesitions, but they- were there 9 Then at the Johne Hopkins visiting the library-, st.udying in the library, arid going to original eourc.s was almost ae natural as going to the current lectures. It was in the air. Dr. Welch did it. or course, the great bibliophile there from the very beginning was Dr. Osler, and th• Osler Library in Terento now is one of the great.est collections of aedical boeks, and Dr. Osler infl.12enoed very aueh the man who was probably the ll&in actor in raising the cvtain for the drama ot the Yale Library, Dr. Cushiag. Dr 9 Cushing was ·veey aueh infiuenced. by Dr0 Osler., probably- was lured into the collectien of boob 'by th• example of Dro Osler. Dr. Cushing had been an Associate Professor or Surgery., a great experiaenter at the Hopkins, and he carried that saiu impress with bi.a to the Brigham Hospital in Boston and brought it with increased richness and power to Yale when helllS given a place there tbreugh the activit,' ot Dr. Winternitz after Dre CL\Shi111t11 retiraent trom Harvard Medical School. I think that nuist have happened early in the 1930s, when he came dOWII te New Haven. Well, it seem axiematic that the library sh•uld be the heart of a great inatitutien of learwing, and so it was at Yale. The Sterling Library is one ot the greatest libraries ill the eountey, arid in additiea at 1 ale they had very­ rich depart.aental libraries which was ene thing I and s911e ethers worked against when we began to build up the Yale Medical Library. 1-ta of bo•ks that eught t• have been available easily t• the medical students were in the depart.mental 11\ e. libraries of chelliatry, physics, or biol&Q"-al.l[w~across town-and since tbie Yale Libra17 vaa built 11p1 ■al'IT or those depart.mental collections have been put in the Yale Medical Librar.,o Tbe tiae •• ripe. The need was there, and the tillle was ripe fer doing s011ething1 and the doing ot it, I tbink.t aame about I really' reel miraculously and accidentall7 through the presence en the faculty of two great book collectors; ' 1, namely, Dre John Fulton and Dr 0 Har{,~ Cushing. They knew and trusted each i other, and they had friends also among other collectors; namely, Dr. George M. Smith who had a great collection of boolca, and Dr. Edward Streeter who had tbe aost t&IIOUS collection of pharmacies, measures and weights. 'I'bey had another triem in Switzerind, Arnold lleba, the son or t.be great bacteriologist llebs, who had au.eh to do with early stadiu on tuberculosis and diphtheria, was a aan or culture with an intereat in history which be passed on to bis so11. Dr. Arnold neba in Switzerland had specialised in the collection or incunabula., and he had probably all the incunabula or medicine. He had a huge collection. Drs. Cushing, Fulton, and lleba slowly for•d I won't sq a partnership, but a very close relationship bound together~ their interest in books. They were infiuenced by the need or Yale for a great library- in the medical school, and they' were, or at least Dr. Cushing and Dr. llebs were reaching the point in their liTes 'When they were 'beginniag to think or the disposal ot their rich collections. Dr. Fulton's enormous collection which he had been ■&king since ne was a student at Hanard was in the possession ot hi■aelf u a young and 'vigorous man vho 0 expected to liTe quite a lot l\nger. He was not yet reaq to giTe it outright to Yale until he knew what these other men were going to do. Now this takes 118 up to about 1936-a bout that tiae • There was ■ueh talk and negotiation, letter writing, a.a to when Dr• Cushing would make a aove, Dr. nebs ■alee a ■oTe, and Dr• Fulton make a ■ove. Somehow or other they unaged to aOTe along ~ f\ a congenial trio. The first real step to the library project-Ir I could call it that-vu Dr. Cushing. Ile :made it ver:, plain that if provision could be made tor the housing or his books, he would give them. 4.30 Once he did that, bis friend neb• said that he 1 d do the~~~e, and in due ti.Ile Dr. Fulton prcaised to give his books, but there was no place tor a building, and there was no J11oney- for a building. That's lib.ere the Dean caae in aost.:Q' because he had a little say about calling meetings ot people and dealing with the authorities in the University". e. Very iaportant in tbe influence u.pon the University- was a cles~ friendship betwen Dre Cushing, Dr. Willlarth Lewis, and tbe Treasurer Mr. Toa Farnam~ and it was really through them, after they'd convinced Mr. Farnam, that the Corpora­ tion at Yale voted to make available a S\111 ot money .trom the Sterling bequest, the same source of aoney that had built the Sterling Hall of ledicine. There was a lot of land still~round Greenwich, Connecticut, in the Sterling estate, that could be sold for purposes like this, and they said that they would build a building for the historical library particularly', and, of course, 110body wanted just the historical library. The ideal was a whole 11.odern libra17 as well as a historical libr~l'T• The7 d ecided~ben that the7 would be able to put up the aorie7 for a building in part froa Sterling funds, for the historieal library chiefi7, and in part froa regular UniYersit7 sources. There was auch diapate as to where the library should be• The lot of land where the Sterling Hall of aed.icine was situated was crowded with buildings, but there was a vacant space on Davenport Avenue near Cedar Street, where Mr. Atterbury, the architect •ployed tor this plan, thought it would be fine to build a beautiful marble--vbat I would call a aausoleum for the housing ot this libraey. Dr. Cushing and I felt opposed to that and so did Dre Fulton because it put the library' out of the normal trattic ot the students and the tacult7 meabers. The7 Jlight Yi.sit it as a curiosity, but we wanted smething tor them to tall in.to, 10 they- decided that the building should be 011 the lot of the Sterling Hall of Medicine, but vb.ere? h31 At that time one wing of that building extending from the center ended in a very large anillal ho11se. If you'll turn those plans around, you'll see how you 1 d enter. We 1 re talking about a plan of a building. 'I'his is the entrance way, am right about here was the aniaal hoase--tull of doge and monkeys. It se"ed aa the animal quarters of the whole school, and yet this wa1 the very location t.hatf-• aost favorable tor the librar.,. It was difficult to get any­ agreeaent from departmental heads as to where the anilaala aight be housed. Fiu.117 soae cleciaion had to be aade1 and I took the libert,- of issuing a suggestion that the animal house be abandoned, t.orn down, and the anillals moved over into the ba••ent of the Brad1' B1111.ding. 'lhat188 done through the good will of the people concemed and to the great discomfort of the people over in t.be Brady' Building. The stench from the anillals went all through the building, through Dr. Winternita•s departaent, through the luraing School which was housed u on the first noor, through bacterioloa ~ ora the third noor and teaching on the second noor. Of codrse that was on the land where the New Hawn Hospital was siruated.1 and the noise of barking dogs and mewing cats was disturbing to the patients, I•a sure. But that'• the only' place we could find to put the animals. We knew it was t•porary-1 and, u a matter ot tact, eince that ti.Ile they have a modern., air-conditioned, soundproof an:illal quartera that are beautif'ul and very salubrioua. Well, ha'ri.ng decided on the place for the library, the plan then developed in the fora or ax, a wing extending~ut tr• the center of the building and extendiq out in two wings in a Y shaped •nner into the back yard of the sterling Hall of' Medicine propert7. It was a ache•• that gave plenty ot light, plenty of ventilation., and quite a lot or roa. The building was planned there to go down belov the ground about three stories~ to be thorottghl.7 air-conditioned, e rising abo•J<,_ the ground about three stories, and that's the way it caae out 4.32 finally• There was one period or great uncertainty- and that, a a Ir em•ber, was 1939, just atter the outbreak ot World War II in Europe. The occasion or the outbreak or the war was taken by certain officers of the Uni-Yersity- as an excuse tor proposing an abandonaent of this plan at this ■oment. Their argument was that it the war vaa caing ori, steel woul.d be in veey short n.ppq, costs would go up greatq, aad it would be ditticult to get labor. E'Very- possible objection vu brought. i&a, even in 1939, when the United Stat.es was not in the war, but aa a Mtter of tact I know later troa the things that I•• studying tor the history- I•• writing ot Preventin Medicine, that there was a very- early- per­ ception ot the possibility, or the probabilit7 that the United States would join in the var. President RooseTelt declared a •liaited national ...rgency-" in September 8, 1939, one week aft.er Oerm&l\1 had itffacled Poland, so it was reasonable that the authorities at ~ale, who knew all of that, would thillk that this libr&r)" project. we'1ld beoOll8 involYed in wartime striagenciea, that it wouldn't be a favorable ■Olle&t to undertake the construction and eflUipment or a library. There were soae very •otional aeetings and auch worry-. SOJD.e or these conferences took place at my house on TrUllbull Street. Others took pace at Dr. Fulton's ho11se, and at nr. Cushing'• house. Mr. Wilaarth s. Lewis was a aoderator or a good deal of this am brought to bear soM very- good sense and power because alwa7s as a member or the Corporation he supported the libraries and auseuu at Yale. The central Universit7 Library', the art school, the Peabody- Muse121l all benefited troa Mr. Lewis's et.tort. Fortunately- the authorities ot the Universit7 sav the opportunity- to attract these irreplaceable collections of Dr.Cubing, Dr. Mt.ea, Dr. neba, Dr. Streeter, aad possibly aaetaiog troa Dro Saith, although he didn't put aueh into it, to the UniTersit7 if' there were 433 suitable housing for th• 011 the medical school grounds, and so that prevailed. I S It~• been a veey great. success-renown in the United state~ as one or the most valuable medical libraries in the country-. It's ~ntegrall! woven into the fabric of li~arieo at Yale. It bu relaU.oM with·&+ libr~riea in the country-. It. • extensively used not only by the students and faculty, both the "' historical and the modern aedical libr&l'J', bu.t also by the pby'sicians or Connecticut. Thq have free access to 1 t, a ad there is a loan sel"Tice for tba to it, so in Uft1', many wqa fr• the huaan aide as well aa the intellectual aide, it has been a aost valuable additioa to the scheol and to the Un1Yersity. Nov, what kind ot' thing should I sq aore about? This J.aa- ust to fix it in tiae-waa a out by the Corporation on May 81 19371 and the amopriatien, I thinka or - $6001 000 was voted bz the Yale Corporatio• ea June 21 1 1939. You aee, they approved the plan two years before they approved the support of it, and, u I sqI the plan existed tare, but when the war came oa they were just going to let~t stq. tt jast caae on the eve......Tune 211 1939. ~,. interested not only in the collection of books as a fora of-I collect books. So did Io Yes 1 ~o did you. I think ulti.Jlately you deposited•••• I gaff Yale &bout four thousand boob, bu+be one■ I gave to the Ialo Medical Library were the books I had collected in my own field. I had prac­ tically- all the original publications in bacteriology. Now, bacteriological N~ publications took the form of books1in the textbooK line, but in the monogra.pbic A -----'- la34 line, the;y.. rere what you 1 d call pamphlet. type books. They were specialized monographs on saaller subjects, parts or it. Most of the bacteriological litera­ ture was spread in the journals. Pasteur, however, published considerable books on the diseases of beer and wine, his molecular diss,-etey studies, and I had all of Pasteur'• books. Robert Koch, the other great founder or bacteriology-, published aostly in journals 0 His work has been collected, but the original works are in journals. I gave all that to Yale. It was in the air to do things tor this libraey. It sure wu. Mro Starling Wo Childs and Miss Alice Coffin got interested in it, and in addition to the Child's Fund for Medical and Cancer Research, the Childs Estate and Miss Alice Coffin, who was Mr• Childi' sister, gave money directly for the support or the library. There's a Childs Fund for the library separate from the medical research. In addition, on the advice of s•ebody"-I don't know-very i,') ~e actviee, I the Dean set up the Yale Medical Library Associates and got quite a great group of fine people to pay ten dollars or more a year, sometimes more, to help give funds for buying books. One of the persons I was fortunate to meet in this etfort to get books and associates for the library was a lady in Pittsburgh CMrs 0 Rachel McMasters HuntJ wbo had a great collection of herbals. She gave only a tew ot those books to Yale, but she was a great belp 0 She was a relative of Mre Childs too. Students got interested in it, ~nd people gave money for subscriptionao It came right along. Now, I don't know how many journals they t&ke, but it I s reall.T an up to date place as well as a fine historical laboratory. One person we've mentioned who has had soae continuity with the libraq since 43, and the records that are here coveri those early daf! after it OP!_ned1 show the difficulty of funding the actual work of the medical libra the Starli Childs Fund. It's a beautiful place--a.s you can see trom the representation here. " Dr. Cushing provided for support in bis will., am Dr. F~ton1 s wife, Lucia, had a fortune of her owa., ~nd I think that John, a rather impecunious student, plU"chaaed most or his books through gifts frm her, and she's very modest. I Youd hardly know how auch good she does. Itm sure she must have contributed ~ to the support of this libraey. Certainly ~he did for Jo~'• collection. The I "' !, \ library 1• a beautiful building• It• tasijtully designed. It 0 s an inspiring ~ place-good for exhibitions, good tor meetings. ' ' la• it eened in terms of it,s original. desiga u a catch-all? Oh yes, it'• crowded all the tiae. They walk in there and spend a lot of time-so much so that it 1s opened 'till Jddnight 0 The medical historical side is built in an ornate Tudor combination, great huge beams, pendants, pendentives, galleries and carvings, whereas the working., er at least the current medical library- is a stark, industrial type of building• You can see it there in that picture. There 1 e no ornaJnentation to speak or, but bright and very pleasant. All the wall spaces ot the entrance hall are hung with pictures and prints which are changed constantly', and there are beautiful cases in which exhibits of periods, publicaUoaa, and •n, biographical things, are put on from time to time by the d&Yoted Miss Stanton and other people on. the start. It's interesUs. that two birde were killed with one stone-the rumor or the thol!iht that Dr. Ousb:ing would give his books,a it a 8Uitable place could be 436 111&intained1 was made to serTe the interests or the school also in its genera}. working library;. Solved both problems. I like the way you ~ay solving both problems, rather than a mortuary metaphor--killing two birds with one stoneo I I was thinki!!fi or the Dean's Report. They#41re pretty bleak in the early days about the condition or the library. There's no question about tbe need. The desiga just lent itself to accessibilitr, whereas that other site was on Daven­ eort Avenue, and it would have been a lfh.olly different placeo In addition in tbat library- building it was possible to use an upper story fer t.he headquarters or th+hilds Fund wbich you'll notice later on. That's a subsequent develoP!!fl;t• For which they paid Yale a nice little rent 0 I think it 1 s also true, isn't it1 that the Childs Fund itself found an absence or materials 1 books 1 references relevant to the cancer.field and established a fund wherebz books were purchaaed and stered in this library, still under the •••• We had a plate for the Childs Fund-ownership, and we b,l~ lotsrr books on cancer and subscribed to journals slowly because, I.as we'll poiat out later, this 1937 period was known as "cancer the great dar~esa "• It w u a pi ti.fully' inadequately supported field of research. Peo le haTe continuit here also-Oeor e M Smith. He not onl has it wi the libr&, but later oa in th.e Childs Fund. Be'• quite a fellow, I don't know that th.ere is ~hi!!S that zou 1d. care to saz about these people u people.. 437 9,ui te apart trom their interest in books which 111 tPt \.) . help to ill,&r•na.te this librarz• Well, Dr. Cushing wu a producti'Ye scholar. He was an eloquent speaker, cogent, and a writer or grace and facility on many- subjects, notably his bio• 0 graphy' ~f Sir Willia Osler and his writing on Vesaliuso He was always inter- ested in books before this librar)", as I said before, and carried that forward into it 0 Dr. Fulton was Professor or Rlysiology and had come to Yale from Harvard, a very vigorous and wide ranging man, cou1d do almost anything, a great, N energetic, facile person.o He had collected pretty ~early all the 18th Century scientific work in England. Rebert ,rJl• '" I was one of his specialties, one of his special interests. Harvey on the circulation of the blood earlier than Boyle was one or Fulton's special interests, and be had-I don't know how man;r thousands ot book&. He housed th• in bis Departaent of Physiology. Dro e Fulton attracted a great 11&0¥ students, graduat~ students and young members on his racult7. His main field of interest in physiology was primate physiology, N s the "-ervous syst• of the higher aP\ and also dogs. He brought up a line of imrestigators who have been eminent men in that field in the countryo Dro Fulton was able to go abroad tor studies and social m.eetings, and scientific meetings about every ,-ear, so he personally knew everyone from Sir. Willia.a 0sler to Charles Scott Sherrington and all the great neurophysiologists or the tiae. He brought all this back to Yale in a stimulating manner. Dr. Fulton wrote incessantly-at least be dictated because as I told 70111 he had a dictaphone in his office, in bis automobile, in his bedroom, and in his study in bis house, and he was carrying around these records to his secretaries all the time. He had a great sense of fellowship with the people in his departmento They were deToted to hill, and he and Mrs. Fw.ton issued yearly 438 not an encyclical, but s011Sthing of that type, printed and telling what had happened in the 1aboratocy during that yea:r and giving personal news about 11embers of the st&tf' who bad been there, or were there. I didn't know Dr. llebs very well-I wouldn 1 t say th.at I knew him at all. I met him, but he was over in Switzerland. I knew of bis reputation, and I knew the value of his boob. I knew that Dr. Fulton and Dr. Cushing had to be very persuasive to get Dr. llebs to join in with the plan, but they did, and that's the reason for this three leaf' clover on the front of that pamphlet. That'• their motto. It is a three leaf clover. Dr. Edvard Streeter was a friend of Dr. Cushing 1 s more than be was of Fulton's, or mine, and he lived in Stonington, Connecticut where w+aw him occasionally. For years he had been collecting weights and aeasurea, b¢ng thea wheYe'Jer he found them all over the worldo He vaa a well-to..cio man, could travel, and he had the greatest collection of weights and aeasuree going back to ~- Phon1tcian ti■es aad all t.be way tbrougho They persuaded biJII to give them to I\ the library, proTided they would be properly housed, and they are housed there and were right away in twe adequate roamso I met Dr. Streeter at his house a tev times when we went to talk about these things, but I can• t say I knew bill at all well. George M. Saith had been very infiuential at Yale in the field of cancer research. He was the medical director or what was known .as the Acma. Fuller fund, a fund given by Mr. Fuller, a businesaan in New Haven which was the first en­ dowaent for cancer reaearcb--well, it waen•t aa endowment for cancer research at Yale. It was the first collaborating, or cooperating foundation that gave prior consideration to Yale'• needs. It could make ita grants aeywhere it wanted, but it gave most or th• to Yale. It didn't amount to a great sa, but it was 439 a seed, and it was a seed that put out plants that attracted Mr. Childs when he caae up to New Haven on a rlsit just before he made his great. foundation. Dr. Smith was housed in the Department ot .A.nataiy-• He was a great friend of ' Dr. Ed.gar Allen who was Professor of AnatC1117, and his special interest in ex- -\ perimental work were fish-particu~arly pigmented fish-fish with big black spots because they developed melanotic tumors, and his collection of books was ~ largel7 in icthyology-. He •s a 11;,ysterious man, kept his own counsel prett7 \ closely., and one was newr q11:1te sure what he was thinking, or what he was going to do after he said something. Yeu liked him, but he aroused caution. I could aay more about Dr. George Smith, but I dontt think l 111 do that. He •11 come in again in the Childs Fu.rd where his experience was tapped, his knowledge on a consultant 'baais 1 I think he was ultimately made a member of the ad\l'j_sory board1 so his knowledge wu made servicable• Turn it err tor a minute, a.nd I 111 tell you something• This is terrible. LThe recorder was turned oftJ There's one ether person who baa no special connection with aedicine 1 but who was quite instrumental as a ~" member of the Yale Corporation. His inter.fest• were in li terature1 particularly ·~ the Horace Walpole collection, but as a person. This is Wilmarth Lewis. Wil.Jll&rth Lewis was the class of 1918 at Yale and has been devoted to Yale ever since he was an undergraduate. He went over in the Artillery in World War I., caae back and was soon elected aa one of the self-perpetuating members of the Yale Corporation. B7 that time he bad alteady begun to be a book collector in his own righ-t. He had aarried A~Burr Auchincloss., and both the Auehincloss fami.11 and the Lewis family had considerable fortunes. She bad the larger £or- 440 tune, and she was interested in building up the book collection of his. His interests turned to Horace Walpole, and he beca.lll& a great authority on Horace Walpole. ~ His e:f'torts to p11blish and annotate the letters of Horace Walpole turned in to an anterpriae to :mcenstruet the 18th Centur,r. He had p~anned forty volumes in his series. That will give you an idea o:f' the scope. He soon became interested in all the collections at Yale-areheologieal collections, the Peabody collections or animals and artifacts of all kinds, the art J1U1seum, the school of ■usic, and most ot all tb.+entral Universit,­ Libraey. I don't remember how I got to know Mre Lewis, except it au.st have been through Dr• Cushing because they were great friends t'rom the beginning• I thi¥ ."t:.1!.E:..first letter is an acknt?vledgeaent and generous thanks for being ~ble to stop off at your house at Trua~ull Collese• Yes 1 he bad some engageaent with Hr. A~terbury1 Dr, Cushing and ,others, Tl?,a~•.s C the 1'1~!,t instance 9 His own book-::I think he published a little book 'alled; Collector's Pro1ress. I haTe a copy et that. It's a wittz1 subtle tbi!!6• I Hes a aost attractive man, full of interest, literary interest, historical interest, and interest in people, but he was the power behind this library move. He supported Dr. Cushing, Dr. Fulton, and had a close relation with the Treasurer of the Yale University, Mr. Farnam-could influence him. I don 1 t remEll'lber what bis relation to Dr. Winternits was. Dr. Winternitz was, of course, 441 in the background of a great deal of this-didn't oppose it1 but didn•t appear too 11uch on the promotional side. Mr• Wilmarth Lewis has done wonderful things during this period as a Corporation member, which ended two years ago, for the 1 buif18d-ng up ot the central library, the appointment of the librarian and stat£. A.bout this tille, an example or what he could do-there was a change in the librarian at Yale. Mr. Andrew Keogh, the chief librarian, reached the retirement age. He was a thoroughly trained guild librarian, and he wanted to haTe the next librarian ebesen fron among the guild trained librarians, some or whom, to tell you the truth, seemed to me to be more interested in whether a catalogue card should be tbl"ee by f1Te 1 or two and three quarters by six, or something like that. They spend enoraous amounts of time on cards for catalogues. That ran through the kind of thing that people thought Mr. Keogh was mainly interested in. On the other h.and, Mr. Keogh took that library through a veey 1:aportant stage. Fra the time t.hat it was moved from the Yale campus to the superb new building,. it had co11e from saall to great, but Mr. Lewis in the Coproration, am elsewhere, showed even at that early date what he could bring about. He was largely respens1ble for tne appointment of Mr. Bernhard Knollenberg as the librarian. Mr. Knollenberg was a law;rer aoo. a financier in Wall Street, bat he was also a scholar. He published a book on George Washington and other things. His wite was a sculptor. Knollenberg was an interesting and Tigoroua librarian but the particularl7 interesting thing was that Mr. Lewis / was ab)le to break a tradition of Tested interest in the appointment in the guild and bring in somebody that wasn't trained as a librarian at all 0 I had the E_leasure, of meetinl him jus,t 0110e 011t at his home in Farmington_, a !•rm P!rson who ude lou readily at home-no tuss 1 but then the 29tail into which he could go in terms of ,indexiDJ-it was like an educati,on for me• Oh yes. Out at Farmington, he bought an old house, an early 17th Centlll'Y house, I think, and then built on to it additions to house the Walpole Collection. The house is tilled wit.b Walpo4eana, portraits, objects from the Walpole nstrawberey Hill" mansion, if you call it tnat. He set out, among other tbings1 te get al+he books that had been owned by Walpole in his library., and he got most ot th•• He bad the shelf list troa Horace Walpole, and the books are all in the places Where they were in ,,·;1Strawber17 Hill"• He has a 11ost enor-aous collection ot political cartoons and prints of 18th Centuq England which be­ came the field et work tor Mrs. Wilaartta Lewis. She beca111e a great expert and cataloguer of these thousand.a of prints. She was a veey lovable person, quiet, unusuaing, and yet absolutely constant in her support or their joint enterprise in the Walpole Library. I got to know Mr. Lewis :fairly well. Mrs. Bayne-Jones and I have been up to a ee hill at his house in Newport year after year for a good many year•• We stay a week. Well I thi The next. sub act ••d like to brig up is the Child.a Fuod.1 and that's goini to take 11S a little l!!!!.• 443 Mag.y of the things we've been talking about the last three or tour sessio~ all happened at the same tiM. We 1ve been focu~ing really on the deanship 1 th~ variety ot exP!rience ~.•an can have as Dean. Some •t th~.things are indicated lon ou ever becou Dean--the heir to s011ething in motion. Al!1),ther eart of the task is dealing with. something that comes in who which d'1rin the time of lour deanship1 burgeoned into a aeans of support tor research, n~t.alone at Yale.a. but beyond Yale.,_ This 1s novel in teras or its time. You had had ,.e_re:t:i.ous ex rience I think on the National Researc ouncil in the su ort of research. Yo,;! had some cofttact through Hans ZiDBser with ,the Leona.rd Wood Le2x:,osy Foundation and its problas or get~ii!,I a foothold in the field, not in a!lY: direct, official waz, but throujh Hans Zinsaer •••• ~ I was a member of the boa~d• From the start, -,q connection with the Leonard Wood Memorial was as a member of the Central AdYisoeyMedical Board. I guess you wer..... I 1 • ~hinld.'91 of corresp•odence with Hans Zinsser where you wrote that you had .~en asked to sit with thea 1 There J'f&sn't then agy: indication that it was a fo~ relatJ.'?nship1 but simply because z011 were ill Washington. In thoee photographs there are dozens of photographs of the board-Zinsser, Frederick Ga71 a lot of peopl•• I mention it to indicate that you'd had experience-what to do with a problem. Yes, what te do with grants-in-aid. Tiie same in Rochester-we had a fiuid research fund at Rochester, and we had granta traa other places. 1&44 C The wb~le develoJ!'lent o.~ the ¥xademy of Tropical hedicine had granta-in.-aid in ~e• u a possibilitz1 Well 1 here 1s-well1 I don't know how zou got into this> except that the correspondence shows it c011es via Dr 1 Saa Harvey• .A.o;(thing z~u can remember by waz of background1 certainly the negotiations which lad to :he formal &i;tt to Yale ot the Childs Fund and the establiabaent of the C1!1,l~ Fum will be helpful because it is rather novel, given 1937. I think it was Pasteur who said that phenomena occv and mean ni>thing t. ••e people, but in ti.Ju mean a great deal to the prepared aind1 and I think that c_.ent would apply also_ to the prepared institution. In this case, in• terest in cancer had been nourished for a long time at Yale. It goes back­ vell, it goes back a long tiae1 to tell you. the truth, to the missionary work in Canton, China. Peter Parker sent to the Yale Pathological Department about 18h01 a great series of oil paintings of tuaDrs and cancer in the Chinese people in Canton. They were-exhibited around there keeping up a Yale interest in the natural history of cancer. Then in later times at Yale there was the influence of the Arma Fuller F~d which aust have begun in the 1920s. I haven't a history ot the Anna Fuller Fund here, but I know th.at Mr. Fuller, a busimssman in New Ha,eri.!,i got interested in cancer probably, as so often happens, because of ' the death •f' some member of his f'anily' troa the disease and through his association with George M. Smithe He founded a fund for the support or cancer research which gaTe aost of 1ts aone7 't6 Yale, aJJiough it didn't. need to confine it to New Haven and Yale. It could and did give fund.a elsewhere. That was the basis for what had beem existi11g for perhaps five 7ears at least before 1937; namely', the Atypical Growth Study Unit which is a n&Jlle Dr. Wiaternitz gave to C!! this group of scientists and medical people interested in ne~plastic disease. It was prophetic that he called it "atypical growth"', foca.sing oa the problea 445 er growth because the fundamental problem in cancer, as all recognize, is a problem or the JIY'&tery or growth, and fortunately, if you have the conception that it is a mystery or growth that you're studying, you can be very broad in your activity because there is hardly a biological, chemical, or physiological process that is not s-.ewhere im-olYed in the problem of growth, and that allewed the cancer illV'estigators to ro• veey widely over the field or all the elements that had to do with growth. Those things exi•ted at Yale soaetiae before this accid•~atal thing ve•re going to talk about now happened. Cushi!!il-a tuacr clinic was there tooo Yea, Dre Salluel Harve7 was interested in growth. There wre tumor clinics in the hospitals elsewhere. or course, in Nev York Dr. James Ewing who was the great man in cancer work at the Memorial Hospital and at Colmibia and. re• lated hospitals there, was much interested. in cancer research. There was a good ~ journal published in this country r or a number or years on ea~er which failed about this ti'llle, but what ~pened that broa.ght ae into connection with the ' cancer field was an accidental happening arising frOll sources which I still do not fully comprehend. One day in 1937, early in 1937, Dr. Samuel Harvey-, the Professor of Surgeey, sent me a copy of a letter that he had received from John Dz:•• Yes, John Dye, a physician in Waterbury, Connecticut, in which Dr. Dye told Dr. Harvey that he knew or a wealthy- man in New York who bad shown sme interest ~ in s etting up an endowment for cancer reaearch, or a f'oand.ation £or ca~cer re• search, but had not yet cleared his mind whether it would be for cancer, or sane- 446 thing el, e, and had not ude any commitment to any other institution and probably had not given much thought to settling this foundation at Yale. Well, Dr. Ha~ with his usual wisdom, his ~ift of thought and expression, wrote 11e a long letter analyzing the advantages and some disadvantages in having such a teundation which he thought might cae to Yale, and if so, should be part of the medical school. His idea was that this would not l:>e a separate foundation, but soaething like a department in the medical school with its own funds. y This put me in touch with Dr. Dye. We arranged to meet, e.nd he in,ited me to accompany hia to New York to see this Jl)"sterious person whose nu1e was given to• only- on the train going down from New Haven to Hew York an+nly given to me in a Tague wa:r, Mr. Child.a• His first name wasn't given, so I thought that he meant Mr. Eversley Cbilda who had put up a good deal of money for the work on leprosy that the Leonard Wood Memorial Fund had used and started a long tiae connection. Last year on the Philippine Island ot Ceb• the Leonard Wood Memorial dedicated a brand new laboratory- known u the EYersley Childs Laboratory. Dr D;ye didn't tell me aeything abo11t the collegiate connections ot this gentlnan that he was taking me to aee, nor did he tell me that he was deaf­ quite dear. We got oft at Grand Central Station, went up 1-'ark Avenue to an apartment hows•, and we were adllitted to a duplex apartment on the fourth, or }:tth noor ef a fine building there,. Mro Childs caae in, greeted me in a 0 friendly way, and we sat down in an alcove windw ~verlooking Park Avenue. Mr. Childs then told 118 about his plans and his connections and ear]31 fortunate­ ly-it could ccae out possi'bly in answer to questions..-that he was a Yale 111an man in the class or 18911 and a great friend of Dr• Havey Cushing. That made me reel at home right away because 1892, was ay Uncle Hugh Baynels class at Yale, and I knew people in 1891, and I was an admirer and fortunately admitted to the :f'riendahip or Dr. Cushing, so we got oft on a good start 0 447 It soon developed that Mr. Childs was seriously thinking about starting a foundation. He didn't tell me how much money he was going to put into it, but be did indicate that he was interested in having a foundation on which his three cl sons could serTe as trustees, Richard Childs, Edward Cbils, and Winston Childs, possibl7 u a ■otivatedlJ" idealist.ic thing forfhem to be" doing, Tiley had very different interests at that ti.Ile. Winston Childs wu a plunging financier on Wall sft-eet with very original ideaa-rer example, er cornering all the dogfish and getting the vitamin-containing liver oil rights out or their livers. That went on for sae ti.Jle, but his enterprise• were not too suocesstul. I think at one tiae he was a big owner er Newsweek. Richard Chil~was a more intellectual, visionary- type, not so auch in business, alfbeugh I think he did have a publishing company which didn't turn out too well, but be was en the side of liberalism and had different opinions soaetimes from his more conservative father and bis other two brothers. Ed.ward Childs, a big handsome man, was a bachelor whereas these other two brothers were married, and Ed.ward'£ m.ain in­ terea\ was in the Yale Forestry' School. The Childs family had a great tract of land over the beautiful hills of Norfolk, Connecticut, where they had what sOJD.e called •a sumner hoae"-it really was an all-round patriarchical mansion -with stables, horses, land, lakes, canoes, and was ver,tlose, next door, to Mr. Childs' classmate, Senator Frederick c. Walcott. All of this •°H5' or less came out at the talk, but I•m adding to it tram things that happened later on just to put them together here. It turned out in this talk that Mr. Childs was primarily interested at the moment in setting up a foundation for the study ot probleas d. poli011Telitis at the Rockefeller Institute because his son Winston had had an attack of poll• and had a little rer,idual paralysis. I didn 1 t argue much against the Institute. It didn't seem neeess&l"J'• I didn't believe that the Institute would be interested in doing the kind of thing that Mr. Childs wanted to do because at that time they were rigidly defending their independence and would not accept grants from out.. side• Maybe they thought that would keep Mr. Rockefeller'• munificence more in their own control, Bl.ore in their own interest and not allowf t to be diverted by comparison with gifts fr• the outside. I did tell Mr• Childs the wonderful work that was being done at New Haven by this Atypical Grewt.h Study' Unit aa representati'e " ot the work going on chieO.,- in the Departaente et AnattNV and Pathology. Ttie Professor of Anatomy, Edgar Allen, wu greatly interested in the estrogens and the female sex homones, and he had with h1lll Dr. Willia u. Gard•r who vu alao a brilliant worker in the field of hormones and the prodnctioa of neoplastic growth. Gardner has succeeeded illen. Also in that department there was Strong-live forgotten Strong•• first nae for the moment-but Strong wu a great geneticist. Is this L. C. ltrong? Leonell c. Strong. He was a genetieiat, had been breeding llice for years and years and years. Mrs. Strong worked vi tb him too, and he was able to bring up certain strains of lli.ce that would have muunary cancer in a certain percentage am were very valuable aaterialJ as a matter of tact, as good aaterial aa was beginning to caae oat from c. c. Little'• genetic statien at Bar Harb•r., Maine• Well, fortunately Mr. Child• did cane to New HaTen. He was accompanied-I re­ aeaber that da7.-by- his son Edward, and he went all through the Department et Anat01117 and into the Depart.aent of Patholeg,- where Dre Winternitz had soae in• teresting things to suw...tuaors trOJI\ huaan autopsies., and various things. We introduced tbeia to workers in the inaediate field and fr• the periphery of the field like the biochelli ■ ts and others wllo were interested in cancer research, net to Dr. Harve7. As I recall it, we didn't go veey tar into the clinical side 449 of cancer becaase it was detel'llinod that Mr• Childa was intereste+n :aaic research rather than setting up al\Ything tor~the care ot cancer patie~ts. Froa the start a principle which came into our eo~versation was that if he did set up anything in cancer for research, 1 t would not exclude certain clinical studies, prOTided those clinical studies ottered some opportunity to understand better the etiolea of the disease. Mr. Q:iild.s appreciated. what he saw very- quickly. He was very much impressed and talked with intelligence about cancer as being a greup et diseases, not just one thing. Cancer is not one thing. It may be hundreds of things, but he also wu iawrested in two other phases-.ne main phaa• that comes out in his speech of dedication o! the foundation later, that soaewher• behind the door, or stairway there was a Banting who would discover for cancer what Banting and Best found in insulin for diabetes. He had that enrl;~preneur 1 s hope.....I suppese a good old American pioneering outlook that s:>mebody, a genius is hiding, or lost somewhere• and all he need.a is a little help to get out and do some world asteunding thing• The other thing that interested. me in this highly intelligent un at the start was that he showed that he 1d had s•e contacts with people whe were quacks o C in cancer. He not only t~ught that scmaebody w:uld discover the ~ause of cancer, or some cancer certainly with a little hlp, but also he was beginning '\ to be pestered aore and mere, by letters f'ran qu.acu, cracks and cranks who were trying to get bi.a to do all sorts of cttrious things for the support of their work. I don• t know af!IT field in which there are •re wild notions of cure• We tad t• deal vi th such probleu as a Swiss Institute that cured cancer by mistletoe extract. It was that kind of thing, although when you look into it, it's net so foolish as it seems. In medicine there is a great doctrine of 450 "signatures", as they call them--things that look~ike sanething and are good for soaething, like bepatica is good for the liver, nnd there are mandrakes that are good for male disorders because they've got two legs in the rootso There is a great cancer institute in Switzerland that made all its ex'liracts from mistletoe, and that does sound very foolish. It didn't have aey" good effect on cancer1 but 1 t • s a very old noti••• Mistletoe is a parasite-and it suddenly grows on a f•reign tree just like a cancer grows, a foreign growth, on a hum.an being. Mr. Childs was already 'bothered by sae of those things. I think: they caae to 0.) h1a because he was(well-to-cio1 public-spirited man, and people, even before he had a cancer institute in his llincl, were beseeching him for gifts. I think you ought to go into bis bacground in Norfolk•-his tie with Senator '!alcoft and with Dr• Wek h 4 Mr 0 Child.a coaes frm an old f'aail.y out in the Pittsburgh region and af'ter he went to Yale and graduated in 18911 he developed even more his CoMecKcut origins, and I think they reach back rather far in some lines. The family place, as I have said~ is this beautiful old house on the hillside, on the lake in Norfolk, Conne~t•\ Nerfolk, Connecticut was famous long age ae the birthplace of Dr. Williaa Henry Welch who was born in 1850. Dr. Welch 1 s father was a great physician in the region. Dr 4 Cushing has written a ver,- moving paper called "The Doctors Wek h of Norfolk"• The Childs family knew Dr. Welch and admired him, and thq knew his tradition. Senator Walcott knew Dr. Welch and supported Mr. Childs in his loyalty-, as he always did when Mr. Chilil wished to do seaething as fine as he bad 'ri.siened this cancer research foundation-when it got in his llind. that it would be cancer0 Mr• Childs-most of the money, I think, which Mr. Childs intended to put into this foundation ca:ae !ran the estate of his wi.te, Jane C•ffin Childs. She 4.51 was a Ceff'in, and she had come froa the Coffin F&llil.y who had made its money in General Electric. She had died or cancer. She must have been a most channing and womerful person. I never met her. She was dead before I met them, but her sister was still living, Miss Alice s. Coffin, a friendly, but very shy' lady, living on one of' the noors in this duplex apartment, or part of a noor, and she also became a contributor to the YKl.e Medical Library Fund---'What I told about last time 0 There's a Ceffin Fund there for the support of the library-­ salaries and books• Miss Ceffin died a tew ;years ago a£ter having led a ve-ry secluded sort of life for all her years. As I sa:r, she wu ver, shy, but very nice and friendly. I think Kr 0 Childs was interested in what he saw goir;-! on in these labora• tories quite as much as he was by the sentiaental attachment that he felt toward the Rocke~ller Inatitute where work was being done. He and Ed.ward both appreciated that the7 were talking to earnest men who intelligentl.7 were worlting very hard at difficult probkms. Alse this was a critical time in the enmination of support tor cancer re... search. There were in this country two foundations--the Anna Fuller Fund vbich was nall, ver, small, and the International Cancer Research Foundation established by Mr. William H4 Donner in Philadelphia under the guidance of (. D:ir. Mildred w. S0 Shram, who was a very able woman and director of their affairs. " They had an advisory board, and the foundation made grants all over the worJd. They were in the field ahead of the Childs Fund, but not with the same breadth ef concept, nor the same generous outlook toward the investigators and the work, though they were doing very good work• Atfhis time Fortune magazine published a great article on "cancer the great darknessn, and cancer was a great ~ darkness. It was a mystery. Nobody knew, and th,r don"t know yet what actually 452 brings cancer about, what keeps it going, how it kills people and what to de to cure it-I ""an reall;r substantia1 cure•• Surgeey •n+adiation are sti1J. the best means of treating cancer, although they have hundreds or drugs now, some of which are beneficial and palliative. I will now talk briefJ,' about what happened after Mr. Childs nade this first visit which I think was in January, 19370 Things m.c,ved very s wittl;r after that. Mr. Childs made up his mind quite soon that he wanted tile foundation to be in cancer research, wanted it to be called the Jane Cef.f'in Childs Memorial Fund for Medical Research-broadly termed, but he expressed its main interest in cancer, as your.11 see .f'rom his dedication. He had plans for a Board of Scienti tlc Advisers and plans !or a management board composed largeq of people that he knew very- well1 mostl;r members of his family and close associates. There were Mr. Childs,. the three sons that I mentioned, Mr. Walcott, andMr 0 Christie P. Hamilton, who had dealt with the General Electric accounts and management for a long tae. Mr. Albert H. Barclay­ was the legal counsel and also a member of this Board of Managers. Mr. Barclay was a classmate of Mr. Childs in 1891. Then Mr. 'Childs wanted on his board at least two representatives from Yal•• They would be ex-officio--Mr. Seymour, the President, and George Parmly Da71 the Treasurer. All that moved very fast 0 I think Mr. Childs was used to formulating broad conceptions and adai.nistrative 11anagement without any loss of ti.Jlle and without. any real uncertainties. We 1' soon began to talk about ~ese details. He would co•-I think he caae to my house in Trumbull C.llege over and over again for long afternoon talks, and he stayed there over night some times 0 453 Ii OAe of the first things that had to be settled after he had decided that he wanted his foundatien to be located at Yale was •n the side or personnel, the festion of a director of the scientific activities of the foundation. At the start, it seemed that the man who would be chosen would be Dr. Wintern:itz. There was a great deal of' inquiry and soul searching talk about the question of a director. I had no real part in what went on privately on much or that. I ,l i was ~ d my opinion• It cqi.e out very soon vben Mr. Childs asked me if I would be the director or the Board of Scientific Ad'Yisers and if I could do it, as I thought I would b.ave te, in addition to being the Dean of the Medical School. That would have the advantage of keeping the fund in very close contact with the medical school. I had alread¥ agreed., or about this tille agreed with Mr. Childs that the Foundation would be set up almost w1 th autotioayr.f' its own. It was to be at Yale, but not under the control of Yale, a very- e•traordinary arrange­ ment. The securities were set aside and held in a bank in New York ander Mr. Huu.lton, Mr. Child8 1 and the Beard of Manager■• Yale 1 however, was called the "custodian", and Yale handled the checks. Moae7 passed through Yale, but 0 Yale had no rights to say anything about the sale., or purchase ~f the securities. Yale agreed to that. I don't think the Yale Corporation had anything like it in the place before. It 1 s still worlcing that way now~ although the University has lll8.de a number or efforts to get control of' this fund as 1B rt of the Universit7 and under the control of the administration of the University. The Childs Fund, as is said~n Mr. Childs( dedication, is not to be exclusively used at Yale, but Mr. Childs expressed the hope that the Board of Scientific Adrlsers would find at Yale opportunities to use aest of the aonq. Isn't tnat about the I way it s said? "' 4S4 I~avenlt, read that document in quite a whil•• You can imagine what a long series of difficulties had to be faced after these general principles were agreed upon. I saved all the dratts of the Charter of t.he foundatien and of the 't,y'lawso All of the governing regulations are in these doCUJ11ents, and they were worked over and over again. It you look at thea, you'll me hundreds of changes troa time to time. It was very severe work for Mr. Barclay who had a big legal practice and had much else to do, but Mr. Childs had a way ef pressing business associates so that they did what he had in mind as being desirabl•• He did not use the same methods in any sense with the ecientific adviserso He admitted into the bylaws a stateaent that the Board of Managers would never make a grant for research in the field of the foundation, unlus the Board of Scientific Advisers recomEnded it firs\• I u had some instrA•entality in getting that into the bylaws as a regulation. I had to auwer many of the wild letters which Mr. Childs was receiving trm people that had all these queer, crack notions about cancer and~ ts cur•• In addition the newspaper pablicity that emanated, I think, troa the Yale offices was very unfortunate at tne first. It says in the early accounts that came out in the papers that the Childa Fund would be twenty million dollars. It was nothing like that. It-.s several million dollars, and its principle has gone up a great deal since, but all the world was informed that here were twenty Jli.llion dollars going into cancer resear eh and that would be receptive to any ideas as to how the money might be used• That had to be dispelled by practice rather than words-I don't think anybody ever put out any definite contradiction of the original publicit7, but it waa soon apparent that tile Fund~•n•t opera\!.na at twenty aillien dollars a year. The Fund also had an interesting financial angle at the first which the direct•r was able to turn, although some of the businessmen on the board were l I 4SS very hard to convince that it was the wise and proper thing to doa The first budget I bro~ght in aftertthe meetings ot the Board or Scientific Advisers covered a period or about three to five years. We realized that cancer research was a long, tiae...eonSUlling process. Most er the problems undertaken in cancer research are heart breaking. They turn out to be no usetul results at all, or a negative result• mray a man has broken his heart working on cancer research, although many a man baa stayed at it• Yeu couldn 1 t get projects under way, or good people devoting themselves to work in the field, unless they had some promise , •f support for at least three to five years. Well, when that process starud, I brought in a budget covering from three to five years, and the total bttdget. for that period was about three to five tiaea the total annual income of the Fund. These men didnft want to c011111it money it didn•t have as current imc••• Of covse, it could sell secvit.1••• Sa:y- yeu make a grant of two thousand dollars tor one year. It you aake that graat tor five years, 19u'•• got a commitment for ten thousand dollars, and you've enly got the current income that would ••t five. I hadn't expected that kind of a problem te arise 0 I had been used to foundations that had money in the bade already. The first time we went otr on this venture, we pledged more aoney- than the income would support, although we knew that the Board of ftanagers could sell securities, if' they had to. ......... , I think there was a provision which allowed the Hana gers to sell part •f th~ '- That's what I aean by' selling securities.....y-es1 a proVi.sien empowered the managers to do it• Also there was a wise provision in the bylaws# that if ia the opinion of the Board of Scientific Ad"fisers approved by the Board ot Managers h56 it appeared that there was nothing further to be learned, er gained b;r cancer research• the aonq could be dffoted to research en any- other problem in the whole field of medicine without disturbing the organic relatioraship with Yale. They never mentioned the Fund being aoved out of Yal•• They never mentioned " the Fund being 11o~d out ot Yale, but the Fund could be shifted froa cancer to some other work. The other thing that infiuenced the judgment or the Board of Managers was that they didn 1 t wa11t to put Fund money in bricks and mertar which ia a horrible conception to my llind because ;rou •vo got to have a building in which to worke There was aucb effort at Yale to get a cancer institute built, and the managers were all afraid that th• money would go into a building and. leaTe nothing te continue with the Nsearch0 The onl;r building that the fund ever built was a ao11So houa t•f•onell St.rong. We built about a fifteen thow,and d8llar IIDUSe house which is still there, using, economically, part of a brickr wal.l that had been s et up to see what the new wall of' the library ruld look like. It was still standing so we built the aouse house around that. Wasn 1 t. the intention or tte drafters-that includes yourselt1 Mr. Day1 Mr. ~arclala and'}l.Childs-to writ• an enabling act with the least restrictions possible, although tqe !>zlaws1 enacted after the Fund was established1 created the process-that is 1 the Board or Managers couldn't ~a}Se a pan~ without it being initiated1 or sanctioned by the Board or Scientific Advisers built into the process once the Fund was established• It could lie initiated anywhere, but it had to come through the Beard ef Scientific Advisers. Se far as the Board of !lanagers was concerned.1 they bad no separate power to 457 initiate their own ideas 1 Thel had to eoae thro!!lh the Board er Scientific Advisers. Maybe 1 •a getting into semantics now., but any aanager could sq."I think this is a geod field to go int•• and then"" would work en it a-+- what it looked like. Mr, Childs seems to have beea a very fruitful aan with ideas, One of the earg ,!!Otiona he had-I think there wre at least three1 "ne was an independent toundation. Then there was a could go anywhere, inen there_was the endowment te some specific in~tituti~n and under this las\-he had talked to Dr Rufus Col at the Rockefeller Institute -was a urg,v~rsitz aedical school with an attached hospital. Apparently he had these prett71!911 thought out as eossibilities. He dido He worked hard en 1 t,, and evidently before I met hi.JR, he had probably beea a year or two thinking it over and talking to people 0 His main supporter and adviser was Dis son, F.dward. I think in the files there i,a little sheet of paper where Edward drawe up the institute for polie inveeti• gaticn. Did you find it? Yee 9 As a matter er fact 1 eelio as an interest, doesn't drop eut of these series of' drafts until June 1 1 1937 1 Reference to polio is finally omitted• I thit,lk this is because they ap:eed to the breadest shifi in emphasis in the • no longer a problem, event that soaethi!!S, hapP~na in cancer and it•• The Board of Kanagers is empowered te chm ge the sights to some ether problem, How was ~~• Childs to negotiate with? He nust have been pretty easy because he had such interest• 458 Mr. Childs was a Tery forthright man, and the only difficulty negotiating with him was that b.e was quite deaf. Yeu had to speak pretty loudly, and some• times you'd have to say it oTer and ever again. He was a big aan, about six feet two, broad featurea,•sily smiling, friendly, net noisy, but a warm person. From the time I began to be a directer of this foundation, I began t~ be almost a aember of his family, and so did Mrs. Bayne-Tones. Mrs • .bayne..Jones and Mr. Childs fonned a lasting friendship. We still see the members-just a few weeks ago his daughter Barbara was down here with her husband, and it was Richard, largely, who did quite a little in having 'flfY' portrait painted for the Dean's cc,llection1 painted for the medical school a few y-ears ago. In a letter that he writes quite early on~arch h1 1937 1 Mr. Childs is thinking of zyu as the chairman. Taere's some problem, soae contusion in its name­ chairman1 or director, whatever it was, but &PP,!rent~•••• I think it'• chairman et the beard. I don 1 t like the word "director"• I doa•t like to consider 1111"Selt directing people. ltd rather be their servant. This is quite earlz, but you indicated in COlllllents you made that in view of the proposed develoraent at Yale 1 in the light of his visit, and the interest and backgroulld alrea9: existing at l'a1e 1 it was easier to have the Dean's Office represented because that was where the various parts of the medical school met, but then Mr. Chila cbese zou as a person, qllite apart fraa being Dean. That •ust ha,e been very fortunate because I never acted in relatien to the Childs family- as if I was representing the •ants Office. In fact, I would tend s to oppose thi°\ that would seem to coae like pressure frcn the University-, or I I the Deans Office. The Deans Ottice in the medical school procured for the 459 Childs Fund twe eisable rooms above the library which they still us• as an etfice. The Childs Fur¥i fixed it up1 decorated it, and they held their meetings up there. IA.) I used other rot:IIS in the ~•rling Hall of Medicine, a l\onderful big receptien roc:a where they would have lunches and social meetings. The Dean could probably get this place ••re easily than an out~~r could have gotten it, but such things as that were in the ordinary protocol of the dq. Ats Dean you'd do it tor other organizations too. The Childs Fund paid Yale rent tor that room, the office, and still does 0 Yeu ued-I say "you ued" but you had access to i;dgar Allen. I think you sent a draft propeeal nar to hill for his CCllllllenta once. We nren 1 t limited to where we could d for advice. The Board of Scientific Adn.sers would receive frs tbe chairman ot the board in ad-Yance of a meeting d.ckets which gave the whole of the application, the references, letters of in­ quiry-I cou1d write to anybod7 who knew anything about the kind of question that came to us. When those things would cane in, we'd have long discussions at our meetings, aake up our recommendations, er else put it OTer to another meeting to work out saething etlse., but there was no limitation on what con­ sultation you could seek. This was evea bef'ere tbe Fund was established.a when the process of negotiation I~a• net put under a07 bind of' secrecy- in the preliminary negotiations. I don't think I talked very much about it. Ne. 'I'here was something of a blanke\ so far as the outside wor~ was concerned, but Dr• Harvey was close to zeu1 and he had views aad expressed them well1 was 460 thinking in tem •f Yale u the beginning and end for this Fund. I d.en•t know HJ what Dr. Allen'• views were but he had alrea he De rt.ment of Anatmz these various studies that were engoing 1 se be would be a logical source to consult. with too. Yes, and anether source, and I know I rust have talked to him, was Dr• Francis Blan who was equal to Sam Harvey in wisdom and experience in the school. He wasn't ill\ereotetl in cancer auch. There wao little going •tn the cancer field in the medical department• Surgel"7 saw a lot. Obstetrics saw a good deal with the gynecological ca•••• The Department of Urology under Dr. Cl7de L. Deaing saw plenty of prostate cancer and other things. These were the chief ones with pathology. I Hew much of a r mentioned at all. Wt2 n did Seyaour becane president? Let me look atfbat Yale Catalogu.e there. Mr1 Angell was still President--Mi-. Angell made this announcement becawse it was ready in June of 1937. For the acadendc 7ear 1937•1938, and that academic year is July 1st to June 30, so we nerlap parts ot two calendar years. Mr. Angell would have been President the first part of 1937. Mr. Seymour comes ia after July. This was ready for announcement at the meeting of the Corporation on June 19, 19371 and Mr. Angell made the announcement. I don't know that you talked much with him about this. George Daz. Oh 7es, Geerge Da7 and I saw a great deal of each ether--this was right in 461 A George's field because he was a great fund raiser fer the Y)\le University Press and all sorts ct things. He was very much in'\erested in tb.e suceessf'ul pursuit of this. I think Mr. George Day- really- thought that Yale University would co11trol this fuad. and the resourcesJ in fact, I have evidence that he did• The search for acientific adTisers gets somewhat involved-a survey of people en the scene. A.& mmber of names are mentioned...:Warren Lewis I J aaea Ewing, Fraocis l..arter Woo2, Burton T1 Siapson1 JU1es B. Kue&• 'lbere •s a peried when z•u go to Atlantic City f'or a meeting, tor example, and part of the meeting is re resented !written notes. At meeti s ou can talk with eo le as to who would be truit.t'ul1 and the names that finally cem.e out of this are a good group ot people. It isn't long before that original list is extended, increased. Ross G. Harrison is one. He 1 d had a long eontinuit7 in this picture9 Dre Harrison was one of the wise, original people in the biological worldJ and he was the first one to cultivate nene tissue, grow tissue outside the hum.an body-. That tissue culture wu a fundamental aethod of cancer renarch­ very important nowada1's everywhere. Then there was Rudolph J. Anderson. Anderson was the head or the Department of Chemistey-&-you see, we had a chemist, a biologist, a pathologist-Winternitz, a virologist--Peyton Rous. That's about all there was at first, I thinko 462 Yeu talked to SiJllon nexner and a lot of people for information. Yes, I was trying to get a balance on this board. Piddng someone's braina with respect to eeople 9 There's a lot of commentarz en them in these notes that bear en kow lon one S e of it isn•t ve fruitful with reference to sae-like James Ewing who was pretty pessimistic. Dr 0 Ewing was a great figure in cancer pathology and cancer treatment. Dr 0 Ewing didn't discourage me, although his ideas were against what we were ti\ng I\ to do• I went to see Dro Ewing one day in Nev York and told him that we were interested in studies bearing on the causes ot cancer. 'l'here were two -,M theories o~~es of cancer as there are in many other things. 0 ne is a \ C proximate cause, and the other 1s an ultimate cause. L~ts of things can be called "a cause"• Ir you expose your hand to radiation, x-ray1 you'll get a cancer of the skin and you•11 sq that radiation is the cause of the cancer, but what dees the radiation do to the cells tha,tweAty years later develop a cancer in that place? Me\hylcholanthrene causes cancer in rather the same kind ef way. A great ma~ other things are carcinogenic, cancer producing, but tnat doesn't tell you what the real process is, and Dr. Ewing told me one day. He said, "B-J, if yeu do anything to have this Fund try to work out the ultimate causes ef cancer, you'll just be persuading them to waste their money", and he wouldntt have anything to do with that. That's strange. He was a strong :minded man of enormous influence. Carter Wood was another, but he was finishing. Hew as head of a tailing journal which we took over later and helped to run a bit. Carter Wood-I used 463 ' to go and aee him. He was in the hospital at Morningside Heights behind the Cathedral there-Roosevelt? No. ["st. Luke 1 sJ Wasn't h_!..._with the Croker Institute fer Caneer Researc~? Yes, the Croker Institute was transferred later to Columbia. Carter Wood was out of-well, there's coming into my mind a story as to why I knew these people. Before the Childs Fund came about there was a thing called the .American Cancer Society 0 It•s an old cancer society, and it was under the presidency or c. c. Little. We used to aeet in New York, at the HarTard Club and various places, and these meetings would last all night sometimes. Simpson would be there rrom Butralo, Carter Wood, Ewing sometimes, George Smith, all the people in cancer. I had a preliminary acquaintance with them without being connected with them. I kept it up for a long time. Burt Simpson was a very interesting man, devoted to the building up of the New York State Cancer Institute at Buffalo which is now quite fame\lS and able, but he was beyond the fiel~f interest in age that we were aftero He had no special ideas about cancer research, but he was a good man. I think we've gone as{¥" as we ou&ht to go todaz, Next time 1 j•a.~ike toge~ into the state of the art and how Pe:Yj:on R~us fits into that state because there's long continuitz with hiJ!!. Yes, he just got a thirty-five thousand dollar prize for proving that viras causes soae cancers. 464 Tuesdaz, !4-ay 17 1 1966 .A...60, N. L. M. I\ ... , I'm not too clear• I may just bat l rill up for you. i\ I ran into this note, as I told you1 in looking through the record 0 I find that ~he establishment or the advisory commmittee and the way in which it functioned.o., We called it a Board. Yes 1 the .Advisog Bea:rd1 and the wal in w~<:.h it functioned is really somethina new and novel. The Scientific Advisory Board. Right, and the bylaws created for the Board1 I suspect, came at the first meeting of the governing board1 or the Board of Managers. There's a note here about Mr 4 Bar.clay having to draft these bylaws in a verz quick t~•• Do you remember the cireWllStances at all? I remember that we consulted a great many people about the organization or a scientific adYisol"1 body because we'd had no experience or &ff1" extent in it e{'ther ,J in 7q lite at Yale, er in sme ot the others, and I•a quite sure that we mus~have gone threugh a goed maqy prelimina~ formulations as to what we wanted to do and naturally breught them, in time, to the legal counsel ef the Childs Fund; namely, Mr. Albert ~&relay. Now, this note that you read said-what did it say? '.l.'ne .note said 1 in substa.,nce 1 the bylaws which he was forced to write in abo~t four minut~s in 19.37,_ when he felt that he could well have sea,. t r 011r zears ~n 465 I imagine that 1 s an exaggeration for some kind of a rhetorical effect that I may have had in mind at the celebration-the 10th Anniversary. Well, Mro Barclay would not have been able to write these bylaws in four minutes with• out preliminary drafts, and I'm sure that 1 s what he dido fhe bylaws of the Childs Fund have never been altered. I don•t think they've been amended since they were adopted in 1937, and the bylaws and the rnraseology ef the Deed of Gift became quite influential throughout the country. 'l'here were marry requests for copies, people illitating ito Where this wisdom came from I hardly' know at this time, but it must have been distilled from the advice of uny, many people that we consulted. For me, I know there was a great deal of traveling around to see people tbatwere experienced in cancer research and in administration, s• that what we put together passed through many hands and throagh many minds and stuck. The beauty of the bylaws lies in the fact that they enabled this Scientific Advisorz Board to function and to have that degree of control over idea and pro,,,. gram which without the bylaws it might not have had. w.'d known other cases where the Board ef i'ianagers, financial managers and adainistrative managers, or the non-scientific affairs of a foundation would by intentien, or by accident, or by ignorance;~ things that were not consonant with the scientific aims of the foundatien. Also, as I said last time, Mro Childs and other m•bers et his famil.7 and aembers ef the Beard et nanagers were under pressure fr,m quacks, reputable and disreputable quacks, to do things that were not scientific in the investigation of cancer, er tewards the treataent of cancer and part ot the provisione in our bylaws was to protect ourselves, protect the scientific advisers from ill conceived actions on the part of the Board of Managers without imputing to them any base motives. We were afraid that they ndght do some- 466 thing out of enthusiastic ignorance. Once you've got the Scientific Advisorz Board establish- ed ou confro, this whole new field real as to where its limits are and what to do in the develo,21;ent ef a progra--d~ 1ou wait for applications, or de you design a progrui That search for a program began, of course~ from the very start. I see here from one of these early Jli.nute book records that we talked with Dr• Gye tor ene. Dr. Rous, who was a member of our Board of Scientific Advisers, had ideas about a prograaJ in fact, I think we asked a lot of people to give us suggestions as to -what the progru would bee It was perfectly obvious that the program of the Fuoo with relation to cancer research could be divided at the start into ~ two main subdivision-one a progrua initiated hr the Fund and carried on for \ purposes that the Fund, the advisers with the managers, selected, the sort of program based on ideas that were initiated and brought out by the people con- ~ stituting the scientific ad'Yisers ot the Furn. That would~ a program sui gener1:,a, a pregram particularly as the Childs program. ·J.'he second subdivision wast• carry out the ordinary affairs of acting as an agency making grants-in-aid •f research. That we could do quite easily because we were in contact with very fine investigators of imagination and ability wb• needed funds tor the support of their research and who knew hew to put in lucid and convincing applica­ tiona. We also included in that group of projects supported through applications \ requests for aid that had been invited. We~d see a man whe needed additional support for his work, er some support t• start work, and we 1d suggest te him that he put in an application, and it it was good enough, the board would recemmend its support and adoptien. '( We did start later en in Dr. Cyril N. Hugh Long's Department an inf'rted 467 program which taught 11e a lesson in not a bad sense, but in a rather human natural one. I bad a notion that the central proplem of cancer was the fabrica­ tion er protein by the cell-protein synthesis-that cancer cells can't grn without synthesizing pretein, that no cell can grew witbeut synthesizing protein. It seems that the synthesis or protein is a fundamental biological, biochemical process C9Jl11llon to all cells, and it probably differs in different cells, and it might differ in malignant cells quite considerably fr• nol'llal cells because the aalignant cell in a bedy' can continQe to capture the substances that are built into pre\ein8 1 while the rest of the b9dy' is starving. Yeusee animals and human beings with enomous t11J110ra which continu.011aly enlarge wbile the body bearing that tuaer aelts awq as if it were starving, so certa;nly there's something peculiar about the synthesis of protein by :malignant cells. We got Dr 0 Hugh Long, the Professor of Physiological Chemistry-, interested in this progrU\1 and he brought into hisfaboratory a worker who knew soae particular traDSaminase reactions, or soae reactions that were particularly important in the building of protein and who started to work on that subject. We hoped that he would use malignant tissue and keep his bearing on c~ncer, but it was net more than a year before he was way off in a field of enzyme chemistry that had ao real connection. I•m talking not er a connecti•n in the sense er applied research connection; I'm talking about its ideological connection with the synthesis of proteino Here was soaething that had been started en an invitation welcomed by a chief et a depart•e rt, initiated by a brilliant young wo~er I and then abandoned because soae other phase of his ill'Yestigation had greater appeal. That experience, I imagine, would happen with a good lll&ny attempts to impose a program, er to start a program somewhere even by invitation. Ye11 can•t control what the ill'Yeatigatora will think, or what they'll do, so at least we get on better by supporting engoing work, or work that semebody really wanted ..._ 468 M to de, and not soxething we wanted done. I don't know that any fourxiation ~l cancer research bas really succeeded in getting an overall program. There are big prograllS at the National Cancer Institute, but they're all divided into sub­ parts, not one cancer research pr~am• The Royal Cancer Hospital in London is interested very much in carcinogenic studies, the actions or carcinogens, but is v:orldng on a program ef carcinogenesis tbat is not as broad as the field of I cancer by any means. Well, it s extremely difficult to be 6,~oad enough-or it 1 s " di!fieult to devise a prograa. Maybe none of us were bright enough to think ef where the central problems lay and how to attack thea, aod that is still going on-a foundation in search ef a pr•gram is a coJllllon wandering sort of a creature. Initiall certainl the• or basis was aasisti local ideas at Ya1e and the build u there or the contiauin rants for work alrea ss. Yes, as you recall, Mr. Childs in his speech opening the foundation, his dedication speech, said that h+oped that although the Fund was not primarily an affair of Yale, the Board er Scientific Advisers would find enough worthy work at Yale to make Yale a great center, an outstanding, or leading center for cancer research in the country. Tnere was auch going en at Yale, as he well knew from the impression it had made en him when he came up for his first visit, to justify a considerable inveataent, so to speak, in the cancer research going on at Yale with the hope that it would be extended, that new people would be added to the Departaents of Anatoiq, Pathology and Biochemistry, particularly, and that this would develop a broadening and stronger interest in the subject. Our grants at Yale frea the start were all thoreughly well censidered and were net influenced too much by the fact that they came trom tale. \J That's true-the min tes show that some rants are ared down from a re uest because the wo~k really oantt be shown to be necessarily related, or something in which the SCientific Advisorz: Board wishes at that momeat ~~ proceed ;with. To jump ahead-.1.'ll show you that yeu never can really tello We gra11tad a fellowship to a man named Joshua Lederberg later on--this is in the l940a 1 or a little later. He was over in the Sheffield Scientific School working with a noted scientist named Eo Lo Tatwn who found a variation, genetically determined, e. in a mold called nurospbera. Lederberg tried to look for the same thing in "' bacteria, and he was then able to transform bacteria genetically. He proved- 1'\ nobore1 knew at the time-that there was a conjugation between bacteria. He made all sorts of variants that he could distinguish metabolically. Some could use, we'll say, leucine, and some ceuld not use leueine. Different 211ino acids had different effects en their growth. Well, that seemed so interesting to the basic problem of growth in relation to the normal cell and the malignant cell, that we gave Lederberg one of the first important fellowships of the Childs ,., Fund• We were very eager to have a Fellow~ship Fund which would support pro- mising young men. Although that seemed to be stretching the concept of the liaitations of the fund a bit, the Board of Managers readily understood the impertance of this WDrk as promise and made the fellewship. Lederberg from then on becaae more and more competent in genetics, bacterial genetics, and a few years age he got a Nobel Prize for this work. Now, this work hasn't solved the probl• of cancer, but it has opened up a lot of good issues particularly in the modern field of DNA and the modern chemistry of genetics. Well, allrf that is important for cancer, but you couldn't have been sure of it when you started this bey on a fellowship. We did a good many things like that 0 There's a great scientist in the country working with non-pathogenic protozoa named Tracy M. Sonneborn, a man 470 out in the West. He round in parameci'IJJll a lethal factor called the kappa factor ·pA,\A i\ iti A which is transmitted genetically and causes the death •f the ~ a t receive (\. I this parU1ecium. Thats a very interesting-the possibility that you could get sClllllething going in a cancer cell that was lethal for that cell, so we supported IJ Dr• Sonnebornts work for quite a while. He was a ramo~s geneticist and became even mere b\portantq Those things have a sort of pregrammatic-ir I can use such a werd-ccnno- ,, : tation.. They started small and is•lfl48d, and i:t theytre good enougb.1 they grow into quite sizable projects. Thie is the first time since we 1ve talked, I believe 1 when geneticists hav! appeared, but I gather this indicates the wider ramifications of the particular problem you're confronted with and the need fer picking brains frem many sources. This isn 1 t the first time that geneticists have appeared because Leonell Strong was a geneticist, and we supported hill from the start ia one way or another. Here's his first thing-Leonell Streng,"The differential effect of methyl aalicylate en the growth of spontaneous tumors on two strains ef inbred miceu, ["30 Journal Qf Heredity 85-86 (1939l,7. One of the first things supported was a genetic stuccy-. I don't know that there's auch aere to say on the eubject. related. It hadn't anticieated the need to put funds into eguipnent 1 but the problem was beginning to get mere C5'!J?lex1 and it required more c~plex eguie- - ment., 471 I think there was an intimation coming from the Board or Managers that they wouldn •t be particularly interested in spending large sums of lleney on physical equipment, but there was no prohibition of thoughts about it, Gr what might be done. As a matter of fact, the Board ef Scientific Advisers found out, or learned from Dr. Long, or Dr. Kurt Stern, that some quite expensive physical chemical apparatus was needed to carry on the kind of work he was doing on gly~ ,elysil and other metabolic processes. One ot these pieces of apparatus was an ultracentrifuge which we bad te have aade. We putt.hat in a basement. room and enclosed it in a b•b proof cement coluan because it rotated at fantastic speeds, and when and if the rotor broke fr•• the centrifugal forces, it would go right through anything almost. It had to be protected, and it cost a good deal. We had the eptical apparatus tor stud;yi.ng diffusion of protein, migratioa in electrical. fields and solution-quite a lot of expensive apparatus in Dr. Long's department. The others were not expensive. We bought no end or cages for Dr. Strong's llice, fitted up roms in which they could be housed, and occasionally we bought an ordinar)" •icroscope for some one. These were the days before the thirty thousand dollar electron micrescope came in. If it were in then at the start, \he Fund certainly would have had to go inte electron microscopes at considerable length because that is a tool that opens the lid of mystery• Later on we spent a fair aaount of money to aid the Chester Beatty Cancer Research Institute in London, and that goes into the World War II peri•d• The British were not able to provide the apparatws needed for the rehabilitation of this laboratory, and yet Sir Stafford Cripps said that they must b\11' British. We defeated Sir Stafford Cripps by making the grant and saying that the money would remain 111 this country, so we bought the apparatus ever here and shipped 472 it to Lorrlon. That went on for several years. I don 1\ recall, aside from the equipment for Dr. Long 1 s Laboratory, any expensive outlay for apparatus. Bz and large where eguipnent was involved frem outside sources, the thinking of the Scientific Advisog Board was not to get involved--the czclotron1 for example, while it :may hold some promise for the future 1 thez didn't see tzing up the fund either to California, er te MIT. Yale was stupid about cyclotrons--if I can use such an adjective with lff3' Al.Ila Mater. There was in the Department ~r Physics before this time the man whe invented and built the cyclotron, Professor Ernest Lawrence, but he moved out to California. Then his brother Dr. Jehn Lawrence got interested in radioactive substances, radioactive phospb~ru, beginning studies ef the treatment •f leukemia with radioactive substance•• We helped to buy radioactive isotopes, but we didn I t ge into the machines to na ke th••• I think the program. at Yale-there was no work being done in the field of viruses, and as part of JU.king Yale a center, or a drive in the direction er re­ search in the field of cancer erigins 1 provision was made for studies in the virus field at Yale in zeur laberatory without the man being mentioned until some time later. Yeu pick areas, and that•s important. What date is that? The actual vete is Januarz 151 1938-some time later than thie publication appears, but nonetheless, the thinking goes back a good bit for the inclusion at Yale of this kind et study. Yes, the man who interested and influenced us very much in thoughts about the pessibility that virases have a relation to neoplastic growth was Peyton Reus 473 0 and, as I recall it1 we invited Peyton Rous to be a member or the Board ~f I I Scientific Advisers from the very start./ In doing se, we had to oppose the candidacy of Dro Rous•s main antagonist, Dr. James B. Murphy, who at the Rockefeller Institute did some excellent work en cancer, transplanted cancer and other growths in animals, but whe w.s fanatically opposed to the idea that a virus ceuld either initiate the cancer, or continue its malignant progress after it started. Murphy was a clese triend of some important people at Yale-Presiti dent Angell and some others, so that he was in a position to put a good deal of pressure en the Board of Scientific Advisers to nominate him for appointment te the boardo This illustrates the faith put around the advisers by the bylaws because they not only ceuld deal with the scientific program and projects, but they dealt with matters of personnel. They nominated all the men who became members of the Boar4of Scientific Adviser•• Tneyfd1dn 1t attempt to nominate the members et the Board of f1anagers. All these people-both of the boards­ were appointed by Yale University only on the nomination of the managers. The way it worked was that the Board et Scientific Advisers would recommend to the 11anagers, and the managers, if they apprOTed.1 would pass it on to Yale and Yale weuld appoint. When it came to the appointment ef managers., the Boardff f1anagers could among themselves decide who they wanted. Yale could not initiate a nomination. They could turn a nolllination down, but they never did. You alse talked to Dr. Gye fran England. Gye was over here a few times. He was interested in bacteriophage and other viruses, and he made suca extraordinary statements that could net be con­ firmed that he lest standing for a bit, but when he returned to England, he kept on with his work •n viruses. I tbink bis work was at Mill Hill Cancer Research Laberatory outside •ondono He was a friend of Dr 0 Hans Zinsser. Dr. O,.e was a 474 prolific scientific writer in the field of virt1Ses and was a very interesting and able man. I see by this beok you mow me here--the minutes-that I have a quotation under the progra111 cf advice that we got !ran Gye as well as RollS1 but I don't recall that we actually followed anything that Dro Gye recommended specifically. It was mostly a point of view and an attitude. Yes-he had certainly genuine enthusiasm for the virus field. This developtent takes place in 1937 and 12381 and in an earlier paper. This period is referred to as "the physi.elogical year" because of the developaents that were takin lace en the national scene. I don't know to what e nt the developaent.s en the national scene are related to chan_g~s i.~ the American Cancer .A.ssociation1 or t~~-!E.~_l!,¥,oh c. c1 Little •!l have provid~d• t •m not sure at the aoment ...!!!!.--I guess zou were on that _bo,,!l"do Yes, I was on the board when Little was the director of the American Cancer Society. ije reviTed the people out or the doldrums and apathy'o He formed what was called "the Women•n Field Ann:y-"• He attacled cancer with Amazons, and this women's army that he developed became a very enthusiastic and powerful body all ever the country. Groups of them had a great effect on the administration of the American Cancer Society in the New York headquarters. 'J.'hey raised a great deal of money for those times and did good worko I forget when I first got in con• nection with that societyo It might have been around 1937, about the same time that the Childs Fund was forming. We used to have long, leng evening meetings­ 1 the scientific adviser s body-in New York at one place or another. One of the members was Mr. Frank Bo Jewett, President of the Bell Telephone Laberatories 0 De you know him? 475 I know the name. He was •n the Board or the American Cancer Society. He opened my eyes to the industrial support of research at one meeting. He said that the Bell Tele­ phone Laboratories in its communication research had a research program that would double, or triple anything that was available in the cancer field for research on cancer. He hardly knew how much was going in to research. I think he was talking in terms of maybe twenty million dollars a year, or more, but he said one of the things be did itlation to the management of their investigators was to leave them pretty much alone-"don1 t try to force them to put up a certain mmtber or ideas, or inventions a week and be sympathetic and helpful with their Tagueri••• r+• have an investigator 11ho suddenly gets a blonde secretary and wants his office furniture changed from mahogony to bird•s eye aaple, we re• fitted his effice, gave him the pale carpets he wanted and the light colored furniture and let him be happy." That's wise. I think that's wise. The investigators are not really too temperamental, but they are high strung, and they work very hard. I suppose no group of men are subject to so many frustrations that have spiritual pains with them, so what difference did it make to Mr. Jewett. If he could get a coaxial cable that would take twenty-five messages in both directions by letting a fellow have a bird's eye maple desk, he could be well satisfied. This is also the zear in .~ich the ~ationa:J. Cancex:, I,nstitute Act is eassed• That was passed in-was it August of 1937? It was signed in A~st 1 1937 • 476 That was the first separate institute under the National Institute of I' Health. It used te be just the National Institute of Health.Then when they . started the National Caneer Institute, the first subdivision, they had to put I " 11 on a plural, and it became the ~tionaJ. .l.nstitutes of Health. he Cancer In• stitute was founded at the instigation of a very influeatial man living in Texas. Ir'\9 forgotten his name, although I have written a biographical sketch ;ts this Dr., Dudley: Jackson? Irve forgotten his n&Ja• I wrete a sketch ot him in the 1950s somewhere, published in the Jeurnal of the National Cancer Institute. Itts too be.d that my- memory bas goBe at the m.ement-his name and what he di<L-but he had an in­ nuence on the Congress, and he had an influence on Dr. Dy-er whe was head of the National Institute et Health, Rolla D,yer 0 They got this legislatien, and they started an enterprise for cancer research out at Bethesda where the Nm wu thenfttled. It didn't haTe any program to begin with. It was just a -vague 7 seide1 Dr. Parraa1 Tom Parraa, who was the Surgeon General of the Public Health Service under the jurisdiction 0f which these institutes function, called together a ommnitt1te of adviser• to draw up guide lines., or plans for a program for the National Cancer Institute. The members d the committee which was appointed, probably in the fall of 1937, were myself-lisJed in their report of this meeting as Protesser ot Dacteriology and Dean of the School of Medicine at Yale, Dr. Ress G. Harrison, who was the chairman of the National Research Council and Sterling Pretessor of Biology- at Yale and who had been the first man to cultivate tissue outside the animal body". He did it wb!n he grew nerve cells. The other members were Dr. Clarence Little, who was then~ irector of the Roscoe B. Jackson 477 Memorial Laboratory at Bar Harbor, and Dr. John Northrup, a member of the Rockefeller Institute for ~edical Research, who was a very distinguished physicist and mathematician, a devoted friend to Dr. Hans Zinsser, a physicist with bio• legical interests and inclinations, and some of his work was in physical chemistry. The other member of this greup of five was Dr. James Be Murphy who is here listed as a member of the Rockefeller Institute tor Medical Research where he worked in the laboratory concerned chiefly with cancer. We had a nuaber of aeetings and supplied Dr. Parran with a report which Dr. John R. Heller has since called the guide lines for the National Cancer Institute and which some of us called the "charter" of the scientifi• work ef the National Cancer Institute. We gave a report on eur thoughts about the biology of the cancer cell and what was knewn about that, the then present status ef the stuey of the caroinegenic agents, a discussion of the hereditary factera in :malignancy, and a discussion of research objectives. In the consideration ef' neeplasia and the field to be investigated, we pointed out that there was a difference between what you might call causal genesis, the things that set in progresa the ilarlediate neoplastic change frm a normal cell to a cancerous cell. That's called a causal genesis, the itmn.ediate effect, but once a cell has acquired neeplastic properties, it goea on as an uncontrelled type er multi- o plication and gr'A_wth without al1i1 necessary further cormeetion with the arent that started it. A good example or that is the ca1cers that ari•• fra radiation. People expesed to radiation at some tills or other have sm.e change made in their akin cells, we'll say, that briags about a cancereus growth twenty years later, and, of' course, there's no ••r• radiation going on to effect that :malignant growth. Thats eemed to be tbe cue in many of these neoplastic ehanges. ltd like to know hew auch technical discussion of this is pertinent? . T ~ I ' 478 1 This report we can read now1 but it x s a consequence er a RrMess1 and Lra in- terested in ttie process in 1937 as between these individuals. They all knew each etner., f I was he yo~ungest and the least experienced or the lot. I believe Dr. Murphy was the chairman, but it doesn•t say--does it? Well, anyhow Dr 0 Murphy' was the one I had the sharpest contr.versy with­ was least successful in cenvincing because he was se strongly opposed te the notion of the virus etiology- ot cancer. I rem.eaber that he was responsible for ene or twe drafts of this repert that absolutely denied any significant in­ fluence to virus. I had been for some tille much impressed by Dr9 Rous 1s brilliant studies en the virus cause of sarc011&1 neoplasms in chickens, fowls. He had a filterable virus that produced a fatal aalignant disease in chickens. ,.1, I theught that was rather convictag evidence •f tbe virus etiology- of smu forms f\ of cancer, but Dro Murphy said, and truly at that time, that no one had ever proved that there was a virus involved in the cancers in 118J1U113.lian species, although staring hi.Ill in the face was this remarkable work done by Dr. Richard E• Shope, wh• was alse at the Rockefeller Institute, on. tm 'Virus that was gotten from the papillmnas, wart like tumers, of cotton tail rabbits. Those wart like growths sometillles would turn into cancer 0 As long as they were in the ordinary wart fora, you could get the virus back out of them. When they became cancerous, you couldn't get the virus anymore. You could, hewever, know that it must be somewhere ar•und because you could get serological reactions-a complement­ fixation test indicating tha4he virus, •r the antigen of the virus, was still in the tissue, but that~sn•t a proof that the virus was in the cancer. The proof' seemed to m.e to be unnecessary because we knew from other con• ditions that ence malignancy started, it continued without any further contact 479 with the thing that preduced it, even with the carcinegenic~compounds like methyl,holantbrene. You can produce a fatal sarecma in the rat,• 111 say, by planting a little pellet ef 11.etbl7cholanthrene under the skin. You take that out, excise it after the growth is started, or even before the growth has started, and you cannot detect any loss of :methylcholanthrene. 1 he amount is se small that you can't find it by weighing ite It you remove the aethylcho... lanthrene pellet fr• the tissue or the animal, the sarcomatous growth goes on, and there never is an;:r more carcinogen in that particular thing. The same thing might be true of the virus. Well, Wf1' controversy was mostly with Murphy-. I don•t remember that either Little, er Harrison, or Nerthrap joined into that part or the talk very- much, and so when the mport was published in Public Health Reperta in December, 1938 9 it contained phrases which I now see on renew of the text th.At I got int• that in spite of the eppesition of Murphy. Some people regard the statements in this report as denying that viruses are of &01' importance in producing malignant changes in cells. In reading over this repert todq, I feund that which I hadn't really- noticed betoreJ Dr. lieller•s quotatien of a part of a sentence, saying that the man;r organisms which haft been described as specific etiological agents of cancer mq be disregarded and included Ti.ruses ameng these specific organisms. The text ef the repert doesn't bear that out. There are two sentences in this report that Itm referring to--onelt them deals with animal ·r ~.. parasites s.nd bacteria, and the other refers to 'Virus,--~- later on in the Report it says that the possibility that viruses do exist in mammalian tumors is certainly worthy of further consideration. That was meaat to encourage further work on viruses. The interpretation of this Repart was so unfavorable to notiows of the virus etiology or cancer that relatively- lictle work was done on it for a while. 480 A few people worked on it, but nowadays it 1 a the whole field-well, I don't say the whole field. That•s a foolish remark, but there 1 s an enormeus aaount o! in­ vestigation geing en in viruses in tuaora, viruses in cancer and lo and behold, they have viruses now that produce all sorts ef cancers in ha118ters and in guinea p~,s• They haven't tried them on human beings yet, and I don•t know that they 1ve--yes, they have some viruses out of human Meplasia, chiefiy out of leukemia and some out of warts that becae malignant. 1' his I is a very difficult subject because it e so easy for tissues to become " contaainated with viruses. Tne extraordinary- pains that you have to go through te preve that if you get a virus, say, out of a muscle, or a gland, that it ' isn 1 t just there in a carrier. It just llight be drifting through. It t, s all preaent eTery,rhore. Virw,es contaJlinate •ost everything, so it'.• a veryFficu1t field, but to go back to this report. I•~waya taken it as an encouragement for the irrrestigatien of viruses. ~.t ae ge ahead and say what I helped to do in the Child• Fund in this field at Yale particularly en the advice and under t.hfunuence er Dre Rous. There were two things-I helped to secure first Rous•s appointment to the Board er Scientific Advisers. He was the ene we looked to for advice cm viruses in cancer. The second thing was to bring t• Yale a very brilliant Spaniard who had been at the Rockefeller Institute, after some rema~ble work on the spreading factors so--called in vaccine, small pox Waccine material, which he had done at Barcelona. We were fortunate to be able to bring Dr• F. Duran-Reynala to 1 &1.ee I could give bim a place in tfie space allotted to me in bacteriology. I think we had to take some romns f-N.I'\ somebody else, but Reynala was in there and did very remarkable work on viruses, Rous sar­ coma, a whole series of virus studies in neoplasis until his death about twe or three years ago. 481 This is a siae issue. An administrative problElll arose in his case which teaches a lesson 0 Ya1e University had no funds for a salary for Dro Duran­ Reynals, although they gave him an academic appointment. His salary was paid by" the Childs Fund 7ear after year. Well, arter•-oh, some time in the 1940s1 after the war, some member of the newer board didn't think so well of the progress and productivity of his work. They began to que~tion it1 and reasonably so1 be- e ..! language. It was very difficult .';.et:bnea to grasp what +• cause Duran-Reynals had a most wid ra~ging imagination and equally pictorial trJing to d•• and it became a question whether he s~ould continue to get the salary from •"7 or the Childs fund• If his salary were withdrawn, he 1 d lose his position at Yale. What would have happened if he had not died about the time when this problem I ,.. arose, ~•m net able to say. Its a disastrous situation when a foundation - puts up the salary of a man °' advances whJ\_ into.a we '11 say, the 50s of his years 0 and has no fe\tiag oa any other academic laddero Tbe same thing happened in the caae of Leonell Strong. We paid his salary, and there was a strong~ deep colffiction in s•e members or the board that hie work had coae to an end and that the fund waan 1 t justified in supporting him any further. He had to leave 0 He went to Buff'al•• That question is whether a fund morally should suppert a man that is in a position of tenure and depends en the fund. It 1 s bound to come to an end0 ~sually the salaries, arentt large. I think the lesson drawn trom it intluenc•d the National Institutes ef Health ... to make what they call career appointmenta 0 ~hey provide salaries, life time • salaries, for promising investigators, and scme of the other organizations are ...- doing t~ t teo, realizing that •-thing like cancer research is really a life long jeb with no assurance of a productive issue. Well new, the relations with the others were very friendly. Dr. Little was 482 a vigoreus person who coatributed te the genetical discussions of our part in here on genetics very effectively. I can't remember very much what the con­ 11 tributien r£ Dr. Northrup wu. Itve spoken about Dr• Murphy. Dr. Ress arr1son was the wise patriarch of research in this field, slow of speech but very cegent, absolutely honest, the one on whose opinion you depen:led very much. ,; To what extent did Dr. Parran figure in this? " Not conspicueusly~ I think Dro ~arran felt that he had appointed a cOl'llllittee ef advisers, end he wae wise enough to let them alone~ Dr 0 Parraa was a vigorous I.I Surgeon General et the Public Health Service and was interested in this. This would indica11i8 that tbe Cancer Institute Act cU1e 1 in part 1 as something of a surprise to the Public Health Service, so that faced with an institute, they had to devise a prograa1 er som.e guide lines withia which to function,. Yes, Itir. sure the inetitute was aet up befere the7 bad any pregram1 and that•• wh7 I 1m regretful right now tbat I don't have the manuscript ef the thing I wrete about the aan who really' did it0 Alld yet I suspect that dra!'ta o!' this report !!l be up at the Childs Fund-that t•u may have had• I doubt it. This was something I did &a Dean• I haven't round them ia the pae!rs here. This 11!1 what I did as Dean.. Although I was thinking about the Childs Fund all the time, I don't think I mingled these two. Once the institution on a national scale is established it brin,gs up the re- 483 laticnship between the Childs Fund and ether funds in the fi,,ld of cancer generally For e xame,le I Yale is Just en the edge1 early in 19381 r,f the Hubbard McCormick Fund1 so that there i~ an increase in money interest in the whole field. Tai& :m&y have been I in part1 rtaapeded through these Amazons-I don't know1 but the climate was created. Yes, there was a burst or support fer caacero The National Cancer Institute was to have a large budget, but I dontt recall hew such. It badntt yet set up its procedares tor its council. I became a ••ber or the Council of the National Cancer Institute fairly early and have had connections with it off anfn until a few years ago which I'll talk about later. Lots ef meney began to come into the field of cancer research, and an enormous amount has come in later years, •• that a private foundation like the Cnilds Fund now has to think not only about a large pregram in cancer research, but whether it has any oppertuni.ty. The tellowshipt tunda that eoae troa natienal soarees now are se auch ■ore aple than tne private feundatien sets up that it's very difficult to attract 'i able, yeung mea to the fellowship that the foundation gives, though a lot or \ thea prefer it to a national, gneramental grant. In the field of support of research, thousands of projects are now carried and supported by the National Cancer Institute and the other institutes, whereas tne private foundations have much less epportunity to function in the supporto Nowadays support is so generously supplied by the governaent and federal agencies that even a great 1 feundatien like the Rockefeller Founclatioa kaa altered its objectives. It s net any ■ore concerned to the s&M extent that it was in medical research and medical education. It~s gone into~epulation studies, agricultural studies, learning studies, ramunication, music. 484 V The Public Health Ser ce had at Harvard a •sed of Hareld Stew&r'i . Murr Shear H B. Anderv•nt-I back to -1 W Schereschews -- working en cancer 0 Shields Warren. ,., Se that they bad s/(e program. Yes, they had a caacer group np there around. the pathelogy department, in anatomy, biochemistry..-a.ny- good medical institutien is bound to have fields ef interest, and they include cancer. Had you known Voegtlin1 the Directer of the Nati•nal Cancer Institute? Yes, I knew Carl Voegtlin at Hopkins. He was an assistant to Dr• Abel in phamacology. He came over f'roa SW·•tzerlan.d, I think., about that time. He wu a tall, very handscae 1 elo+•ving1 dignified man. My tirst impressien was that he wu amusing as to his language. He wanted to be very emphatic one day1 talking about a drug, and he said.,"This substance is useless to say the least doubtless I" That's maneloua. That was very convincing. I knew Dr. Voegtlin in cennectien with this cancer report because he was the director of the new National Cancer Institute. He was not a aember of this COllll'litt.ee. We were reporting to him directly and to Dr• farran. I saw Dr. Voegtlin repeatedly and had onl.y' one difficulj with him which came about w threugh the activity of' Dr 4 George M. Smith who was al"-ays full of ideas about enormous projects that would come about through his stimulation. One of them 485 was to set up all ovar the country prolonged longitudinal studies of specific kinds er cancer, like gastric cancer, or mammary cancer in places~ He drew Dr. Voegtlin into this plan a good deal, se that Dr. Voegtlin and Dr• Smith came up particularl7 to see the chairman of the Board •f Scientific Advisera­ ayselt. They wanted t• see if they could persuade the board threugh me to put & large SUDI of aoney ia this project. To me it was a survey type ef thing that had interest, but n• particular scientific value• I didn't have any real difference about it with Dr. V•egtlin, but I was a disappeintment to Dro Smith, that he didn't have his way en this thing. 1s that in the records somewhere? Another one like that--I felt that some cf those things had a piratical motivation to capture the fund. To jump ahead again and along that same line, 1A1' friend, Mr. Reginald Cooabe whe was the head of the Board of the Memorial Hospital ene ti.Jne when Dr. c. P. Rhead.a was the head of the new Sloan Kettering Research Institute, they actually-those twe-came u~ and arranged for a meeting ef th• Board~f Scientific Advisers with th••• They practically made a plain prepesal to transfer the Childs Fund to the Sloan ~ettering Institute. That must be in the recerds toe. I think Mr. Coombe was the instigator of that. Dr. Rhoads was embarrassed by being brought up there to set forward the great advantages that would accrue to the:-vorld in general, so to speak1 by a transfer of this money to the Sloan t(ettering. It turns out that Sloan Aettering is so munificently' supported by Mr. Alfred P. Sloan that it hardly needed what would have come from the Childs Fuoo., but anyhow, it put this propesal before a board that had already saae practice in this piratical kind of operation b7 having to face the authorities of Yale University on matters of similar nature. The board didn't regard this as an entirely new idea. 486 Wasntt it lucq that it was set up initially as an independent entity? Yes• A curieus thing as I look back on it--Reggie Coombe; a Yale man, was en some important committees at Yale, the Education Committee, the Committee on Dev~lppment. He was an attractive person, and this Childs Fund episede came near upsetting our~lationship because I ventured in one discussion with him in Hew York to say that ~dn•t think it vu right for bia to be doing. That cooled our relationship for a while. It came back in an almost extremely friendly• easy way afterwards. Reggie Combe was deveted to cancer research like so many who have had the tragedy or it in their fanily-his daughter died of sarcoma of the bone in her leg. We certainly have jumped around. I don't know iha t this will make any senae, or not. We've got the year fairly well covered., I think we ought to stop new., Tomorrow Ifd like to go back to soae ether things at Yale and pick up the Childs Fund somewhat later. What kind or things at Yfle? 487 .. Wedaef!.dalt ~J.8..a. 1,266 A-60 1 N• L. ,!1• It may have mzstif!ed you •n oecasior;_ but we've beel! _.<!ieeus~ing the ~eans.hip fo~_a,~out a week, We talked about prebleu et ,t~e general hoseital a~d i~s need in medical educatio• and for educational..2ur2oses 1 the budget,gy eroblem_! about that and means to hell? it, W• talked abeut research,.in terms of the e pursuit of tw~ ideas-one, the Nutrition Institute, a marvelous idea, but ua- \ . successful and the ether the Chalds ~nd. Toda Ira like to ome to what is an administrative problem.1 I believe, inside the Universitz and a human problem as w~ll1 involving Dr, Robert M. Yerk•~~ I think to get into it we ought to ~ke up the connection Dr. Yerkes had with Yale because it had long continui~. As a matter ~r fact, his first publication,"Provision for the Study of Monk:ezs and AP;"s", appears in Science in 19161 so he 1 d had lo~ continuity with the sub~ect)?z the time the problem emerges as a real 2robleJI! in 1936-1937. I~ 19241 at Yale therewwas established an Institute •f Pszeholoq, In,.J.J25, ~ affiliate of that Institute was the Primate Laboratory with Dr. Yerkes hous~q in temgorarz headquarters in a barn with four chimpanzees. In New Haven, wasn'l it? Yes, in New Haven. A good deal of work went Dn1 but mast of it ~•ems to have been of 1!he field research varietz. For examEle 1 in 19291 there were two in particular-one Dr. Harold c. Bing~ wht; ,,eursued a naturalistic study of the mountain gorilla in the Albert,Nat•onal Park in the Belgian Congo SU;EEOr~ed by Yale1 in part 1 and the Carnegie Institution in Washington. Thats ame year saw Dr. Henry Nissen 1?,ursuin.g a naturalistic ~t:udy of the chimpanzee in cooperation D with the ~taff ~f the Pasteur Institute Laboratory which was located in Kin~ 488 French Guiana., The report of the latter study whic,e_ I read la~~J!igb~was a s aarvelous report 1 ~ut the first step taken by the Unive~sity for the ex_!en~i~n ~nd improvement of the facilities for anthropoid research is in l~JO, with the cC?,Dstruction at Orange Park1 Florida, .~f ~he ~~hropoid E?cJ?eriment Station. Its purpose was ~o establish~& breedie,g colony of dated animals of known lite histo • I think the followin in 1931 the old Primatet&borator~ ~ounded in 192$1 in New Haven was abandoned, and a new laboratory was created in the Sterling Hall of Medicine oallea the Laboratories of Comparative Psyc~o­ biology. For adainistratiTe purposes the laboratory was transferred from the Insti~ute of Ps1chology to Phzsiology under Dr 9 John F. Fulton. By a vote of the Yale Corporation on June 181 1934a thez established a University DeP9:rtme~~ of Pbysiological Sciences, and the co-chairmen of that department were Professo~s Latazette B. Mendel; and John _Fe Fulton. In the school of medicine the Deeartment of Phzsiolop: was chansed to Laberatories of Phzsiologz and under th~~ te1,:!! were grouped six laboratories as a conceptua~ groue::-phyaj:ology 1 erimate biolo&, neuro ba:Pacolo and texicolo chemistry. Only thre of tt;tose were directg integrat!.d with and responsible to the school of medicie•-the laboratories ot phz:siolep:1 pharmacoloq and toxi­ cology, and neuropb.ysioleq, Applied ehzsioloq was acress to_:wn1 and Fhzsio• logical chemistry. while it wu integrated in tae work ef the medical school• its budget went elsewhere~ The Yale Laboratorz er Pr:i;Ju.te Biology while the~~ relations were intimate with 1 but again1 tor budget and administrative pure•s~s., they were not part of the school of medicine. Once this University Department e J Sciences was established Profess r Medel dies and President Se)'?!Ollr set up a committee to stugy: and re.£ort on the problem c~ated !?z Professer Mendel's death as to wh~t to de. As Dean, this for you was a FEt~ied of retrenclnent--University policy. You were asked to cut out of tte budge~ 489 •t the medical school over a two zear perio~ fittz thousand dollars, and there's a statement in your report, "the budgetax;z restrictions...were particularly i:,~... e:etted as thez wiped out not only a hoped for increase, discussed when Dr, Fulton was consideri5 the candidacy for the protusership of Phlsiology at Oxferd1 b11t alee cut into previous allocations" 1 so whatever arrangements the University may ha~• 11ade with Dr. Fulton, the fact of retrenchment as Universitl eolicz made ita I gather, impossible to perform. This is the adllinistrative enblem that emerges~ In 1936 and 19371 and I gather by this time Dr 2 Fulton is chairman of the University Department of Phy:sielegical Sciences, he writes in his report te the president as follows, and this shows a difference in policz which is the a~nistrative problea: The chairman •f such a group, therefore, is bound in decisions and in the adoption ef general policy to think in terms of the University, as well as the immediate needs of the School of Medicine. Consequently when pressure is bro1:1ght to bear upcn him to curtail things not imm.edi• ately useful to the School of Medicine, decisiea must inevitably depend net upon actual requireaents of the School of Medicine, bnt upon the broader needs of a great University. The School or Medicine as such aight not be justified in maintaining a section of protein chemistry or a laboratory of biophysice, but, if these disciplines are not supported in sny other parts ef the University, it is obvious that the School of Medicine is not only justified, but it is clearly obligated to maintain themt'I Thatls a statement by Fulton. Yes-I have no idea as to what the University mal have agreed in their bargaining with him with respect to the Oxford offer, but 1 you know--you hang oa to a rar! orchid somebow1 aomeway1 but nonetheless the University policy which he talks about here was precisely this- 11 to bring pressure to curtail thins;s net immedi­ ateg: useful te the Schoo~ of Medicine" given this particular time~ You have no quarrel with his view as you state: "With this statement of the ideal of Universitz organization I am in entire agreement", but then later y•u write: J 490 When limited funds and facilities must be distributed among numerous departments, to meet urgent needs, rr~ctical considerations take precedence over ideal arrangements. It then becomes necessary to compare obligations and to make selections according to the best judgment of the value to science and education to be anticipated from any single part of the whole organization••••There is no occasion for a conflict here, but the problem of distributing support•••bristles with difficulties. ~ell 1 one of the difficultie~ is what to do about the LaboratGriea of Primate Biology because in 1936 and 1937 1 they are approaching termination of their supporting grants. :rhey are without any definite assurance of continue,!;! finanoial support. This crisis has caused uneasiness in the staff. Membel::,! have resigned to seek ether more secure positiens 1 and this has meant a con­ sequent curtailment of investigations. Some are abandoned1 er otherwise cut back and while it never is real clear what its relations ar to the school of meeicine 1 they are intimate, but from a budgetary point of view and adminis• trative point of view this laboratory has nothing to do with the school of medicine, so you are compelled in this annual report to say: Deeply as I reel concerned in the fate of the Laboratories, I have had to tell the President, as I have intimated to Dr. Yerkes, that, in my opinion the ebligation for the future support of the Laborateries of Primate Biology does not rest primarily upon the School of Medicine. Wella the fat''s in the fire, Do you remember anything about this internal problea? I'm hazy in my recollections as to how this proble!I came up to me for complete selutien, so te speak, because about this :Jtime I was well aware of the ~ the laboratory and that the Rockefeller Foundati•n had decreased its ---~~in support an+ntended to decrease it further. I saw the value ef the scientific work on behavior with these higher apee and primates. I knew that they had value as research subjects and as subjects about which teaching could be developed, but I think that the problem get so acute, and I think that as there 491 ns no one else to whom Dr• Yerkes could turn, he naturally would come into f the Dean of the medical school. In addition, I always had good personal re­ lations with Dr. Yerkes. I admired him very much. As I said to you before, he had a Jovian head, a vecy fine head and an appearance, a dignified man, reserved, perfectly honest, very able1 and working in a field which interested me, in the sense of an amateur psychiatrist, but I knew I had n• competence with ito Probably I began in a small way with this to act as an intennediate negotiat•r between Dr 0 Yerkes and the Rockefeller Foundation because I knew very well the man in whose divisi•n at the fouQdation this matter rested, and that was Dr. Alan Gregg. It111an't very long before I had te prepare, really, a lawyer's brief en behalf ef the argument for the continued support of Dr• Yerkes for presentatien to the Rockefeller Foundatien, and after visits and talks, the Foundation agreedlto renew its suppert for a year er two more. It relieved the tension and anxiet7 in this case. I don•t remember what the exact next step was, but it appeared to all of us that it was necessary to have a Scientific Advisory Board connected with it, outside of the primate laboratory sta.f.f'R and with that in mind1 I can recall consulting Dr. Edgar Allen because an endocrinologist was needed, and I think we brought in Dr• Carl G. Hartaan as chairman at that time. He wae one of the first. - Yea. Dr• Leonard Carmichael came in as a consultant about that time1 but I forget wh• the rest ef the people were. Dr. W0 H. Taliaferro from the University of Chicago 0 14 You pronou/\eed it wrong 9 492 I'll be darned• Yes, Taliaferro is an old Virginian name, and it 1 s spelled the way you pronounce it, but it's pronounced "ToliTer." He was a man I knew very well when I was eut there teaching in Chicago in 1929. We became fast friends, and we 1till are friends. He was a great parasitologist, and you nP-eded a parasitolo­ gist in dealing with the possible parasitic infections ef these animals from jungles. Also he was a very- intelligent man and knew a great deal about adminis­ tration of ,a department, and hew as a biologist basically, a fine bielogisto Who else was there? Yerkes was the directer, and then you were ex-officio on this beard which in• eluded Hartman, Allen, Carmichael, and Taliaferro. The problem got pretty severe in same ways because there was a special committee appointed by the Yale ' Cerporatien1 a jojnt colllllittee wast• report their recemmendation as te what to de in April or 1937. I don't remember either what the Yale Laboratory of Primate Biology In­ corporated signified, except that it did own property in Florida and wanted to be in a position to conduct business cf its own. It had probably land in Orange Park• They were close to Jacksonville and had political and business conneetiens t,-£atch out fer, and :maybe one ef the reasons for incerporating was to be in a position to receive gifts. T,h•n I think in keeping wit.h the view that Jl)U had1 that the medical school' a iaterest should not be tion cemmittee may have been. established s• that the University cammittee could be called the custodian of this and while it would be administered in the Deants 493 Offiee1 it required a committee that went way bezond the Dean's Oftice­ Hartman1 Carmichael, Taliaferre 1 and so on. That 1 s a group ef scientific advisers mere than adllinistrative people. Hartman was administratively inclined, and so was 1 eonard Carmichael. Actually that greup1 er one like it, had te de with the selection ef Dr. Yerkes•& successor in due time"-! think it was Jacobson who was in the greup there; Nissenwas too-and determined a program for the use of the animals and th• future research. My- recollectien of these events that we are now talking abeut is that I t01'k it as if it were whelly an obligation of the Dean to work it out. I worked & good deal en this. I dontt remember separating it in my mind from an affair or the medical school. You don't have the papers? No, Just this one here• The administrative porblem is an interesting one ~nd ' in a sense it~s loaded with the pcssibilitiee for mischief, even for the most disci lined of eo le-to have a Universit De- eartment with a direct line to the president ~nd three of those laboratories reporting directly to the Dean--you know1 it takes a very strong president to sustain and support tbe position of the University with reference to his administrative heads as Deans and have another person who is volatile, creative, impatient, like John Fulton, and I mean no disrespect to him1 although it does take a degree of discipline net to deal with the three laboratories also in the direct line to the president. It places a great premium on the quality ef the man wbo is president. I thought in readins this annual report-that these were a built in succession of straws from an administrative point of viewo The Nutrition Institute w&s the final one because it was a bald refusal to approve publicly what had been designed and developed with approval. I cantt see why 494 1:0! w~u!_<i_~~clude in l~ll!' annual reEo£_t the_J~.~neral pro2ositions 1 exce2t t• 1 clarii)': what zo.~ LC!~~E:.,'.!;~ -~<!_d-2,~,1 a~d had been c_om.e~~o under the Universitz rule, and make the record. I don't know whether this is so, or not. My recollection ef the University Departments at Yale is that we paid little attentien to them, either as administrative units, or as educational units. The main funcuion of some of themwas to deal withtdvanced degrees eutside of the medical degree-the PhD degree in the sciences. There was a University Department of Medicine which Dr. Blake and Dr 0 lia.rvey representing Mdicine and surgery rarely used. It appeared all the time in the catalegue as something that was there. I think Dr. Fulton and Dr. Long did have some direct association with the president at this time in connection with their university departm~nts, or in connection with this University Department of Physiological Sciences, and associations between them and the president were troublesome to the Dean, but I•ve forgotten the datails about ito I don't know I~ \ that I worried very~ about it. No1 but if IOU were a battalion c~mmander and had a rifle come.a& that~as assigned to regim~nt and assigned.to you for ra~ion~•••• Well, Dr. Phillips, the analogy is quite proper, but the practical situa~ tion is Tery different. I 1ve drawn up many organizational charts, but lrve " never been confined to the channels in that chart--very much like, for example, what General Sanervell did when he took over the Aray Service Forces. He said, "Avoid these channels. Pick up the phone and talk to your opposite numbers so you get the business doneo~ I bave never been confined by an organizational chart, so what you say 495 about a battalion having different commands coming to it from different sources is troublesome te a battalion in a llll.itary situation, but it wouldn't be s• troublesome to a school and its parent university and departments that are in beth jurisdictions. You can always reach people by easy conversation in those places, and you're in a place where even +hisper is heard, so very little goes on that yeu donft knew about. One thing I didn't understand about this ·s that the ma·or field of their con­ cern in the Department of Ph_zsiclogy was the physiology er j:, he central nervous 11stem or primtes. Wh~weren•t thel more interested in what hapPened t• Dr. Yerkes? I think that was a personal 11atter--Dro Yerkes and Dr. Fulton. Dr. Fulton was a neurophysiologiat, had been trained by Sherrington1 and he had an experiM mental methed that required him to per.form all sorts of operations on the brains of dogs, chimpanzees, and other creatures to study the pathway of nerve trans• mi.ssien, and what happened when you ablated certain parts cf the hemisphere of the brain, but Dro Yerkes never did a~ work like that, p•obably would not be able to oarry on the kind of study he did in behavior, if he began to m:1tilate . the animals. !erkes was very reserved, and Fulton was very ebulliento Yerkes, I think, got on all right with Dro Fulton, but I cantt recall that they were fast friends, or easy companions• The objectives of their two departments were entirely different. Dr. Yerkes always throughout the whole period that I saw him was interested in the behavior of these animals without any more restraint •n them than was necessary to keep them in cages. I went to Orange Park and got pretty close to some of these animalso It was interesting to see how at that time they were bringing some of them along by addicting them to morphine, so that the chimpanzee when it came t~ need a dose would go and lie down on the 496 table and prepare itself to be injected-practically get the syringe for the doctor just like human beings, I thinko I thought the Oran,ge Park s~ation was a source.of sue@• I gather from you that it •s not. No. They had some animals born down there, but they kept them for their own purposes larg~ly. They didn 1 t supply them freely to other institutions in the country--! don't mean "freely" in not getting pa.id ror them. They may nave passed arou!'ld some animals, but that was not a pa.rt of their task. Dr. Fulton did not rely on this as a sour<:!.• No, Dr. Fulton bought his mostly• and Dr. Fult.~n didn't have many primates. He had a few on the top floor of the Sterling Hal 1 of Medicine, but a great deal or his work was done en the higher priutes 0 He used monkeys, and he W!led. degso That weu.ld ex lain-I was disinterest but I •n't mean it as it 80Undso Separate interests. I understand, I think1 why the problem fell on you, There just wasn't anz other place. I think tbat•s right and being a Dean-1ou have to be concerned with every• thing that concerns your school, and when you began to get into a problem of administration and support, such as this was, you cantt, let go and say, 11-Well, only a part of this I can do. Yeu do the other parto 11 497 light, but in personal terms in 1936 and 1937 1 it was sufficien:bll serious for Dre Yerkaa wh~ saw the fruit of a lite time of labor S•• Yes, he was about to be wiped out. He'd lose his colerv, and he 1d lese forty years er work? At least he 1d lose the fruits of forty years of con­ tinuing work, but he had a great deal of netes and material te be written up1 so during this period of stress, he had an outlet in his writing, working at his It 1 s only been until recently that we 1v~ now get primate centers. '!'his was the oru.y source of its kind as of its dq. Yes. Now they have large establishments that have recently been built and supported by the National Institutes of Health called Primate Research Center■• They are intended to breed animals, to have animals for the study of behavier1 ' have an,mals with silllilar susceptibilities almost as human beings have te viruse■• They plam to use them for cancer research. They plan to use them, and are using the•• fer example, fer research on leproq which can not be trans­ llittei to an;, mammalian, including the primates s• far. They've innoculatea a lot or them at the primate statien at Covington, Louisiana at a statien built and supported by the National Institutes er Health• There ts still a good deal of dispute as to whether these very expensive installations, expensive places to maintain and expensive animal• to study, a.re going to justify themselves, but they probably will in time• Dees this Dean's Report tell the outcome of this? I know it got refinanced, and I know it got helpful advice from its advisory conunitteeo Very much so. 498 The director was changed. Dr. Yerkes went eut as directer in 1941. I forget hew long it remained down in F1orid.a1 but I know that in the past two tr three years it has been meved up to l!mory University at Atlanta under a totally different management-scientific and otherwise. It hink the Rockefeller r~fina.ncin • There ;!!,San ini~ial burst to develop a new laboratory at Orag,ge Park for phzsiological s studies, and then sucoessivelz dwindling contribution frca them, This was off,_ ,\ set 1 in part, by a study of infant behavior under the Pela Fund1 eo that thez ' were able to keep al.eve through this De.ants Report and the first report I have here bz Dr1 Blake because of these infant studies, alth01y~h his report indicates that the financial eroblems are as yet realq uneolvedo It 1 s a rare kind ef e thing. Yes, and very courageoue people stick with it• This is just one of the magy; things that came to zou as Dean-the maintenance of a resource, aa distinct from creati5 the means for new research support, or s t new idea to develop a program, or how to keep the local community reasenablz ~ happY and world.ng1 ~is is whelly difteren\, ' personal in terms of a man•s It~s whole lite wor where for this man. We 1 ve forgotten another phase of neurophysiology that came almost separately, and that 1 s the laboratory of neurophysiology that Dr. Dusser de Barenne had. He was in another part of the Sterling Hall of Medicine. He was a great big Hollander who had been brought over by Dr. Wint'ernitz. He was a brilliant man who did excellent work in neurophysiology, especially the physiology ef muscleo 14 He died shortly after the period we're talking about 9 I don't think that 499 Dro Dusser de Barenne was concerned in this primate problem9 Not at allo0 The stcrz in a way was that the termination date was jast shoved eff again1 but they did some great worts, I read that field report with gre~t fascination last night 0 This is an account ef thtaboratory. Then there 1 e a special report on Dr, Nissents field studyJ Maybe people better educated than we are new can make more use of the accumulated wisdom they find just by this quiet observation they have 0 \ Probably-well, it~s better if you can study these creatures in their natural environment. In talking about the Nutritien Foundation we got you separated from. the deanship, /\ \ but outre entitled te some views with r · ect to the ex erience as a whole. It kept you awq from the bench, but it didn•t keep you from thinking about the ( financin of research and the need and necessit fer such financin. In some wy:s 1 you got a better overview of the total needs because you had t& deal with them than you would have 1 had you not had this experience as Dean, but there may be other things to8"-tl:E line is certainly developed toward in­ creasing administrative responsibilitv plus the search for men and ideas. Do you have any views on the deanship? Well, as far as the sources in my case are concerned, sources of informa­ tion, they were constantly increasing in number from the variety and interest. In other words, I became a member of a number of scientific advisory boards, or committees of foundations, a.nd even of societies. I always rad an interest in 500 the bacteriological side, the Society of American Bacteriologists and bununolo• gists. I became a member for a while about this time, I think, of the Advisory Boam of the International Division of the Rockefeller Foundation• I was invited t to be on that beard. I served a year and was not reappointed, although most people were, because I had a little bit of an independent line, a line different from that which the directer, Dr. Sawyer, cared for. As a matter of fact, Dr. Sawyer, Dr. Parran, and Dr. Joseph Mountin ran that division with a closely knit management of their own, so that the meetings really were rehearsed in A advance by Dr. ~rand his close advisors and were characterized by plans I being laid before the rest of the membership and approved rather routinely, but it was full of interest. Youtd listen to people cf great knowledge and skill disot.1Ss problems of yellow fever, dengue, malaria, tropical diseases as well as diseases of the people of this country~-all kinds of things were coming in all the tille. To me, it was all part of a 'lfflole continuum from the Dean's Office to these foundation and committee meetings and back to the Dean's Officeo It was just like going around your own home, so to speak,. It doesn 1 t seem to be a departure to go fran one to the other. In the course of that kind of round or associations, you meet many people who might be suitable for appointment in the faculty of your own school should vacancies become available for new. appointment ■• I imagine every Dean has a sort of a recruitment center in his brain that works all the time• A ready c~rd index 1 But you do get stretched, in a waz:1 at the Internaticnal Division because of its team studies out in the field. I don't mean to delimit your interest in any way prior to your joining_ this 1 but it is a continullll'l in I! areas which the Deants Office as a Deante Office didn 1 t allow. It was like salt en the steak1 some condiment where you could go back to tropical medicine, deepen z~ur interest, because you 1 d had that interest with much continuity. Looking from this point back on it, meeting with th• International Division certai lent itself ..,.....;._;.;..,;;;,s_________te thinJ.d. about;.._;__,,__= _ _....,;;......____.....,._...;..;___ ~ the kind.....of robleme which becam ortant ---.....;;.....;;.....,..,;;;;;;......,.=-.;..;;;.--.....-.,;~.,;;;;.;...........;. ~ with 1939 1 and the advent of war 1 thinking in broader ways rather than whether we can meet the budget for the hospital.a or whether we can do this1 er that 0 I was thinking expressly about your news ea the deansP:1.p when yeu leave the Dean's Oftiee. I gather you have ne particular regrets with respect te it after the five year J>!riod you put in there. Ye~rd had concern with students, with multitudinous problems. I think it would be incorrect to sq that I didn't have regrets in leaving /'I it. First, perhaps my f,~ings are mixed up because the manner of the separation was a great shock to me-I mean, it depressed me for weeks and weeks and in addition that happened in December--I mean the decision to go out of the Dean 1 s Office happened in December of 19390 My r esignatiott was in in early January, and I had six mere months of a lame duck existence in the Dean's Office in which the problems were just as pressing, as it I were going to be there all the rest ef the time, and yet I didn't have much of a heart to tackle sane of theme I had no associatien. particularly with my successor at that time. It was some ti.me before they got areund te asking Dr. Blake to be an acting Dean, and he knew the place so well there wasn't any necessity for him to COllle and find out anything about it from me 0 I regretted leaving the Dean's Office because it meant separation from my admired friends. If you g• out from Cedar Street over to Trumbull Street, you've got three miles or diff~rent country between you and your own old friends. e You regret too, if you're honest about it, hanging up the robes of power, bew I cause you have great power as Dean. Its ,, there, and people respect the office, 502 if they don 1t respect the man. 1 •m quite sure that I was natural enough and maybe vain enough to enjoy the authority and was sorry to have to put it asideo I Then many- other benefits come to a Dean. Hes en a great many desirable invitation lists. He has dozens of interesting a:d imporlant visiters se that going out of the Dean1 s Office at Yale is cutting eff quite a bit of life. In my- case, the Childs Fund was continuing me as Chairman of the Board ef Scientific Advisers, and while that appointment had no organic connection with the deanship, it gave me a lot of continuing interest in scientific enterprises and association with delightful people and interesting people, but life was not so full as if the Dean' a work was going on along sidc1 of t,hat. It was good t• have the ease of treedc,m. from some ot these difficult probleJl'IS, but I think I really was serry to go• But the ti.mes change too1 and they were about to mal<:e even greater demands on The war., We eught to stop now and consider tomorrow the chanses in atmosphere. One of ihe happy things about these reports is that you include insight into the times .-- in which these events occur. Of cours,e they end in 19401 and the last report is as you describe the lame duck year, less cf you because it. is the last report--that ie 1 more or less a summarz or reports made to you with less of you in ita as distinct from this one where you use the report at once as a swnmary and also an argument for policy. The period of 1939 and 1940 2 brings a new context in which wetre going to have to operate for a while, and if Yale Medical Schoola or Yale University was anything like Amherst College 2 the friction •f ideas, possibilities, and lines of cleavage developed along wholly • I 503 new and unexpected routes, fight er net fight, war or no war, the America First Committee and the Committee to Aid America by aiding the allies, the Destroyer Bases Exthange--all these thinss began to turn the world in which we had lived in the 1930e almost u side down. I den't now that it disturbed ou in those terms, but we can go back next time and find out 9 I want to say one more thing about leaving the Dean 1 s Office to have it on the record-the Office of the Childs Fund was in the Sterling Hall cf Medicine, so that every day I was back in the medical school environment. The office was there, and many of our grants were at Yale 0 It was not a complete I think the new offices were above the library. Yes, from the beginning 0 Se there was continuity. Yes with the people 1 the work, and the location. Thurs4&1 May 19 1 1966 A....60 1 N. L. M• I want to-oh 1 trz~~ll& today in a._!.q• ~..i~ess itts tr'!! that any.J?!rio<! ~ e is a collection of variables ~¥ch keep cha~ging. I gu~~s that is i~ g~~tcrx, and as it chan~!_ it e~ates new scenes that zou have to confront both as~ person, an individual, af!._d_as Dea!;: As the 1930s def;.Een toward the 1940s our whole involvement in self concer'!, .which perhaps characterized the early part of the 1930s certainly up to 19372 begins to shift. T~ere are new voices abroad in ~h,!..~o!:!~-!e.!..~ss the!••• We face a Johnso~_Act ,which enjoins a studie~ indifference-~~tralitz•. There's the inva.s,io,!1 of Poland, Dunkirk-successive 1!,hings which are disturbing•. I tqink this is 2aralleled bl a political cam.paig~ between FDR and_Wendell Willkie 2 the third term issue-all of it must have had some impact, and I 1m basing this on what transpi~e~ in the atmosphe~~ at Alnhers~ Collee• It soi:t .!!.,f churned thinss uF• _\.!~.had deba~es--between ~eric~ !!_rsters and Walter White•~ Committee. This s2,emed to be the great debate tha~ !ent throughout the land terminating with the bla~t at Pearl Harbor. This is an uEsetting period,!n a wq~ I don't knew how lou s~~.it from the Deants Office. I haven't ao;y; idea 1 which is why I ~aise the 4!!8Sti•~.as a preliminar.z to the actual action you do_g~ J:,nvol~a. as a consequence of war. peri~1 .!az 1938 I wonder in this throu,sh 1940 1 with increasing severity in 19391 as reflected - in our ,own govermnent 1 s ~ctions~-the limited emergency 1 the efforts to de two ~hi!!£_s at the S!!'-Je ..... time-build a fire proof house and ta~e out fire insurance • I don't know how yeu saw th1s 2 but this is a feature of the period. I don 1 t ~now whet~er there's any .respol!!'.• you'd car,e to make 1 or not. ~_llope the~J;!• t, It did have i.DlE_lications .for education-unknown ones at the moment, as to wnat w!s going to be e~cted of medical sch~olss medical personnel 2 scientific personnel.a. It just loomed suddenly. I don't know whether yo11 anticiipate~, ■ 505 or whethe~ lou had any thoughts about~~• '$ Ye$, I had thought, but it 1 s difficult for me to separate my personal \ emotions and thoughts from official emotions and thoughts as the Daano The Deant$ efforts were always very personal affairs for me, .3.nd I don't believe that I had the mental stature to generalize thoughts about the situation as broadly as you seem to imicate Jrl%t have been the case. I was sympathetically on the side of France and Great Britain !ran. the start. My roots are the traditions ' natura1o The British of Napolean and French people in New Orleam. and it~s are my relatives, Itve always felt, and I despised the Germans even medically before the war because we had a tev of them, Prussian doctors, as visiting residents ef Jeh°fopkins when I was down there, and they were the most arrogant--Jaaes w, Fulbright to tne contrary notwitnstanding-overbearing people that I ever saw, and I didn't like them; in fact, I think-well,. I have a feeling now that I expected we 1 d go to war in our alleiiance to Anglo-Saxon traditiem and ties. I expected it so much that it wasn't a surprise to me when it did occur• '\ In the medicN, school even in 19391 after the invasion of Poland, we didn't make any particular moves to get the school in a position to take part in the national effort for war. As I said before, we were effected immediately in September of 1939, when the plans for the great medical and general library er th·• medical school were in danger of being pusned aside by the crises ✓ or the var in Europe. Th.at l i as one operatien of the school that was immediately in­ volved in the wartime situation. I remember practically nothing about 1938, disturbing the people. I don 1t think it affected the school. I don 1t r1111ember any particular debate. I was still in 1938, the Master of Trumbull College, and I did have arguments with the 506 \\ st11denta abeut their j{wticipation in military activities, sheuld it be necessary for them to do so. I can remember distinctly talking to men like Jehn Hersey and others along the lines of telling then that they seemed to me to be ashamecl et their best patriotic and devotional attributes. They wouldn't adJn.it that they would fight on tbe side of this country, and yet they turned out to be the unsung heroes of Guadalcanal and all sorts of places. At that tillle-you correct ae it 11 a wrong-there was a book in favor, called the Wave of the Future by Mrs. Anne Lindberg. They were all reading that. It has a lovely title1 but it is a book that seemed to me to advise a selfish withdrawal from the affairs of your own country, ard it had a little tinge of the Nazis in it., as I think her husband.4Pharles A.J Lindberg at that time was somewhat inf'l.uenced by CHermann Wilhel.aJ G&ring and the air force people there in Gerrnaqy. This book., the Wave or the Future took the students of Trumbull College by storm, so to speak., and was the basis of arguments that I'• telling you about, which shows that I e did feel a concern about the attitude of the generation that had t~ bear the burden of a war, if it came along, but the behavior, the ordinary behavior of C! the medical school population, the people in Trwabull College, and those 1\utsid.e in the University- were very little, if &l\Y, altered. I was close to soae people who were engaged in larger affairs, and lta sure they affected 'Bf/' notions about medical relations with ccnmunities at that time~ and one ot these was Rex CRext'ord Gui7 Tugwell. Hew as in the Yale Law School, in and out of it at that time, aad would come over to Truabull College. As a aatter of fact, so■ewhere in that time I went to Pu.erto Rico where Mrs. e Roosevelt had beeno She cleaned up San Juan, or help>\d to clean it up because in San Juan the people were living in hovels on sticks over the mud fiats. She did something, or she and Mr. Tugwell were responsible for econcaic improvement that was connected al.Jllost Ulllediately with a sanitary disaster which influenced 507 m.e in thinking about whether you ougnt to do everything that appears to be good before you know all the consequences. What they did was to electrify the hills and taru, the backlands ot Puerto Rico. ~ n they did that, the people ,, got '. electrie refrigerators. Up to that time they had been boiling the milk /~om their cows, and when they got the electric refrigerators, they put the unboiled milk in to keep it cool and fresh. It was not maey- months before they had the largest epidemic er undulant fever-I moan Brucella abertua t7P" of f•••+hat they had ever had. It was all because they bad done all this good to give them electrification in the back area farms. Someway or other that set up a principle for me in sanitary work and in thinking about public works that look as if' they are going to be all to the good, that unless you thoroughly- consider all the possible consequence• youtd better not undertake smae of them.0 That sort of thing was happening 0 The Willld.e campai~n-was that 1940? - Yeso That campaign influenced me politically because my classmate was licked in getting the nOlllination. by Willlcie, and Robert Taft.~as a man I •~red 'very auch, but I frankly' aust sq that I wou1d not have wanted to see hi.a be president. While this convention. was going on and Willld.e was coming forward and got the nmination, naturally IQ' thou(i~f;•~d deal to the national. political situa­ tion. Willkie 1 s nomination didntt have aey- effect that I could recognize in the medical school, except that he had beea identified with the Tenneseee Valley Aut~ity-. He had been legal counsel for the public utility company. ' .,,. The Tennessee ..... Valley Authority coaes into the history of the Yale Medical School, joining the school in a national, sociological experiment and undertaking because Dr. C.-E. Ao Winslow fostered the ideas of the Tenneessee Valley Authority, supported them, and knew one of the Morgana. Morgan l-Arthur F.raestJ was a commissioner there, I thiok. Well, Dr. Winslow would have Mr. Morgan at his house. He had me there too, and wetd talk about the problems of the Tenne~seee .... Valley Authority in relation to the sanitation of the area1 the health of the country, and its JB opl•• I got rather aroused in listening to Mr. Morcan because he said. all the tiae that all he was engaged ia was a water conservation probl•, to •f• Po. these d8II.B and to keep fiood control when, in effect, he really waa thinking about free electricity almost, schooling, and a socialistic-type of state which at that tiae was beyond my actiTe sympathies. I feel very different now. I'• a little more educated. Well, that's the kind of thing that would happen on the national scene and would affect the medical school to sOllle extent. Did you 1B ve any tllougl't.• about the Johnson Act? I dontt know about it. The Johnson Ac as the act that ~.ioined neutralit • Oh yes_, I thought neutrall ty was humbug. You couldn't be neutral. Tech­ nical~ you could be neutral, but of all the things that will tie your hand11 is to be mquired by the Congress to refrain from doing certain things. At the same time we were stirred by Mr. Rooseveltts talking about the arsenal of democrac7-about that time, certainly by 19401 and shockingly saying-I think in one of his speeches when he was talking about quarantining Hitll!r, he assured the nation that he would not send any American youth tc fight on foreign soil. Didn't he say that? 509 Well, those things at the age that I was then-I wasn't a kid, but I still had a few ideals about truthfulness and the meaning of words-it seemed that it wasn 1 t a wise thing to say, an honest thing to say-1 ard saying it showed he really didn 1t belieTe it. Wben the talk of politiciau, the talk of the President of the United States, did involve matters of whether or not young men would be sent abroad to fight, the welfare of your students, their future lives both in medicine and in the c'Ollege becaae rather prominant in your daily thoughts, ar¥i again this "-- provoked arguments with the studnta, but I didn't take part in any movement, or I\ any organized diseussions of the war; in fact, Yale didn 1 t have any as far as I know at that time. Did it get into in any way the debate that ran between Lindberg and the America First group and William Allen White-because some Yale graduates, Dean Acheson, Judge Thacher, and two others who may not have been Yale graduates, but~! names esca ae at the moment ublished a statement in the New Yor to find a way around the Johnson Act in order to aid Lord Lothian who was then in Washington, D1 0 9 and was much interestei in trying to sustain England and hoping that some means could be fOJ,nd--I d.ontt know whethe~ that argume di-well, I know it occasioned a good bit of discussion at Allherst 1 but then marbe we read the New York Times. I was not oa the governmental plane that Dean Acheson had achieved by that timeo He was a public figure and had served in the Roosevelt Administration. He had already been an Assistant Secretary of the Treasury, and he is a ver:y articulate, intelligent person whc was destined---even then you could. see that he was destined for high achievement. 510 This publication in the New Yoik Times was as~ private citizen theno I think Roosevelt bad sort of eliminated him from the New Deal. Yes 1 he had his polite farewell with Franklin Roosevelt,. But this in a way was the basis for later things-like Lend Lease which is a aew concept certainly and the Destroyer Bases Exchange which came in 1940. Itm very familiar with both the actual operation of the Destroyer-Bases Exchange and Lend Lease from the point of view of its effect upon the Army Medical Department, the h•1ge problems of preventive :Medicine that came about (\ ! :l' through our having a responsi~lf.ty for the civil population as well as a place fer troops on the islands in the Caribbean. Lend Lease presented the Army with the greatest logistical problem tha.t anyone had ever faced4 Again1 it didn't appear to influence things in the tiae we•re talking about. It was later that I came into contact with Lend Lease through its effect on medical supplies, compe1ition between the British and the United States for material of all kindso ~ut as an idea in terms of making effective the arsenal of democracy. I was all for it personally. Y••a although its full imelicatiou as to how you go about doing this is a different problem entirely. I think I was cynical enough to think that the term itself uns a misleading one. I can\mmember talking to friends as to whether anybody really believed that the lend would beZ:epaid1 or the lease honored0 I thought it was a give­ away which it largely was, especially to the Russians. Yes 1 but in genenal terms there is a shift in the scene. 511 Yes. It's sort of pervasive and huge. I must confess that the scene N was shifting, but that it was like great objects moving i~ the dark to me., That sounds like a stupid thing to say, but I•m telling you the truth. Well, when you come to each day:1 though we 1 re taking advantage of hindsight now- when you come to each day 1 the thing which I suspect was important.1 certainly at .Amherst, 7as self-concern in the sense that I wanted to continue with my lducaticn1 In 19421 I won a fellowship to Harvard 2 I wanted to take that fellowship so rard I could taste it 1 and two dal! later I was in the Arm:y~ It was that kind of thiDfi• I don't think you ever really~-Itm talking about &self-that you ever really come to ur1derstand the nature of the forces that were alive until you're practically through the experience. You walk in and take Dachau and you have a visual image of what this was all about, this inhumanity­ incredible things 9 Then you ~et a kind of footnote, a rationale, a visual I ecture which you don't get in 1939a or 19400 Ith s just beyond you. I suspect that happeaed to a lot of kids. It was a fumbling period. They wanted to continue with the warm and familiar. That's right. And this despite the fact that a great discussion raged and certainly sympathies went toward London--you know1 and how do you share self-t:1l5?athy with concern for if ondon? 512 That was inspired and kept ablaze by .Ed Morrow. It used to move me a great deal to hear "This is London.m Ala➔ I had the recollections of my close attachment to Brigadier Charles Hudson from World War I. I al.lllost claim hilfl as kin. It wasn't long before the Battle of Britain disturbed us a great deal. That wa.s in 1940, I think, after Dunkirk. Dunkirk was a moving thing that we understood, and we wondered how that nation could stand Without any ame; witr.­ out any forti!ications, Without any ships to interpose-they had ships, but they couldn 1 t get them in there. The Battle of Britain started me and a good many or MY' friends on definite plans of how the school might do something about aiding the British and largely though it took a personal turn as to how many­ British children we could take out of London and the bombed area. Dr. Fulton and Lucia Fulton were leaders in that. They brought over the two Florey children. ["Sir (later Lord) Howard Walter Florei/ I tried to bring over Charlie Hudson's son~-I had an enormous amount of papers to fill out, statements as to what my incaue had been for the previous five years in detail, and by the time I got it all together, young C~rlie Hudson had gone into the British Air Force. He didn't come over. Another stirring thing about that time was the arrival in New Haven of a gentleman now known as Lord Howard Walter Florey. He came over here to get some money to promote the production of penicillin. He came to see John Fultoa, and he came to see me. This was in the 1940s, and he wanted about twenty-five hundred dollars. We got it for him-largely John got it trom the Rockefeller ,. Foundation. That was the beginning ...... of the practical penicillin developnent in England. Penicillin had been discovered by Dr 0 Alexander Fleminp; about 1928, and actually crystalized in the preceedi~ year, or close to it, because Dr 0 Gye whoa we mentioned here not long ago, a few days ago 1 told me that his son had been wounded and had an open wound in his thorax, his chest, which was 513 purulent, and h~ managed to get a few crystals of penicillin and put them in to this boy's chest with his own hands. He had a marvelous result, but that I s the way it was doled out by crystals, not as they made it later. Professor George R. Cowgill in the Yal.e Medical School Department of Physiological Chelli.stry-, a man we mentioned before and who had SOllle thoughts about cancer research which were not supported by the Childs Fund., was one of our friends and consultants. He moved out tot he fermentation laboratory of the government in Peoria, Illinois, where they made penicillin according to new formulas that be brought in for the fermentation by the mold Penicillilllll1 a new strain of the 110ld. He did splendid work out there--he could get it out by the ton. Those things were going ono 0fte. One thought about what you do to bring back the opportunities for training such as Dr 0 Winternitz had set up in the Brady Laboratory around World War I, and we did have some training courses in prospect, but I was out of the deanship when that developed. I suppose that there are a great many things, if you sat down long enough and laid a piece of paper out you could realize that there were involvements in events that were the product xr the European 0 war. How much can you tell me about this little episode? CBiologioal WarfariJ I don't want to get into these others yet. [I.rm,- Epidemiological Boa.ref/ Can I use those papers tr,at you have downstairs? Can I look at them? Yes. The ones that you showed me when we went to try to find the papers on the development of the board? Yes, you can look at those. Theytre very disorderly. There's a report from every cOlllJll.i.ssion in thereo I'd like to see them. All right,. I have a feeling about scraps of eaper. But this one on biological warfare-­ there isntt very much on this. Itts tremendous. In my Aray file down there, my declassified file on biological warfare-it 1 s probably got two aundred and fifty pages in one w binding. Do you ~ant to get into this now? r Yes. Let me tell you what Itye seen. There was an interview with Rene Dubos who wouldn't talk about this. You interviewed him? No1 a triend of mine did1 He also talked with Alphonse Dochez who also talked mainly about influeua and colds. What year was this? This was-11• guessing 1 maybe five years ago 1 but this in terms of the way in which it emerged as a problem, given what was going on in the world1 is an interesting story1 and I don't know that there's anything anywhere on it. How far do you want to go in talking about biological warfare now? It begins for me in 1941. Right-in November• In 1941, there were roors of the Germans ~sing bacteriological warfare, as we called it at that time. These rumors were very strong, and they were ,1; brought to the attention or Mr. Stimson [1ienry L. Stimson, Secretary' of WarJ. You may have to go over--pa.rentheticall7-all this when I get tbat 1'1le because I u7 get it 111.xed up now. Do you want me to go an.d get the 1'1le? 1111 go get it. Let's do tbat beca,i:se then we'll have the ,eonte!eora.q: !,t.ems. I have a great many papers on biological warfare because 11-s asked in 1941, by Mre stiJUon to come to Washington aml meet with ueneral /:James StevensJ Simona, Captain Charles Stephenson, Dr. Willi• B. Sarles, and Dr. Ee Be Fred cbieny, to discwss what we knew about biological warfare, to help Mr. Stimson evaluate certain ruaors and to consider what might be done tor the future in this country- in relation to preparatioM tor defense against bacteriological var.tare and possible use or ite This began for ae, I think, in the sUJ1D1er ot 1941. I w ae called in probably because I v as a bacteriologist. I bad no prertous experience with the subject, and I couldn 1 t find anything, as I r•eaber now, in the general scientific literatare about it1 but I did by accident find in the index or the New York Times a number of reterencea to the prev1ous 11Se of tests of bacteria spread artificially by' Germans. I went to the UD1versit7 Club in New York, and they had a collection ot the Nev York Tiaea;. I spent several da79 going OYer those references that I picked up in the index. There was enough to show that possibl.7 the Gel"lll&ns bad used it a little bit in World War I on a very 8111111 scale in sabotage efforts in this country. There was a good account ot how soae Germans had liberated Bacillus Eodigiosus, a test organism. That's a 111.racle producing bacterium ot great historical in- ..__ S].6 I terest. It produces a red pigment, and its ,., called prodigiosus because the;y got it out or one of the early lliracles in a cathedral. In the cathedrals, moist and damp, they put the waters of the host out in front of Lhe alter, and this bacterium would settle on th•, invis•bly at tirat1 and then a red spot would occur, and it vu the blood of Christ, so they would go out and kill a lot of Jews. That 1 s that organism. ' one that the bacteriologists use for Its ~ teaching-the beautit'ul color it produces. ~he color is solu:ble ...... 1 and I once had a necktie dJed with the pipent ot the prodigiosus, so it was a test organi•• 'l'hey have several test organisas that are nonpathogenic1 can be sprayed around and followed and were ued in a&DT of these things. We collected what w knew about biological warfare at that time in 1941. Thia group tb.at Mr. Stillson called together vaa quite an informal caaittee. There had been••• papers published b7 aedical otticers, chiefiy General Leon A• Fox. He was a captain then. He published his tirst paper in 19381 or 19391 about biological vartare and came to the conclusion that the techm.cal ditticultiea would be so great that yva. couldn't•• those biological agents tor offensive purposes. "'e neral Sillmons also u tar back u 1934, had written about the Tul•rability of the Panaaa Canal. to biological warfare at,tack1 and General Sillnons vu so iapresaed that when he caae in prevelltiTe medicine in 19401 hs determined to his own satiafact,ion, that there was a great danger ot the spread ot yellow fever by liberation. of infected mosquitoes. He used tbis scare to persuade the general statt and others to sanction vaccination of the .Aaerican soldiers against 7ellow tever. That had an enormous consequence tor the A.r,q, and we'll talk about it later, because the vaccine, unknown to the people aaking it even, contained hoalogow, serua hepatitis virus, and we'll eaae back to that later. It produced perhaps two hundred thousand cases et hepatitis in 1942. .$17 To go back to the Stimson connection and skipping a lot ot other tbings in talking about what we knew about this in 1941, there was enc,ugh afoot to make 70u take it very s eriousl71 and we told Mr. st.iuon that. Thie is betore the Japanese had attacked Pearl tlarbor, tbe period l,• dealing with now, and I•a teying to get the date ot a very- alarming episode that oecarred with the Inter­ national Healtb Division Laboratories or the Rockefeller Foundation in New York. "apanese appeared t.here, and tried to obtain the yellow fever virus strains that were being uaed in experiaen.ta toward making a vaccine. It looked as if' we had atoot some thing• that would con.tira General Simmons• tear that yellow fever might be ued by- an .en911T co11nt17 to inte at our soldiers. There were other ruaora that JU.de it se• apparent. that it aight be w,ed1 or it bad been uaed1 and this brings us to the tiae in Au.gust of' 1941--as I said, the suamer ot 191tl....tien Mr. Stimson al1<i llr. Bu~ arranged to have an advisory­ ccaait.\ee toraed. This did beccae an of'ticial cad.t.tee vb.ea Mr. Stimson asked the National Research Council to set up a ccmnittee. The Secretary ot War didn't appoint the ccadttee at the tiae. The National Research Council did, and I wu still a aellber of ite I was a aember ot that cOllldttee and ot all the changes of the caaittee that occurred during the war. ~eneral S1maona was a aeaber. E. B. Fred stayed as a ■ember. Sarles stayed as a ••ber, and a great uny- other people. It bad a series of nu.es 1108'tJT to try- to disguiee it-"the WB Comittee. B. w. was too disclos1Ye, so tbey- just reversed the letters. Then it was called the ABC coalittee at one tiaeo Those na■es don't aean ~h1ng1 accept tbq thought they- were '-1ng ~17 clever in concealing what 1118 going on. MT con• nection with it wu large+cau• tbe Bllrgeon General.'• Office vu iDYol.Yed troa the start. General. Silnoaa persuaded Major General Jaaee c. Magee right Sl8 av&7 that there was such a danger, or supposed danger, froa biological 11aterial liberated by the enemy that it was abs~utel.7 obligatory upon the Surgeon General to de'V'ise protective Masures, to find out what the Oenaans ~~e going ' to ue and imuni•• troops against the organias. Anthrax was 0118 they talked about immum.zing against. Even at one point we went so far as to persuade l; Gel'IIII n prisoners of war to be bled so that we co,rd have the serllll to test to see whether thq had any antibodies in their own trooP9 to uansual organisms. Biological warfare had beea outlawed b;r the Geneva Ceuention, but people felt that the Oeraans wou1d disregard that, and later on when the "apanese cae in, it vu felt that they would disregard ite The Surgeon General had to be in• forud about all tbis and had tot.ala a part ot it. The organisatiou that. reall.7 handled the problea tor the Ar.,- were the Ottice of the Surgeoa ueneral and the Cbeaical lllartare Serrlce. aattll"allf it tall.a in techniques of toxic Surgeon General, and relatiou w,~ gas ue. The latioul Research COIIDCil had definite advisory obligatior1s to the tine. I do not beliffe that the Office of Scientific Research and Developaent had auch to do with this probl•, but the Committee on Medical Research was under the Ottice 'Jf Scientific Reeearch and DffelofJlllent Cos'RDJ, and the CGlll'llittee ou liedical Research ["amJ, was housed 1u the Rational Research Council, Division of Medical Sciences., ar1d so there wu a close relation between all t.hHe organisations• It wu a dittical.t noundering tiae. Jfobody knew what wou1d be used, or how it wou1d be dispersed, or p11t into the air, or put in water. There were all aorta ot vague positions, or situationa...tor instance, serious consideration was giTen to the possibility tnal tbe Geraans wo11ld load a great big airplane full or culttll"e fuild, gallons and gallons and put typhoid bacillus in there. Then the7 would ny it over a reaerYoir, and the United States would shoot dovn Sl.9 Ula plane and wow.d bring dowa typhoid into their water supplies. There was great worr, about sabotage. When-now if n can pus on to Pearl Harbor in December ot 1941.i the situa­ tion became auch aore tense and serious because actwilly Lt. General Robert c. 0 Richardson was Yeey teartul that the Japanese would lose tbe material, or " distribute it in a tubion ot sabotage in Hawaii, so we sent trca tbe Preventive Medicine Otn.ce, Lt. Colonel Joseph F. Sadusk, a long ti.Jae good triend of aine, n.t to Hawaii, and he took charge of the anti.biological warfare service in Honolulu and wu bu97 at it tor more than a 79ar, set up tbings that had to be done-set up teeting laboratoriN, collect aaapl••• watch people, control th• •• auch as you could. There vu a certain aaount ot that in this country too ~ tor the watch ner possible saJbotage ot food supplies. For instance, one tille a great deal of canned aeat vu found to be tull of powdered glass, aod it hadn't been NED until the caos wre open alter th• aeat. bad been sterilized. Tbat sent Brigadier General Bayaond. A. lelaer to great ettort on the part of e the Yetrin&r7 service to sample enough cans of aeat to be sure that they were \ all right. I think this was an accidental tbing--tb.is glau in the tood. Bact.eriolgoical warfare got to be extreaely interesting and extr•ely iJll... portaat ac:l.entificall.:y because aoney poured in to conduct new experiments on the study ot aetabolin. ot orgalli••• of toxins, and the studT was tor two reasons. One was to get to know ae auch u you could about large scale pro­ duction or organieu tbat aigh+• ued by- an en8111' aad aight be used by our• aelY•s• The organisms particularly vere the anthrax bacillus, soae ot the Yirusea like the Q fever Yirus which had been worked on ver, extensively and bas bee11 ued to produce infection in volunteer Aaerican troo,- in fields o.it s20 in Dugwa.7 Proving Ground, Utah. Toxins were studied like Staphy'lococcua enterotoxin. A verT interesting possibility vu botulinus toxin mich is so I extr•elT poisonou that a billionth ot a billionth ot a little bit will kill. There was no tacilit7, as they call it, for doing this work 111 the Anq at this ti.lie. The Surgeon General bad the ordinary- bacteriological laboratories, but no big tacilit7 and didn't want one, so the big tacllit7 tor the aass pro­ duction ot caltu.rea and toxins was pt1t in the hands of the Chemical Corps and an enol"llou plant vu built at Fort D=etrich, Maryland, to c&rrJ' on their 1n­ Teat.igat1om-both of the aetaboliaa ot the organisu and the ■earas of dispersal. They built all sorts ot boabs out there th.at when dropped trma airplanes burst u into little round paek&1•• that nutter awa7 and scatter the st~t, 'bollbs that produce s■oke•lilte elllllaions in tile air tbat. drift OTer fields, over acraa, all Yer, int.eresUng and as alarming as you want to make it, and u .foolish u ,ou. want to make it• HobedT kaev what really wu the extent, of the threat. lfobod7 knew what actuall,1" was practical, wbat c mld be done, and nobodJ' knew wbat would be the best aeans of protect.ion against these things. One part of the protection wu detection-how are 7011 going to know that these il1'11sible microorganisms are in the air? They noat arowid. You cancetect then by aediaenting saaplea or air ia an impinging apparatua, but that takes time and you have to wait for them to grow too. 0 The philosophical and moral proble• were veey difficult"[ solution. I•m sure General Magee and .t.lajor General Norman Te Kirk, b.1s successor, couldn't bear the thought of the medical depart.ment going into biological warfare and killing people in what the7 thought was a very dirty and sneaq method. They would sq the suie about poison gu. Well, as a matter or fact• 7ou can make a fine arguaent tor the fact that biological warfare is a humane method, even ■ore so than gas. The idea soon became prevalent that you probably wouldn't $21 kill •IV' peop1e with these things, but 70U could make them sic~ and if you could make a town sick, or a garrison sick, you. could take it with ease, and aost of the work has goae on that way now-even in gas warfare where there is quite as auch concern with incapacitating agents. ll'lCapacitating agents nowadays include everything frm LSD on to all sorts or behavior--atfecting compounds, and they don 1 t necessarily kill. 'rbe same mq be said about aost of these infections that would be produced experimentally, artifically in bio.al. warfare. They might be uncoaf'ortable, but not lethal. The Surgeon General centered the biological warfare interests of his de­ partment in Preventive hedicine, and that•• how it fell to us in Preventive Medicine to stand for the Surgeon General in these thin.gs. It was called b7 quite secret and nondiselosive wa-t. rthe Special Pro• soae other naae that WU - tection UDitJ in the Surgeon General•• Ottice, and it was handled in the Laboratory Division in the Preventive Medicine Service. We had a liaison with the Chemical Warfare Se"1ce which worked very well for a wb:Lle because we camdssioned Dro Cernelius Po Rhoads, the head of the Memorial Hospital and Slaan lettering Institute•• a colonel with the thought that Dr. Rhoads, being a medical colonel and the liaison officer with the !!I Surgeon General, would be aore devoted to the Surgeon General than he would be to tte chief of the ~ Chemical Corps, but just the opposite happened. Colonel RhJt._ad8 was fascinated by- the Chemical Corps's scientific interest in the subject, and he becaae a close friend of General Alden H. Waitt, and not onl7 did we not see so much or hia in the liaison position with the Surgeon General., but he actuall7 made no end of difficulties. This whole st.oey is just personal difficulties and conflicts or personalities and opinions. Colonel Rhoads stayed in this a couple ot yeara--aot quite to the end of $22 war, practical.17 to the end or the var, about a 7ear frc:a the end of tb.e war. Be had been brought in by Mr. Stimson on a pledge that he would be allowed to go back to Sloan Kettering in about a 7ear or ••• He stayed a ,-ear, but he then insisted that he be released and it tell to me working with Major General George Lull, the Deput7 Surgeon "eneral, to go oTer the papers in Mr. Stimson's office and to arrange tor this discharge ot Colonel Rhoads, al:hough we at that C tiae wanted to send bill to Japan. We were getting ready' for an ill'f'asion ~f Japan at the end ot 1944, or the middle of 1944, and the Surgeon General took actions, and PreveutiTe Medicine helped to carey the actions through tor the preparation or and storage tor antitoxins in large aaounte, botulinus antitoxins, what antibodies we could get against anthrax, and a good one was found out atter a while. There vaa a good deal of attention paid to an organiSll: called Bacteriua tgarense, the organiSlllS that cause tularemia, and to the rickettsia ot Q fever. It waa a curious 111.xture of sort or frantic preparation to protect the troops against saaething which could not 'be weighed or aeasurej in any exact aanner, a aixture between that and scae ver,- iaportant scientific advances because it vas like so many things that happened in the var-they result in scientific advances. Great adYancee in PreventiTe Medicine have occurred in every war and •dicine and surgery of course, and aost ot that goes ever into the ci"f'ilian so that the product from a war is not all death and destruction. I have here a caaplete ltst of all these c.-dtt.ees and technical things-­ who, what, and where. Look at all this--bere•~a whole page of names ot people ve drew in. When the cmadttee--I don•t think I want to put those in the record. It isn't necessary. When the cmudttee got reall7 set up the Secretary­ found tni t the field vu too big just to be carried by his usual staff', so he brought in Mr• George Merck, who was the president of Herek and Company to be the bead of biological warfare in the Office of the Seereta17 of War, and $23 Ir. Merck stayed there until the end of the war. He wrote this report that I 1tunred you called the Merck Report. He vas a very- valuable,. level-headed 1l&ll in that position. I think h.e helped. Mr. stillson who bad sreat confidence in hi.Ill. We all did, and it helped very au.ch to have George Mercie remain the responsible officer or representative-he wasn't comd.ssioned-in the Secretaey1 s Office. I have here-I wish I'd had this when I was ta1Jd.ng about yellow fever Taccine. Thia is a page tr• a publication or the Warfnepart.aent called * Technical Manual TM 30-h801 called •Rand Book on Japanese Mil1t&17 Forces" dated or lh, 191il• rt tell• about the Japanese, but in 81lall print atr• page ho, in this edition, is this sentence "The existence et bacterial war­ botteoi fare battalions baa bee~orted•-tbat io, ameag tbe Japa•ae--"and organizations and strength are unknown. It is believed that yellow fever would be the most likely virus tba t may be used." General Si.anons got that inserted in there, and that appeared only in one printing of that manual. The next sets ot prints leave it out. Meaawhile the vaccine had been sanct iomd by' the A:nrl'o That 1 e prett7 clever. It scared tbeao Well, the biological warfare effort and interest still continues. It's being supported b7 the Chmcal Warfare Service largel7 at a rate perhaps or t.en million dollars a year, I suppose. Does that give that enough? In te1"118 ot our relationship to our allies? Yes-the British were intensely interested, and we bad liaison with them all the time. The7 had a biological warfare station ot their own at Porton. I knew the bacteriology- professor who was in charge or that. They were particu... larly interested in producing anthrax in sheep. 'J.'bey would be tethered in a field and a shell containing anthrax exploded, and anthrax would be produced in aaiul• that were wounded b7 fragments contaminated with the organism. We bad a cl••• connection with the Canadian.a in exchange ot all intormatien and in addition secured in the st. Lawrence River an uninhabited island on mich it wu possible tor s•e of oar aedical otticers and other people from. the Cheaical. Warfare Semce to work on toot and aouth disease and rinderpeat. You couldn't I illport. that. 'l'hat s too dangerous te bring into the country, but the "' Canadians let tbe Aaericane put on experi■ents on this island soaewhere in the st. Lawrence River. The other big establisbaent tor ~•ting biological warfare agents is what ii known•• Dugwa7 Proving Ground. Have you ever been there? Dugway" Proving Ground is just to the west of Salt Lake City. It's a ~ goverment reaerve that is bigger than the state or Rhode Island, in the hills I and rugged mountains. Its practically' a desert; in tact, it is the basin of ... a great ancient lake called Bonneville. It is ee drJ" that the tracks of the Donner Expeditioa, or Donner covered wagons going through to the west are still there-40 they •«T• ~•ve aeen th•• I don 1 t know whether theyrre.shen t.hea up all tlle ti■e. Dupay Proving Ground is so big that you can fire artillery at target.a against the hills and see hew you can spread biological agents trca ·~ the shelling. Dugvq Pro~~ Grounds is where the test with Q fever virus wu put on with about a tho11Sand volunteer American soldiers in the tielda The material was liberated 011 a carefully aeasured wind, and samples taken everr• where, a beautitul piece ot work by Colonel William n. Tigertt. Bacteriological warfare was kept very secret. Nobody could talk about it. There was nothing said to people. Public Relations weren't involved because it was so secret. It came to rather iateresting notice however in 1944, when the Japanese sent tire ballou over here. The Japanese :made a great maey paper balloons, and they llherated thea in Japan. They went way up and got into th• jet streaa. They crossed the Pacific and tell in the aountaina of Oregon, California-oh, th.ere aw,t haf~ been twenty, or thirty ot theme We bad to go and baff people watching and get those 'balloons, the fragments. An enoraous aount ot work had to be done to aee whether the7 were cartng biological agents. We thauyght the7 vel"B. It was an extraordinaey thing that these things cue o..-er. Fortunately' the7 didn't carey biological agents-they would burn, I but they didn't •ke aD1' serioua forest fires. 'l'ney could haM--•Japanese Fire Bal10011S" they called ttm ■• Those jet ■ treas are thfnea that have so much to do with our weather, and the7'tre veey constant, pretty tast. On the eositive side-you mentioned metabolic studies on bacteria. I remember the ones that you did1 that J• talked about back in Hopkins and Rechester. The ositiTe side with reference to medicine now-- ou know. .Are there ubllcations? Oh yes, pablications on anthrax toxin and antitoxin. Most or this scientific work has been published, and tbe publications will tell about how t you aake iaprovements in the production of diphtheria toxin, tor e~ple, or botulinus toxin by altering the aedia. There are studies on the nature of these toxic substances that were very much like those that were carried forward by Eaton Who worked on diphtheria and tetanus tonns in..,- laberatory at Yale. 0 The thing I tried to do wt.th tetamus has not been p1dced up, or carried ~rward- , the mystery or how tetanus torl.n gets arount! in the bo"1'• It,.._s still unsolved. It's supposed to be picked up by peripheral nerves and travel along nerve trunks to the central nervous system. That•s 1n there. 526 Also while this is going on there's great improvement i11 physical apparatus and precision apparatus. You·can measure-these are called aerosols, and they round out a great deal about how large a particle in an aerosol must be1 say, down below 10 microns. It won't ge down into your lungs, if it's even a little bit bigger. The method or :measllI'ing the number ot particles in an aerosol in a cloud all haTe been beautifully worked out-all sorts or optical apparatus bas been d ewloped. Manutacturers have been aided a great deal by \he1r collaboration in these big projects. I think a great deal or positive eontr1but1ons have been made. It is a very old thing. Here is a picture trm. Esquire Magaz~n;e or 1965, showiag a catapult throwing a dead man into a fortress. In the old days, they found people dead et small pox and threw them with catapults over the walls of the city. Your friend, Lord Jet* Allherst, was aD early practitioner or•••• This ez:ticu.lar art? Ies, he was with the British and would have arrows dipped in small pox lesions in hmaan beings and shoot. the Indiana witn them, and he produced out• breaks or mu.11 pox aaong the Indians before the revolution. I . Its an old art. It's an old art. That was nall pox. They also did that with plag11•• When people died of plague they threw th• over the wall, or into the fortresses or cities. It did represent a _potent~al. dal$er wb~ch had to be met. Oh yes. 527 I only knew about its early .bes!nnings but from what you said this had contin11- ity right through t.~e war and continues-that studies are .~ing made.• Therets enoraoue investment in them, and I think their research program would run into the millions. After I finished with these cmmdttees in war tble, I came back to be Technical Director of Research in the Office or the Sargeon General and i:Jlllled1atel7 got back into bacteriological warfare activities which involTed both the Chemical Corps and the Surgeon °eneral 1 s Office at that time. Then I becaae a member not as a representative of the ... ,, Snrgeon General, but just aa a member or what was called the Array Scieotilic Advisory Panel, ["ASAPJ. That lcientific Advisory Panel had a separate sub- panel on biological vartare which is still in operatioD in the Office of the Chief of Research in the Departaen\ or the~. ! think I 111 turn ru looae. 528 C, ~st ti.lie we talked in lar1eg eneral terms about }.939 and 19401 the c¥1ng or ,:Ile ~r-& the shift in the wiod1 and it.a consequent changes in thi;ald.n.g abou~ vbl,t to de. ~n the end 1:_hat becaae the preNcuetion of eTecyone who had s0Jll8. rese,onsibllitl ,ror sOM ~ontinui,na prograa-what woul~ it~ etteet be? The qtrmaas were lo~•t ~ritain was bei91 boabed1 and we .were trzi:ns to do tw thi5a at the aw ,tiae 1 one consia~at with the Johnson .le\1 neut,ralitY, aQd \be otber l"_!&~Z~!!I, that ve were invol;~f!da really1 and all that we were was 1~.. volTed-Western Euroeean Civill~ation, It torced reconsideration of events, aad it w-=,a in .t~t context that I noted certain positions zou held. I don•.~ know how important they were_,, or whether th!{ were imeortant. .1.,. not sure even whef! thq begin1 but th~re is a relationstp.p1 a col!~inuing relatiol1A!,hip1 with t~e Natienal Research Council on two particular COIIDlittees1 one on scientific raonnel aa consultaa'ti • eek:1 men and ideas and the ether i field ot patbolosz: w,tu.ch wo'¼1:,d.i~dicate lines to Washington and th•.~ente~ o~ things. The ~ational Reaearcb Ceuncil was oP!n to you1 al? it bad been ~hrougl! ~ acquaintanceship picked !Rover the yeara 1 Out of this conte~t there eurg~ _ certail)].y \w• men in earticul;ar I irµ t1a:µ1, wbo were r eseonei'ble for fecusiry{ !!Yemem. 1 or ,their_anxieties into the s,2eeial board1 the Arlly Eeideaiologi~al h Board1 though 1~ A&:" a larger title, I wa:nt you to think in ~l'lls o~ the ~ergence of this board1 and. aore particular3:l: of the two peoele I mentio~«!, Colonel ,Jaaes Ste.,?ens Sillmone.. and Drt Francia o, Blak•a though there are others t•o, ~~tits backgrouftd. 1 \he etling8 the reference, or kez p~ints that hel,E!_~ to noat and sustain it 1 Th~~ is guite meortaat ia the light of what happens. I baTe the opinion that the connection with the National Research Council 529 111 1940, was a relative~ minor affair tr• their point of view as it waa f'roa mine. It was habitual with Deane and JR81lbers of' faculties of' 11edical schools tt serve on all sorts ot cmmdttees o:f organisations at that ti.Ile, and it still ... ,, is. Yeu1ve naaed two camnittees of' the National Research Ce11ncil, Division of' Medical Sciences which appare11tly I belonged te, but I do not think either one of tb•+u or au,y particular iaportance. The aanpover, aoion~ti• manpower personnel cOlldttee was ene that. dealt with qMationaires, ci~ted people to tind out what t.b.eir cemmitaents were and aake priority lists tbat 11:lght be uetol it it becaae necessaey tor the council, or any of' the agencies to call in aen to serve voluntariq on scae scientific adainistratiYe project. The Committee en Pathology was a broadly interested cOIIPli.ttee. It was not limited to anatomi­ cal pathology, but was one cenceroed 1111.th the realtbasi~meaning of' pathology which is scientific kn.owledge of disease, and this dealt with pathological physiology. It dealt with inf'ectiou diseases and quite a rmaber of things that are outside or anatoaical patholoa. Those eOJllllittees nr• pleasant and interesting bodies to be united with. Tney- bad two er three aeetings a year, soaetiaes aore, and whea called together, this caused a group ot men froa areund the country to aeet in Washington for a day, or tw•• It was a mechania for keeping the lleDlbera currentq informed, and th• ••bers could aake some f.l contribution too, but as I sq, aeither one of these camittees in my opinio~, vu illportan\. In additioD the Ratienal Research Council Division or Medical Sciences had at least a two day annual meeting in Washington at which saanary reports were ude on large fields of actiYit7 within the Division of Medical Sciences. That was an occasion when fol"Jl8r officers of the division would appear, and it was also a social as well as a scientitic occasion. 'What other things brought me to Washingten at that time, I don't know, but I seem to think there were soae things like the activities of the Leonard Wood Memorial, a Foundation for Leproq 530 studies and coatrol, 011 which I was a member of the Scientific Advisoey Board tor a good many years. It met usually in New York, but sometimes it met in Washington and vas another ce rt.inuing connection for me vi th the people con-­ cerned with the coatrol of inf'ectiou diseases, people who did not live in New Haven only', or 11•• ia Oubington onl1, but were representative people fra around the ceuntey. I tllink 1 •-n alreaq told about the dieturbancea that were caning into our lives through the ovarwhelaing Jlal'Cb of the Germans through the Low Countries, the tall ot France, Dunkirk tor the British, the bollbing of London, the Battle of Britain, and the concern we f'elt to do aaething to bring._. of the British children to this c01111t17. That kept us personal.l;y in contact with the progress of' the war in Eurepe. I bad no real close oo nnection vith the pre­ ventive 118dic1ae developaenta in the Ottice of the Surgeon ueneral, although ~ I kaew a bit. abnt what vu going on throug~ 1111' connections with Dre Blake, whom you've aentio•d, and. Lt. Colonel, u he then vaa, Siaions. I really haven't ve17 auch aore that I ean add that I can drag up out of rq reoollectioa about acti'fities ot 1940. ~~ aentioMd one la~t time, not 19401 tbi• ap~cial st11dj; that zou did tor the ~•cretu:z of War which.... On biological warfare? Tbat was in 1941. That,as all cOYered. in that other talk. I In so tar. aa zou.lmova even if it19 s .~econd hand_,. h~ did this •erge and wnat is it related to in the waz ot: backgr~ur-!,? S.31 Yeu •an the A'ffll' Epidemiological Board? The stoq should really go back to the activities and ideas of General Georg• M. St.emberg who was the Surgeon General ot the United States A.ray froa about 1893 until 1912, somewhere along in thereo Part or his activities that can be said t• be related directly' to tbe genesis of tbe idea er the Aray Epidaiological Board were those activ.lties through which he established re­ search boarda that had in their objectiv-ea, their procedures, many- of the elements that reappear in the Ar,q Epidemiological Beard ■ et up. These were reaearcb boards that General Sternberg established in the Medical Department ot the Army' about 19001 when the United States OYercaae Spain in 18981 and sailed eut into the world as a great, cOlling nanl power and. tor the first time an international irrl"luence and force. It was soon realised that the United States was responsible for the welfare and health of aillioas and llill.ions of people linng in a tr~pical enviro~(~, and that the health of these people was proper~ a utter for coDBideration by the Medical Departaent of the A1:fq which was the only professional, aedieally equipped and trained unit in the War Department tbat could undertab the necessary work. In 19001 General Sternberg established the Walter Reed CClllllissioo tor the atud.y' ot yellow fever in Cuba and within a year-that story is so well known that you don't want to rehearse it here, but within a year Walter Reed and his associates, Jesse w. Lasear, Aristide Agramonte, and JAl\fi;S .CAA.to\\~ had shown that the Aedes egypti aosquito was the arthropod vector of yellow fever and that yellow fever was caused by- a filterable virus. That was all done within a year. By 19011 yellow fever had been stepped in Havana, and the whole 532 of the modern era or the control or yellow fever began to develop. Walter Reed had a long and possibly disorganizing field service experience with the Arrq, s.nd at one period he did go off to Johns Hopkins and was able to study under Dr. Welch tor a while which was very important, and Walter Reed hoped to get back there soae day which he did after the Cuban experience. I menti:on this because Walter Reed 1 a association with Dr. Welch is not suf'f'iciently- well known. A few people know that it was Dr. Welch who said to Walter Reed once and I think wrote him, that since he could not find any visible bacteria, &f\Y microorganisms in the blood of yellow fever patients, he really should look for a filterable virus. About that time the work on foot and mouth disease, a viral infection, was first coming out !J),tner and Frosch, 1897. 189~, and Dr. Welch was alert to those things. For example, I heard it said­ well, an example that :makes me want to make this point is that I heard today a major general high in the Medical Department, speaking at the 25th Anniversary­ of the founding establishment of the Army Epidemiological Board, sq that Walter Reed like Sternberg was a lone worker without much help frC!ll advisers and consultants as the i?lf'eatigator can get nowadays trom the wide association. Well, thatta not true. Walter Reed had advice from Dr. Welch, and Walter Reed had great adYice trom Carlo• Finla7 who believed that this mosquito carried 1ellow fever, but waan•i able to prove it, and Walter Reed had the extraordinary and important advice tr0J11 Major Carter who noticed that after a case of yellow fever appeared in a town, say, in Louisiana, or soaewhere, there was about a period. or two weeks before the next case appeared, and that observation or Carter's• ••• Made all the difference 0 Yes, made all the difference, so to Walter Rsed from the outside came the 533 i definite, positive suggestion, almost an opinion, of Carlos Finlay that the aosquito was the carrier., Carterts observation cf the period or time that •s required fer the dffelopaent of the virus in an infected person and transferring it to the aosquite, and then Dro Welch's suggestion that it was a virus. Walter Reed had tairq good advice, and that wae used by hill with great power and skill. Nov1 the type or operation or the Yellow Fever Commission in Havana had these main elements. At first, it involved the calling together of a group or able, well infonned men capable or ~onducting experiments under difficult conditions with very scientific, critical protocols. That was one element. 'ftle other element was tbe association of civilians with the llilitaey in such an umdertaking which occurs again, as you will see. Walter Reed was associated with Carlos Finlay who was a civiliaa, and Dr. Agramonte in Havana and several other people whose naaes I don't reaenber at the mo•ent were civilians and knowledgeable oiviliane. The third element ct importance in the arrangements for any such board is the financing. Walter Reed probabl7 had relatively little money for the conduct ot the work that he was doing on yellow tever1 and he didn't need much aoney. He had a hospital that had been taken OYer from the Spaniards. He had voluateer soldiers as subject.a, and he needed practically very little equipnent besides a tew tubes and a microscope. The financing, however, had to be provided trom the Medical Departllent ot the Amy. That required travel expenses and other things, so all of those elements were in that original Yellow Fever Cemmission•a charter, ~o to speak, er set up. At the same ti.Ile in 19001 or about the same tille1 General Sternberg established the Tropical Disease Research Board in the Philippines which was a very important one. It lasted tram 19001 really, until about 1933, through about two or three phases. There was one bAard that lasted a while, 0 and then lapsed a bit, I think, under Surgeen '-'eneral Robert M. 0 1Reilly and then another board vu appointed, and then a third one. The people on those Philippiner Boarda were gi"f'en the freest charter, so to speak, or the finest choice of problems the1 would work on so long as they wre probleaa that they ■aw were important t• the people in the Philippine Islands, tor example, and to the treops in these islands, and they were thought to be important trom the point of new or their threat to the healtb of soldiers and of civilians and t• the econamy of the country. The purpose or undertaking scientific research in the Philippine Islands vu to •ke it possible for the Tropical lisease Research Board to study these diaeasea in the land in which they occurred. They had a principle which reappeared again in the Anly" Epideaiol0€ical Beard objectives; to study diaea••• where the7 eecv and also in labora,oriea that were rather backup laboratories, you llight sq, or where the basic work could be carried on after \he apeciJllens were first exud.ned in the tield. Well, examples of what was done out in the Philippines was the discoveey of beriberi by Captain Charles B. Vedder, a whole lot of nutritional studies en the deticieacies or vitaains, or froa eating polished rice which causes neur:l.tio froa the lack et Titatu, e - • paral1H•• There were+,xceuen entoaological studies on the aesquitoes and. arthropod vectors of the island8o 'ftlere were studies en malaria of all kinds. Colonel Joseph r. Siler and later Colonel Jaaes Stevena Sialons discovered the virus of dengue tever out there and its transaiasion b7 an Aedes aoaqldto. The W1>rk vu carried on in totally aedern methods and conceptions that almost-as ~ 1ve often thought, the Amy Epidemiological Beard was jut a continuation of that kind of thing• Another research board was set up in Panaaa, and to that Colonel Simmons, or Major Silllons 'then, was transferred, and he served on this board in Panama I ! $35 for a D1111lber of years. He got deep~ interested in malaria and had sOllle extraordinary field experiences when the troops were taken out of their barracks in Panama City-, or the Canal Zone and were sent on maneuvers through the jungle down there. In neither case did they come across 1ellow fever, as tar as I • I remember. or course, in the Phillppines there is no yellow fever. Its one '{.-1.k011v 'F'i.\(ICR_ !'I er the myeteries ot the world-wb1' there is nd ~ b e Philippines, or in Southeast Aaia, or IllCliao Those countries including New Guinea are the natural habitat or the Tery aosquit.e that carries dengue fever and carries 7ellov fever, bu.t tor seae reason, known only to Ged so tar, yellow fever bas neTer broken out in tboee regieu, and there•• no ial.unity er the people• This tact, will coae up later when we talk about quarantine regulations worked out by PreventiTe Medicine ia World War II., , . Tb.e tear or the intro­ duction ot y-ellew teTer into India was so great that the quarantine regula.tions of the aost restrictive type were instituted by the British and the Indian gcrvernmenta, and at one time these regulatione were so ditf'icult to live up to and so ebatructive that our troops could not be landed. They had to stay- two ,.;•. weeks on a ship in a harbor in Bembe7, and air night were illpededo I,u tell aere about tnat later. ', s To go back to these board-they did excellent researca in the Philippines \ and in Panama, and it is iaportant. to note t.bat Lt. Colonel Silulou, as be I s now becaing, finally" Brigadier General Siallon.e, wn• was the founder, in.,­ opinion, or the Army Epid•iol•gical Board, had basic experience as a member •t these research beards in the Philippines and in Panuia, and actually as tbe President of the Board in Pana11& tor a while. Another gr•up of boarda caae about in World War I, appointed by General Willia Crawford Gorgas, the Surgeon General, and these are called the Pneumonia Caudssioa. There were dreadful streptococcal infections and empyema- 536 highly fatal-and pnetaonias ia the induction centers and in the big caaps in the United States in 1918-1919, which is the same time also as the fierce pandemic of influenza that swept the world. You cou1dn 1 t do anything about influeasa. Yeu can't do much about it at present, except to vaccinate against it, but the7 didn't even have a vaccine then. The mortalit7 from sickness in that period from 1918 to 19191 w.u due to streptococcal pneumonia, lobar pneU.11onia of the pneumococcus type, •wemas, septicemia, and very- violent in• fe;tions. "' This Pne~onia Board that was appoi~ted at that tille bad a ver, di~inguished coa~tion. Its leader, I think, was Dr. Rufus C•l• who was the head of the Rocke!'eller Institute Hospital. Associated with h1a was Dr. T• Rivers, the brilliant Dr• o. T• Avery-, another brilliant and thoughtful worker in infectious diseases, Dr. Alphonse R. Dochez, and a very substantial man who becomes important again in the Artir/ Epidemiological Board., Dr. Francis Gilman Blake. That group worked just as the ~ Epidemiological Beard Com• missions worked by' going out into the field and studying the diseases among the trtops in their living ennrornent, the ecology in which they existed, and u.king observations in the field and in the militar, laboratories, and bringing back t• their own laboratories specimens for further study. Dr. William a. MacCallua who was a member of the Pneumonia Ctalllission brought back a great deal of aaterial. trca pemmonic lu11&11 •..+tiler lesiou to Johns Hopkin.o De~ partlllent or Patholoa. The bacterial and serolegical studies were conducted aostly at the Rockefeller Institute with Dr. Cole, Dr. Avery, and Dr. Dochez. Nov that is, I think, a sufficient. background of the Aray Epidemiological Board because the 8&1118 general ideas prevailed in the establishment of the board and ma~ or the sam,, people that .1.,ve aentioned were connected with the "'---} Board. In the Surgeon General I s Office, General Simmons, as I said, was brought first from Panama in 1939, to be in the Oftice of the S\ll"geon of the 1st CoRpr'!i S37 Comand in Boston. He then was transferred to the Surgeon General's Office in Washington on February- 24, 1940. !he records aren't entirely clear, but I think he was chosen for this move through the knowledge that the then Surgeon General, Major General Charles R. Reynolds, had or General Simmons. General Reynolds was distinctly interested 1n Preventive Medicine. Nevertheless, in the Surgeon General 1 a Otfice at this t1me Preventive Medicine had no standing u a specialty. The activities in Preventive Med1c1ne were diffused in a nameless fashion through the Professional Sel"V'ice Division in the Office er the Surgeon General. The Sllrgeon "General explained 1n A1s '-' Annual Reeort for that year, that the demands on the Professional. Service Division were so varied, as he put it, that it had been found impractical to bracket any- of the actiVities in any special subdivision. professional service, for example, was concerned with military sanitation, with reports or sanitary inspectors on which action had to be taken by the Su~eon General. It was concerned with statistics of mo~idity and mortalit1a It was concerned with venereal disease control. It was con- e eerned nth a whole range of preventive med1A;ne and public health, but under no name as such. ti Well, it didn't take General Sim.ous very long to persuade Surgeon eneral Magee who I think already- was or the same opinion as General Si.Jmons, that~~­ organization was necessary, that increased power and increased personnel were necessary it preventive medic1JM were to do anything worth while, so it was on the 7th or Mq, 19401 veey shortly-S1.Dmons there in February 24, 1940-in about siX weeks, they,issued an order setting up the Preventive Medicine Sub­ division still under the chief of Professional Service. :1 :, ,-1 Tbs.twas a disr~ssing thing for preve~ive medicine and for General Simmons too because the chief et Professional Service was and continued for some ......._____ 538 time to be an officer who thought that the cbiet important duties of a aedical tfficer were only the care of the sick and the wounded. He didn't encourage preventive medicine, and he got in the way of a lot of things, this time and later, that were desirable. Now it was in this period ~ tween 1~ay and the middle of December1 19401 that the plans for what became the Anly Epide:aiolegical Board were formulated and finally apprOTed. The formulation seemed to nave occurred, aa I have been told, in conversation between Lt. Colonel Simmons, Dr. Francis Blake, Dr. Doches and perhap• Dr• Aver7, but Blake and Simmons were the chie.t ones tbat aade the m.oTea, and it was Blake who was then i rotessor ef Medicine and Deaa at Yale, having succeeded •• in the deanship, at this time--­ ao, ht hadn't come in at this tiae, had he? It was just at this tille-Decem.ber. Oh yes-December, but I•m thinking or Blake getting in before June, to I talk about the Soard--perhaps be dido Its the period after June to Decelllber. 0 Curiousl7 enough at tbis 25th Anni.Tersaey ~t the Army Epidemiological Board, f\ , / \ celebrftt~ toda7, Dr. Colin HacLeod, who as one of the first aembers of a K comnission under the board, recalled that Dre Blake had sp\n to him somewhere in the s\lJllll'l8r of 19401 so persuasively, that he cancelled his appllcatien tor a cOlllllission in the Navy and decided to be the head of the PnellJllonia CNllldssion under this new Board, preferring that• u he said, u a serTice to ao;,y other available at that time because it titted in with his interests, although it ' aeant be would have to remain as a ciTtlian which. he did all during the war. We tried to get Dre MacLeod to come in to the A.ny-1 but we never c•uld get a uniform en hi.lie Dre MacLeod was natiTel7 a Canadian, and I think he'd become a naturalized citizen at that time• He was in a very promising academic, medical career at Hew York University. 539 Dr. Blake and General Simmons worked very hard with such consultation as \hey could find, largely, I think, from Dochez, Avery, and Rufus Cole on plans tor this board. Eseentially it was to be a central board composed of1 I think, Dine members and a number of other groups which were called cOlllllissions composed altogether of civilians at this time. The military persons connected with the board were the servants ot the board, but not members of it. General Sillmons had this board placed in the Office of the Preve'ntive c.,, Medicine Service in the N G Office of the Surgeo)\ eneral ot the A.rrq. I was under bia as deputy chief ot Preventive Medicine Service inlh• Surgeon General•• Office. I became in \ille the adlllinistrator of this board, and at the start the Board had one or we otller ailitary aasistant.a, notably two who haven't been recognized 111£:tieiently. One was Major Williaa s. Stone, head ot sanitation in the newly set up preventive •dicine organization and the other was 1'!ajor Carl Lundeberg, an epideaiologist really• Well, after preliminary drafts• I think, of the plan for the organization or the board, the board~•• established and at that time was called the Board tor the Control and Investigation of Influenza and other Epid81llic Diseases in the Arrq. That long title didn't surVive very long, but it was an extremely valuable sales tag. The recollection ot the horrors of the 1918-1919 pandemic or infiuenza and the deatba among the soldiers and the population or this b ceuntry was right in the 1111.nda of all the officials that had anything to do with the approval "' or this plan. General Sillmou knew the power et that group of words very well, and he used tha intentional]¥. He built on it. Ies--atter ror11olation or the p~na General Simmons in Daceaber of 1940-­ vhat•s }he date? 540 On December 271 19401 General Simmons addressed a letter to the Chief of the Planning and Training DiYision through the Chief of Professional Service Division recoli'l!llending that the Surgeon send the attached letter aft.er signing it, a letter which had been written by General Simmons, te the Adjutant General a1ld.ng tor tbe establishment of the board with the long name with the approval et the Secret&r7 or War. This was acted upon with astonishing speed. The letter from Surgee'l General Ila.gee which had been written, •• I said., by Celonel ~ Si.mom, dated December 271 19401 was approved by order of the Secretary ot War on January 11., 1941. Tbat is exactl,T fifteen dqa-astenishingl Wasn't Selective SerYiee in operation at tbie tiae? Weren't. we col;t.ecting zeung aen in caps? The ope~,!I phruea and eragrapb8 of this letter relat.e- 1ou know•••• To the expansion or the Al"!V-0 Oh y-es. We weren't. in the war, but there were many things of a war-like nature going on. As a matter or fact-this is a side issua, but the A.ray' began toe xpand late in 1939, and by this time in 19401 or shortly thereatter, there were a million six hundred thousand men in an Ar,q which at the beginning in 1939, 1fU around tvo hundred thousand, maybe-not quite that aucb 9 In 1940, the !rrq' was large enough fer the War Department and the Operations Division. or the War Department to conduct maneuvers in Hew York State, in. Wisconsin, in Seuth Carolina, and in other places ill which divisions and actual AI'Jliea were put in the field, so that by the time we really got into the war, our 541 general• had had field experience in handling corps, anq, divisions-all sorts or logistical problems. Thia expansion had gone prett7 tar whea the Board was approTed, and it set this country- in position to enter Worlfar II in 1941, atter Paarl Harbor, December 7, 1941, in 'better position than it ever was at the beginning of any- war in which the country- had been engaged• It still needed plenty to be done, wt it was in pretty good sba~• Well, this is an excellent letter tran General Simmons. It deals with 1rganizatien and personnel, the statua of civilian personnel, the procedur.. to be r ollowed. an+ow they would function. The board w as to consist of a central "4 bodJ of' aeientists and technici~1 such as wol1l.d be required, and would meet at th+al.l ot the Surgeo~ "eneral. The Surgeoa Ueneral' • call wu in this senae1 as in all others, issued b)" the Surgeoa ueneralta representative-that is, the Surgeon General calling the meeting here would be General SilDlons. That•s a stock phrase• Then there would be an additional group of expert scientists and e te~nicians-"technists" as he called them. When called on by the President of the Boarcl, who was a civilian, the in­ vestigative terms rwould ge out in the field and do work there, and thi• was called "fire fighting•" An imestigative team would cane out right away, go int• a place, look it over, make a study, see what needed to be done, make ree01111endations, and often they would continue work en the problems at their bOJN laboratories in universities when they got through with the field work. This was done with great generosity by the civilians who composed these cm­ Jlli.ssiens and by the universities to which they were attached. They were faculty, and the universities contributed laboratory space, the salaries of their faculty members who were members of tb.e connissions. The twenty dollars a day e per diem which was paid to these men while they were ~n duty would barely feed them. The universities paid their salaries and never asked for reimbursement. 542 ) : It was quite a wonderful thingJ the way they were aoved by patriotic sentim~'98 l even before the United States entered the war. Atter the United States entered the war~ there was nothing asked ot these ccaaiasion ••bers that theycwould net do. In a year there were upwards of two hundred civilians, expert• connected with the board in this manner. As I said, the long n.ame ot the board-"Board for the Investigation and Control or Innuenza and other Epidemic Diseases in the Al'Rl1'"-took too long t.• •AY, and after it 11ade its impression General Silmou didn't object to the in.formal substitution of A:ff67 Epidaaiolegical Board for the long nae• He himself called it en bis organization charts and in his reports anything that bappemd to coae into hi• heA4l. Saetiaes it would be the "civilian epidemic• board." Sometille• it woul.d be the "civilian epideaic control board" and those•• well• he might have had soae reason to emphasise the word "ciVilian" in those ca•••• Tbat 1 • the onlT tble that caae in, but he was very proud ot this h civilian connection. He was connected with, or had contact witp., or knew all the toreaost public health, preventive medicine authorities in the country. He traveled a great deal to scientific aeetings. He gave a great many papers about preventive medicine, and he had a great host of friends and scientific colleagues. This Board was so•thing quite MW in Arrq procedure. The newness ef it, aside trom the ana-logies to the sternberg boards which were chiefly composed ../ otailitaey people, was that this one put a greater eapbasis~n the civilian coapoMat. lbis was rather nev, and the tact that they would be paid a I?!!:. - dia of tvent.y dollars a dq when on duty was scaething that had rarely been done. I can remember dealing with sme of these questions at a tiae when the budget officer of the War Department was so opposed to this that he would ex­ aggerate the possible dangers and disadvantages of letting the Surgeoroueneral .543 ban such power o-rer the pocket book or the War Department and th• professional 11.anpower or the nation. He said that there was nothing im this plan that would pre~ent the Surgeou General rrom hiring every doctor in the country which was never the intention. These were carefully selected and thoroughly, broadly trained specialist•• The Beard was officially approved in ~anu.aey 11, 1941., and it began to work bJ first establishing different commissionso they had all sorts or namea-t•n coamissiona and according to this memorandum here, the first oaes were appointed on February 6, 1941, and the 10th was appointed in May, 1942. The names et the camnissiou are what you would expect in general, but you 1 d have te know more about what they did to tell what they were-the cOlllmission on infiuenza, on epidemiological. surve7, on p~onia, on measles and mumps, on hemelytic streptococcal infection, on memingococcal. meningitis, en neurotropic virua~fiisease, on cross infections in hospitals, which became the Commission on .Airborne Infedions, on tropical diseases, and on acute respirator:, disease•• Those names are simply the naaes or the most important greups or diseases that the ~ilitary had to contend with. The Ccmdssien on Epidellliolofical Survey, tor example, was an ill-defined affair of' which I happened to be the director. Its main program was outlined b;y Dr11 Dochez on the supposition that if you made a constant bacteriological examination .from cultures !rem throat swabs and looked for infiuenza bacilli, pneumococci, and streptococci and found the norm.al dq to dq proportion of the distributioa or the organiSJIIS that appeared in cultures you would be able when nl that distribution was changed to pr~~t that soaething was going to happen. For instance1 it you had a normal, proportional distribution in which fiTe percent of the colonies would be meningococci, and all of a sudden you'd get seventy percent meningococci 1 you'd be frightened. 544 You'd know that something was UJ>::::right. It wu a very tedious study though, and it was hard to work out. We set up our groups to help us in the First Corps area around Boston, the Fourth Corp8 area in Durham, North Carolina, and the Nin~th Corps area in San Francisco, \J and we had another group ~nder Morales Otero in San Juan, Puerto Rico. All of them did sane ot this routine bacteriological survey that i•ve ~ told about. Some ot them became quite limited and apecialized from the start. For instance, the Ninth Corpe area, in California, had a group on which Dro Charles E• Saith served with distinctien. This group get deeply iaterested in dust borne coccidioidOIIIY'cosis infectiona in the A.ray Air Force Training Bases iu the Desert Training Center, wherev.r there were dry1 dusty regions that carried these spores. I don't lmw how auch technical stuff you care to have put in here, but I sh.u.l.d make it limited, unless there 1 a soae principle involved. You're primary source material for this, and ~,d rather not have you limit such c_OJ1111ent as you care to make0 The interesting thing on the establishment of this commission is on February 22 1 1941-this plan•••• Yes, but the commission was appointed on February- 261 1941. Tb.e pre&r• was w,ost immediate-work began. Y•a-well1 I came down here many times and met with a good many or th••• men. J O Hnard Mueller in Boston, David T. Smith in. Durhaa1 and I were on the telepho11e for houra....ost of that was set up by' telephone•-there was a great pressure to get it done. Up to this point, aside from the twenty dollars per diea allowed for men 545 who would come on dut7 and aside from reimbursement fer travel expenses, there was no money in the Treasury of the Board-no treasury, no money. It was very hard to get the meney. The Director of the Bureau of the Budget of the War Department couldn't understand this. He just thought that this was almost a criminal raid upon the funds of the War Department. I think Major Lundeberg and a Colonel Francis c. T;yng in Supply in the Surgeon General I s Office carried on most of the negotiation toward this end, representing Colonel Simmons whe even at that time lmew very well h A•w , to navigate in these tr•~ublea waters in 1uch a way that he wu never in danger of' getting sunk personally, and he could therefore sort of stand on the deck and dri•• his associates into dealing with the hard-boiled War Department budget people. I don't think we get any meney set aside for this until late in the 7ear, but I left those papers downstairs. I think the Board in a ••ries of meetiggs during the spring or 1941•-one in e. Februarz1 one in May1 and a later on in June developed a yearly progrus with a \ budget and subnitted it. Bz the time it received consideration, thereguest wu "l tor a propertion of~ zear 1 because I don•t think funds were made available until October or 1941. There's a parallel development going on that seemed to suggest to Mr. Bundy who was Assistant to the Secretary of War that there aight be duplication involved. Tile Committee on Medical Research under OSRD had been f'loated1 I think1 some time in 19411 and ...-you know1 who was going to do what. Well, the difficult;r with words is that they easily' appear to be duplicates, but it's the substance. For instance, at one tiae somebody in the Detenee De.. partment aaid1 "We 1re going to cut out du.plication. Look they have a Department ef Phy'sics in the Artq and a Department of Pby"sics in the .l.~vy, and that's duplicatioal Wetre not going to have•~ duplication." To go back to the names of these caamissions-there 1 s much duplication 546 aaderneath tb•se namea 1 tar aore than the general gentlemen running the funds et the War Departaent possibly appreciated, or asked questions about. You have a Commission on Pneumonia, for exampleo Well, one of the cOD1111on complications et measles is pneilm.onia, but we have a Colllllission en Measles. lie have a COl!llldssion on Innuenza. Influenza is a respiratory disease, and pneumonia is a constant complication of ito The Commission on Hemolytic Streptococcal Infections takes in everything troa a sore throat to bronchial pneumonia, and there's pneumonia again. Cross-Inre~tions in Hospitals is another one in which the Cc,mmissien on Cross-Infectiona in Hospitals would be dealing with the pneumonias that arise f'r• infected sprays coming frm the aouths of patient.a, 1neezes and whatnot. It became the Airborne Infection COllll1i.ssioa in 19421 but it vaa still interested in the results of airborne infections which were often pneuaonic. Tropical diaease•-there are m&l'JJ' pneU111.0rda-like diseases, pneumonitis and pneumonias connected with tropical disease■ • The whole thing looks as though it 1 s separate, but it could be said to be a duplication, although eaeh 0 one et thJ\ae has ite own characteristics aa pmauaorda and a certain ecological and associational individualit7 that sets it apart. In addition, neither General Si.anons nor I, nor the Directors ot these coamissions felt bound by' these name■• In 1943 1 there was this huge eutbreak ot hepatitis caused b;y the introductien of the viru.s of hepatitis into soldiers with the vaccine against ;yellow fever. There ••7 have been two hundred thousand caa••• The ■ortalit7 was not high-two percent or hospitalized ca•••• Not two percent ot the thowsands. Many- of thea never went to the hospital. We threw everything we had into this critical inTestigation of hepatitis which was frightening. !bis outbreak was frightening to General George c. Marshall and to the Secretaey of War. It was incapacitating great sections of the Air F•rce 547 Jll'ticularl7 at the time of the Battle of' Midwq. It•s a great worry-. It was tlfestqated in greatest secrecy too. To attack that probl• we used the drologiats and epidemiologists trc:n the Cwmdssion on Influenza and the Com• iiesion on PneUllonia, and the Commission on Measles and Mumps did some or the kat work on hepatitis as did the COlllllission on Tropical Diseases under Wilbur Soyer. ~ater en tke Connission on Jfeurotropic Virus Diseasesa working in the ~d4lo _.t and in Sici:Q', got deeply interested in nonoal infectioua hepatitis and its relations to post vaccinal jaundice. Well, that continued throughout the rest of the war. One of the veey delightful things about the Board was that we could under.. 1tanf each other even if we put meanings in words that were not apparent from consultation with a dictionary. That same thing, I think, struck me in the 1rganizatioa in tbe Preventive Medicine Serviee in the Office of the Surgeon General-the names of the divisions and branches. The Preventive Medicine Service got to be a huge organizatien, and it was a puzz\e to give names to all the sections and branches. Ueneral. Simmons was constantly changing t~m, and 19t they were often just names to subdivisions of one group that had done the whole thing at one time, say laboratories, or enteric infections. Those names didn't trouble us too nu.cho Yeu had to be veey precise when 1ou sent the 0 organization chart forward to be appr~ed in the Office or the Surgeen General's Executive Officer, but among ourselves, certainly •• far as I was concerned, the name didn't mean too muchJ in fact, at one time I thought that the creation and the nud.ng of subdivisions was a method of securing a slot for a promotion 0 Create a new branch, put a captain in, and make hiJll a major in a week. That was doneo Now, we 1 ve finished enough with the finances., I think. This beard-I'd 548 like when I get that sheet back to put in the amounts because it 1 s piti- fully smallo I think when lou bring those papers back1 it will shed more light on the proceas--the internal struggle for recognition within the Army. quite apart from Preventive Medicine, plus this relationship outside, again for recognition, to the new idea that was noated under the Committee on Medical Research of OSRD. Somewhere along the line, I guess, Dr. Blale was persuasive enough to obtain from Dr. Levis Ho Weed a letter to Mr. Harvey Bundy' sustaining the necessity tor this board and its financing. This early period became what was referred to in some notes that I have seen as the fight for the recognition of the entire program and a battle for the appropriation. That went on all the timeo 1 We d bet,!!.r. cane back to. that }~ecause I•a ~ust about at the eh~ here. We'Te gene on for over an hou.r• I Yes, it s twenty atter three. Iesterdaz we got into--oh1 the historical background of the Aral Epidemiological Board with sOJD.e insight into then Lt 0 Colonel Siam~~9 Sl.Dllllons was a f'ull colonel by that time• We traced smething ot bis. ~ekgr~~nd and 11!,ter.e•~• See if that isntt signed Colonel? He wrote that for General Magee--Lt. C~lonel-this letter which came out repre­ senting his thinking, or the thinki.ng~!3-thin the Preventive Medicine Section.... 1 It s the e011bined thinking or Colonel Simmons, Dr. Blake, and Dr 0 Dochez, I think• This letter was accepted-I,~ not ~si(!S proper Army terms-by the Secretaiz !r War on January l~, 1941. The letter was submitted oYer the signature of the Surgeon '"'eneral to the Adjutant General, and the Adjutant General laid it before scaebody in the Office of the Secretary or War who was able to put an endorsement en it as of January- 11, 1941, "approved" l-with llinor exceptionsJ "by order of the Secretary et War." Which gives it a verz good parentbood.1 and I thin~~t ,ie :ily>ortant in sub.. sequent develoflllen~~• That approval by the Secretary ot War was a very high and important approval. It overrides lessetpprovals, and i+as very important further when 1 I these consultants were appointed. The first Board was appointed by the S.eretary of War. Most of the consultants were appointed by the Secretary of War; in fact, we called ttea •consultants to the Secretary of War", and they were very proud of that. It had a valuable leverage in m&l\f places that they vent. This letter aRproved embodies an idea which is activated u saethin,& real in a series or meetings in February through June 1 1941. A program and a suggested ~dget ~omes out of these meeti5a. There's work aroot 1 but insufficient fund.so I I think as of that ar or for 'it ear the Board was authorized not to exceed fifteen thousand dollars. Very small. The Beard ~eemed to require ~t only the approval of its prosraa1 but fund• with ~ic~.to 15>leaent that proe:aa, and thi~ ~kes us prettr much through l~lfl:­ October. The tirat thiag tbat was dooe in the organizatioa ot the Board vu t.he decision on the nwabers or cOlllldssions to be appointed first and the direetora ef those ccaaissions. If you'll give• that penciled note, I•U refer to We talked--where is that? Here. We talked about the condssionso ! 111 just put in again for the recerd that by February- 6, 1941, sevea eonnissions had been appointed, and by Nov•ber, 1914, the eighth commissien had been appointed, and byfnecnber, 1941, the ninth commission. Altogethe\ there were ten cODDUssions, the last in May of 1942. Once those commissions were appointed, or were decided upon, directors were appointed, and the directors were asked by Dr. Blake wbo had been appointed the President or the Board, t• tormulate plans and to suggest names ot men whD would be suitable as ■embers et the C011Dlissions. That took a lot of hard work and ti.lie in the early- part ' tf 1941. It was rather rapidly C01lpleted. At the sue tiae a commission director, attar he had gathered around bi11self soae of the specialists in 1-be tield ef a particular CMlllissionts iaterests, foraulated a pregraa fer the work of the conaisaion. Field work was implicit-if I llaJ' use such a word- in the "fire fighting" conception of the Board. The coaissien withottt formu­ lating a prograa would just sq that it was readJ' to undertake inYestigations in the tield1 in cUlpa, or ia recruitaent centers, or whereYer troops Jlight be, and wherever troops 11:1.ght be faced with a problem that this particular cGIUIJlission was competent to attack. EYeeyomt had the same idea. You didn't have to taraulate a research pregraa to attack events that had not y-et occurred. At the•- time eaeh cOIIIRi.ssien could make a pregra tor the continued, long tera studies that they would carey eut in their own uni.Yersity laborateri••• That w as easily done. As yea say-1 the next iapertai:at thing, and this was siaultaneou.sly worked en with the other plans, were the efforts te obtain fund.a. Tne funds were •eded tor three purposes-travel funds tor members of the ccaaissioa, assurance that the per di• ot twenty dollars a day- while on active duty in the field would be paid, and the aoney that could be used for the support of research carried on under the auspices of the collllission, er b,- the ccamission. Tbat,as quit.e a • • probl•, a new maneuver at least in the War Department's-­ I won't sq that it was entirely new in the War Departaent 1 s support of re­ ■earch, but it vaa in larger vol- and u..i.+oro urgent cirCU11Stanceo at :,1" time than it had been for some ti.Ile in the past. The people who were dealiM with tlds subject of the financing of the Board didn 1\ understand it. The1 552 didn't understand the aima of the Board very- well and were anxio~s about federal aonq coaing through the War Department for the support or these medical in• Testigative projects. One group or people in the Budget Office of the War De- 1 part.11lent, especially the director, were st1Spiciows that the arrangements for a e!r di;• of twenty dollars a day and no l.illitatioas set yet on the amount that ■ight be 111&de available would., a a he told me, possibly give the Su.rgeen General the power to call in all the doctors in tne United States. It wa• ridiculous. He waa a very difficult man te deal with when it came to getting aoney for the actiTitiea ot the Board, and u a matter ot fact, he wasn't persuaded to approve this tr• the War Department Budget Bureau. point of view until into 1942. The Office or the Secretary or War wished to assure itself that this undertaking cv the ArtJ:r Epideai.ological Board was not something that would duplicate other things that the War Department was doing, or waa being done by agencies clese to the War Department. The agencies close to the War Departaent in the ■edical field were at this tiae the Office et Scientific Research and Developllent. which had c•• aleag and also the Natiooa.l Acadeay er Science•• National Research Council, and there are record.a in these papers we have here before us of the applicatien of the War Depart.en\ to, we'll say, the National Reaearch Cewacil, to detel"lline whether or not the Council regarded this pro­ graa and proposals for the AnT Epidemiological Board as a duplication of effort in •dical research. The War Department addressed letters to Dr• Lewis Weed who wu chairman of the Division of Medical Sciences-•I think Mr. Bundy was the ene who approached hia and in a very natural way because the National Research Council bad been set up by' the National Academy of Sciences in 1919, in accordane• with suggestions in an Executive Order of President Wilson to furnish scientific advice and services to goTernment departanents. That was its 553 function. In essence that was the function of the original National Acad-.y t! Sciences, but the National Reaearch Council was aore of an operating agency 'in its relationship to government departments than the 1"ational Academy of Sciences. It was perfectly natural and proper that the Secretary or War would call on the National Research Couacil !or ad.Tice on the validity of the program 0 1 et the Board, on its capabilities, and particularly as to whether they th?\ught it wu an effort in duplication that might be wasteful of JllOney• Tbe replies, as I remember th• and 1 •ve seen th~mcently-, both from Dr. Weed and also Dr• A. No Richarda, who was the Chairman of the Cmud.ttee ta Medical Research of the Office of Scientific Research and Development, were that the Board was n•t a duplicating mechanism, that it had a militarily oriented program that the National Research Council did not have and that it was set right in the aidt!t of the llilitary affairs in a way that the National Research Ceuncil could never attain. Although they didn't say it, they showed, and everyone knew this to be true, that Dr. Richards and Dr. Weed were very elese and adai.ring friends of General Si.JlmonsJ as a aatter of fact, the coaposition of the Board and of the ommissions was enriched by drawing into it a great man;, members of the boards and coanitteea of the National Research Council and the members of the National Acadel!T of Sciences. Dr. Blake-well, I could nUle dozens of them that had positions in both organizations. Furtheraore, they were--well, the first authorization of the Surgeon ~eneral to set up a separate subdivision of Preventive Medicine in his office contained a require­ ment that that Preventive Medicine Division should have a liaison relationship not only with the Public Health Service, but with all civilian agencies that were concerned in the field of Preventive Medicine, and it was assUJ119d-General Simmons was the official liaison officer to the National Reaearch Council and to the C<anittee on Medical Research; in fact, he was a member of he COIIDli.ttee SS4 Medical Research appointed by the Secretary of War on the recommendation of Sur~eon General, SQ this was all very natural--what we called s. o. P. It '.Jsn•t going outside of the War Depart11ent to have such relationships. r : There were some tripe outside the War D~rtment by individuals such as 1 General Simmons and Jl'\V'Self, but that was done to bring influence to bear on itficials in the government by laying problems before important civilians out­ side the government who could reach, we'll say, the Secretary ef War, or reach I ' ., ' . 1011e of the members of tbe Gene~l Staff which I will tell about mere plainly : when it comes to the story of the all•~men ts and the control of the personnel tor the Board. , Maybe Itn again being too logical, for which please forgive me 1 but this !etter--this letter of December 27 1 19401 in view of expansion, had in it a note of urgencz, The action from the first and second meetings of the Board related to a sense of urgency--that is 1 young men are COIiing into the Army1 and tiae is !!J?ortant.1 and this appeared to be something of a road block. What was a road bleck? Whether the program was goieg to be a duplication, or whether it should be supported with funds seeu to have been a duplication itself in the face of thi! urgency;. W.111 General Si.mmons and Dr. Blake certainly had the sense of urgency, but the guardians of the check books have a sense or conservatism. The country was not yet at war and a tev of them appreciated the semi-war like con­ ditiou or recruitment centers, mobilization centers, training centers. At the sue time the Anlry was increasing, getting up by the end cf 19411 to abOTe a million men, e.nd it had engaged by that time in the extensive :maneuvers that •• talked about. Those wbo were concerned in the ccnposition of that letter knew ••re than some of the people who were mostly interested in financing. Right--and I think it.s int~resting to point out that Dr. Weed's letter builds en this sense of urgency-the early experience with infiuenza and its potential explosion at any timeo Yeso Well, that was General Si.JnmcH.u 1 cleverness and wisdaa at putting the word "influenza" 1ft the title of thefrganization. Itlils an al.am, seunding an alara at the start, and influenza--you don't need to have a war to have a devastating infiuenza epidemic among people in the lando That would attack beth civilians and military- at the same time, as happened in 1918-1919. Also fromtey" experience I,• sure that a sense of urgency, or an exhibition er urgency, adds emphasis to the points or persuasion. It you just natly put that out, nobody would pay an;y attention to it. I showed you in the Manual about Japanese ■edical affairs a f'ootaote saying that the Japanese might use yellow rever for biological warfare. That puts urgency in a sort of threatening manner. I think the letter or December 27, 1940, 1s not at all owrdone. I ' it was urgent ami urgent too, in the sense that al\Y'OM knows that these thong~ things take time, so the taater you can get them going the better. I-ctmiy to it fresh•• I de-in reading this I don•t get ta• sense of sales­ manshiI? here. This is real. It's a sincere thing--of eourse it is. What is it-whatever aggravation comes in terms er delay doesn't subtract trcm the seriousness or it and the sineerit or it althou h now human robleu I in a big organizatioa like the A!!l take time. It s iateresting 2 I think1 to 556 know that 1 n one er the memoranda I read this that even the conservative forces within the War Department who had to do with finance in the verz act ef putting a lilllitation on the fund.a which could be used in 1941, also included in that order, in the event that something like iafiuenza might occur, a provision which empowered the Board to do whatever was neceasarz 1 and you can't set looser language than that. No. Also the letter had to be tairly strongly stated to overcome reluctance of the stand pat Medical Department officers. !·wondered about that. They didn't care tor this Board. They thought it was an intrusion-a lot of thea did. Theylwere-I won't say jealous. They didn't ba.ve the capacity- to be Jealous--! mean they weren't jealous because they were better; they- were jealous because they had a s1'9tem with which they were satis!ie4. They'd had years or peace. The warm and tad.liar. Yes. We ran across that all the time as will ecae out in some other things here. Ef'!erts of the Beard to conduct its work with some independence and originality came up all the time against tbe nabituated rule-governed medical e.ffieers. This accuaulated pressure and claritz of the program and its need from the National Research Council and OSRD aided not a littl••••• Oh yes. In educating personnel that had to deal with finance to release funds 1 though 557 while the budgetaa designed as of June 261 I believe, and papers were forwarded, the actual grant didn't came until some time in October 6. 1941? Yes 1 so funds were proportioned fort he zear. Just to g• outside of the Board.. National Research Co11ncil-Medical Department relationsbip--I could show yeu in books that I have downstairs how policy of the Surgeon ueneral wa• baaed on. recommendatiou trom Preventive Medicine that got. approved by special coan,~tties or the National Research Council. The whole bmunization prograa was aul::aitted....I was going to say dose by dose, but I mean aaterial by material., to the National Research Council. It would come back from the National Research Council, after deliberate consideration in a coanittee, approved, and then the Preventive Medicine Division would lay the plan before the Surgeon General f'or approval. As these things in Preventive Medicine that affected the whole Ar'JJY could not be put into force by the Surgeon General, he then had to get the approval usually of the Assistant Chief of Starr G-4 of the War Department General Starr. If you'll look at the Aray Regu• lationa, we'll say, on everything on sanitation, hygiene, inolunization, eYery­ thing for the prese"ation of the health of tt.roops that concerned the behavior et the troops, they all are over the signature of General Marshall who was Chief of start. The Surgeon General can•t give any orders in the line. He can order things for his own people in the Medical Department., but he can't issue any cemmands for line troops. There are whole beoks of •rders that are just signed by or~ of the Chief' of Staf't signed George Marshall-I mean by order . of the Secretary of War signed George Marshall. That binds the National Re- e search Council by its action in approving the recommendatioa that c"'A•s to it 558 fr0Jl Preventive Medicine, we'll say, for the adoption of the yellow fever t ,accine. It puts the National Research Council in a chain of what becomes )command. Well, those relatiou were very- harmonious. We knew nch other, and some aan troa Preventive Medicine attended every oanmittee meeting in the National Research Council that had al\}'thing to do with the work of preventioa of diseaae all through the years of the war. We knew not only the officers, but the ■embers ot their ad'Yisory colllllitteee, and we had free access to much special information that they gathered, or wu reported to them for information. Well, I think it aiEJit look on the surface of this as it it were a strictly Medical Department-War Department undertaking, but it was done in thorough collaboration with important civilian agenci••• Well, is there any more there? I think we•ve clarified the financing-that is 1 it was available in October, ~ut by that ti.lie smae of the ccan.issio11& had started working and I think in• troduced new probleu which the War Department hadn 1 t confronted-the whole matter or contract with the univers1t1N 1 the special problem--I guess itts in " Camp Cla{'borne which led to•••• Atypical pneumonia. Yee 1 which was sntoreeeen at the tiM1 but a commission lab•ratorz emerged as necessary in tel'llS et the continuity which I think you ought to go into. ~ Well, the contact-the War Department contracts-or "research contracts" '\ as we called them, contracts for the conduct ef research, were full of problems 559 that the War Department financial starr had never met before like this. They were used to coatracts for tangible objects-Rbardwaren it is called. They nre used to contracting with people that could make sOlllething according t• apecifications in the contract and deliTer it on a certain day, or suffer a penalty. They had to learn that you could not do that with ideu and biological •terialso With the latter you can•t be sure how you're going to cCllle out, and 1eu cantt be aure that the problem reuin11 the same while you~Te wor~ng on it. A Contracts had to be adjusted to intellectual fiexibility and a degree of un• certainty that doesn't exist in the ordinary ccnmereial field. These contracting officers tried at first to just adapt the ordinaey connercial type of hardware contract to the intellectuall~, and I say spiritually, variable factors that they hadn't had much to do with before; namely, the problems and the scientific inYestigatiYe methods on the one hal'¥l and the universities as organizations and the people of the universities on the other--a group of people they hadn't dealt with before and a group or subjects that they hadn't dealt with. It took a good deal of time to reach understandi~s and work out satisfactory contracts. Those early contrActs were sul:nitted by uniTersities to their legal counsel. Strong objections were made, and draft.s vent back and forth while the work was already ander wa::,. It has always been very generous or the uniYers1t1es to take on these costly' jobs tor the goverament without immediate reiabursement. It happeaed in two ways that they weren•t reiabursed immediate~-one was that some of this work began before the contracts were actually' signed, and the university paid with the prospect or being repaid, and the secend was the lapse or time that occurs between the beginning or a rucal year and the time wnea s an appropriation becomes available. There were period in all of this work A... when there was no money-tor maybe two months-to be paid to the universities 560 to meet additional expenses. Often the Congress had not acted by the end of the fiscal year and the beginning of the next fiscal year. Sometimes they hadn't acted until the seesion was either over, or about to begin. The rule was that the authorities in the budget sections of these university departments could continue to make money available at the rate at which it had been made available in the previoua part of the year, even thoup;h n~ new appropriation had been made. Often that w asn 1 t enough. There waa more work going on and need for aone:, than the older rate of pq could support, so the universities went rather far into-I won•t sa7 real debt, but tbey advanced sums of money to keep this work going out of a sense of patriotism• • The same tbinga happened to inYest-.gators who were sent abroad and moTed arou.nd, or were lost track or, so to speak, and didn't receift any pay for several months sometilles. They1ere working in the back woods ot Olctnawa, way oft in Iceland, er ?fewtoundland, or North Africa, and they didn't get any pq because this pay didn't come through ordinary Army cbaMels. The paymaster with the troops never paid this money. This money came out or a central Wasnington p&J' system with veey complicated voucher• to fill out and all sorts or scrutin;y of the items by the accountants. Finally it got paid. I have here recorda I was going to use, the actual budgets by commissions for everr I year trom 1941 until 1946. It • interesting that the total e xpeooi ture r or the ten c<mdssions over that period wa• $1,4981 044. The present ra 1- ot expendi.. ture for this Beard is about three and a nal! million dollars a year. But some or these things look ridicllloua if you look back over them. Oi:ae 79ar 1 a ex• penditure on Tropical Disease Researell here ia $540. Big coatracts of $20 1 000 with Chica~, or New York Urd.Yersity, or Coluabia wer• eye catching and startling to the people who dealt with thea, but the7•r• 8111&1.l now. I think we were what I used to call.....and do in present talks with directors of' coamissions•- 561 thousand dollar agonizers in these day-s1 and now they 1 re million dollar agonizers. ;ou ifti tialg had this Coaai.ssion on Epidemiologica-;__ ~~z, and I have that ! !•ntract here-I think I do-yese The can;elJ;cation was a contract directg: to Yale with the gower t• subcontra_ct to other institutioaa. 1 That wasn•t--what•• the date of that? This didn't start that wa7 exaetl7. It practically did though. The Comaissien on Epideai.olegical Survey was, as I think I haveecplaiaed, pri.Jnarily designed to keep watch OYer the bacterial nora in the throats and noses of I soldiers because it... s useful. It you found in a camp when you started that ien percent of the soldiers were carriers of aeningococcus, and the next week there would be thirt;J' percent, you'd get alarmed. That would mean that there are that many more hundreds of people carryi.ng the organinl. That was what we were looking tor. I now remember what you're driviag at because this is early 1942. The plan was approved by' finance officera as well as by the Board management that this ccnmission-or it Blight have been any- cOlllllission-eould be u■ed aa a sort i et a banker for others that needed moaq and didn't have it i°tbeir budget., er had oTerspent.; as a matter of fact, atter I wsnt out as directer of that cumission in 1942, it was taken onr by' Dr. Blake, and under bis direct.ion .acurring in the fields or C ot.her cOJlldssionso t. bacteriological survq or throat and nose ~ultur•• practically dropi;ed out, and tbia beCIIIM a c0Bllission which could finance unexpected I ' I that were It never had a ver,- large budget. lfo. He~ in the four areu-lst Corps 1 4th Corps, and 9th Co¥ and one other-- oh1 Puerto Rico. 562 Yes-Puerto Rico. The total for tbie 1 and this is for all purpose!,, 1• $31 1 000. In 1942? .letualy- expenditure was $13 1 000. I•m not sure that the amount ,eu gave there as being tbe amount allocated for this commission isn 1 t too large. Ia that a final contract form that you haw? I don't know. Yea, this 1• an approved contract. Tbat 1 s about the way it ran, but the expenditure• were much less than that. It ran about $18,000-1 have it in here. Soaetillles it waa ure. It [Ot up in 1944, to $76,ooo, and in 1945, tbat contract was 4tl.J6,ooo with expendit11res of $127 1 000, but it chd a lot ot interesting 5 thing. \ I'll say it did• It was very useful when the outbreak of post vaccinal jaundice came on-­ hepatitis. There was ■uch extra work to be done then. Yeu•ve iadicated that there waa cress reference amogg all the connissions so IJ that when soaetl'li.'!£ did happen, you cou1d draw ~on three 8 four, or f'iff coa- lliesiona for the particular probl•• As a matter of fact, we drew on tae capacities of the men who were attached to these cGlllllissions. Of course they were listed under the coDldssion beads. It was a cenveaient. rubric in the earlz dq•• 'but when yo11 fa!t tunctioning 1 tnez lent themselves to a wider••• Besides. :,ou couldn't anticiE!te what wu soiri& to walk over the horizon, and wbea something dida you had the wherewithall to un. The original design was field work and sueeortiy interia work in the 9• laberator7. There are two thl.91s here--wa■ there any relatien with the !!l Medical School in Washington and were there a& relationships at all with 1 tbe Army Corys Ar~ Laboratories? Yes. The Arrq Medical School in Waahington bad in the past a Division, or a Department of Preventive Medicine or which General Si.Daons was the chief. It. also had a large laboratory section of which General S1Jmoas had been the chief shortly before he came back to the 1st Service Command. There had been a long I.I standing relation between the Surgeoa eneral. 1 s Office, Ar couree, t! and the !r11J Medical School, and it got a little closer in the development ot measure■ ot preventi"f'9 medicine and materials. A noted example of that ia the t7Phoitl vaccine. In the years going back to before Colonel Siler 1 s time to General Rus ■ ell' • time, 1904, or thereabout.a when he introduoed typhoid vaccine in to the Arsr, the Aray Medical School :made all the typhoid Yaccine that tbe Anq ued. Itwasn1 t put out tor C<llllercial production, and they were continuing to make it during the beginning of World War II, during the period we 1re dis.. ,nssing. An example of how they worked with Preventive Medicine on this is round in the c011position of the typhoid vaccine. It used to be called triple typhoid vaccine in tbe earlier days because it was composed of typhoid. bacillus, paratyphoid A and paratyphoid Bo They decided that paratyphoid A was aot sat'ficiently prevalent to justify its addition to the vaccine, and that it ought to be eliminated to reduce t~e reactions. fyphoid giYes you quite a red spot on the arm where it's injected, a little fever and malaise £or a couple of dqs. It you could remove soae ccnponeat ~bat had the capacity of causing these symptoms, you could reduce the disccaforts ot the vaccination, so at the beginning of the war paratyphoid A was not in the vaccine, but the National ... $64 ltlearch Council in auwering a question from Preventive Medicine dealing with Vit literature though,that paratyphoid A would be met suffieientl;y often in Ua• regiona to which troops were going to be sent to justify its return to the nccine, so triple typhoid vaccine was adopted almost-well, in 1941 anyhow. 11,e got it downstairs in a book, but that is oae example of the relation ot P,enntive Medicine to the A-rsr:, Medical School. The other taing--the Board is not so auch concerned in that. This is ao,tJ.t PreTentive Medicine to the J.fflT Medical School• Your questior.a was what the Board had to do w:t th the medical school. I••• Tllere were,'1.a existence Coros Area Laboratories. 1N we tallciag abollt tile Board., or Well, General SiJlmons fostered laboratories all the tme. we talking about PreventiTe Medicine? W11re talki.Dfl about the relationship that the Board·•" abt have had witll an m.sti9 Mdical school ~n the A1!!l and the existigg Corps Area ,Laboratorie•• The7 didn1 t have an;y official connection with them, but they worked with th• and were aided by the facilities there. When the Board investigators would go out to a region, they often used the Corps Area Laboratoey as a base. They n would use the ArJy Medical School as a place tor scientific cCD111union, for '\ WeP.I?) exchange of ideas, and for certain materials. There (\ Tery fine people at the AfflT Medical SChool who could give th• adrlee on tbe problems they were Meting ill the field, but they had no organic connection. I asked this because there is a phrase in the ,coptract with respect to supplies where you could draw whatever possible traa medical. supfll: which would imply !nstallations, or laboratories. S6S The camnissio11S when they went out? Ytea and yet anything else that you couldn't o~y.in through existing SUpPlies, l!U could buz directl.J:o Yes, that was put in, I imagine-I don't remember now it was. that's an actual thing for govermneut purchasing agents to require that they use the stocks they baw. The people who handle supplies in the military- don't like noutand.ard 1 '8118. They don tt like purchases outside when the material can be drawn from stock piles or supplies. This is quite reasonable, of course, because standardization is 'Very illportant in the Al'IQ" tor educe multiple types ot the same thing. Take the standardization ot scissors. There's an endless aount of different scissors that surgeons want. The sae thing is true about in.gs, but the great standardization process is going on all the ti.aeo The Board wouldn't care particularly' about standardization. These men on the cOllfflission were used to buying drug• and things trom their local drug storN, or pharmaceutical houses. In addition, the gowrnment-buying in such huge quantities as it has had to-eTen. before the war could get these materials and drugs aueh cheaper than the cQllllissioas cou.ld buy- them.. But to have an itea in a contract which enabled civilians in the field to draw SUP,I?lies from. existing medical aupeliea,_ I think1 is a novel wrinkle-civilians they were. Yes, tbey were civilians with a kind ot a cloak on. They didn 1 t. have to account for this uteriale They drew very large amounts or it in saae place■, as in tlns Respiratory Diseases Ccanission Laboratory in Fort Bragg. I can 1 t recall &DJ" difticultiea. Tb.ese~eople were sensible people. Nobody oTerdid. \/ I ne"r had any iad:l.catioa or graft, or black market work, or anything of that 566 r,ts was set up to enable them to function. It had that in l'i.ew. Yes. Those laboratories were very helpful. For instance, the 4th Corps .&rt& Laboratory under a ver, able c mnander was a beautiful place. They dlfeloped a aobile laboratory-big trucks, which our caud.ssion people used. It wua' t very satisfactory, but they• d take this truck out of there, and it was filly equipped with media, stains, chemical reagents, standardized reagents-all right there at the hands of the C<IIDYlission. The cODllllission you speak of at Claiborne started in a relatively informal R'f• A peculiar pneumonia broke ollt, down there in 1941, I think, and the people who vent there first to look at it were Dr. Ao R. Docbez, Dr. c. M. MacLeod, and Dr. Yale Kneeland. They came back and said that they had found a peculiar pneUllonia which they called(~/pneumonia. It's now proved to be due to a wirua-like organism. that was disconred by Monroe Eaton. He discovered ii atter he 1 d gone out of rq laboratory in New Raven. A subsequent investigative teaa, composed of Dr. John H. Dingle, Dr. Barry Wood, and Dr. Gerrit J. Buddingh didn't need a great deal of material. They had unlimited facilities tor x-ra79. Their studies were largely x-ray studies. This peculiar infiltra­ tion in the lungs had a characteristicf x-ray appearance, and its distribution ii hard to recognize by pby'sical diagnostic means, but the supply of x-rq til.Jls and x...ray service was like what you've been talking about. There was no charge against the group of inTest,gatora, or the commission they- represented. Out or that experience the Board is confronted with thee etablisblllent of a ~ontinuigg laboratorz•••• For respiratory disease•• 567 ~ch was not anticipated in the original program. There's no erticul&r reason why it should have been. What were the considerations that weighed in ~ingle 1 s mind. Hets the one who presented this as a possibility. Well, what weighs in the mind of the Carunission on Respiratory Disease, is before them in the title of the board--"in!luenza and other epidemic diseases." : Respiratory diseases in new recruits are predominant, the most prevalent of all the conditions they meet. 'l'he dangerous epidemic disease• in recruits are well known as respiratory diseases, including infiuenza and now we know a lot of other virus diseaaes. The pneumonias of several types-pneumococcus pneumonia, streptococcus pneumonia, bronchialtneUJB.onia, lobar pneumonia•-the pneumonias belong in the respiratory disease group, and the third main condition they meet is the gastrointestinal infections. Typhoid fever was no longer any problem., or no special problem to t h e ~ and the soldiers ot the Second. World War, but diarrhea and dysenteries were and still are, and I can say right now that we 1re going through very difficult tilles with respiratory diseases in the Arar, in the United States with the increasing recruitments. Dingle was interested in respiratory diseases. He primarily" was iftterested in Boston in meningococcua infections, but he saw the scope of the problem and the scope fitted his sense of capacity to devise and design and carq out faithfully' and constantly and over a long period the most difficult clinical and scientific investigations that existed almost. He couldn't do that by periodic appearance at a caap. He had 1D be in a place where he had a big laboratory, a large start of competent people, a hospital in which there were apt to be many cases of repiratory disease. You had to be in a place where they occur, and in the Ar'ST you don't send from hospital to hospital very much the people who hare sore throats, or upper nasal pharyngitis, or pneumonias- 568 they stay at the hospital oa the post. He could have chosen Fort Dix, it he had wanted. to, because Fort Dix had plenty ot that kind ot trouble. Fort Bragg " ~ partl.7 because it was a very large post. was ch~_,sen I think Bragg had a strength ot eighty thousand, or more sane times. It had a big hospital. It had a very advanced statt or clinical chiefs who had come into the A:rmy out ot private practice, or a uniTersity practice like Dre Worth B. Daniels, a leading physician ot Washington, and a nt111ber of other men who were glad to cooperate with a group of imrestigators who would come in. In addition, the kedical Chier at Fort Bragg was then Brigadier General H. c. Coburn Jr. He had set up one ot the best aedical establisbaents in the Antr, equal in many- respects to ao,tbing I think we had aeen in civilian lite. e He had a large medical h~spital there. He had a large medical dispens&r7, an.a lle even went extensi"81.y into the prenatal care or babies expecte4 to come to the dependents around the eaap becaase there were 111a07 people in Fort Bragg. He had a very intelligent venereal disease prograa. He had a camianding general Major General Do Co Cubbison, who was in coJ11111u!d of the Field .Artillery Re­ placement Training Center. Th• acronym, of that doesn't sound too well, it you put FARTC--so we were careful. I guess you were. Field Artillery Replacemem. Training Center--C instead. of S at the end. Major General D. Co Cubbison was receiving thousands ot recruits. Bragg was a Field Artillery Center. It was an unrivaled opportunity for Dingle to get at what he wanted of the appearance of respiratory diseases in men just brought into the A:wy. He•sn 1 t depending on the hospital until these men got sick. or com-••• There was no other s:2milar place that had so maa;r inc0lling susceptibles that were sure to come down with scnething, and Dingle is a very remarkable investigator, ctt.d superb work down there, and in addition we were able to supplement. his subjects with. hundreds of conscientious objectorso Dingle'• laboratory was extended by- a hotel, a near-by hotel that we took over under contract--we had money for it--inwhich were housed groups of conscientious objectors who allowed themselves to be sprayed with material that was thought to contain the viruses of these infections. Dingle produaed experimentally atypical pneuaonia for the first time. He produced other things. One extraordina17 thing about Dr. Dingle wu tbat he saved in frozen state samples of practically everything he got from patient•• or was using trom patients. He had thousanda of specimens frozen, specimens obtained in the period froa 1942 until 1945. He then went to Cleveland as the Professor of Epidemiology- and started. a study of respiratory disease• occurring in the f'amiliee in Cleveland. He was at Western Reserve, but about that time there began to appear at Fort Dix and elsewhere people suffering with what he ~ I ealled undifferentiated upper r"apiratory tract infection. He d never been able to find the cause down at Bragg. Coincidentally, taough, in the latter period Robert J • Huebner at the National Institute of Health and Maurice R. Hilleman at the A.ray Medical School b.ad discovered several new respiratol'Y' tract viruses, adenoviruses, so using those new viruses Dingle could go back into his collection of frozen sera and do complement fixation tests. Ten rears or more af'ter the war he began to work out the pattern cf undisclosed respiratory diseases that he couldn't do an;y other time because he bad savee the specimens and these new viruses had been discovered. That has been one of the fine examples of how military findings can go over into civilian practice because the importance of this was eeen, and it was possible to make proper vaccines for soae of these special virus infections which was beneficial for the troops as well as civilians. The trouble is that there are so ma'DY' of ........._ 510 these special Yi.rus infections. So many- varieties are occurring all the time t that its difficult to keep up. The creation of this laboratorz raised, again, a financial question. It raised an acbrdnistratiTe question because there was opposition to it, and it was difficult to getrxactly- the authority that was wanted. Among these ! papers is a letter signed by General Magee under the line by cOD1111and ot Major General Brehon Somervell. Major General Brehon Somervell was the COJllllanding general of the Artlf:f Service Forces which by the reorganization of the War De- .,_ partment in March 9, 1942, w~• the new controlling element over the Surgeon General. The Surgeon ~eneral by this reorganization lost his staff position. He had a whole lay-er ot c011malli put between him and the General Staff, and he '\ was relegated to a very inferior and unoo,&ortable position. He couldn't do anything really without the approval of General Somervell, but it was possible in ways that I don't really recall entirely now, for Colonel Paul Robinson, head of supplv at this moment in the Surgeon General's Office, in consultation with some people in the Army Service Forces to devise a letter--what is it? Here it is. A letter on Auvust 12 1 1942, addressed to the Commandine: General of the 4th Service Comm.and, and it was thens. o. s.--Service of Supply; it wasn't the Array Serviee Forces yeto It became Army Sernce Forces in a very short time, but this reorganization had put the Surgeon Ueneral under s. o. s., under General Soaervell 1 s jurisdiction, so this letter was addressed to the Commanding General, 4th Serrtce Command, s. o. s •., Atlanta, Georgia, for the attention ot the Surgeon. The Surgeon was Colonel French. Colonel Sanferd w. French was not particularly' involved in the implementation of the requireaents in this letter. Be merely passed it on to General Coburn at Fort Bragg because $71 the letter asked for the)e stablishmert.-well, really directed. the establishnent ot this respiratory disease laboratory in Fort Bragg. Somehow or other it was possible for me, General Sbunons, and Paul Robinson to get the approval of the Surgeon General to sign this letter and the substantiating signature also ot /.l Colonel John Rogers who was the Surgeon GenerO.laits Medical Department Executive -re; n Officer practically telling the 4th Service Command Medi~ Establishment to set up this laboratory, give a building for it, or put aside a building for it, enlarge some quarters that the C0111D1ission laboratories already occupied, provide cooperation, provide certain supplies, transportation, securi v, a ssignmeo.t of additional personnel and technical assistants, and really put Dr. Dingle and the Respiratory Disease Laboratory in bllSinesso When General H. c. Coburn got this letter he tboug hl,;1 I suppose, it was somebody1 s dream that had little substance, but after a week or se, I remember u he drove ~ riedlr up to Washington and came in to see me--I dontt think General Sinaons was there at the JllOllent-and what he said was 1 "My God, I just realized that this was a cOIIUlland letter." He took it as a command letter, and so did e-werybody else. From that manent on this laboratory did superb work. It brings in bz way of supPort-the ~ finance group were what they were_, but ~ there were efforts an uccesful efforts to accu11.ulate a fund establish a \ fuad to sustain this laboratory f'ran outside goverment sourcee--foundations. Not much. It 1 .s to be noticed too, that this was August, 1942-the war was on. We were deep in the war then. Patriotic feeling was high, and you could do things in this period that you couldn 1 t possibly do in alack time, though Simlons did interest the Markle Foundation and the CQDlllloDWealth rii'und 572 too, I think. He even tried to interest the Rockefeller Foundation to supplement Army support with graDts, but that ne-ver reall3' amounted to much. He had a much larger project to set up tropical education with a grant tran the Markle Foundation along the Central American Highwa7 in Nicaragua on through Panama. §nitiallz I think the problem arose as to how to accept whatev~~ grants wer~ soing_to be .ma.de and the s rate fund I believe in New Haven. I think we found out that you couldn't make grants to the Ar,q. Yes, so they set this up under the Dean at lew Haven. The -·Pl"esident ot this Board. Yes. I have one or th••• folders down here-Foundation Grants-where the policies and all are discussed 0 I put that aside because I knew that•s an interesting developnento qertainlz novel for this time. Here it is 1 but there's nothing in the ~older. I must ~ave eulled that outo Well, it was just a mechanisa to•••• Here it is. It was just a mechaniftl to make money available. What you've just shown me is a handwritten copy of mine of a memorandum to General Magee trcm me June 22, 1942, in which I told of the interest ot the CODIDloawealta Fund., the 573 Rockefeller Foundationt and the Markle Foundation in making grants tor the support ot research on acute respiratory disease ■, the gra~ts to be adminis­ tered under the Army Epidemiological. Board. I said in this memorandua that the amou11t may be as much as a hundred and fifty thousand to two hundred thousand C dollars, that after consnltation, the best way t~ proceed would be to permit the foundations to uke the grants to Dr. Blake for use of the CGllld.ssion on Acute Respiratory Diseases under the supervision of the Board, and that Dr. Blake is read7 to accept the responsibility. He did so. This was approved by Brigadier General Larr:, B. McAtee who was Acting Surgeon ueneral. at the time. He got the memorandUll on June 22nd, and he approftd it on June 23rd, and the same day I wrote Dr 9 Blake to go ahead. There are all sorts of background notes •n how to set this up. This is all right. Dr• Blake was the agent. I think ~ou pointed out t.he a•ene had shifted. by 19421 and it was possible to do a lot ot things•••• This is June, 1942 her•• !!,• which zou could n~t have done in Jaru1arz of 194,!• V S I 1ll gi~e you an example of very- modern tiaei\.. The Armed Forees Epidemi- ological Board has just celebrated ita 25th annivers&r7. The total cost of ., \ this cereao!O" and celebration is probably ■ore than two tho,~mi dollars---! I don't know bow much it iso The payment of tta,.,t slJlll partly ccaes from available R appropriations fo~ travel, or whatnot in the Medical .Department, but most or it has come from outside. The way that's been handled for this function of the Board was to s et up a bank account in Boston in the name or the President or 574 the Board at present, Dr. Gustav Dammin, and beta paying the bills out of this money set up for the Board. I don1 t suppose the goverment would care ver, much where an account was set up to help one of ita agencies as long as it didn 1 t have to administer the fund and be bop~ by any policies of the fund• The only distinction ltd make is that there is a ditferenee between a ceremon.r and a full scale laboratory innstigation by Dingl.e 9 Out or this comes the need ~uipn.ent too1 which is a coJD.plicati!S thing becauae thay are novel thing• that are needed--not nuts and bolts that the War Department is used to and this foundation money may have facilitated that. Having this fun~ available •z have facilitated the reach tor machinery. J. 1 Sure'"""'luicker and with greater treedaa. ve seen some mquisitions for equipuent batted around and batted around. One man will put an endorsement on it sqing ue this, and another oae saying use that. Also, the foundations must have been aware of the nature of the prograa1 the validity of it, and the possible general u.se of the findings. Yes, well each one ot these discussions there wita the foundations are not with the Board of Directors of the foundation• but with the scientific directors. The Discussion with the Markle Foundation were with Fo s. Russell• the Camnonwealth Fund with Laster Evans and the Rockefeller Foundation with Wilbur Sawyer. You were talki!S a common language. Yes. And it was a matter of exJ?!diting utter•• Dingle was a--I don't know. ,I set 575 this f'rom some of' the correaPondence 1 a real impatient fellow to get started. = Dingle was always impatiento He wanted the most extraerdinary- amount of 1 everything all the time. He d ct1me see me about once a month with enormous requestso Dingle was a man of imagination. He wasn 1 t\{elfish in any of this. I wasn 1t that but he was cbUl enabled him to at least get startea. Well, we 1ve gone longer than an hour. I guess we 1 d ~tter stop. We can come back to this tmorrow. We haven't finished this financing because I think you ought to dictate y-ourselt in there something about Robert Tatt coming to our help. We can cme back to that tcaerrow. ill right? Leave that aaterial soaewhere. $76 Sneral days age yeu asked• rq recellectieu e.f' the werk aad sigll:ificaace ef the CNlllittee •• Scieatific Peraeuel et the D1Yisien er Medical Scieacea et the Natieaal Research Ceuacil ia 1940. I was ••t Te'r'T clear ia rq recellectieu whea I spen abeut it t• the lllicreph••, but siac• then I have N'Yiewed s••• ■aterial that I ui ia the precess et usiag fer the writiag er the first velU11.e •f th• Histery er Preveative Medici• ia Werld War II. Ia the first World War there was•• qstem ef classificatiea e.f' scieatific aad aedi.cal perseuel. They dida 1t knew what a 11aa•s qualificatiens were. They- didn't kiln hw te assign them0 They had all serts er lllisfitB. They e didn't knew hew t• tra•sfer peeple fr• ene jeb te aaether becauaQ. they hadn't \ this iafermatiea •• qualificatieu. That applied t• m.&IJ1' surgeeu, aaay physiciau, and many peeple ill lewer grades i1t"~echnical services. Th• eut• I standing••• like Dr• Ziuaer, Dr. Siler, and peepl• wheres• te be Saaitary Iaspecters ef Araies, er Cerpe were easil.7 place~, because they were well lcaewa---like Haven &lersea whe was great in public health. They kaew where te place hi.Ill, but there were 11&ny, maay ether ■ea wh• Oeaeral Merritte w. Ireland as the Chief Surge•• ef th• A. E• F. ia 1917...1918, ceulda 1t very- well place becattse he didn't have aa;y systematic measurement et their training, their oapacities, and their experieacee. That was the reasea wby- with the seue ef the possible oncemiag war in. 19401 the Natienal Research Ceuacil set up a Ce11nittee •• Seieatitic Perstanel with a view te dertsing systems et classificati•• that weuld be et value t• the war effert, ••t just the Surgeon General. It was fer the War Maapewer Beards that were fonniag abeut that time. Yeu asked meals• a day er a• age what the relati•• ef the Natienal Research 577 Ceuacil waste the Office er the Surgeen. General in technical aad pelicy matters, and yeu •••med te think that the liaise• and censultatiea betweea the Office ef the Surgeen General and the Di'Yisien ef Medical Scieace1 ef the Natienal Research Ceuacil and the censultatiea that the War Department., the Office er the Secret&r7, had with the NRC was seme pessible indicatiea that the War Depart.meat and its agencies were geing eutaide the War Department te get iatlueatial advice. Well, as I explained, that wu very utural because the Natiena.1 Reaear&h Ceuncil bad been set up in 1919, by the Natienal Academy ef' Scieaeee ia reapeue tea suggesti•• ia a• Executive Order ef President Wileen as an ageaey te render advisery service in the fields er acieace and mediciae te the War De­ partment and ether agencies. Well, ia 19401 with the i.Jmnanent appearance ef invelvement in the Eurepean war, the Natienal Research Ceuncil began tertudy the classificatiea er medically traiaed peeple, peeple in the field er medicine and public health, and that is acknewledged very clearly in the publicati•• abeut medical perseael ia Werld War II where it states plai.111.y that this classificati•• system suggested by- th• Natienal Research Ceuacil fer the designati•• er the proficiency ef men and their specialties was the first eae adepted by the Medical Department. They adepted the NRC system er specialt7 classificati•• and the rating ef etficera, aad that wu the basis ef the much mere extended study by the C911111ittee •• the Natienal Rester er Scientific and Specialized Persennel which was under the chairmanship ef Leeaard Cal'lliehael werld.ag chiefiy under the War Maapewer Cemmissiea, I thiak it wu called• That teek ia aa enermeus aeunt et area fer study aad classificati••• 578 eut in bis repert, it wasn't a Civil Service ebject that they had in made It was a ceaplete classificatien ef the talent ia science and medicine ia the ceuntry. He cites examples; that they actually supplied ia a11Swer te requests the names er tw• men whese iacae was ner tw• hundred theusaad dellara a year. Theyw eren1 t seeking a jeb, but they had high qualificatiee fer scie11tific w•rk. Th• same thiag applied te the classificati•n ef the physicians ia the c•uatr,y. The Surge•• Ueneral'• classificatieawu ceupled with the American Medical Asseciati•••• attempt at classificati••, aad the Surge•• Geaeral•s iaterest, ef ceurse1 was the classificati•• ef the specialties aad abilities ef pe•pl• wh• were ia the A.ray aad peeple wh• were 1a the Medical Reserve Cerps. I men.ti•• this ia s• much detail te make up fer what I left eut the last time and te indicate tw• things. Oae is that 1• 1940, the first definite, in­ valuable classificati•n ef specialties and c-.petence in the bread medical field caa• abeut. This was rather slewly utilized aad devel•ped ia the Office ef the Surge•• General. As a matter of fact, it didn't ceme int• exactly the erderly manaer that it needed until Octeber, 1943, whea a Traiaiag Manual et the War Departaeat published in Octaber, 19431 carried ever the classifications that had beea werked out jeintly by the NRC and the Surgeea ueneral 1s Office and had ia additien a cede attached te it, a system er aumbera-a faur digit auanr with a letter ea it. The letters A. B. c. aad n. indicated grades •f c•peteaceo The numerals iadicat•d specialty and sub-specialty experieace. These were knewn thereafter as MOB--eeaning Military- Occupatienal Specialty. I think it 1 o a good oxaaplo of thetcooperation of tho silita17 .. tablishmo~, beth general aad medical, with a great civilian agency like the Natienal Research Ceuncil. I thiak I may have miscanTeyed ia a sense. Oae cu leek at the beek published by James Phinney Baxter and get a whell.y wra11g impression as te what c•eperati•• 579 !!!.• Baxter had 11ethi11g ta de with this. He was OSRD. Y••• but ia writiy that up 1 he s• cenceatrat•• •• that agency that eae can gain 0 aa impreesiea that semehn er ~ther there were walls. My impressiea ef the Baxter beek is that it is bia•ed1 aad that the twe velUlles--y•u knw that there are twe vellllles-ar! iudequateo I dea't thillk: that Presideat Baxter kHW what I 1m talkiag abeut. Yes, and this begi• ia 1940• Leag befere h1stt1me. There's the decwnentatien er it ia same er these beeks. I waat t• g• and get thato Yesterday I was asking abeut the relatieuhip between the Beard and the Anq Medical Scheel and the varieue Cerps Area Laberateri••• aad yeu had respeaded. Then it eccurred te yeu te s• •• iate aaether relatie11Ship abeut which I didn 1 t knew and hadn 1 t uked z•u-the relatieuhip betweea the Preventive Medici• Service aa it develeped and the Quartermaster C•i:J?•• Well1 the r elatienship betweea the Medical Departmeat and the Quartermaster gees back at least t• 1775, when these twe effices were mere er less started because the Quartermaster was respeuible alwaysf•r subsistence, clething, ehees, teatage 1 shelter, and many et the physical thiags that a seldier had te use te care fer his health. Ia additien, the Quartermaster has always beea respensibl• fer the pre'fisien ef ratieuo He has se much cencern ter th• preservatiea er the health ef treeps that it is impessible te draw a liae be­ tween medical preventive mediciae aacl Qµartermaster preventive medieiM 1 and 580 that has beea ever the yeara, siaee the Republic started, a seu.rce er beth disc•rd aad c••perati•• because the Surge•• General, the head •f the Medical C Department, has the ppilrl.en that aaythiag that a.ttect■ the human 1ndivi.dual1 .; I anything dene in the AI'lfl7 affecting the physielegy •l the~••• individual, is ia the field •l aedicine aad that the Surgeen lien.eral eught. t• han the ma:i.a say. The Qu.arteraaster, •• th• ether hand, has a breader peiat er view, sayiag that these &N physiel•gical. ruactieu that d•n•t have t• be studied aad :maaaged. by aedical peepl•• I perseraally had this ceanict be!ere me ia the Pre"Yentive Mediciae Service aad even ia parts e.t the werk er the Army- Epidemielegical Beard, bu.t ha'Yiag beea at udical scheele where the Pretesser ef Physielegical Chemistry was a Pb D decter aad net aecessaril.y aedically triiaed, I ceuld well uaderataad that y•u dida 1 t. haTe te haTe aa MD t• be able t• be cempeteat and very valuable in the field et health and aedical care. The peiat I waated te briag eu.t ia •ntieaiag the Quartermaster wu the relatienship specified ia 19401 whea General Simmens came int• PreventiTe Mediciu, and succeeded ia May et 19h01 111 haVing Preventive Mediciae set up ae a separate subdirtsiea withia the Dinaiea •f Pretesaieaal Services. PreventiTe Mediciae tua:tiens had been ditfueed threugh that Prefessienal Service Divisi•a ia a prett7 •arly UR• reoegaizable tashiea. When Geaeral Simneu get the Pieces tegether and dratted the statement et functieu that the Surgeon General appreved and issued in ene et hie effiee erdere, he included ia the statement et fuactieu that the aub­ dinsiea ef Preventive Mediciae weuld have liaisea with the Qllart■nu.ster De­ partmeat regarding feed suppliea, water supplies, waste dispesal, iuect ceatrel1 heusiag sites, sallit.ar,- appliaacu and bathiag peels, nillaing P••l•• In ether werda, the first charter et the sub-d.1.Tisiea ef PreTeative Medicine reiterated tuactieu that had beea pertermed ever the past century •r aere, 581 aad they were very specifically stated here as a mai• fuactiea aad ebligatien ef this new sub-divisien.. It was quite natural that this liaisea sheuld eccur, alld it did eccur with great prefit t• beth eides. It was haraeaieusl.y" devel•ped by General Si.Jmleu wbe was a friead •f the c•l•nel whe became a general, Brigadier General Geergea F. Deriet, ia the Research and Develepnent Divisiea ef th• Quartermaster Cerps at their experimental lecatiea at Lawre•c•~ Massachusetts, and later at Natick, Massachuaetts-just eutsid• Best••• At that time the Quartel'll&ster and his Research and Develepment peeple had established fiu w~rking relatiea­ ships with the Fatigue Laberatery- at Harvard aad with the autriti•• departments ia varieu parts er Harvard Uaiversity Medical Scheel. They had wide iaterest ia fabrics fer clething. They be~a• te get interested ••re and mere in ~ 5 climatelegy-1 the acclillatizatiea et seldier■, the study et the r~r•ues et seldiera te heat aad celd. They had a c•ntiauin.g iatereat ia the feetwear, the feetgear •f seldiers, as the SUrgeen General bad al••, datiag back particu­ larly- t• the tiM et General Mu11Sea wh• develeped the Muns•• last aad made aa Arq shH that ude it pessible fer the seldier t• walk f'ifteea miles ene day aadwalk f'ifteea miles aaether day'. Up te that time they had sheee that •ramped their feet, defermed their feet, caused blisters, and the Munsen study Q. at Fert Leve~rth ia the 1880s, er 1890•, revelutiellized ideas abeut the " feetgear •f seldiers. The Quartermaster was deing s,mewhat the saae thing as was being deae ia Preveative Medicine. Parallel with the develepmeat ef, we'll say, sautaey engineering ia the Preveative Medici•• Divisi•• et the Surgeen Ueneral•e Office, there was alee saaitary engiaeering ill the Quarte:naaster Department. Iaterests were cmmn••• The lines ef eadeaver were parallel, but ut ceincideat all the time. What ltm trying t• say is that there was•• real duplicatiea er .582 e!fert, altheugh we were werld.ng in the sae field and the same werds were m,ede I think that says about all I wanted te briag eut ia that ceanectie11. The Chief ef Medical Histery has had Quartermaster auth•rs fer tweer three velumes ea the Qusrtermaster Cerpe in Werld War I I which I have seen but dt net have befere ae an. They emphasize what I 1ve said; that the Quartermaster Ctrps ia Werld War II, as befere, had the principal business of previding fer btusing, feed, clethes 1 perseul equipment, fuels fer camps, laundries, baths and ether services, and many-, many things ceuld have been censidered te be in the field ef public health and preventive medicine. Quite early there was a study ef the ameunt •f space-evercrewding ef men in barracks. That was dene by the Preventive Medicine Service which called upea the Anly' Epidemielegical Beard• In 1942, I think, we were asked by the Sur gee a General te make a survey •f the cenditiens in barracks with special relatiea t• the aaeunt ef neer space, er the ameunt et cubic feet space alletted tea seldier ia barracks. What was dene illustrates the value er tm Army Epidemielegical Beard te the Surgeea General ia makiag available t• him expert cenaultaate ia the field, maa very breadl.y' infenned and men e:t eaineaeea It iadicates alse that the Beard ceuld undertake a study ef this kind wi theut being restricted te the use ef a named cemmissiea. A greup was appointed headed by Dro Perry Pepper whe was a great physician from the University ef Pennsylvania, from the very distiaguished Pepper family, a maa whese speech had been influenced by his patrenylll. He was very witty aad peppery. He wrete a btek en medical etymelegy which is very witty. Well, this greup et peeple assembled areuftd Dr. Pepper and fermed a sort ef Cellllli.ssien •• the Heusiag ef Trteps. At that time the Surge•• Geaeral 1 s pretest at actiens taken by the War Department, which resulted ia the crewdin.g •f men i11t• barracks, had been futile. They11are futi+e because General Marshall was net at all cenvinced that it was necessary t• previde mere space, considering the then great shortage •f buildimg material and the shertage of lab•r• Fleor space-I forget the required ameunt. I thiak it was ar•uad fifty square feet per man. I ferget what the regulations were, but they were av•ided by the billeting peeple, and as a result soldiers were actually crowded into about half the space that Anny Regulatiens said they should have per man. This Commissi•n on the Housirag •f Treops went all around the ceuntcy, visited a number of peats, and made observations and measurements-◄bservatiou •• hew the men were liviag regarding the space available in the barracks4 They made a repert aad strengly urged the Surgeon General te forward this repert te the War Department f•r the c•... sideratien ef the General Staft,asking that steps be taken te preVide mere square feetage per mania barracks. General Marshall was iaterested in that, but he disappreved •f the recemmendatiea, and it turned eut that the General was quite right. We aever had an epidemic ia Werld War II of any seri•us cen.sequences, and the crowding centiaued right•• threugh the war, but c•uider the crewdiag •n tr••pshipa like the Queen Elizabeth, er •ne et th••• beats which carried fifteen thousand men •n ene trip. Feu.r bunks high. The bunks were never empty. They slept a group for eight heurs alld then let them go semewhere else and had an•ther greup c•e ill and sleepo They had three shifts in these bunks per da7•-beye8'i belief• They didn't. have any severe eutbreaks •f disease en th•se ships. Mest of the eutbreaks eccurred ia tran.s- 584 C, perts and places that had ~~•r latrines, peer "heads" as the Navy called them. They had much diarrhea and dysentery attributed t• fecal eentaminatie• ia these evercrewded and dirty latrines, especiall.7 ea transpert•• I knew somethiag abeut this because with the aid et some peeple trm the Beard--I ferget, but perhapa the Ce'Dnissiea en Cress Inf'ectieu, Airborne IRfectieu, we made a study ef the air systems ia the Queen Mary ~nd the Queen Elizabeth, as examples, at the Pert ef New Yerke This Cemmissien en Airb•rne Inf'ectiens had discevered that spraying prepy'lene glycel vaper ia the air weuld sterilize it. We tried te prevent respiratery disease in barracks by spraying glycol vapors ia the air, and they seemed te be effective ia see cases. The idea waste see whether we ceuld de this •• thee big traneperts like the Queea Mary- 0 The ene er twe visit• I ude te the Breekl.y• Yards where these ships were decked, I teuad eut, fer example, that the QueeaMary had seventeen separate air ventilatiag systems in that huge beat, and that the air was changed every- few heura. Well, I dea 1 t (. rem•ber hew much. It was cal-.ulated that evea te get the S11&1l ceaceatratiea \ et glyeel 1• the air that was needed, yeu 1 d have te fill halt the sbip with barrels ef glyeel in erder te have seae te spray because as seea aa yeu put the spray in••• et these places, it weuld be sucked eut and bleWII away. Ia additiea, tm Taperizing lll&Cb.iaery and the added plumbing that weuld g• with it te dieperse the &pray weuld take up aaether let et re•, se we didn't de But Geaeral Marshall-well, I dea1 t want to put this ia here/. What's that? That'• bl erder •f General Marshallo What I was gein.g t• say is this preblea et space ia barracks and in hespitals is cemplicated by' the deubl• bunkingo This was studied by Dingle aad the Airbera• In.f'ectuen. 585 Well, it isn. 1 t enly the erdin.&r7 respirat•l"3" illf'ectieu that are cen. cerud in this, but als• the airberne mellingececcal illf'ectieu. Epideaica et aeaillgitis eccurred rather disastreusl7 ia W.rld War I. A greup et English i iaveetigaters, whe saw tne7 ceuldn 1 t de anything abeut gettiag ••r• space !tr men. ia eroded barracks ia Eaglalld, develeped a syst• et sleepiag head it feet, s• that a man weuldn 1 t ceugh right int• the race et the ether man, but yeu ceuld watch them and see a man sleeping with his head te the Nerth and 0 uether man with his head te the S~uth, and if the maa with his head te ths Herth starts t• sneeze and ceugh, be i11Velu.atal"3" rises t• a sitting pesitiea I aad is ever the man next te him a11d ceughing right teward him. He s net ' ceughiag up int• the air. It didn't werk vel"3" wello As far as deuble bullld.ag1 eur ccmmd.ssieu as well u the sallitaey efficers tf Preventive Medicine were et twe ainda. It l••k•d u if deuble bullld.ag weuld add te the preblema caused by crewdiag because a deuble bunk was put in place where•• bunk was betere, but u a utter of fact, my iapressi•• and the impressien er seme ef the c-1.ssiea members was that the deuble bullkiag ia barracks was preteetive. It separated the men, and it reall7 aade it pessible it take a space allecated fer twe men and eccupy it by what yeu aight call a Siamese Twia-tY'J)fl ef arran.geaeat, where the two ••• became •• ia the deuble bunk, sleeping •ne ever the ether. 'lney had actually ••re space areuad. them than if they- had separate beds. The whele problea is caplicated b;y ether things ia cmaps fer treopa--d• 1•u want all this stuff? Couider what happeu ia the wash reae alld latrine•• Yeu nave fifty-••• ia a barracks, er fifty ••n •• a neer, we 1ll say, alld they all have te ge to 586 tbe bathr••••-t• uee the pelite upressiea an--abeut the same time ia the aerni11g. Th.,.-'re all c,~iag aad spitting at the same ti.lie. Tbey 1 re cleaaing •eir teeth at the same ti.Ile. They1 re washing themaelves at the same time, It tbat these "facilities", aa they 1 re called, becama eccupied by' peeple lhtulder t• shtulder, back te back, all serts of miagliag, se that if yeu had plenty tf eeparatien aad space ia the sleeping part tf the barracks, it•• all crtwded tut by the ablutiea. The ether place where crewding a11d iafectiens eccur is in mess halls. Ille stldiers sit crewded side by side in mess halls, and in additiea, if yeu ftlln dewa a mess liH, which usuall;r has a rail en. it, and make cultures off that rail, yeu ca11 get streptocecci, meningicecci because the soldier~ geing dtwn the rail, saeez•, put their hand ever their meuths while they saeeze and ctugh, an.d then put their haad •• the rail, aad the next soldier comes and put.a his hand •• sae wet ■uceua that has erganias in it. The ether eroded regi•• that gave us really definite iadicatien tf' respiratecy illf'ectiea trannd.tted threugh the air aad daagereua ia a crewded place were the Ar.,- Air Ferce traitdag scheela-like the Patters•• Air Fer•• Bue. Thea• -.en had plenty ef sleepiag re• quarters, but th.,.- were a.lwayw haviag epidemics ef ltbar paeumollia eut there. They had high carrier rat••• Dr. MacLetd a11d s•me ethers studied them and traced it dewa te the greups that ,•re take• 1• t• small reelllS l\J r,r lectures and mevies fer training, s• that it isn't as simple as it seems by' just sayiag that they must have a certai11 a■euat tf space in barracks. As a matter of fact, yeu I d think that putting men in tenta would be a healthier thiag for them1 but it's a,t always se, because cend.itiou tf chilling aad wetae•• and even ventilatiea in teats is nets• geed s•etilll••• Geaeral Marsha.11 was iaterested 111 these things, and as yeu said this eae here--tbis 587 AR•• meniagececcus preventiea, aa I teld y.u1 waa signed by' the Chief er staf'f' by erder ef the Secretaey ef War. It c•••• eut fr• the Surge•• Geaeralla Office, aad this particular••• dealiag with neaiagececcus •lli.ngiti ■ is the experieace aad theught •f ■embers ef the Ceamdssiea •• MeaiagececcaJ. Iatectieu ef' the A'ffllY Epidellielegical Beard. De z•u want t• tell ae seaethiag with this eff'? Ye•• Yeu meatieaed the Air Ferce. The Cmaissi•• •• Epidemi.elegical Survez, eut ia the 9th Cerea Are• had net a little ceatact with the Air Ferce. What was I thetelatieuhip betweea the Surge•• General and the Air Ferce? That weuld take a beek te auwer that0 It deesa•t figure 0 Are yeu talking abeut the Beard? The Beard weat where it was called• Yes, but it dida 1 t have aaything te de with the relati•u• The Beard didn't take up the preblt!llll of the relatieu betweea the Air Ferce alld the Surgeea General. Was its fu11Ctiening shaped ia •!l w!l' by the relatiens? Yes, the-this is ;aceaprehensable unless yeu g• int• the relatieu be­ tween the Air Feroe Medical Departmeat and the Medical Departaeat er the Surgeea General. I guess that's impertaat thea. $88 Well, 11 11 de it briefiy. From my persenal experience, when I weat dowa tt the Surge•• General's Oft'ice in 1942, I f'eund the Army Air Ferce Surgeen with his greup ia the effice en 1818 H Street being a• entirely separate medical service and with very hard werda said abeut the S~rgeea Cieneral" This was a '\ ctltael I get te knew naaed Grant wh• became Majer General David N. w. Graat, \he Air Surgeea. I theught that there was an internecine war betweea the aedical departments ef the Air Force and the Surgeen General. Itts a fact that the Surgeea General., General Reyaelds, be.f'ere General Magee, waated t• ctnsOlidate under ene directiea all the medical activities et the Arrq. The medical activities et the Air Fercea were part •f the Arrq because it was called the A.rtay Air Ferces aad was under a divisiea et the War Department Geaeral Start. I•••• learaed aad s••• get a syapathetic eutle•k •• this divisiea et' iaterest al'ld jurisdictieu. I get a rather s;yapathetic feeling ftr the Air Fercea whea I kaew ••r• abeut the histor,- because even ia Werld War I there had beea aa effert for the Air Ferce te get autonniy, aad fer the Air l!'erces t• get autem.emy was a ceatinueus thing fr•• Wcrld War I until it aetuall'7 get its autenWlJ' in 1942, but in 1941 aad 1942., it was struggling very acutely te be an autenemeua arm ef the military establishment. It practically had it in practice, but net 111. name. Geaeral He1117 H. "Hap" Arn•ld, I think it was, f'iret Cemmandiag General •f' the Amy Air Ferces, had direct access te the Army- Chief of Staf'to General Marshall made a nU1Rber of steps: tt recencile the differences and give the Air Ferces as much autenomy as ptssible, aad it gradually worked te that. What we saw down ia the lner level ef the Medical Department were the chips ceming f'rom this battle fer General Araeld had an unfertuu.t• experience that pushed him te make a repert and imquiry that breught this t• a head in 1942. He was cemi.ng back 589 fr1m the Philippines, and hi~ pil•t was medically under the contrel ef the fiight medical efficers who were uader the Surgeea veneral1 and eae of these flight medical efficers., flight surgeorus as they were called, in Honelulu disqualified General Arnold's pilot fer some minor medical reas••• It made General Arnold se mad that he started a veadetta. Of ceurse1 ••w whea yeu lttk at that experieace, it is just superficial stuff because the great., deep thing was the struggle of the Air Ferce to become an autenemous service ia the llilitary\• stablishllellt 1 and it was aot long before the Arr/I/I Air ForcH became the stroagest arm in the whele erganizati•n• The Air Ferce strength rose to abtve two milli•n• It was bigger thaa the Army grouad ferces 1 far bigger thaa Artillery. It was a very important and justifiably an individualistic aervice 0 . The cry of the Air Ferce efficers, both medical and liae 1 las that the prtblems ef the selection., trainiwg, management, care, an.d service •f an airman was entirel.7 different from a foot seldier1 that they had te have, therefere, their n11 medical establishment t• care fer these men ia a special wa:y-­ psychelegicall.7, physicall7, and se ferthe They found the Surgeea General wasn't c•peteat and dida 1 t seem te b• iaterested very much, altheu.gh Surgeea General Magee and other peeple just kept•• to keep the Air Ferce Medical De" partmeftt uader the Surgeon General. It extended very much further theugh1 when the Air Force, General Grant and his asseciates, began to insist that they sheuld have all their own hospitals, and the1 succeeded in gettiag their own hospitals. I have a memoran.dUJI or General Magee saying, in effect,"Le•k, we have an Armored Ferce, mea ia the tanks subject to noise, heat, and incinera­ tien. in this tallk when it gets hit. The wounds are very peculiar te the tanko The phy-sielegical aftd. envirenmental cenditiou are peculiar. The Armored Force is net asking for special hospitals, er special medical service. Why 8heuld the fii•r have it?" $90 That, I think, is an argumerat with analegies that are net very suitable_. but the Air Ferce did succeed ia get~ing general hespitals, stati•• hespitals•­ vel.11 they actually succeeded ia getting a separate medical service, including enrythiw.g except certaia supplies that were made available threugh the geaeral medical supply. They alse were ver., successful in recruiting civilian dtcttrs that the Surge•• Gefteral waated very much. They had some wellderf'ul recruiting peeple like Colenel Russell Lee wh• is a friend er mi••• They get the cream 111 many ways..-very fine peeple. They needed, of ceurse, a premeti•• system aad a pay syste• that was different frem the greuad medical efficerso t.\ The prebleu eught t• have been seen ia my epini•• and adjusted by the Surge•~ Gtaeral tea c911f'ertable ~rangement witheut the bleed letting that weat •• during these very severe argam.ents • The upshot of this was that when the War Department and the Aray was re• trganized ia~arch, 1942, three ceerdinated services, three branches er the military establishmeat were listed. One was the Army Oreu11d Forces. Aaother was the Army Air Ferces, aad~h• third was s. o. s.--services ef Supply, which bf August. becaae ~ Service Ferces. The Army Air Ferce had a camandiag general wo sooa became a member ef the Joint Chiefs er start aad sHn became a member ef the c•biaed Chiefs •f Statf, so that the cemmanding general of the Air Ferce weat right oa up to the top •f the staff level. Ia these Jeimt Chiefs and Cembined Chiefs er Starr pesiti••• he was net evea the servaat ef General Marshall. He was equal with General Marshall, •• they had a de f <J.Cte autenomy even ia 1942. Anether thiag that helped them fra the beginning et the war was the fact that the British and the French had separate, aut•n••ua air forces, se that when Kr. Churchill aad Mr. ReeseTelt met•• the ship and the Atlaatic Charter was discU11sed ia these early daya, the British 11.r Ferc• Marshal.la were there•• the same level aa General Marsnall hi.ll8elt, and •ur 591 Air Ferce peeple came in•• very high pelicy makiag levels. Whea the reerganizatioa of the Ar"l/q ia 1942, was developed a little further between March aad August, when A. s. Fo was set up, the whole Medical Department was placed under Army Senice Forees-S. 0 11 s. at first. The Surgeon General then came under the Commanding General of the Army Service Forces. Befere that time, he 1 d had a staff p•sitioa that made it pessible for him to speak directly to the Chief of Staff and to the Secretary of War o ije lest all that. He had a whele cemmaad level placed betweea hi1ll and the War Departmeat--I mean the General Staff ef the War Depart.meat. It was a bitter aad rather crushiag time, full of extreme difficulties alld led to aore th.ings ~~ thaa ce11cera this Board, but I will say that Preve11tive Medicine was relatively little affected by these changes than other divisieu or the Surgeon Ueaeralts Office. There was an iavestigati•• that took place, and Preveative Medici• was complimented by the people who were attacking the Surgeoa Oeaeral'• Office, and we had very- geed relatiou all the ti.lie betweea Preventive Medicine aad its agent, the Board. For example 1 I happened to know the colonels ia eharge reepectively- of the Preventive Medicine Sectie• of the Office or the Chief Surge•• er the A~ Ground Forees and tbe same with tbe Chier Surgeon or the Arwy Air Fer<•s-I knew their preveative med1cine officers wh• were rather aev to the game, so aew that they were coastantly needing advice. We used te have almest a daily- telephou conference-at least I did-with these K efficers 1 taling about problems collliag up i• their services, so our Preventive I\ Medici• Service helped thn as much as possible. . If I didn't kaew what te say, I could fin.d out and tell them at another title• There were problema ia the Army Air Forces that fell right int• the interests et a number or Conmd.ssioas er the Beard. The Aray' Air Forces before the war, before the establishment er the Board, was very much interested in 592 ceccidieidemyeesis, a fungus iafecti•• ef the lungs that •ccurred ia th• dusty air training ceatere ia Califernia. It was called "San Jeaquia Valley F•ver 11 1 but we had te change that because that was ut geed public relatieu. It dida•t werk well with the Seuters and Represeatatives ef Calitern:ia te name a disease after a regi•a e:f their ceuntry. Did we talk abeut this last time? I just peinted eut the 9th C•rps Area because the Air F•ree is iavelvedo Werk had been started ia Califernia by General Charles Ro Glea whe has i remained a friend,.-Brigadier General Glen.a 9.• the Air Ferce. We seea lillk:ed \ thea up with e11.e ef eur camd.ssiea •• which there was an expert ia ceecidioid•1111"c•sis; aamely, Dr. Charles Eo Saith. They werked fer a while with Preventive Medicine •111~ with the Air Ferce medical efficers in the dusty- c. airfields ia California, but after I came dewn here, we ceuld take that preblea int• the Beard aad briag Dr. Smith int• the picture 0 That continued threugheut the war, aad they did extra•rdinary and valuable things fer the Air Ferce, fer seieace ia general, and fer the relatiene between the Air Ferce and at least Preventive Mediciae in the Surge•• General's Office 0 The ether fields were the fields in respiratory diseases, particularly streptococcal and meningoceceal iafectieu. Our cemmissieas werked at Cha11Ute Field, Wright Pattersea, and ia fields eut en the West Ceas\, als• in s•e ef the fields ia Maiu aad Massachusetts, as if the cemmissieu were a part et the i Air Ferce0 The c--.issiea weuld befcalled in by them, and there was•• particular red tape ia getting ia. Yeu dida 1 t have te use much red tape te tie up a bundle t• ge eut to ene •f these placeso We had commiasiens ill Air Ferce iutallatiens in Saa Antonie, Fort Sam Houston, and many- ether places. K The relatienship ef that kind contiaued threugheut the w~ with man;,y preblmu, ia cmmoa, aftd. they got very- clese with Preventive Mediciae ef the $93 hrg••• General's Office aad the B•ard when it came t• tereiga qu.araatiae. Tu air travel betweea, we'll eq1 Africa and S•uth America, betweea the wstera ceast aad the Pacific Islands raised hundreda er preblem.s that required ill'festigat1••• We had a whel• branch 1• Preventive Medici• called Fereiga Quarantiu that did wonderful. werko Lt Colettel Philip T. Nies 1 s werk tied in with the illterests et the Ceaissiea ea Trepical Diseases ef the Army Epidemio• legical Beard. It was largely administrative. It invelved liaisen with the Public Health Service because they're respensible fer quarantirae. It invelved relatioM with the 'l'Jrphus Cemmissiea and a far reaching intellectual aad scientific asseciatiea that was festered witheut much attentiea paid to the I administrative differences ef ther,e•ple that were working in ito I thiu: that 1 s its sunshine. No matter-let me say this--n• matter what was geing ea betweea the tep rankiag peeple 1 it dida 1 t effect the interests et the ilffestigators in a givea area whether it was Air Ferce 1 Greuad Force, Field Artillerz1 Tanks 1 er what. Yes. With the tanks, the Armered Cerps, we had the :mest il'lterestiag relatienship at Fert Knex1 where Ueneral. Simmens was largely instrumental ia setting up the Armered Ferce Medical Research Laberatecy. The personnel was largely selected by him, and the peeple in Preventive Medicime and some er eur Board ceJIDlissien members worked dawn there on atabrine1 fatigue, climate, exposureo Yeu 1 re going te have a time straightening this out between Preventive Medicine and the Beardo It deesn 1t matter because it was all part of the same thin.g. We were talking in part yesterday about the preblem ef gaining financee 1 er suppprt fer the Board 1 8 work1 and out of that problem came what the relationship 594 was between the Preventive Medicine Divisien and NRC 1 alld CMR ef OSRD 0 Yeu said that zeu wanted te make scme mentien ef this as alse a functi~n of the guestiea ef finances, er appreEriatieuo What we 1 re lookiag at here now is a letter to me fram my friead, Se~n.tor . \.; Rebert Taft., August 121 19411 in which he 1:1~s that he has written te General l Magee regardiag the Board for the Investigation and Centrol ef Epidemics in the A.nrrJ, asking whether its apprepriations were included in the aw.rreat apprepriatiens bill, and offering to present an apprepriation resolutien as an amendment te the bill en the neer ef the Senate. Beb Taft encloses fer me a cepy ef the letter which he had received in.reply and makes the cemment, "I take it that the matter is not preceediag very quickly." General Mageets reply which was probably written for him by someoae in his office is an unenthusiastic, rather weak acceptance of the status_ quo aad indicating that he didn•t see that he could do very much about it in a hurry in getting funds for the 1'eard. Well, new this is August, 1941, and the Beard is much ift tl!ed of funds. Cellllllissions are already at work probably supported largely by universities. I cite this as evidence that o~e can ge areuad the higher efficers of a great establishment and bring to bear some personal interest. Therets ne cen.cealme~t about it because General Magee knew that this was going •• and probably was glad to have it ge> on.. The state of affairs discouraged Francis Blake because about the same time in 1941, he wrete to General Simmons that if the appropriation wasn•t coming aleng., perhaps the whole thing ought to be dropped, and he adds te that,"It 1 s toe badn which is kind of a strong expressien for a New Englander, aa inhibited man 0 We got the money. Did I give you the amusing stery ef General SimmoM and the budget officer? 595 The budget officer of the War Department--the acronym of whose title was BOWD. General Simmons from Nerth Carolina pronounced Board ''Bewd" i and he pronounced the acronym of the Budget Office~ of the War Department as BOWD, se it was not always possible to know what the general was referring te. The BOWD--meaniag at this time the Budget Officer of the War Department--was either suspicious, or too cautious about making these monies available. He said at oae time that it looked to him as if the Surgeoa ueneral was tryiag to get authorization to empley at twenty dollars a day all the physiciau in the United Stateao It was difficult te get them to uaderstand--I can see now that it was difficult for them to urrlerstarid something quite so new as War De­ partment support of intangible research. That's what I thinko It wasn 1 ~ a lack of cemmunication because it was supplied with cogent statements such as General Simmons• and the Surgeon General's letter about the establishment of the Board, and that even went further with a mimeograph frcm General Magee to the Commanding Officers of the Cerps Areas and to the War Department toe, which excerpted a let of that letter, so it took~ I suppose, a precess that kept us poor. When yeu get to talking abeut the procurement and allettment and the heldiag ef officers for the Board, this tna ef maaeuver1 where a civilian member cennected with the Beard, er even an officer con.n.ected with the Board was able to have a direct asseciatien and contact with the Secretary ef War and ene or the Assistant Chiete er Staff, resulted ia actions that overrode the Medical Departmeat and the Surgeon tleneral with benefit. I think eace the problem of financing was clear, the questions ef contractual arrangements for somethiag ether than hardware were more easy. The contract 596 itself I find a fascinating document in terms of the ability to function under it. In eur talks we didn't get into the difficulties ia ceatracting directly aad subcontracting from a general eoatractor which was part or the setup, but which later was set aside, and individual contracts were made with each individual. universitl where work was being d•••• But they always could make subcontracts. But the practice, I thiak1 later winnowed out the process of subcontractiag because you dealt directly with that university where work was ia progress• but uader the eoatracts 1 certainly ia your owa case 1 there emerged this whole question of eoatlict of interest, a very aeat prebla1 aad the manner ia which it was handled bf the legal representatives er the War Department is superb. There is a marvelous memorandum here as to the appro~ch to take. Now1 ia yo~ own ca~•--from what was generally knowa1 I suppose, or gein_g on1 and te which ru may have had access-Vannevar Bush was concerned about conflict of interest. He had a different scale of operation iR OSRD thl n you had. Dr. Blake raises the guestien1 aftd yeu raised the questiea in z•ur owa case because of your coanecJi•• with the Childs FuJld and Yale 1 and yeu fouml cen­ fiicti a.uwers within the War De artment de case and to what e.fficer1 whether it was the Adjut~nt General, or the Judge Advocate General.a er the Surseen General's Office. This is 1 and was then a aeat E_reblem. It arises frem a statute that makes it a criminal offense fer an agent of the government• er aa efficer in the Army, or in ene of the positiou we were ll in, te have financial dealings with orgamzati••• or people, •~taide the War Department whea the matters concerned were work that the War Department desired t• have doae. I suppose it's called a confiict ef interest. It is a conflict S97 of interest, and it 1 s still continuing at the preseat and at aa intensified I rate. Its vttry severe aow. President Jehn F. Kenedy made it very much aere difficult as far as reperts go, but geiag back t• 1942, when I came ia to the Office •f the Surgeon General aad was charged with administration of the affairs of the Arm:, Epidemiological Beard, I looked into this subject because I soon realized that I was dealing with contracts with the ulliversity ef considerable amouata. The amouats were inereasiag, and fffT advice u a representative er the War Department weuld influel'lCe what the universities weuld de. It lligbt appear that I might be favoring Yale, fer example, in this case. The Childs Fuad wasn't ia the picture at~l• It was my coanection with Yale that made the con.Q.ict of iaterest. The ceatlict of iaterest dida 1 t arise when I was a civiliaa at Yale and was the directer ef the Cemmissiea en Epidemiolegical Survey-. It arose •••• When iou joined the Army. Yes, when I put•• the ul'liferm and went ia the office ia Washingtoa,.-the Surgeoa General's Office. It appeared to me that I was in daager •f being accused ef doing things that might be prejudicial te the policies ef the management er the ful'lda of the gevernment and that I was ia danger ef the appllcatiea et the statute with regard t• confiict ef iaterest1 se I asked a let of questions abeut it f'r•• different agencies and, as you said fnm ditfereat peeple I ceuld get different answers dependiag •n!fow I preseated the preblem. I 8beuld have put in earlier that ia rq existing arraagemeats at this time, Yale University, actiag as a fiscal agent for the Childs Fund, was paying in te ...,. salary- aa ameunt that made fffT salary as a Lt. Celonel •• active duty equal to what I had at Yale, alld the salary that I had at Yale at that time came 598 entirely frem the Childs Fund. That'• where the Childs Fund aight have been involved, altheugh they had•• projects. After a while I just wrete to Yale aad said I didn't think it proper for me to centinue to receive that salary-, and Yale didn 1 t object te cutting it off. Yes.--that'• how it emerged. Nw, Dr 0 Blake was in a similar positioa when Dr 0 Blake was President ef this Board aad a censultaat to the Secretary •f War, but he was not under the restrictive erdera and contrel of the War Department that I was uader as aa efficer. On the ether hand, civiliaa achainistraters and civilian official.a in the gevernment are subject to the statutes of conflict of interest. We leoked int• Dr. Blake'• position aa carefully as possible aad got hill advicoo We didn't make aa.r changes in financial arrangements. We then intreduced procedures in handling the contract recommendatiou and budgets in the affairs er the Army Epidemiological Board which were pre forma cerrect, but maybe substantially deceptive. The rule was that when a proposal for a centract came up for consideratioa by the Bearda the director of the commissien would present it and argue for it, and then he would leave the reom when the Board consdered taking action. The lli.nutes alway'B shewed that the director ef the cemmissiem had left the room. I don't believe that made the Beard feel aay freer because they were never uader any preesure, recognized pressure, to de anything special for aay one of these men. What I mean is that net oae ef the directors of these commissions were any mere favered than another, but they left th\OOlllo Dr. Blake would leave the room when anything came up about Yale, er aa;y financial thing in which his po31ti.oa eutside the Board might involve him. 599 The alternative was toge te Congress for a law. If the application ef the criminal code was to be made here, the work of the Board really hu11g ift the bala'ftCe 1 The question was do we devise a procedure which will enable us to convey disinterest with respect te decision making and make the acti•n cea­ sistant with the criminal cede 1 er get• Congress for a special law excepti111g ~- I Well, it a impractical to go te the Congress and get a law passed in any "" reasouble ti••• Just thiak if this proposal would have goae te Congress what it would have opened up--all the ceatractora that were mak:iag caaaon, I tam-,, and airplanes. It 1 s still a matter •,argUJ11.ent u te how these people fun.ctioa. Dr 1 Bush went to Cengress 1 or thought he would go to Congress and get a law, but the application or the very law which he obtained was quite severe also. I donft recall that we had an;r contact with Dr. Bush over this, or OSRD at all. This was something settled. As far as I knew, this was the only division of the Surgeen General's Office in which the matter came upo I don't really know about the resto Procurement and Purchasil'lg Officer& of the Surgeoa General•~ Office seon became involved ia expenditures of mere than a billion dollars a year 0 The Surgeon General. 1 s budget rese from a few hundred theusand te mere than a billien m fast that they couldn't keep up with it 0 The men in those jeba couldn't think i11 those terms and didn't kuw what te do• The difficulties ia obtailling the williagaess of manufacturers to turn aside from work they primarily intended te do and adapt their machiaery and their staff to makiag new things needed by the Medical Department was a cen­ etantfifficulty and a temptation te, I won't say, briber;r, but to make seme 600 ·• ftinge benefits availableo I don't kaew that theee purchasing officere ia 1 1ltw York, er St 0 Louie I or any place ever had any problemB over conflict of Ir iaterest 0 ,I,. \, We've goae m•r• than an hour. Are y-ou kind of tired? I 1Te got a few mere items 11ader centracts which I want to put to yeu.4> Go ahead• One •f them involved the question of patents in the event that somethiag was '\ ! discovered that was marketable, Now, so far as I can see iw. r~ing the reports, the enly place where this might apply was in those aerosel 1 anti­ insect sprays. The DDT spray. Yes-particularly Air Sterilization at the University of Chicas•• Yes., that was the Commission. on Airborne Infectioue The glycol vapers 0 Right, How were patents handled? That's a pretty rough matter. Fpr example, here's something thatw as designed, I sus;eect1 at Yale. The simple thiag about the patent was that the iavestigater whose work I had been aided by serTice fursd.8 1 War(i)epartment, or anywhere else,was required \ to notify same responsible efficer of his discovery and the possibility of 601 patenting it, and if it were patented, it would--well, it had te be pateated by the individual. Yeu can't--an institution can't patent a thing, and that individual was bound in some way-~'ve forgotten whether he was bound by agree­ ment0 Maybe this agreement here in Yale is a paraphrase of the ieneral rule that the iavestigator, the indiVidua11 would take out the patent and dedicate it to the public. Thatwas utderstoed. We had•• case ill this. Sae ef it might have I, beea patentable, but aobody waated to• We all ;ated the pateat questioao It is roreigR te the spirit of anybody traiaed in mediciae to pateat eemething that is valuable to the health of the people 0 The ethical physiciaa ie breught up ia the belief that eal.y quacks aad the selfish, people out to make money, im. preperl.7 pateat medical discoveries. It's aot ia the oath of Hippocrates, but it 1 s just as biadiag ia the mores as if it were 0 D This has emersed in correspoade•c• all through the R}rhester zears aad evea before that--the qusstien of patent ia the event that •••• Yeso ~ The ethei thing under cofttracta was the final dispositien of property purchased l' under the contract. Ye8 0 The preperty belenged to the United States Govermneat, and the property officer, hewever, could look it ever and declare whether it was surpluso He could th•• fix a price a11d give the iastitutiea ia which the property had bee11 U8ed and l•~ated a chance te buy it first•-first chance to buy it 0 We had no difficulty over that. As a matter ef fact1 we didn't have a great deal ef expeMive property bought. Most of the property under these contracts was dispoeable--druga, animalao They were thiags that would wear euto Right 1 except the Harriet Lane Home, the property of the Airborne Cormnissiea 602 wu transferred te the United States Public Health Service for use at Bellevue--it says in therecord~• We had to put blewere and things in there, and it costs se:methiag to do that. It wasn 1 t much. I think the ceatract itself expressly indicated that final disposit:1.•• et the property gave •• eptiea te the university te buy0 Once declared as aurplus 0 The ether thing that comes under ceatraets and maybe it's a little mere cemplicated questiea was iuurance. Let me turn this ,rr, aad I 111 see yeu temerrew. What de you meaR--malpractice •••• 603 Thursday1 May 26 1 1966 A-601 N. Lo M. We've exhausted some er the substance •f this verz iaterestiag facet et cen• tinuiw.g growth er the Army Epideaielogic&l Beard and the Surgeon General'• ,. Office. The guestieR ef alle~ents emerges. There were certaia efferts . made El ether ageacies-Navy, Selective Service, from time to time te iatrtgue, er otherwise caj•l•a er corral the civiliaa member ■ ef the Beard. The question arese quite early that if it ceatiau•d t. •& considerable extent., it would perhaps be the end of the effective working et the Board alld its work, This is a real problem as it emerged in tel"IIU5 et sustaiaiag effort, and•& eemment • that • d care te make as to hw this art cular reblem was handled•••• Well, its••• became apparent after th!i cemmissiens get te work 1• militacy ~ituatieu that a certaia auaber er officers were aeeded to make it possible !er the work to be accomplished, and te have these officers of the cap&city desired, they had te be selected according to specialties, their investigative interests, not cliaical specialties, but their scientific and iavestigative specialtiee. They had t• have alse some premise of ceatinuati••• or security ia the pesiti.,u 1 er the jebs which they were asked to fill. There was •• such thiag at that timfs aa assured research career ia the Anny. They would put a maa in a positi•• and tften change him to seething els•, even though he was a special, excelleat investigater. There were of course many ether men wh• had stayed fer a l•ng time during peace years in their research positieu, but whea the war was en, thed!mlan.ds fer officers were so great that the I.I authorities ia the Surgeon eneral's Office couldn't promise a man that he would be kept ia eae pesitioa fer a1q particular length of ti••• Furthermore, there were people withia the Surgeea General 1 s Office who thought that 6o4 the assignment er efficers t• this investigative Board weuld be wasti11g a military- persen in a situation where probably a civilian would do as well. Well, civilians would de u well, but as I sq, they weuld de as well episedically, but they weuldn't de as well over a leag peried aad de as well i• a lllilita17 situati•• where there was a coatiauatien ef work. This situati•• alee iavolved certaia future eensideratieu ef the actiTities of the Beard all ever the werld ia years after the war wh~ certain efficere with experience with the Beard's procedures and methecls •ight be aeeded1 but that wasa't paraeuat. The practical situatioft ef neediag te get and te held efficers with certaia qualificatieu suited for the work ef the cemmiesieas was the guidiag and sti.llulatiag illfluence oa eur behavier. Well, as you mentiea, the Navy sem.ehow er ether could effer these men mere attractive placement than the Artrry' could. The Navy actually could take a young ift­ Testigater, er middle aged iftvestigators, cemmissioa them, and keep them ia the laborato17, ar in some place, but the Navy didn 1 t have at this time any special lab,rateries, or beards working in this country aad overseas ef the type •f the Army Epidemiological Beard. The Navy did get some special ia­ stallatioM later on-ene~a Caire atne •• Taiwaa, for example. Well, we were anxious abeut gettiag and helding efficer ■, aad the matter came to a head ia the case ef Dr. Aims c. McGuiaaess, a pediatrician ef Philadelphia who was•• the staff ef the Childrea's Hespital under Dr. Jeseph Stokes whe was the directer ef the Commissien ea Measles and Mumps. s McGuiuess was offered an appointment in the Arffry Medic<\]. Cerp\ as a major at the time when the Navy was also ettering hi.JI a positiea ef similar, er equiva­ lent rank, with an added lure ia the Navy offer sf some censiderable permaneace s ia the assignment, whereas the Army Medical CDrp could not offer the maa they ~ wanted; namely, McGuinness, atly assurance •f continuation in the work for 605 which he was being brought into the service. This went oa so far that almost an ultimatUJ11 was sent. Dr. Stokes had te send almost an ultimatum to Preventive Medicine, to General Sinnnens and me, saying that unless something were done sooa, he would have to let McGuinness ge te the Navy. Well, it so happened that Dr. Stokes had kn~wa pretty well another pediatrician in New York nam.e«l_Philip Stimsoa, the nephew ef Henry L. Stimson, wh• was the Secretary ef War, aad Philip Stimaen had introduced Dro Stekes t• the Secretary of War, and in the course ef the conversation, a year ors• maybe bef•r• the McGuinaese episode ares•, the Secretary er War had told Dr. Stekes that if there ever i• a~h.iag you thillk I can de for yeu1 let me new. I thiak that was aa uaguarded statement, without any expectatiea eft the part of the Secretary •f War that Stekes weuld ask him t• de somethi11g that would affect the administration of ene ef the agencies of the War Department. Stokes then, as r\remember1 breught this up with Dr. Blake and 'With me, ~nd it wa11 decided that he make another effert to see Secretary Stirn.sen, which he did, and Secretary Stimsen put him in teuch with Brigadier General Miller White whe was G-1, Assistant Chief ef Staff, the head of persennel in the War Departmeat, a very understanding and intelligent man. I say that -ot ellly because he agreed with 8111' proposed procedure, but because it was a fact that he was. Then it was arranged that Dr. Stokes and Dr. Blake first should write to General White, and that took place Qft November 13, 1942, accerdiag to this memorandum. Dr. Blake follewed that with a letter summariziag the discussiere and putting ferward definitely a request which General Simm~ns had approved that an allotiment, a special allotment of twenty-five efficers be c/ made to the Office of the Surgeon General, with the ranks specified from Lt. Colonel down to Captain among the twenty-five, fer assignment to cemm.issions s of the Army' Epidemiological Beard, or te the headquarter office of the Army \ 606 1 Epidemiological Beard. We had in mind bringing in McGuinaess and cemmissiQfting him as a major and assigning him to be an assistant to me as administrator of the Board,. From that time on we had a series of unexpected difficulties. Although General White turned over this letter of Dr. Blake t• one of his assistants with a view to putting the allotment threugh1 nothing happened for quite a while• Finally a letter did g• from Beneral White'.~ Office te the Office ef the Surgeon General, and it fell iate the hands ef Coleael John Regers, the Executive Assistant to the Surgeon ueaeral1 Executive Officer in the Surgeon General's Office, and General Geerge Lull who was the Deputy Surgeoa General. u pl These papers were sent to the S~rgeo)\ General's Office en December 5, 19420 Hewever, Colonel Rogers at about that time had to tell General White that the 0 papers c~uld not be found,--that 1 s a paraphrase of his statemento I had no knowledge how personnel matters were handled. General Lull did because he had been Chief of Personnel in the Surgeen General's Office, and the regular military people would know what was necessary. I think the first paper simp\1 gave the Surgeon Genera.l a procurement objective or twenty-five efficers witheut specifying an allotment. So I went back to General White's Office, a11d he turned me over to a colonel Lii'eubert L. Jenkiny who k11ew the r~pes, and he wrote a statement by order of 0-1 and the General Staff that the Surgeea General should have a procurement objective er twenty.five officers, and a special allotment for use by the Amy Epidemiological Board. That came back ever t~ the Surgeon General's Office and somehow or other disappeared agaia. It was said that it had beea misplaced, er that it was lost. One Sunday mornimg, a few days after this, I went dowa te the office at 1818 H Street and wandered dowa to the lewer neor te the personnel effice and feund Colonel J. Ro Hudnall, who was then Chief of the Personnel Service 607 in the Surgeon General 1 s Office. I was told by him that he hadn't any recollection of the papers, so I sat down by him and asked him if he weuld kindly lo•k through the drawer of his desk to see if it hadn't been perchance attached te other papers and somehew er other gotten in the drawer. He did, and he found the paper in the second drawer ef his desk, and this was the paper fer the authorizatien of the allotment ef officers--2 Lt. Colonels, 23 Majorso It was given by direction of the Secretary of War which established a special precurement •bjective and a special allotment of officers for the Beard and from that time on we began to accumulate officers. McGuimness came in shortly after, aad we filled our quota which was necessary because several of these officers were sent right awa:y to Fort Bragg te work for Dingle. Seme were se~t to other and different places. It was all finished ia this stage b,- Deeober 151 1942, but what I used to call "picking at11 our people contiaued. There were ao erders issued to take these efficers off their assignmeat with the Beard, but there were iadueemeats presented te them from ether divisieas 1 and many times eH or anether of the men oa the staff f 0 the Surgenn General•s Office would take it up with mete see if it wouldn't be preper to release one of these men fer what he considered a higher calliag. It got se bad through events that I d•ntt remember very well now and it seemed so risky t• ge tn as we wore going, that we transferred the whele allotment to the Respiratory Disease Cftlmissioa Laboratory at Fort Bragg which by that time had beea set up as a Class "N IMtallation u11.der the Surgeon General. The reason fer doing that was that it relieved the Surgeon ieural of a charge for these officers. Theywereatt counted against him, se te speak, after they were removed to the Class IV Installation. In other werds 1 whee he reperted on his strength, he had to list twenty-five officers which were ••t workiag oa what he coasidered his primary purposeso 608 Right, and I think there were some areas where all the officers allewed were• comeleted1 and the Surgeon General's Office wanted te make certain promotie!IS and they wouldn 1 t put these through because "You have vacancies. Use them.•" Also they liked to take some of these slots, put somebedy in, promote him and then have him doing work that really wasn 1 t for the Board. Well, it worked pretty well with the officers carried•• the list ef the Class .N In• stallati•• ef the Respiratecy Disease CNlllli.ssien at Fort Bragg, but it was very cem.plicated and di.f'ficult te handle the papers aad their PAT aad all that1 ! sort ef thiag. It was a little bit iuecure, but abeut this time threugh the stature that the Typhus CeJ11JU.ssiea had attained, er at least had frem the etart under the E:xeeutive Order •f the Presidea\ with high ailitary authorit1 C ae a special agency et the War Departaeat1 we ceuld use the sae prot•Ative method fer t_hia Beard by gettiag the Beard classified ia a greup called "Mieeellan.eeue War Departmertt Activiti•••" I have somewhere a list ef them-I forget, but there were five er six. The personnel and affairs ef a Miscellaae, Activity er the War Department were handled at the headquarter• ef the War Depi ment in the General Staff regien, s• the allotment of officers was put in te the Miscellaneeus Activities er the War Department; namely, by name, the A.rmy Epidemiolegical Boardo It made •• differeace ia the han~ing ef them and thei1 activities, as far asf was ceacemed. As administrator ef the Beard, I found out how the staff officers ever there wanted things reported, what they cared about, and what they bad to do, and they waated to see this thing go forward 0 for the h~n•r of the Secretary of War by that time. Se it was takea completel.J out of the reach of the Surgeon General and stayed that way to the endo The original order that came down couQled two subjecta--procurement !Ejective 609 1 tfp allotlleat. That was the trick. Thatllls net twe subjects exactly. It sounds like it, but that Colonel teld me that just procurement objective weuld~•t de me any geed. The alletment has a purpose. Where's the order? DeesQ't it say fer the work et the Beard? qh zes 1 but later ••a this order is attacked aad split ia half bz s•e ether V colsnel in the AdjAta•t Geaeral 1 s Office wh• waated ta refine it a bit• I•ve forgettea that, but it deesa•t make aay differeace 0 Ne 0 It wa:i true with the ebjective and alletment as ••• Where does it say that they shall work fer the Beard? That ought to be en a piece of paper in that file. Ifll tell yeu what it leeks like. It's •• a pink carbea copy sheet with r11led lines betweea parts ef it. Is that my copy er it there? Ne 4 All you have here are these two 0 0 Yes, that 1 s it. You see, the precurement Abjective is separate. The allotmeat here is a special allotment of efficers te b+rovided the Board fer the Investigation a~d Contrele•o• Yeu 1 d have the procurement objective ard this states the purpose as to what they are to be used for. This went threugh 0 Yes, this went through by order of the Secre1lary of War. Here's a note also where he says a precur•cnt ebjective will be a matter ef a--what is it? 610 A matter for a separate cemmunicatiea, but thatte December ll, 1942. What's the date of this oae? December 2 1 1942--but n•, that's the Surgeea General's business. Sometimes they left off thtate, and they get stamped•-oh, there it ie. 11/23/42--Novembero Those are enclosureso The memorandum for record attached te this paper was that the above actioa was taken to provide officers for the above preject in accerdance with a request of Dr. Francis Blake president of the above men­ tioaed Board, dated November 161 19420 I don't carfbout this--this is techaicalo Yes, but they begaa to snipe away at it 4 For example, even do~• in Fort Bragg Cobura declared some of the men in the laboratorz as surplus se that it was necessary to take the officers for the morning reports and attach them to a procurement section ia New York Citz. Oh yes. Ia order to protect them before the discovery of the Class IV Iastallation. Yes, they were attached to the purchasing office in New York City for a while--any place t0 run for cover. That didn't last long. Then when I think the reorganization of ~he Army itself toek place, it was further complicated by the attitude of the Army Service Forces. They had different views. They trected the allotment as part of the bulk allotment for the Surge~~era1 1 s Office which agaia, a special allotment suddenly became part er a bulk alletment. 611 That was a very grieveus time-that reorganizati•• period, the behavier ef the Commanding General &Rd hisftfficers in the A. s. Fo They just made all the possible troubles that they could, and I can shew you in writing the state• ment that it probably was an effort to get General Magee. The way cut of this was the Miscellaneous Activity because that put the Board under the General Staff. Yeso Aad gave it their pretective cover, and also that particular process shortened the name of the Board. 0 The name Army Epideui~ogical Board•-we did that without an official actioa of aiv kind. It just got so that i• comversation we were calliag it that,. 'lnere was no specific actioa that changed the name given it by the War Departmento This piece of paper here--there's nothing sacrosanct in a piece of paper, but there is one here where the Beard is referred to. Here. It look! as if I had done it. But as I say, it was changed to Army Epidemielogical Board without any particular action. The original name had official sanction be~ause it had been adopted with approval of the Secretary of War, but ws didn't g0 back ever that trail. No. Most er this snipi11g is a normal part of liviag 1 I suspect, and when you 612 operate, when you're trying te fuactioa wherever problems emerged, it was a little difficult to keep the kitchen stabile sometimes. Well, it was all done with the courtesy of a duel. It was expected. Yes. I think all of us remained frier&ds through all this. Nobody said any harsh words. rhey might have thought them. I was having aa advantageous double experience at this time. Iwa.s the director-well, soon after this begaa, I was the director of the United States of America Typhus Commission, and I learned a lot about higher rallk:s and higher pr~cedures in that because I was actiag urtder aa Executive Order of the President, had a Lt. General•-Gen.eral LeRey Lutes, a :~·\ friend, aa extraerdi1ary man, as a maber of our executive committee ia the Typhus COllllllission which I'll tell you abeut later, if yeu 1 re going to take that up. I want to 1 but not now. But what I 1m eaying is that this is not an isolated thing. I had three jobs at this time. I was Deputy Chier of Preventive Medicia, Director of the Tyhpus Commission, aRd Administrator of the Army Epidemiological Beard. It put me in contact conveftiently with a lot of officerso What was true of settling thie was to keep peace with the worksrs to•, to keep them worki11g 1 keep them I operating 1 and Dr. Blake's re2rese~tations to the Beard had a vivid sense of urgency"-that in the event something wasn't done ••• o I think they operated initially uader Selective Service, that yeu could designate certaia people as necessary civiliau 1 but this overlooked the fact that they might be iaduced int• the araed force ■, and there wasa 1 t aay power 613 in the Board te protect its owa personnel 1 and there was ao particular iaterest shewa in the Surgeon General 1 s Office generally to graat that protectioa 0 I That had to be carved out te sustaia the work of the Board. It s part of breathiag 1 but an illterestiag part of the story as to how it sustains itself 0 They weren 1 t iaterested 111 the Board particularly, but they were equally disinterested in Preventive MediciM. That was a part of the unrcman.tic, dry perf~rmance that Preventive Medicine has to put on to preserve the health of ,,. the troops. It alse is sort ef iahereaet in Preventive Mediciu that it has a• spectacular, er dramatic accomplishments to show because the better you are in. Preventive Mediciae, the less you have to shffo If you prevent ·,t all, there's nothiag. They•nt yeu to stepo It happeu i11 civilian lif•• It yeu stop small pex by vaccinatien, the people stop being vacciaated, and another l generatiea cG11.es on that's not immune, and they have an epidemic. Its a fact--tt. better you are i11 Preventive Meeiciae, the less yeu have to show for One ef its consequent problelllSo It hasn't get the appeal that surgery has 0 Even the problem ef trying to get a certain efficer from the Mediscal Army Corps, the Surgical Corps •••• There 1 s no Surgical Cerps...-Saaitary Corps, and M.A. Co.....Medical Admilli.s­ trative Corps. We got later 011 SOile M.A. c. an.d Saaitary Corps officers. YesN-this is that quiet aegotiatiea trying to work out the words that would be acceptable to people whe were pretty sticky1 I think1 in some cases in the readiag of the regulatioas 1 but it made your task iateres)ing ill hum.all tenru, 614 within the Surgeon. General's Office t• Ciet this idea noati11g and keep it alive. What I 1 a goi-.g to say souads braggiag1 or foelish maybe, but I always had i11 the Army aort of a rule that whea you got an. order, wait for the counter­ maad, and I did that ever aad over agaillo Well havi read these ers these shark illi'ested water•, because I knew ia the Iafantrz whea we got things like this--we didn 1 t have half the expertise that you had in keeping alive. Well we 1re racticall at the en i' this ta but there's oae ether•••• I 1d already beea a Deaao Yea-I knew1 but there's•• ether•••• 615 Wednesd&fz Jun 1 1 1966 A...60 N. L. M. Let's see-ia the past we've talked about the Childs Fuad that you continued te swrve on after you get out of the Deanship. We talked about the change in atmosphere ia late 1939 and 19401 with the ceming of the war. We talked about the several committees ef which yeu were a meaber1 where you had continuing asseciatien ia Washingten1 D. c,, alld we 1ve also talked abeut the developnent of this Army Epidemiolegical Board as an idea and then as acceptable to the I Secretary er War 1 but we never got you to the point wherer•u actually left civiliaa life aad eatered military life and what ygu really joined. What did the Office of the Surgeon General and its Preventive Medicine Section consist ef? That's what I'd like to know today...-get you into the Anny because there were chaages te meet different problems both in an organizational setup and1 I suspect, ia teras ef the intelligence you received from the field. I came•• active duty ia the Office of the Surgeon General of the Army with aa assignment to the Preventive Medicine Subdivisien oa February 12, 1942. It didn't take very long for me to make up my mind that this is what I should do and what T waated to de because Itd had a reserve coumissioa fer a long time. 1 •a been through World War I, and I had knowa the new chief of the Preventive Medicine SubdivisionJ namely, Lto Colonel James Steveru, SimmeM from the early days and admired him, liked him very much. He called me up oa the telephone-­ I think it was on, we'll say it was on a Thursday--and said if I 1 d come down to Washington, he wanted te talk to me about assisting him in preventive medicine administratiea ift the Office of the Surgeon General. I came down to Washington and stayed a night with Colonel Simmons, went back to New Havea to think it over, and by the end of the next day, I telephoned him that I would be 616 very happy to come dowa and be oa his staff, which I did. I was dowa in Washington and on active duty in a relatively few weeks, or leas than a week~ Less than a few weeke 0 Yes, less than a few week8. I packed up in a hurry and left an enormous amount of books and furniture and things to be packed by Mrs. Bayne-Jones, but she managed to do it with greatability and much cost to herself from the fatigue of ito She didn 1 t come down to Washington until about a month after I was hereo I entered into the Preventive Medicine Division at the time when it was a Subdivision. I keep calling it a Divisio~, but it was only a Sub­ division, or at least it was just about to emerge, or had just emerged lr~M bei11g a Subdivisioa. To go back a little bit. In 1939, u this ergallizatioa chart shows, it was aa iaceepicuous sectioa ia what 1 e called the Professioaal Service Di'Yisi••• Toward the ead of that year the Surg••• General reported that the demands ea the Prefeaaienal Ser'Yice Divisioa nre so great and varied that they hada't beea able to set up separate organizatioM for the separate functiou. I• ether word.a, there was•• formal preventive medicine orgallizatiea ia that Protessional Service Divisi••• As I say, it was t1tfuaed ia a kiad of nameless aggregati••• General S:Lnnnoru, was brought fr• the headquartes• of the Surgeon of the 1st SerTie• Camaad ia Bost•••• February 24, 1940, aadwas givea charge ot the affairs of preventive mediciae that were miagled ia the Professieul Serviee Division. ~•a he tallc•d te you the llight z•u came dowa here ia a11swer to his tel_eE_hoae ! c~L ~1!.•_!;,,_d_!! he sketc.!!_ ta zou2 er wha:t k111d _!! pictures did he ha~i• .!!!!, I head? 617 He was a preventive medicine evangeliet-Tery eathusiastic and a keea sense of the world wide significaace of the work, a great and burning faith in the ability of a well applied lot of knowledge to keep the soldier well and fit te fight. That was his slogaa at that time. He was very friendly and ki!lld, a lovable person, but higp-stru~ and impatient. He was impatient with stupdiity, and held be impatient with blocks that were put ia the way by people who couldn't grasp the whole scope or the preventive medicine effort as he did. I thiak: he talked to me ia terms about like that. He didn 1 t have to spell things out to me because we 1d been thiaking alike so much of the time. I had already seen him eccasienally on National Research Council work, or work at the Anq Medical Scheol,. I used to come down in those days and visit him in the laboratory when he was working on dengue aad sae viruses, and typhoid vacciae, e• we'd exchaaged ideas ever the year■• It didn't take much talk, and I don't really remeaber that he made me aay sc,eecho ' I wae just thk'lld.ag--well, I would assume that this earticular existiag schmne was unsatisfactory tea man ef thought and actiea. It was unsatisfactory to any-bedy. But he happened to have beea fingered fer the respensibility. Yes. Colonel Simme11m was made responsible for these actiTities ia Februar,r 0 By May 71 19401 a set et plaas and vieioas f•r the future that he had ia his head had geae berere the Surgeon General and had been approved, and they carved cut or that Professional Service Divisiea a Subdivisi.en ef Preve•tive Medicine which w ae soon orgaBized. It was under the siagle...haaded direetiea er Simmou 'because he dida 1t have more thaa a couple er efficera to 618 help him, but he got his orgallization out under a separate name, though still a aubdiviaio11 et the Pro.teasion.al Service Divisioa, aad he divided thia Sub­ divisioa up iato braach••• I happeaed to be receatly just looking at the tunctioas which were given to thie Preveativo Medicine SubdiYiaioa ia Mq, 1940, under the directorship of Colenel Si.Jmnona, aad briefiy it was given the tunctioa of having an advisory superYisioa .ver military sallitatioa aad control or c911Dllunicable disease•--• very broad statement--except a:mong allimala. It had the functioa of having liaiso11 with th• Quartermaster Departmeat regarding teed supplies, water •uppliea, waete disposal, iuect control, housing sites, saaitary appliaaeea, and bathing pools. It had supeniaery tunctione et aa advisory aature over the medical department laboratories, except the central deatal laboratories. It had a tuactiea specified to have a liaiaoa with tho United States Public Health Service aad other goTerment and civiliaa agencies and should take office actioa oa sanitary nports tr• saaitary iupectora. Well, that cempreeaea ia a tow words a aumber of thiaga that sound like abstraction, but they area•t. To aay or us who were workiag t• get receg­ llitioa et the fuactiee of preventive mediciae, this sap, a great deal because you latow that these abstract tenus are susceptible to imagiutive iaterpretations. You. caa--aa Simmons weuld--see a world wide activit7 just ar the mentiori of teod supplies, er insects, er aay of those things. They just are nare words­ you see tar iato them. This also is a basis for recommending expansiea because I whea you start to do aay •ffthia werk ia abstract te:nu, yeu find that you get I •ore thaa was written iato the text at the memeat, aad yeu go and put up te the t\ Surgeoa Gener~l, as Simmons did, plaas for expansi•• over u1d ever again. Alse this is the basis fer requesting personnel. He bad eae er two officer• with him, but by 1940, he had four other remarkable men on temporary- aasigamenta ••• ef which remaiaed on a pemaneat assignment. Three of these were sanitariau-- J 619 twe sanitary- engineers, Lt Celonel A. w. Sweet aad Lt. Colonel Williaa A. Hardenbergh, capable saftita17 engineer•. They caae •• in Juae of 1940, aad these two men aade surTeys ilulediatel7 er Greealand alld Newreund.land ia ceanectiea with what was going•• with the British ia the Atlantie, those matters which were iavolved ia the discussi•• er the Destroyer deals of that da7 aad were i'll"folved ia the defease er the United States against sul:nariaes, airplanes, and anything that the Nazis 111.ght think up. These surveya that Celenel Hardeabergh aad Colonel Sweet aade were the :t':1.rat area aurveys aade trem a saaitarr viewpoiat that the Army had possessed. They had area surveys in the United States, area surveys ia the Philippines, are~survqs ia our possessiou i or Hawaii and Paaama, but aothiag like this--a survey of a foreiga cou1try's posseesioas. They were so geed that they were immediatel7 of eaormeua value to the planaiag ia Preventive Medici• because the conditions were described very well. They passed immediatel7 to the War Departaeat. The General Starr, Operatioas Divisi•• had aothiag like thea, and they could use them tor strategic couideratiou. That was the basis--that was a start of a very large aad valuable activity 1• preTentive medicine called aedical iatelligenc•• We had a Divisioa of Medical Iatelligence represeated by that beok oa Global Eeidemi•l•Q' li5hiladelphia, 1944 504i/, that collected iatormatioa abeut health, disease, feed, railroads, and water supplies in all the countries all ever the world. The other sanitary engineer, or trained salli.tariaa in the office was Colonel Ira v. Hiscock Who was the assistant to Dr. Wiaslew at the Yale De~ partment of Public Health. Celonel Hiscock came down in June, etayed a few weeks, aad was soon transferred te the School o! Military Govern.meat at Charlottesville. Fr• there, after a while, he weat over te be with Major General John Henry Hilldring ia the Division of the Special Staff of the War Department that handled Civil Affairs and Military Government all ever the 620 world, aad General Hilldriag called Celonel Hiscock his Surge•• General. It vas a woaderful liaisoa he maintained with Goaeral. Simmou aad the rest of m, going back and forth betweea preventive aediciae i■ the Surgeen Geaeral'• Office aad preventive aediciu ia all the occupied alld liberated countries. It was just the global Mfillmeat that General Si.mluu would prize very highly. With his imagin.atiea and ability-, ho could see what should be doM. A remarkable thiwg1 I think, ia the work or these two •••--Colonel Sweet aad Celenol Hiscock--was that aa early- as the 26th er Juae, 1940, at the ia• stigatiea er Colenel Simmeu, they produced about a tea page, typed report •• plaaniwg for civil a.f'.f'air•-military government 1• eccupied territory-. Now we hada 1 t aft1' occupied territery at that time, but the:, just sat dowa aad illagined what would be dou. This was transmitted to the Surgeon General by Colonel Simmeu as it had been sigaed b;y Hiscock aad Sweet. That's the first decwunt or thought ia the field er civil affairs aad militar:, gover•en.t. It aatedated anythiag that General Eisenhower was thiak:l.ag about. He hadn't evea got the cOIIIDlaad ia Africa b;y that time. This is 1940. Major General All•• w. Gullion, the Provo•t Marshall General, who had charge et the Military Geverl'lll.eat School at Charlottesville, Virginia, the University- et Virginia, had •o coaceptio• of theee thiftgs aftd had n• prepar•tiou tor training, er teachiag people aft1'thiag abeut the salli.tary, or medical a•pecte or civil affairso Thi•&veloped int• a• enormous cooperative effort betweea preveatiTe medicim aad eiTil affairs because aot eal.y was there a Civil Affairs Division ia the Geaeral Start, but in due tiM the Civil Atfaire Division was established in the Preventive Medicine Service under the direction of Colonel Then• B. Turaero Well, then the other remarkable••• that Celenel Simmons brought into hi• otfic• ia the latter halt ot 1940, was Lt. Colonel Leen A Fox who stayed in the Preventive Mediciae Subdivisioa until January, 1941, when he was put ia 621 charge of a remarkable, aew type of thiag 1 a medical service run by the Chief of Eagiaeers. The Chief of Engineers set up a ..dical serTice under Geaeral Fox to superTiae the saaitatioa, hospitalizatioa and care of all the •ployed coutructioa laborers who were buildiag bases in the Caribbeaa, in Newtoundlan.d, Greenlaad--en the Atlaatic side of all thHe thing■, se Fex weat out into that, reaaed the couatry Tigereusly as he would, alld just peured 1• reports ' et great novelty aad value•• Trim.dad, oa the Virgin Islands, Puerto Rico. He covered the whole thing--down ia Surinam, in Aruba. All places that you caa thil!lk: of that you dida 1 t know aaythin.g about, Fox would go there and :make a survey and r epert. Fu would c•e in.t• the Preventive Medicine Office every time he was back in the country aad see ua, and all eepies ef his reports were This is 1941-Fex left th• effice ia January of 1941, and went •• thi ■ aedieal serTice fer~the Chief of Engineers and thea went further ia 1942, aad \ into 1943, through Africa. ROlalel was aakiag trouble up along the Mediterauaa shore ■, and it looked like we had to build aa alter11atiTe route fer getting supplies te the British ia Egypt, aad the route picked was from Acera--well, dewa acroea the North er Brazil te Asceuioa Islaad, to Accra and then up, as I re•ember it, te Maiduguri, El Fasher, Khartoum, aad down the Nile te Caire. In other werda, it went acr••• Ceatral Africa just about at the b•tt• or the Sahara Desert. I knew it because I•ve f'ltnnl it. That teok us into the Mcessity or aaldag surTe7e in. all sorts or aw countries. Ascensio• Island had te be surTeyed1 Natal had te be surTeyed i• Brazil, Leopoldville, Accra--all those place ■, and that's where this enormous accumulation of medical iatelli• geace just grew up tor the benefit of the Strategic Operatiou SerTic• of the A?'lftY' and for the health aad aedical affairs for the Surgeon Generalo 622 It struck ae as very remarkable that Celonel Simmeas who ef course kaew ■oat everybedy', ceuld draw these able mea ia right away, and he never Id.seed a bet. He was his owa best personnel efficer. This was before-what they called SFN numbers, Specialt7 Field NUD1bers, and the MOS auabers, Cede for Military Occupatienal Specialt,.-, were only just being talked about. It was three ,.-ear• before MOS numbers caae in, and besides you caa•t size up a man from a dry little paragraph about his specialt7, his educatien, his preficiency, aad his experieace. There are qualities that you should loek for in these V i men•-qialities of imaginatiea, spirit, te say nothing of honesty, th~~ don 1 t show up on those MOS aumbera. Colonel Simmons could see whether a man had such qualities, er whether he didn't, in a moment, aad as I say I don 1 t ~hink M ever made a mistake en a majer officer-present eapamy- excepted, of Den 1 t be bashfulo This is happeai.ng in 1940. This is over a year befer• Pearl Harbor. This is May alld June aad the rest of 1940. In 1942, whea I weat there the Preventive Medicine Subdivisiea had become the Preventive Mediciae Dirtsien, and here is the orgal'lizatioa chart ef May- 15, 1941. I have a cepy. Yeu can look at that. Now yeu see that two things have happened frem this chart that werea't shown•• the previeus one. The Preventive Medicine Division is up there•• the tep line as a coerdinate divisiea with the Prefessional Service Division. I Its ao longer lost ia that pretessional care part. The little pick under the Divisieu above meaa that the,.- have a lot er subdivisioas and branches underaeath them, but I didn't want te clutter the chart up by putting them dowa there. This chart is cepied from oae that General Simmoe had dran up, aad as you'll see on the right haad side coming e!f ia a positiea that is abeut 62.3 equal with th• subdivisiou, there is ene thiag called the Beard for the Contr•l et Epidemics. That was a shortening •f that leag name that Geaer&l S1.nmtou put ia theret aad when I did this chart, I put Ar,q Epideaiolegieal Board ia parenthesis, alth•ugh it hadn't been se called at that ti.I'll•• Uader that, the c9fflllissiens that had been appointed by May et 1941, are listed, aad that includes trepical diseases teo-tea of them, I think. What yeu see on the left hand side ef that 11• in. the middle is that the Preveative MediciM Divisiea eentains aa Epidemiology, Disease Preventiea, and Industrial Hygi••• Subdivisi••• Now, 1 111 say something abeut these names 1• a ai11ute o It s ee■s like a mishmash te put epidemiology, disease preven.tion, alld iadustrial hygieu ia one block. That was done ever again and over a.gain because you had to put a nam• •• these bloeks--Geaeral Sil'llmeu had to put X a IWll• •• these blocks, alld it didn't bether hi.Jll te ~{ thiags ia the s aae bleck. It deesa 1t meaa that that subd.ivis1•• had to be all under one aaao For instaace, industrial hygiene by this time had te come i• because the Aray was begianing to have industrial •obilizatiea bear upoa it. It had enormous centraete--the governmeat had contracts under way fer munitieu, feed, clothing, all sorts er things, that were wrapped up ia Lead Lease. Lend Lease had eoae ia ia 1940, I think. Well, there were thousaads of people iavolved 1• this, aad the7 were working in plaats that were sometimes 9Wlled by centractera, and sOllletimes they were eperated by the gevernm.ent. They were governmeat owned and operated aad eontracter owned and operated plants, but the j•vernment had a responsibilit7. This Industrial Hygiene Division developed because General Simmons saw the need ot it, and he got right awa7 from a very able maa named Aathol\Y Laazer, Pretesser of Industrial Hygiene at New York Universit7, the '{ advice he aeeded. Alse preventive ■ediciM had a fery f i • relatiea with the i\ 624 National Research Ceuncil ia wheee DiYisioa of Medical Scieaces there was an Industrial Hygiene SubdiTisiea under Abel Wolma.a, but this was in the air. It was appreTed right away as soon as it was aentioaed. It was put •• this piece or paper with epidendology and disease preventiea, but I den•t think that bothered Lanzer. It dida 1 t betl'l!r Karl R. Luadeberg wh• was ia the epidemiology side of ito Venereal Disease Ceatrel Subdivisioa was a branch or the Preventive Medicine Subdivisioa even from the early' 1940 dqa. It was enorm.eusl7 i.lllportaat and had e:xtraordli.u.r,- relations with the government. The runctioa er the Preventive Medicine Subdivision that I read where we were instructed t• have liaison with the United States Public Health Service and other civilian govermnent agencies--these were these who had a backgreund in the contrel er venereal diseases. There was a ver7 large orgaaizatioa ia the government under Secretary--net MCNamara. Paul McNu.tt. Yes, Paul McN!u.tt, and i• that ergallizat1•• was Charles Taft. They deTeloped a great syatea or attempting te centrel veaereal disease in the civilians in area ■ areuni military- establishme &s. It was a huge organizati••• This was work that General Parran, the head er the Public Health Service, was very auch interested in and was the source or rather bitter criticisa--I aean that work was a source er criticism ef the A.rtay because General Parra• thought at ene time that the Army wasn't doing its dut7. This liaisen with the Public Health Service took•• government-wiu activity aad sigllificaace right away, aad that Veaereal Dis•••• Centrel Subdiviaioa right here ea the chart had most t• de with it. 625 Sanitation, Hygiene, aad Laborateries was anether rather mixed up sort or a thing because the Laboratories Divisiea develeped later•• its ova into a huge scientific and medical affair 0 It was a• aid to sanitatiea, but dida 1 t have awy- respouibilit,.- rer saaitation. Th• Sam.tar,.- Engiaeeriag Su.bdivi.siea was uftder Hardeabergh, did superb work ••tater supplies, tiltratie11 plaata, sewage disposal plants, ditching aad draining, mosquito ceatrel, garbage dis~ ~ posal-all sorts or thiag that the santar,.- engiMers would deo Then you see " down at the bettOlll we've get Medical Intelligence coming eut, but the,.- m.agled the Trepieal Medicine Subdivisiea with it because you could ellly have a certa.1.a aaber or these blocks, and ubedy cared whether you mixed th• babies. That's the wa,.- it looked about the middle er 1941. Shall I go•• with this? The next big change that you see is ia this organization chart er February er 1942. This erganizatioft chart is just before the big reorgaaizatioa of the War Department aad the Ar,q. Suddellly' ea March 2nd, effective March 9th, ! the War~ Department issued a circular aad same ge11eral orders which did away I with the old War Departmeat General Starr OptratiellB Division. It consisted --rather it constituted and established three main services; Arrq Air Forces, A.r,q Ground Forces, and the s. o. s., Services et Supply, as it wae called at that time, later the Anrry Service Forces, Ao s. F. This was the Air Forces cemin.g out toward their auto•OJIY'• The Army Ground F•rces were the competent foot treeps under General Lesley J. McNair. The s. o. So which tve months later became knOWll ae the Arrq Services Ferces was the whole suppl,.- and mater:htl section ot the Artfl1' uader General Somervell that fed and clothed the Array, ~ beught munitions, all ••~ts of enermeus thil!lge, probably the biggest busiaess \ 626 in the world, legistical.17 speaking, but it hit the Surge•• Ueneral a terrible blow. Up to this tiae--that is up t• March, 1942-the Surgeen Geaeral was a statr etficer. He had direct access to the Chief of Staff aad to the Secretary •f War. By thia reorgaa:i.zatiea aad the illlpleaentatiou that weat ea, the Medical Depart■eat wae reduced to a very low order ef one of the branches •f the supply ser'V'ice. Ia staff relatieuhip it wa• way- belw the administration of the Ground Forces, or the Air Forces. The Surgeoa Geaeral e found a whole level of command had been put betwen hi• and the Chief of Staff. 1\ Th•• the A. s. F • began to take things away fr• hi.a. They tffk his control ef' many h.apital• in the Cerps Areas away- from hill. They teek away fr•• the Surgeoa ueaeral his autherity ever selection and appointaeat ot efficers in certain ways. It made it extremely difficult for the Surge•• General t• function. It wae humiliating, aftd. it aroused the pretession et the ceuatry. It was a great blew to the medical service er the Arrq. Very bitter times, and it led finally t• a very serieus investigatiea of the Office er the Surgeen ueneral in 1943. There were, in my epiniea, doctrinaire 'ri.ews •f the aatter by people 1• logistics that weul.d lUDlp medicine eiaply- with the supply" services. They didn't understand the scope and intellectual ceateat et mediciae, but I thiak there alsew as pique and, what is already- ia print, seme ebvious feeliag that the medical officers were eld, uapregressive, incempeteat peepl•• The medical budget had risen fr•m a few hundred thousallld dollars te ••r• than a billien, and the old supply effi.cers 1• charge of finance and ~ other• who hd r, been promoted during this expansion just because they had te \ have slets for colonels to be filled, were iacempetent to handle all this new business. It was very eevere, se we're talking aow--what have you get? I have the chart of February 27 1 1942. 627 191'2 and 1943--yeu see, this antedates all this I•ve beea talking abeut by a tew weeks, aad if you'll ••t1ce at the t•p there are f1fteea diviaiou-- u large divisi•u ill the effice reporting te the SJrgeea Geaeral. General Somervell aad his start said that ne maa caa have that many divisieu reperti11g t• hill, alld part or his plaa waste cut the■ dewa. Well, yeu see Preventive N Medici• e• this ene has aew nade s•e clearaaees ia its •~, ergallizat1e•• It 1 s beea able te take eccupatienal aad ■ilitary hygie• eut et the Salli.tatiea Divis1en te staad separately-0 The Laberatery- Divisi•• has cane eut ••parately. Iatectieus Disease Centr•l has a clear separate thing. 'l'he Sanitary- Ellgineering DiVisiea, whiltit was separate befere, it's clearer there, and Medical Iatelligeace staads eut by itself. This is evidence et the evolutiea et this ergaai.zatienal pattera which shna Preventive MediciM grning up aad developing seme muscles. The ether part-the AJmiy Epidemiological Beard aad the Typhus Camiasien are still carried there as if they belonged in, and they did belo•g ia the Office or the Chief •t Preventive Medicine. They are net under one of these aubdinsiou. '!'bey are right ceming err fra the Preventive Mediciae Divisie11 at the top. Well, the philesophy er the change you'll see en the next chart, July, 19431 which is about a year er se after the reergallizatioa er the Arrq had taken place, aad you'll see what the chart makers have dene here. There were teo ■any people reperting te the Surgeon Geaeral, aad they have chaaged that an. They have ■ade them ser'f'i.cea--six thiags they call ser't'ices, but leek what it did te the Chief ef the Prefessieul Service. It ude seven division repert te hill. We've got thirteea, and that's abeut as maJV" as we had tepside ea the previeus chart, but it doesa•t leek the saae. The Chief ef Pretessienal Senice was aet c•pete11t te haadle all et that, and I suppose he had to let these i j 628 diTisiens uad.er his service ge their owa va7. For instaace, the Medical Divisiea was under the celll'll&nd ef Brigadier Geaeral Hugh Morgaa, eae er the meat aeted ph7sieiau ia the United Stat••• He was the medical censultaat; fer the whele J.rri:r, ceatiuat,al United States aad abroad.0 The Surgical Divisiea was under General Fred w. Rankia, and he was ene ef the great 8urgeeu e! the ceuntr,-. He had charge ef all the surgeey everywhere ia the Army• He was the CMef Surgical Ceruiultant. The same with the Deatal Divisiea which get te be very illldepeadeat. Veterinary DiTisi•• get te be very- iadepend.eat, aad here caes the Receaditieaiag Divisiea because the soldiers are cemiag back an. This chart is draWII agaia leaviag eut the subdivisieu er these ether Divisiene, ' but it shew• Preventiv~Meticine witbla, divisiea aad sevea branches with the nn \ \ established Typhus C911l'fflissiea and the A.rrrr,- Epidemielegical Board colling eff fr• the Office ef the Chief, but it wasa•t clearl7 under the Office of the Chief 0 It was really a Miscellaneeua Activity et the War Departae11t which ve 111 talk ••re about, but eve~rbedy- agreed that it bele11ged in Preventive l, Medici••• The Uo s. Ao Typhus Cumdssiea begaa with an idea ef Geaeral Simmons whe waste be the first director er it, but he didn't want te take it. All the plaaai11g fer it had been ia Preventive Medicine; as a matter of fact, it was plaaned fer a Tisitiag commissi•• te see what the coaditiom, ef typhus ia Nerth Africa and the Midd1e East were, but it get placed ia this independe11t !ltate which we'll tell abou-th.ater. ! There is the Army Epidemiological Beard I still attached to the Office er the Chief ef the DiTisiea, and there ia u change ia the commissiens ia aum.bers. I will aew pass te the chart et February, 1944, which illustrates the maximum growth er the Preventive Medicine Service. General Simmeas and all of us were very sad when we weren't a Service. Ia 19L.3, we were a Division again-- 629 Preventive Medicine, and it was semething te be a Service because that was tepa, and as yeu see en this chart, dated February 3, 1944, I had it drawn se that the Preventive Medicine Service is ia the center here-coming straight C etf fra the Surge~a General, net under aay of the ether Services. This is the maxiallll develepment. Preventive llediciae Service has a deputy chief-I was the deputy chief by that time, Directer ef the United states ef America Typhus Cemmissiea, and Adainistrater et the !ray Epidemielegical Beard, but General \ SimmoM cal~ me ia one day alld said that he theught it advisable for hi.a te have ether Msistaats, aad he thea appointed aa Msistaat chief fer sallitatien, hygiene, epidemiel•~ and eae fer trepical diseaee~entrel. That partly came abeut because beth •ts aeeded help. I had about all I ceuld de with the Typhus Cemmissien aad the A.ray Epidemielegical Beardi. Besides there were persenal matters in these arra11gements. I found myself ever regular efficers whe • ' had a senerity in time ef serTice, but net ia rank te me. I was a Brigadier I\ General shortly' after this-iaMarch er 19440 Now we have under this Service tea divisiens each ene with frem three to feur te five branche1, and that is the mu:imum expansiea of the PreveRtive MediciM Servieeo I think at that time the Preve11tive Medicine Service had fifty.three officers and ever a hundred clerks, starting £rem oae maa and a , couple ef clerks i• 1940. The branches•• these charts are iadicative et special parts or the work ef a divi.si••, but I thilllc ia all ef these charting exercises there was seme private theught ef ukiag a sl.t fer a maa whe eu@:lt te be made a celeulo If he ceuld be made a head er a di'Yision, he would be a celonel. I! he ceuld be 11ade a head of a branch, he was apt te get a pranoti•• tea maj•r• This kind er a thing ia the A.rmy is a preutiea scheme asrwell as administratively aecessary. Well, that's as big as we get. 630 0 Now passing ever acrAss the Rhine iat~ 194.5, here is the chart fer Janua17, 194.5, where you caa see it is a chart ot only the Preventive Medicine Service. I left all the rest er the thiags eut because I di.dft 1 t wa:at te crowd the page teo much, but twe new things are interesting en there. Cemiag off C 1 fra the Office ~r thefhiet and the Deput7 Chiet aad the Executive Officer is a thing called a Special Pretecti•• Ullit. That 1 s BW--Biolegical Warfare, aad en the other side is a aew addi ti•• called Health Education Ulld.t which developed a pretty active role ia preVidi11g •~di• Tisual aids, 0 as they call them new--f•r 1 educatiag the seldier ia utters ef health. It a still a quite large aad active ( divisiea with lets et braaches aad very- interestingr••ple aad werk goimg ea. l Civil Public Hea.lth Divin•• came il'l 1944, aad it s still •• the 1945 chart. That was under ColoMl Turner. It had a ve17 i•pertaat illfluence ea events in SHAEF aad Civil Affairs Military Gevernmeat ia Europe 0 Then the war having finished in June of 1945, demebilizatien took place rapidly" aad the Preventive Medicine Service dwindled to feur divisiens aad eleven branches. The work was still pretty heavy, but the ergaaizatiea was cut down ia offices aad efficerso I stayed ia this Preventive Medicine Service, er as it was called after a while, Divisien until September, 1946, whea I get separated rrem the Army-. Did the Office er the Surge•• Geaeral regain at a& time the lines to the Chief er Staff? Yes, it did ia a curious way. Ge111eral Kirk had su.cceded General Magee •• June l, 1943, I thinko I 111 leek that up te be sure. He had a great deal •f respect !rem the autherities ia the War Department alld !rem the Preaideat. He tried te regain the staff status that the Surgeea General had had, but he 631 ude •• progress fer a while. There was a very valuable un ia the Arwr tbreugh these years named Tracy s. ~ z Veerhl'>:s, a lawyer rrea New Yerk, a busi•ss- \ ,i ma11, wh• eame in as a Celonel and was attached to the L1t<:rAL Divisiea er the Surge•11 General 1 s Office at eae time. "- was rather like General Tracy Voorhis LoRt,y Lutoo. You coul.d selld hia all ffer the worl~ aad he 1 d atraight•"tut san.ething that was bad. Yeu ceuld sead him te Iadia en ••di.cal supplies, I think, to the Philippines, a very persuasive, thoughtful maft elese te Mr. ~ Robert P0 Pattersea wh• was Assistaat Secretary et War, and Tracy Veerhea knew \ Mr. Stills•• tee, s• he exerted his intlueace te briag about a resteratiea et the Surgeen General 1 e staff status, and aa11aged to get a letter trom Mro Sti.mse11 sayiag to the Surge•• General, that I regard yeu as 1ICY' chief ••dical adviser 0 •• matters .~f health aad care et the seldiers, aad I waat yeu to speak t• me whenever yeu feel like it, alld I want ether people to know that yeu are 1111' doctor, se te speak. I have that letter downstairs. That wasn't erganizatienal, wasn 1t charted, so to speako This was a letter from the Secretary ef War as to hew he regards the Surge•n General, but it was effective. Hew he would functioa1 but SemerTell waso••o Semervell was still ever himo That makes it a bit sticky at times. But didn't--well 1 yeu indicated quite early that the informati•• that was cellect~e by the intelligence unit found ' ,/ useful11ess in the greund forces too? Oh yes--all that uterial went eTer te the Central Intelligeace-CIAo Well, it 1 s net that, but there was always a staff officer concerned with in­ telligence at 0-2. G-2 always had a staff efficer with which we used to battle 632 someti.D'les because they wanted te take over this veey successful udical ia­ telligeftce enterprise. They used all the material we collected, &ad they used it as bases fer campaign plau and all these war studies. Ift additiea, they h cellected aa enol"lllous aaount of material on ~~eir own aftd had a big reading reom. Our officers used to go over there and spend days in. their readiag rooms getting their uterial. They used our material, and they put eut a aum.ber er intelligence publications. Then with the collapse ot Germ.awy, they begaa to send all sorts of ndssiol'U!I abroad to collect Gel"lllan aaterial, German drugs, Germ.an clothing, Germ.a• books, Germ.all weapol'U!I. One er these missions had a very secret purpese--t• look after, we'll say, the rocket situation. The Germans were firing the V-2s toward the last of the war. e.. Peaemfbtde. \ e Yes, Peae•~•de, an.d. Geraaa fuels. All of that was bound up with medically ' iaterestiag things some of which were collected by medically interested people. One of the missions was/called Al58S Missioa. Do you kaow what that means? Alsace? <,.; '5 It 1 s a greek word for Grove. Remember Maj or General Grove? '\ '\ Who made the bomb? Well, A1So5 is just a greek wort\ for his name. Well, they had enoI'.lllow, intelligence from the Army Service, and our Surgeon General put out a series •f :aimeographed, legal-leagth sheets called "Medical an& Sanitary Data", n.otes Oft Java, Indonesia, CePl.tral Africa--stacks of them. In short, what began quite early in Greenland was another waz for ground troeps 633 to look at what they might aaticipat!o That was the intentioa. They collected rainfall data, climatic data--food ~ supplies, water supplies--I mean information about them. ½That •ve been sayiag--I den't know whether you waat all those words typed out, but what I've been sayiag is that the concept ef preventive medicine ia the mind of General Sillll'llons and the s,mpathetic minds ef those who worked with him was a world wide I Its hard1 I think1 to beat an imaginative man who is successful~ It just is. Also something came from him that made for effective congenialty. All the officers as heads of these divisions and branches often had desires for the same thing at the same time, but I never recall al\Y bad tempered situatiems 0 except possibly on my part when ,~ne of them would try te take officers from the Army Epidemiological Board0 I can uaderstaad that, but agai• the leader makes a difference. Another thing about General Simmons is that his influence persisted whether he was around or aoto I thiak I was deputy chief and ia the chair pretty nearly half the war, but it all went en just as if he'd been thereo He was sick for a while, and then he 1 d go off on long trips to India, Europe, Panama, Haiti. Enough problee sprang up with reference to the health of trocps te make ereventive medicine even in the eyes ef non-medical personnel very i.m.portaat. What I want to emphasize again is that this is ut, as smne of the medical efficers in the Surgeoa General's Office thought, empire buildiag 0 This 631' ergaaization chart represents even less than we might have deu, it we 1 d y had m•r• m•ney alld ••re mea, but it must be underetood that Preventi~ Medicine ··t is conceraed with the preservation er the health er the whole Army0 It is larger than the Surgeon General 1 s field because his jurisdiction extends oftly to the people under his COlllllland; namely, the medical corps, enlisted men and officers and hospitals, and he's illterested in the cureo People are brought to him and if he can cure them, he cures them. If he can't cure them, he re­ habilitates s~e or th•, and he buries some et them. Preventive Medicine is all the tiltle concerned with everybody- in the .A:rm::f including the Surgeon Geaeral to try to keep them all well aad healthy and fit to fighto It works through-­ Preventive Medicine works threugh the line. Ever since the days of George Washiagtoa and the Continental Arar:, it was worked that way, alld all the Army Regulatiom, having to do with immunization, sanitation ef pests, certain measures fer the health ot tro9Ps are issued by order of the Secretary er War aad sigaed by the Chief or Staff, s• they doa 1 t c•e out from the Surgeea General, although the texts were prepared in the Surgeon General's Office 0 Who was it that ,fingered Geaeral Silmtons fer this pesitien way backi--put him in charge? I have a very shrewd notioa who did it, but I never had it from him, or I have never seen it in writings, but I think Surgeon General Reyttolds, the predecessor or General Magee, who was very 11\lWq ,, aware of preventive mediciu aad wrote a fiM introducti•a t• Geerge C Dunham 1 s book ea Military Preventive Medici•_, was the man who did it. He is the ••• who issued the erder that breught Simmons from the Office ef the 1st Corps Area ia Best•• int• his effice. General Reynolds kllew Simmeu in Panama, made him President of the Beard down there and had kn.own him 1• Washingtert. Oeaeral Reynolds was a very 635 intelligent man. In World War I, he was under Gefteral IrelaRd and later succeeded General Ireland as Surgeen Geaeralo This is like bringing ia a fellow with horse power who is going te stir UE the aaimals 1 but who is going te get the job done and--you kaew1 it just takes that drive. He had it, but I weuld not put him in the class or practicing adminis­ traters ia the s ae sease that I weuld be 0 He didn't have te fool with details. He already kaew their significance? C No, he would just say, "We're gl.ing .\ te de thi••" The work that the divisi•• chiefs did aad the deputy chiefs did was infinitely detailed--a• end te it. We weN encouraged te go about things with K sae eriginality by evea se hard a disciplina-1a• \ as General Semervell. ; Were ~u? He was a curious mixture ef coatradictioas of small type things and broad ideas. I think he 1 s much broader than we realized at the time, aad that some tJlfi(E 0cf.c:_, ot the small thl.11g11 that were donefby his assistaats, but he said early that I\ he didn't waat time wasted ever exchange or erdinary memoranda and reuting through channels. He actually said,"Pick up the phone and call your opposite llUlllber on For me that worked extraordinarily well in two waye--two cases that I know abeuto One er the• was ia 1945, whea we crossed the Rhine, and there was all this typhWI uncovered ia the Rhineland, thousands of cases straying out frem these coneefttration ca111pso A cerdea saftitaire was set up•• the Rhine •• that al.l the people, the thousands of,refugees alld ethers that were headins 636 fer the Ne·:therlaads and places lile that, had to cress the river, and they were net allowed to cross the river unless they had beea dusted with DDT 0 The cordon sanitaire were inspection posts at the Rhine cressings, ferry crossings, bridges. Well, DIYl' was hard to get-a little bit, but Lt. Colonel Leonard Ao Scheele cuae ever eu dq from London and talked t• me and said that he was desperately in need of mere DDT to dust these people. Believe it or not--this is what actually happened-he waated eight million pounds, I think, ef a ten percent DDT pewdero Colonel Lundeberg was Assistant Chief of Service at that tima--March, er February, 1945. Celenel Scheele and I went te see Lundeberg. Colonel Scheele was in the Public Health Divisioa ia SHAEF in Load.ea and teld Colonel Lundeberg what the eituatiott was 0 We then and there drew up a little short memorandum addressed te the Surge•• General saying that we recemmended that this be prec11red alld seat ever by air as soon as possible. Bllrgeea General Kirk, wha we weat te see, imtediatel.7 approved it, aad I tHk it ever te Majer Geaeral Gl•• E. Edgert•• who was the Chief •f F•reiga International Health Divisiea ia Ao s. F. He apprOTed it right away-, and ia two days we had that uterial ever there by air. The only piece or paper exchaaged was a little bit of a piece 9 I was at that time Director of the Urdted States s or America Typhus Conmd.ssioa staading oa aa Executive Order of the Pre~dent, so I didn't feel teo shy about asking for it. The ether time that interests me, a happeniag outside of channels, resulted in the revecati•a or an order that General Douglas Mac.Arthur had givea whea he was Supr•e C81111Raader in Toky'•• There was an International Divisiea of A. s. F 0 There was a Jewish captaia d.ealing with typhus supplies, alld this captain would come ever aad shew me a picture ef hie latest sea, er tell•• about his wife, fantily, this and that, an.cl one day- he called me up alld he said, "Geaeral, did yeu see those tep secret telegrUlS from General Hildring to 637 General MacArthur?" General Hild.ring's telegram said te Gefteral MacArthur, ia effect,"What de you meaa ½r saying you wea't have any typhus cemmissioa coatrel supplies ia Japan, er aay- aedical supplies seat te the Japanese whea I going to the Ceagress to get m•aey fer this supply of drugs and medical things?" In the meantime we had thirteea ships, farts ef them loaded with Typhus Cermnissioa supplies in seTeral ports ia the country, and they had been uftl.oaded by erders that cae from SCAP over General MacArthur's signature. I telephoned te Lt 0 General Lutes who was the Deputy Chief or A. s. F. and chairman of the executive committee or the Typhm Cemmission and gave him the lllllllbers ef those top secret telegrams and he sent fer the• and read th••• He took the• to the Office or the Secretary er war., Chief of Op, ratieaa, aad said what I told them, that refugees were pouring into Osaka from Korea--aad this is aow late September, or October, 1945--aad there was some typhus there, and we got very- much worried• General Lutes got a telegram seat back to Tokyo sayiag that these ships would be reloaded, single hatch top loaded, and that the material would be accepted over there. My executive officer @olonel Joseph F. Sadus!g was i• Tokye at the time, and when that telegram came in., there was collSteraatien, he tells me, ia the effice because words like that hadn't t1 co~e from the War Department te the imperial general. This is in keeping with Somervell 1 s netion to function. Those aati-typhus supplies got there in. 0 ctober, er ~e in November. Typhus breke eut in Osaka and spread through Japan. I have a chart er the I outbreak ia another publicati••• and it ea most spectacular thiag. It was in the winter and cold and by delousing with DDT aillieas ef people that curve weat straight up to 31,000 cases and doWll to the base line by the ead et 638 Jaau&r7--just like a spike, but it could have been real bad. Had they net had the materials 0 Yes, if the materials hadn't gotten there. What interests me-as I say about going through channels--it all started because I happened to know this boy and talked te him about his child.re•• Well, I imagiae whatever was done within the division had the design and e support from General S ~ u tH1 and geed support within a d.ivisien helps it to functiono Yes-men I talk about the Typhus Commission, I didn't always bother General Simmens with all these thingso Some ef them happened when he wasn't there 0 He was ca the executive committee, and he, Dr. Dyer aad Captain To Jo Carter of the Navy were ceutantly consulted oft the executive committee. The executive committee had General Lutea, the Surgeon General of the Navy, and the Surgeon General ef the Army' also en it, but the affairs were mere or less routine, and I did not bother them 0 This executive committee--yeu mentioned Dr. Dyer--ties in public health• Yes, because the Executive Order not only made the Typhus Commissiea rather indepeadent or the Surgeen GeNeral, but part of the Executive Order says that ene of its duties--what is it?"-he says,"By virtue of the authority vested in me as President of the United States and as Commander in Chief of the Army and Navy of the United States, and for the purposes r:f protecting the members of the Armed Forces from typhus fever and preveftting its introduction into the United States, it is hereby erdered...." That last is an obligation of the Public Health Serviceo I never tried to de anythi11g under that authori- 639 zatien, except oace, and that reused up the e~ecutive cemmittee, se I didn't ge through with it. That oace was when we were gettiRg Mexican laborers from Chihuahua. They were coming ia, and they had occasional cases of typhus among ,, those Mexican.a working in the middle er the c~\ntry--I•wa and places like that. ·rhey were lou:51', aad the problem was to get DDT down. there and to get it useda There was some hitch, so I started as Directer of the Typhus Commission to get up a tem to send down inte Mexico with dusters and DDT, usurpiag a function of the Public Health Service. Dr. Dyer was quite aroused by that. We had a meeting am decided that it would be mere pelitic net to de it that way0 There's--these bexes don't shew the relationship to the Department et Agriculture aad the scientific work there. No, there's nothing there ea those charts that is not organically connected with the Surgeon General, but we had--well, the Natienal Research Council doesn't shw there, the International Health Divisiea, the Agriculture Departmento In fact, I don't show the War Department 0 No-I thirtk it 1 s a let easier te see some of the ramifications of change 1 and th• Army Epidemiological Board work that we talked abeut.o Maybe we'd better stop because we've gene loager than an hour 4 Well, I'd like some of that to get in there because just to drop the Board ia and to talk about tropical diseases, hepatitis, to me is without a head. Well 1 it illustrates that 1• the effice you wereR 1 t jealous of title--that if problelllS did emerge 1 you could use skills available, or skills you had access 640 te-the comnd.ssion designatioft didn't mattero I get s•mewhat cenfused after going through all these papers. You're too legicalo I guess it's your functien to pull me out of the confused state. Is that still en? Yes, and we caa take up next time heeatitis as it goes through. Perhaps we'd better set the Board aside for the time beins and bring in that Commission here-this fantastic erdero Don't yeu think these charts will give a little picture ot the Office? 641 Will yeu make it¥,ewn there {_the Cesmes Club meeting ef the Washington Academy ef Medicin.!7 all right tonight? Yes--6:300 Yesterday we talked abeut the development of the Preventive Medicine Divisioa1 in part in terms of its guiding light, General Simmons-we got saething of his substance aad quality aad the wq matters happencd­ illogically1 but they happened to aid the growth and development of preventive medicine as ene ot the big items, certainly, with concern fer niu million troops 1 shifting populatiens, the possibilities and potentialities inherent in thiso I find ia the scheme--an itea you've given me--the emergence of another agency, different from the Army Epidemiolegical Beard aad sustained by an Executive Order of rather far reaching power. This had to do with the Typhus Ccmmdssien. As we've indicated1 words by themselves are net self-activating, asi to put substance int• this Executive Order requires the push, the idea of men. I wondered out of what kind c£ context, thinking, this emerged? Since this involved aq number ef agencies; aot just the Army, but other agencies as well, hew this was really managed--I guess that's the werd--g~ that it came into being and acted as effectively as it did in the area of typhus which has a long history of being the great scourge of Armies in the field, civilian populatioas overruno Ty:phus was held in check so well by this commission, in part by the discovery of DIJI', and by the accumulation of evidence to conditio• judgment. I suppose there are two things--how itemer·:ged and some iaternal i u criticism as to how it o erated in terms the vastness of this power which is conveyed to this Commission. Well, I 1 ll give you a short historical sUJlllllary, and thea I 1 ll say frankly 642 what I think abeut the Executive Order as an expression et policy aad as aa iutrument ef pewer. The uacertainty as to the amount ot typhus, eo to epeak1 ia North Africa atvthe time er the iavasion had General Simmons, the Surgeon I General, and ether peepl• quite worrieda The amount er typhus was aet knewaN- as Celenel Perrin H-Loag oa the staff in London whea the North Africaa illV'asien was being set up said,"They didn't knew what they were going --t.o face i in the way •~typhus in North Africa," and as a matter ef fact, looking at the records later-such as G. Greneilleau 1 s study or typhus in Algeria and Merecce shewing that there were about forty thousand caees in that population, aeag the Arabs and the people the Army was goiag to mingle with. It w a~not knowa, but there was a suspicion that something was geing •• because typhus was increasimg in Egypt, aad it was likely that it weuld iac~se in North Agrica in the winter too, se General Simm.cu and Dr. Dyer first began te con- ~ L sider getting authority t• send over a co11'11111.ssioa, if you want to call it that, to make inquiry, cae back, and make a report, and•• the basis er that report, it was supposed that a deliberative plaa would be made as to how te deal with the situation threugh the normal chaanels or sanitation aad pre• Teative medicine. At that time there wae, ~,m sure, no thought of the kind or instrument represented by the Executive Order 9285 or December 24, 1942. There was no thought of an instrument like that, but the cell'Dliesi•~•s aever sent. They ! bega11 to get some informatiea that typhus was eecurrl.ng among the natives or North Africa and that obviously something more than erdinaey exertien against typhua should be put ia •IJ'ratioa for th• protection of troops. They at first asked General Simmons if he w.ould be the director of a connnission eve11 before the erder was draWl'l up. ~,. talking about the period maybe in Septeaber ot 1942, certainly in October. They asked General Simmons if he would accept the appoin.tmetrli as Director or a Typhus Cuunission. He couldn't de it. He couldn•t leave his directership ef the Preveative Mediciae Service te take on this eP1e thing. They asked next Dr. Rella Dyer who wae Director of the National IMtitute er Health. Dr. Dyer, a Public Health Service Officer., had the raak of Brigadier General then., a ftd he didn. 't wa11t te leave his iltportaat work on public health of the U11ited states in. the time of war te go abroad oa a lllissioa of this type. The other man they asked te be the director was the Chief of Preventive Medicine Service ia the BurR,u of Medicine and Surgery of the Navy and that was Admiral--he was Captain Charles s. Stephenson. at that time, an.d then things began u, change. Stephenson accepted,. an.d fran - that time .. oa the centact ef the Army representatives with the developing plaas., as well as the perselll'lel plau and operation.al plans fer going overseas to study typhus, were more or less u11der the control of Admiral stephenson as a Navy op.eratioa. AdJliral Ress To McIntire., the Surgeon General of the Navy, backed up Admiral Stephensoa, and now I•m talkiag from hearsay--I was told by Admiral stephenson. that he knew very high ranking people in the State Department, and that oae of them had suggested t~him that if he went abroad on a mission of \ this type that required extraordinary powers to be successful, he should have an ambassadorial rank. It turned out that those who had charge of recommea­ daticns for ambassadorships dida 1 t want to make one for StepheMon., so someway or other he., with the advice of lawyers, I think., in the State Department and e perhap• in the Executive Mansion, fo! all I know, dr•w up this extraordinary \ . Exec11tive Order 9285. I do not recall ever having seen a draft of this before it was published. I didn't, or I don 1 t believe that either General Simmons, or Dr 0 Dyer saw it because Isw most of the papers that came in. Being Deputy Chief of Preventive Medicine at this time., I saw most of the papers that came in te General Simmons' Office, and I have n.o recollection of having seen this 644 order until it was published. As you said, it is an extraordinarily powerful order. The President says that he is appointing a Typhus Cemmission to serve directly ul\der the Secretary of War. The language after that makes the Secretary of War and the Director of the commission empowered al'ld responsible for doing most of the things. The Director is directly- referred to in such a way that the Director later felt that all he 11eeded to do was to report to the S_ecretary of :War, that the Secre1a ry of War need 11ot be involved and was. not involved i11. the local decisions that were made. The beginning of the Executive Order says that this coJl11li.ssion is appointed for the protection of the troops against typhus wherever it eecurs,"or may: become a threat" to the troops. That opening of what "may become a threat" to the troops is a very extending term because one place may be a threat, er what starts an epidemic? Who knows. On.e louse might do ito I don't believe that's so, but it could start soaewhereo The Executive Order also says in the very first paragraph that there is net only this protective function, but the cemmission must do scmetbing, er the conmdssioa is empowered te do something, to prevent the introduction of typhus fever into the United States. Well, the introduction of typhus fever, or any communicable disease into the United States is aa obligation by law•• the Public Health Service with their quarantiM systemo I alwaye thought that whoever wrote this Executive Order did not coordinate it with the Public Health Service because I don't see how the Surgeon General of the Public Health Service, or aay of the chifes '' there could accept infringement of their jurisdictioa to that extent 1 and I got into a situation only oace as Director of the Typhus Commission when I ~ started to do t1omething that involt,ed an infringemerit upon the Public Health '1· - • Service, &nd that was te set up a plan for delousing Mexicaa laborers coming into this countcy--the leusy Mexicaa laborers comiag into this country trem a typhus infected district in Chihuahua. Dr. Dyer epposed that1 aad he had the backing e:f General Sinmtou and Captaia To J. Carter., who was then actiag fer the Navy., and we drepped ito The other main points about the Ex:ecutiv« Order are these paragraphs that begia over a•d ever agaia,"The director of the commission is authorized aad directed te fermulate and effectuate a program fer the study" ef typhus u,d .s its control everywhere it exists, er may be a threat--nThe director i 1~ authorizes aftd directed" to call on all agencies in the gevernmeat that might be able to help., aad these agencies that are under the_ control ef_ the govermeat are told to supply th• co:mmissioa with fuada., personnel., al!ld supplies., aad provide fer their housing and feeding• That was told te th• emmnandi ng generals of the theaters in a special letter from the Secretary ef War te General Dwight D. Eisenhower in the European Theater of Operatiell81 te General Deuglas MacArthur in the Seuthwest Pacific, to the commanding general of the United states Army Forces in the Middle East. That letter accompaaied by the Executive Order hat very persuasive effect en these high ranking efficers. They ever questieaed it. They toek it as aft order and never, except in ene case, tried to say that as they had all these responsibilities for fundiag., transport, provision and caring for the e01111ission1 they should have coatrel 1 aad that was late in the war when an Air Force Major General in command on the forces ia Egypt, Caire, the Middle ) ll East, without co~,~ltiag the commission. aotified our executive officer that the organization chart showed that the conni.ssiea was thereafter attached fer command purpeses to the headquarters of the commanding general of the theater. Before that time, it had net appeared on ergalllizatioa charts et the headquarters of the theater. It had just beea listed as som.ethiag "attached 646 ,'\ fer admiaistrative purposes" which is aa Army phrase for f•~ag, clothing and transportiag and deesa 1 t involve command. That aetice dida 1 t ge int• effect. A:tpretest was made right avq. The general saw it., aad in. a friendly W&'1 let it ge. Well.,•• the basie of this Executive Order fer sin.gliag out oae disease, the Typhus Comnrl.ssioa Office was set up in the Office of the Surgeon Genera1 et the Uftited States A.ray and was carried as an appendage of the Office of the Director ef the Preventive Medici• Service. The Chief ef Preventive Mediciu Service was alee the superior officer ef the Directer ef the Typhus Commission because I was the Director of the commission and was also Genera1 Simmou 1 deputy. I also-.s a medical officer uader the Surge•• General, but I 1ve always had a hyphenated existence, aad I seem to be able te fuactioa amicably', I weuld say., with the Bayaes aad the Jous just the s&llle--that seems like a childish way to put it, but that's the wa:y it waso Thiags were doae without aay argwn.ent that I recallo I got approval all the time from General Kirk, the Surgeon General., General Simmeu sufficient te de what the Executive Order says the e81111lissiea caa do, and tt set up practically its on channels er commutrlcatioa. The Office of the Directer er the commissi•• in th• Surgeon Geaeral 1 s Office in Washingtea had its owa message ceater and could send cables directly overaeas, but the wording of these cabla • was like this-from Kirk to MacArthur iafom Sadusk. Sadusk was the executive officer ever there. The cable would never.. get to General Mac- - Arthur. It would ge somewhere in his staff, aad seme coloael., or major would pass it•• dowa, but General Kirk's naJll9 was alwa,-.. ia these radiogras going everseaa to cemmallders, er to anywhere-anywhere they went eut of the Surgeon General's Office they had General Kirk's riame in there as the sender, alld. whea they came back, as a rule they were addressed to the Surge•• General fer 647 Bayne""'1oaes. I think practically all those radiograms were to me, a few for Silimons., but they'd all g• that way. Thatvas an. exaple1 but whea these radiograms were prepared by•• they would ge down te the classified message ceater to be looked over fer proper pbrasiwg, t?~ kind of thing that you'd have to do fer cryptographic securityo Yeij 1 re not allowed to repeat a whole lot ef words over and over agaia because that gives the code away. If a policy of aftY' col\Sequence was involved, I alwayg cleared it with General S~_ons and General Kirk. I don't thiftk: I ever did aaything that they weren't fully aware er., except miaor matters about seading a thousand pounds of DDT for some job, er something like thato I This Executive Order is so powerful thatiit could have brolaa offices te \ pieces and yeu could have raised hell., if yeu waated te. If yeu wanted te rear back o• this aad assert-as s0ll9 reugh efficers might waat te do­ authority, it weuld have made trouble. Don't you thillk se? Oh yes 0 But it Mver did. After I get settled in it., I had in the epidemic typhus group ia Cairo, North Africa, and Italy, and 111 the group in the Southwest Pacific working on scrub typhus through New Guiaea up through the Fhilippines., even to Japaa., about thirty medical officers of the Medical Department aad Sallitary Corps officers. They were assigned by erder to the commissioao I had all their records. I arranged for their taYo In other werds, I had a contingent. I had about fifteen Navy officers., ab~ut fifteen., or eighteen Public Health Service efficers and perhaps fifty civiliau from Navy., aoa-ealisted m••• All those rjcnrds are still ia a gr•up ill the Historical Unit, AMEDS. I eught te have counted before I tried to do thiso I 111 correct it, if yeu need it 0 It ran as a separate ;sort ef iastallatiea, 648 so to epeak, although it was right i• the he118e with the Surge•• Geural and Preventive Mediciae, ia the aext room te General Simmeu, in the same r•• as the Army Epidemielogical Beard, the 8 a• reom ia which I did all the work I ~1.1 Chief of Preventive Medicineo had te do as the Dr1flty '\ If it had beeft under a Navy efficer, I don't think it would have worked as well as it did because they had a separatist tendeacy. It was net 0111.y appareat 1• Admiral Stephens•• who developed coronary trouble ia Jerusalem, and I will say fra~., provided aa epportuaity to make a change ia the directorship. He was succeeded by a Navy Captaia nuted E. Harvey Cushing, nephew ef Harvey Cushingo He's a leng time friend ef mine, se what I have to say is ebjectively- aa assessment ef a streak of arrogaace. It was in the man, I think, but he didn't last very loag as Executive Officer. When-well, . he . was breught back fro• Cairo aad at that moment, about March, 1943, General Simmons took a very positive aetioa and brought in his long time, life time friend, Colonel Le•• Ao Fex who ~ a splel'ldid record ia saaitatioa and pre• ventive aedicin.e, who had been ia charge of the Corps of Engiaeer's health service for the bases ia the Caribbean and the Atlantic, and wh• had surveyed I the air reutes from Georgetewn, Nata~ Aeeensien right across Africao Colonel I J .,,. y .s s Fox was a volu_:,:ble, vi~•"'o~ pictur~~ue, profane maa of great ability. He was willing to accept the directorship, al'ld he was promoted to Brigadier General ia about a week ors• and sent to Caireo Do you want me to go on with this kil'ld ef stuff'? When he got to Caire, he found the group at Caire, which was the only group functioftillg at that time in the field, in ar disorganized state 0 There were seeds of dissension in the very formation that Admiral Stephensea ••• 649 giaeered. In other words, Admiral Stephensen brought in the reaowaed Dr. Fred L.Soper f'rem the Iaternatienal Health Divisioa of the Rockefeller Foundation as a member of the cemmisaioa with the understanding that the Rockefeller Fou~datioa would pay his entire salaey and that he wou+d still be mare under the centrol sf Dr. Sawyer than hew as under General Fox, er General Simmons., or aftY'bedy else. Dr. Seper is a very strong minded man. There were two ether Rockefeller Fourrlatien people, International Health Divisioa--Major John c. S\lly'der aad Major Charles M. Wheeler. There was difficulty- in agreeiag on plau and policies among these•••• I~asn 1 t there at that tiae, but I know from the correspondeRce that it was a bitter and heart breaking business. It broke up so that Dro Seper went ca off into Africa, North Africa, and joined up with Colonel Williams. Sto••~ the Preventive Medicine Officer of the North African Theater just at a time when a curieus thing had happened. General Fex, Dr. Soper, and others ia Egypt had been working•• dusting clothes with DDT to kill the lice and control ty-phus. Soaethiag went wreag. Oae experiment failed, and the rumor weat arouad that the DDT was defective, and samples were sent home to be tested. They were all right. There wae a lot of name callil'lg aad cross talk about the efficacy of dusting clothing with nm. Dr. Soper went on to North A~rica and immediately', without any further question, put•• a large program of dueting l•usy- Arab prisoners ia North Africa using DlJI', using Rose Dusters, Admiral Fl.ewer Dusters-you puff it under the clothes, a remarkable thing. It killed the lice. It had a long lasting effect. It would stay- in the clethi!'lg for weeks. They-were far better than delousing by heat and bathing, because after you delouse by heat, er bathing, and yeu put •• clean clethes, you get lousy- in fifteen mirrl.tes agaia. With DlJI' you get protection lasting for weeks. Also DDT soon got en the black market because it was thought to be an 650 opiateo These people could sleep after they get deloused 0 They thought that this was the best sleep producing drug that they had ever come acresso It was so goed that it was possible te delouse Moslem wo~.! with their clothes ea, poking the dusters up under their clothes and down their bodies, so it was very successful, and it was already to go whm the Naples epidemic started, Now to go back te the commission ia Caire. As I say, that was the ollly functioning unit at the time, aside from the central effice ia Washington, and in that central office ia Washington I had by this time come into form.al assistant relationship with some authority in the Typhus Commissiono Up to this time, I had just been hand)ing the papers without any authority at all; teek the• as the reutiae of the deputy's job--that is, the Preventive Medicine job. General Fox was so disturbed and worried by what he saw that he sent (: a ~ablegra. back te General Simmolll!I and me and said that he intended to bring the commissioa hae. It ollly took us a few minutes to realize that that would u be a fatal thiag te de 0 Actr\ally we sent a radiegram. to.General Fex ia the usual way, Kirk to the Commaading General for General Fox, sayiag that yeu will net do that-about as plaia as thato General Fox then came home. He could get orders from the Commal'l.din.g General, and he made mallY' trips back and forth to the United states c ft a mmnent•s aetice. He came back to talk it over, and he uBderstocd what it waso I He said--well, as Itremember, he really didn't like the administrative paper werk se much. He was a f ~ maa. Se he was. He'd been commander of the Medical School at Carli~~, and he made all these extraordinary sanitary surveys from Newfoundland dawn to Surinam aad everything ia between, and all the other routes, Air Feree routes across Africa. He loved field work, and he was able to de it1 and he could take awq kind of a beatiag ia the work, got cooperatien wherever he weat, aad he just enjoyed it far more than he did 651 office work of any kind, so he was satisfied to be Field Director, aad I was satisfied to have him be Field Direct•ro They made •• Directer. I never raised the questioa as to who was boss., but F•x handled it very nicely. I went overseas twice in this time--in 1943, in December, whea he was Field Directer as a Brigadier General., aad I was a Director ia the rallk of Celet1el. We had a tremendeus Typhus Collfereace ill London with all the leadiag •fficers •f the Royal A.rr4y Medical. Corps coaceraed with typhus.......Major General Sir Alexander H.Biggam, Major General Do To Richardsea, a few frem the British Medical Research Oouncil, people from all M doWll the lir:9• Sitting in this collfere11ce room talking about typhus., going through a very cemplete agenda, the sessien would g• on, and the British efficers weuld waat aa authoritative auwer, and they turMd to General Fox there and asked hi:a what the Gefteral 1s opini•• was, and he weuld deferentially bn te the Colonelf I and I had t• aaswer. He was playing a game, I thinko Then later 011, when I we11t t• Egypt ia March of 1944, I was the11 a General and Director, aad I weat oa a long trip•• the air reute across .'\ Africa te Khartoum and on te Caire, aad whea I arrived at ~~ro., General Fox was there at the airport with a big car and some aideso aad he bowed this general into the car. He was pulling my leg a little bit, but it werked eut all righto While I was •ver there ill Cairo, I weat around with General Fox to all the laboratories--we had a superb laboratory--and we had the whole fever hospital. Fox had made great friel!ld.s with the Minister of Health of ~ t and a lot of Beys and high ranking •fficial.8--th• Typhus Cemmissi•n was the thing ia Caire at the memeat. Fot had rehabilitated it., and they were doimg excellent work ia the lab•ratory and on the ward. I stayed there about tea days and saw these thingsci, 652 I had aaother job at the saae tia8 talkiag to the Millistcy ef Health about yellow feTer vaccin.ati••• The rules--the Eg,-ptiall8 were being geveraed by the Iadiaa rule which had not yet caught up with the new knowledge, aad they were unnecessarily severe ia requiri&g revaccinatien at more frequent intervals than was l\ecessary against yellow fever. They dida 1 t knew that the immunity would last a loag time.. The Egyptian were playi.ng_, I thi~., SOJll.e kind of a game with the Iadiae and the British. It resulted ia holdiag up air travel through Caire, military air traTel, and kept our tregps from ~ getting off ship! ill Be.bay. Sometime they were kept en board for two weeks. '\ It was serious enough that I wsnt to see the Egyptiall Millistry of Health and got the rules changed because I had plenty of eVideace aleag with me, that I had gettea from Dr. Sawyer largely, but that was a side issue. The fact that I was Director of the Tp:phws Commission and had this Executive Order aad was well received by the minister--Americaa minister in Egypt aad by general officers didn't do any ham. New we're getting tward Naples, and l 1d rather aet go•• with Naples right now. It will take a loag time. Let me just ask you this--what part in the develepment did the d Hire te vaccinate the civiliaa pepulatiea play? Did the commissi•a licease public health associatieu in ceuntries? Didntt they? Ne. We gav• it away-0 But as ageata. 653 The vaccinatien ef civilians could have beea done by any doctors anywhere, where the doctors could get their hands on the typhus vacciu. Anybody in this country- could buy it and give it, but the Uaited States Gevermneat had milliou ef doses made. Here even the cf>lllmissien came in oa the supply of C: typhus vaccine. At o ■e poiwt, the phannaceutical manufacturJ:_rs in this country, wh• were makiag the vacciM, dida 1 t have eaeugh beu. fide firm erders te l) A j~stify their continuiag product!••• This was critic'1zl, because the staff makiag typhus vacciu were i.Jam.uae. Seme ef them had had typhus--it was dangerous work 0 S9ll8 caught typhus and died while they were makiag the vaccine. Mest of them had been immunized by iajectioM of the Taccine. Seme of them got doses that they- cculdn't handle, and it was a daager at that time that those expert, innuae staffs d: the manufacturern would be dispersed, se I went down te see the supply efficer in the Surgeon Generalts Office and waTed this Executive Order at him, and he said, "All right. You write Ile a piece of paper alld say that we •ust erder tea 11lillioa dose•", er something like that, aad I did. It was a little piece er paper that ~ept theee staffs at work. Well, s• far as civiliaa vaccinatioa abread there were two things ia there. A certain amount or vaccine was just given eut free, we'll say, ia Naples and adllli.aistered by- the United States people wh•r•re working en the epidemic in Naples. They did that in ether places t••• We had a very geod vaccine,~ better vaccine than the British had, aad we used it. It began te be distributed by General Fex in some of hie trips, notably to Teheran in 1943. He then got terribly outraged about it because the vaccine found the black market in Iraft. He took it up to Iran to be givea te the peor people, but it got in the hands •f the bankers aad the lawyers, and they kept it for 654 themselves, and the poer people didn't get much which di~turbed General Fex a great deal. In additieft, wheft Gen.eral Fox and Colonel Edwards. Murray were ~ent in civilian clothes in to Turkey, they teok the vaccifte along with them te give to Turkey--we had a project to study the effect ef vaccinatiea in produciag illmunity by usiag the prisours in the Zend.ulak Prise•, I think, but the great distributioa te civiliau came after the Caire Cellference. The Caire Cen- ference was in•••• Late 1943 1 wasn't it? Yes, late 1943 l'ffovember 22-25, 19427', aad General Fex was at the Cairo Confereace, stayiag out at the Meu House, and he had some access te the Q Presid~nt's party. Along on that party were Admiral McIntyre, who was Presideat Reosevelt 1 s physician and a member of the Executive Committee ef the ~- Typhus Cellllllissien, and Lt.General LeRoy ~utes, who was the c1~rman of our . Executive Committee, and all these gen~en were in the Pres~deatial family, so te speak, at Cairo. General Fox had the very bright idea that it would be wonderful for Alllerican prestige and good will if there were a free distribution of typhus vaccine to the citizeas of the Middle East countries. He got that approved• Admiral McI•~re took that to the President, aad the President said all right, aad immediately a cablegram came over s~ag that the President approved the distributioa ef typhus vaccine to the Middle East freeo We hadfillioas of doses in storage in Caire at that timeo I think another thing that might have in.flueaced General Fox, aftd this is a matter or record anyhow, that it would be better to put it out through American agencies rather than through the British, because the British had a habit ef taking the American label off aad putting a Britieh label on a good will package. I think 655 V maybe we distributed tea million doses of typhus )taccin• oa this presidential approvalo This was in an area by aad large with which we'd had little experiencew-Iraa, Egypt--nemadic tribes ift Iran that are on the move all the timeo Iran'e typhus came don from Russia, from Poland. At the very beginning ef the war there were Polish refugees that came down the Persian corridor, as it is called, aad they breught typhus there. It was a British medical efficer naJ1.ed Brigadier A.Sachs who wrote a paper ea typhus and got werried about typhus in Iran right from the start, and of course through Iran was going all the Lend Lease supplies to Russian from Abadan on the Persian Gulf, and the bottom of the Caspian Sea, through there, so that it was a Horryo We were more familiar with Iran than we were with some other places. I forget the name of the commissien. ffe'illapaugh Cemmission--Arth1.1r Chester Millspaug!!.7, but there were missions under American people who were making health surveys and economic surveys ia Iran. I don't remember the name of the Commission that had beea functioning there before, but it came close to me toward the beginning •f the war. Femer ~ajor General Charles Reynolds, who had been. the Surgeon General, was offered the position as the head of a health commission to go •ver in. Iran, and we gave him a lot of information. We did know a lot about Iran, mere thwn we did about Egypt. There was a fellow named James M. Landis. In Iran. He was in the whole middle east in economicso Well, the Middle East Theater started as an economic affair, supporting 656 i\ I Ii the Le~ Lease operation for the Russians. There weren't many troops there for a while. There never were veey many. Did the laboratory work just on questions of typhus--er did it also de these iatelligenc• suneys 1 ether diseases that JniGht be ia the area? Only incidentally. The only other dise.ase that it surveyed was relapsiag fever ia the British Sudan. Relapsing fever is carried by a leu.se. The big diseases, schistesomia~is, bilharzioa s--they didn't bether with that. They saw cases of it. I will briag you the whole briund volume of the Typhus Commission scientific reports. Yeu haven't see that, have you? Well, come down with me after this, and I•11 give them to you. They made studies on immunizatioa•-K. s. Ecke and J • c. Snyder. They studied the susceptability or a rodent called GerbillW!! to infection with typhus organisms v and scrub typh\8 organisms. 'Ibey got material from India, Burma. They ma.de fiM clinical studies oa typhus, alld the big basic study was on the pathology of typhus by Cemmander William B. McAllister, Jr. Back in the States-1ou said aomethi!i yesterday about an Executive Committee that functioud" The Executive Committee is not in the Executive Order. No 1 I kn.ew it. The Executive Committee was set up by General Simmons, Dyer and Stephensen at the start because they wa~d to d.o two things--they wanted to have high ral'lkiag adviser8 1 and it was a geod political move to have the 657 Surgeons General--Navy, Army, aad the Public Health Service--and the Deputy Cmwmander ef the Ao So F. as the so"ctlled Executive Committee. I think the name was badly chose• because it never executed mucho It may have been part of the channels of communication to keep everyone apprised of what was going on. It didn 1 t meet very often, and maybe a good deal was done en the telephone to General Lutes. or course, I used to :report to Surgeon General Kirk at least once a week about all this, aRd I suppose somebody reported to the Surgeon General or the Navy aad somebody te Dr. Parran at the Public Health Service. This Executive Committee, I believe was looked oa as something that would come to your rescue, if you got into trouble. Like a buffer. What about the questions of priority--yeu had no funds. We had ne fuNds at allo I have some correspoadence where :B. ., applied to the Director of the Bureau of the Budget fer a budget, and this is the aewer that I got. The Director of the Bureau of the Budget and the D·irector of the Bureau of War Department Budget-he had a say because the Typhus Commission was set up as a Miscellaneous Agency of the War Department, personnel matters, al"ld really its line of communication passed straight to the .,far Department • These other services couldn't touch it, so its fil'la~ces would also be of interest to somebody in the War Department, as well as the Director of the Bureau of the Budget. They studied this request of mine for a while, and actually the reply I got was "With this Executive Order, you don't need a budget. 658 All yeu have to do is just tell the Commanding General, or ask the Commanding General for funds." What about travel--it says that you can &o anywhere. Yes, travel-I had relatively little to do with the travel orders, except D those I would requesto F'J'f instance, if a man was in Cairo, and I_ wanted C him to come back to head11uarters.,_ you'd send the C~anding General a radio- gram, saying, "Request that Col.onel Sy-ad.er be-· sent back to .. Washington 011 Temporary Duty for tea days." All the travel orders would be writtea in the theatero As a matter of fact, I don't think tr0vel was any particular con­ eideration to anyboey in the war. There were no limitatioms to speak of on the amount that was spent. I 1 m sure that the travel I had under the commission was charged to the Surgeon General as a regular order. When we sent officers over on travel orders which turned out to be very big and complicated thin.gs, I woul_d work with a Colcmel J • A._ Grote11rath ill the War Department. All our travel orders geing out for people who weren't on the . - staff, we'll say, of the Surgeon General, and couldn't get them some place else, we'd get tho through Colonel J. A. Gretenrath. I remember oae case where we wanted te sead a greup to Burma to the scrub typhus laboratory we eet up 011 the Irrawaddy River. For exam.pl•, Colonel Thomae T. Mackie was the head of that, alld. I caA recall working eut Colonel Mackie's order with Colonel Grotearath in the War Department because Colonel Mackie at that time was on the staff of the Army' Medical School, and they had ~o concern with traveling him over there. You moved public health personnel too--A. Go Gilliam. Yes--well, you'd get the theater to write the order. I forget when we 659 sent Gilliam out of here. He was oa the first group,wasn't he? Yes 1 and he went to China. Gilliam get scrub typhus out of that. When it came to maki11g action effective, this was a pretty good ru]t..-this Executive Order. Oh yes--it 1 s broad enough, and you had to do it. As I say, I don't ever remember it being used as a stick ift the sense of beating anybody. No, but we can come to it temorrew where certain effers of aid and assistance were made in the Mediterraneaa area which were, in fact, refused--yeu know, Naples 1 but that'• too long 1 and you said earlier that you had te go1 and it's a quarter after three. I■ it quarter after three? Seems like ~'ve been here an hour--! cae a little ahead of time. Well, it varieso Wheft Lt General Ronald~ackenzie Seebie weRt into Greece, the Typhus Commission in Cairo was then in working relations with the Middle East Supply Unit, alld I've got great files of minutes on the Middle East Medical Commission, British officers mostly, but we were able to attach Major C0 lo D. Zarafonetis u to an o\tfit going into Greece at the time when th• Greek Civil War was on. The British were just enteriAg the cou~try, and the Gem.aftl!!I were being 9ushed out. I don't remember the details oa that, but we had no trouble traveling Zarafonetis into Greece. It was handled out of the theater, the Middle East Theater, and he was brought back. There is sOlle delay mentioned ia here, owing to discussions betweea Churchill 660 and Stalin with reference to the Balkan areas. Not only that--it involved Churchill's desire to attack the soft under belly of the Axis, and I think Churchill, if he'd had his way, would have ~ gotten through ("Vienna and stopped the Russians before they got dowll te the Danube, but there is a recerd somewhere of Stalin talking to Churchill about this, and they pr:tctically decided,"You let me aloM. I 1 u let you alone." They gave it up, but while that argument was going on, General Fex was very urgent to get into Yugoslavia, maybe to Roumania, but certainly ~ugo­ sla'f'ia, the Balkans, and I tried my best to fix it up for him to get per­ missioft to go there. I even went so far as to go and see the Chief of OperatioM in th~ War Department General Staff, . clo~e . to Secretary Stimson's Office. It dragged on that way, and nobody would tell me what was holding it upo I didn't know there was this difference of policy opinion between Stalin and Churchill, and that the American war plans were somewhat affected by that detent, or whatever yeu want to call it. In the middle of that, Fox got a little tired of waiting, and he sent a radiogram over here saying, "Unless I hear in twenty-four hours ~-1hether or not I can go into Yugoslavia and the Balkau, I•m goinge>" Well, all those radiograms are read in the War Department too, and General Styer LLt General Wilhelm D Styer, Chief of Staff, Ao s. F.J was scting for General Somervell, was the commanding general at that moment. He called me up, and he told me to radio General Fox that the War Department was not taking orders from Foxo I devised a polite radiogrui to Fox saying about that. It was a Saturday, as I remam.ber, and I went over to Baltimore to the christening of a Liberty Ship which was being named for my friend Jim Trask IJJr. Ji.mes n. Tras!?' who had been on the Streptococcus Commissiono I left the draft of my 661 radiogram to Fu which had te go back out through A. s. F. with Colonel Sadusk to take over to th• Pentagon, to f;et it cleared and sent., because this in­ volved General Styer. Colonel Sa.dusk took it there. They took it away from him and rewrote it in General Styer's Office in the most insulting terms to General Fox and sent it over my name--that 1 s right. Sadusk called me up in Baltimae and said that I•d better come back.,"This is pretty bad." I did come back. I went over there., and I talked to a Brigadier General-­ this sounds foolish, but I got into a state where I practically invited him to me~t me out back of the Pentagon., and his excuse was that he really didn't agree with the rewritten message over my name, but General Styer had told him to do it. That was the end of that. Fox didn't get into the Balkarus at that time. Later Fex did get into Yugoslavia aftd the Balkans, and we had one of the aost successful typhus control operations of the commission's history then because Fox is built like Tito and acts like Tite., and they 3truck it off together right away. General Fox told me that he met Tito on an island in the Adriatic and told him that he wanted to get into Yugoslavia, and after listening to him, Tito said1 11 Dubro 11 which means o. K. Fox had his own plaae by that time. General Fox had a personal plane qiven to him fer his use in Cairo, and he new_ back to Cairo. He got d three or four of the members of the commission and flew back to Zagreb 0 We worked on typhus control in Yugoslavia fer the rest of the war and even after­ wards. Eo So Murray made such friends over there that he 1 d go back year after year after 19u5, and do typhus studies, and in the course of those studies they made a great confirmation of Dr. Zinsser 1 s idea that Brill•s Disease in the United States was a latent typhus infection., and they proved it. The arrangement which saw the development of a field directer with a reserve 662 rear eschelon. headquarters waa a good working arrangement. Yeu see, there• s no field director in the order, and the order still said that the director is authorized and directed to do this, but he didn't swil'lg around on the field directoro I would have thought that it would have been impossible somewhat for Stephenson as the director and in the Eastern Mediterranean to really run the shopo Of course, he wasn•t. He didn't foresee it at all. He couldn't run it from out there. He was just thiRking of kudos--am.bassador. Were there coAtinuiag relations with the State Department as this Executive Order implies? Right through--! have a great file ef cerrespondeace with Dean Acheson and people like Kirk, the Minister at Cairo, Ambassador Laurence A.steinhardt in Eurkey, uld John Go Winant in. Londono Earlier you mentioaed a problem that developed as you put it 1 with DDT1 but that was :MYL at that tim.ell Yes, MYL was the louse powder that started the thingo MYL had pyrethrum in it, and MYL was probably first used at Naples, and got the Naples epidemic under control before DDT o It was called Powder Body- Crawling Insect. One eacho In shaker tins. MYL was a pretty good powder, not as good as DDT. I think there was some seasonal problem in Kenya which was the source of 663 the materialoe .. Made MYL shorto Yes. It involved the Typhus Commission representative, mys~lf, and the Surgeon General ia a little controversy with the British Purchasing Commission ever here which'!,11.S under the control of Dro John Ro Mote who was an American, but he was acting more British than a cockneyo They wanted to1'1S of DDT at a time when we didn't have enough for ourselveeo I 1ve got here from Simmol'l1!! 1 diary a statement--cu.."'1.ously enough where Simmon.s says that he's willing to help the British but that he is not going to penalize the Alllerican needy forces by giving away DDT at that moment. Well, we tried to get pyrethrum plants over to this country to plant in Arizona te start a plantatien. The typography of the country was rather like that where they grow in Kenya. It's a kind of chrysanthemum-like flowero They did get some plants, but they didn't succeed in growing them0 To go back to the British Purchasing Commissi•a. Dr. Mote, after he didn't get the DDT because we couldl'l I t give it to him, s aid to me, "General., I just want to tell you thi~., that if ycu don't arrange to have DDT released to us, the Empire will squeeze you." Imagine an .American talking like that! DDT as a compou!\d had been. il'l existence for seventy years 0 w DDT was a dichlorophel'l01--it 1 s got to phenol rings with a couple of chlorine atoms betweea them 0 " It's like so many thiftgs in medicine. It was made for sffle other purposeo It was made by a Swiss chemist who was simply 664 studying for his Ph.D. chloriu.ted phenols. This had been put on a shelf in some laboratory in Zurich--! believe it was Zurich, until Ho Mooser began to try different things in a screening process en in.sects. They didn't know that this was good to kill insects. They didn't know anything about th• pharmacology- of DDT, and they tried it on flies at first, and it was lethCll for them. 0 I have a reprint from Mooser about his work on DDT, and he signed it to me aad signs himself as "The enemy of lice and sometimes the frierrl to Somehow, or other th•Y: sent you a sample of thie 2 and you shipped it down. to Orlando, I guess it was. Net to me--the man who is important ia that is Colonel William So Stone who was the head of the Sanitation Division •••• In the European Theater? No, he was in the office in Washington. General Simmons didn•t send him to North Africa until January, 1943, but the Geigy Company sent DDT ever with some information, and Colonel Stoa• got the first S'1ll'lple aad sent it down te Orlando. That certainly revolutionized th111gs 1 didn't it. It certainly- dido I did the usual infantile act on it 0 As sooa as I saw it, I ate a piece of it 0 How did it taste? It burned my tongue. You know how children put things ia their mouth. 665 I Well1 you'd better go because its twenty~eight minutes after three. Stone is a case too. That's on there theugh ·o 666 Moaday, June 6, 1966 A-60, M. L. M. Last time we talked1 we talked about the developments which led up to the executioa of this Executive Order 9285, and it 1 s a fantastic :\ quite a bit of power om paper, but again the agony ef making paper walk is part ef the problea. In a sen.,e, the first opportunity one gets to make it walk is in the Mediterranean Theater, European Theater generally, alld perhaps more particularly North Africao You indicated last time that you established laboratories ia Caire and got set up, that there was some development in re• fifting the administrative process within the Typhus Commissio11--astablishiag the field director and a home base with deeper roots than had existed before, and on the basis of some experience. But North Africa had cone off as an invasion, had taken troops into an area which was quite a problem from the point of view of typhus and unknown. virtually at the time of the iavasioa. You showed me a letter the othsr day from General Simmons, a memorandum re- questing from those in connnaftd of troope 1 or those in command of oprations like this, much more ia the way or informatioa than you'd had theretofore, so that you could make available the expertise in unknown areas through surveys aad se 011~ Getting this Executive Order implemented as a moving thing appears in the Mediterranean, and more particularly Naples. In the absence of clarity, N i the absence or communication desired or otherwise certain o erations are set in motion to which you fall heir by invitation toward the end or December in 1943, in Naples, with a full blown, desperate situation on your hands and the roblem of giving it shape dimension and or anization to a conclusiono ( rt•~ ia JUld.ng ttp.s paper walk ia that area--this is the effective thing as distinct from whatever hum.an foibles were on the scene that are ill some of f~• documents I•ve seen. Ita like you to comment on the Naples situation 667 as to what you had by way of aid1 what yeu had by way of productive facility, material, peopl•--whe was on the scene that you could rely oa1 what the relations were with the British, French-it's a complicated picture, the Fifth Army ia Italy1 complicated even more by the introduction of eney territory that had to have military government Sllperimposed ea top of it-­ aot an easy picture evea on a clear day. I don't know what sort of comment you want to make, but it's an arresting problem ia a lot of ways. Well, the Executive Order, as you say, was not a self-executing docum.ento It had first to be accepted by any . . Theater to which it. was tote applied, although th• acceptance came u:-m~lly :3.n r,,,:pon3t.: i.,,:; ;1 Jetter from the Secretary of War tr, 1 '1e C:omm,qnding General of the Theater. As I recall it, that was not doae in the case--perhaps a letter was not sent in the case of the North African Theater, and why it wasn't se!'lt I don't knowQ There were a good many things that were not done in relation to that theater that were done in otherso The lack of information about what was going on in the theater to which you referred, in citing that memorandum of General Simmons of I I think, sometime in the sunrmer of 1942, was that memorandum requested that Preventive Medicine be informed as fully as possible on impending campaigns, or movements of the Army and informed on what the possible needs might be 1 numbers of troops, dates ~nd so fortho That memorandum was addressed to the Plans and Operations Division of the Surgeon General' 3 Office. The c plans and Operations Divisi~n did get most of that information, but they didn't pass it on, so that Preventive Medicine was in the dark a good part of the time--at least at this stageo \) I would like t.o leave 01.1t the disc;\ssiol'! of personalities, but let it be understood that personalities and ways of thinking had a lot to do with the 668 troubles that arose in the administration of typhus control ia the North African Theater. l 1 ve spoken of that in the chapter in the book, Volume VII of thie Preventive Me<tl.cine Serio• and have said inreforonco to tho dissonsioo and the rather bitter situations that developed that there were qu.eetioas that never ceuld be really aBSwered c}early an.d to th• satisfaction of all con,. cer11ed, that there was a gr~t accomp~ishment to be shared by all coacerned and that there was glory enough to pass around to e ach person. some of it, and that 1 s the way I'd like to leave ito As for the organizations that you talk about, there were in that Th~ater a very complic~ted series of interlocking organizations. In the first place; becaUB• it was a British American Theater and double command throughout and not always a clear jurisdiction-not clear jurisdiction between offices and officers ill many. cases 0 i There were 11ewly formed organizatioM operating there such as the Civil Affairs group which had never had any experience before in the field. They were people hurriedly trained at the Provost .- Marshal✓ 's School at Charlottesville and were sent out to North Africa to work with Civil Affairs. Now some of these were Publac Health Service officers who knew about publi+ealth mtterlF ia the United st,tes, but that was different front public health administration under military rule. t7 There were similar sets f; British civil affairs persons who had more 0 experience because the British got interested in civil affairs for ~ccupied a11d liberated countries as early as 1940. They saw th• needs right away a.nd had been building up civil affairs; in fact, when the campaigM were being organized in London, when they began to think about moving across the channel aad all the things that preceded the Normandy Invasion, the British had what they called "country houses a II Each country that mi~:ht be liberated, or occupied had an office staffed by British officers assisted by some efficers 669 from those countries. There was a country house for the Netherlands, oae for Denmark, one for Norway-, a big one fer Fraace and another one for Italy, N aft.d these "country housee" as they were called, studied the co~ditioe ia the countries they r epreseated aad made plans for the care of the ciViliaM that would be put in effect when the occupation, or liberation took place. They were inhibited ia their comm.unications with each other and with the Americans because of the great secrecy that had to be imposed on any of these cross I chaanel plane. Its inconceivable how you could talk sensibly about what you were going to do in Hollaad fer the care of the liberated people, unless you could say that we're going to be in H$lland on Wednesday, the 1 ,J_[J ~ of March, 1 or something like that, but you couldn't give away that kind of information, Qftd so they planned in the dark. They got along. The same soAt of thing was affecting us in relation to North Africa. You can un:ierstand perfectly well why they wouldn't broadcast their campaiga t) plans am~ng all sorts of people, but there were some major bits or information that could be imparted that would be a basis for preventive medicine planning that wouldn't give away the campaign secrets. We could talk in terms of letters or codes or something else of that nature. The local government first in North Africa under Admiral Jean Francois Darlan and the residue of the French had relatively little to do with the t'(1,11'(, control of commul'licable diseae• in the R.reas. All of the ,,/ ports, Algiers, on up to Tripoli, Bizerte were ur.tder, from our point of view, tetal American control. We had laborers from. Morocco and Algeria, but no authority, no police, nor medical authorities of any consequence, so that I thought of it at the time ae a strictly American affair which, of course, it wasn't because the British were in thl re. We went pretty much our own. way cooperating and 670 collaborating with the British, or American unit until after they had gone through Sicily and had moved into southern Italy. They entered Naples on October 1st, 1943. u Until tlbat time there was no really operating Allied Civil Affairs 'rgani• zation. They had formed one in North Africa before they got across the sea, but it hada't aay practical experience. They had collected some fin.e men to I work withfhem both on the British side, Colonel G. s. Parkinson, and oa the American side--men like Colonel Wilson c. William.so They set up an Allied Control Commissien with a Public Health Section which had extensive meetings dealing with problems of the accumulation •f medical aupplies, food, things that they would need for the rehabilitation of the country. They had some of that in readiMss whea they arrived in Italy, but the Allied Coatrol Commissioa, whose records are volum.inous, itself had difficulty um.fying its functioM. Theywer• at cross purposes very often, so much se that early in 1944, General Simm011S seat Colonel Thomas B. Turaer, who was ths HW head of our Civil Public Health Divisioa ia the Preventive Medicine Service, over to North Africa and ia to It~ly for a reVi.ew, a first hand look, at what they were actually doing ia the Allied Control work for civil affairs public health activities under military govermnent. Turner made very valuable reports. The• he went oa to Loftdoa ia time to have a good deal of influence on the Civil Affairs Public Health Sections of the Supreme Headquarters of the Allied Expeditionary Forces, civil affairs th•• being under British Lt.General Sir Arthur· Edward Grassett, so while there was great need for improvement, there was a great need for haste and improvizatioa, and much was happening while these men were ~· ~~Ilg to get their orgafti.zation in shape. In the medical headquarters of the North Africaa Theater of opratioM there were some strong peopleo Brigadier Gen~ral Frederick A0 Blesse was the 671 Theater Surgeon following General Aenner, and he was a very good mano On.e time he thought there might be a serious af:tllir with typhus in Italy, as any-body would say--a million people crowded into a bombed aad wrecked city, water supplies gone, food supplies iaadequate, no soap, no cleanliness, ne sanitation--awybody could sit dowa and write a memorandum saying that this is the fertile soil of typhus and that it will be bad if it breaks out thereo H~ didn't take any immediate steps, and I doft 1 t think he became alarmed about the typhus situation in Naples until much later 4 R After they had gotten into Naples, infomation about typhus that might have ~ A\ been available somewhere els• not only was utilized by the BBC in that ~tp.d• l cast., but could have been utilized by AmericaR medical authorities because /, typhus had been iRcreasiag ia Italy from about January, 19430 It came in across the Adriatic with the prisoners of war from the Balkans. There had bee• ne typhus im Italy for the previous twenty years,s• that it was a non-immune population, and th• few cases that were cmllg al.ollg are all set forth here. In th• absence of a letter to the commandi11g general of the theater poiating out that the Typhus Commission was eet up by this order aad would be ready to assist ia any way it could1 and with the feeling that the Theater medical authorities had, or apptared to have, that they wel'l9 quite self­ sufficient, and with the stroag meves made by the International Health Division of the Rockefeller Fou~dation to take charge of typhus control largely at its own expense in North Africa--with all those things, no call was made en th• Typhus Conmdssioft to render any assistance. As a matter of fact, on• ti.Ille when the questioa was asked if the Typhus Conmd.esio• was wanted in there, th• aewer was ao, and yet typhus was increasing in Naples. The louse powders were at that time effective, but ia rather short supply, so far as DDT was 672 concerned. MYL was plentiful enough, but DDT w.i.3 just caning into production. ia any quaatity. The theater had asked for large shipments of DDT, had obtained some in the period August to October, but was turned dOWll oa a request for a rather large amount in September of 1943/. I was able to put the case to the Quartermaster in Washingten about December 1st, 1943, aad get a shipment of DDT over by plane and boat pretty soon. They used that as well as MYL in dusting the people of Naples, but most of us think that the MYL cut down th• lie• sufficiently to reduce typhus before they had enough DDT. Wsll, all sorts of people were involved-~Wilson William.e, Brigadier J Gallaway, Brigadier G. s. Parkinson, Colonel H. D. Chalk•, ~h• British Typh~s Commissioa sent out from London which included at least two~ericans, Dr. Joseph E. Smadel, and I forget who the other onu was. There was much con,.. fusion. and many units and many individuals trying to do the worko Finally, it looked as if it would be getting out of hand, so the authorities in the Naples area called General Fox who was ia Cairo to come aad to bring such help as the Typhus Commission could give them, and thatts about the time, in the middle of December, December 20th, that the Typhus Cemmission went in to Naples, Fox had supplies of ~accine which were not thought to be particularly i useful in the situatien lJe!cause it takes a while to produce a stat• of immunity after vaccinatioa, and the conf'lagratio• was rolling on. Fox had DDT in Cairo and could get more, and he had a number of able workers with him that he took in. He enlisted-..General Fox enlisted the aid or Colonel Harry Ao Bi~hop who wa:! or enormous help in managing the werk of the gronps on typhus £~ under General Fox after December 20th~1nto January, 19h49 The program was the usual 0111e.--a great dusting of all the people, a million or so dusted in a short time. There was isolation offpatients in hospitals. There were follow-up -------"'"'"' 67) contacts--delousing all the contacts ia a typhus patieat•e house. His bed clothes were delou~ed, dusted with DDT. So were the rooms, arid there was a fairly widespread delousitig of the citizeM of N.aples rationally guided with a possible contact with typhus and guided by the fact that they nearly all were infested with lice. Also the Typhus Commission organized what were called "fiying squadrons" to send groups out in the environs of Naples to look for sparks of typhus that had blown out there, and they did fin~ some secondary focio Then in addition the work involved a Navy epidemiological unit uiader Lt. H. M. Gezon, Epidemiological Unit #23--I see here. It crune in and did some very nice work toward the end. The epidemic reached its peak &nd started down shortly after the Commiss.on got in there, and there's a dispute as to whether the efforts of the Commission brought about that tura, or whether it was going to turQ alreadyo That's hard to answer. The other things that General Fae was abl!t to do was to get much needed transportation that the Rockefeller Group had not been able to geto They had not beeat f .1rnished any tran.sportation by the theater itself'• 1 There was a i division or so in the Foggia area near the heelfof Naple~ under command of' a friond of' General Fotam.•d Major General Arthur w. Pence. He understood th• situation from the way General Fox described it to him. He put Naples out of' bounds right away aftd turned over not all the transportation of a d•vision, but he turned over jeeps, two andr half toA trucks, and motorcycles and side care, ;nd the boys were able to get around after that. Bearing on the remark I made the other day, the better you are in pre­ ventive mediciAe, the less you ha.ve to show for it, I would like to tell you 674 what a representative of the p}ss i'II Washingtoa said when he cmne to in.ter... view me about the Typhus Epidemic in Naples. About th• second question was, How many cases did you have?" 11 I said,"Nineteen hu11dred. 11 The:reporter closed his book and said,"That 1 s nothing•" Well, having nineteea hundred cases in this susceptible group of a millio• and a half--theyweren't all susceptibla--the accomplishment of cutting that infection cow• to that size in that short time was something the reporter ought to have hailed with fanfar•, but he wanted thousands and thousands of cases to mate it worthwhile to write it up. Typhus control in Naples was continued largely with dusting DDT from the various machines, power dusters and hand dusters. Naples continued to be a point of collection of supply and for forwarding of material--oh, even up toward the side of Polaad. We had some people ge up through the Balkans up to v-i Poland and into Austria toAard the end of the war. Well, I think that the ceoperation with the British was very harmonious and effectiveo There was a time when the British typhus group under Colonel Chalk• 58emed to thi~k that the American typhus group was trying to tak• too much credit, but Chalke in the end wrote nice polite papers o\ th~nks and so did General Parkinsono The British American typhus collaboratio• was dangerously near aa un­ happy complication in 1943, in Nov~mber when a proposal was made by D~• John Ar-ltl i1_,,, R. Mote, head of the Britieh Purchasing Commissioft ift Washington, (came up for I\ discussion at the Typhus Conference in Len.don in November, 1943. He p~osed that there be a joint British American Typhus Commission with powers and !l'ivileges and obligatioe more or less as outlined in this Executive Order 67S 0 9285. General SimmoM and I ~ppesed it in our talks abeut it in Washington, and I was sent over as a delegate, or at least a representative of th• Surgeon General, on the on• hand1 and as Director of the Typhus Commissio,oa th• ether to attend that conference il'l London in Novembero It was apparent that the British authorities didn't want a joiat commission really, and they saw that we didn't wutt it either, and they dropped it. Had it gen.e through, I'm sure that there would have beea much trouble. I 1m sure there would have been iMffectivo rivalry anfneffoctive fights for d-nance had tho British madJI a joint arrangement with us. We had all the material, all the productiv. capacity and machinery, and mere people available, but the British--this man desired control of all these resources, ~. Dr. Mote, representi11g what he theu[ht was a British op.Ilion, would havo m sure. The outbreak of typhus in Naples was the most serious outbreak in modera times for the American Army ia Europe and North Africa, and th• next ones eccurred i• Japa,in 1945. This had to de largely with concert with the civilian population which apparentlY didn't meet the te3t of the Army commanders who were thiakin~ in. limitad terms 1 didn 1 t understand the nature of preventive medici1te a lot of times. We had. 1\0 typhus to s.,:e ak cf in the America• Army--103 caees, I think, and no deaths at all., whereas tho British in Algiers had more th.-.n a hundred cases and about twenty deaths. They didn't have as good a vaccine. At that time our troops were nnt lousy, and we were thoroughly immunized with the vacciae. It is hard te get liu officers to see in. a quiet moment that the eaviroll!llental civiliaM can repreeeat a considerable menace to their campaigM. I 676 They ought to have learned that from maneuvers in the United States. There were big maneuvers ill 1940, in Wisconsin and in Louisiana, in Texas, larger oms even ia 1941, aad im eachrf those maneuzs areae, the extra military area sanitatioft beca'l'f'\8 very important, and the system was built up by which the Army medical establishment cooperated With the state establishments and the Public Health Service. They actually set up three cornered directorates, so to speak--state, Public Health Service and Anrry medical inspectors as a rule under a surgeon. Now, the chief diseases that these groups combatted were venereal disease in extramilitary areas and malaria. In the system of cem­ battiag those diseases among the populatioM in the environment surrounding military posts, or in areas that were occupied by maneuvering troops•-in those situation.e there were the same elemea.ts that were ap!f: aring agai11. in the typhus control of civiliaM. That's why I say the liM officer eught to have had some appreciatioft of the importaac• of sanitatioR control in civiliaRS because they represent a source of infectioa of troops. Wall, you have to explain that all the timeo u a whole area that ant to come to-- art of the develo ent out of this is a whole educational program, publicatioa program, sign painting I program.~-eadlese to try to influen.c• awareness--whether it s in the South Pacific, or wherever it is 0 This is a development, that the need for in­ struction is part of Preventive MediciMo General Simmoe 111 19u4, when he got hie orgaRizatioa into this hifh state of being a Service added to 1 t a Health Educatiol!l Divisic,n which was to educa.te the civilian.e aad educate the soldiers and the line officers, the enlisted men A aad the line officers. We were educating them ag,inst and trying to tell them about the diseases occuring among the civilians that would be ham.ful to their 677 military activities, and we published a book about mosquitoes called "An.a" from Anopheles. We published a thing called "Saail Fever" which is the nams the } soldiers gave to Schistol5omiasis Japollicao We put out a lot of audio Vil'lual aids which in my opillioa were n.ot too effective. They'W!re cartool'lish a.nd Oil a low level.. My own feeling is that you can talk straighter to people. Don't you think so? Yes Remember the o liaesof the filnl on venereal disease--I guess I saw that about nine times the first moath 1 "Most men know more about tre ir automobile than they do aheir own bodies." I11t that Fort Eustis heat in a big theater"-thatwas some picture to see• Thatwas hitting straight, I thought. The need for this is a continuing thing. There is nothing inconsisteftt with this Executive Order aad continuing Army R'egulatioe at all. This is a broader base on which to op;rate than the Army Regulations. The Executive Order never was interpreted to weaken., or detract from the medical service sanitary arrangements that were required by Array Rogulationa aad by the stated missioa of the Medical Department, but the Executive Order 9285 does something that the Ara:, Regulations couldn't possibly doo It tells the Public Hea1t h Service, and it tells the Navy to joilll with the Army in this undertaking to control typhus, study, contrel,treveftt typhus wherever it is, or may be a threat to the troops, and whea that EEecutive Order was written we kaew nothing about scrub typhus as a disease. Scrub typhus just came into the field because of its last name, and it was far more importallt as a cause of sickfte~s, disability, and death than epidemic typhuso ~Theft we took in scrub typhus, no one stopped to ask whether the Executive Order applied or not. 678 Yes, and I think there was a full blown bona fide request from the field which wa! loud and clear in terms of their experience. FrOlll Australia--frcm MacArthur. That 19oke~ike a full blown reqoo st, but it was prompted. The thing which is done ro11tiuely in a case like that, and I think that I could get the telegram.--you learn. in Preventive Medicine about the outbreak of a disease, arrl you il'l.mediatelp: get it'l touch with the commanding geaeral and say, r1-1le can help you.a Ready to send so and so", but you cannot send these people into a theater unless the commanding general asks for it, so his reply is not a reply of obedience to a warning flag that is hung out before him» but his reply is couched in the terms of a commanding Had tho British been worki wl. th dusti owders thew we had? To some e xtento They had some knowledge of I DT; in fact, I think th~ 1 Geigy people had given some to the British too--yes, they wer~ like anybody that was intelligent enough to see what, comes from heat ~?.nd steam meattt--any- \ body would try to get some chemical poison for liceo It's much simpler to use, :.nd ~ course the spraying of chemical poisoM on arthropods, insect:, is old. Paris Green was sprayed to kill mosquito larvae a long time ago. !_hey didn't have anythi~g comparable to the Board that you had. Thez~ad a Typhus Commission, but how about their scientific approach to their troops? Did they have laboratories in the field? Yee, they had laboratories in the field, but not as extensive as the American laboratory system that General Simmons built upo A good example of a labora- tory in the field is the big laboratory that was set up at Salisbury, England, 679 by- Dr. John E. Gordon before we got in the war. This was the Harvard Unit sent over at the request of Sir Wilson Jameson who was a very fine Chief Medical Of'f'icer in the Ministry of Health of Great Britai.no Thq had this big laboratory at Salisbury wbich became General Laboratory ll tor the Americans when Normandy' was cOJling on. The British field experimental w~~ was very early, for example, I in typhoid fever. Their work on typhoid vaccine was done by Sir Almoth Wright in the Boer War. We sent General Frederick Fo Russell over to see wnat it was, and he brought it back to this countr.,. The British were well ahead in their tropical studies of' parasitic diseaeeso PatrickMansoa discnered the trans• mission of tilaria in the aosquito, and Ronald Ross discovered the tranSJllission of malaria by anophelene aosquitoes. The romantic stories of-oh, this cattle disease in Africa, kind of a sleeping sickness, Trypanosomiasis. It 1 s called a sleeping sickness. David Bruce knew about the parasite0 They kuw about the chemicals to fight these nies and ether chemicals to tight the insects. The British tropical aedicine was far ahead or tropical medicine in this countrJ', but their actual establishments in the field were not as nuaerous nor as well equipped as ours4 Continuing with this liai.son with the British-how ,as this handled in Australia, China1 Burma, India? In Australia relations were ver., good, but rather confused because General MacArthur had s011e medical advisors that were more, I should sq, his acquaintances than people picked for their special capacity. He d.id1 however, bave OJ4 hie statt ia Australia one or the finest men in the American medical service, and that was Colonel Maurice Co Pinco.tts from Mllr)"Ja nd. He became the great preventive officer for the Southwest Pacific, especially after they 680 got into New Guiaea and up through Manila. The British in Australia cooperated with the Americaas very thoroughly- in their atabrine studies on the control, or suppression of malarial illf'ection. A very fine man n.uned Brigadier e Hamilto• Fai~ly studied the dosage and the time intervals in atabrin• and worked ~ l/ with our people thoroughly. In addition when. it got around to scrub typ~tS the great expert on the mite was R. Lewthwaite in Australia, and we had fine relations with him, especially through Colonel c. B. Philip+. We h.d relatively few troops in Australiao There were a good many there in 1942, on their way, but they get off into New Guinea before very long, and the ones that were in Australia were up toward the Northern point. opposite Port Moresby i~ New Guinea. The\relatiollS wore harmonious, helpfu1 and valuabl.0 0 In India and Burma, the relations with the British that I know about concer• scrub typhus again. We had a large contingent of the Typhus Commissioa on the Irrawaddy River where we built a big laboratory a!'ld put it ullder the command of Colonel Macki•• That group studied scrub typhus largely with th• aid of Indian authorities and sometimes the BrititSh authorities. We had oM British office~ attached to the commission-at Myitkyiu, and we had some relatio~s with Lord Mouatbatteft, but the India-Burma Theater to start with was a poor little orphan thing. It was the India-Chiwa•Burma Theater in the beginnilllg, and then it get separated to two theaters, and it never was properly supportea._ It was always sort of a motherless child in a way. Irm almost at the end here, so let m• put on some more ammunition0 681 I We have established the Division or Preventive Medicine..:, It. s in beins, 1:nc! ~•.,• added to it t_he Tz@us CClllllissien1 a"'! this Executive Order__!!!• taining it. Eyea earlier ~n that ve .set up the A13f Epi~e,aiolegic~ )!oar.~ with ,its :tunctions to contin11e labora!ory work and q,e on call in Y!!, ~v•n"tl that soaetb\Y unt.oresee.'! h,a2peos to w1!!_ch •(!~•.i:s are req1!1-r•'tt, ei: .•ca.!. \ aMwer is re uired. In the course r this goiy to ue in. zeur bo,ok1 but it shows certailllz ,t.he interest, t,he raDJ• a™! I extent et c•l'fP•.F.• 11\ J!reventi~• Medic;l,ne. ItKs erett,: ~•r reachig,iLwith all liqie• en this, map 1•!'!11\C 1!-ck t~ Waahingten, n. c. and ~!'!9,uarters. We've t~ked abollt men. I ehond pu. s~ things I :round!! Gener¥ ,Si.-Hns' t•~i: abo~t 11&fte!!,!l"• In talking a~•ut Maples, the subject ~t the .eroductien.!!, DDT came Ufa the problem of hew te expedite it as ef tb&t tble. I want to - see the etfice 1 ud. ••,re ,earticular);r, pm: •~fice--.zour co~en ia Washiyt•l!­ tunctiea and hew it • t three d!~fereat pr•bl--..cepatitis1 be"t:h here and •veraeu aad fr• l h I think l it. -: scrub t us which was a bran~-~ erobl:• that came ea ~e sceae1 ~ad _1~;h,~ sch1•1!••0lliuia 1 ~ !r•pical c!!,sease which ala• eccvred. I want t• ••• hew •n• erganisea to meet thel!_e er•bl9Jl!S,wha~ be has at his c. . .nd, what. t.he llld.tati•11s are in JM!reennel, t\. suz,1.z:1 whateTer 1 ~d I tbink th;••• utters•~• seea best fr• where pu were \ 1itti5 11! Washin,gt•a• Well, pu. have te have this ceatered ia Washingtea when y•u•re talking ab8llt the Preventive Medicine Service o:t the Office et the Surgeen General because that'• where it wu ph:ysically lecated, and in that central place, J. '• there as the Deputy er the Chie:t •f Preventive Mediciae, General Simmens, ~th 11h• I have bat long tiae, pertect:4' tree aad easy useciation, where 682 yeu can talk abeut aaythiag that yeu aight want te talk abeut. General S1.mlleas had a rangi\\g mind and a Ti.aien, aad he actually fereaaw a great JU.IQ' et t.he pnbleu tbat were cemiag up. There were aev preblema that were appearing that he underateed right tr• the tirat eaergence et the preblea. Aa example et that I can give yeu is the suddea development et the Ocoupatienal Hygiene Industrial Health progra in the Surgeea veaeral'• Office. Industrial Bygiefte 1flUJ alaest •• big....well, qdte as big as the TJpbus C...S.aaien ia a sense, alth•ugh it was liaited largel.7 t• Waahi-.gt•n, but the pregram that Oeaeral Silaleas develeped tor Iadustrial Hygieae under Celenel Lanz~f teek ia the health, care, aad supervisi•• et, I suppese, •re than a ailli•• vertera ia t.he deteaae plaata, the chem.cal plants and all the plaats that c\ were eagaged ia LLL preduct1••• ~ Nn that erdinaril.7 bad aet been ill Preventive Mediciae betere, ae what de yeu de when yeu aeet a situatien like that? Yeu get a :man wh• knews seme­ tbiag abeut industrial by'gieu, aad that was Celen.el Aath•ll.1' J Laua, breught ia tr• New Yerk Ulliversit7 where he was a pretesser in this very subject. Iaapite •f bei111 rat.her deal, he va■ an eutgeing, aggressive pers•n vhe seen u.de his W,J' w1 th the higher et.ficera et the War Departaeat. He was takea int• centideuce b.r t.h•, aad in a tev •••tna he had the respeuibilit7 ter the healtb care et all the werkers •plqed in centracter nned and eperated plaata alld geYeraeat evned and eperated plants. That pregra11 extended very tar ,. eutaide et the preducti•• line because 79u ctn regard s•ldieriag as an eccupatiea. s... peculiar b7gieaic aspects et a seldi•r's Ute c•• uader what the Iaduatrial H7giene Divisiea bad ,, te deal with. Fer example, taxicelegy vu very iapertaat. ia these plants t~~ were making JRuaitieu and peiseneus gues and peiseneus c•p•unda•-well, the aeldiera were expeaed te the aaae thiag. The eeldier cleau bis rine with carben tetracbl.eride. It will kneck 683 t.he deTil eut et bi• liTer, it he isn't careful, se terleelegy gNs ever tr• seldiering iate eiTilian iad•■ trial hygiene wi.tbeat eur being bethered by the transitien at all because it baa aa iatellectual ceatinuity. 'fhe aaae thing applied, we'll say, te the rela.tiea between the Quarter• ••t•r, the Cbeaical C.rpe, and ev PreventiTe Medici• Service ea the ill• pregnatien et clething. Clething, tentage-these material• were iapregnated wit.h c _ . i a t.e aake ~waterpreet, er t.• make tbea flre •entUated, er te keep iuecta away, er ....ti.lies t• have aa antidetal ettect en aurreuadiag nmeu ageata. ?few, iapregu.tiea-the substances that yeu pat int• clethiag te iapregnate th• are etten things te wbich the hUll&n bedy is allergic. Slcia eruptieu break eut-irritatieu et the skin. Yeu have te de theusanda et teat.a•• nel'll&l individuals betere yeu can O.K. a piece et iapregnated clethiag rer a man t• war. That tell int• the Iad11Strial Hygiene Laberat•ey vbich was established 'bJ' Celenel Laua, r~at at Walter Reed and then it ■.-red .-rer te Balti■ere. !few I 1Te gene away tr• these subject. that yeu spelce abeut because this industrial, b.7giene bealt.h pregra■ aight net be risible ia its ecepe, aigllt net be Tieible tr• the charts yeu have, and unl••• yeu Dff what I•a t.elliag yeu abeut t.xic•l•a, abeut the iapregnatiea et clething, 19u wew.dn't •• the rud.ficatieu er that te all serts et phues et ■edicine, et Arrq' adld.llistratiea, and er A.ray pred~cti•• and ut.ilisatiea et •teriala. Well, yeu eeuld de the aae thing it 7ev. l••ked at the ether Dirtsieas et the Surge• General'• Office, er the Preventive lledieine Office. Fer example, the j.aberateriea DiTisi•• had under its centrel net enly the super­ Tisi•• er laberateriea, but actual.17 the Jlissiea tor tmich they wre cen­ structed. There were huge A'l.91' laberateries. There were Cerps Area labera­ teries. There vere bespital laberateri••• Tberearere diagnestie laberat.eries. 684 There were test laarat•ri••• There were lab•rateriea fer all s•rts et purpeses which tell iate General Si.amens• ideal that he deriYed fr• Sternberg. His ••n beek is dedicated te Sternberg, te the great • • wh• established laberateries in the A:nq, and hundreds et ether Arrq ettieers are indebted te hia tH fer the ataadards he set and the pl••• The Laberateriea Diviaiea like ••• et the ether divi.aieu-th97 had a large persennel etfice. I Celenel m1ett s. Rebinsea and the ether efficersttravelled all areund the ceunt.ry, get naaea, recerds er peeple, had a big file•• 1>9ssible laberate17 etticers. Hw, L,• aentiening th••• activities because, aa I srr, they- den 1t shew up in the charts very well, b\l.t the7 1re very like-the7 de11 1 t differf in ap1.?'1t, er ia activi.t7J the7 dea•t ditfert •uch tr• the Ceaaisaiens •f the Anv Epideaielegioal Beard. The7 de beth things. Tlle7 g• eut int• the field t• deal with a aituati•n• Tbe7 briag the aaterial and the theugbta back t• their efficea, and evea seae et it is breught back te laberateries like Walter Reed Medical Center, er the Ar,q Industrial H7gieae Laberater;r, er the AraeredKedical. Research Laberat•l"7• All those are eeaparable te University Laberateri••• Hew, these things 7•11 aight haTe 11entiened, just as 7ft did the hepatitis, er the achiatesaiuia. Y•11 want. te get at hw these things er1g1ute and start t• cause a stir. Yeu haTe te appreciate tbe tact that at least~ur aectiea-er 1 111 sq, at least. the Surgeen ueneral'• Medical Department with ita Divi.sieu ia mere clHe t• what ia happening all threagh the Arrq, cleaer te events bappeniag all threugh the Arrq thaa, fer instance, the Artill•l'J', er aae Signal Cerpa. D Tbe7 dea•t have the .... huaan relat.iens that. aediciae d~es, uer de they have the aaae ceOYereatienal relatiens--as I llight say it. ~• eur effice, the Preventive Medicine Ottice. Right fr• the start, teleph•aic and telegraphic 68$ c...ullicatiea was autherized a• that the heads er these ~isieu, Epideai•l•a I D1rt8ien, La~erater;y Divisiea, Industrial Hygiene DiTisi•Bt Saai.tatiea Dirtsien-th••• heada wre talking all the tiae vi th t.be ~ l • 1• the aaia caapa in the ceunti, and etten wereeas, but I•a l.iaitiag it t• the United States a't. the aaent, se tbat the Preventi"f'e Medici• erganisati•n in the Surgeea "'e•ral'• Ottice was never iselated f r • the tielcl, er fr• the actiYities et sanitarians, er trea preventiTe •ed1ciae etficer• eut ia units et the Arrq. I It ••ed. very natval, ter in.staace-aad I~ll ge w hepatitis uw--th.at we sbeuld Im• a'beut what was happening u seea u it happeaed. Hepatitis started early in March, 1942, te be aeticed because surgeeu at pests, aedical .rn.cers in the field called. in and said, 11 I•v• get a strange let •f jaundice eut here. It aeeu peculiar te • , but there's •• a&ff1' er th•, and they're ceain.g right ale11g. 'What ia it?• We didn •t knew what it was at that tiae. Gall it jawidice ter the aaellt. be!ere ve tey t.e ditterentiate. Tbere waa a well kn•n disease called catarrb&l jat1ndice, aad that'• the naae that gNa fl'er int• intectieWI hepatitis, u.turall.y eccurriag iatect.ieus hepatitis. Catarrh.al jaundice get ita naae giftn te it b,- a great Gerau. pathelegist, Rud•lf Virehew. He theught that a auc••• cellditien et the bile duct teek place and backed up the bile and caused jat1ndice. That'• what eYerybedy theugbt this was at t:lrst, altheugb sae people kM1r eneugh abeut ttle literature te kuw that WlTty jaumlice had beea useciated ~/ artificial-I was geing te say inteetien, I\ but I•a net sure; I'm geing te eay iatectien at the ••ent-inteetien caing tr• the use et ayringes. Peeple kaev abeut salversan jaundice. If yeu use . the saae syringe te inject salTeraan in a series e! indivaduals, there were well kaewn little eutbrew •f jaundice 8llleng these peeple fer wh•• the Balle 686 syringe was used because a little bit et ble.cl stared ill the ba1e where the needle 11. There alse was knewn te a geed ••OT peeple, bat aet as clearly as 1 t sheuld baTe been, that in Africa a auaber ef British werkers......_ybe tiTe or tea ;rear• befere this war, er f'iTe ;rears •~•--bad uticed the eecurrenoe et hepatitis and jaundice iD peeple vb.• receiTed yellev teTer T&cciM that c•rataiaed haan ser1J11, that puts baan serua in the vacciaao The saae •baerYatieu were ude en so• ceaYal.escent sera jauadice intectien when used t• prevent measles er ••P8. These things were ka.-wn. It was lmwn, I think clearly t• General Sim•••-it was nt kn•wn te •• at the start.-•tb&t. it was ~ssible that jaundice weuld be aaseciated with illjeeti•u et baaan bleed int• hwaan beings. It was knewn te eec\11' after ~e9d transf'usiena. That vas called h•elegeu serua jau.ndice. The ceD.f'usiea at the tint was that it wa1a•t realized in the first f'ew da79 b7 ene11gh people that tve diaeuee, t1?\ jaundice producing di1easea were 0 taking place at the saae tille-natarally' •ecurring iatect.ieu hepatitis was eccurring, and then this pest Taccinal yellew f'ever jaundice, vaccine induced jaundice, was eccurring. r.; ,'1 ~~ As I sq, the report& began te cae ia early ia l'tarc~•-it was prebably by' " the first week, er ten days, in March, and we were getting reperts oTer the phone and telegraphs ef as 11JAny as a hundred cases ia a da1" 'Which is veey ertraerdinal'J' ter intectieu hepatitis. It cUte-11 a trying te auwer yeur questien as to hw 7eu get started ea this in Washington--just u naturally as if yeu were talking te the un ia Caliternia as if he were in the re• with 7n, ee te speak. You get it very- qllick. It was ebV'ieus tbat we had a very eerieus situati•• arising. General Sialllens and the rest ef us naturally fell.wed the preper ceuree-te attempt te arriTe at the cause befere y•u knew 687 what te de te preveat it. Te arrive at the cause there were ebvieusly twe wqs et deiag it, and eae was te accept the hunch ef a very wise man like Karl Meyer me fr• the start• 'When he first saw these eccurrances et jaundice ia Ca1.1ternia1 said that it was related te the vaccinatien ag&iast yellw fever. The vaccinatien againal ;yellew fever had bee• started in, I think, Nneaber ef 1941, et111ewbere aleng there, with Air Ferce pe•ple. General Siaens get appreval fer this vaccinatien1 receaaended by the Natienal Research Ceuncil, appreved by the Surgeen General, and appreved by the Adjutant General ala• fer adJld.nistratien. The seurce er the vaccine was the Inter­ natien&l Di'Yisiea Laberateries et the Recketeller Feundatien where ter abeut five J8&re Max Theiler and •then had been aldng a yelln fever virus vaccine tr• aa attenuated yell• teTer virus strain called the 17-D virus. This vacciae that they •de wa• a Berkefeld filtrate et aa extract ef tbe chicken •brye en which the virus h.ad been grewa, .tUtered, stabilized...-aa they taught-by the addit1•• et a ntall aaeuat et suppesed3¥ inactivated huiaa 0 serua that had been heated at .$6 C degrees ter halt an beur, er an h•ur• It, didn't iaactivate the vinia. It 1 • heat resistant. Iaaediately General Si.lllQu began te uk the Jlfllbers et the Ar,q­ Epidemielegical Beard te help ilffestigate this situatien. There's n.etbiag aew in that principle. Tbatw as what yeu weuld de• l'bat was llhat the Beard was created ter-t• be reaq, •• he get-well, ene et the first greups he called up was Dr• Tb.•u Francia, the Caad.ssien •• Influenza in Michigan. Francis was available and ceuld get ••t• He get a geed epideaielegiat, Dr. Kenneth F. Maxcy t:ma Hepkbu,, t• jeia Francia, and then. be appealed te Dr. WilDur A. Sawyer as chairman et the Cnmd.saien •• Tr.pical Diseases te g• •at te Califernia and start the investigatien. '1'be CNlllli.ssien en Trepical 688 Diseases was breught in net because this was tReught te be especially" a preblea in trepical medicine, but because Sawyer was the head er the Inter" aatienal Health Divisien and knew the vaccine prebl• .f':r• the begianing. I ~gine that perhaps he and General Simmens bad had s•e cenversatiens abeut thia pessibility even befere it happened. I den't knew that fer a fact. I•ve been \eld that, but it••-- natural that aa the Internatienal Health Divisiea had knewn abeut peat-vaccinal jaundice eccurriag with their verk ea yell w tever i a Brasil--Dr• Seper had made reperta ea. i t--there wu s•e knwledge er the pessibility. It was regarded as a reaete pessibility because, as I •&'1', the serua hacl been heated, and we theught we were dealing with an innecuews stutr. Well, the epidaielegicalipreblem te be wrked eut was very difficult becauae, as I say, these tw• diseases were running al•ng at fhe sue ti.Ile. One ••'r'T sharp ditterentiatien I utioed at the start--the incubatien peried et the naturally eccurring hepatitis vu abeut twenty-three te twenty-five days, er thirty dq'a-s•evbere in there. The incubatiea peried frem the time the vacciae was given until the ti.lie the hepatitis appeared was usually ninety dqao We didn't knew that until we were just beginniag te cellect the in• termatiea. Fertunatel.7 they did start te cellect the intermatiea very- early as te what let nuabers et vaccine these seldiers had been injected with, and it appeared very seen that certain let auaben were what ve called icteregenic. There was great anxiety because J18.ft7 et the health etticera in the ceuntry theugh: that it vu actual~ ,-llev fever. Seae et oidvisers en the ipid•ilegical Beard theught it was yellw fever and were frightened. In the ~ Surgeon General1 e Office, and ia Preventive Hediciae1 it was net kn•vn at tirat u te Whether it was yell• tever. Very few peeple had seen ,ellw fever in this ceunt'r'7••bardly anybec:IJ'. S•ehev er ether the situatien. get 689 settled in_,. eftice in tbe PreventiTe Medicine Service, and I became almest t•tally abserbed in this hepatitis preblea fer the next six ••nth8 •r ••re. lie cellected a great deal •f data which has been used ins•• er these splendid reperta like the Persis PuttUlll repert, and there are •thers. By the end et March, 1942, eertaia.17 early 1• April, I wh• had theught the disease was catarrhal jaundice believed tbat it was related seaehew te the 1ellew !eTer Taccine. I•a eure that General Silulens get that peint er view ab•ut the same tble. I mw that Dr. Francia and Dr. Maxcy after baTing first rather sus­ pected that yell• f'ner •• being preduc4td., neticed that it wu pessibly ure related te the vaccine. They were studying a fiae greup t• bring that eut. Tbeywere etu~ng the .Air Ferce pe•ple whe had beea vacciaated ld.th yellew fever Taccine at Jeffers•• Barracka. Everywhere these greupe went-Chanute field, •r up int• an airfield in Haine, er s•ewhere elseg they all get jaundice abeut the saae ti.118, and that peinted te saetbing fr• their erigi•• By the 15th et April, the decisien had been ude t• discentinue the Reclceteller Internatienal Health Divisi•a vaccine and get vaccine fr• the Public Health Service. Thanks tea recelJllllendatiea •f the Hatienal Researcn Ceucil in 1941, the Public Health Service at the Reeq Keuntain Lanrateries had set eut te equip itself and get a capacity fer, a capability fer making e.. yellew fever vaccine beth as a ree~e ill case •fan emergency and as a. aeam et supplying vaccine te the civilian pepulatiens in yelln fever areas, if DBceesary, like the Virgin Islands, •r sniewhere. 'I'bey had a serum vaccine at the start, and they had a little treuble with it. The Public Health Serrtce vaccinati•n in the Virgin Islands was useciated with hepatitis. It get very clear fna studies in the literature and censultatiens that we had with everybedy that knew anything abeut it, that the serUll was prebably the oex:!.eus agent ia the vaccine. It seeaed wise te get rid er it, se we persuaded the 690 Public Health Service te make what we called aqueeus vaccine. They put aqueeus aalt seluti•n in place ef the serua, se by' the end et April, we bad an aqueeus vaccine fr• the Public Health Service, and it was used thereafter all the ti.lie ia the J.ray. The Reeketeller greup changed t• aa aqueeu vaccine al••• There were bardl.y' an;, new caaea atter April 15th attributable te the vaccine, except these that were al:rea~ •• their vq te cae dew sick--except ene greup wh• had net either get.ten the verd1 er disregarded. an erd.er fr• the Surgeen General'• Ottioe. We called in all the lets er 79llew fever vaccine that were all areund in different •di.cal supply' depets, in hespitals, in all serts et placea--dispenaariea, and we theugbt we get it all in. I get a letter ene dq tra a surgeen ia Alaska, and he aaid,"I think I•a geing te have eutbreaka et jaundice here in August.• It•• en ene et these chart.a, isn't it? He said that fer••• reaaen he hadn't turned in the vaccine that he had it. and had given it. He dated when the e1at~~s weuld start, and it did start-- I think it',s ·, illustrated in the chart in that article. The preblem was ••lved by' the epideaielegiats ia varieus wqe. At first the C-1.asiea en Trepical Diseaaea was net tee helrtul-well, yeu can under­ stand that when it is headed 'by a un wb• is re-;:epensible ter the great erganizatiea that makes the vaccine, he lli.gbt tend just naturally, as he did, t• eaphasize the i.Jllpertance et the eleaent. er naturally eccurring hepatitis in this •ituati••• while a 1ll&ft like Karl Meyer went straight te the vaccine and f ellewed it right threugh. Tb.ere was n• wq--well, there w ere n• serelegical tests ter it. Yeu eeuld test fer liver f'unctien, and the ~ests fer liTer 691 tunetiea were iapreved by' the need fer thea in all the material that was available, but that test was a nen-specifio thing. It shewed that the liver was da:aaged, but it d1dn 1 t shew whether it was damaged fr•• natural.l.7 ecearring hepatitis, er vaccine. Nethiag ceuld be seen. Ne erganisma ceuld be aeea, ner cultured fr• the bleed, •r fr• the tissues, and n• all'iaal was reund. te be susceptible either t• the pest vaccinal jaundice, er plana in­ tuaiena, er the naturally eccurring hepatitis. It vaa aecessary te use huaan beings vel11nteering f'•r tests. 'l'his waa dene With great enlightenment because it shewed that this material wu filterable, tut it wu highly- resiatol,jt t• heat and chlerinat.ien, that the A agent, er whatever it wu, eccurred in cent~mi.nated water supplies as in that water suppl7 at Akiba, in Penn97lvania that Dr. Jeseph Stekea studied which was water pelluted !rem a aearbf priY70 Further, the experimental werk. en haan beings shwed that the disease ceuld be predaced by' putting a veey Bllall aaeunt ef tecal uterial 111 a glass er 11ilk, er s•etbiag like that. Yeu 1 d get the disease. Much scientific iaf'el"ll&ti•• caae eut et this werk, °Dut as ,-et the7 haw net yet preved that it. is a virus disease. They are suppesed t• have teund a virus ia recent years, but the werk has net yet been centirmed, •• it' a still a ay"Bte17. The nUJBber er cases that eccurred in the A.ray will never be knewn. I think my chart had abeut twenty theusand, er twent7-twe tbeusand cases en it iu this peri~, but there aust have beea ten tiaes that aaey-. l•ve been t• peat• vb•r• eTerybedy' wu sick at the ••• tiM. They bad a little pain in the jeinta et their banda, er swelling lips and f'ace, er a little tever, but • jaundice. It was aere shecldng te the c..u.nd.er et the Aray1 I think, than &JV' b•bardment at the -•ent that w u geiq en because s• many peeple were sick, and there were•• many critical things in the effing and geing terward. 692 Fer example, the Battle et Midway waa ven by air pilete soae et vh•were auttering tr•• hepatitis, jaundice, and great secreey was illpesed en all werk1ng ia this situatie11. As I p•iated eut t• 79u, w were n•t able te tell. Dr. O.rdea, Preventive Medici• Officer, Eurepean Theater et Operatiens, that the Secend Anaered DiTisien element.a that were being sent ever t• Nerth Ireland, centained pe•ple wh• bad beea vacciuted with 7ellw fever vaccine and vhe were c-1.ng den with the jaundice. They did have it. It frightened the British at first, but tbq--apparentl.7 Sir Arthurs. Mclalt7 knew the African verk et the British en jauadice fell.wing yelln fever vaccinatiea an.d Dr. Gerden, very intelligent, verked eut the epidemielegy et the asseciati•n• The ether phase •fit that nebcdy- knew anything abeut at the start was that it was net traandssible f r • ene patient te anether. I never saw a aecenda.ry' case. That was a cemfert. In Dro Gerden•s big Histery et Preventive Mediciae in the Eurepean Theater, it'• ind1cate4 tbat when the British peeple aaw that this was p••t vaccinal jaundice,. they jut passed it up and said that the7 weren't afraid et an epidemic starting. He epidemic has ever ,../1;;d,f started tr•• it•. There·· :l('e secendary- caau, as tar as I knew. Well, tertunatel.7 it •ni• I Hew did it differ titis? Hardly at all. It ditters ia the incubatien peried. The incubatien paried is lenger. Y•u ceuJd n •t tell the daaaged livers ea.a frem the ethers. The livers were little d&llaged ia stae cases, terrifically damaged in etherso The regenerative precess gees aleng with the neeresia. 'l'be length ,t the sickness ie very variable. In beth caaea there are very light cases, and in beth instances there are very prelenged sicknesses with nerve degeneratiea, 693 brain damage, ~nd all s•rta •t pr•l•nged illnesses. They were studied in the 15th Air Ferce a ge9d deal in Italy, and it was shnn, as it was in Nerth .ltrica, that the nermall.7 eccurring jaundice--intectieus bepatitia that I'• talking abeut-ie respoMible f•r incapacitating tor a lengthened h•spital stay that far exceeds anything that Tenereal disease was preducing--f•u.r er tiTe l1aes as much, but -.er:, :au.eh fewer cases. The naturall;y •ccurring in­ tectious hepatitis becaM quite prainent in North Africa in 1942, and 1943, and stqed se all threugh the war. It was a seasenal affair. It caae up aestl.7 in sUJllll.8r, late smnaer and tall. It. occurred in Italy ia the fall and wiater. At the sue time, u we knew nw, it was occurring the sue way in Dernark-it 1e a werld-wide affair,~,. sure, though I den•t knw abeut the .uian side very- JIUCbo Sabaeguent.ly 1942 1 19h3 1 }!orth Africa, I think: 1 and 1944 i~_Ital.y--~at Waf! the na.t~• ot c~unieatioa? Wu i't: •• i:amediate? Did z•u.have,the same centact wi~h field etficers that zou had with base •e!ratio~ eeeple her•.i~ this ~ ountrz! s Ne, there wasn't• There was clo1e c-unicatien, •r easy Clllllllunic&tion between the central theater erganizatiou and their field installati•ns• Dr. Gordon knew everything all the ti.lie, but we didn't knew whatw as going on all the tiile in the European Theater because, aa I have peiated eut, the Surgeen General l•st his staff status/. He was under A. s. Fo He had a block there. He lest the autherity in maa;y cases t• appeint 11edical e!ficers in the Cerps l;reas. He had trouble in getting acceptance, or even netice of the aateri&l that he was sending abroad f•r i11t'ermation, and so t• imprne cmmunicat1one they arranged for the Essential Technical Medical Data /j:IKDJ letters. Did I put that en the tape last time? 694 These are E'DID. It was a repert te the Surgeen General fr• the cR111&nding general et a theater ef eperatiens written, ef ceurse, by the theater surge•n and his assistants, but c•ing tbreagh the caraan.ding general witheut the surgeen 1 s name, signed fer the camanding general by tbe adjutant and als• begin!rl.n.g "In accerdance with" s•e number et the Adjutant General er the War Department, let's sq, Letter AO 3$0.05 (28 Dec li2) OB-S-SPOPH-M, "thie repert is subaitted.• They were voluaiaius reperta. They had sectiens en aanita.tiea, en eygiene, en preventive medicine, surgery, medicine, supply. The;r were beeks alm.est-.nce a menth. That didn't happen--well, I t.hink E'lMDs caae abeut in 1944 probably. They made up fer this lack er cemmunicatien, but it was et!1c1ally uthing like as easy as the c. .unicatien between the Sargeon Geaeral'• Office+• people iD the field in the United -te•• On the ether hand, velUllineu persenal letters paased between the Surgeea General and the Theater Chief Surgeon. Whe a I speak et the Surge•• General, I•a taking the •b.ciiment. ia the Surgeen GeneYal et all the chiefs er services. Fer instance, the Censu1taat in Surgery and the Censultant. in Medicine, General Rankin and General Mergam1 traveled all areund t• the theaters and saw what the surgery was like, s av what mediciae was like, had cenferences with the surgeeu in the field and with aedical 11.eao I know General Silm.nns had a great •a~ letters frea different places, and he himself ode leag trips-I think he c.vered every theatero I waa thinking at Dr, Stekea wh• west a~read t• the l,2th Air F~rce te pi~~ llP s•eles ,and brig them 'back. Jee Stekes? -Yes. Well, goed werk was being dene in that area by the very fine 15th General Medical Laberate17 under Dr. Ress L. Gauld whe is new in the Walter Reed Anq Institute ef Research-splendid werk. Alee they werked •• Q fever. Well, en the same subject in answer to yeur questien--hepatitis, schisteseaiasis- it deesn't dif.f'ert• It didn't differ in my opinien. :frem what went eo. in the I Dean's Office. Yeu re talked te b7 aayb•df wh• has an_ything te sq. Yeu " hear things. Yeu hear things at dinner parties. Yeu hear things in the latrines. EYe9!heNa Everywhere, but yeu get a sense abeut what uy be impertan, I supp•••, and what might net be iaportaat.. D• yeu want t• ge en with schistesemiaeis? ~at z•u said te • eft the tape .•.•• 2&" age was _the tact that ,the rubri.=,~ that z:•u ~d1 wh,ether it was the Typhus .~llllllissien1 •z: the Army !fidemielegic!!, Beard1 aeaat ■•e.thi?l,a put whell a specific ,thing like heetitia cae u.e, where r• had the P!saibilitz either te exa11ine s•ething in the field1 •i: bring it back t• the ,laberaterz, ~• rubric <li;dn' t mean anz:t:hi~S• Yeu ceuld take--what l!_U knew had been §,•i!§ en with centiauitz1 like D~• Steke 1 s studies !!! Ph11.~delphia1 and th• chance hap_peniag at t.hat Caap. The .Akiba Camp0 Yes. He eeuld right. awar ch~ck .l!is lecal .res\ll.ts against eae~hiy that was eccurring 1a the field and ala• study it ee,ideaielegicallfo Y••• Stekes waa the Directer ef tbe C-1.ssien en Measles and Mlllllpa, bQt he did his best work•• hepatitis. Dr. Jehn Paul becaae a great autherity en hepatitis. He was ehail"Jllan et the C91111i.ssien en lfeuretrepic Virus Diseases, and semehew er ether he get out in the Middle East with General Crawterd F • Sams and the Army eut there, studying sandfiy fever. Sandfiy fever is caused by- a little bit er a gnat called a Pble'betmus ea,,2,atas~i. They were working en studying this little gnat en the banks et the Dead Sea and eut in the lfegev Regien, varieus places. They evea get a little hospital section fer it, but in the ceurae et that, Jehn Paul was testing cenvalescent serum tra peeple whe had had sandfiy !ever, deing mutrallsati•a tests, and he gave h.iJD.selt hOllllelegous serum hepatitis. 'ftlerea.tter, he did extremely gettd work en hepatitis, but that was the ce..issien en Neuretrepic Virus Diseases. Of eeurse, his sandfly fever werk extended in rgust the wq yeu 1Te eutliraed t• a very large undertaking vitheut a~ inhibitien because et the names but rather a great been because et the knowledge of the capacities er the peeple and their interest•• In Sicily it looked aa it fer a while they had the largest outbreak et ularia that the Aray had witnessed, er suttered trem. Thousands er cases were sent down te hespitals with fever et unknova origin, small tevers, inter• aittent feTers, peculiar fevers, and they- were all diagnesed -.alaria" after a while. One et the decters thought that the7 1 d feund malaria parasites in the bleed, but they were prebab}T making a aistake at Jlisinterpret1ng the apr,earance et bleed platelet• riding en a bleed cello That went en. for several tVeeks, and all et a sudden malaria st•pped in Sicily, and we could tell tr• the reperts ceaing in that an epidellic ef sandny- fever had cue en. Well, new, in Preventive Medicine in the Anq 1•u have two kinds et epideaics 0 One is an administratiTe epidmic, and the ether is a really natQrally' 697 eccurring thing. By an •adainistrative epidea:ic• I aeaa the sudden change ill tert11 and classif'icatien. Seae peeple will have ca1111en colds. ill ef a sudden the effioers in charge will decide that that's infiuenza, and yeu get a repert et tw• er three hundred cases er influenza breaking eut, whereas up t• that ti.Ile they had just been c-•• celda and the sniffles. The Navy m d the same thing. 'I'bey have a thing called cat fever Which is catarrhal fever, and every nw and then soaebeey decides that it is pnbably intluensa, er it might be eae et these arbni.ruses, er s•e kind et Tiruaaa. Tbq • - ~ change tba name, and 79u 1Te g•+ - epidadc. '!bat vaa a little bit the explanatien et the Sicilian situatien. When they dis- cnered that it was sandfiy fever and net malaria, aalaria disappeared practicall.1'. The peeple wh•rerked that eut were three peeple ••stly--Jehn Paul cud.ng ~ •11___, t ef the Middle Fast en ,rndny feTer, s and be had w1 th hi.a Lt. Celenel C.rnelius B. Philip, wh• became ene er the chief men en scrub typhus in lfew Guinea and threugh the Philippines and whe wrete that superb anicle 1 n here, and the ether persen vhe was sent in there was a remarkable aan, Albert B. Sabin. Albert Sabin vu ea the Ceamissien en leuretrepic Viruses Diseases, but he get intereeted in eandfl1' fever as an effsheet fr•• Dr. Paul'• werk. Sandfiy' tever didn't really have auch et a neuretropic significance. It aeunds Tery l•••• I•a sure, te yea, but it•s practical. It works. I ■l'lff it worics. Tha;t's the beautz of ita but sitting ~re in Washingt•n and reading these statistics, l!U haTe te have••• sense as te where te eut yeur !!P~sia--hew te read the•• Yea--•.t ceurse, we all st.art with a fair aaeunt e:f training, er experience. Silmle• bad been a great deal in the trepica and areund t~werld, and I had 698 been areurid a bit, and ••st ef these peeple are very iatelligent, able peeple1 and they think things threugh. Centrast this With the scrub ttphus that cue ue-that E!t:ticular preblea­ f!U knew1 aa seen tr• Washingten as it first emerged because it was new1 er it turned eut te be aew. The scrub t)"pbu began with a bang. It began •• Geed Eaeagh Island in Milae Bay ett the westera ceast ef In Guinea Deal" De'badurai. On Geod Eneugh Island, a hespital awed in there, and instead et geing int• an area where treeps had been aacl which was burned ett, that hespital aeYed int• fresh kuoai gra••• luna1 grass 1s the h•e er the mite-this little ~ t , that carries the ricltetteia-Tautsugaauahi, the7 call it. I•u bet yeu can't spell that1 TS••all righto Well, that first eut'break--excue me, this hespital had the first eutbreak ever ther• and, u I sa7, the7 uved int• this virgin graas lands, se t• speak. It hadn't been bur•d effr, and it hadn't been cut. It was full et Ti.gereus llitea, and that was prebab~ the aeat fatal n.tbreak ef scrub t1J)hus that w bad• Seae eutbrealm ef scrub typbu had tbeusands ef cues and enly a ceuple et deaths. T~is Geed Eaeugh Island had abeut twent7..five eases and aaybe ten deaths. One er these peeple wh• died was a pretege, er a relati-nt 1 a psychiatrist, whewu a relative •f' a Cengreaaaan, and that areused the Cengresnan very auc1l-Vhy sheuld a psychiatrist be aent int• the kl1nai grass en the tiring line like that? Well, he wun•t aware ef the fact that psycbi­ at?T like surgery was ••Ying right up te the f'r•nt. They were rella.bilitating Hn en the battle field alaest which is geed practice. That was the first stir. As seen u we began te leek into it, we began. te get r eperts that put yeu 699 wise te the conditiens-Australians had knem saething abeut it and had a bit in the literature, and ene er tlle great experts en mites, Dr. R. Levthwaite was tr• Australia. Abeut the saae tiae, as I :remember it, we get a repert et a British Divisien wbich had gene ashere en Ceylen fer a rest, and they had a bad eutbreak er scrub typhus tbere. Scru'b t;yphus bad been known in the rubber plamttitiens. Fer s•e tiae it had been knovn.-it had eccurred in the regien ar••r~d Fera•a, in the islaw betweea Feraesa and Chi•• A.s I say, it had this leng naae---'fsutsugamuehi disease/. The Japanese called it that. They diacffered the rickettsia in it and the mite transmissien prebablJ', but net t•• auch was known ao.11t it at that tiM. It callSed a great fright t••, because the bite or the mite is a little bit itchy at first.. The itch Iii.tea are werse, but they dea•t cause scrub typhus. The scrub typhus illjectiea by the llite sHn turns int• what they call aa esehar. It gets a little black necrotic area en the skin abeut the aize or the end of your thunab1 aad when the seldiers saw that happen the:, thought that they had the finger of death •n them and a let of thea did die-• 11.t t•• m&l'JT died, but that frightened them very much. Yeu can see the pictures. 'Ibis is in 1942, when Geed En•ugh happened, I think'. In 19431 after talking with General Si.m1Hos, it seemed that we sheuld send a c911111lission out there, if General MacArthur weuld accept them, te study the disease•• the gr•und, and it wasn•t .ccurriog anywhere else. We had ne idea what the extent of' it would be 1 •• we persuaded Dr. Blake and Dre Maxcy t• head up a jeiat cll\Jlissien ef the Typhus Commissi•n and the ArlfT Epidemio• legical Beard to go eut-well1 first landing in Australia and then on up to New Ouiaea te investigate this disease. They did that. They made superb iDYestigatiou, isolated the organi• in animals, brought these animals all the way back te this countey; in fact, studying these far away diseases which c•uld 700 be carried back te the laberater7 enl.y in an animal made an infected menkey1 er a meuae, en.e er the best passperts fer a quck flight a.cress the eeean, u yeu can imagine. Lets ef efficers escerted aenlceys and mice back. That,as a valuable thing because it gave epportunit7 te study the disease in the b laberatory in this ceuntr,. F~rtunately the Department et Agricult\ll'e and the United. States Public Health Service were very liberal in granting per­ aissien fer bringing infectieus material threugh quarantine te be studied fer the benefit et the war effort. S•e of these things they didn't want te get in this ceuntey. Well, scrub typhus extended through the jungles o:r Bew Guinea. We had t• deal with it all the way up. When Dr. Blake, Dr. Maxcy, and Colonel Sadusk returned., they left, ever there Major Glen K. l•hle and several others, including Cornelius B. Philip and Jia1mond. c. Bushland, who studied the prebl• mestly tr• a preventive aspect. Tnq devised an iapregnation of clothing with diaethylphthalate, a soap chemical mixture, and taught the soldiers how to dip their clothes in this solutiea and impregnate their clethes in the !ielde The trouble with that was that it rained most •f' the tiae in New Guiaea, and the stuff leaked out of the clothing pretty fast, but it made the aen c•nscieus of ito The7 also began. te understand the value or burning ett this ku.nai grass in certain areas. We soan noticed a very interesting thing abeut scrub typhus. It eccurred in patchea. There would be an area about, sa7, half' an acre or•• fr• which cases would be coaing and adjacent, areas where u cases weuld be cOlli.ng., The reasoa undeubtedly is that the rickettsia or scrub typhus is tranaevt,:'iall.J' transmitted in the mites. It gees thr•ugh the egg, sea female laJing eggs would lq the rickettsia, and that weuld develep int• the next geuratita and se terth. It'• just like patehes of the Japanese Beetle. 701 They- eccur in patches where they live. I£ the Jlites were infected, the patches were infected. Scrub t7Phus eccurred in Burma, and I have already said that i trccurred in Ceylen, a.nd s•t.f' these peeple eae up .trem Ceylon int• Burm.a. It eccurred a geed deal in the led• Read which had been built, put threugh b7 General Jeseph w. stilwell. The Typhus Commissien studied the disease in that area and helped te contrel it lecalll". We put up a very time statien laberatery en the Brahmaputra Rinr, near Myitk:yinao We had a little te de in China, but nething et a111 cellCern with scrub typhus. There vu nething, as I recall, in Fermesa. Scrub typhus did eccur eccasi•nally in. Q. the Philippine Islands......MindlNI• right on up te Luzen and, ef ceurse, we were . afraid that it w were geing t• iDTade Japan1 we weuld have te aeet it againo It was se clearly variable 0 In s•e eutbreakll the mertalit;y weuld be tiverrcent, and in ether eutbreaks the aertality weuld be less than e11e percent. At Sanaaper, near what is called the Vegelkep in New Guinea, there were prebably- twe theu.aand cases. As seen aa these treeps get r-shere in an eld abandoned plantatien, scrub typhus practically stepped the wrter them fer a while,, but they didn't die fr• ito They were incapacitated. The same en the Island er Biak. They net enly had the Japs te centerui with, but this disease alseo e / Much has been learned tr• thu investigatiemr. It resul~d finally \ ...__.,. tbat peeple whe had experience in this disease: went back and werked en it in b Malaya, and they feund--tbis is after the war, but it was baaed ,ttn the war experienee--a• antibietic, chleramphenicel that steps ito It's geedo Chloraphenic•l is als• a cure .ter t;ypheid fever. Likes• :ma.IV' things that the Ar-, was deing, the results went right ever int• civilian medical practice and public health. Nene ef this was held secret, except fer the statiens and ftUlllbers er tr••pa invelved, s•ething like that. 702 On the basis er what yeu disceTered zou enter int• a peried er trainin&, educatien1 directives--! den't like the werd& but circulars which wew.d indicate what te deo Yes, and training net enly aedical persennel, but line efficers as well. I In tact, the line etficers toek change •f Bushland.1 s •pregnatien metheds very- quickl.Jro New we ceae t• an •ld friend ef z.•ura--schistesHd.asis. The Nerth African capaign-very little. Ne there wasn•t. There was hardly any- schistosaiasis in Algiers and Merece•• ScbistesHdasis is largely ia Egypt, in the delta er the Nile, and tbat 1 s largely caused by Scbistesema. mans•ai 'Which is a herrible disease. This is a fluke, er fiat worm fer the female, and the ma~ is like a little thread. In the h~n bedy- they live in the veins around the lower part of the intestines, fer exa11ple, and the nat teniale terms a aesting place f•r the thread-like male, and he spends his life in what•s called a gynecepheric canal. She carries him areund in this embrace. In the Philippines where we first ■et schistosaiasi ■, it was due tea nuke er the same family, but et a different genus called ~chiBtesaa japan:1.ca, and then there's still anether variety, SchistesNI& haematebillll_,.qbe mere than that, theugh japanic:1l and manseni are the chief ones. The erganism, the wera, the nuke has an intermediate hest-a snail. It lives in little bits er snail• called Onc•elani.a, very- small snails that are attached te the reed.a aleng tresh water streams, river banks, lake banks and peele. At a certain stage the parasite migrates eut er the snail--and this is a little, invisible thing-swims in the water and bcr es threugh the skin et a aan whe happens te be in the water. Yeu 1 <i think that it weuld be 703 easy to centrel--just keep peeple eut ef the water, but they needed a bath eTer there. Yeu can well i.Jlagine that in that h.t sweating place. Yeu ceuldn't keep them eut er the water. In additien, where the eutbreaks started te be bad wu en Leyt,e when the Engineers were sent in t•r_!pair bridges ever fresh water strealllt• They just waded right in the streama, and a let er them get ■ chistesndasis. In additiea, seme er eur dect.ere weuld be en a sand spit and didn't want t• get wet with salt water, but they ceuld see, as in the cue ef s• uey ef these sand spit.a, there weald be fresh water trickling behiad th•, and they'd ge int• the fresh water and they get infected. Thie was a aerieus disease. It was studied by twe greups et peeple. One vu a straight rerward laboratery survey greup that caae out •f the Army itselt-n• relatiea t• the Beard. At the saae tiae the Ara7 Epidemielegical Beard, the Cennnissien •• Trepical Diseases erganized a special. subcemissieu en Schistesllliasia, headed up b7" Droliraest Carr•lY Faust wh• was head •f trepical aedicine at Tulane UniTersity, and I 1ll have te leek in that beek because his naae is gene again. J:lureace 1 isn 1t it? Ne. It's right en tb.e first page. I underlined it s•ewhere. Once this K 1• feund., let's tey t• r•eabeA it-Willard Ho Wright, Celenel Willard Wright.. Seunds like Laurence, deesn't it. I theught zeu aeant Fausto Wright t{~ ever tr• Faust whea Faut eae back. Beth these greups did a let et geed work, and thq didn't, aeet eneugh te tangle. Altheugh the A. u. s. peeple veren•t cennected with the Ctlllllissien, theT didn't raise any- particu­ lar criticism as t• what the CMl!issien er the Beard was doing, and the Beard 704 CNlld.ssien had all the backing we could give it tr• Washington-net enly in the pers•nnel and equipment that was sent eut with them and tile equipnent that was renewed f•r them, but fer their work en snail peis•ns• Trying te get rid et these snails in the streaas, we sent them what's called a 1181.ic•l•giat. He 1 s an expert en snail•. Then they wanted a great •rv expeuive cempounds that veud be aade fer u by du Pent, er an,-b•dy that knew, er had sae chemistry aleng the lines we were interested in. Abeut ence •r twice a week, er ••re, I vew.d send twenty...five peunds et sae chelli.cal to these people en Leyta, air aail, alld that.ls abeut twe hundred and titt,y della.ra a abet, but the var vu ea, and there wren• questi•n• asked. They did find snail p•ia•ns, and they're st.tll.l l•eting fer better enes. Were they able te break the czcle? I Ia certain places, b11t it ,., • s• huge a pr•blea. It weuld take teu and ter:aa et this material to get the snails eut et this fresh water river, say, even in Leyte. The disease occurs in Japan, and Willard Wright was ready and after the eccupatien •t Japan did s•e studies in the Fujiy8118. regien. That ala• resulted in a great iacrease in knowledge •f the bi•l•gy of this vera, the snail•, the parasite which is all te the value et tropical aedicine tor ci•ilians. Al•• it alerted the pe•ple et this ceuntry to a danger because these aen caing back were excreting the eggs of the worm in their feces. 'ftlat raised another preblea that PreventiTe Keclicine hadn't Tisu.alized at the start, but t••k it in its stride, and that is the sanitati•n et a railread bed with troop trains affing ever it. Think •f the excreta that is dumped •n the railroad bed. Yeu can't contain it all in buckets in the care, and the cars were evercrewded, and when they w•uld be passing ever a trestle, er a streaa, the streaa weuld be intectedo They stepped in stations. We had a great preble•• The bHk abeut the sani tatien. ef the railread bed bas n•t yet beell vrittea, I guess. It illustrated the part ef an.ether pr•blea that we get inte. We get very much concerned teward the end •f the war with twe greups et peeple c•ing t• this ceuntry-priseners ef war. We had abeut feur hundred theusand 1 11&7'be1 in this ceuntry. What diseases were they bringing in? Then when eur wn treepa returned f'r• malarieus regiens, er schistos•e regiem, what weuld they bring int• the ceuntry? I r•eaber ene instance when just sitting tigbt and figuring eut the prebabilities and acting en them turned eut all right, theugh I wonder why. In Gnttaglie .lir Base in the bettea ef ItaJ.7, a very peculiar fever brelce eut aaeng the treeps. It wu Q :fever, as we knew new. We didn't knew it at the tille. That tro•p~ ship bringing these seldiers ever t• this eeuntry bad a few sick vhea they vent abroad, but they had maybe twe hundred cases en that ship ceming in. They all get int• New Yerk and Broeklyn and got dispersed betere &llY'boey was alert te what they were doing. Here we were cenfrented with, say, twe hundred carriers of s•e inf'ectien going to Maine, te Louisiana--well, we had a centerence, & talk as to whether the Preventive Medicine Office sheuld buaediately set eut to lecate all these peeple alld herd th• ia te some killd of e'bservatienal detention. We decided that we nuldn't do it, and nething happened. The sae thing happened during the war whea I happened te be in charge0 lt •• tiae peli.-qelitis breke out ill a recruit training center in Ca11r~rnia. Sweral hundred er the peeple., yeung seldiers that had been asseciated, were being sent ••~reops trains to Indianapelis, to Chi.cage, clear acnss the eeun.try. The health etficers get werriede There was quite a pressure brought te bear te step these shipnenui..-even step~rains. The sensible thing waste kn9W that poli-.y-elitis is not t•• centagious ameng 706 -p s•e et those age groups, that the peele were scattered, and that it weuld A. be very di.f'ticult te catch them. We let it alen.e, and I don't knew et &IQ" secendary case. Maybe the Lord's with ;reu sem.e time. Hew abeut the treatment et•••• SchistosGlllliasis? - Yes. ,r They probably try,t• kill these flat werms that are in there, but ea¢ce _, the parasitic werm lies in a bloed vessel in the rectal regien and areund the bladder and excretes these sharply spined eggs--seae haTe a lateral spine and ethers have a terminal spine--those eggs work their way through th• tissue and cause a great deal et 1nn. . .t1en. They all get buried there, and tbeytre practically' inaccessible. Seaetimes they have big eperatiem to take H11ae et that infected 11.aterial eut. One ef the dangers in it is that cancer deTelepa on tep er 1 t after seme ti.Ile. In this particular lett~~ there is illdicatien ef ~ shipent of the hos~• Yes 0 Dr 0 Fo Jo Bratt, whe wrete that letter is a aalacol,gist, a verr goed ••• Again, we breught back into this country m.a?Q" ef these snails, packed in vet grass, seaweed. Several celeaies were built up. Dro Henr,r E. Helene7 had •ne in Nev York# cultivating snails and infectieae passing tro11 one te anether withe11t an., harm t• the CNllllunity because yeu know how to take care et it, but a.gain, here's another case where military etrert and research directl.7 enriches the knowledge et the civilian. I can shew yeu that it isn't half as difficult as i t • • - to be trm an organizatienal peint et view-this is daily' cenversatien0 707 Y•u knev--z•u have\• 1£!!.W whe~e th.!, P!ople are and have t~e power ,t• send tbea se lace and the have t• have the desire te eo Yeu can't awaken inter.!,s,~,_ It. has te ~e there, and i~ makes its ~~• Bear in mind that this is in the war time. i eople weuld de things at their greatest. incennnience t.• serve their ceuntcy. It didn 1 t take any­ persuading. The pereuasien that had te be exercised was directed •f'tea against the autherities ef the institutien, • t th• preress•r that 1•u wanted. The pr•fesser was v:ilfing t• ge, 'but the dean didn't want him te ge because he 1 d have te t'iad semebedy else t• run his classes. What ,I meant was that this relati•1'9hip that Preve~tive Medici;_ne Service, ~ with sld.111 with able men with interest, didn't direct thea. I.t jus;t; •.pen~ up eppertunitz fer them wbi~h is a dif!er~nt ~~i.!!§a and this is a war tiae l!i;.tuatiel!:,-it. was like peace time 1 real?:z• The. skilled man ceuld merelz purs11e an interest. That was the guiding principle in assembling this Array Epidemielegieal. Beard, er the Typhus Cwaissien. Cllllli.ssieli were organized and set 11p in \ line with the interest et the ehiet. As a rale, he assembled his celleagues 0 Mz; experience in the A.1"1171 particularly ia the Iatautrz:1 didn' t allew. f•,! diseretien1 ~t here it_did. In the field er science where scientists were ■- I I 1 I I • T P T . . .r ceneerned8 it was actien as a functien •f interest en their eart1 and yeu h~ to knew whe-vella just the .sterz ye11 tol~ abeu.t,_P,r 1 Paula It just unfeld~• Thia is different !rem the eenstructien ef t he atomic bomb. That was-the peeple werking in that had t• work strictly in nuclear physics, mathematics. Q The1 ceuldn1 t ge eft en sandny fever while they were trying to mak~ a bemb 708 The sandfiy fever peeple could ge ett int• Japanese encephalitis, if they wanted te. I don't think that is sufficientlz renected--that an !raz can be erganized with this Preventive Mediciae Semc• t• allew fer this kind ef treedem- t.hatts what I shewed eu the ether d;az-and this i;_s perh&[! en a worki!I level-•ne ef the preblems t~t yeu een.tr~nt ia l••ld.ty, fer ee•ple1 s~td bz izeeple for malaria contr•l;­ ditchi!!eja ,draining and so en. While ze~ h&:t! &£Elicatiens1 these whe are titted beth by .t,raini5 and ,soae ex2!,rienc• :r~i:, it were_nall. It shewed tha~ zeu needed far aere in the wy et trained er~•nnel than was availabl~• That 1s right. We had hage traini:11g pregraae and screening er the peeple0 Many of these whe applied, se te speak, fer pesitiens were net capable et carr,ing en the work. There was alway-s a shertage, particu.latly in the aala.ria cont.rel unita capesed er etfieers and. enlisted 1181\o B ot.h got te 'be very valuabl• and desired 'bJ' the everseas theaters in malaria regions, and it was hard work te find eneugh and te keep up their training. !fbere was the centrel ef malaria cent:ered? ~ ,den't find it-we had charge et it? Preventive Kedicine 0 That I haven't found in aq et~• P!P!r••... I knew that tnere were lets ef velumes published. Velume VI. Wella I den 1 t have Velum• VIo 1 A theusand pages-its downstairs. I know that there wei:e a let •f malaria studies geil!f?i ••-:all thr•!!Sll the war, Nati•?la:1 Research Ceuncil and OSRD. Yes, the CMlldttee en Medical. Research-studying antinlalariala, leeking fer a drug, but JU.1.aria centrel is part et ene et the aectie• e:t the Preventive Medici• Service. Oliver Mee-., was aestly in charge e.r that. We had a gNat 11&1.arielegist with ua na118d Paul Rwsael, and then he we11t te lfertb Africa. He ala• vellt everywhere-in the Pacific. Semetiaes ularia centrel weuld be in what was called the Epidemiel•U Divisien, semetimes in the Trepical Disease Centrel Divisiea. Tbat 1a vb.ere it usually vas--Trepical Disease Centrel. Wellg thank yeu verz :au.cbo A:re yeu finished with these been? Yea_, I•n brii¥ them dnn with. •o no '.£hursday1 Dune 9, 1966 A-60 1 N. L. JI!,!, Yesterday we talked a~ut three ditferent areas-hepatiti■1 scrub typb1111, and the schistos•e lem and thew in which the bus C8lllllissien and the ~•ard functiened when zeu received repert.at er infonaati•n that saething was u in the tield that needed te be cevered the wa in wtrl.eh· hes• tters were e:xeed1.ted 1:r:respeetive et title ,!'here interest was allewed te runcti~n-­ i;ndieated just in tl'\E; stu&; et Dr. Paul hillselt 1 hsw the fr~e ,curiesitz et a scientific seid.t tunctiened within this everall A!;?l cover 1 discretien ~n the field whiebw~s preserved. There•• anether aspect et the scientific cMl!l'lunity and that's the nec~~•itz fer the publicatien ef findingf!• Thie varied in the latienal Research Ceuncil1 OSRD1 seme et the mere erehibitive aatters in which 1he were invelved scientists ha the Dean et a •edical scbee1 1 there were certain erecedures which zeu de establish here which alln~ eubllca.ti•n in beth areas, both in the Tzyhu~ Cenaissien and the Beard. I den't kn• what the considerati•ns were which led ~~ this 1 ei:, whether th4?re was mz problem cennected with i to ..To ae 1 this 2recees ia a unique exeressien--the grattiqg ef a civilian understanding ente ' I tbiak it,• impertant and werth a werd. Certainlz yeu were i~- undated with pa,zers-tbere were a let here in the f'iles trGm the Dingle greue which I•Te seen, but . .re than that.a there were scads er pu.blicatiens that. came eut.. Hew did yeu handle this when zeu theught abeut it be.f'ere publicatiens began te cae in te zeui I didn't haTe te give much theught to the desirability •f scientific e publicatiens aaeng the greup that were in PreTentiTe Medicine beca11Sf\ it had been habitual with the• in their university cennectiena and even :f'or General Sinuaens in bis J.raT cennectiens. General Sillmens was publishing papen about dengue, ty-pheid, mesquite transaissien of disease, malaria, ever since be was a lieutenant in the Arfq almost. He had an academic sense abeut publicatien. The members er the Beard and the CeDlllissien were used te tree publication., the pelicy et the medical schools to which they belengede The only difference between publicatien in civil lite in a aedieal scheel aad these that were desired tr• •eientific work in the A:r,q was the need te preserve security. ObTieusly there was certain inte:rmatien that could not be reported in the papers that the writer would ban desired to baYe and that had to do with the number •fr reepa involved, their loc~tions, m,d an,y plans that would indicate an encCllling campaign, er another move in a campaign. There had te be set up ever these publicatiens s•e superviseI7 function of the Surgeon General which is net fair to call censorship, but is to be looked upon broadly as an aspect ,r the protection of security. In the Surgeon General's Office, er at least the Preventive Medicine Office, the method ef handling these manuscript• that were destined fer publicatien was essentially' this-•the author would write up the work, er a piece •f the work aa he saw fit. He picked the subject. The subject was not banded t• him rrem the Surgeon General's Office, er the Preventive Medicine Of'ficeo He wrote a paper as he weuld if' he lie had been in a faculty or a school when his research reached a point where it was desirable te publish it. He thought it was desirable to publish it for the usual aetive that influenced the investigater in the direction cf publicationJ namely, the desire to make new knowledge available for the advanc•ent of research, •r the imprevement of practice, er fer the benefit of the public health, er any­ thing that weuld c•e of the work either in relation to basic research, er applied research, or applied activities. These were the norm.al motives, and 712 these men concerned with the work in the Army behaved in the neraal manner te which they were already accustomed. When the manuscript was received at}the office, we'll sq, in. Preventive Medicine as an example, it was read bys everal peeple in Preventive Medic:iae fer its scientific centent, its validity, and its relatien teecurity. If w it was decided that the manuscript was acceptable, if it was soae~bat edited at the tiae of its first receptien, it was then referred te an everall e. eftice in the Office et the Sur~en G~eral, usually called the Office of . , Technical Infermatien. That was capesed ef a staff ef peeple whe read these papers wit~eut lmewing anything about the scientific sides er them, er the clinical sides-ttey were interested in.security, and they read the manu­ scripts fr• the peint ef View •f seeuritYo They bad an added element ia the security precedure ever which they were guardians, and that was, ye\l aight sq, a pelitieal element. let enly- was it net permitted~• discleae llilita1"7 illf'ormati•n that lli.ght be •f cnd'ert and p.d to the enetQ", but it was net permitted tbe auther te sq deregateey thinge &Hut •ther efficers, er abeut ether services. It it sbeuld creep inte an article written by a aedical ef.ficer in t.he !ray that the Navywas na geed in the situatien, they- wouldn't allew that te remain in the manuscript. dl.'hat 1 s N understoed.1 and there were si tuatiens whe,)\_ that might have been said epenly-I mean, it 111.ght have been said and havef8en remeved. After these papers were scrutinized fr• the peint ef view ef security am were appreved, they caae back te the Office ef subnissien; namely, we'll sa7 again, Preventive Medicim, er ene •f the branches, er divisiens er Pre• -Yentive Medicine, with a stamp en it "N• objection t• publicatien"-stamped and signed by the Office e:t Technical Inforrnatien. That's as far ae they went at that time. They didn't g• te the War Department Offices, er the ru General Starr Offices fer advice en a paper unless seme high peliey, er general start matter was involved. There was ne Department et Defense at that time. The General Staff and the War Department didn't have the same kind et public relatiens, •r technical information senice, in effect, that nw exists under\the Department er Defense, e• that oace it was cleared by the semce, the Medical Department, fer example, it was finished unless seme high pelicy was involved. Then it was returned to the branch, er division, er service, Preventive Medicine again, and it wu sul:aitted te the jeurnal selected by the auth•r• Snetiaes General S1-ene weuld like te see a paper put 1a a pregram •f a •eting er a scientific society-, and that scieatific society- nuld detendne where its preceedings were published as in the cue er the hepatitis paper by Deuglus w. Walker tbat w l••ked at. That was p11blished in the American Journal et HzSzena after its presentatien at sae public health aeeting in which General Si.lunoms was interestedo Usually the papers were sent f rem our office to the journal se$ected by' the authoro The cerrespondence was handled that way and preef sheets, galley preet and page preo:r, sent in the usual vq, either through PreventiTe Medicine and te the author, er s-.etilles it wu just the je11rnal dealing with the auther. Once it was cleared and 011 its wq, nebody wanted te put any- ebstacles in the way er pr•pt publication. The eutleok en Preventive Medicine toward these 118.tters was that there sbeuld be the greatest treed• et publicatien and, as a matter er fact, publicatie• tre111 General S1alllens were ceming eut u early- as the early 1940s. He published••• things as•••• as he got te the effice almost abeut the prnentive medicine pregram et the A'r'a¥ and what was in his mind. The Beard's 0 •cientific publleatiens begaa after the Arrirs' Epideaielegieal B\ard had been tunctiening abeut a year. Publications frem tti.t Beard befan to appear, I 714 think, in 1942. They were published centinueusly after that aa manuscripts becUle available. I don't recall-I think I saw them all-and I den 1t. re­ call any eTer being stepped because it was theught that the material eught te be classitiedo We tried te aveid classificatien as much as pessible er reperts and manu• ttcripts. That was net true et ether organizatiens like the Caudttee on Kedieal. Research which was campoaed largely et civilians with sae ailitary efticere, Navy and A.r-q, en. as liaisell members. That CRIJftittee on Medical Research classified al.meat everything. Se did the Natienal Research Ceuncil. The Navy had a very strict classificatiea pelicy which ude things very difficult at one tiae. Hew itratienal they can seem te get is illustrated by­ what happened in 1944• with regard te malaria. I was teld that Admiral Chester w. llimits said te General Marshall ens day in the Seuthwest Pacific t.hat there 1 s tee duln auch talk abeut malaria, and General Marshall said, 11.ill right, we'll shut it up.• I•m net queting hiJI. I•m makiAg up what might have been said. There was a ve17 Sll&ll piece et paper that came eut •f that saying that •~•rything abeut aalaria will be regarded as secret £rem this tiae en. That never was the attitude et Preventive Medicine, s• we started te eppose that .fro the start. The eni'ercement •f that pelicy adepted threugh the actien e.f General li!arshall and Adlliral Hbd.ts was se strict that it began t• prevent eur circulating ancieat documents en W1&laria-fer instance, spraying the jungles with DDT eaae np, al.meat reutine precedures in al.aria centrol fer killing ••squiteeso All the textbeoka ued ter years shew airplanes dusting tree tepe with Paris Oreen., and insecticides were listed all the time. It was said that nothing ceuld be said a'beut atabrine, an antimalarial drug, because the Japanese llight benefit by it. We have Japanese papers trans- 715 lated shc,wing that they had atabrine in New Guinea and were using it fer the suppressien •f malaria and for the treatment ef malaria. This get se bad that they had te term a Jeint Arf/lY' Na~ Cemmittee at a high level, gene~al staff leTel, and they- happened te have appointed me assert ef a respensible melllber fer the--I ferget the name that it was called. tJ•int steering Cemmi.tte!:7 It'• in sae et these papers here. I attended ••"1" meetings in the Peutagen racing a stern Admiral wbe 1as uphelding the secrecy et the 1laYy'. Finally we wen because I went ever ene dq leaded fer this Amdral with a suit ease full ef all the standard textbeelcs I ceuld get, eld circulars and stuff abeut malaria, full ef pictures, all the material that bad been used in the epen ter 79are. I teld the .A.dlliral that this was what had been geing en, and he said, "Sir, I de net mean te be effensiTe ia aay wq, but I just den 1 t believe I had this material all areund S1' feet at the table, and I put them eut and pasaed tha areund aeng this elllllllittee, this Jeint Ce-1.ttee of Ar.y, Na'97 and Start, and that ended that. It tied the thing up fer, I guess, ! nearly a year. Fertunately netbing like thatrappened in the Preventive Medicine SeM'ice with regard te publieatien either er members •f the staff, or General SiJmHne, er the A.ray Epideai•l•gical Beard• er the fyphus Cmmissi•n• B:r the end ef 194$, upwards •f-•h, I 1 d say upwards er two hundred papers bad been published 'b;r m•bers •f the Beard, and it was a system that centinues tbreugh all the life ef the Bea.rd since its reunding, fer twent;y-fiTe years, tbreugh Korea and all the special AJ."IIY aiasiens it:arrferaed with the reau1taftt publications that were shewn in an exhibit at the 25th Anniversary er the Beard abeut twe ween age--abeut 1450 papers have been published Dn its work. That is the essence ef the publieatien syst• with regard t• scientific papers er curreat work. 716 The ether-I might mentien it here--the ether big publication pregraa l \J ~ich Preventive Medicine was invelved and rather deeply inv•lved is the histerical pregraa. De yeu want to mentien that? - Yes. Fr• the very- beginning ef the war always there were beld1 large ,t!DS 111.de fer the cellectien ef •terial fer the bistery. This is iagained in the Artq' since the Civil War. In 1862 1 General Hamaend, the Surgeen General, wrete a very- faaeus circular that started the cellectiell ef material for the famous Anly' Medical Kusea and at the saae time fer the publicatien ef this enermeus six volume, almest tolie--size voluaee, called the Medical and Surgical. Histerz ef the War et the Rebelli••• a title I hate te recite because in my part ef the Seuth they den•t use the werd "Rebelli••" in cennectien with a difference er epini•n which eccurred at that tiae. The collectien et materials fer the publicatien ef the history er the medical department in a war was traditienal tr• the Civil War •n. Af•en aa it leoked as if the A:rsy- was geing int• World War II-eh, befere that, the histerical pregraa f •r the Medical Department in World War I re­ sulted in the publieati•n er abeut 14, er 1$ huge heavy veluaes under General Ireland, and that 1 a a superb )1stery ef the war. Even befere that, a •*l vaa the history ef the Crimean War which wa• really the first geed medical history that bas ever been put eut, se we had plent7 et histerical and literary traditien in the military services, particularly the Medical Departaent, that festered the idea ef the eellec'1.en et material and ite subsequent publicatien in an historical. aanner. At the beginning er Werld War II an Histerical Div-isien was get up ia the Surgeen General's Otfice aad. Celenel, later Brigadier General, Albert LOTe, a veey tine scholarly efficer was put in charge ef it. He was tall and thin and quiet speken, very pelite, but a Tery firm and able man with a very fine 0 History et the Develepnent er Statistical Meth4d in the Army-classificatiens and handling ef histerical :materials. General Leve set up the Surgeen General's historr branch, as it was cal.led, and began to cellect materials, but abeut the ti.lie we get into World War II, very cpwer:fu1 civiliana, began te take ever the idea that they might write the history ef the war. These pewertul civiliana were heused1 we '11 sq, ceatered, er nested in the Watienal Research Ceuncil. They teek it upen theuelvea te sq that they, representing the civilian interests in the ceuntry, weuld publish the medical histery ef the war. On their beard were twe very "figereua peeple; namely, Dr. MGl?'ris Fishbein., the editer er the Jeurnal et the .American Medical Aaseciatien, and Dr. Jehn Fulten who was Pretesser er Neurephysielogy at Yale about whom we've talked befere--very active peeple. They began te set up a sy-stea for the cellectien of JUterial fer the history of the war and cause4 General Leve te wring his bands 1,d!lspair because the materia1 vao being diverted trea his eff'iee. Fer example, Dro Fulton, prebabl.7 uncenaciously, er at least witheut clear knowledge of what he was deing, put himself in centact with the surgeons er some ef the theaters and teld them te send their reports t• hill and net t• y the Surgeen General. I met with that ci,ilian gr•up, and I think that there are s•e pictures in the files here that sh• eur meetings. It was ebvieus that they couldn't live up te this ebligatien that they bad aaslDled. There was a great deal •f bickering and treuble, and finally­ getting areund te General Kirk 1 s ti.Jlle....Oeneral Leve was supported by the Surgeen General te the exteat that recegnition ef his Histerical Divisien was of'fieial, and he had ne further dealings with the civiliaa greup of' the National Research Council with regard to histery. This civilian greup was then ns disbanded. General Leve tried very hard t• get all ef us in the division and branches te cellect material and te be sure that copies get t• his office fer 0 the histocy, but it was obvious pretty soen that a sec~ndary group, a secondary agency, set• speak, ceuldn't carry the spirit ef the thing. The history- has te be written by those cencern.ed in it, we telt in PreventiTe Medicine, altheu.gh I aust sq that I d.en 1 t believe that Preventive Medicine ceeperat.ed very well with General Leve 1 s Office, although we had plenty et aemeranda about hew necs•&l7' it was to begin to write history and to give hi.Jll dratt;s and copies, am. especially decaentary' matE!l"ial, archives. Abeut 1944, er 1945, the idea develeped that Preventive Medicine, fer exaaple, should write its wn history as a part of the medical histery, •rfthe history er the medical service. A. Beard was termed ef which General Simmons was a member. I was a me•ber. Abeut six er eight people were members frem the Preventive Medicine Service. The centrel ef the beard aside trom being under the chairmanship ef General Sbneris was pretty much under th• nay ef the head er the historical service in the Surgeen General's Office. One er these was Celonel Joseph H. McNinch whe was at the saae time head •f the Surgeen General's librar.,. He was succeeded by C.lenel Calnn Geddardo A. great deal et material vu cellected. A great deal ef neunderin.g toek place. It va• very difficult te know what they bad and hewr• make a pregraa fer ito The aecUllllllatien oentinued, and elll" Beard on the Histery et Preventive Medicine in 'W•rld War n as a part ef the histel'J' er the medical department did net get well erganized, er at all productive until abeut the 19.50s. Its first publicatien in a volume form came out in 1955, and it had to de with Personal Hygiene and Iamunizatien. In the saae year a velume was put eut en Environ- ~ mental Hygiene which is a mixture of sanitatien and quarntine accounts. These two volwnes caae out about 19SS, tully ten years after the Beard had begun 719 te functien. The program after many, many change•, finally centemplated puolicatien of nine Tolumes in this series. Te make this shert, let me say that as ef this date, there have been siX velumes published in Preventive Medicine. Twe mere are in cemplete manu• script fera, but net yet edited and the third •ne; namely, VelWRe I is being written by me. I teek it en a few years age after a manuscript by a paid lay writer was feund te be entirely unsatisfaoter,. The Beard weuldn 1 t accept it. It was &tarted ag&ino Shall I tell about the meeting when it startedt It came abeut 1961. I becaae Chairman e.f the Advisory BG&rd 011 the Hister, of Prevent.ive Medicine, a board appointed by the Surgeen General annually'. I became chairaan in 1954, just after the death •f General Simmens. C. He had been chairman tra the start in 1945. lllen this big :manus,'fipt by this lay writer was sent in fer reTiew by all members er this beard, it was IJ fe1d by all meabers or the Beard te be so unsatisfactery- that they didn 1 t want te have anythiag te do with it, er with the Surgeon General's Office, it it were publiehedo It was decided that te say that it was so unsatisfactery that it waa not acceptable, and in that aeeting the members •f the Board were sitting areund the roem, leeking dew at the table in a glu:a wa:y, WGRdering what te do next. One of them-I wer1 1 t say his naae, theugh it was prebably Celenel Hard~nburgh, turned te me and said, "You certainly can de this fr• having been mixed up in all er the affairs ef preventive medicine during llhe war. You're an eld man. You have plenty of time. You take it enon I teld them that I would take it on, provided they would let me do it in my cnm way; namely, that they wouldn't harass me every month and ask 118 where IV I was with it, er put any kind •f a rehip ever me, and that. they wouldn't ray \ me anything fer it. As a result, I have been slaving at this theusand page beok since abeut 1962. I find it very severe and very interesting. I have 720 reviewed the wbele ef preventive medicine ef the war in many aspects during this past rev years. I aentien here my cennectien with this ir•ject er the publicatiea er the histor., in cennectien with the things that Dr. Phillips has been e~tracting frn met• shew that the current feat of memory is ne~ much ••re than a reciting exercise in class fr•• either recent, er previeus reference to a beek where I know the informatien lies. Hew didpl!u find the material preserved? In the archives? Yes, cevering this war P!ried• Well, the material--we call them archives-are preserved first in the Surgeen General's Office. He had a whole neor i'ull--a lever fi•or full in ene et these wings ef these-called Main javy Building. Half •fit at least was his recerd reem, filled with steel drawer files, seae lecked aad sne net. It vu a rule et the Sargeea Oeneralta Office that any ti.Ile a117 letter, er repert was handled, it bad te be aent devn te the recerd roem fer filing, er else a cepy er it seat den. That built up a huge collectiea. That was a syst• 0 that was tellned tee ia the Offices or the Surgeens ,f\veraeas. They cellected their recerd.s currently'. Se did hespitals. The ameunt er recerds that were preserved was ener•uso The letters and reperts ef Preventive Medicine didn't always ge devn te the recerd re• because I, for exaaple1 kept all the Typhus CNIDlissienreeerds tegether in a unit and all the Array Epidemielegical Beard recerd&: tegether as a unito General Sinuum kept his effice recerds as a unit, and be sent dewl'l t• tbe recerd rea ef the Surgeon General 1 s Office, it I my tell the truth, u little as pessible because it get lost. It get l•st 721 during the war because it was tiled in sae arbitrary way that weuld be change+t anetber time, and yeu ceuldn 1 t relecate it. The secend treuble which began during the war and developed later, came tr•• the decisien er s•aebedy wh• knew abeut archives, that rubrics sheuld be different, that the unit filing qstea, like keeping everything et the Board tegether, er keeping the Typhus Cemissien tegether, er Preventive Medicine tegether was not legical. The system that caae in was that these unit files weuld be br•~ up, subdi.vided, and refiled under such rubrics as "public > 0 health", fer exaaple. Public health is broad e°J\ugh to cever much in pre- ventive medicine, but net all et it, •ueh in the Aray Epidemielegical Board, but net all er it. Fer instance, all the basic and general work th.at Dingle 1 s greup did en acute respiratery diseases haste de with public health, but it ala• haste de with virel•gy and pathelegy and aereever, it belengs te that unit laborater7. S•e peeple ceuldn 1t see that. C, In additioa, u the material caae back from Eur~pe, alld it did ceme back trem A.trica, the Southwest Pacific in great crates er files and"freeords. Seme didn't ceme back, and a great exanple et that is the files ef General Mac­ Arthur. Ttut7 have •nlT recently' c•e in to the tiles ef the War Department-­ trunks et them. You. knw about that. Well, i.Jl&gine what is happem.ng in the wareheues, er stereheuses, when these 11lilliens et pages c•e back te be preserved. They come back. They were put in wareheuses t.bat are used by the Natienal Archives chiefi7--in different parte et the country. There are great sterage files in the Sto Leuis Medical Depet, fer instance, and medicine is only one thing. Ordnance probably has as much, er Chem.cal Warfare just as much, but I'll talk about tie medical. We 722 h&Te great sterage depet files in Kansas Cit7. There's an eneraous World War II cellectien ef rec•rds in Alexandria. There's a whel!t huge building there with high ceiliags, se that files extending fro■ the neer te the ceiling, twelve er fifteen feet high in this old building, can be approached enly' en step laddere. It's prett7 hard to search a file ea a webbly step ladder ten feet 6 f.t'f the n ..r. The Surgeen General has been trying te collect archival material that belengs to hill--this sterage place, the Research and Reference Branch of the /\ Histerical Unit in the Fer~t Olen Sectien is a big building, and sae big re9118 in ether parts are full ef files. They have an easy access te Kansas Cit7 sterage, st. Loais, and I think that st. Louis has all of what we call the 201 files. Eve17 officer in the Ar,q has a 201 file in which ever.r order and everything he 1 a thought abeut alllost is kept. They 1re all kept. You can get at tb•. It takes twe or three weeks to get it out. The material is there. It gets disturbed ever,- nw and then by somebedy in the Adjutaat. General'• Of'f'ice who thinks it is net being handled properly and ought to be refiled. The staffs that are handling it are net. adequate. 'l'he7•re net particularly trained tor this werk. S•e er them are histerians. Others are net. After a while they get pretty good at finding things. They are net productive histr ians. They are filing people. You 1 d be astonished te see hew auch material is available, and it you work hard en it., you can dig it up. Anet.her thitig that has happened to the files is that there was one time when a pr•etien system was instituted by which a person got advancement according to the number of linear feet of material he destroyed in a year. If V \ Y•~ des~'\ey•d in a year fourteen feet., you get a better position than one who I destroyed only twelve feeto Its all authentic material. It's astonishing I'\ to see the original cepies, carbon copies of everything, orders, endorsements, 72.3 epiniens very freely expressed and very disceursively put ferward. iu these things. What was their criteria fer destructi•n? That was a mystery to me. Otten they are des tr eyed by- peeple whe den' t lmtnr their value. The eriterien is that tbeyw ere tee crewded and that the,ti better get rid of seae ef this t5tutr. That is a pressing preblea. Have yeu ever been in the Natienal Archives Building? That I s very- much crevded, but in these Alexandria Buildings, it 1 s even wer••• 1-.l Are all the war effice files er the PreveAtive Medicine Service available? I ~ Have they all been preserved? Ne-aet all et th•• I nuldn1 t be able te tell y-eu th.at. I didn't knfi hw aa111 they bat start with, I kn.., t.bat there are • - things I caa•t fiad. because, as I sa-,, theyw ere broken up and filed under ether headiags. They mventt had staff eneugh te sert tha ~ll eut. \ They tried fer a while te catalegue them, but they hawn•~ catalegued all the documents. They have a big steel cabinet with three by five cards, er three by seven cards, and I n•ticed that they are not using tba t aey aere because they have changed thea, changed the filing cabinets. The filing system, ef ceurse, if it is te be &Jl1" geed, haste shew the lecatien er the decument as well aa what's in tbe d•cument-- C at least sne ene little line, and eccasi•nal.:J.7 they de that. Then they g"- k and change all the fili~g cabinets, and when they de that, they change the lecatiens and d•n't enter them en cards, and so they finally threw the card file away. De they still have z•ur tiles intact? 724 I den•t let them touch them. I teek them ever there intact, and theytre practically all intact. Seme ef the A:rrtt:/ Epidemiel•gioal Beard material get eut ef my hand when I went f'rm the Anay back up te New Ierk"-te New Haven and 0 New Yerk. The Anr:, Epidemiolegical B~ard was then still functierrl.ng as it is rww, as a part er the Preventive Medicine Service. I had ne right te take the files. I begged them te keep them in a unit, and they did as much as peesible, but they are scattered, some of th•• Sometimes I can't find what I knew is there. The Ty'phus Comissien•s files are in six five drawer filing cabinets, and they have net been disturbed since I put tbem there. I had it written in te Mr. Truman's Executive Order disbanding the Typhus Cemmissien that the femer directer be resp•nsible fer the dispesal •f the recerd.s ef the Ca• mission. I had a cevering letter en that fnm Mr. Pattersen who was the succeeding Secretary ef War. He was very kind in what he said abeut my service with the C-.issien and confirmed the fact that while I should have " due regard te the interests ef the Navy and the Public Health Ser~ice, I N sheuld have the sq en the distributien, er at least the h8A_dl1ng •f the files, se when I went fr• the Surgeon General's Office back to New Haven in 1946, I toek these six filing cabinets lecked, cembinatien locks mostly, and bars in combination on a truck with a guard te New Haven. I put them in a locked roan in the histerical libracy--Dr. Fulten1 s librar7. There was rHm up there. I kept them there about a ;year. I aeved them in the same way down te first ene and then anether apartment that I had in New York always locked because they hadn 1 t been declassified at that time. I didn't declassify them until I was back here in the late 1950so In 1953, when I came dewn here, I breught them dewn again and get a carrell in the Library ef Cengress and put them in a lecked reem up there. They let me work en them there. I brought them a11 725 down again, meticulously, with an armed guard and fanfare. Frem there I a.ved them out to my effice in the Historical Unit. While I was at the Library of Cengress, I get authority t• declassify them, and I spent about a year putting a declassified stamp en everything, perhaps exceeded the auth•rity, but it .was a reasenable thing te have dene, and I wasn't letting them eut er sight, and they- a.rtev net in locked files. They've beens• much associated with me that nebo~ ~•uches them without asking me, a.nd the reason they ask me is that I kno, them all by heart meetly., but it weuld be wonderful if ~l the unit files ceuld haTe been kept tba t va7• We've gea,...e about an heur 1 aad I•u have te get t• these peculiar dazs. It weuld just tlisrupt what w e 1ve deneo We'Te been eursui3 a theme--rec•r~ hist•:.1, publicati•ns• We 1ve finished that. There• s nething mere te ea~·o 726 Itve been talkigg flff the top of my head en the guestiea ef foreign quarantine and the efforts of the .A.rmz, I wanted z•u to explain the relationship that the Af!l, and ••re erticularly1 the Preventive Medicine Service 1a the A:Y, had with exiaties civilian agencies in the United States where tr•opa might ge either for purp•••• of aaneuver 1 er be statiooed1 and we had a lot of tr•eps stati•ned where none bad been bef'ere. Big e&lllJ>• were being craated1 and there are these relatienships between existing civil institutions and the Armz: that had t• be taken care f£. Then, ne one anticipated that we weuld send the en­ ermeus number ef treeps everseas which we ultillatelz did1 nor the fantastic amount of supplies and equipment in their support which invelved transpert, ships--all the basic things 1 potential plague 1 cholera-•the works. So• aware• i.'1 neas of how this roblem emer roblea and occu ied the att ·' en of et the Preventive Mediciae SerYiee in the Al?l: and s•e ef tbe;pr•blea that emerged which I think in sae w aye bad t• do wi tit iJmnunizatien-you were ia t.h th•• India was anether area where i relation• with a aatien etate ude ter stickiness. There is runni5 tbreugh this the Army1e basic impulse fer secrec1 se tar as transperting treeps and supplies are cencerned1 ingrewn1 basic, and yet the attendant possibility et insect intecti•n in areu where thez waat te exel11de them. Y•u have the possibility •f human carriers ot disease ala• that arises. It's a sticq er•blem--reading this sumarz versiea bf Dr.-let•s see what was his name? Lt. Celenel Philip T. Knies. A& cemment yeu 1d care te make weuld preve helpful-in terJtS •f Preventive Medicine. 727 ~ It is in the Army Regulatien Manuals and many statements that the United \' States AI"a7 has te ebey the laws ef the l•cality in which it llight be eperating, and these laws in eur teday 1 s talk are the ene ■ tbat have t• do with quarantine. Quarantine by statute is a natienal matter and a state :mat.tar in the United States, and the enferceaent et quarantine ef human beings ia in the hand.a ef the Public Hea~th Se"ice, but it is net te be f•rgettea that there is alse the necessity te apply quarantine regulatiens te animals ••Ving acres either atate lines, er fr• rereign ceuntries int• this country-, or eu.t et thie eeuntr., iate sae ether ceuntey. That w as usually handled by the Department et Agriculture, altheugh the Pu.til.ic Health Se"ice was als• in­ Telved and interested in the diseases er cattle and swine. S•e ef these diseases are tranallissible te human beings tee. Furthermere, there is anether side et quarantine that every ene is fudliar with, a state matter and a lecal utter, and that is the plant quarantine. The soldier can•t drive his auteaebile acre■ s state lines with, we'll say, certain plants in bis trunk witheut being held up and having the plants taken away from him because very serieus ecenaic losses have been preduced by infectien--'ri.rua infectien, fungus inf'ectien carried by plants and even citrus fruits, petatee ■ , even things like tut, s• it 1 a a very bread field et activity and ene with which the citizen is fBlliliar before ne gets int• the Arttq. When he gets int• the Arllf¥ he finds that he's faced with the Salfte situ­ atiens that he weuld haTe as a traveler in civil lite, and the differences are these breught abeut by the Army specialized, characteristic activities •f mevement in the epen, or troeps in 111&sses, of treeps mingling in all serts et regiens. It bec•es a mass prepesitien rather than the individual ene I was speaking •fat first. Quarantine applied te masses is a large under­ taking, altheugh, ef course, in the end it cemes dewn. te the individual. 728 Hewever, to deal with large aasses and in a way to prevent carriage et disease, carriage et infectien by these masses as such, 1•u have t• have aass metheds like 1.Dllnunizatien which starts as an immunizatien er an individual., but yeu seen have theusands ef individuals illllllunized ~inst aemetbingo Y};:eLL lese sight ef the individual, but y•u've gained the pretecti•n et the mass. Quarantine al•• requires attentien te the vehicles, the transperts that transpert the masses er the individuals. An example is the tranapert ef ■esquitNa by airplanes. A ••squit• can get int• the covers •fa retracted landing gear and be carried for miles and miles rapidly--aay a mesquite in­ fected with malarial parasites in West Africa will be en the nerthern ceast et Brazil ever night almost. That's what happened. Prebably the Anapheles gaabiae mesquite wu breught ever fr•• the regien ef Dakar, and it carried a malarial parasite which l••ked n• different frem the ether parasites in the intectieu but it had gained an unusual virulence in the 1a11biae mesquite. I This situatien ameuuts te--I think its just likes• many ether things in I Preventive Medicine and in the Al"WY'J it a the enlargement ef well knewn " civilian public h! alt.h and preventive measures and the adaptatien et thue ■easures t• the A:nlr.y' situatieu. The principles are all well knewn, and I de net believe that in the war &01' new principles et pretective quarantine were develeped, but tney c•uld be applied very Tigereusly' and with a let et terc•• I Fer example, in a sense it a quarantine it you r•eve trea a locality in which seldiers are quartered, er eperating, the lecal pepulation te seme ether area. In seme ef the islands ef the Caribbean the enly available geed place fer stationing soldiers, we'll say, weuld be on a beach with a bit ef a barber, and a native village weuld be right there t••• What was dene then-­ they just transplanted the whele pepulatien te an area some miles frem where 729 the treeps were, beyend the flight raage •f mesquitees. This in a sense is impesing a quanantine in reverse, and the reverse of it is that a type of pretection of a post containing soldiers is tc locate it semeplace away from native populations. That was not dene, fer instance, in the region of Dakar. One tillle the Air Force units had their quarters right in the middle of a vallq, a nice piece of land, in which the natives were living, and the natives going back and forth brought infection into the troops that were there because the insect vecters were the same in beth cases. Obeying the regulatiens er states and ceuntries is an intricate matter requiring a great deal ef knwledge about people and about situations. The ebedience is not just a routine affair, autaatically exercised, or automatically observed. The local quarantine laws are administered by local health officials, and even the7 come uni.er the purYiew of a governor of a state, we'll say. That brings the military group into contact with the local civil government all1lost on every level fr• feed handling,•ter supplies, on up to pelicing an area, er traffic regulations. This sounds very confused and mixed up the way l•a telling it, but it's rather true te life that the complexities aust be appreciated and variation must be made t• meet those complexities. S•e of the quarantine regulatiens, however, affecting the meveaent of eur troops were verymvere and inflexible. The ene that is the best example er that is the Indian quarantine against the possibility of the introductien or -7elln feTer int• the great ever-populated subcentinent or India. Yellow fever has never been in that region. There are ne immunes. At the same time the Aedes _l!_egpti aosquito is prevalent, and we know that it is carrying a virus rather like the yellew fever nrus; namely, the dengue virus. Dengue eccurs in India, and it ••curs in Asia, bu.t there has never been any yellew fever in that region. Why that is so, nobody knows, but the Indian Government so dreaded the pessibility of the introauction of yellow fever into the 730 ceuntry and ceuld se vividly see the great less er life that weuld eccur if yellew fever were •Jintreduced int• this nen-ilmnune pepu.latien that they adepted quarantine rules involving immunizatian against yellew fever that were hindrances t• treep mevements. These Indian quarat1tine regulatiens fer yellew fever were impesed perhaps ten or twelve years be!ere the war, and we were beginning te knw seething abeut ilmnunizatien against yell• fever, but the Indian quarantine regulatieu didn't change with the advancing knew­ ledge. At the ti.Ile ot the war the Indian quarantine regulations, specifying when the soldiers sheuld be immunized, bew e!t.en the immunizing injectiens sheuld be repeated, and what interval should be allewed to pass after the injections had been ude, were ant,1quated and were much. mere stringent. than was necessary. The application er their rules semetimes resulted in holding up troop ships in Bombay Harbor fer tw• weeks lenger than they needed te stay there. In additien, air travel across Africa, threugh Egypt t• Karachi and Nerthern India were impeded by these sam.e regulatienao I became invelved in it when Ueneral Si.mm.ens was net able by cerrespondenc• to persuade the British and the Indiam autherities to make these aaelierating changes iD their regulatiems. I went to Eurepe in 1943, en sort ef a Jllissien to de several things. I was instructed te add to my duties en a visit te Lond•n~ t• try t• have conferences with what was called the Interdepartmental Quarantine C.mmission et the British. It was a eambined Indian, African, British eemmittee. My erders seunded as if they had cane from on high. I was representing the Surgeen General, and in the letters and things I carried, it was stated that the General Staff of the War Department was interested in ay having a chance t• lay this new knewledge befere their Interdepartmental Quarantine Commissien. 731 I was in London for nearly" a week being teld everywhere that it weul.d be illpessible for that cemmissien to meet because ever,ybedy wu away semewnere. All er a sudden the members ef the cGlllld.ttee turned up because a British Air Marshall--! think it 111.g ht have been Air Marshall Sir Arthur William Tedder vh• might have been in tbe United states--heard abeut this preblem and cabled ever te the authorities in Lenden, telling thea that I was ever there and that they sheuld see •• I had meetings and get along very well, particu­ larl1 with the aid ef Colenel Toa F. Whay-ne whe was Military Medical Attache in the American Embassy-. They were ver,y interesting people te meet, and the cenversatiens indicated what I have said at the beginning, that the relations between the Army and the lecal civil authorities is iapertant and has to be nurtured. I returned te the United States with the feeling that we weuld get aloag further with the Indian Gevernment after this meeting, and that was a fact because Dr. Saw.,er et the International Health Divisien gave me all the latest infemati•n en the yellw fever vaccine and the immw:rl.zatien precesses which the Indian. Government didn't have. It w asn•t all ever that year, 1943, s• that in March, 1944, when I went t• Caire, I had a chance te talk to the Egyptian Minister et Health and people in hie gevermnent whe were still adhering to the Indian strict quarantine rules, net se much because they were afraid that yellew fever would eccur in Egypt, but I think they were having some arrangements with the Indian and British GeverMents that were peliticall.y advanced by their taking the pesition that they did. This again shews the ramificatiens of what looks like a mere regu.latien ef quarantine int• the high policies ef a country-. Well, the Egyptian Mim.ster ef Health listened to all ef this and after a while :made the necessaey changes ia their regulations, and that cleared the air passages, s• te speak. 732 Quarantine was ef interest te the Preventive Medicine Service in the Surgeon General's Office trem the very starttaltheugh a quarantine branch, er a quarantine divisien didn't appear in the erganizatien chart until abeut 1944, I think. That didn 1 t matter because quarantine waa handled in the Divisien or Epidemielegy--it weuld have s•ething to say. The Divisien ef ' Tr•pical Diseases naturally- had a geod deal~o say in its relatien to malaria. ' We had a branch called the Centrel er Cemmunicable Disease which naturally tl w•\ld take in quarantine. In the manner characteristic ef the Preventive Medicine Service, the jebs were dene by different people in different parts et the erganization with•ut having te have their activities tall in just one nld, or be melded by j11&t ene set of affairs. They ceuld work threughout the Service in different divieiens en the preblems as it p0inted up the iaterest or that dirtsien. Quarantine utters naturally didn't con.fine themselves te the Arrq because the IfaV7 had peeple in about all the sat11.e places as the Ar'llfT had peop'le • The Air Ferce had peeple and vehicles in the same places as the Armty had, se that \_/ quarantine problems tended, really, te unite the separate services even befere there~as the unified Department ef Defense. There was an organization called an I~terdepartaental Quarantine Coadssien, I think, cempesed of Anr:,, Navy-, and. Public Health which was supposed to do s•e jeint work in adjusting quarantine utters, or helping te enterce them, or peinting eut the need fer the applicatien d'quarantine metned.8, but_,. recellectien is that that cun.ittee didn't function very well. I doa•t recall anything that it was lcnewn ter, but as usual, General Simmens saw plairu.7 the scope and ilaportance ot having some ceatral quarantine office, so to speak, for the A'ffllY', and be -to brought in~ the Preventive Medicine Service Lt. Colenel Philip T. Knies who turned out to be an utraerdinarily able quarantiu efticer. 731 Celenel Knies was sent all areund the world and met peeple in th• AntfY', the Na"'Y--h• didn 1 t aeet the Public Health Service fferseaa because the Public Health Service was net involved in fereiga affairs Yeey auch at that time. Celenel Knies sent in «tr•ely valuable reperta and had great success in getting peeple to understand the prebles, er in persuading peeple to ta1actiens that would support :measures to prevent the introduction ef diseases f r • one place to anether, er the spreading of diseases fr• one place to fereign placeso Knies was Yery- aueh interested in quarantine applied to eontr•l ef insects. I think he was mere cencerned vi.th mosquitoes than he wu vith men because a aeaquit• they were interested in was pleased te travel en an;, vehicle that wu moving whether it was an airplane, er a destrqer, er a truck. The methods ef centrelling the vecter arthnped were the same in each ease. Tne preblea wu the aa11e, and that•• anether ••­ lightening and unifying bit et infermatien that I think neither Army-, nor NaT7, ner Air Ferce people had at the beginning et this joint effort. Knies develeped a lere--call it tb.at-•f foreign quarantine. It was very effective and userul. He was net ae much c•ncerned with the quarantine matters er priseners ef war tha~were being adaitted by several theusands into this country-. Those people cue tr• aalari•us districts ef North Africa, or Italy--we had several thousand Italians, and they had malaria. The Germ.an prisoners er war didn't bring in any particularly aerieua intectiena, unless they bappened to have served in malarieue areas when they were captured. They were breught in when the7 still were int'ected. There was rather geod control er these imperted individuals by caretu~ examinations and b7 heusing in screened barracks in area■ where there were vector •••quitees. Fer the ether parasites that the7 might bring with tbea, they were screened by fecal examinations and bl.••d 734 exarai:natiena, applying te a prisener et war reutines that yeu weuld apply at a pert ef entry in peace time, but applying further measures at the places where these prisoners were settled, the prisener ef war Catllps, and when the prisoners er war were sent eut en laber duties, like cutting tilllber~ they were handled just as you weuld handle treeps in the field in a malarieus regien, er in a healthy regien. The etherygr•up-the third main greup te which quarantine rules had te be applied were eur ewn treops returning fr•m fereign areas trem which parasites ceuld be bnught int• this ceuntry by the infected individual. That pessibility gave us a great deal •f anxiety and caused a let ef difficult work. Exaaples •f ~h• parasitic diseases against which a guard was erected were malaria, filariasis, amebic dysentery, erdinary bacillary dyser1tery­ typh118 fever alse. Typhus fever really aeant that yeu were aere cencerned with the elimi.natien ef lice trem leusy individuals and their clething than yeu were in eliminating the disease. It is easy te recegnize typhus and quarantine the persen by iselating hi.at in an isolated disease ward. The pessibility ef the intreductien ef diseases into the country b,y returning ••ldiera was kept in lli.nd censtantly net enly teward the end ef the war, when the big deaeb111zatien and redepleyment was in effect, but even in the first part ef the war when pe•ple were returned even the first year. See weuld g• and caae back sick within a few menths after they had been abroad. Fertunately ne eutbreak ef disease that I knew abeut in the war was traceable to a returned seldier, er a prisoner er war that had been breught in threugh these quarantine barriers. Why that freedem ~f' disease eccurred is hard te say. \ It~s stretching it t•• far te sa7 that ~uarantine preventive aeasures did it. They might have. There may be sae !/Jtther rules abeut ! starting infectiens that we den•t understand yet. Of' course, starting in- 73$ fectiens is one ef the preblems ef bielegical warfare, and it hasn't been selved yet. Perhaps there is some natural pretective canditien that we den•t quite recegnise that helped in this case to keep trem starting diseases in this ceuntry. Malaria was the ene most dreaded, and it ceuld be easily spread in the Seuth, but all this time the malarial rate in the Ar.,- and the civilians was going dewn te the lewest level in hister,---almest. There was a scare er the intreductien of small pex fr• Kerea later, at ene time there was a scare ef the intreductien ef filariasis frem Okinua because these Japanese priseners en their way ever were feund in Hawaii to be largely in- fected with this bloed worm. The Hawaiian authorities 3•t quite excited abeut it, and these Olcinewans and priseners from Okin~& were mrded tegether, iselated and net allewed te circulate in Hawaii and not allowed te c•e int• this ceuntry. Where they were sent I dentt remeaber--I suppese back te Okin-.wa. I den•t knew that ther•••ery au.ch ■ere t• say abeut this particular thing. Feed--like the impertatien •f treeh pork int• Australia. In Australia peeple were afraid et trichinesia--they weu1d be in any ceuntry. It's remarkable why these things den't spread when yeu think they weuld. In New Zealand the veterinary peeple, eur veterinary peeple were herrified t• see hew dirty and d,ngerous leoking were the abateirs and the meat handling plants in New Zealand. Semething was slowly accomplished by example and persuasien t• iJnpreve these cond.itiens, but it was a cenditi•n they never did f'u11y impr~ve. We den•t knew hew much it c•sts in health-the cenditiens affecting the milk supply, especially with relatien te tuberculesiso They didn't have pasteurized milk, and they had plenty ef tubercu1esis in the cattle. !tve been recently working with an officer wh• is writing a chapter 736 en New Zealand, and we can•+ find hardly any evidence that these conditiens were detrimental to the treeps that were statiened there, and quite a few troeps were in New Zealand fer a rest. There are alse naturally eccurring areas in the Seuthwest Pacific, areuni the Adairalty Islams where they have ne malaria at all. This area er the ecean and the islands is shaped like a great big pelar bear. General Simmens used te have this polar bear well •utlined on his wall aap. Nebody lmewa lih.y malaria isn 1 t there, although the vecter mesquitoes are in the regien. Anether disease that has been subject te frantic quarantiae in ti.Iles past is leprosy. Lepresy was very prevalent •n s•e er the islands in the Seutnwest Pacific. Ninety percent et the pepu1ations would be leprese. Leprelf' in the Philippines was se preminent that the Leonard Woed Memerial fer the Eradicatien er Lepresy in honer ef General .1.,eenard Weed was established. They have that • werd •eradicatien• in the title ef the origknal thing, thinking et eradication which is a cencept that is net accepted by some in this ceuntry at present, but it certainly is a valid cencept. Well, leprosy was frightening, ~n.d it was thought that lepreey weuld be spread in this country by peeple returning te this ceuntry particularly from the S•uthwest and the :mid-Pacific teo, u in Hawaii, but lepresy develops s• slowly that we may net have the answer te that p~eblea yet. There's ne real evidence that anything bad happened about lepresy. Twe cases ef' great interest eccurred in this peried that made you think that lepresy might be transmissible in this regi•n, and these were the cases ef' twe men whe develeped leprosy in tatteoso 'l'hey1ere taloeed prebabl.y- \ by a nati•• who was putting the needle in his meuth, er semehew er ether carried iafectiou because these two men did develep leprosy in a relatively 737 short tille in the places where they were tattooed. It was a remarkable experi• ment that ene wishes might be tried mere eften by the scientifically inclined because the lepra bacillus has never been cultivated. Nebody' has ever been able te gr•v it. Nobody has preduced artificial infectiens with leprosy, except sane peculiar lesiens that are nn being seen in the last few years in the feet pada ef guinea pigs and rats where they inject tke lepra bacillus, er lepra material into the feet pada and it loeks like a multiplicatien has taken place. ?A~'&e0!:_.) 'Why lepresy disappeared from werld, as it did in the last hundred and fifty years er se, er less, nebedy knns. It was very prevalent in Scandinavia at ene time. The lepra bacillWI was discevered by a. A. Hansen. Unless the iaprevement is due te better hygiene in general, better nutritien, yeu have ne real explanatien as t• why' leprosy dwind1ed. Quarantine is an extremely interesting subject bisterically, legally, demographically, and militarilyo It's a very bread .field ef preventive medicine, and it brings in everyt,htrigo It's certaiplz a surprise in terms ef the quantities ef men and material that we shipJ?!d eut 1 seme of which we brousht back 2 salvage, troops--that we didn't stir up mere en the way. Yes, it is•t For instance, scrub typhus has never eccurred in this ceuntry, and yet we were afraid that it "might." 1 •m net making a pun, theugh I was thinking et mites at the Jllmnent. They were breught inte this ceuntry because the salvage peeple sent tanks backo If they didn't send the tanks, very eften they weuld send the treads, and these tanks had been plowing through the fields in New Guinea, through scrub typhus areas. The treads weuld dig up the mud, 738 and the mud would have kunai gr,ass in it, and the mites als• live in the '-' greund at ene time, s• we had a fiurey of excitement once when tanks and tank parts like this from a salvage area were feund in this ceuntry te have mites in the material that was clinging t• the parts. That was ialediately examined and feund net te be significanto It was net a trabicula type of mite. It was like an itch mite. Mites are a very large family', and they dif'fer in 1181V' minute wqs, but ~t iapertant wa.,-s. Of eeurse, quarantine als• invelTed some consideration et bielegical warfare because it was felt that the disease might be breught into a country by an eneniy sending in infected individuals. It was very important in the field er veterinary intereste, the pessibility that feet and meuth disease, er swine plague, weuld be shipped inte the e runtry without its being recegnized either by evert enemy action, er by accident. I don't recall anything about plants in this. I den't know that Kllies even mentions plants. Ne. He does indicate that there was s•e ecpesure te plague, but n.• cases ef plague, ne rats were discevered that were plague infested, that 11ihere was expesure te chelera1 but again1 n• tunnel, no channel. We were lucky in that war. Therta• n• influenza epidemic. Cend.itieu were all right fer it, but we didn 1 t have it. His general view is that the pregram based upen preventive medicine, a c•plete pr•sraa1 a normal gay by day affair, which given the size ef the Army we had and the aaeum:. et material we shiEped abread1 covering embarkatien and de- ,,. barkatien everaeaa and then in everse that as le as one adhered t• that c ,, , pregraa1 everythint, went fine 1 altbeugh certain is~~~~ cases came up-like '\ the fellew wh• was flewn, I tnink1 back fr• Japan with small pex1 discovered 739 en the plane. All ethers on the plane were revaccinated. Yeu ceuld take steps like that. Yes. My" Executive Officer in the Typhus Cemmissien got typnus on the island ef Hekkaide frem leuse iaf'ected blankets ef the coal miners up there. He wasntt leusy, but he did get s•e leuse teces, I suppese, in his eyes and his neee, and he began te get sick in abeut a week. He came heme, and he was sick en the plane. He had a t7pical case ef epidemic typhus in Alexandria. Nebedy telde Yeu eeuld take steps. Things didn't ceme in waves, but by individuals. I 1 ve eften theught er that. Of ceurse, nobody teld. I had some respensibilit7 in that case. Yeu have t• repert by law cemmunicable diseases, but I de/not believe that his case was ever reperted t• the health autherities. It~s just fantastic that mere didn't eccur. It is--even s•, it seems a• risky. Even the redeplment •f treops fran the Eurepean theater, er the Far East. Yeu knn 2 that's a simple statement te make 1 but the precess •f redepleyment is a bit mere c•plex. In redeployment, the treeps went mestly threugh the United ,'3tates-e.est ef them. S•e of them went eut threugh Suez. I don't know hew many theusands were aetuall7 redepl.,-ed--you see, it didn't last very long. V-E Day was Ma7 81 1945, and V..J Day was August 15, 1945, ~• there were bat three months in between, and you eeuldn 1t redepl•7 many treeps. 740 Where were you en V•E Day? I was in the surgeon ~eneral 1 s Office, and I think we breught a radie dn11 and put it en the desk. v...E Day came quite graduall7. We were fellewing the treeps up threugh Gennaey, acress the Rhine int• German;y, int• Austria with Patten. Itwi.s ebvieus that it was en the way--I think everybody' expected te have a V-E Dq as s••+s the Armies get acress the Rems.gen Bridge. Evel"J" da7 was just another German Arm:, captured, another German Cerps, anether German Divisien knecked out. Victol"J" was expected momentarily, whereas V..J Dq came rather suddenly. But en v.E Day I think I heard it ever the radi•• We md gene to werk en an erdinacy- day-, and I don't recall that the eff'ice was cleaed, er that anything special was done to break up the routine in the Surgeon General's Office. I can't remember fer sure where we were. W+ere at 1818 H Streeto Let me ask y-ou--when did President Roesevelt die? I think it was earlz in Maz• V•E Day was Mq 8th. The President's death preceded V•E Day. It may have been in the latter pa.rt or April1 but I think early Mq--mazbe his death preceded V-E Day 'by a week1 er ten daf•a maybe mereo I knew we ceuld hardly wait to get the Stars and i \ S ' s when it came eut frem December 1944 en. B that time wenever the Russians teok ott1 they seemed to move a hundred miles at a time. We were all expectAtnt 1 hopeful that we 1 d meet them at the Rhine. In the evening Mrs. Bay-ne..Jenes and I walked down Cennecticut Avenue from abeut the bridge to Jackson Square, and evecy-bedy was milling around down there- 741 blewing h•rns, swirling areund. I think we stayed down there a ceuple et heurs in the crewd. What about the changes that this would make--that this part ef the war pr•blem had been settled? There were lets of anticipatien ef the changes in the Surgeon General's Office. We had been working en it fer months--& whole series •f demobilization actions that had te be planned; what are you going tc do with these treeps when they came backo In addition, there were lots er hard studies •f the reerganizatiens that were to come about immediately follewing the surrender in Eurepe and hastening en with the expected surrender in Japan. These I theugbt were very tedieus paper exercises. They were awfully hard too. Yeu. had to make all sorts et calculations. SOile men in the Preventive Medicine Service were extremely geed at these things, and some like myself were not any X good 0 Colonel Robinson was ~~cellent, but all threugh the office they were planning what they called "post war planning." They had to. Immediately Preventive Medicine began to get cut d•wn as yeu can see it in these chartso It swindles dewn fairly rapidly in 1945. ill the Surgeon General's Office was busy--I can remember that General Kirk was concerned greatl1 in all •f the future things that were going to happen., 3.nd we had many conferences. Well, the growth, in part 1 had.bee~ 11resEonse to a ~~d plus the internal structure ..!.,f the A£!5Y.J;~{.and it_s reorganization. T~e gro'!.!d! •! _Preven- !ent and to s~dden1t ,!_ace the necessitzo••• You hadn't much :treedem as to what you Blight de. The Medical Department W¥J really' demobilized by a very bright yeung :man named Eli Ginzberg. He was brought down te A. s. F. and under General Sftlervell--one of his sections had charge er this, and it was Eli Ginzberg 1 s job to figure out the precedures-- 1 I mean the calculated numbers and the type or effic":13' that should be let out at certain times--try to keep a balanced greup while it was a diminishing group. It took a lot of savvy to do that. I want te cae back next time because we 1 re just a.bout at the end here--<?!,'!! back te .!=E Day and the who~e of 19451 and J?,lace it against the implicatio~. in th~ ~irst chapter that zou ve 1 written about Preventive Medicine which shows the czclical develo ent er the medical de rtment in res onse te a war and the c!l,!ficulties between the war eeri~ds-te all in ents a~_epose~ it becemes ne more ~han a belding ferce • ..,!!,W different preblems emerge ~i~h V-E Day-that is 1 the necessity of continuing the Al'J!Y in th~ ~ield, eceuI?atien1 which is a much larger base the.n ,the one z•.]; originallz had ov,er there An the Ar& ef Occupationo ThaVeguired some plannins fer ~edical things. Here in l~452 yeu antici.E,ate ~be withdrawal •f effective numb~ but not the nature o~ the problem, and h!? zou pparm_~d.. to mee~ that problem in the 2eriod of 194L~e~ause zou 1 re still there through 1.,2!!,6 up threughoe•o September of 1946 I was separated. Letts come back to that en Mendaz. , All ri~ht? All right. 743 Menday1 June 13 1 1966 A~, N. L. ~• Have yeu got it en? Turn it eft-I want to shew yeu semething. We•ve been treatin,g changes in erganiz~•n and growth ef Preventive Medicine to meet the demands ef war time activitz in the Jnrrl, but. the summer of 1942, beginning in May with V-E Day fellowed by the ex£losien ef the atem.2:.:, bemb in August /,[iroshiu and Na§asatg]' and the surrender of Japan in August, ferced recensideration ef reor~anizatien so far as the M~dical Department is concerned. Somethin& yeu wrete earlier.which I have read1 the ~st chapter \n yeur Histery ef Preventive Medicine shews the ~rowth er the :!1:&Medica~ DeP!:rtment given stressful times and then almest the abandonment of its wai: time pesitien. The world had changed in 19451 and thoughts abeut it may have changed ia 1945, since we were falling heir 1 in a sense 1 t• areas ef the !,!I'ld which had to be policed with contimed concern for medicine and health plus the work that had been going en •fa re~e'¥"ch nature during the war. _! rv den't knew ~han thinkint.of this kind starts-post war de'!,!lepments~- I have befere me testimeny before Senater Pepper's Committee earlz in 19441 s•-~ar_ ae the research as ects are concerned but there are at least wo te ics--what happens te the Medical Department ef the Aoo; given the summer of 19451 and its needed reorganizatien1 and out of that reerganizatien ~!w do we er~vide fer ".Centinuing interest in research as well as support for research as far as the Armz is concerned atter the terminatien of h•s~ilities. 1945 and 1946 is a erettz critical time. I think yeu eught t• go back further than thato All risht. Be SY guide. I'll first menti•n-I'll take the subject et research and deal with it in teras of the Board's research in the Surgeen General's Office. The first Research and Develepnent Beard--aside frBl these I have alreaey mentiened which had te de with research in trepieal countries, the Philippines, Panama­ in Washingten ef any censequence in relation to war was connected with a Research and Develepnent Divisien which was established in the Office ef the Surgeon General as early as Ma7 1, 1942. That was called a Research and Develepnent Divisien. It was in the Adainistrative Service, and it was charged with the planning and executien er all research and devel•Jaent activi­ ties dealing with the Medical Departaent-pretessienal and field equip11ent and supplies. We vhe were ceacerned with the UJII" Epidemiological Board and its really' intellectual interests in the causes ef disease and centrela, really blessed the language ef this limiting directive te the Medical Research and Develepaent D:f.visien1 cen.tining th• te cencern with prefessienal and field equipnent and supplies. That left us entirely free te ge en with the Arrit.y' EpidePtielegical Board as an aead8Jlli.e university type of erganizatien interested in prefeund problems, net supplies. Celenel Roger a. Prentiss Jr., was made the chief ef that divisien, and he was alee liaisen efficer ef the Division er Medical Sciences. His name appears ever and ever again from 1942, with various research boarda ef the Snrgeen ueneralte Office. There were a number ef thea, and they increased their scepe se that the7 at oae time practically-about 1945-began to take ever the frJ1' Epidemielegical Board. (; 1 We managed te avoid caing under the authorit7 or a new group of officers that didn't understand the traditiens ef the Beard., or know the peopl.e. That was n•t limited only te the Office et the Su.rgeoa General, but also to the War Department becauu the7 set up 745 in the War Department about the end ot 1944, beginning in 1945, a Research and Developnent Board under Brigadier General William A• Borden who tried to have ver-y extensive control. His group didn't functioa as long as half a year, and the Antr:r Epid•iological Board could go on in its traditional manner. In August, 1945, there was a very definite establishment of an Army­ Medical Research and Development Board in the Office ot the Surgeen ~eneral with broad scope and interests sufficient to cause a i1aison with the A:l.'flq" Epidemiological Board, but the officer commanding it, the chairman of that Medical Research and Developnent Board in the Office of the Surgeon General was Roger Prentiss, Colonel by new, who allowed the Board to proceed in its normal way and was satisfied with SUJIIIJlal7 reports. He didn't interfere in attT wa7, but you can see from this--well~ I 1 ll say from 19421 1943, 1944, right on through, ~ere wu continuing iat.ere■ t ot the Office of the Surgeon General in planning, coordination and prosecution of •dioal research• The planning and c,~nation fl"oawar t:lm actiYitiea aerged without any perceptible change into post war planning. They began certainly- in 1944, to begin to make post war plana-estimateR or personnel, estiutes ot organisation. It was perfectly plaia that the war wae going to end and that these €Pod things would have to be carried en scae way, or other, and people began to think about ito If I can-it it 1s all right to go frol'l aedical affairs to very important civilian affairs, I would like to refer to the correspondence between Vannevar Bueh and President Roosevelt in l9h4. I have here the falllous book by Dr. Vannevar Bush who was head of the Office of Seientifi• Research and Development and ot the National Defense Research Agenc7, I think, and this book is entitled Scienc•: the Endless Frontier. It consists of a group of papen that Vannevar Bush bas written at one time or another since the early 1940s while 746 he vas head •f ,tRD. They were gathered by the chairman ef the Natienal Academy er Science, Dr. Frank B. Jewett--do yeu knew this b•ek? Briefly in chapter 3, Vannevar Bush refers to a letter that he received en November 17, 1944, from President Reesevelt asking a nlll1lber ef imper)ant questiens; what can be done censistent with military security te make knewn te the world as aeon as pessible the centributions which have been made during eur war effert te seienti!i~knewledge. Fertunately the Anry Epidemielegical B•ard i had been publishing right en through the war, as we br•ught •ut last time. p This was a benedieti•n upen •ur last efforts. ,\ The sec•nd. question the President asks had particular reference to the science against disease; what can be done now te •rganize a pregram centinuing in the future the werk which has been d.ene in medicine and related sciences. Yeu have seen in General Simmons• papers, the cellected papers er General Simmens, that that is a censtant theme en which he played ever since the beginning--the unien between the military eff•rt in medical research and education with the civilian effert in aedical research and education which was perfectly plain and agreeable to him; in fact, he was o?E of the chief pre­ penents in festering such relatienship. I think all ef us who had responsi­ bilities in Preventive Medicine were constantly aware ef that and pr•ud and pleased to have any eppertunity t• peint out where military disc•veries under war conditiena went right ever int• civilian life and were ef benefit te public welfare. The President then asked what can the government do new and in tne tuture to aid research activities by private and public erganizati•ns• Can an effective pr•graa be propesed for discovering and developing scientific talent in American youth so that continuing future scientific research in this country may be assured •n a level CODI.parable to what it has been during 747 the war. These questions answer themselves almost. Any enlightened man would knew how to answer these. I l::ring them eut new tc tell ycu that a good maey ef us were aware ef this exchange between the President and Vannevar Bush. I knew Mr. Bush slightly, but I knew better one ef his clesest asseciates, President James B. Cenant ef Harvard. President Cenant was close to General Simmons bec~use abeut 1945, President Cena.nt began te think ef bringing General Simmons to Harvard as Dean of the Harvard Schoel ef Public Health. It was that time that President Canant get a millioa dollars from the Rockefeller Foundatio~, a hundred thousand dollars a year for ten years, provided General I Simmons would go there~s Dean. It s a fact that 1.e used te see Mr. Conant I occasionally ~n times wren it was not pessible to talk with him in any detail because at this peried, he was deeply concerned in the construction er the atemic bemb. He was down here living at Dumbarton Oake which is a 0 heuse that Mrs. Bliss gave to Harvard. I used to meet Mr. Conant \n the 0 street and at varieus places. These ideas semehow or other were~~ ccmmonl7 discussed tha+ey episodic paper like a report te this committee of Mro Pepper 1 s--what is it on? Subcmmittee on war-time health and educationo Yes, that statement centained ideas which are in these questions and were in the minds ef all ef us whe were cencerned1 net enly with the daily operations of research, training, and procurement, or nurture of scientific personnel, net enl.y in the minds with respect to current operati•ns, but natural thought fer the future. Aveut the saae tille, as I have said before, all effices in the Su.rgeen Ueneral'e Office were concerned in 1944, with drawing up plane for the pest-war activities--demobilization, refitment of 748 y organizations, reorganizatiens and reductions. Reductions m•st •brusly I. would come about fer twe reasons--ene is that it is ingrained in the Anglo- Saxon people to disband their armies as soon as the fighting is over. We 1ve done it ever and over again as yeu see from the chart there, where the Army drops fre111 eight milli.en to twe million in a half a year or se 41 It was veey drastic. A1se we used to say,"~'hat are we going te substitute for patrietism when this is ever?"--h•w to hold these people who have been devoted to the service or the Arw:y and the government when it was a matter ef strengthening the countl'7 and doing what you could to pretect it? What are yeu geing te dote hold them when they were mere keen to get back to their hemes and their own jobs than they were to stay- en saething that was practically applied in the military? Fortunately the Army Epidemiological Beard was able te continue without any jar, er rupture, its traditional course. All the divisions e:f it remained the same. The person•iclremained the same, and it has continued from that time to the present with some ups and downs, I must say, but it has grown a great deal. It has gone on as it was intended to. Now, te go back to these statements that General Simmons and I made t• the Pepper Committee 111 December., 1944, I would say that theywere a little bit late, in a way. They say what we had been thinking abeut fer fully a year, and they say essentially that the natien has grown great through its scientific achievements in the war which put tt ahead ef practically every ,\ ~ ceuntry in the w~fld, and that research is absolutely essential fer national security. It's br.eught out very plainly that the results ef scientific research helped in a way, a very primary way t• the winning of the war; that it was perfectly ebVieus that steps must be taken to preserve the stature that had been achieved and 1i, previde for future growth; and that prevision 749 required attention n•t only torresources and ideas, but attention to persQnnelo It was necessary to have very good registers ef peeple who were specializing in varieus kinds of sciences. It was necessary to strengthen the instituliens where they were being educated, and it was necessary te make this syetem such that the universities were net trammelled by the efticialdem •f the gevernment. All I can say again is that while \ was not in the upper councils ef any of these chief agencies of the government at which pelicy was detemined, I think I could have used the language that the pelicy makers did because I was familiar with it through asseciations and natural ideas both at Yale and in the Arrq. Were ideas like this expressed by peeple like--just citing them as examples-­ Dr. Paul, Dr. Dingle? Oh yes. They expected--well, they knew abeut our actions. It was--well, 11 I sheuld say that it was almost l ~ What are yeu geing t• have for breakfast?" It didn I t take much talk. It IRS scn.ething in yeur heart and soul., an appetite--you aight sa7 0 Scientific meetings were carried on all during the war by scientific organizati•mi--like bacterielegists, pathologists, i.Jmnunol•gists. They'd meet. Usually the general ideas are expressed more \ epenl.y- in a presidential address at the time its laid down, but many, many- er these papersrr the period begin with some generalized statement of setting. All the heads et the cemmissiens-Paul, Dingle, Francis, Shepe--the leaders in there and all the members ef the Beard were enthusiastically and often Tecal.ly supportive ef the things that are breught eut in these papers. Nothing in the pest Y&r period changed the basic concepts that are ia General Simmens' letter er December 27, 1941, about this Beard, except there \ . were some practical changes. This is rather p~:r,phetic--this letter ef .v 750 December 27 1 1941. The great consequence that~rese frem. this beek LBush 1 s Endless Herizons7 was the establishment ef the National Science Foundation to which I would like te return after speaking of anether erganizatieno I 1ve mentioned. these ArtlfY boards, the Surgeon General 1s Research and Development Board under ,.. General Prentiss, the War Department Research and De-✓ velopment Beard under General Bordea and a rising growth ef research an:i development ef enormeus proportions within the War Department. That kept right on. Very interesting preblems came up after the cessation of hostillties-­ I•u sq after August, 1945, and made acut~ in 1946. Weuld it be app;- opriate te speak of them new? The questien was asked what provision would be made for the continuation ot all the desirable contract research that was being carried en by universities umer contract with the government agencies, particularly the War Department, or the Navy Department, and even the Public Health Se!"Vice? Were all those contracts to be cancelled with the terminatien ef hestilities, or what pro­ vision could be :made for financing them and holding the peeple at work and "') I cemfortably in the po~ war period? Fortunately the Navy quietly had built ! up a research organization just fitted for this that tew of us understeod, er knew anything abouto There had been fer years a branch ef the Navy Dep~rt­ ment that•a oen.cerned with basic physical, mathematical and bielegical re­ search as well as the applied research needed te build ships, submarines, guns and ammunitien, and that in 1946, became the United States Office et Naval Research. De yeu know about that? 751 Yes, but I didn't know that it had that deep a backgreund 0 See what it says there--"super~~ded"-I feu·rl that this atterneon. {!'Office ef Naval Research: 20 Years Bring Changes" 153 Science 397-400 (July 22 1 1966);/ The title ef the organization that it supersedes is on that papero Office ef Research and Investigation. '!bat's what it had beea called, and it had been geing en fer~ears. This new becaes ONR-we called it--and it was established en August l, 1946. It was established therefere, after V-E Day which was May 81 1945 and before I V..J Day- which was August 15, 1945. I~as taking ever things that this previeus I organization was net fitted to manage. They get large and new apprepriatiens. They stepped into the field of supporting contracts en basic research that was a blessing beyond beliefo The Army dl.dn•t have the means to de this, •nd the Natienal Science Feundatien hadn't yet beenestablishedo The National Institutes ef HeaJth were in a relatively small stage at this time and had ~~~~ their own pregrau se tbts this ONR did a wonderful thing te back up ~ the cheice and fine projects in basic bielegical research, medical research, and medical research applied as well as basic, mathematics, erdance--all sorts ef things. They have continued te the present, but with diminishing activity in this field because the National Science Feundation has gotten so bigo Is Dr. River'~ hand in this? No. Rivers at that time wasr out in the Pacific. Ore Reynolds was, I think--he was the chief one, but I don't knew wh• led ito I have never located a history of that erganization, but I knew Ore Reynolds--he stayed in research and went way up tep in the Defense Department's Research and 752 Develepment Sectien. He still is a director •f some feundati•n new-"I den't knew what, and I do net knew the naval officers whe had the wisdom to de this,, I•m sure that Dr. Rivers if he had been censu.lted, weu.ld have been back of it, and maybe he was, but I den 1 t knew that ftr a fact.. Well, new ONR eased ' the situatien ve'l7 much because in~~ead ef these contractor research prejects ' L, falling dewn because they had ne financial preps, the Navy could take them eTer, if they were good eneugh te be taken .ver, and they did. The Anlry Epidemiolegical Beard was able te centinu• oa abeut the same fiaa.ncial 'ftl..oh '"'11. A~t-1 suppert that it ha. It neverla8 great--it had tweer three hundred thousand dellars a year, something like that. I have the figureso I den't knew whether I shewed them te j•u• - Yese The tetal fer the expenditures en the Ara:, Epidemielegical Board !rem 1941 t• 1946, was abeut a llillien and a halt dollars, as I remember. 1 •u I check that later, but its lev. The ether big thing coming up at this tillle was the mementum. of the re­ search effert and the need for continuing research on nuclear pbysics--well, there was a revelutien in physics geing en, but that was the practical push t• it. All sorts ef things were just beginning to be talked about--solid state physics we knew nething about until about this time, transistors, and the atemic bemb research was immense beyond the knowledge •f any but a few people, se revelutienary and importaat that it seems trite new te say so. It had been geing •n in this ceuntry since the 1930s more er less, and ve'l7 intensel,- carried en after Enrice Fermi and Karl T. Compton got a chain reactien under the grandstand at Chicago. Albert Einstein wrote the Presi­ dent a letter saying that this ener;gy __, released frem this reaction indicates 7$3 that you could make an explesi•n cf enermeus pewer, practically suggesting a bomb to President Ro•sevelt. I think that was in 1939, or 1940--somewhere areund that time. That work became known as the Manhattan Preject. Now we talked ab•ut the Manhattan Project but we were not sure wtat i~ was. It turned out later that it was conducted by the Army at Oak Riuge and eut in western places under the directi•n ef General Greve-what was his first name? .1.,ve forgotten his first name. /}faj•r General LE.SI te .Z.,. Grov!7 He didn't take the Surgeen ueneral into his cenfidence at all. I suppese nebedy talked very much about it. The management ef the Manhattan Project was centered in the Office of the Secretary of War in the hands of a Yale classmate of mine named Mr. Geerge L. Harrison. He was down here a great deal ef the time. Years before he had helped Senater Carter Glass draw up the legislation fer the Federal Reserve System, and he was president ef the Federal Reserve Bank in New York, a great expert on money. He dealt a great deal with the Chanceller fff the Exchequer in England and the monetary policy ef the time. He was brought dewn by Mr. Stimson te take charge of the matters or the atemic bomb in his office, just as Mr. Stimson• had Mr. Harvey Bundy as a special assistant fer other matters. l1r. Harrison didn't talk, er tell me anything. I didn't know about this until afterwards; in fact, I knew very little about it. The Surgeon General knew very little abeut it until it was about ever. I had an inkling once when Dr. Stafferd Warren, who was one of the medical directors of the Manhattan Project, came te the Surgeon General's Office, up te Preventive Medicine to get a let of the kind of vaccine you have te give people going into the Pacific area. This was for the crew ef the SS Indianapolia which carried the bomb. We supplied him with the vaccine, prebably in July er 1945. Te repeat the dates ef the bem.bing-the 1st atomic bomb was drepped on 7S4 Hiroshima en August 6, 1945, and the one of Naga~ en August 9, 1945. We knew about that very soon. I can't remember the publicity in the paper, but it was known. They couldn't conceal it. No--not very wello I think there was a White House an~ouncement. We get anxieue--Gener,31 Simmons and I, although he 16.an' t there all the time, but we thought the Surgeon General eught to begin at least to do semething to protect the soldiers against blast and burn and radiation. Without talking too much te the Surgeon General about those dangers at that time, we talked te him--this is General Kirk as Surgeon General~b•ut his 0 need to knw. One day when General Si.JnJ!q.ns happened to be away-the fact that \ he was away had nothing to do with what we did--the matter came up casually. Brigadier General Hutjg Mergan and I were talking this over, and we thought V we'd best go down and see the Surgeon General at 1818 H Street, s neor •r two belw, and we did. Gm eral Kirk said that he would be willing to ge with us to see General Grov:. General Grov: had an office in the War Depi rtment '\ " building which is now the present State Department Building, 22nd and K Street. 5 We walked ever there after getting an appointment with General Grove. General ' ~ r Grove was just as 1-ank and nice as he ceuld be--just as if nothing had ever I\ ieen concealed. He showed us pictures--one of the first pictures of the bomb bursting ever Hireshilla, the •ushrea cloud and the damage that it had done. He agreed with us that it weuld be advisable to get a group of medical officers and biophysicists into that region as soen as possible to see what could be done by a study'. We knew that some Japanese studies had been made, that there had been a tem~rar.r look in by I think-some American \' officers, perhaps Shields ~rren, and perhaps Dr. Stafford Warren !rem s Rochester too. General Greve said that he thought that was a good idea. \ 755 Morgan and I went back te the office and drafted a radiogram te General MacArthur 1 s headquarters for General MacArthur through General Guy- B. Denit $ and. toek--it was s~ned Kirk--but we took it back te General Grove, and he . \ said,"This is fine. Would yeu please ask the Surgeon General that he not limit me to saying merely that I concur with this. Ask him 11' he would allow me to be co-author?" s That message went out signed Kirk and Grove-I guess General Kirk was A. senier, a Major General by that time, and I think that that is the basis fer Colonel Oughtersen's commission. Ashley w. Oughterson was a Yale man, and we knew that he was eut there 1 in the Pacific. He d been interested in radiolegy. He was a wonderful man, a good surgeon but he himself, according te this stery in ways that we didn't knew a~thi~g about, had already made a proposal that is described in here that they send a cemmission. in to study it. This is not an attempt to stq who did it. r,m just putting this in to show that in several places in the world people were thinking about the same sort of thing. Colonel Oughtersea and Maj•r Averill A.Lebew, a pathologist, Colonel Shields Warren, a biophysicist and a medical man of distinction, and ethers went inte Hireshima in September 18, 1945, and worked there until late December, 1945. Their being there led te the establishment of a commission still geing Abn,J.),~'fEuD • Couoc:,; '--. en called the Atomic on, the AB It's now under the charge of Dr. George Darling. A~ter years •f difficult times, it is coming C. along. It is supported, I think, abeut at the rate ef a :milli•n dollars a 7ear, by' meney frem Navy, Army- and the Natienal Science Foundatieno It's done superb work. It's get a big laborat.ry and a big hospital and great records of cases of people the7 1ve been able to trace. They're looking fer late effects ef the radiatien. The chief late effect is the occurrence ef an unusual 756 amount of leukemia among some or the younger people who were exposed and keloid, big scar tissue, among some of the womea. The bcab has been a tos"d ball cf propaganda by the Japanese and the communists and we 1ve had trouble with our medical people working in that regioft because the Japanese hate the people who burst the bmnb on Hiroshima, and they attach the gu.ilt to all .Americans they see. Fortunately the relations between the Japanese •dical professien and medical efficere there have been good, and good things are coming out or 1to Well, we have ONR1 we have the Ar,q continuingo We have the National Institutes or Health growing up in this period right after the war, the Atomic Bab Comd.ssion1 the continued studies on nuclear physics, continued enormous studies on the physiological effects of radiation at Oak Ridge and other places-at Rochester, an enormoue developnent of laboratories in the medical school at Rochester to study the effects or radiation. The final develo(lllent, I think we ftheuld mention here, is the foundation in 1950, by aa Act of Congress or the National Sc:i.ence Foundation. It was de­ layed a long time. Vannevar Bush proposed it essentially in this book which was publiehed in 1945. Yes, this book, Science: the Endless Frontier, was published in 1945, and it bad the gem of a science foundation in it, but the people who were putting up the National Science Foundation from the start said that it shoul.d be an agency independent ot the goveraent 0 They didntt want aey gOTernment at"ficials on their board of directors, or any hand or the government put on free, scientific inquiry in the country. They were afraid tha.t applied re­ •earch would take altogether precedence over basic research en which you coulcn 1 t put a price tag at the moment. There was 11.uch bickering and other- wise back and forth for nearly four ;rear•• Then when the National Science Foundation started, its appropriation was far less than was asked for 0 They 757 had treuble, but they 1Te grewn and new have an apprepriatien ef ab•ut five hundred milli•n• I den't knew what it is-five or six hundred million, and the National Science Feundatien under a friend of mine named Alan Waterman-­ do you knew him toe? He 1 s a good man. Yes 1 he is a geod man. He 1 s retired lately as the directero I sheuld say that they came eut of the war with a geod, strong erganizatien fer the future develepment ef science and training in this country. What was the experience with OSRD that saw OSRD go eut of existence? Was that ~~st a statut•ry thing? Yes-eriginally' it was the Office ef Emergency Management. Then it was ~atienal Security Research Agency fer a while~ Office of Scientific Research arn Developaent was en.e echelon under that, and when the war was over, apprepria­ tiona stopped. Other agencies carried en, and a lot ef the contrac- ef OSRD were picked up by ONR, especially in the malaria field• They1ere spending about three millions te feur milliens a 7ear looking for drugs, but the un­ fortunate thing about that was that when the war was over they theught that they had all the drugs they- needed t• contrel malaria and mesquiteesD Well, mesquitees get se they could cbew DDT and enjey it. Theyw ere resistf\Ut te it. The malarial parasites, as we new know fr•• the Viet Nam experience, the falciparum type is resistAnt te chleroquin and antimalarial drugs that were theught te be more powerful than quinine. Quinine in large deseB will 758 still get this malarial parasite, but the dose is se large that it makes the taker sick. The whole emergene,o ef resistAQce te insecticides, and pesticides i \,,- and parasite resistAnt to antiparasitic substances was rather new. It came eut after the war with a bang. We have a paper inf ront et us entitled "How Magic is DDT?" We ceuldn 1 t tell hew magic DDT was. General SllJIDllens theught it was so magic that it was semething that was created by the Lerd, It probably was. It was endewed with p.-wers ef divinity in General Simmenst mind and in the mi~ ef all of us, but cockroaches, mesquitees, and flies-­ all sorts of things are resist~nt te DDT now. A ,new form of variabilit,z. Yeu cans ee that and the Arm;y 1 s interest in basic research-this is much ... later--new, )'m getting, fer the moment, inte the 1950so I was sti:l con- nected with research in the Surgeon General's Office and with the Board, and we set up as huge a plan to study resistAnce in cockreaches 1 nies, insects that you could manage, and that took us into the basic physiology of the liver of the cockroach and how it detexified DDT-lots of basic problems in chemistry and physiology ef the insects worked out under gevernment supplied funds. What pesitien did the N~tienal Research Council have after the war? It had been certairµy a chann~l through which the ArmY••co I happen te knew about the history of the Nati em l Research Council from haVing written something about it recently. I was the chairman ttf the Division er Medical Sciences in 19331 end I know that its history is largely one er an advis•ry body lacking funds and real authority. The first bedy formed as an advisory body in sce~n.ce ,__; to the Pres:id ent was the ~atienal Academy ef Sciences, founded in 1863 1 with the approval of President Lincoln and an act ef the 759 Congress in response to a group of scientists proposing that such a thing be done. The National Academy ef Sciences with great distincti•n went on its way from l'l63, living up as best it could to its directive from President Lincoln which said that it sheuld experiment, investigate and report in the fields of mathematical, biological and physical sciences, including agriculture, and all things that are important to the security ef the country, and it did a fairly goed job en a whole lot of things. It was the maia adviser to the President in a statutory manre r, but when World War n came 011, President Roosevelt fer reasou that I can guess at, and I won 1t talk about them tee much because it's largel7 gossip, d.ecided to bypass the Natienal Academy ef Sciences and form the National Science Research Cmnmittee, NSRC under which was the OSRBo OSRD for the medical field set up a special Committee on Medical Researeho New there is a step in here that I have left out-the National Research C•uncil which!WJ,s created in 19151 not by the Congress, but by the National ! Academy of Sciences. The National Academy of Sciences in 1915, feeling that 0 we were going to get involved in World War I in Eu.rope, wrote~\ President Wo•drow Wi~n and said that they would like te de anything they could to help the government, and he replied, possibly in words that had been furnished him, that he would like to see the National Academy- establis~ research council with rather special interests and objectives to investigate and report and advise on things of importance to the g•vernment and having to de with the war1 c,r possible war, and that's 'Where the •~ational Research Council came in. It was not established by an Act of Cengress. It is a creature of the National Academy without statutory basis. In 19191 when the war was over another exchange took place between the President of the United States and the President of the National Academy of 760 Sciences by which clarification was so@ght. They wanted the National Research Ceuncil to continue, but theytd like to have some defining statements from the Presidemtjas to his outlook on it, a reorganization of its own organization­ in etheb words, more divisions created, roore people brought in, more authority to raise funds. .1.·hey had no money. They wanted more authority to raise funds fer grants, get it by founiation grants, individual grants and even some appropriatiens from the government. They even went so far as to get a ruling from the Attor~ey General as to w~ther it was legal fer~the Academy to have an organizatien like the Natienal Research Council acting fer it in these matters. The Attorney 0 eneral approved everything they wanted to do, ~o in 1919 1 the National Research Council was reorganized by the National Academ;y of Sciences in the terms of an Executive Order of May 18 1 19191 1 issued by President Woodrow Wilsen in which he stated what he d like to see done, but he didn't order that it should be done. It's called an Executive Ordero I have a copy of it. This strengthened the National Research Council ' very much, and its gone on generally in that way ever since. ['~~A.i.~ u; ~fl :rr In the war, urne er uts quarters and much of its staff to the I\ Cemmi ttee on Medical Research of OSRDo For instance, the chairman ef the V Di'ision of Medical Sciences of the National Research Council was Dr 0 Lewis Weed who had been dean at J ohn.s Hopkinso He kept an office over here, but the chairman of the Committee on l"J.edieal Research e:f OSRD was Pre:fessor Ao Newton Richards, a very distinguished man of the University ef Pennsylvan:ia.. He set up an office down here, and he was really superior te Dr 0 Weed, but again, among fair minded men and generalt people who were patrietic, who wanted to do the right thing for the country, that didn't make much difference. We had a very great respect for the National Research Council for two reasons. It 761 had the approval of the President, the so-called Executive Order. It was an efficial advisory body, and as I think I have said before, it practically became an element in the chain of comm.and. The Surgeon General did net adept the vacciae for., say, tetanus, or yell•w fever without first consulting the National Research Council, and it continued to consult the National Research Council all through the war1 even though there was a Committee on Medical Research, and with great help to the Surgeon Ueneral. The National Research Council appointed a great many advisory committees. I was talking to Dr 0 A..Keith Cannan the other day about these matters--the present chairman of the Division of 14edical Sciences. I was asking him where I weuld find the recrimmendations and the rulings in the adoption of tetanus toxoid as the immunizing agent used in the war, immunizing against tetanW!lo He said., "B..J, we 1ve never writ ten any of these things up, but you' 11 find .t: some of it in the Minutes of the C0111!1ittee on Pathology, some in the Minutes of the Committee en Surgery, seme in the Minutes of the Committee on Immunology, ..; ·~ and some in the Minutes of the Committee on Bacteriology." In ether words, the ~ational. Research Council was doing things the way we did them on the B~ard very much without fercing one subject toge under ene I heading. Its too bad that they haven't written up all these things. They have piles and piles of records down in that NRC office-their deliberatienso i r, They had a hand in almost everything t~at was d.eneo For the malaria studies i \ we were mest closely related to the Committee on Medical Research of OSRD. General Si11mons was a liaison efficer to both the Natienal Research Council and the OSRD Cmmni.ttee ea Medical ResearchJ in fact, he was a member of the Cemmittee en Medic al Research and held an appointment as liaison efficer direct from the Secretacy- of War, but that got so busy for him that he got Dr. Themas Turner appointed as an assistant fer this 0 762 In terms ef that swmner of 12~5, with the nuclear problems, you were going to need even mere in the way of research for something which had been unknown and had just burst on the scene in twc instances. It changed the whole nature of the game in a lot cf ways. Yes. Nobody knew how to protect against radiation, er te protect against fall out. It was a great stimulus to Civil Defense, but Civil Defense people were at a less to know what to d•• They had.insufficient centinuitz• No, but they don't know yeto No, and in tems of that ear).y chapter that you wrote, the likelihood er a medical department being submerged in the light of the atomic bomb and subse­ uent events in terms of the statien of erican treo abroad with continuit seemed to fereclose--you knew1 the diminution of the importance of the Surgeon General 1 n Office, as had happened in that early chapter. I know frem my c~ntact ., with the Surgeon General that his line of research has been on the treatment of burns, a great deal on the search for some drug . that could be taken in advance that would pretect against radiat~on damage, or if the body had been irradiated, the drug would be a palliative, maybe a cure. Enormous work has been done on that. The Surgeon General-this is jumping way ahead-put a reactor in Walter Reed so that they canf get direct radiation of animals. I den•t think they're making any isetepes. Did the Typhus Ct1111111ssion continue? Ne. The Typhus Commission continued te about September, 19460 I closed 763 up as fast as I could after the war was over by bringing efficers heme and getting them eff the CQJ!IJ!lissien and either reassigned, er separated fr•m the service by maybe July. Certa ♦nly by August ef 1946, a11 of the people whe had been serving on the Cemmissien, except myself, were separated from it and probably separated frem the A:nrry. I was separated from the Ane:y in September ef 1946. I drafted the Executive Order, and Colonel Tracy s. Voorhees helped me, that President Truman signed disbanding the Typhus Cem­ missien"-I think I~peke about this the ether day, and I have further amplifica­ tion of it in ~•tters from. Mr. Patterson wholes then Secretary ef ~Mar which put me in charge ef the recerds and the final settlement of the affairs ef the Cemmissien. Fortunately the Commission had never had a budget se I didn't have a nickel to account fer. The Ar& Epidemiolegical Board continued 0 . , . Pretty much the same way, though it has grown a great deal since th~no e The AriffT Epi~ological Beard has twelve commissions new and a far larger budget than it ever had befere, but it is really-it became in 1953, or there­ abouts, the Amed Ferces Epidemiological Board. It get a charter from the Defense Department which was suppesed to bring together the research interests in this field of the Army, Navy, and Air Forceq In this charter the Army is made the managing agent, se the Beard 1 s headquarters are located in the Office ef the Surgeon General er the Army, and the Army being the agent puts up practically all the money. The Navy and Air Force have put in very little mone7, though they get plenty of benefit from it. They are very appreciative in all they sq, and they furnish a lot of inf~rmatien to the Board. The Board has continued, but it has come under a fairly close surveillance Gf the newly fonned Research and Development Command in the Office of the Surgeen General. There used to be a Division f•r Research and Development, but now they've got what they call a Command which has taken under its control, so to speak, all the research laboratories of the Surgeon ueneral and all the research that is done in those laboratories--Fort Knex Laboratory, some in Quartermaster, some at Edgewood, and the Armed Forces Epidemiological Board has to process everything through that command--all the research done in Germany and a great deal of effort to have research done in all the general hespitals ef the Medical Department is uni er the Research and Developnent I Conmtand. Its a vecy large affair new 0 It has about thirty-five million dollars a year for research and develoEJ1ent 0 Durirg the war was there much liaison with th• Navy? We've seen it in the Typhus Commission, but ONR bursts en the scene 9 We must have knewn. a little about that, but there was not a great deal of ceoperatien with the Navyo Again, I know a personal thing that was done from long friendship with Dr. Biverso Dr 0 Rivers w~s put in command of the splendid Naval Research Laboratocy called NAMRU #2, I think, first on Saipan. About 1942, or 19431 Rivers was made a Commodore. In New York he collected material, fabricated buildings, and had ttrem all shipped to Saipan 0 He set up a large research establishment out there. Thteports, however, that get to the Surgeon General were carbon copies that Cemmodere Rivers gave to a woman lieutenant. She was going back and forth, and when she came te Washington, she would give me a sheaf of these reports. They didn't send copies to the Surgeon General of the Navy to be forwarded to the Surgeon General of the Amry, but he and I exchanged material, I gave him a lot ef Typhus Commission stuff. He was certainly operating out in the South Pacific, but there's ne basis so far as you're able to recall at the moment, for the emergence of ONR1 exce.E~ Rlnolds. \ Reynolds is the one we had connectioB witho I say I don 1 t know the background of the higher cem.rnand that brought on ONR, but it super~aded a Navy research crganizatien that had been in effecto Dees that date jibe wi t_h the 1::_erminatien of OSRD? , 't 1·t1 It· ..does 1 doesn I Thel ~4,enti~~ng grants. I They were taken over by ONR mostly o What begins in 1940 mushro~ms. Oh, it was a big time. !h!. ~lannigg 1 _s~plinE ~~eas about er,ianization f.o~ pos~ !~r years must h~ 0 been _gretti 3:.ough--you kf!GWJ ~iven this curve in teI'JIB_,\f people, tht; paper requirements or__reorganizi~_1he office 1 9:nd to, know that ye~}'l~re goi~ .t~ (_ ) have to deal wi..:S:,h the preblems, even if y~u h~d ~w..! thousand men in the Ann;y;o Oh y-es. The charLh~re from January 1245 1 ~~ October of 19451 shew~ a streamliniQi• It was greatly decreased. I think these charts are quite graphic. You save a lot of werds. Yes 1 and some agony too-I should t ~ • K 766 Oh yeso What was the attitu~e on the p~ of the ~ people toward Dr. Bush? I wouldn '1' be able to say. Wouldn't have anz idea? I could tell you about my own. I have-I said that I admired him very much. He was a fascinating man, meat original, vigorous, tangy. Tough. His t~inking went way beyond matters medic~ into basic research !~ the Qhysical science~. Yes, physical sciences, but applied stuffo He envisaged an encylopedia of it that you could just throw into the desk console of his called ~{imex", and he could retrieve anything from it that he wanted. He was all int• computers--way ahead of things. !,~at I s another thing the, :fa ct of war demonstrated--the increased equipment in the. signal corps I radi• equipment I measuring devises,,,t,, and so on. The great thing in the war was radaro ~he applicati•n ef this new electronic knowledge subseguently i'!__!..!~~~e 1,ou__needed new and more cam.:olex devises. I don't knew2 but I suspect that the Sur§eon General or youraelf4 as deputy chi!f of Preventive Medicine, stood with reference to the new problems in 19461 pret1Y much where you steed as chaiman of the Scientific Advisory Board of the Childs Funds, with the kq~~­ ledge that there was a lot of basic work to be done where the connectiens be- tween the basic work and the field ma not have been clear but i had to be 767 done. I suspect that was probablz in the thin~lng anyw;az--that we needed t~ scratch the surface in a lot of things even before we understoed t ~ eossible relevance. Oh yes--sometimes the possible relevance was perfectly clear, but some­ times the investigator was just driven by curiosity--he was going to find out. Then teo 1 wh~n you read t~e_reeorts of Dro Dinsle's greue and the kind of detail into which theywent--they had the opportunity to function. All that ef Dingle 1 s has been carried on ever since he left Fort Bragg eut ia western Reserve. Last year he and his ccllaboraters published a great book on health in the homeo The Chief of the United States Air Force announced the other day that he had copies ef that sent to all his officers. It haste do with respiratory diseases in closely living communities which is easily ap~lied tea situation on a ship with people altogether. The Navy has been \ very careful with it. On shipboard they are horrified if there is the slightest suspicion in a man ef tuberculosis. There have been some secondary cases on a ship. Then they have, like the Anry, a problem in diarrheal diseases on shipboard when latrines get infected. I find that the war set a Eremium on certain kinds ~nd qualities of scientists, gave them a chance to reallz run wit_~ the ball, in effect. There's relative;i;i little in terms of the institution~l.leadership-universitiee 1 colleges, wh_,!, in terms of the research development during the war 1 were.the recipients •f funds 1 grants which enabled centinuing work to go on. sented1 without a voice. I don't knew. I don't understand it 1 but the - Yet they seem ur('repre- the scientists reallz1 I_think1 came alive during the war time pe~iod. They 768 were the fair-haired boys--I don't mean arq disrespect in that term. I ti don't know whether Conant talked and acted as a scie~tist first, er as an f\ administrator. I'm sure the universities fr•m the start were worried abeut the possible lo~s of their independence. They couldn't avoid serving their country, and they ceuldn't impose their conditions en it. They couldn't say that you must net de this because it isn't in the spirit ef the free academic life1 but after the war they could, and some of them actually refused te have any mere classified work done en the campus. They wouldn't de that. Now, they really have the problem--they're s• everwhelmed by the largess ~f the National Institutes of Health in this field that half of their academic budget, er more, comes from eutside in the sciences. In 1946 1 was there arq; inkling that you knew ef1 er was it in the air--this growth of N:nlo Rella Dyer--his experience had been in the Hygienic Laboratory•••• The ~atienal Cancer Institute was rounded in 1937 1 so that they already got the plural en the institutes. 'lne other institutes were coming along. ' clear from this letter ef President Roosevelt to Mr. Vannevar I think it~s Bush that he's inquiring about how the gevernment can operate with the private agencies, what can the govermnent do now and in the future to aid research I activities by putil.ic and private agencies. Hes still thinking that it'e aid they're giving"•n•t centrol. I ge back to the Dean's Office time at Yale when net a little of your ene~ies were channeled int• these areas •f raising funds to support research. I remember that the Dean's reperts sh•w a stea& increase in eutside funds f•~ the supp•rt ef reaearch. 769 I never was much geed at ito But it grew and helped sustain research at Yale in the 1930s 1 and i~ c~­ tainly pointed to th~ fact that outside funds were necessary. Ob yes. Pitiful academic budgets. 'I'bey didn't have enough meney to raise decent salarieso Right--z•u knew 1 with the war it was a ld.nd ef continuation. Te be sure with a single interest-the government. I don't know that any feundation weuld be cemparable to what has happened in government support. I Look at it fra the point of view of the scientist. Hes had the eppertunitz tog• back te the pre-war erder of things, er to do somethi~ te maintain oppert11nitzo That must have been a simple cheice fer marll of themo We get it all right. Let's call a halt--all right? 770 tuesd!l, June 14, 1966 A-60 1 N. L. M. This ~s the first time that we've met in the mornin~. We sheuld both be just searkling. Yes-that 1 s right. v We 1 ~e talked briefly before we turned this machine on in two areas realll--the terminatien d the war 1 and I wondered the ectent to which anz comparativ:,e studies were made with respect to Preventive Medicine in the ene19: ferces­ Japan and Germany. Alse whether there were any responsibilities imposed en the Preventive Medicine Service for American prisoners of war--where con­ tinuing medical problems Plight present themselves beth as seurces of care and studies for informatien--whatnot. I don't know. Yeu indicated that there wasn't much1 but it might be an area in which you might care tf> comment. After the end ef the war with Germany there were tremenrltus problems of handling refugees, displaced persons, and a group that we called RA.MPS--Re­ covered Allied Military Prisoners of War. All of that involved application I of preventive medicine for~he care, feeding, and control of communicable disease ameng the millions of refugees and displaced persons in Germany-; in fact, it was one of the main problems or Civil Affairs.- Military Government, taken ever frerr. the Anq in Germany- and was an am ~f f'r-iin'Jrc>l Clay, and in General Clay's boek he has a paragraph saying that the medical service rendered an extraordinarily useful service during this peri•d in the handliftg I ef all these people. It was!/la.n enormous pr0blem because there ll!re far mere I refugees and displaced persens than there were American troops, and yet they were still handling some of these situations on the basis of troop strength 771 for issue., and there were places where., we'll say., there were mere German prisoners of war tc be fed than there were American troops in the area, but the supplies coming f~om the Quartermaster were based en the treop strength so that therewasn•t eneugh te ge arourxio Problems of that nature involving Preventive Medicine continued right on thraugh until after 1946--I had some­ thing te do with the handling of the problems from our office up to, ~ay, September of 1946~ They weren't insoluble problems. 'rheywere largely matters of supply, erganizatien, and personnel. It took a geod many people to come in through the Allied Military Government to manage these affairs and nearly all these Allied Military Government groups; notably the Americans, had fairly strong Preventive Medicine Sectiell8 staffed by efficers whe had some preventive medicine experience in the Armies that captured these areas and in the corJ:S and divisions that were involved in the overceming of Germany. They left be­ hind through this organization of Civil Affairs~Military Jovernment, a public health establishment that continued f•r some time and was related mere or less to the Preventive Medicine Sectien of the Surgeon General 1 s Office, but als• had other connections because Civil Affairs had been a part of the Special Staff of the War Department, and they had ether avenues ef communica• tion and supply. The people were in great distress in those areas and much bad to be done te safeguard the people themselves and our troops in their midst from outbreaks of disease that might have been bado Fer example., water supply systems were all destroyed-..Berlin and most ef the regions from Berlin to the vest, that part er Germaey--there was great destruction of water supplies, depletion of food supplies, depletion of clothing, lack of soap., lack ef bathing facilities, and lack of food. There was a great deal ef underneurishment which would make people susceptible te disease. All •f that 772 was understood and remarkably quickly conditions were improvedo Therelere some excellent men in charge like Colonel William L. Wilsen of American Civil Affairs Public Health, a.nd the British had a somewhat similar organization, but they were not se much involved as we were with the masses of the people, ~xcept for the British in the enclave around Hamburgo What's not realized alse, not realized nntil yeu read the records of the Air Force strategic bombing--have you ever seen those records? The strategic bombing ef Berlin, Hamburg, Pfnemftnde, Dusseldorf--all thase cities were the ebjects cf very I\ destructive raids which left people in destitute conditions, and they left considerable preblems, but fortunately' great shipments of food were available from Army stores and additional things, and it was less than a year before conditiens of health in occupied Germany were in pretty good shapeo The syetem applied was the system ef utilizing the German public health erganizatiens and regulatiol!B as much as possible and to use alse the German public health persennel as much as pessibleo A hitch in the use of the German persennel was the denazificatien pelicy--an;ybDdy that had Nazi sym­ pathies, or had been in the Nazi party, couldn't be used for this work. Many times the work was impeded by the fact that there was a rambunctious Nazi in charge of it who didn't want to co~perateo It was impeded alse because it was hard te find peeple to work in all these subdivisions of Germany, but that cleared up, and I think the problem cb refugees and displaced persons, while enermous, passed fairly soon out of the ken of the ordinary military preventive medicne that we've been talking about in the war because other •rianizations were formed to take care ef the relief necessary. The ster:r •f the American prisoners of war who had been in German camps is complicated and contradictory. I ferget how~ny thousands of Americans I were captured, but it ran to a large figure--a hundred theusand, er more, and 773 they were scattered in camps in the meuntains. Yeu probably met seme of them in the Austrian region. In some of these places they had been badly treated--mostly by a limitation of their food supply. There was actual starvation, malnutritien among American prisoners of war. '£hey were liberated as rapidly as possible and taken care of through a dispensary Army system, or through hospitalization, if necessary. Net much was known at that time about the proper way of feeding a starved person, er a depleted person. Sometimes they get these liberated prisoners and filled them too full of chocolate malted milk, a.11 sorts of meat and stuff, and they weren•t quite ready to digest them. '.Chey got Bick. On the ether hand, the limitation of feed for a starved persen need not be as strict, it was found eut a little later,as they thought at that time. The best examples ef studies ef this were the liberated people in Helland. In northern Holland the Germans under Arthur Seyss-Inquart really set about te starve those people to death. When we liberated the Dutch, the famine dis­ covered was almost unbelievable. Well1 they began to feed these people with ire-digested protein 11aterial obtained from England which they could inject. That111.s intravenous feeding material that is used in surgery everywhere. It was found, hewever, that a judicieus, slew increase or the erdinary ft,cd taken by meuth was a perfectly feasible and wise thing to de. The people had digestive enzymes that were still evokable, I 1 11 say, because although they had not been in use much, nothing much to work en in an empty intestine, or stomach, the machinery fer making them was there, so it only needed recall. They fou~d out that they could feed them by mouth fairly well, and they tried that en our returned prisoners also• Themturned prisoners en the whole, in my opinion, were net in too bad a conditieno It was starvatioft chiefly. They hadn't been treated with a~ 774 particular brutality. Se far as I knew, they were net treated as the Japanese treated eur prisoners. I happened to be involved in a study et the after effects ef the imprisonment on civilian and military personnel both by the Germans and the Japanese. There's an orranizatit>n in the United States set up to present to the Con};lress claims for lasting injury. That's ito Yeu have given me this report that this cnmdttee made en this subject. It contains a section--! can•t put my hands en it at the mement--of the American prisoners ef war that were in German prisen camps. It was about as I have said 0 It wae not as bad as ene expected, and this study showed that there were net many recegnizable after effects ten years or more after these people had been released and back int• work. I represented the De­ partment of Defense on a committee compesed of people from the Navy, the Veterans Administration, and the Pu.blic Health Service, and we made a repert te the President which he presented te the Cengress. Yeu might want to make a reference in the margins to that report. {!Effects ef Malnutrition and ether Hardships on the Mertality and Merbidity of Former United States Prisoners ) ', et War and Civl)i;i.an 'V Intern.ees of World War II: An Appraisal of Current In• formation" House Decument Ne. 296 8hth Co!":Sress 1 2d Session (Washington, 1956) 69 pp;l People use that report as a basic document because there's nething quite like it. For the study ef the prisoners of war recovered from the Japanese, the Surgeon General sent te Japan Brigadier General Hugh Mor~an. He went t• d Japan and through the country and studied these prisoners just at the end of the war, and he get a great deal of physiological and medical information about them., published one or two~apers •• the subje~t, and feund that the main trouble was malnutritien, starvation, sem.e effects of exposure, and psych.ological depressions because the Japanese were brutalo There are well authenticated 77$ ca.ses •f their handling prisoners of var--ast•nishingly brutal. One group et eur prisoners •f war were sent from Manila up te Fermosa, I think, crowded in a little, hardly ventilated cabin in very h•t weather, and many of them died just as they did in the black hele of Calcutta. Some of the prisoners were beheaded with Samuri swords. Some of them had their legs cut off while they were standing up by big swords hitting them. Several of them were fastened with wire, •r ropes en the bew ef a submarine, and the submarine would submerge for a while and then come up, get a breath, and go down again. Nothing like that was done to our people by the Germans, and we didn't de anything like that to the German prisoners we caught, except for one instance ef their being put in a hermetically sealed box-car--I told yeu about that, but that.as an accident. Now, that's about all I think I have tc say about the refugees and the prisoners of war. You can see that there were ordinary preventive medicine problems involved. There were no new principles. No. This wonld indicate that there was continuing concern with the effect ef malnutrition and brutality on prisoners of war. This report indicates that the concern naturally was by the governme_nt, but the chief agitat•rs were a greup of representatives o.t' these people who were continually introducing claims for indemnification and getting representatives and senators ~rom their_ district_ to P!ese~t bills. It was semething to be exploited rather than the .fact that they had any particular , , reason, medically, to do this 0 Itm righte Right here--ttapprox~tely a hundred thousand members of the United State_s military establishment wer_e captured in the European and Medi terrane~n Theater, about twenty seven thousand by the Japanese." The survivors living here had this organizatien defending 776 their ewn int~rests and pushing for a bonus type of thing. Naturally the Medical Department, the divisiens of medicine in the Surgeon General's Office were interested in the knowledge ef the nutritional state er these prisoners returned, and Preventive Medicine had a Division ef Nutrition in our service. In 1944, it was established, but it had been partly there before, and even before that there was a Divisi.en of Nutrition in Professional Services under Colonel Pa1tl. E. Howe who went &Ver te England and helped in the Eurepean Theater. After 1945, whenever it was heard in the European Theater that prisoners were released, or were in an unhealthy state, the Surgeon of the Theater, General Hawley, would send a group of investigators from his office 0 One group, I knew, went out under Colonel Wendell H. Griffith who was the chief nutrition officer. Another group under Colonel Herbert Pollack went to camps in France where American retunned prisoners were. They made studi~~ of vitamin deficiencies, hemoglobin, bloed anemia, weight studies--just the way nutritional studies would be made, and they found some vitamin B deficiencies. 'nlis would indicate that there was some eff•rt tot~~ .l!~t29!ght _be used as e.. a scare headli~~•nvert it inte somethi9S k~!!l~d~~ble. Yes. " Yes 1 and A_S of this, ~ime 1 I ,wonder if there w ere_anz efforts made te assess ~he condition •f the enemy ArJD-z in ereventive medicine in the field as com­ pared t• what the Americans had done. 1 1n thi_nking specialq of a book I read the other '!!z, thoUJl~ ,i~ is not limited to that, subjec~-:~he Cold Injury book. This would be l!~ether the Germans in their own thi_nking and development-­ they're not an un1.inaginative _Qeople--whether thert were efforts ?113-de t• asS,!SS 777 their _experien<?.!.!._Y•u indicated before we turned thisJ!B:.~. on that there were a number of teams inve1?,tigating German rec•z:.ds and so ~n which _were keEt, I but I don't kne~--l_ou inqA,~ated that there was~t much d~ne, but just thinki1;!€._ !.12.!."':!t it and with sEe£_ific reference to cold i~urz .which was a-well1 _!t 1 s a horrib~e book, buta\y;ery interesti!if; on~. I'd like you to get in the record the whole title--it 1 s Cold Injury_G~~':!_l!_d ~ by Colonels TIHll F 0 \\bayne and Michael E. DeBakeyo Now cold injury ground type means that it occurs in the foot soldier, ~s a rule, and it is synonymous with immersion footo The reason it is put in there as ground type was because it occurred on the ground about sea level, or maybe up a little bit, ani it differed a iood deal from the cold injury air plane type where they actually froze from exposure to the cold without being wet 0 High altitude--ze.!• Yes--high altitude, but this cold injury grcund ~ype that Colonel Whayne and C.elonel DeBakey studied and about which they wrote such an extraordinary book was the injury that followed exposure t• wet and cold en the lower ex­ t~emities chiefly. These men didn't have proper shoes, and they didn't have proper socks te keep out the wet in trenches, er fox holes where they were 0 They didn't have encu[:ll socks to change as they should. There was a great­ did yea read about the Quartermaster, Major General Robert M. Littlejohn, in England who neglected, or he didn't listen to the medical opinion on the need for socks to be stockpiled in advance 0 That's why our men didn't have them 0 Apparently in Italy at least, the Germans didn't have among their troops cold injury. I have seenlrecerds where German medical officers in hospitals that had been overrun by our troops would ask to be taken to Americm hospitals 778 so that they could see this condition, said that they didn't have it among themselves, and I think that's because they- had better foet discipline, better socks and more of them, and probably maybe better boets. It's a very difficult problem. to handle, except by foot discipline and a chance te change socks and rub the skin because if yeu make an impervious boot, as we did, shee packs, as they called them, the foot stews in there. The skin peels and comes eff--just like boiled fish. It was veryeerious--this cold injury ground type was very serious in Italy and in the LUJ1emburg bulge region. Preventive hedicine peop:e on the ground over there--Colonel St~ne notably in Italy, Colonel Gordon in the ETO, and the teams that were sent out-were all aware er what sheuld be done and made urgent recemmendatiens. The Preventive Medicine Service in Washington was informed of these conditions and tried te help and went so far, looking ahead, as to send Colonel Gordon and Maj•r William L. Hawley to the Philippines in probably June of 1945, July. As soon as Colonel Gordon could come back from Europe, he was sent to the Philippines te try te berin to prepare the medical service and the line officers ta combat, er prevent celd injury ground type among tr•ops that were going te be sent into the invasion of Japan. It was expected that the terrain in Japan would be conducive to the recurrence of this type of disability unless something were doneo They had the th~••ugh cooperation of General Denit, the Surgeon \. of the Army which was destined to go int• Japan, and he helped erganize a team and make plans that would be ready to go with the invasion forces. It wasn't neceasarye Your view is that there either wasn't tilll~, or interest, or necessity to a~~~ Q,erman ereventive medicineo Well, speaking for myself--! don't recall any special effort except this 779 incessant demand of the Medical Intelligence Sectiens ef Army Service F•rces chiefl.y, to send collecting missions over to Gennany to get any kind of in• f'ormatien thatwe could-they collected drugs, dressings, medical kits, manuals, mimeographed sheets of paper which by the time ef my separatien from the Anny amounted to a great mass of materaal which, as I recall, none of us really studied. The push on the fttudy came threugh the desire of the War De­ partment and the A'!Tlf1 Service Forces to make availabl! to COfflDlercial people in this couatry German manufacturing processes, German patents, German dis­ ceveries of new materials not in the medical field especially, but in the field ef conunercial interest and economics. These missions were very demanding and scoured all ever Germany, and, as I say, sent back a lot of material which was examined sometimes and sometimes net. I don't recall any special contributien ' that either The Germana, or the Japanese made to the control of communicable disease, or preservatien ef the care am health et soldiers in the ware A View yeu expressed before we turned this en waste the effect that German medicine at one time had been a leader, but the erganization of the state1 •r the positien ef medicine within the state 1 those reasons er something else a~ain1 had reduced it. Yes, it deterierated--possibly as a result of the policy ef the central government, or possibly because goed medical people were used up in the Arrq which was very large in Germany and had huge lesses. Also the Germans were cut off by thtir own actions, or perhaps by the natural situations of the censorship of countries from the literature, or the reports of medical progress in the United States. What about their research activities during the war? 780 I know very little about that. I don't know er any special contributions s that the German' made during the war, except for their attempts in biological warfare--their experiments, their cruel experiments on Jewish prisoners where they were studying such things as exp•sure of the human being to heat and cold, putting a human being in\w a.ter and bringing it almost to a boil, seeing how he could stand it, or submerging him in very cold watero The cold water experi" ments were motivated by the German's knowledge of what ha9pened to a sailor, or an aviater who fell into the cold North Seao The temperature of the waters there is down belm, forty, I think. Rather coldo Our people were interested in that tooo The German•' experiments on j exposure to celd1 particularly, were examined after the war 1 and as far as I know, they didn't add anything special to physiological knowledge. The other experimental work in Germany that proceeded at this time was their effert t• make typhus vaccine, improve their metheds of typhus vaccineo They didn 1 t have typhus vaccine ma.de with rickettsia cultivated in chick embyins \_. .: \ as was the seurce ef the Cex vacc::l.ne that we and the British used. They used the eld method ef infecting lice and grinding up the lice and making a vaccine out of that.. '£he usual way that they infected the leuse was to strap him down with a little fine wire urrler a micrescepe and with a very fine glass pipet put typhus blood into his rectum. Thatllls dene. I have a great series of pictures of Hitler 1 s fine laboratory in which that type of vaccine was made-I forget the name that is given on it Ltleigl's vaccini/o Where is the Rickettsial Disease~ in Man? Risht there. 781 Are we wasting tape--are we? Well, it deesn 1 t give an account of that in here. 11 11 put it in when I read the proof of this 0 The Germans knew about atabrine; in fact, they~re responsible for the earlier introduction of atabrine, and they used it for malaria control. They did not have DDT, altheugh it was right over in Switzerland near them. The German preventive medicine procedures had been laid down pretty well in the Franco-Prussian War in the 1870s 0 They knew hew to prevent small pox by good vaccination, and they used that in this war, and there was relatively little small p•x in the Germans. As a matter of fact, ~,m quite sure that I 1m not just being ca~eless, er deficient in memory when I say that there was no special thing that seemed to come out of German preventive medicine during the war. This has been the generalizatien1 but scientific personnel had always counted eretty highly in the German state in the sense of the contribution they could make-I don't mean to say that they had positien1 but thy were needed and were necessary. They certainly had a highly develoeed chemical and pha~- ceutical 1ndustry1 but again bombing and the ravages of war•-their installations had been eretty well knocked out. And also probably raw materials were short--things from which things are made were not s0 readily available. And when demands begin to be made on a dwindling competence-first things come first, and apparently they went into P~anemftnde and rocketry rather than other 782 areas. What position did J9:Panese scientists hold in tt.his war? Relatively little. Japanese scientists that I know anything abcut didn't contribute anyt'l-iing during the war. They were probably engaged like the Gema n scientist• i+ educed activities along these lines• Before the war they were in scientific strides of advancement both in the fields of gastro­ intestinal infections and rickettsia.l diseases. They discovered the rickettsia of scrub typhus before the war. They had some scrub typhus in the course of the war, be.+ I don•t knew that they did anything i"l pA.:r",;,icular about it. Their own conditions were very miserable--all that I have read about. Japanese detachments in New Guinea, in Burma, in the islands in the Pa.cific were mere or less left to fend for themselves. It was a discipline ef penury. It seems to me that they didn't have any real feeling for the welfare of the C soldiers~ He was there to die for his country, and it was hard efl:\.ugh for ! \ them to bring in enough supplies after a while. The Japanese by the time New Guinea had been turned, had lost about eight thousand of their pilots­ ~11 their best peopleo There was nobody left that was any good, and they re• duced their pilot training, for example, down to about seventy hourso I happened to have recently had to answer the inquiry; what was the sttae of mind or the Japanese pilot? Well, fortunately there wasn'~ much written about it, ~xcept a section of a strategic bombing survey of the Air Force on the strategic bembing of Japano There's a good rec ti on in there on the kamikaze pilots. They~ ere volunteers. They didn 1 t want to be called suicide pilots, 1 and they didn't want t• be called :murderers. They thoughtjit was the highest ' i calling to sit in a plane and go diving d0v,rn on a~hip and to lose your life l for your emperor and your country. They could use a low type of pilet as they did by the hundreds in that case because a man didn't need to know much about 783 flying. He fellowed a guide war plane over to the regien where the battle­ ships were and then took eff at. an angle and swooped down. There wasn't any particular finesse that he needed, butt hey caused a great deal of havec at I OkinQwa. For two o~three days there they sank many a ship and killed many I an American. Theyw,re not the best pilotso I had the same impression about the Japanese Medical Services. Either .~ they didn't hve good men, or the good men were used up. Nothing shows up t\ very much 0 Itve read translations of Japanese accounts of malaria control in New Guinea. They had sOJ!'le interesting ideas like giving atabrine intra­ veneusly0 They did do a certain amount to treat malaria, and they used atabrine a certain amount to control malaria. I think their quinine supply was even lower than ours. Quinine from Java and through there was pretty well cut err, and I don 1 t know about the Japanese capacity to take the raw material and make relatively pure quinine sulphate out of it. Their sani­ tation in their camp~ was relatively poor from what I•ve seen in the recordso i If.don't knew what they did in the burned up cities such as Tokye. They must I have had an awful mess. The Japanese talent was there. It came back fast ence the war was over. As soo!l as the war was over in 1945, General MacArthur became Supreme Commander of the Allied Powers--SCAP I 1m trying to say. He brought ever, or Surgeon General Kirk ~NT" ever first Colonel, later Brigadier General Crawfard Sams, who had been the Surgeon of the forces in the Middle East, one of the meet remarkable public health officers that the Army military has produced, and in this supreme headquarters set up in Tokyo there was a Public Heatth Section under General Sams which did the most remarkable things for the benefit cf the Japaneseo For instance, they vaccinated the whele Japanese population--millions of people"-with typhoid vaccine. They vaccinated 784 the whole population with small pox vaccine. With relation to the Typh 1.1s Commission they practically deloused the whole populationo This is in the period shortly after the surrender, and the period continued for sevezal years. The cooperation of the Japanese was wonderful in all of this. They furnished teams. They wanted to learn. They soon caught on how to make DDT themselves from what we taughtfthem~ They began to make their own vaccines, showed much enterprise and much inr~rest in these scientific things. There never was any serious outbreak of disease even in devastated Japan. It seems to have been characteristic of situations all over the workd all during the I war--therfas far less spread ef disease than we would have expected.. I don't believe that there was any serious cholera, or any serious plague in Japan at that time. There were good Japanese institutions that cooperated with .Americans in preventive medicine work. It was not long before the Anny Medical Service established in Tokyo and later in Camp Zama the 4oi General Medical Laberat0ry which is a splendid laboratery--big, capable of doing all sorts ef things from the study ef air pollution to the study ef water pollution te the study of in.fectioue diseases. It was under the contrel of very able men most ef whom had preventive Medicine in the Surgeon General 1 s Office and in North Africa, and Colonel William D. Tigertt whe is now the head of the Walter¥teed Army Institute of Researcho They had excellent staffs and people to work with them. It was continuouso Ycu would have thought--well, the transitions were net sharpo Then I suspect this reexamination of what the er.emy had done save way because so many new problems emerged that summero Yes. There was difficultz eneugh. Some of the difficulty in ecamining these enemy records was the difficulty to find enough translators. We were always looking for Jl'I ople who cc~ld read and translate German and Japanese. The only way; I came into some recerds of German "scieatists" was some of the r, records ~f the Nuremberg Tribunal where they IJised involuntary prisoners in fantastic ways. Whether therevwas a stated goal or aim1 it didn't appear. They had am, but they put it under curious, lay medical control some times. That famous paper by one •f the special guard type ef Nazi soldier for experimental testing ef typhus vaccine-they gave vaccine to a lot ef these Jewish internees, and then innoculated them and ethers tha$ictntt have the \ vaccine with typhus rickettsia, typhus materialo They had a high mortality, I think, from the unvaccinated, maybe twenty-some percent and very little in the vaccinated, but that was under one of those special guard type military­ policemen. I think maybe we've gone as far as we eught to go tedaz, and we won't get into a personal assesBll'lent. 11 11 leave you free to think about that. Personal assessment? Is this thing running still? 786 Thursday, June 16 1 1966 A-60 3 N. L. M. I guess in some w a.ys if we 're conscious and we have an experience, we pick up some wisdom because of it. You've been in positions successively now--all the way back te the laboratGry at Johns Hopkine 1 the University ef Rechester, a much larger domain, to Yale--you 'knew1 with problems as untidy as hum.an affairs usually are--and then this sudden expenditure of energy en a twenty-four a daz: basis, really1 because you think1 eat 1 drink1 sleep1 talk all about these probleJ118 during the war. Yeu've get that out ef chro~ogical sequence because of the war--•h, I see. Yeu 1 re talking about World War II. Yes 1 and working always en a larger setting where problems are greatero I know when you go through them 1 ru wm-k frem day to d&o Yeu have an idea where you're going 1 and what it is yeu want to attain1 and you do whatever you can within the given time to achieve ito HUl'!lan problems take time--sometimes mere time than you want to put on them 1 or that you see the necessity for. Many things we have by way of experience we learn from, and we don't articulate what it is we pick up from the e.xperience. We never do. We just carry what- ever it is on to the next task--a broader way of looking at things perhaps, a greater sensitivity to people, a better realization of this elusive, magnetic thing called America-whatever. I wondered in personal terms looking back en 1the experience I what it all added up to in personal terms I working with ~en1 working with idear1 working with reference to supplies, needs 1 pressure- ;.._ yeu know 1 the locatien in which this particular human variable had to function. This is kind of arbitrary because thereT~ no break in thinking about these 787 things 1 really, but arbitrarily isolating the experience you bad jta'ing the war 1 viewed against all that other accumulated wisdom that yeu'd picked up .s along the route-take them; institutienal obligation, men and men, idea, means--you use some very interesting words in the manuscript that Itve seen. "" You haven't seen it yet--but questions ef "leverage." That's indicative of what I mean. You get to the point where--as~t. It's almost like the I\ i"fantry in attack, I think. That's subjective on my oart. I don't know that it accords with what you think about it 2 this poriod1 or whether you've ever thought about it in these terms. I doubt if I have ever thought aoout it in those terms because the terms that you use there imply a censciously conceived progressiono My life as I thin.~ of it mostly is episcdico In other words, as I think back en it, I can say that I didn't regard any of these experiences, hewever complicated. or long drawn out, as a preparation fer something else. In ether words, it was not a course Df planned development, I b~ no thQught, for example, ' '~' during the deanship that I was being fitted for the kind of;twork ~,hat I had te do in Preventive Medicine Service in the Army which, however, was very much like tha occupation of the deanship. As we have said before, most of the problems of a medical school are vecy much like operating in the existing organizatioMl activities of a Preventive Medicine Service in the P:rmy,, In a military setting the people, the names, and the titles are different, but the principles are the same. As I say, I can't think ef any of this as being regarded by me as a training for something next to come. I never tnew what was coming next except in genera.lo I suspected after the war that I ~ould co back to Yale which didn't tur:1 out too well and was only a temporary staging, but I never expected after I had been through World War I to go back inte 788 uniform in Warld War II at my age, er that such an opportunity as I had in World War II would have been availab:13 for me. I think if you look back on these things as affairs in passing without trying to read inte them any depth of planning, or a.~· measurable future, you understand what I mean when I say that I think of my life as rather episodic. Even grantin~ the. episodic nature-that i_f!.t_ th~-1:!..fected role that i s _ ~ ~ zour w9:. To live is to functien within what you 1find., and I would suse,ec,1 that X!.~'d sharp~ both insight 1 pencil, wit, human:-you know 2 knowledse, whatever th;e .eeisedeo I think I had a good heredity, a good education, and I had a great advantage of being associated with, I think, noble people most of Iey" life and able peopleo I accumulated a sort of culture as I was accumulating experiences-­ if you use "culture" in the sense that I•m trying to use it now; that it's n~t just a foible of wit, but a way of life, so to speak. Th~se qualities that I acquired through associati~n, heredity, and education were reapplied each time with enough variation to meet the situation. Another element I think you acquire is this--yeu den't just meet situationsa You foresee them, and that's a little different type of mer.t,al activity...- foresight and really reaching a solution of a problem before the problem has come across your path, or before you see it, or before it has occurred. Now some people can deVise intricate philosophical and behavioral conceptions and methods and without actually being involved in an experience. I take it the philosophers, economists, creative artists do that kind of thing all the timeo I think I went from ene thing to another dealing with events as they occurred, but dealing with some events that were sure to occur because similiar events had occurred before. In other words., I w &8 telling you that it I s like going 789 into a familiar room. As long as the door is shut, you don't see what's in that room, but you know pretty well before you open that doer and go through it what you're going to find. Yeu might find the chair and the table in a different place-well, then you just sit around, or move it around and put the chair where you think itrought to be 1 or leave it l~~e it is. That's very poerly said, b11t that's the kind of thing I mean where you come across situations that you have not .foreseen, can deal with very easily on the basis of past experienceo In all of these things I suppese I had the usual fits of temper that people have i-R which, in my case, sometimes make me think faster and better, and sometimes they are just confusing and distracting. As you go en through m~re and mere frustrating, ~r difficult, or vexing experiences, you stop getting mad about the:mo General Simmons used to say, "There's a war going eno There I s no time to get mad about these things o 11 Thatlt?.s good principle to acquire. For the medical side of it, I eot no arlditional proficiency either in laboratory work, or clinical urk, er in san:ttar:r work as an o:i:erater, but I did have the advantage of havingjan immense amount of new informatien provided for me by my associates and the people IW:ls working with like all these brilliant and able scientists on the Army Epidemiolegical Board. Being with them was like being in the midst of an active and productive faculty of original investigators all the timeo The administrators on the Army side were sometimes very capable and enlightening men. Seme of them were stupid and not any good. I look back on it as being very fortunately situated and having semJ,ery fine teachers areund me all the 1. time, people that contributed to I11J increasing knowledge even theugh they were not intentionally, or conscieusly carrying on such work as the stated purpose ef their liTes. In other words, they didn't care to train me, but they 790 couldn 1 t help but train me 0 I gather that you look upon m0·tjs I \j of the things through which you g& as a form ---- of training--like a roomo YoU~ve been in it before, but not quite this w&• Thatts just what I think--that you pass through these different rooms. I don't think that anything is Just a~ it was beforeo Everything is in the process 0f change--the Pythagorean notieno He said that you can't step into a stream of running water twice in the same place, but it's still running watero That's a very wise saying--it's all altered. Yes, it's all altered, and I could understand some of the early talk about relativity from being brought up on that Pythagorean notion. One of the early obsenations of the people who developed relativity and modern uncer­ tainties of nuclear physics showed that just merely by looking at an electron, you ean 1 t ebserve those little things without altering their position, or their size, er their velecitieso Well, that 1 s true about these other thingso Yeur running water is changed by your geing into it, but it is still running water, if yeu want to abide by ito Naturally, ~,m sure I was very ambitious and always have been more or less competitive to the anno7ance of some of my friend.so I can still remember ' whte 'fffY' classmat~ at Hopkins, Dr• Frank Evans-he became a doctor--said 4 He said that the trouble with me when I was at Hopkins was that I always want~d to be ahead of somebedy. I told him I couldn't help 1t 0 He thought I meant that I couldn't help being ahead. That didn't endear me to him 0 That's marvelo•lS• 791 I don't think ±tve ever done an.,v particular dirt just to get ahead ef somebody. That would be 1 I think, unlike you-that 1s 1 unlike the yeu Irve come to know throu.gh these papers. I can cite just the example of the length to which y~u ~ent to aid the Associate Professor of rlacteriology at the University ~f Rochester after President Rhees's lettero You wrote--at least fo~r different laces--the nature of intere sand concern. Birkhaug? Yes, and you have at least expressed in Yft!!: feeling about microorganisms an~ rickettsia 1 respect for them 1 ~nd to step on a man, someone you could see--I Just don't associate it with you. I don't lcnov--I have shet birds, shot animals. Oh sure--that's part of breathing too 1 but I think the general flavor is on~ er res ect and re ard for livi • I i would ~hink that a huge organization in which you're attempting to effectuate a giv~n aim, trying, iq effect, to grease the wazs in which that ship will float more easilz and readily--t,he whole sense of delay in a military situation ~ something you have to anticpate and come to understand for what it iso It's not a preventive thing 1 not real1.z--it 1 s just that there's more te move-­ "leverage." That 1 s wh_y I picked 11,e that wordo Well, in the military situatien you meet delay and frustrations all the time. The reaction that I had, as I recall it now, te delaying innuences was of twe, kind.so One was to be bored to death with the situation and to L 792 wait it out. Very often in active service, say, in the trenches, you'd wonder how you were going to get through the day when nothing was ha.pi:e ning. You probably know what I mean by being in the infantry, and there are many other states where you're bored by the situation and can 1 t de anything about it, and you have tort it out. The other reaction is to attack it as furieusly as you can Rnd as wisely as you can with whatever weapons you may have, or whatever tools you may have. That is the one reaction that you would characterj_ze by leverage., You can have wonderful leverage in your body, and if you know how to use it, yeu can lift huge weights, shoVing it up on your thighs and your back as levers, where yeu can 1 t use the lever of the forearm te lift a great many pounds. One is experienced with levers from the physiology and structure of the body, but in administrative work, leverage has to be devised. In the first place a fulcrum is very necessary. If you don't know the kind of orders, or whose they are, depending on whether the fulcrum is in the middle or behind, or above--the position of the fulcrum determines the way the leverage is appliedo When you get out of tbi~ pictorial language and take a practical situation, you may find that you have to push somebody else into a move o As I think you recall, I asked Colonel Hudnall if he would kindly look in the drawer of his de ac to find the authorization for tre officers for the Army Epidemiological Board. That was a kind ef gentle leverage to the colonel in charge of the Section on Personnel 0 There are other kinds of leverage th1t you useo As an example, the leverage te get the typhus supplies over into Japan through the mediation of a strong man named Lt. General Lutes. You in.form your lever, and then the lever begins to act by itself. Yes--General Lutes. 793 He dido He went straight to the Secretary of War about that and elem- ed it up. Another kind of leverage is through clandestine trickery, I might say, but I don 1 t think we did much of that in preventive medicine. I certainly don't remember any particular episode wher~ a result W\S accomplished by trickery in our groupQ Its ,., said to occur in the universities. As one very famous scientist told me once--he came to see me and told me aboutpthe diversion ! of money intended for a herd of Arabian horses in his university to other purposes. This man wanted the Arabian torses project carried fcrwP..rd, but the president had diverted the funds, and this scientist came storming around talking ~bout the inherent dishonesty of university pre~idcnts which occurred a littl~ bit, I think, in the case I described of my own experience with the Institute of Nutrition. That kind of thing you don't descend to if you 1 ve I I/ really got good genes4 Also it s the kind of experience that can ~e a man bitter. The only time the word was used as I recall it, in my having a re~ction of bitterness is what Mr. Dean Acheson told me when once he referred to the Institute of Nutrition episc,de some yea.rs ago. He said, 11 Yes, I under­ stand that you left the deanship on account of that with not a little bittierness. 11 That was the way he put it, but I don 1 t think so--at least I didn't ca.rry it too long. You ought te put his other com~ent in--after the factQ Yes, the one he told me the other day,"Yes., that was a mistake that we made"--to de, away with that project, establishing an Institute of Nutritieno It's in the correspondence and also in talks I 1 ve had with you--there 1 s a direct 9.uality about you which would preclude participation in a kind of 794 trickerr• I I•m interested in yeur saying that, but I take it rth a grain of salt because I may be having to restrain something that would lead to trickery, er tricky behavior, and that is the way I had to scrounge to survive, so to speak, in rrry early childhood. I wondered about that. I don't understand myself why- I didn't became a juvenile delinquent for one thing, or how~-I was obviously ver-J deceptive and had a fair amount of castigation on account of it when found out, but it didn't last long enough to cause me any great pain, or put me in atlJ· great jecpardy, either in college, or afterwards 0 I think that whatever you did in those days was also done directly--that is it was done where it could be discovered. For explcsive 0 This wasn't any clandestine thing. It was something that was done, and it exploded. There is this guality ~f directness~ I think you also gut your finger on another thingw-that if your ~enes ~o deep enough, there are somethings you just don't do. There's another thing that runs and I wondered ~ihether it had anr!:hing to do with life in the Army. Pictured all ~hrough what we've done so far is regard for not just older men, but older, able men~..Joseph Zones, a great hero, Dr. Welch, Dr. Goler 1 Dr. Rhees~-people you can single out either because of their guality1 their own directness, and their abilitl• I wonder if this had a91:thing in the--well 1 it's hard in the military establishment. You were all prettz much in the same age grouE• I 5 I think it~~ easier in the military establishment because your evere 795 your commanding officer. I revered the Office of the Surreon General not only because rrry relative, William Crawford Gorgas, held that position, but because I had respect for authority perhaps beaten into me, or perhaps again ,, from association with peo~ who attracted respect, but in the Army you start with a high regard for your canmanding officer. I don't know how it is in the infantry. The into.ntry tends, I suspect--ce~tainly in the elements I know anythin§ about --to be an all civilian agency. I mentioned this before in the distinction drawn betws~n the 11th Sherwood Foresters and American units--there is some- thing to the 11th Sherwood Foresters quite apart from the men who were there. They had a tradition, a history. Yo~rs was just an outfit put together at the last moment• But you had good and sufficient reason--if nothing else up there in those two bound volumes of Gt"neral Simmons. He worked--at the bench. Yes, he was quite a fellcw. He was an intricate and puzzling man at times.. He had--very attractive manners, was very friendly-, very intelligent and imaginative and vigor~us, but also I think he had some of the limitations acquired, or imposed by- Army- officers, er a regular Army officer 1 s life. He'd been used so much to being fed and clothed and getting handeuts that I think the moral distinction over som~ things were dulled, not that he did anything that I know o~ that was particularly bad, but you see that kind of thing among officerso In the Surgeo~Generalt~ Office I admired General Magee, liked him, and I see General Magee all the time. He lives in the Army-Navy- Club nowo General 796 Kirk was a Violent and most attractive man respected for his honesty and ability and his frankness. Simmons we talked abouto The rest of us that were colleagues in the sane flight of age, so to speak, chiefs of divisions in the Preventive Medicine Service and the deputy chief whe was really a chief of a diVision as I was as deputy chief were like--I'e say members of a faculty again, so much se that the work seemed to me more like seminar work all the time than anything that was prescribed by orders. We used to talk I I very freely at staff meetings and all sorts of meetings. I got an impression that the military service was more democratic than some of the things I had seen on the faculty at Yale. I recall several times 'When rroblems were under 1 discussion, there'd be a master sergeant, or a sergeant in the groupo Ha d have an epinion to ecpress, and he expressed ita "People would listen to it, and it would be debated. Semetimes it had an effect on the group and on the decision that w a.s made. It was just like you were talking ever a thing as a group iB the classromno That 1 s an interesting ebservation--the seminar approach. I know in the infantry as yeu come from all walks of life and you're there for a while, suddenly you take on the coloration of a team in ways that are not entirely clear to you1 but yeu begin to think in different terms. I would suspect that a good mary Preventive Medicine Service people came to it both from the regular Army and from civi.lian life--that it was a stiake dowri cruise for a while until you found, without ever articulating it, that means whereby you get the task done, and it is a teamo The regular Army officers, of which there werea very few really in the Preventive Medicine Service, were different from the t't'serve officers, or the civilians that h.1.d been brought in by Genoral SLi1mons f:rem universities, 797 and it might be that they were different because they had had a confining sort of training. They had COllle up through the Army Medical School and had served under erders from lieutenants en up to when theywere Majors, or Colonels when we saw them. Therefore., they were living more according to Army regulations than the rest of us whe didn't give a damn about Arrrry regu• lation"I in the same sense that they did. Anether thing--and I say this just to be truthful without meaning to be offensive to the memories of these Regular Artrr.y Officers who were with us., and that is that the Army Medical Officer's life is a very protected life. He's hardly had to meet th~ com­ petitions, or the situations that the civilian had to meet coming up through a faculty in a school or in the practice of medicine, or making a living by his own wits in laboratories that he may run, or some other work; whereas the Army efficer has a protected and safe life, a career that is before him that he can achieve just by being a good boyo As long as he obeys the rules and has enough sense to make a little contribution every now and then and keep out of trouble, he can go on up and gP-t promoted regularly when the time comes, whereas men who ro out in medical fields as practitioners, or as teachers, or as investigators have selected a life of uncertainty and jeopardy, different from the protected life of an Army officer0 Those who come through that with some measure of success tend to look down a little on regular officers--don 1 t you think so? Yes. But ou 1 re ri ht--the demands im osed on each rou are different in ldnd and quality. Yes. How much of whatever it was Secretary Stimson was filtered down? This is a 798 large organization. We indicated I think before, certainly with President Rhees, that whatever it is he was created a tone for the University of Rochester. That-ms equally true of the Presidents ef Yale um.er whom you served as indicated in the files 1 but here--this is a huge thing. I dontt know. I know somethin~ of Mr. Stimson through talks with Justice Frankfurter. down? I'u ~ot a fair sample of the filter bed because Philip St~nson, Mro Stimson 1 s ne:phew, was a classmate of mine at Yale, made a great name for hlmself a.s a pediatrician and a great expert on poliomyelitis, so through that I knew a little of Mr. Stimson before I had any Army ccnnection. Then Mr. Stimson's two main assistants down here were close to me. One was Harvey Bundy who was just a class ahead of me at Yale. I knew him very well and that lcept me closer to Mr. Stimson than some of the other people in onr group who j11st knew this great figure somewhere down town, or in the Penta.gon. The other 0ne was George Harrison, my classmate at Yale too, so I had a sense of Mro Stimdon's qualities, the way he thought, the vigorous honesty, stead­ fastness coming to me because of these persora 1 associations that other men didn't have, but I think he was a very remote figure in the Arm:f. They hardly knew that there was anything but a Secretary of War. He wasn't Mr. Stimson to anybodyo He was a Secretary of War all S111.rrounded by generals and rules. He had r~lations with his assistant generals and others that were admirable • .s General Fox wanted to get into Yugoslaviao I went ,:~o far as to speak to Mr. Bundy about it and get him to speak tc Hr. Stimson because Mro Stimson by Executive Order 9285 was the head of the Typhus Commission--'' l'l1e Secretary of War and the director" are mentioned equally in many of the provisions in 799 that Executive _Ord.er, so Mr. Bundy thought th.at this ought to be brought to Mr. Stimson's attention, since Itd urged Mr. Bundy that General Fox was quite restless and probably right and wanted to do what he was boing to do. Mr. Bundy went and talked to Mr. Stimson and brought me back the message that Mr. Stimson would have no hand in it at all because--to quote Mr. But1dy, "Mr. Sti.. mson said that he 1 s net going to tell these generals how to run this war." Well, as I know now, that wasn't quite the answer. He wasn't going to tell the generals to do t h i ; ~ of so mnch)rnspect for the i_;enerals, but because he was prevented from taking a hand i r) it by the conversationfl between Roosevelt, Churchill and Stalin. I think the British were the ones who didnft want Fex to go into Yugoslavia, or the British representative. That kind of thing which displays some characteristics of Mr. Stimson caraefo to me on accou~t of my position with the Typhus Commission and my intimacy with Mr. Bundy, whereas it wouldn't have gone to anybody else in the Division, so ... as I say, I'm not a good samplt'! of the filter bed. ~ Even assuming tha;t so far a,s the Preventi~e Medicine Service was concerned he was a r~mote figure, what ab~ut General Marshall--di-~~Ll!}..~~rely? General Marshall was, of course, even more remote., but I think as I have already told you we came in contact with General Marshall because he had some definite ideas of preventive medicine 0 He opposed the introduction of the finest agent to immunize people against tetanus; namely, tetanus toxoid, be~ cause it took him about a year to 11Nderstand that tetanus toxoid was not tetanus 1 anti-t~xin. He ,. d had tetanus anti-toxin, horse serum, injected and got the ;1 hives and was very uncomfortable in the earlier years, and heK:1eught that this tetanus toxoid would make the soldiers sick in the same way, and he held it 800 Tten I think I told you about his letter to the Surgeon General on the subject of the vaccination of the peopla in the Southwest Pacific. He wrote General Kirk that everywhere he went he saw soldiers losing time be• cause they were getting one ~,accine injected after another, and General Marshall said to General Kirk,"It doesn't seem to me that the Surgeon General needs to get a hundred percent record in these matters", and he advised the Surr,eon General to look at the policies and procedures of the General Staff, a.a General l1arshall said, ''We take a calculated risk. Why can't the Surgeon General take a calculated risk.t" I have that letter in my file and am keeping it as an example of what a contrary thing a man might de, because if the Surgeon General took a calcu­ lated risk and there was a bad outbreak of disease, General harshall would have peeled off the head of the Surgeon General. I never met General Marshall. I have seen him in action talking. One of the customary things during the war was for General Marshall to brief colonels and generals of all grades whc were in Washington~ They would be called over to a great big assembly room on the t0p noor of the Pentagon, and General Marshall wo~ld speak, and he spoke usually very sharply and in a manner that no argument, or contradictionms to be tolerated. It was clear in his mind. He was sure of what he was saying. He was very positive. I have read the Stimson••• o The diarl? I read the diary and the book--On Active Service, and ~'ve gotten to know a lot about Mro Stimson frem that, and I•ve read another book abeut Mr. Stimson a while ago 11 801 Yes--that 1 s right, very good. I liked that better. Well, as Is ay!) I have so many sources of knowledge of Mro Stimson that I don't know wl:1at I got out Qf his influ~nce during the war and what I got out since th~ war. Whell._~e time cam~in September of 1946--vasntt it~-for youJ?_o leave that !ffice 2 that office had alreaq.y beeq Virtualll shut_~own. Yes--well, it never was shut down, but it was greatly reduced down to a division again. ~ost of its previous divisions and branches were cut off and all greatly reduced. How did you feel about ~eaving the office then? Put it this waz-it isn 1 t ~eri <¼Y; that a fellow becomes a ieneral. I had to wait a lo?E time to b~come !,_Captain--so I know. Well, 1t 1 s very nice t~ be a general 0 It's a long step up from being a colonel to being a general. You get all sorts of unexpected pleasures and privilegeso When I came back from Caire in 1944, I had two examples of courtesies paid a general on ~y trip back. One of them first came whea I was sitting on the porch of the .Shepheardts Hotel in Cairo. We were talking to General Fox anrl having a little drink in the afternoon, waiting for the passage of time until the plane wast~ take me out to Casablanca in the evening. A staff car drove up, and this officer sa.id to me,"Ig the general r-an get ready right away, we'll take you out to Payne Field hecause therets sand storm coming, and we want to get that plane off the gro mdo" 1 I had a little bag of stuff upstairs. I went and got ito I was driven out there. I was taken te Casablanca in the belly ef a hgue four engine plane. 802 I was the only one there.~ They had about six or eight mattresses in that belly. I piled them together and had a good sleep. Then when I got to Casablanca, they gave me as a billet the most beautiful three, or four story house that had been General Patton's billet. I was the only one in there, had a great big bed less than a foot off the floor in a big room. On the roof the windows went out on to tiled terraces up top overlooking Casablanca and the harbor"-living very high and being a generalo That's the kind of thing that happens to you. I think when you get to i. be a general, you have a greatyincreased sense of responsibility. If you have \ any sense of responsibility to begin with, it gets sharpened and extended by the experience of being in a position of trust and some authority. It 1 s easy to forget you're a general. After a while the novelty wears eff, and you find that you 1 re just the same person--almost. It was difficult fer me to forget being a general when I took the uniform eff. I was walking down Elm Street in Yale about the last part of September, 1946, and four soldiers in khaki shirts and pants came down the side walko I was in civilian clothes. I forgot that I was in civilian clothes. I didn't think about it until I walked right square into them, I think. I was used to having soldiers in khaki give way1 and that's one of the cha:t"acteristics of the life of a general--he finds that things give way. Thel sure do 0 You begin to expect it automatically--well, I bumped right into those boys. They thought I was an impertinent civilian. When I got separated, I had an experience that indicated how some generals behave on that occasion. I was in the Pentagon, 4nd I telephoned down to the dispensary that I would like to make an appointment to have a physical examina- 803 tion for separation--did I tell you that? The girl said, ''Yes sir, C:eneral", and she gave me an appointment. I went down at the stated time, and she pulled out a card and said to somebody ~tanding by, "Here is General Bayne-Jones-physica.l examinatjon for retirement for di~ability." I said, "I didn't ask you for that. I have no¥-isability. I want just a physical exmination for separation,." "Oh," she said, "you I re the only general officer who has been through here that hasn't asked for retirement for disability." You see--generals not only cause things to give way in front of them, but they really take the props out from under some things, and it's easy to push them down. That always struck me as a curious bit of medical doings, I would say, that ~o ma ry of these g~neral officers who retired for complete, or A·-- S0riOUS disability, went into ~ven more taxing jobs than they were under ay the t:!Jne when they were inrrvice. General Simmons is one. He got practically total disability, and he went immediately into this strenuous wc)rk of being the Doan of the Harvard School of Public Healtho I!e was separated before 1ou~ Yes--in July. Retirement for disability has monetary value too because the retirement pay is exempt from income tax. That's a nice thing te know--that is 1 if chance ever strikes meo Wella you know, when you close the doer for the last time on this period and go back to I Yale--it s a change 0 804 Yes, it is a greta let down. I suspect that the pressure was less in 19h61 than it had been theretofore in the office-wasn't it? Yes, it quieted down a great deal; in fact, there was nothing going on. Demobilization was taking place, and there was great activity at the ports and at camps, but nothing that stretched the Preventive Hedicine Unit in any place that I know of• They'd had so much harder work in the war that this vas all routine and easy. I recall the gr~atest bsuiness of the last month or so for me in the office was writing citatio;;1s for people to get medal.so We tried to get medals for everybody, so much s~ that one day I went into G~neral Kirk with a list, and he flew :"lte a raga, "I won't look et itl :.: won't have aey- c thing to do l-rith it. Preve'ltive Medisine is so 6rasping that they just want all the medals we've g0to 11 That's par for the course. Well, I don 1 t know--a catalogued day in the w~dst pf this had no hour 2 did it? In the war? Yes. I didn 1 t have any hours. I worked all day and way into the nie;hto Got up early in the morning. Did a great deal of writing in lonq. ~and, 3nd for­ ! tunately my secretary could ta\€ a long hand letter and type ito Some of trem regard that as J.n insult 9 They'd rather take dictation. On the other hand, in the Army, Rome secretaries ar~ penalized because they take dictation. ~ Some of the promotions, I found, are based on the n'..l.r..ber of people O,f of I these clerks ~uperVised, whereas one whc took a lot of dictation frOJ11 an officer 805 was regarded b,Y the personnel management people as being a slave-like, sub­ sidiary person, although that persen taking dictation also contributed te i the composition of the letter. You can often leok at~he secretary and see i I whether what you're dictating has get any force or validity. It s easy for them to raise their eye brow, or look bored. They'll tell yeu. I used te spend a lot of time writing. Practically all of the letters I wrote long hand at night, er during the day when I had ti.Ile, butte go back to this supervising system, I remember one woman who got up to a GS 6, er 'fc or mer• who was handling the disability and discharge records. She had a ro• with abeut forty girls--about that many were under her supervision, and she'd get aa araf'ul of officer's 201 files, records, and walk around and distribute these things to the clerks, but she was the supervisor ef a platoon. Well, we're practically a:t the end ef thi8 tape 1 and I think next Modnay !vi ve 1 ll go back to the pin ball precess agaiao You aeaa going back te Yale. That didn't last very leng. Is that on still? !here is some centinuitz all during this period of the war-the Childs Fund which we abruptly teraittated--which we want to ge back and pick up 1 and then there's that marveleus maiaziM and that print shop that tailed. I had aethiag te de wi ta that. No-but it was an agem.zi11g taing te get the journal published. That haste de with the ca11cer field, but we caa ge back and pick that up •• Menda:y. All Ri~ht? 806 Yeu 1 d better put down a note that you're going to talk about the Childs Funds• that you'll be sure t• re1tember it. 807 I•ve made some notes while yeu were away. No, I just wanted to--I'm sick of this rambling stu:ff. What? It's good. Last time in ee,rf!,o_nal terms we gave some swmna.ry !!._the experience in the Anly. One !!!lf is faced with ~he necessi~~•f retur~l_!lLto what might be referred to as a normal eperatien. I don't knew what "normal" is certainl.7 I s• far as the Childs Fund and Yale are ceneerud. Y•~d ,B!St bee~ through an ~xaeting E!_ri•d, and I suspect all institutiol'ls are altered in the pr•~ also--they can't es~ape it. I wonder what you feund whenz•u returned te Yale. We can pick up t'.!:aces ~a~k inte the period just passed. We haven't mentioaed Dr 2 Meader, the administrative changes 1 ~he search_!!!_l!unger men in this peried :which is implicit threugheut all these records here, fenci~ in this field where the limits are still verz: elusive...L how ene deals l!1,th ~~• The new attitudes that one has toward it, I suse!ct1 are tied to peopl;!- I don't knew, but I get that in reading the minut~s of the meetings ef th~ Board er S~ientif'ic Ad~iers. Yeu had continuity with the Childs Fund_ all ~ ~ h e war 1 and that's important, s!emethi~ which we haven•t_brought out--that is, it was ftot something that was d_ropped. C•n~iBuitz of interest continued plus dealing with the substance, the beiness of the efficeo Yes, I think that 1 s important to put in, but I would like to go back of 808 what you just mentien.ed to, say, 1940, er thereabeuts, to bring in the relation of the Childs Fuad to the Journal called Cancer Researc_h, the problems that were involved in that; the shifts and whatnot that journal had to go through, the war, and then go through the war tiae management te IffY' return t• New Haven in 1946. All right. Shall we deal with the journal as a separate thing? Yes. '-- All righto I 111 carcy that right on through th~n until 1947. Yu. In 1940, the only Aaerican scientific publicatioa er value in the field of cancer research was called the A11erican Journal of Cancer. It was edited by Francis Carter Weed. It was supported, in part, by the Chemical Foundation through the iaterest ef Francie o. Garvin and at that time, in 1940, it was ru.nning a deficit, a very large deficit. There was much anxiety about the future of this important journal and much dissatisfaction with the wa-y in which it was being managed by Dr. Wood. One of the first ventures in support of publications by the Childs Fund was the generoue response to a rec8111l.endatiea ot the Board of Scientific Advisers by the Board of Managers in ~itherizing in 1940, about 1940, a thousand dellars a year for five year■ 1\. to help support the American Journal or Cancer. This was continued right on through; as a matter of fact, the Childs Fund is still supporting the successor journal to the American Jeurnal of' Cancer, a jeurnal called Caneer I Research. Its unusual fer a feundatien to do a thing like that, but I 809 think that set a pattern. Other feul'ldatiens fellewed. Netably the next ene whe fell.wed was the International Cancer Research Feundati•n called the Denner Feundatien--Mr. Denner being the doner and president ef it and having with him a very able Victeriaa lady' named Mrs. Mildred w. s. Schram who was the secretary. The American Journal ef Cancer accepted this thousand dellar a year graat fer five yeare, and I was appointed t• the editorial board. As a matter er .tact, I said this was 1940-it gees back actually te 19.38. I was appeinted te that editerial board in 1938. It was dene within the first year ef the Childs Fund's existenceo Yes, I think there had been censiderable dissatisfactiea--m.aybe that isn't the correct word-with Francis Carter Wood's editerial management et the jourD.9:.l_, so that semethi_~_,!'lad to be done, and it was a continuing source of un- easiness. Right through 1939, the difficulties with the journal increased, and it was perfectly apparent 1n January., 1940., that a reorganization would be aeeded, and in the course or the reerganizatioa there was a question of whe would take the ewnership or the journal, if it were reorganizea. The Crecker Institute tor Cancer Research at Columbia University Medical Schoel was thought or, but they wouldn't take it. The three main preble.. then were the management, editerial and financial of the American Journal er Cance.!:, the questioa ot wnership of it, and the question of its financial support fer the future. The upshot et all this consideratiea, many conferences, was the decision in 1940., te start a new journal to be called Cancer Research, and thi• new ,1 jotrnal was guaranteed support fr• the Childs Fund, the International Cancer 810 Research Feundation, and ether organizations amounting te s... twelve theusaad dellars a .,..ar. Thatl-s censidered sufficient with the additional expec­ tatien et subscriptions. It turned out te be a satisfacter;y estimate. The Beard ef Managers ,r the Childs Fund did net wish te be respeneible as ewners et this new journal, Caneer Research, but the Internatienal Caacer Research Feundatien agreed to be the own.er and spenser. They had the business effice et the new journal, Caacer Research, at the effices et the Internatienal Cancer Research Foundatiea in Philadelphia, largely under the aanagement ef h Dr. Mildred Sera. That was dene by the fall et 1940. A,. Ul'lder the aew management the first issue of Cancer Research came eut in 1941, fr911l the Lerd Baltillere Press which was th• publishing agency, and -flu. this arrangement worked all right fer a little while. Tne editorial board ~ l uw jeurnal Cancer Research was curiousq set up as an advisory editorial beard in a way. The chairaan ef it was Jaaes B.Murphy •f the Reckefeller Institute, -:, friend and ena;r, er at least ..,- friend and -my superier eppenent for so leag, and I was called the secretary er this beara ef edit•r•; as -!-atter or fact, the secretary did all the werk. All the manuscripts cue t• M, all the abstract manuscripts as well as the articles, and it was t•• hea'Y)" and toe time censwai11g ta send them all to Dr o Murphy aad let him decide what was geed and what was bad, so tb.e secretary- became ill fact the editar. We get en all right because sense eneugh was used te send Dr. Murphy the kinds of things that he weuld be sure te cend•n, and that ma4e him feel thatte vas serviag with special value. He centinued in that pesitiea all the way threugh. When I went int• the service of the Medical Department er the A.r-r en February 12, 1942, I had by that time getten a censiderable experience in my first reund •f editing a scientific jeurnal, and I breugllt down with me te 8ll. Washingten in February ef that year, 1942, manuscripts that were in the process ef t:eing edited fer that jeurnal. I remember fer the first ceuple et weeks down here that I had a little back re• in the Raleigh Hetel, and I edited this jeurnal en the top ef a steamer trunk, er foot leeker type ef trunk. I den' t knew why I had such a little roan, except the town was very l, criwded at that time. Mrs. Bayne-Jones was remaining in New Haven te clese \ up eur house and put away the very large cellectien ef beeks I had in the heuse, put away by having them transferred to the basement et the Yale Sterling Library- fer sterageo Well, I edited the j•urnal dewn here until abeut may-be April, 1942, when we persuaded Dr. William H. Weglum whe was Asseciate Pretesser ef Cancer Research at Collllllbia University Scheel ef Medicine, te take it en, and he teek ever the editerial jeb fer the new jeurnal Cancer Research and carried it threugh until the early' fall ef 19461 when I get eut ef the Arrq and teek it back te New Haven. In the aeantime, the Childs Beard had appointed Dro Ralph G. Meader as assistant to the Directer et the Beard ef Scientific Ach'isers, and Dr. Meader's w•rk began en February 1, 1942. Dr. Meader is a very careful--! say is because be still is as he was then a very carefu1, thoreughgeing, reliable studeat, reliable adainistrater, but not a man ef great eriginality, er special originality, er productiveness in research. This was se much s• that he had ctme te the third tera as an Assistant Professer ef An&t9JIIY' at Yale, and at that time it yeu cuie threugh. a third tem and hadn't been prom.eted te Asseciate Pretesser, yeu I d have to ge leek r er a j eb semewhere else. Well, this wu true in his case. Nevertheless, the Beard appointed him. as Assistant te the Direct•r at first, and then he was called Assistant Directer. Th~a was discussed with the Dean, and it was peinted eut te the 812 Deal'!., Dr. Blake, who had succeeded me, hew valuable Meader weuld be in thie situatien fer the Beard, how he ceuld serve the scheol as well as the Board l' because he was al.lewed te centinue seme teafhing. His salary would. pass \ I ever into the Beards Administrative Budget. Altegether it was a mutually beneficial arrangement when they agreed te let Dr. Meader remain Assistant Prefesser er Anatonzy-. He was enermeusly helpful te me., te the Board, and has been to the Nati~nal Institutes of Health te which he went as an assistant in the Research Grants Pregraa abeut 1946, er s•ewhere like that. Oae difficulty with Ralph Meader•s metheds is that he didn't knew when to step being caplete. He began te review fer the Beard ef Managers and the Beard ef Scientific Advisers everything geing en in cancer research in the world, se the reperts ef the Assistant Directer becaae velumineus abstracts, sert of news bulletirus ef cancer research everywhere. It got so big that nobed:y ceuld read them much, er read them thoreughly, se that he made a separate sort ef publicati•• er them, as r\r emember, in the beard' s affa•rs, but he werked very diligently threugh all this period en the Childs Fund recerds, but he didn't have anything to de with the jeurnal, Cancer Research. New, let me say ene mere thing about Ralph Meader and myself-all during the war he weuld come dewn with an enormous brief case filled with applications and papers about the Childs Fund. We had at least one long meeting every month. I would ge to New Haven and attend as many meetings as possible of the Beard of Scientific Advisers and the Beard of Managers during the war, so I kept in very close contact with the Fund all during the war in addition to the other things going en in the Office ef Preventive Medicine Service. Dr. Wo~Jum managed the jeurnal very well as editer during this period. Publicatien was net interrupted. He had a goed -ssistant, Miss Elizabeth Bo Barber, and continued to put eut a very geed journal.. To finish with my part l 813 ef the jeurnal, I will carry it through now until the last year and a half, 1946-1947. When I came eut ef active duty, the editership passed te me again right away, and I meved the material and the Assistant Editer-Secretary, Miss ~ !C.; Barber, from the Crecker Institute at Columbia~ New Havea. I was given reoms fer the work of the jeurnal by Dr. Fulten in the new medical library and was s comfortably set up there. I alse had the record of the Typhus Cemmi.ssion. ~ It was net hard to get back int• editing the journal. It had been carried en in the same tradition, the same line ef activities that we had adopted at the first--the pelieies were the same, and the people were all the sae, but the work was very heavy, exceptionally se because people were putting in a great many manuscripts since their publication had been semewhat held up during the war, and we becaae ilffelved in a series ef difficulties with publishers. It seemed best fer me to take the publication ef the journal t• a printer in New Haven--Tuttle, Mcmeheuse, and Tayler, a fine old firm •f publishers in New Havea, that had been publishing learned works fer members et the Yale faculty for years and,i:;ears. It had quite a reputation, published poetical preductiens--very geed work, almost a traditional thing in New Haven and Yale going back into the 1870s, or,1880s, er somewhere there. It was almest a part ef the universit7. They published a satisfactory jeurnal, but the editer had to de a great deal ef feetwork with that. The cuts were made in a little shop dewn an alley, and the editer had to carry the pictures dwn there; as a matter of fact, the editor mounted the pictures that had te be made up fer half tones, and sometillles celer, and it was toetwerk, a persenal jeb te see that this little photegraphic plant did its work in time fer the use ef the plates by the printers. It was always hard te get ahead ti the game. Material was used up abeut as fast as it caae in, and th& schedules were tight. 814 The printer was satisfactory, and the printer printed and mailed the jeurnal--the lists et subscriptione and addresses all came te us frem Dr. Schraa's Office in Philadelphia. I didn't have te deal with sub­ scriptiens, er lists, but a tragedy happened abeut late 1946, er maybe it's in 1947. A Jewish greup in New Yerk suddenly beught eut the nnership •f the Tuttle, Mereheuse, and Tayler publicatien firm because they disceTered they could sell the eld linotype aachines in Brazil at several times the eriginal ameunt they weuld pay Tuttle, Moreheuse, and Tayler fer them, se they bllllediately started te dismantle that plant. They discharged fine eld artisane, printers whe had been there fer years, deveted, almost schelars, altheugh they were empleyees et the printing firm. They carted away the machinery. The place began te g• dewn, but eur ewn jeurnal material was there because we had a clese partnership almest with this publicatien fim. An issue er the jeurnal was in precess et being printed at this time, se that manuscripts and cuts and incemplete frames ef type were carted eff te New Yo:rlc by the purchasers. In additien we'd rented frem. Tuttle, Mereheuse, and Tayler sterage for all the back issues of the jeurnal. They were up in the garret. They were carted off, se that I had t• find eut where they were in New Yerk. They were ffer en the Eastside, down near the Helland Tunnel, s•ewhere in that regien, and I went down there and practically had te threaten these peeple te retrieve eur wn material. They weren't clear as te whether this new firm wanted to publish the jeurnal; as a matter of fact, they were net a publishing fil'll. They were intel'lllediary people. I den I t recall that I had a great deal ef help frem Dr. Schram threugh this episode, although she was greatly disturbed and greatly anxieus, as we all were. Finally, however, the issue fer that year was e•pleted. Another arrangement waste c•e about in 1947. My editership ended in 815 u June, 1947, and Jlf3' friend, Dr. Baldlfin Lucke, a patholegist at the University ef Pennsylvania Schoel er Medicine, the man whose monegraph en the pathology ef hepatitis, epidemic and postvaccinal hepatitis, was examined by us net long ago. Dr. Lucke was a charming gentleman, a schelar, scientist, anti• quarian. He leved old things. Fer instance, he was able te rescue fr• furniture thrown eut frem Walter Reed .Arn\Y" Medical Center the desk chair of I Walter Reed himself, and Balduin Lucke weuld sit in that chair and think about I Walter Reed. It was a nice thing te de. Lucke wasn't very well. I don't think he lived much lenger after this y-ear. He was editer until December ef 1947, and semehew er ether I had te fill in again as editer from January te June er 1948. At that time the journal was being printed a little while in one place, and Dr. Schram weuld make an arrangement for it te be printed in anether place. We had very great difficulty with printers. I theught authers were difficult, but publishers, printers are werse. Finally in 1949, the jeurnal et Cancer Research was transferred for editing to the University ef Chicago, and. a decter friend ef aine, Dr. Paul Steiner, became editor-in-chief, and he continued in that fer a number er years. The j eurnal the~llBS transferred rer publicatien semetime+ teward the 1960s, I think, te the Williaa and Wilkins C..pany in Bal timere, and Michael Shimkin whe was in cancer research at NIH, a sehelar, an epidem.ielegist, quite a thinker in cancer research, toek ever as editor-in-chief. He still is, and the ~eurnal is still geing, ' ,j neurishing with geod subscriptiens and geed support frem the Natienal Institutes er Health. I I think that 1 s all I want te say- abeut the jeurnal. It s a very interesting episede, and unexpected episede in m::, life. I didn't expect te fall heir to such difficult werk, and I didn 1 t expect te have such an educa- 816 tional experience. I learned a great deal rrom it. The files are interesting in ene respect--strangell., a lawyer's interpretation er what censtituted a centract--y•u knew, it's a technical thing. This was Pepper from Philadelphia. We don't have toge int• it 1 but it is veg re­ Tealing of the kind ef thing yeu can fall heir te when it was claimed that a reply- by zeu censtituted a centract 1 when, in fact, if yeu read carefully the reply1 it isn't se. I don't knew how Pepper figured in this. I didn't have any pewer t• make any centract. Exactl --that's the first cint. The second eint is that what you wrete didn't censtitute a contract. The ,,P8:,~I'.,~ ~9:..~..!!l._1.!,ere. P~~r is net an ~nsiderable atterne.l.!_ The Pepper family is a great family--Perry Pepper in medicine. The lawyer cert&ifY:l didn't Fea.d thl:!~ very carefullz. I Well, in this whele peried--y•u aentien the search fer young men through this whele peried. The Childs Fund was searching net only fer young men, but for elder men. Yeung men came threugh a fellewship plan which we adopted early in the direction of the Fund, and a number er men appointed as fellews of the Childs Fund have become quite eminent-ene was Joshua. Lederberg, a Nebel Prize ~\' winner, and another ene is my friend Rebert Stewell who is net ever in the Armed Foree Institute of Pathelog;y as the Director of Research. You could name quite a few ethers, but the Beard ef Managers liked that pregramo The enly difficulty that I recall with it was the dispute with Mr. Hamilten, the treasurer, as te what the Beard had meant by one time putting aside the sum of sixty-five, er seventy thousand dollars f•r the fellowship 817 pregramo Dr. Meader and I teok it as an allocatien •fa fund te be used mere or less under the discreti•n of the Beard ef Scientific Advisers, subject as always, te appreval by the Board ef Managers. We went aleng and recemmended some fellews and wanted te keep this fund showing in the budget, but Mr. ~amilton tHk it, as ~recall it, tha~ the sutaissien ef the name of a candidate for a fellowship to the Beard ef .hanagers was an admissien that the managers had made a mistake, or didn't knew what they were doing when they set aside the tetal sum. Did you see that cerrespendence? Thatr as a troublesome point. It was the kind ef thing Mr, llamilton weuld de, but it didn't werry us tee much. That was a good successful venture, and it's still geing on. The ether thing the fund did intellectually outside ef its own affairs was to held conferences, many cenferences. In those days from the beginning until I went into the war, and even during the war, I recall meeting a great many peeple through the fund who came ever as visiters, or came in te see me abeut grants, er one thing or another. The Childs Fund from the beginning had in its pelicies the rescue aad suppert ef a jeurnal, the holding •f cenferences, the making of grants, the support er a fellowship program fer yeu!'lg people, and the search for the elder men, these-called statesmen ef science, the elder statesmen ef science who needed some money for research. Mere particularly ene of the latter was Dr. Eugene L. Opie. Opie was working at that time in the Reckefeller Institute which had a pelicy er net accepting outside grants, but in a year or so they seftened up and did take the money from the Childs Fund offered for Dr. Opie's support, and that continued quite a whileo 818 In the course ef this experience with the fund during the war--we mentioned this before--I became involved with the interpretatien ef the statute •n conflict ef interest. Have we had this in the recerd already en•ugh? We talked about_the conflict ef interest as it applied ~centracts under the Army Epidemielegical Beard and the termination of funds !rem~e Childs Fund which were paid yeu te maintain a_level ef ineeme--that arrangement that you had had with the Childs Fund was finallz terminated. Yes--that was a gradual precess. It wasn't terminated at first, but I saw mere and mere that there was a risk ef a col'lf'lict ef interest that would be embarrassing fer the fund and t• the university because I was handling contracts fer research net only at Yale, but at a good many places where the Childs Fund had seme interest. I found I could get any kind ef inter­ pretatien of the law that I wanted, se to speak, by::the manner ef asking the questien, s• I decided finally myself te ask the university to cut eff my salary that they were paying me frem the Childs Fund through Yale and that ameunt waste make my salary--Arm:y salary and what the Fund paid me--equal te what I had betere I went en active duty. Fer several 7ears there I wasn't en the budget at all, but I did g• back en the administrative budget •f the fund in 1946, when I get eut of the Anny and back in the work. What effect did this peried ef warfare have on the contin~ity ef investig__atien in cancer? It decreased it because it toek men eut ef the cancer research laberateries and called en them to de other werk--sanitatien, or bacteriology, er pathelegy. The men remaining in the cancer laboratories were inelligible fer service in 819 the Army. They were older, er ill. The war decreased cancer research abread also as well as here. Abroad they suffered, or at least in England they suffered from a lack of equipment and instruments. After the war the Childs Fund ceuld come in and.help them te rehabilitate their laborateries; in fact, I was in London in 1943--I mentioned that before--on other business, but I saw Dr. Kermaway--E. L. Kennaway, I think it is. Dr. Kennaway was a big, tall man with a beginning Parkinson's Disease at that time. This had nothing te de with Parkinson's Law. Dr. Kennaway was the head of the Chester Beatt1 Research Institute in the R•yal Cancer tlospital in London. He isolated benzpyrine and the carcinogenic material ameng the yellew dyes that the Japanese used t• produce cancer. Benzpyrine is a powerful carcinegene, and it eccurs in soet--it's a coal tar derivative. Chimney ewe~. Yes, chimney sweep cancer, and Kennaway was* friend of George Smith, and he CaJlle to New Haven very eften. We liked him. Alexander Haddow was also, whom I met in Londen in this time during the war. I also went to see Gye at the Cancer Hespital at Mill Hill. My visit te London as a Colonel en a mission to do with quarantine against yellow fever and some consultation with the Surgeon of the Eurepean Theater of Operations was combined with looking areund the cancer work as much as pessible. The same thing was happening ever here. I attended seme cancer meetings, and I was in te11ch witn the National Cancer Institute. _!he war in Eurepe--with the transfer of some regugee doctors and I gather scientists to this country, disrupted the continuity of effort in Europe. I don't know wnether the internatienal congresses were held during the war, er 820 They were net. We put them en after the war. By invitation peeEle wou1d c~me ever. I suspect that certain emphasis was placed en the need for people working in the cancer field to rub shoulders. Yes, and they needed help. The enl.y case that I remember--I should le•k N up his name--there was a friend ef Mr. Wimsten Childs who landed frem Poland in this country, er he was frem some middle Eurepean place. He needed help and quite a pressure was put en Mr. Childs te get something for him from the fund, and we had to pretect Mr. Childs. Mr. Childs •••• I•m talking abeut yeung Winsteno Mr. Childs himself, the father, died in 19461 didn't he? Yes. I wonder when yeu subtract the quality he had, er the quality he represented-- variables--when yeu remeve them1 seme peeple are altered in the precess. Mr. Winsten Childs Sr. died en December 20 1 1946. He was the patriarch ef the family. He was the gentle, but all pewerful controller ef his children. He had three sons wb• were members ef the Beard ef hanagers and a daughter, Barbara. Barbara intellectually was just as able as the sens, but being 821 the sister, they didn't take her into the men's Beard until a geed many years afterwards. When Mr. Childs died, I think the family probably was at sea for leadership, and perhaps the sens who were of very different tempera­ ment and capacities may have grown a little further apart than they would have if their father had still been alive. They didn't separate. It was a closely knit clan, beth living fairly close together in New York City-if you can say that you live close wegether with anybody in New York City, even though you're in the same house, and in Norfolk, Connecticut, where Mr. Childs and his sen Edward had an enemeus estate, forestry, artifical lakes, horse riding fields, boats and everything fer a vigorous outdoor life that Mr. Starling w. Childs Sr. had had. During this period alse--up 'till the beginning of the war and after­ wards--they were building the Yale Historical Medical Library, the Childs Fund iffices in it, and the Cushing Memorial, so to speak, to which Mr. Childs was devoted and this kept him and his sister, Miss Coffin, closely interested in the medical school, in the university, and in the library. He really put his mind en the cancer problems that were brought to him. He read the report of the director submitting and recemmending applications to the Board and giving the list of applications recommended for disapproval, er declination with great care--underlined the words, would ask questions. He studie~ his lessens, and in the Beard meetings usually he was the one who in the Beard of Managers made the primary resolutions all the time. Theylllated fer Mm. How much and to what-yextent was leadership in the field exercised during the war zears bl the National Cancer Instiblte? I don't want this to sound like a curve ball--let me sal that--I can't remember his name, but Dr. Rescee Spenser became the directer. Who was the one before him-the pharmacologist? Veegtlin. Voegtlin. vi'ith premising beginnings in a field which is as uncharted as N cancer was, I suspect that during the war in the National Cabcer Institute, I while it continued to functien and they did their own work there, leadership was wanting. I guess Dr. Spenser with wh.em I have talked and fer whom I have great affectien1 realllz was 2ut in the position ef speaking a language in ! which he hadn't been instructe~~.!111• I 1....spenser was a bacterielegist and his work ever in his labcrat•ry in the National Cancer Institute was dealing with variatiens in bacteria, largely, s.nd they had transplanted pe•ple from Dr. Little's genetic lab•ratery at Bar Harbeur, set up meuse strains, breught Andervont and ether men dewn. As I recall it, the Natienal Cancer Institute when Voegtlin was there working with N George Smith started as leaders in a pregram of clinical ca,cer investigatienso They set up greups te study cM1cer •f the stemach, cancer of ergans in different places--! mean the study at different places. That drepped down in the war, and they were very eager t• get the Childs Fund deeply involved. We took the position that thatwas a bit outside the line that the Childs Fund wanted t• de. The Childs Fund had supported the tumer clinic at Yale largely by providing for its equipment and adhering to the policy of the fund; that the fund was net to be involved in the care ef cancer patients, or the treatment ef the disease unless the case, the situation, and the treatment would thr.w some light en the etiology. The Childs Fund did not help any ether clinic. This was a case teo in which Mr. Childs' remark at the opening of the fund, that he felt Yale ought to be aided te beceme the great cancer research center, justified seme favorite treatment of Yale requests, so we gave considerable meney to the Yale Tumor Clinic. I think that greups te study cancer ef ergans was a design by Dr. Veegtlin and George Smith fer ether places under more or less the guidance ef the Natienal Cancer Institute. I do not recall that the National Cancer Institute was the real leader in these matters at this time. It was overshadowed in activities in the up­ gfothw of the Memorial Hospital fer Cancer and Allied Diseases in New Yerk when Dr. c. P. ,'{heads became its directer after Dr. Ewing resigned. That became the great and vigerous center fer cancer research, but that was impeded during the war because we brought Dr. Rheads into the Anny as a Celonel heping that he would be a liaisen between the Surgein General's Office and the Chemical Warfare Service. He became se enamored of the Chemical Warfare Service and se valuable to Majer General William M. Porter, the chief chemical efficer, that the liaison functien f•r the Surgeon General was re­ duced tea rather routine, ineffective, and treublesome relationship. Dr. Rheada remained in this liaisen p•sitien until 1945, a time when we were wanting to send Dr. Rh•ads to Japan. The Memerial Hespital people recalled that Secretary Sti.ms•n had asked to have Dr. Rhoads' services down here only a year, and that he would be reJleased when the Memorial Hospital said that they wanted him to return. Well, he served. more than a year, but they were demanding his release in 1945, and that was breught about, but the Memorial Hospital was geing ahead at that time in new things. It was the basis en which the Sloan Kettering Institute fer Cancer Research was founded. Another leader in the field going through the war was c. c. Little•~ laboratory at Bar Harbor--the Jackson Memorial Laboratory, a great genetic laberatory with deep interest in cancer, and Dr. Little had brought up there with him Dr. Bittner. 824 Johnny Bittn.er--res• Jehn J. Bittner whe really had discovered whatwas called the milk factor in the cause of mammary cancer in mice, seething in the lactation in the milk ef certain strains ef mice that carried an agent, probably a virus, that causes the preductien ef cancer in mice that are suckled. Bittner's work was geing on in the waro At Yale much ef the wrk continued. Streng (\ continued in his laboratory as a geneticist in ~ice studying carcinogenesis. Gardner was doing excellent werk en endocrines' ~n~lation to cancer. Gardner was Ass•ciate Professor ef Anatomy then--W. u. Gardner, I think. It strikes me, and I may be c911pletely wreng, but unlike the American character which is interested in certain amount et drum beating, pyretechnicsJ and fantastic effort te achieve a goal, that the cancer field in terms ef its management, er the design of exeerimentatien was digginf.i in fer a verz long haul. That 1 a true-people in cancer research enter it with the knewledge that m•re hearts have been broken by the failure ef experiments to disclose the real nature ef the precess, er what to de abeut cancer. That's one thing- the peeple who enter it knew that they are facing a problem that has been in­ soluble for years and years and years. In addition, all the cancer experiments are very leng drawn eu~ things. The cancers by transplantatien take and grew rapidly, but transplanted cancer is a rather unnatural thing. Cancer produced ,<, by carcinogen,___,s, chemical substances, er by radiation may net appear fer three hundred days after you've dene something, se you just take a hundred mice and go and sit under a tree somewhere fer three hundred days. Of course they don't de that, but they have that in their minds. 82S The war gave every indicatien that there weuld be mere in the way of techne­ legical develepment--measurement, teols with which te work. I wonder if this was becem.ing apparent to managers, peeple who were heads ef fund&. I remember that earlz in the Childs Furn they had net particularly wanted te get int• the business of providing equipment altliheugh it did-an ultracen­ trifuge at Yale and same ether thin@-! in the n,oc::i-1 E('t,, Ab. Department for a specific purpese, but with the electronic refinements during the war for war purpeses 1 their utility in the field of science--whether this was becoming apparent or not. I don't knlW. The great instrUD1ent that has disclosed the characteristics of a cancer cell is the electron micrescopeo It was beginning at that time, and a whole new field called molecular bielogy was beginning--at least it was getting to be recognized that there was a biology of molecules as well as of cells. It goes beyond the cellular theory. Ism sure that melecular biology had started and that the electron microscope work was well enough aleng so that the people at the Rockefeller Institute--I•m pretj.y sure Jerd.i Casals and others were trained by Scandinavians who were ahead in those fields--were putting their knowledge te use in cancer research. or course the computing techniques were cendng in. They were used fer data processingo Actually cancer research does not require extraerd.inary equipment at all--ultracentrifuges, ultramicrescepes, all the medern glassware in the separatory tubes, the things that turn things over autematically and save thousa1¥ls of manual manipulations were coming in. Also there was the reginning ef the knowledge ef isetepes. Radieactive isetepes were known fre the beginning of attempts at fissien; in fact, they were known before that, from radium studies, but the knowledge of the value of radioactive isetopes 826 in cancer research, I think, was just coming inte the field particularly threugh the relationship of people whe knew abeut radieactive phosphorus, materials ef that kind, that could be used net enly for treatment but for labeling. By "labeling" I mean putting them in canpounds aad getting the cells se that they ceuld be followed threugh a metabolic process, but I 1m shaky en the dates when these things actually eccurred. Te finish with the Fund--I've finished with the journal. Te finish with the Fund--I came back to it in September et 1946, after I had ceme back int• the :reserve cerps after active duty, and I functioned as Directer of the Board ef Scientific Advisers frem 1946, into early 1947, and it was areund that January that the people in the New Yerk Hospital-Cernell Medical Center began te talk te me about the possibility of my ceming to New Yerk as President of the Jeint Administrative Beard ef the New York Hospital-Cernell Medical Center. I had n• such idea in mind when I went back to the Childs Fund and te New Havea after the war, and it seemed to me a rather .fertuiteus event. One ef the things I was doing in the medical school at that time was te make a survey ef all the laberateries te see if we could get together some central laboratory. There were laberateries of chemistry and medicine in pediatrics, laborateries in pathology urrl.er Winternitz, laboratories in bacteriology, in medicine, elsewhere, and there was much duplication--apparent duplication, but not real duplicationo In ether werds, these departments cou".tln't well function unless theh had a certain amount ef laboratory, but I studied that material, that situation during the early part ef 1947. I wanted to see whatWis happening in ether places, and I knew that the New York Hespital-Cornell Medical Center had a central laboratory. I•m getting eff new int• the oncoming New Yerk Hospital-Cornell Medical Center. 827 That's right--you can ge a little bit lenger en that. ! This will--I will ge onlyl1!3e far as te tell y-9u that it led to my informing the Board ef ~anagers and the Beard of Scientific Advisers of the Childs Fund somewhere early in 1947, that I had decided to accept the effer ef the appointment as President of the Jeint Administrative Beard of the New York Hospital-Cornell Medical Center. To return however te the opening gun, it was fired as far as I knew when i went down to New York to see their central laboratory. The man in charge of that was a mest notable medical man--I think he was one of the most notable of his time, Professor of Medicine, David P. Barr who had been Professor of Medicine at St. Louis and was a very distinguished Professor of Medicine at Cornell-New York Hospital. I was talking to Dr. Barr about the central laboratory., and he said., 11 Excuse me., I want to make a telephone call." He came back, and we talked some mere about the laberatory, and finally he s aid that Mr. William Harding Jackson., the President of the Beard ef Gevernors of the New York Hespital was downstairs in the Governor's Room and would like te see me., so I went downstairs to see Mr. William Harding Jackson in the Governor's R::iom which is a most beautiful, smoked eak panelled room of Eighteenth Century design., splendid table, pertraits., heavy rugs, fire place-just suited for a hespital that claimed that it had been established by a werd of George III of England. The King did allow his name to be used in the Charter of the New York Hospital., but I daubt if the King of England knew anything at all abeut the New Yerk Hospital, as I brought out in this pamphl:t that I wrete en the Charter. Anyhow, I went down and met Mro Jackson who is a vivacious, intelligent, eager perseno He was a partner of Mr. John Hay Whitney. Joh ri Hay Whitney 828 was the son ef the late Payne Whitney wh0 gave most ef the money for the New York Hospital-Cornell Medical Center in 1932. Mr. Jackson asked me if I would be interested enough in the presidency of the Joint Administrative Board te come down occasionally in the next few weeks, or months, to meet with groups of the Board of Governors. I did that from sometime in January con­ tinuing en to about April, somewhere like that. It finally had to come te a conclusion, and I told the Beard of Scientific Advisers ef the Childs Fund and the Beard ef Managers of the Childs Fund that I submitted my- resignation as Director ef the Board of Scientific Advisers to take effect 1st of July, 19470 They accepted that, appointed a Committee on the Directorship of the Beard •f Scientific Advisers and nominated Dr. Winteraitz as my successor. I left the Childs Fund with much regret and with a feeling that I was leaving a part ef my own family because I had getten very close in my re­ latienships te Mr. Childs, Winston, Edward, Richard, and Barbara Childs that, as Is ay, it was almost like a family relationshipo In addition, I was deeply C. interested t• see the fund go ahead, particularly as it was to fa,e new problems as it was coming into an era in which it was ne lenger of very censpicuous, financial importance. When the Childs Fund was set up, the total amount going into cancer research by- 1939, er 1940 1 estimated all ever the country- was areund seven hundred thousand dollars. By the end of the war the National Cancer Instit•te had gene up inte the millions in support ef cancer research, and that was the beginning of the government agencies entering the research support field with great riches se that the probtem was what an independent fund could de. Yes, and where it could make its marko 829 Yes. In persenal terms, after a eeriod of war in which yeu were invo~ve_d in se many things-wer~ at all disenchanted with climbing back into the Childs Fund? Ne, I wasn't disenchanted ceming back into the Childs Fund, as you put it, but I was very unhapw and distressed abeut the situatien I was returning t• in New Haven. Neither Mrs. Bayne-Jones ner I wanted toge back to live in New Haven eneugh to settle the question then--we took it slBwly. When I went back te New Haven after the war, s• far as the medical school was con­ cerned I was quite an outsider. My laboratory that I had used was still partly being used by Dr. F.Duran-Reynals who had remained there, but he was then attached t• the regular bacteriological laboratory of Dr. George H. Smith, although Duran-Reynals' salary was still being paid by the Childs Fund. I had ne enceuragement, er welceme te return te work in the lab,::,ratory at Yale; in fact, I felt very much like an •utsider wh& l:a d net much te look forward te in the place. Naturally after having been busy te the limit ia vecy large enterprises in the war, it was quite a come down in activity te return te the ver:, small and quiet, semi-inte~:ment. I had study r•em space al.lewed me by Dr. Fulton in a wing on the side •f the Yale .lliledical Library where I teek all the recerds ef the Typhus Commissien, intending te write a histocy of the Typhus Cemmissien. I had some help and get a little way with it, but that histery has never been written, excei:t, as I included it in a chapter in Volume VII of the Preventive Medicine Service SerTes ["Typhus Fevers" Chapter x, pp 175 - 274.J I was still a Professer en the Yale faculty, but I had no calls upen me to take part in prefessorial activities. It was a very welceme effer that came te me £rem Nev York. I don't knew what I would have done 830 without it. I d•n't think anything that was ahead of me at Yale could have equalled what came te me in the New Yerk situation. Frem the e,eJ_nt ef view ef content taught at school, was ther_e any earrx•!!! frem the _things that you h~d learned--say1 trepical medicine in the war t ~ in the Yale Medical School? Arter I went back? No., Iw asu't called on te de that. I tried c,nce er tweice to talk abeut some of these things, but I wasn't invited to do ite Was tropical medicine part of their curriculum? Net a fermal part. It was scattered through. I tried when I was there te set it up a lictle bit. The burgeoning interest ef Preventive Medicine frem the ~~udy of ~repical diseases in the war period fell apparentlz on barren seilo Not only at ll•e, but all through the country it twent down. The reasens are easily" understeod because there was no impirtance ef trepical medicine in the ceuntry at the time. Malaria had been practically eradicated, er at least there was very little malaria in the country. The scare ef the intreductien ef tropical diseases by returning treops and priseners of war had passed because nothing had happened there. The sanitatien in PanamaW:Ls in good shape. We were getting free •f the Philippines. There were no spec•al trepical medicine interests in Hawaii, except loprosy out there. Things like the developments of the late 1940s and 1950s in the Middle East 831. had not yet come ab•ut--I•m talking now abeut the Anglo-Iranian Oil Company, \ a huge development in Arabia, and tracho~~ and the things that the Harvard Scheol •f Trepical Medicine bas put ferward. General Simmons had a great epp•rtunity te develop tropical medicine at the Harvard Scheol of Public Health where he became Dean, and he used that ta the limit. He had--that was under his start, and it was carried •n by Dr. Jehn c. Synder-that's beceme a great internatienal scheel with interests in ·tr•piea}. medicine and many ether diseases Qf ether c•untries and populatien preble:ms. Back ef the etfer that came te me frmn New Yerk Hospital-Sernell Medical Center, as I learned after I began te talk ab•ut it with the people there, was the unexpected c•rdial suppert by Mrs. Harvey Cushing and her daughters. I den 1 t know this f•r a fact, but I think they are the ones whe suggested my name te Mr. Jeck Whitney and Mr. Jacksen. I didn't knew Mr. Jackson, and I di<h 1 t knew Mr. Jock Whitney, but I knew Mrs. Harvey Cushing and her daugllterso There are three daughters--ene et them married J•ck Whitney, and ene ef them married Mr. Vincent Aster. Jeck Whitney was the partner of Mr. Jacksen and Presideat •f the Board •f Gevernera ef New York Hespital. Vincent was one ef the most impertani; gevernors ef that hospital. Mrs. Bayne-Jones and I were clese to the Cushing family.. All the time when they1ere living in New Haven we saw much er them when Dro Cushing came d•wn after his retirement frem Harvard. They had a big heuse~n Whitney Avenue up there, and we played crequet in the back um.er the elm trees lo•king aside while Dro Cushing skillfully pushed his ballo We were in his heuse, sitting with him and lecking ever his beoks because he had a let •f his ra~e books eut there at his heuse. We had veryt.;, interesting dinner parties with the Cushings, his ' i daughters, so that relatienship had existed a geo~while, and I rather think ' 1 that they--in fact, ~,m quite sure that they were impertant in at least having 832 my name brought ferward to this Beard ef Gevernors of the New York Hospital. I don't think the Beard of Gevernors would make an appointment witheut inquiring int• qualifications. They were important. The ether daughter ef the Cushings had married the Prei)sdent ef CBS. ; \., The radie statien-Pa.lel• Bill Paley lWilliam s. Palei7-we used to ge out and see them on Long Island, not far frem where you live, where Mr. Whitney's house was. LM'anhasse,17 Yeu indicated earlier yeu studied the central laboratery at Yale. Hew di_d that ceme about? I haven't feund anzthing out about that. Was this an interest of yeur own? Ne--as I say, when I went back there after the war, I was interested in-­ well, we had great laboratery aggregatiens in the Preventive Medicine Service, and I knew something abeut central laberatery work, hew they were managed, and I forget how the questien came up at Yale at this time. There was a ,. move always fer reorganization, consilidation, ecenomies--this was a study that out,ht to have been done. Perhaps I had nothing else to deo 1 was thinking ef it as t• whether the post war peried--certainly the war time perie<!,_ disclesed the need for greup effort. Dr. Winternitz 1 s old idea­ study units. Yeu had a whole reries ef study units during the war under cen- ' vemient headings. ill the commissbns, and there were plenty of others. , ! wondered whether in the pest war peried you saw fro~ the Childs Fund poi~~ tf view an increase in the development of study units 1 greup attacks as dis- 833 tinct frem studying en an individual basis? I can't say I did. We always were betting on individuals and hoping te find a brilliant young persen as Mr. Childs said, the Banting behind the attic doorway, er the cellar deer. The Childs Fu·,d continued to fester conferences and occasionally called t•gether groups of consultants. That runs through the whole story, but no definite pregram of organizing study groups; as a matter of fact, I don't think an outside foundatien can erganize a continuing study group, unless it comes out of the will and wish of the people concerned in the place where it is. You can have large conferences that last four er five days, and then they break up and go away. We had some of thoseo I'm just fishing really--but given the field of cancer as elusive_ as it is am the number of illuminating views yeu can take with respect t~ it 2 whether chemical, genetics, or whatnot, while you still support individuals, doesn't it take a fantastic eynthesis now to climb on the varieus materials that hav~ been produced within these areas? Certainlyo This isn't a generalist in any way, but it would seem te be either a man whe has combined within himself many disciplines beyeoo the nermal ene where you~ say that he is a bacterielegist. That's not fair either because you disclosed in the early work that yeu did1 developments in terms of variation which re­ quired you to lear,!!_about heat, measurement, size, and ultimately metabolism, ~learn something about carbehydrates 2 but the way that has gone since--bow complex it has become. It makes me wonder where one draws the line between support of an individual 2 or support of a kind. ef seminar approach., I don 1 t know 0 As I say1 I,m just fishing. 834 Most medern research is team research, led usually by seme one man, but I he 1 s got very able associates. Its teo big and cemplicated--the attack is to big and complicated to be carried on against ene block heuse as it used to be in the early days. The research, however, can be narrowed to as narrow a field as testing out a group of viruses like adenoviruses, or some of these peculiar viruses that preduce cancer in mammalian species, er it can be as bread as the whole deexyribenucleic acid genetic preblem--chemistry and genetics. I think anybody working in the field to be any good has to have broad interests and broad comprehensions, and how much, however, he applies at arry one particular stage of his investigation depends en his judgrnento ~ I'm kaking a judgment en the basis of no experience whatsoever, except reading 1 some of the things we've talked abeut 1 some of the stuff I 1 ve read in pre­ paration for our talks 1 and that is that in dealing with infectious diseases and the approach one takes toward them, er can take toward them1 from the Preventive Medicine point of view you had at your call, or at the pleasure of the President of the Board1 groups of experts--y•u know, where they ceuld £!._and see-like scrub typhus, where they ceuld fellow it right down, so you ceuld create for yourself a manual en how te aveid ito This isn't s• in the cancer field. Cancer deesn•t lend itself apparently te that kind of epratien. I may be as mad as a March hare, but it seems to me that it deesn 1 t 1 and the volume of material that is published today- in the field of cancer--I don't see how anybody climbs en top of it fer the synthesis. Maybe they don't get enough time to put their feet up and dream and think away the way the individual might--I don't knew. N I think theycdo. I thijk there are analegies in scrub typhus te cancer. 83$ One ef the analogies--take any form of leukemia. Yeu can run that right dewn frem the start to the virus cause ef it, maybe, and the treatment--put it all in a package. Yeu can take cancer of an ergan, like cancer et the stemach and relate that to genetics, food habits, chemical effects. I don't think it's so different. r Are you going to be able to inte~upt the cycle as you can with malaria? No, malaria is transmitted by a vector arthrop•d, and you interrupt the cycle by getting rid •f that mosquito. Cancer is not transmitted in that way. There probably are elements that you can interrupt, and ene of those is radiation. There used to be plenty ef cancer 0£ radielegists who were exposing their hands in the early days to x-rayo They broke that cycle by pretecting their hands, er changing the metheds of handling the material so that the exposure wouldn 1 t be there. There's an attempt t• do that now with nuQroscopic radiatien, radiation frem taking x-ray pictures, and radiation frem x-ray treatment--attempts to cut down the amount ef radiation an in­ dividual has with a view t• possibly decreasing cancer. They're trying t• break the cycle by early diagnesis like the Geerge Papani.celaeu smear work in cancer ef the uterus. They are doing the same with cellular studies ef material sucked out of the stemach. I think there must be some--well, in any precess there's some place where you can break it. That would seem te be a reasonable expectatien. This was one of the reasons why I theught you ljight have been somewhat disenchanted with a much longer haul. i It didn't last very long. I was back in 1946, and out of it by the ~ middle of 19470 8,36 Then the personal associati•n which is real and vivid fer you 1 a s it has been in any number •f P+aces with older peeple like Mr. Childs. Once that 1 radiation, •r whatever it is he was 1 is removed1 it s a different gambit, and chance being what it is--we 111 g• te the Joint Administrative Board next ~o 837 Thursday, June 23 1 1966 A-60 2 N. L. M. I I've gone thro~h pile_s of paper on the Joint Administrative Baar~. It s kind of difficult te knew just wh~re t• begin in terms of what you fall hei~ .1.•• Yeu eught. tt?_give some retrespective vi1:,w af the develeeent •.£..1~ htspital and it~ relations te the medical scho~ before z.~u.~~rive 1 ~ circumstances which Jed1 after a period of yean, te fillins this office ef President er the Joint Administrative Board-I'm n•t sure it was referred to as presid!nt at the time-a~_,_ as y•u saw it..a,_the need for :revision in the Charter !f.._!.rra~gement which would give mere precise scope and dimension to the functions ef the Beard. There als• i~~limate to which yeu fal;_l heir and which I think you can detail. It makes a difference in understandins _th_e_m_i_n_u_t_e_s_o_f_t_h_e_B,_o_a_r_d__a_s_t_o_w_h_e_r_e the interests of various gz:~1!£S _that are present are located. That's rat~er vague, but within these vague contours ••• o f\ I 1m going to start with my acceptance of the extraordinary offer which came to me, or my eager acceptance ef the extraordinary offer which came to me, to be what was called at ,.that time the President ef the Joint Administrative Board. I had fer some months been visiting the hospital and the medical school, and I had a number of cenferences with greups of members of the N Beard of Governers. I became fairly familiar with the magificent structure I\. and building and the very inspiring history of the hospital particularly. The Society of the New Yerk Hospital was established by a Charter issued over the name of George III in 1771. It came about that that Charter was drawn up by the Council •f ~he Province of New York and didn't get to the Privy Council in LeMen. The King never saw it. They put the King's name on it that allowed the incoming governor, the Earl ef Dumnere who was the represen- 838 tative ef the King, a "beloved lieutenant", te act fer the King in these matters. The establishment ef this hespital came about through an address given by a great physician who had been trained abread, and that's Samuel Bard. I brought a biegraphy of Samuel Bard this morning fer you to look at in addition to one ef the histories ef the New Yerk Hespital. In his address tf May of 1769, Samuel Bard spoke ef the usefulness and the necessity ef a public hospital with excellent ideas ef its functions. One that interested lll8 particularly was what he had to say abeut teaching. He said the hospital should be an educational institution. Irm reading a quotation from Samuel u Bard's disco~se on the duties ef a physician in which he said: Another argument and that by no means the least for an Institution ef this Wature, is, that it affords the best and only means of properly instructing Pupils in the Practice ef Medicine; as far therefore, as the breeding ef geod and able Physicians, which in all Countries and at all Times has been thought an object of the highest Importance, deserves the Consideration ef the Public, this. Institutien must likewise claim its Pretectien and Encourage­ ment. Therefore, right frem. the very planting of the idea of the New York Hospital, an educational, teaching hespital was envisened. We like to think that the Jehns Hopkins Hospital was ene ef the first of its kind; as a matter of fact, the New York Hospital was the first of its kind, a teaching hospital in the United states. Pennsylvania Hospital had been founded by William Penn in 17510 It.as twenty years older than the New York Hospital, but it did not have the teaching ideal, er a program like the New York Hospital. I thought these were wonderful sentiments expressed by Samuel Bard and the people who were associated with him--John Jones and ether fine men, Cadwallader Celden--all had high ideals fer educatien as well as for the care ef the sick. I found eut later since I studied this matter at the New 839 York Hospital that as early as perhaps 1714, a Scetsman had laid eut a plan fer a teaching hospital alJnost in the same words, so the idea was in the minds probably ef all intelligent physicians. New Yark Hospital's epening was delayed by the revolution. The British eccupied it during the revolution. There was a fire in the place, and they had troubles of one kind and another, so the hospital really didn't get geing until 1791. After that, it served its community and state in the mc,st beC~lC\I!.__,, high-minded, generous, and intelligent manner and seen(an internationally fameus institution. Everything about it to me was very attractive both from the esthetic point ef view, the beauty of the building--a beautiful building which .1., d better explain nw. It was a building I came to dislike a good deal because it was frezen beauty, so to speak, because it impeded medical activities. Tra central building is twenty-eight stories covered with lime­ stone, with corridors many faced with marble, and with rather Gothic tyi:es of windGws, with many, many angular panes in them, small panes. The building was built •n the principle of the segregatien of diseases according te the sex of the sufferer, so that wemen with brain tumors, or needing ne\resurgery, were on the female part of the surgical section, and perhaps twe hundred feet away would be males with brain tumors and needing neuresurgery. That went all through. You could see from the beginning that you would have to revise a system like that to be medera, and when I talked to Mr. Henry R. Shepley, the architect frem the firm ef Bullfinch in Boston who planned this marvelous building, abeut the rigidity ef this frozen, beautiful structure, he said that I really didn't appreciate the fact that this building was built with hundred year materialo I told him that I thoutht he didn't appreciate the 840 fact that it was also built with what they~uppesed were hundred y-e\lrf ideas. The situation illustrated to me that if yeu are geing t• build a hespital in these modern times with great and rapid changes in medicine, yeu'd best build something you ceuld push dewn in twenty ye~rs er se, not just keep it because it 1 s "hundred year material." That you ceuld see was an encoming preblem at the start. New Yerk Hespital was a very populeus place. At the time I was breught there the bed capacity was upwards ef a theusaad beds; whereas in the original coneeptien when the joint Cernell-New Yerk Hospital arrangements were made 0 they talked in terms of four hundred beds. A th]\usand beds were in that place at that time. In additien, the elevators--! think there were eighteen elevaters in the building--were antiquated before they were putting in the 0 first hoist. They are hand eµ3rated elevaters--teo small and not sufficaently arranged in usable group,. The base population of the New Yerk Hospital- ' Cernell Medical Cellege, and the School ef Nursing, and the employees was about fifty-five hundred. We counted the visiters added to that one year to be hauled by these hand-operated, slow elevators, and we found that abeut 750,000 people were ceming into that place. The traffic preblem was enormous, but these same hand-operated elevators are still there because it is enormously exi:ensive te change these elevators geing up twenty-eight floors an.i requiring now electronic butten contrel in place of seme girl standing in there slaill'lling the doers by hand and pushing a crank to start and stop the elevator which rarely stepped level at a floor. Other things that yeu could see would be needing rearrangement for the sake of the people in the hospital were, fer instance, the toilets. If you broke away from this segregation of diseases accerding to the sex of the 841 patient and put males and fem.ales in the sames ection1 /r we did later in the same ward where the water closets and the bathrooms, wash rooms, had been male or female, yeu had te make a new seto To run flum toilets down twenty-some stories also adds a great d eal to the cost of alterationso Alse at that time there was coming inte medern hespital constructien the piping of exygen te beds where patients had t• be put in exygen tents and oxygen had to be all threugh the hespital. In New York Hespital it was still wheeled around in cylinders en hand manipulated trucks; whereas in modern hespitals they pipe the oxygen in from some tanks buried in the out­ side and brou~ht up threugh pipe. You could see these things when you first went there, but yeu knew that it would take a leng time and a let ef money te get any changes. I was thrilled by the appointment. It seemed miraculous te me that I should have such an eppertunity put befere meo I entered into it with the greatest ent#asm and still think of the experience, t.he six years I w.s there with admiratien for mest of the peeple -with whem I was asseciated, with great respect fer the institutiens and all they accomplished and all that they were planning te accomplish, and deep affectien fer many of my asseciates. It had a bad start which I will tell abeut briefly and witheut any particular hard feelings nowo I found out soon that I was net expected, or at least nobedy paid much attention to my coming there. I.as aware of that C se that I actually telephoned Mr. William Harding Ja~son and asked if somebody would meet me the day I arrived. Hes aid that he would meet me at the doer of the hospital which he kindly did 1 and he showed me to the office that they had set aside for me. I! I hadn't called him, I think I would have arrived without knowing where tog•• I never had any notice at all •f 842 my appointment from th9 trustees of Cornell who took part in making the N appointment \1th the Governors of the hospital. That was managed by Chancellor Rufus Day. I don't believe Rufus is his proper name. idward Ezrao Edward Ezra Day. We called him Rufus because he had a red tinge in his ha.ir. He put the appointment through the Trustees, and naturally they had te take action in the Trustees for twe reasons--one, to give me some Cl ' authcr ity in the position in which Iles being placed, and t~., for financial reasons because my salary was equally divided between the Society of the New Yerk Hospital and Cornell University. In looking over these papers with you, neither ef us has found any indicatien that~e Trustees sent me a notifcatian of my appointment. Yeu ought to explain whY•••o I•m going to get arourrl to thato 1 •m talking now a little b~t about my reception in the place. l 111 give you an explanation of the erigins of some of these actio~; in a few minuteso ' The Dean of the Medical College, Jeseph Hinsey, had been told--! found tut later--that my coming there w0uld have no effect upon the method of arrangements by which he'd been conducting his part in the center and the medical scho••• He was obviously hostile and regarded my: coming as an in­ trusion., and rightfully se. He was right in deing se in view of what I know he had been told by Chancellor Day~nd ethers. The background ef these curious difficulties really is to be found in the events from 1928 te 1935. In 1928 1 a rather loose agreement between the Seciety of New Yerk Hospital and Cornell University had been in effect by which there was an association between the Cornell University *edical Cellege and the New York Hospital. The college was then down on 1st Avenue near Bellevue, and the New York Hespital at about that time was down on 18th Street near 5th Avenue. Well, obvieusly in thinking about the further strengthening ef this unien and increasing the facilities for both the school and the hospital, new lands had te be acquired, new buildings put up, and about 1928 1 they began this jeint building project on funds that had come to the Society of New York Hospital frem Mr. Harry Payne Whitney, who actually though, had a very deep interest in the Cornell University Medical Cellege se that in his contribution to this enterprise, the develoIJftent •f facilities, the development of pregrams for medical teaching, res(erch and care was in his mind naturally te be carried forward by both the medical college and the hospital. I don•t remember all the details, but some ef his gift was intended for the medical cellege and some of it did got~ it. They appointed as di~ecter •f the New York Hespital-Cornell University Medicalf College Associatien Dr. George Canby Rebinsen wh• in 1928, when this was done, was •••• Tulane? No. J.,m trying to de with arithmetic. He was born in 1878, and it's ' new 1928. He was fifty years old and had had a brilliant career a.s Pr6fessor tf Medicine in St 0 Louis, Acting Prefesser ef Medicine at Hepkins 1 Asseciate in Medicine at the Reckefeller Institute, Dean of the Washington University ,.- Medi,_.,.cal Sceol in St 0 Louis, and Dean ef Vanderbilt Medical Scheel in Nashville. He was a productive investigator and a very vigorous man. He came int• this project at the time that they were beginning te build what was later called the New York Hospital-Cornell Medical Center, on a tract ef land, a geed many city blecks en 68th Street and what was then called Avenue A, now Yerk Avenue, extending frem 68th Street up te abeut 71st and from the East River on cne side to Avenue A en the West. Catny- Robinsen accepted his responsibilities and enlarged them rapidly. Hew as a great pewer in the building of the place. He was given autherity e t~ alter plans, to make commitments ef meney, and he had real authority to make some ef the appointments en~he hespital staff and en the faculty. He was, in effect, the director ef the whale center, and he was carz;...rng eut his duties witheut sufficient autherizatien from the~tanding agreement. The agreement had been outgrown, and it was mutually agreeable to both the Trustees and the Governors that these things should be done. I don't mean that Dr. Rebinson was doing anything thatll:ls eut of order with respect to his superier authority. His manner, however, became mere and mere the manner tf a commander, and he began te get int rouble with the faculty. After the building was open in 1932 1 and the educational process and the care ef patients were transferred from the downtown locations to this new place, different problems came about thatl:n,quired a different manner of 1 handling them. He was used to--I don't know what the explanatien of all ef this is, but the point I 1m getting to is that in 1935, the faculty declared that they ne longer had confidence in Dr. Robinson, and he left. It was a great shock to him, broke his life up, I think, altheugh he continued to do various pieces of work like carrying on with the Red Cross Bleod Program and was for many years Director of the Maryland Tuberculosis Society. He moved, h•wever, down te his home in Baltimore, stayed there, became progressively arthritic, progressively sick and progressively concerned with what had happened to him. I wanted to get at the story ef those events frem. him, so A. ' after I had gone to the New York Hespital..Ccrnell Medic~ Genter, I went down to see him. He had prepared for this meeting by setting out en the table 84$ all of his papers and cerrespondence justifying his actions plus a con­ siderable nwnber of pages of a manuscript hew as writing to give the correct story of his life and his relationships. Fortunately after a long talk, he was able to say that it really didn't seem to matter so much now. As a matter of fact, he wrete me when I came back after that meeting to please tell Mr. Jackson, Day and the others that he had decided net to go en with working his case up, sot• speak, but would drep it. He said in his letter that it was all right since I was going into the position there and, to use his own words, he had torn the damn thing up. I think he was happier after that, and se were we in New Yerk. After Canby Robinson left the New York Hospital-tornell Medical Center, they made no appointment. The authorities ef the hospital and these of Cernell did not make any appointment of a director ef the center, so that the medical school from 1935 to 1947-twelve years--went en its own, so te speak, within the center, the hespital mere or less en its own within the center, but hl/-\'y ' neither one could ge its wnibecause it,s obvious that they met on many points and many assoeiatiens, so that somebody had to be in the middle te help them make up their minds, to settle questions, and the person whe emerged inte this important, commanding, or advisory and influential pesition was Dr. Henricue J • Standero Dr. Stander was a square built, slew thinking, able, opinionated Beer from South Africa. He was Professor of Obstetrics. He had built his tbstetrical clinic up in the~ashion ef tl"B Frauen-Klinik of the Germans which was almost a complete and separate instituti•nf of its own. He had his own library, his own pathelegy section, his own obstetrical surgery, his own obstetric nursing group, a separate anesthesia unit-he had just practically a separate obstetrical hospital. He had real re~son to do that historically 846 because the section ef obstetrics in the Center was the old Lying-In Hospital. The Lying-In Hespital had a leng history going way back to the early 1800s. It had been a pet project of J. Po Morgan, had enormous support, and had affiliated with the New York Hospital and allowed its integrity to be pre­ served. Actually it had its own Board of Managers, so to speak. It had a strong committee, and Stander inherited these traditions, and you can still see it in the present catalogue ef the New York Hespital, the Lying-In Hospital stands out almost as a separate institution. I wish you'd explain something that you told me about your approach with Grover Pewers • I said that Stander was very opinionated, and the example I gave you 5 was his resistance to the adoption te what i~ called "Living in 11 , a system by which the baby is put i1a roem with its mother right frE birth and not shut up in a little nursery somewhere separate. The father is allowed te come in to the room with the mother, and the father and the mother get early acquaintance with their baby so that there's really no break when they get I I home together. It~s still all in the family. Its very valuable psycho- logically beth for the child and for the parents, but Stander didn't see it because it upset routines. I showed him that it was rather unnatural to de what they were doing in obstetrics in New Yerk Hospital by separating the baby from the mother right away and letting her see it only when she nursed ! it. Semetimes she didn't nurse it, '3.nd she didn't see her baby very much. His reply, explaining why he didn't want to make any change, was, 11You knew, this professienal management requires you to de unnatural thingso 11 He was like that in a good many things. Stander was extremely able, and he developed into a~ewerful figure. He was at one time President of the 847 Medical Board. He was a patriarch. ~eople in both the medical school and the hespital brought him their problems. He had much te say about those things. I think he explained to this medical faculty that my coming te the Joint Administrative Board would relieve the department heads of a good deal ef tedious, administrative work--that was his conception of my functiono In spite of all that, Stander and I had been friends at Hopkins, and we were still friends up there. There never was any break. My relations with the medical schoel--I came in as an imposition ever their habits and the anthority and behavier •f the Dean. Dean Hinsey had been/assured that my coming vCUld make no difference., and the faculty didn I t welcome me in any outspoken manner. The Dean of the Scheel •f Nursing, who became a dear and extraordinarily interesting friend, Virginia Dunbar, didn't know where I fitted in because, as Ir emember, she said that all she knew about me was what she read in the papers. I got to be very close to the School of Nursing, got a very deep interest in nursing education, which gave me the opportunity te satisfy this interest to a considerable extent. When I uot there, there were several things afoot which I had to take hold of immediately w:theut knowing really much about them. E111 speak ef three. One was the beginning consideration of the affiliation of the Hospital for Special Surgery, which was an orthopedic hospital down on 42nd Street near the East River, with the New York Hospital. That hospital had a tradition and a pride, and ic. didn't want to have its identity smothered if it came up and joined the New York Hospit~-Cornell group. It was very difficult. Negotiations had been going on between some of the Trustees of the hospital and some of the Beard of the Hospital for Special Surgery, and the first thing I had to do after I arrived there,vas to preside over a ~ting '\ of a group, a joint com.~ittee, that was considering the negotiations. I found 848 from that meeting that the hospital had one way of thinking of things and that the Hospital for Special Surgery representatives had another, and neither one was telling the rest ef their colleagues just what was afoot. That even affected the characteristics of some of the minutes of this first meeting, a draft of which was sent to me when I happened to be put in Colorado and was written by a representative of thtew York Hospital. ItW:ls so different from what I recalled d: the meeting that I had to do it. over. That was one problem that was stewing, so to speak, at the time I arrived. 0 Another one I so\n f•und out had to be tackled was an understanding that had been reached between representatives of the hospital, not the Board of Geverners of the Hospital, but I think it was in the directorate of the hospital, Murray Sargent, the director, the Dean of the medical school, the Chancellor of Cornell University, and the treasurer, the executive treasurer, executive officer of the medical school, Mro Edward K. Taylor, to take or to receive frem the hospital as a gift, a piece ef land between the power house and the East River, bounded on the Seuth by nst Street and on the North by 72nd Street, unoccupied by any buildi~g at the moment. This piece of land was to be put to use as a site for a dormitory fer the medical students. "v' Medical students were living in very poor quarters around ~~enue A, 69th Street and a dormitory was desperately needed. They needed proper housing. The plan to build them a club like dormitory right over the banks of the East River facing the sunrise was most attractive, of course. Deeply concerned in that was the most famous and influential alumna ef the Cornell Medical Cellege, Dr. Gennie M. Guion. I was told tha+ sheuld be very careful not te do anything that was contrary to the wishes •f Dr. Guiono My conception of Dr. Guien before I met her was that she was probably a termagant and got her way by frightening people. I ceuldn't have been more 849 wrong. She's a most gentle and charming lady, a North Carolinian-very idealistic, quick sensibilities, understanding, a beleved physician who teok care of many, many impertant people in New York including Mr. Whitney, Mr. Vincent Astor, and others. She's the most trusted physician en the staff. She was in private practice and had a clinical appointment in the hospital. She was a goed teacher. She was vigorous, lively, full ef ideals, and perfectly' honest. We soon talked about this plan·, and she saw right away what I saw and which I had cenfirmed before falked to her, that that was the last bit of uneccupied land in the immediate vacinity of the New York Hospital en the site en which it was built, and indispensable for future hospital expansion. I116s able to get from Mr. Shepley a record of the fact that the Governors had told him, or put down somewhere, that they looked forward to preserving that land for hospital building later on. I was able to get Dean Hinsey te reverse his point ef view. Dr. Guion first accepted the view that the land ought to be preserved fer the hospital and began to think about a medical dormitory en York Avenue which has since been built and is a very fine building. This was urgent problem number 2. The third problem, of course, was my relation with the school and the hospital because, as a matter of fact, there was nothing in the old joint agreement ef June 14, 1927, that really covered the then present situation. They needed to revise that agreement to provide for ~he Office of the President, te define his powers and their scope, and it turned out in a short time to set the President in the Medical Center in such a positien that he bad a normal and easy relation to all the components. This was particularly acute with relation to the Medical College because Dean Hinsey had been told by Chanceller Day that my coming there would make no change in his relations. One of the arrangements I feund needed to be changed was that much to my 8$0 surprise, I was not expected, er invited to sit with the faculty in its executive sessiens. The faculty was a large faculty, and like all faculties, it had t• divide into an executive greup, the heads of the departments--at Yale it was called the Board ef Permanent Officers, at other places by other names. It was called the Executive Faculty, I think, at Cornello Actually when I told the Dean I was coming to the next meeting, he stood in the door and said1 11 Yeu don't enter this room. 11 He was not aggressively opposed to me, but he wasn't cordial at the start. An example is that we had a meeting ef the Board of Trustees ef " Cornell in the \oom of the Beard of Governors of the New York Hospital. They met there once a year reutinely' 1 had a luncheen at that time. I was placed at a little side table along the wall with a secretary and was hardly spoken te by anybody. As I say, when I look back en it now, I don't think I regarded it then as intentienal hostility as much as an eVidence ef a reactien against a stranger coming int• the midst of groups that had been living tegether in what they supposed was harm.eny -md productiveness. Those experiences with the schoel and the need for definitiens caused us to get a revisien ef the Joint Agreement, a;r it was called, and I think that was accomplished within a year. I think that's quite early--Nevember 1 isn't it? It's within the year anywhew. It was within the first year of my being there. I recall that in this effert to get the Joint Agreement reVised, Mr. Wi.liam Harding Jacksen was enormously helpful to all concerned. He toek this problem, algal problem, 851 and he was a lawyer, and he had meetings ef his ewn with the Trustees of Cornell, with me, and with ethers, and it was done by December, 1947. Yes the amendments to take effec as of Janua l 1948. Even that amended agreement was not entirely satisfact•ry because changes were eccurring all the time, and toward the end ef my term. down there., in respense te Mr. Neal n. Becker., as Ir emember, one ef the Cornell Trustees, was a plan to review the whole thing and revise--review with ne thought ef breaking anything dew~., but revise to fit a situation that had developed. The pewers of the President were e xtended1 and it gave yeu.... Yeu mean in 1948? Yes 1 and it gave you access te the various components. It really recognized that by this time the Mew York Hospital-Cernell l-'ledical Center had four main components. One was the Cornell Medical College. One, we can say, was the Joint Administrative Board field. The third would be the hespital itself, and its satellite hespitals--Payne Whitney Clinic and the Westchester Division, and the School ef Nursing. Each ene of these was represented by a budget. Therefore, it was e•sier to keep their interests in mind. rhe medical schoel had a budget. The joint operation had a budget9 The hespital had a huge budget. Payne Whitney had a budgeto Westchester had a budget, and the School of Nursing opl!rated on a budget which was entirely provided by the New York Hospital. Let me say here--while l 1m thinking about the School of Nursing, let me explain its name and how it ca.me about. It used to be called the New York Hespital School of Nursing. It was a hGspital school of nursing. They had 852 some di!ficult1 in attracting high class nurses who wanted to have superior wducatien and a university type •f degree so that shortly before I came I.I there, Chancellor Day and the Tr\stees at Cornell had agreed to take the School of Nursing under the aegis ef the university, provided it was called the Cornell University-New Yerk Hospital School of Nursing and provided the university weuld not be asked for a cent to meet its expenses. .!.'hey adhered te the latter with great fidelity. Curiously, there was something apparently very canny in the upstate New York Trustee greup even though the men themselves may have come from more liberal communities in the South and East, or the middle of the country. Their attitude toward the inceme and expenses ef the medical college as such was that the medical college had to live on the income frem its end•wment, which was only about a million er so dollars--the endowment was about a million--and the fees from students. The Trustees would not countenance a deficit no matter if the income was remaining constant and the costs of medical education, the costs of running the scheol, were going up all the time. The medical school made a contributien to the clinical departments which were regarded as~•int departmemts. That• s what surgery, medicine, pediatrics, obstetrics and some of the specialties were--joint departments. The budget of the joint departments was shared equally at the start of my C coming, between the medical s~hool and the hospitalo After a while, the hospital had to put up a bit more than the medical scheol and the supplemen­ tation of salaries was made for the benefit of both institulions by using money from what we called a "full time fees fund", the meney collected by the full time doctors from seeing patients which they had to collect. l'hey had to make charges, but the money collected went into a general fund which 8$3 was used under the direction of the President of the Joint Beard and the Joint Board for the benefit of the combined institutions. That was a con­ siderable expense to the hospital, but the Cornell Trustees regarded it as-­ I was going to say a Shylock type of •• oo It was a deal. A deal--yeso I took some time to learn about these expenses and budgeting because it was very intricate, but it did work out that under this revised plan, I saw all the budgets. I sat in the meetings of the Board of Geverners. I was invited, en the hespital side, to attend the meetings of the Finance Cemmittee all the time. I sat in the medical faculty and talked to the Dean of the medical sch~ol about his budget, both the medical schoel and the joint budget, and I had much conversation with Miss Dunbar about her budgeto In addition, Payr:e Whitney had a separate endowment and budget, and that came through the hespital, but the Joint Board alse saw thato I was taken in te the Governing Committee, so to speak, of the Westchester Psychiatric Division which ran on its own, income and expenses. I saw its budeet, but its budget didn't come in through the joint arrangement. It's a curious thing how much the r:assing around of a piece of money,n~ matter how small it is, is coupled with intricate political and personal, emotional problems, a token tha~is i very valuable beyond the money, and the money exchanged in those manners opens up slots and doors that prohably wouldn't have been open unless there was a transaction going forward. I think my relations with the hospital were fairly easier than those with 854 the medical college at the start, but after a year or so, it was for me all one family. The separation that disturbed me very much and probably dis­ turbed the other person was the separation that soon developed between myself and Mr. Jackson. I can see his point of view very well. I think I was a great disappointment to Mr. William Harding Jackson, the President of the hospital because he used to talk about balancing the budget of the New Y~k/;; Hospital, the deficit in which was then running around two million dollars a year. The tetal budget was about twenty milliono To balance that, er to wipe it out rather, would cut off a tenth lllf" the expenditures, and when you start to do that, you cut down services. You,, 111 have to stop maldng salary increases. Yeu 1 ll have a small staff. Yeu 111 lose staff. Yeur merale gees to pieces. I really didn't do much about trying to balance the budget, except , studying everything very carefully and soon realizing that little businesses ! ef petty savings really didn't amount to very much when all of a sudden, for example, yeu 1 d have to replace the great oil burners in the heating plant-two hundred and fifty thousand dollars in a week, or when the elevators needed replacing--very expensive, all these things, and the costs of medical care going up and up and up. I was amazed to see that even though the deficit was there, the gifts and legacies wiped it out. They d.idn 1 ti,a,nt to count on those as fixed income, but almost every year the huge deficit dwindled to a rather small figure when these gifts and legacies were taken into consideration. For instance, annual giving--just the simple annual giving in these days to the New York Hospital was about six hundred thousand dellars a yearo It just flowed in, and then .i:' enormeus legacies came in all the timeo eople had willed their money in the past, and it was coming due so yoQ get a feeling that it wasn't too dangerous. The other thing with Mr. Jackson you'll see in these letters he writes bef•re I came, that my ideas abeut the social aspects of medicine were close te his and that he looked forward to some developments. I don't recall those conversations as being very specific. It would be perfectly honest of me to say that I can see the value of greup practice and institutional medicine, and I did, and when I was in the Arnry, I spoke at Rochester and at Yale of the excellent impression that had been made en me by the practice of medicine in -1 Anny hospi~1es--a great big erganizatien, but as good medicine as you want t• see anywhere. 'lne things in this field which concerned me, Mr. Jacksen, the hospital, and the school were first, a plan that had been debated before I came there to establish in the hospital a s•-called diagnostic clinic. Some •f the Governors had been working on this, particularly Mr. Jackson. He wasn't clear ab•ut it, and he still had doubts as to the legality ef the 1 preposed arrangement. ·rhe arrangement was te be a clinic that offered a complete diagnostic service with a referral to some private physician, if I necessar,y, er admission to the hospital, if there was no private phs~cian r to be hado Theywere to admit to this7clinic people •f any income level--rich, ' middle, not indegents though. 'lne latter could be taken care of in the erdinary eutpa.tient department. These admitted te the clinic would be charged a fair sum in a sort of modified gr•up practice, except thai the element of prepayment was net in there. Thes+:ou.ld be payments made fer services of the clinic at the time when rendered, but there was not in the New Yerk Plan a plan for prepayment group practice, comprehensive service. \ Mr. Jackson had been ,:,Jting on that for some time, and I think he was very much influenced by the success ire 1947, of the Henry Kaiser PermanentE Hospitals and greup health system and service in California, Oregon, and 856 Washington. This had been started in the war in the desert in Calii'ernia by a very remarkable doctor named Sidney Yarfield. At the time, when they were putting in the great irrigation system for Los Angeles, therevere abeut five thousand laborers in the desert, and they had no way ef taking care of them. Garfield 1 s original plan was that they would contribute five ~ 1nts a day. They started on that, and they seon paid off the debt for the hospital he t d made, and he made money. He was able to pay the salaries of a group ef physicians, and th.ai was a big success right away. Mr. Kqj.ser got in it, particularly when his ship building enterprise was de-i.eloping in San Francisco after Pearl Harbor. He, however, had to limit it to the men who were employed because he had centributions coming in to this plan from the subcontractors and insurance. That" has succeeded enormously, as you'll see from the books I that I brought up here. Its a great success. My feeling was that perhaps some of the Governors and possibly Mr. Jackson were leeking en this plan ef a diagnostic clinic--in fact, they say so openly-­ as a means •f making money to reduce the deficit of the hospital. At the same time in New York a very extraordinary comprehensive, group medical care and health program was developing under the direction ef Dr. George Baehr. It was called a Health Insurance Plan for New York City--abbreviated and always called HIP. Its affairs and what was happening influenced me considerably to go slow. HIP activities of furnishing pre-paid medical t care by physicians paid fer from income derived from thos who subscribed to '\ the plan was violently attacked by the New York profession in medicine. All the 'rd.mportant people there in the New York County Medical Society--Dro William C B,Rawls, Dr. B. Walla~e Hamilton, and a good maey other were more set in their ways than even the American :Medical Associatien. They accused HIP of' 857 all sorts ef skulduggery and unethical conduct and fought them just as hard as they could. If the New Yerk Hospital had attempted to enter right away into a plan fer comprehensive service on the prepaid health insurance plan, they would have had even more reason to talk about the corporate practice ef medicine because the hospital weuld be doing it, and the hospital was a corporation. They actually made such an accusation later on which I might as well go en and tell new. It could hardly be said lack of courage in not going 1 forward with this d evelepment of either a diagnostic clinic at the moment, or a prepaid health insurance plan because it wouldn't have affected my fate very much whether the battle had been won by the hospital, er the battle had been won by the set practitioners in New Yorko I must admit that I was frightened by the severity of somerf these peeple--Dr. RawlsW:1.s a very hard man. Dr. Hamilton tried to put me in my place immediately on my arrival. He was the all pewerful secretary of the New York County Medical Society, a very dapper, incisive, well dressed, thoroughly reactionary man. I applied for admission to the County Medical Society because I always thought that a physician eught to be a member of his professional societies like the American Medical Association and the County Medical societies. I was such in Marylan~ in Rt><:hester, and in New Haven, and I wanted to do the+ LN&.J YcR;j'__i same thing down h e r ~ e y had a requirement, which could have been waived, that an applicant for admission to the New York County Medical Society had to be interviewed by a member. They usually waived that in the case of a man who had been a dean of a medical school, er ha,een a general in the Army-­ things like that. Net Dr. Hamilton. Dr. Hamilton fixed an appointment for tl ,, me with a Negro physician in the basement of a tubled down house in Harlem, and 858 I had toge there and st'hd out en the street with other youngsters just out \ . ef school waiting to be interviewed alseo Hamilton did that jus+o be offensive, I think 0 Well, I went and I ~ot to be friends with this fellow who interviewed me. We were a little embarrassed at first. No sooner was I in the Medical Society tf the County of New York than they made me chai~n of the Committee on Public Health and Education whose immediate problem at the moment was an intense difference and difficulty over)segregation. New York was beginning to adopt sone laws in the s~~e against discrimination--they didn't call it t segregation; they called it discriminatior,' 1bey accused the New York Hospital- Carnell Medical Schoel of having a quota with regard to Jews. Whether or not there's a quota in the schools, it's very curious though that the Jewish propertion of the classes of most of the medical schools is around fifteen percent. It just happened that way, but this applied to Negroes too. Cornell took Negroes when they get ene that was good enough, but they weren't good enough as a rule. It's very tragic to take a Negro into a scheol of higher education like that at that time and have him fail. That breaks his life up, and it's a less of time for the other people. Well, this was a very severe affair in the c~unty, and they made me chairman of this committee right away. I had to learn all about it and make a report about which I have for­ gotten ~11 the details, but it had to be given at a very large, open meeting at which the debate was acrimonious among the members of the two sides of the questions--whatever they were. Those were signals to me that there was trouble in this towno I guess they were. 859 They slowed me up, er frightened me because I didn't do too much at first, in the first years, except to learn about the place and learn about the people, and ltm sure thqt .Mr. Jackson got impatient. I think he said te me once,''When are you going to do something important?", or words to that effecto I remember that. Also there was a Murray Sanders. You mean Sargent. Yes, I mean Sargent. I know Murray Sanders, but he has nothing to do with e this. H1". was on the Arrrry Epidemiological Board, one of the workers at leasto Hurray Sargent was to be replaced, and there really was n• director of the hospital after he left. Mr. Laurence \a Payson was made a sort of deputy president in Mr. Js.ckson's foetstepe, and Payson, as delightful a man as he was, had ne experience in running a hospital., so for months I used to spend ~est of the time over in the other side of the building with Fayson, Wheeler and other people, doing the management of the hospital, which I didn•t knew anything about either, but which was very time consuming and probably diverted me from some other things that Mr. Jackson would rather have seen me, do, During that time--to show the lack ef entente cordiale--the search for ·.-. this director was conducted by me and unbekno~nst to me by Mr. Jackson. He invited a candidate., a very fine man up to be looked over, but he didn't tell me about ito Fin.all¥ with a great deal of force and foresight., Mr. Jackson decided to get the Governors to appoint Dr. Harry N. Pratt, who was then Director of the Memorial Hospital across the street, as Director of the New York Hospital. This was done, and for the face saving, it was done on the recoITl.Illendation made to the Board by me, but it had been accomplished before 860 that. Dr. Pratt is still there. He turned out to be a good director, though 0 there was a period in his life as a C~lonel in the Arney wren he seemed a bit too dictatorial, and he was sent home for a little relaxation for a whileo Those are the immediately inherited problems which were pretty intricate and diffict1lt Lo solve 0 Did agyone ever convey ~o y~u why at this momen~ they thought t~y would fill this ,E_r~s_i_dency? They carri~d on t~e way th~ had been carrying on fo~ twelve years. I don't expect them to alter their spots, but some reason had to be off~red for filling this post-what: to give a broad general view to the center which hadn't been done for twelve years. I never inquired into it. I can guess. I think that some of the Governors thourht that Dr. Stander had too much unauthorized power. They thought also that the Governors had much 1ees access to the Trustees at Cornell than they wanted. There was no common meeting ground. Whatever--well, they didn't have anything like the meetings of the Joint ooard in this period very m1.1ch. I think that with a basic agreement which only needed a few changes to make it more effective and make it an instrwnent for unity in the combined organizations, it would be natural for them, thou;htful men that they were, to think of building on that basis. Of course, it was the eri.d ef the war too, and peop7-e were having an idea ef a brave new world after the war. Thismsn'Un unimagin~tive Elace bz a long~hoto There were good men he~• Extraordinary--the thoughtfulness and superior work that had been done in medicine and surgery, scholarly work of professors like Eugene F. Du.Bois and Charles Ro Stockard in physiology, anatomy, and medicineo Whether David 661 Barr, the Professor ef Medicine, worked on getting this job filled or not, I den't kn.w. He~d been there only tw• of three years after ceming from I\ St. Louis. He had a great mind and a great concern fer a whole unified operati•n• It doesn't--maybe thel_looked for immediate miracles, and this was a ve!'l'.," somplex institutien--just the b~ets alone, and to ~et time to f e n ~ in, they were perhaps not appreciative of that. For example, even ~q the~ef ~ diagnostic clinic there was oppositien to the ve:ry: unfolding of the plan within the Center. Youf mentior.!,.E!d earlier that a erivate consultation service had existed there for some time. This had all been discussed before you _!l'~ived, and the decision was that they were goi~ te put the diagnostic clinic through an~ay. This was Jacksen--that t ~ were going to1J'ush th~ough this diag~~ic clinic irrespecti~e of what the opposition thought. The priv~te consultation system had been more or less developed by Dean Hinsey out of regard for the young doctors who were coming out of 4the war. They were not only given sfecial privileges by being allowed to practice within the hospital, but they had goed offices fitted up. .1.·hey had their own clientele, and ther1""' a group of some twenty or more surgeons and medical men with offices in the hospitals and privileges to see what patients they wanted, and they built up quite an extensive medical enterprise without 1 much of an organizaticn. ·hey kept their own feeso They didn I t put it into a pot and divide it afterwardso They were all on their own. That became a vested interest that had to be divested later on. 'fhey rerarded the plans-­ some of those regarded the plans for the diagnostic clinic as an infringement, as an activity that would decrease their opportunities for lucrative practiceo 862 Without a head, without someone vest~d with the power of an everall view for twelv~ zears--it's not sq_rprising that the pursuit of p~rsonal interest had created little principalities within the larger organization, so that the ramificatiens of that onlz come up in time as problems emerge 1 and the initi-?:! I one here with reference to the diaGnostic clinic. Its so o~ershadowed by ~e_outrage abroad in New ~York City, the fact that there were misgivin~s within the Center is overlooked, swept aside as not really important because the other was so imEortant. Well, the interests of members ef the faculty like Dr. Barr and certain members of the Governers in the social aspects of medicine and comprehensive care was very deep and constant, and it resulted in the end in the actual establishment of wha+as called the Vincent Astor Diagnostic Clinic along the lines that we've been discussing, and, in addition, the development of a very fine system of comprehensive care based on the dispensary clinic contacts, particularly with medicine. A plan developed finally according to which a student who was ass~~ned, we'll say, to a patient--they called it a case--would do examinations and carry on the study under the guidance and with the association of the docter, er resident, er member of the faculty ~'lh was in charge of that particular branch of the clinico That patient and that patient's relatives then became the family in which this young medical student carried on a supervised practice. ~hese were outpatiem.ts, and the student would go from the Outpatient Department to their Xomes in the York­ ville District, which is a middle class district between 56th Street and 90th Street, East River and Central Park, and see these people in their homes and become very friendly and helpful to them. The students would watch the course of their illnesses, or their recoveries. They would keep thoroughly 863 in contact with the hospital, arrange for revisits., arrange for cons._lltations when necessary., a very sensible plan for the indigent. Theyw ere poor people. They could pay something., but not much. The physicians of New Yoiik didn't care, or didn't bother. Thatl~as the type of corporate practice which had no revenue that they could get. h That Outpatient Department is fi. striking thing because the system Aad to be worked out whereby the relationship between the Outpatient Department and the ~achirljs missien of the hospital _and the school was made m.anifest--that is, some basis whereby1 and I may use the wrong word here, the selection of .,,. patients for illustrative purposes with reference to a student was the para- mount thing. That was a matter debated in the Medical Beard and the Governors--a very serieus thingc, A mupber of Governors thought that the doors should be open to anybody who came--no selection. It was a democratic institution., and New York Hospital belonged to the people. It had that tradition, that there ought not to be any selection on any basis at all. The teachers, professors, and faculty members wanted a selection for several reasons. They wanted variety. They wanted to get what was called "teaching material" of great value, novelty and interest. In addition., this was the very sensible basis fnr selection--to keep your Outpatient Department from being altogether filled up with chronically ill people for whom you can do nothing. If you have, say, a capacity to deal with a thousand patients a day, or something like that., as we did, and if you have started the year with that n,1mber and you have a thousand patients coming., if ten percent of them have chronic arthritis, or chronic alchoholism, or some chronic illness that is not going 664 to change very much and about which you can do relatively little, that increment of chronic invalids increases time after time so that you have no space left with which to take new patientso You can always take emergency patients, if yeu want to, and by the way the emergency service at the New York Hospital which was relatively small when I was there, has grown to be a very big thing and is very well doneo This hospital has always bem greatly interested in new ideas, new processes. In its ear).y history, which you•i~see in that book over there, it develo!Ed the first liberal psychiatric service in this country. It knocked the ch~ins off the maniacs. They had a section hospital at Bloomingdale on the very site of Columbia where yeu've been studying. That's the Morningside Heights Bleomingdale Hospital ef New York Hospital, and the Bloomingdale Hospital, the psychiatric Hospital of New York Hospital, is now out at Westchester, at White Plains. Well, they've done many things that were new in surgery and medicine, and they were always intellectually interested, generously interested in the broad things of the commurri.ty and the cou~try9 The problem of how to spend man hour time in the 0·1tpatient Department on cases that would be helpful and illustrative to the studeqt was part of the mission and not have t~hem spend most of their time on patients _that were called "returnees", people for whom nothing could be done. It was a matter of the expenditure of time and energy on the part of both facalty and students and no necessary learning. It raised quite a problem. The Governors u·1derstood thato A certain amount. of selection came ino Well 2 let's stop for today. All right? All right. 865 Yesterday in talking about the past historr of the developments of the Cornell Medical College-New York Hospital Association we may have, in a • way, misconveyed that tn the absence of Canby Robinson, or with the de~arture of Canby Robinson, a void was created. You cid say that certain powerful figures emerged one of whom was Dro Stander, and he seemed to have had matters pretty well in his grasp, but today we wanted to correct the im­ ression that ther as an absence c,f a central kind of feeling, or power used somewhere in this period before you arrived. For me, the considerations which led to their offering you this post still lurk in in erence. I don't know why--why they would suddenly want to do this, or what the forces in the existing situation were that would lead to the recognition, or the isolation 0f a person especially in this post when one had not really been there to all intents and purposes since 19351 but there were some impressions that you wanted to correct. 0 In thinking ~ver what I said yesterday, I felt that I had given the im- pression that the Jeint Agreement between Cornell University and the New York Hospital in 1927 1 had been allowed to lapse and that there was no real, central organization to attend to the affairs of the Medical Center as a whole, Tha~sn•t the impression that I should have given, The a;:re=ent had not lapsed. It remained in effect. There was a Joint Administrative Board. It held periodic meetings. It hewever did not have a director as required by the original agreement. The person who emerged as the unofficial director--unofficial as far as Trustee action on an appointment was concerned-­ was rtenricus Stander. Evidently he was recognized as an authoritative person 866 in the Center, and he handled much of the common business of the two in­ stitutionso I remembered after I had talked here, that during part of this period, anyhow, he was paid a considerable supplement to his regular pro­ fessorial salary for his services as administrator. At present we're not able .to find among these papers a copy of the Joimt A~!reement of June, 1927, and yesterday we were referring to a paper here, a pamphlet called an II Account of the Agreement •• o. 11 which really deals with the modifications and amendments of the agreement that became effective en uanuary 1, l948. I recall having written this pamphlet, and I know that the first two pages of it, while being an abstract of the main sections and clauses cf the original Joint Agreement, are almost in the words of that agreement, so that this document, if taken carefully, can give the substance e of the agreement under which the Center was op~rating from 1935 to 1947, and will show then the amendments tllt, came in through events that arose after my being there o Dr. Stander had been chairman ef the Medical Board. President of the Medical Beard. He had been President of the Medical Board fer a lon Yeso Which is a source of great influencee Certainlyo And with continuity. I think in 1948 1 very shortly after you come there, within the year, Stander died. l 867 Stander died in 1950, or 1949, somewhere in there.ffeay 2, 194g We got you in the place yesterday with some views as to the problems that emerged the way they would come ino I indicated to you that I had been reading the Minutes of the Joint Administrative Board with respect tot~ problem of affiliation between Cornell Medical School a~d the Sloan ¾ttering Institute...Memorial Hospital. These notes begin, so far as the Joint Adminis­ trative Board is concerned, in September 23, 19~9 1 but they disclose that something in the way of negotiation had been going on for some period of tim~o I thought myse].f' that there was something else lacking in our presentatien -·11 ye~\erday1 so far as you are concerned 2 and that's the connection that you'd iC had for a long period of time~-1942 1 I believe, with Memorial Hospital. 1 its Board. You'ci had something in the wa of awareness with continuit so far as that complex is concerned for some period of time. That is implicit or explicitly stated in some of the things that I told ~~out the Childs Fund. I had frequent conferences with Dr. Ewi.ng in the days : iv ef the formation of the Childs Furrl when Ewing was the great scientific director and pathologist at Memorial Hospital. He was succeeded by Dro lpoads who was a close friend of mine and with whom I had frequent meetings. I also mentioned the Memorial Hc.spital develepments when I told about the time when Mr. Reginald G. Coombe and Dr. Co P. Rhoads came to the Childs Fund, really I thought, on a piratical expedition, wanting to have the fund transferred to Memorial and Sloan Aettering. Soon after the Childs Fund had been established, in 1937, I was appointed a member of the Board of Managers of Memorial Hospital--not of the Sloan Kettering, but of the hospital. Sloan Kettering Institute for Cancer Research at that time had not been established. It came L 868 on later. It had its separate management and boards and went through, as is usual with a big institution, a complex coordinated situation like that, many, many changes of administration, policy, precedure, and eperation. They had to feel their wa~ good deal, but I never wa+n the administrative board of the Sloan Aattering for Cancer Research Institute, although I attended a good many of their meetings. After I had 1e ft New Haven, after I left the Childs Fund, I was still a m1cmber of the Board of .i.'1anagers of the 1 ,. Memorial Hospital, and I stil](w , __,,as invited in to so:n:e of the Sloan l\ettering- I Memorial Hospital meetings. I knew practically all the main people at Memorial Hospital, but I de not recall being brought in to talks about this proposed assoc~tt_~on between the Memorial Hospital-Sloan Aettering Institute and Cornell Medical School and pos~ibly New York Hospital before rather definite plans came up for consideration. There must have been a great deal+f discussion between Chancellor Day, Dr. Rhoads, Mr. Frank Heward, possibly Mr. Laurance Rockefeller, Reginald Coombe, and maybe Dr. Hinsey about these things, but I didn't hear much about them until they came to me as rather a finished product. As I think I mentioned, Mr. Pote<l.t .... Thank you--that 1 s good for me 0 LJ. Uou_l\~-..~ P OTcA,:._7/. You can scratch that spelling out later. Mr. Pote a.t (was the ma nager, or ~ administrator of the Sloan l\.ettering Memorial Hospital complex, an assistant administrator to Dr. Rhoads. He came to see me in my office in the New York Hospital, the J0int Board Office, and presented me with a set of paoehs which outlined the proposed arrangement between, we'll say, Cornell University and the Sloan Kettering-Memorial group. This was the first time I 1 d seen them, and I told him after glancing over them, that I had never given any con­ currence to such suggestions. He took the papers back to Dr. Rhoads, and that cut the matter down to where it could be examined in the Joint Board meetings, and from ther1on consideration of this proposed arrangement comes in rretty definite in the subsequent meetings of the Joint Board, beginning-­ when did you say? September 23 1 1949 o Well, of course, a good deal had gone on before thato It was nearly a finished plan which, as I saw, was so much finished that the very day that the paper care over to my place, Mrs. Bayne-Jones and I had accepted an invitation to dinner with Dr. and Mrs. Rhoads and Mr. and Mrs Howard in Dr. Rhoads 1 E!.partment on the top of Sloan Kettering Institute to celebrate his elevation to a semi-dean 1 s like position. The proposed plan, in essence, was for the establishment of the Sloan Kettering Institute for Cancer Research-Memorial Hospital complex as a subdivision of Cornell University co­ equal with the medical college, and in my opinion, equipped by the plan to take predominance. Dr. Rhoads was stirred te move in this direction by his intelligent appreciation that the Sloan Kettering Instit11te needed an educational pr•gram with a pewer to reco:iamend the a.warding of degrees, masters and Ph.D. degrees in science a.nd biology, biological sciences la1•gely, both for the improvement ~ of the merale of the members of the staff who yea~ned for educational associations and for the recruitment fo1· the staff. He could obviously get better men if he could give them a better opportunity for improving their minds and academic reward. That~s the basis ef Dr. Rhoads' concern-very 870 hifh ideals of the value of the educational opportunity for specialists., biologists and other scientists., working on cancer in the Sloan Kettering Institute. The plan excluded recommendation by Sloan ¾ttering for medical degrees, or granting medical degrees; as a matter of fact, the granting of degrees was so well provided for in the interests of Sloan Kettering that, in my opinion, the graduate school, through which these p&pers would process, would have little to say about it at Cornell. The same thing migt1t have happened at the medical schoolo The discussion after this came out in the Joint Board--I should say after it was dragged out--was very prolonged, but not acrimonious. Although there were strong feelings behind the opinions that were expressed, people kept on talking to each ether o My personal ~eeling was that Chancellor Day was so much impressed by the possibility of financial gain by the University through such an arrangement, that he would have done harm to the Cornell Medical College's interest. I think that's in the minutes. Had the_r_~_been any relationshi)2 be't:_w~ Hemorial Ho~it~ _a!!<! _Cornell Me~ ~~~i or to ~is? They'd had~-Cornell Medical School, I think, had Dr. Ewing as a Professor of Pathology for many years. In the earlier days Cornell Medical College was way down town on 1st Avenue and 26th Street, somewhere like that, and Memorial was up en the Westside in the 90 1 s 1 just off Central Park, so geographical separation made association quite difficult. They had intellectual interests, and of course New York Hospital had plenty of patients with cancer, so that there must have been a good deal of consultation going ono I don't know how much overlapping staff there was on the clinical side. 1'1any of the 871 surgeons that ore rated on cancer in the cancer hospital alse had appointments in surgery in New York Hospital, I•m sure. In addition, about this time, or through this time, this very great and fin.e personality, Dr. Papanicolaou, who had been brought to Cornell Unive: sity Medical. College by Dean Hinsey and supported there through grants, and one way or another, through many years of hard work, was discovering what's known as exfoliative cytology--t.he shedding off of cells from the uterus, or the vagina, or different orifices of the body which wo1t.ld disclose their nature when properly stained and studied. These are the Papanicolaou smears that you may have heard about, a whole basis for the)e arly diagnosis of cancer and rather more certain a basis than inspection, not as certain however as biopsy, but you don't need to do any operation to get these cells--just wash t1:cem out. That was of interest to the Memorial Hospital group. Theywere beginning to get interested in the prevention of cancero They had A clinic supported by Mrs, strang wh,,.,,. interested in cancer prevention, and the Papanicolaou early diagnosis wou1d lead to a joint set of interests between Cornell and the preventive sides, or early diagnostic sides of Memorial Hospital's work. I LYJ1agine that there were other connections. You have mentioned the Douglas Deeds of irust. The Douglas Deeds of Trust had to do with a supply of radium which Mr. Douglas brought over and gave Memorial Hospital on some conditions, which I have forgotten, but which provided for common interest in this radium to be shared between Cornell Medical. School and Memorial Hospital. The Douglas Deeds of Trust came up in connection with the study of the plans to make an association that we're talking aoout here between Memorial Hospital-Sloan Kettering Institute on the 872 one hand and Cornell Medical Cellege and the New Yerk Hespital.-0.rnell Medical Center •n the ether. My recellectien is that there wasn• t much in the Deuglas Fund at this time, and that the lawyers feund the mean& fer satistJi,ng an.r er the questiens that came up. Itwasn•t a peint ef great importance. I just rai••d it u a..fHtpath betweea Memorial Heapital and Cernell Medical Scheol. ..i. h Well, the Deuglas Deeds of Trust, •a sure., ~ad never operated to bring t~ two together. It was there and bad to be taken care ot. The mw organization in this picture then is the Sloan Kettering peoel•• I thiak zou oug~t to point out-:-eertai;_n?iil, from!>" reading of all t~ose minute,! here of the Joint Administrative Board that there was no disenchantment with this as a possibilitl• Everyone wanted this affiliation. Certainly. The only problem is on what basis is the affiliation to be made and how that ~• .to be worked out. There were any- nUDlber of 2roblems that were not thought or and were best thought ot bf delg!y the aftiliatioa until such till• as they can bubble to ttM surface and gain !!J>r•ssion. I think that's tae process we're _going through here. In rq opinion the medical sc~_ool had to be defended against its own officers and thate forum in which the matter could be viewed trom all sides vu t!a• platform or the foint •dmimatrative Board, and I think that it was., although prolonged., a profitable period or deliberation.. What w aa done then 873 is still continuing with harllO!V' now. What it amounted to finall.7 was--it caae out mucb. to the surpr1•• of Dr. Rlloads and others--that Sloan Kettering Institute is now known as the Sloan A etteriog Division or the Cornell Medical Collage-ju~ opposite tr-what ~hey- started out to do, It worked to the advantage of Cornell. You ~d to take smu triP! which are ot interest in terms of the varietz of experience to wbi.ca zou tee~ heir-ta• Board of Trustees at Ithaca. Yo_u_ ,!•cl to go there, or felt that you had t.o go there. Yes, I bad a good association, a frank association with Mr. Arthur Dean, wbo was chairman of the Executive Committee of the Board ot Trustees or Cornell University-. He was also on the Joint Administrative Board. I think I was able to tell nim that we needed to give more information to the Board of Trustees than. they were receiving froa the Chancellor. He h:laself, Mr. Deaa, tlaought that probabq I, no was aore faailiar with this than. he waa, should be a good one to try to tell them about it1 and he invited• to a meeting of the Eucutive Caudttee or the Board of Trustees at Ithaca. I veat with hill. I ' went up to that meeting. It was a rather brief affair, but I told th• about these things. The outcaa\-- tbat they took a position. opposite to what Mr. Dq had recomaended. It disturbed him, and he-as I ranember--got up and I left tae meeting sqing words to this eftec'ti; that he cl bee11 chiet acbnini•- trator of Cornell University- for the past fifteen 7eare and that this was the , first time that the Trustees kad taken a positkion ,_ contrary to some recommendation that he 1 d made. He left the rooa. I left the room with hi.JI. We weat and sat down and had a good talk. Mr. Dean was a valuable person. Be almost became president of Cornell, but I don't know whether I ought to 874 pat that down aere. H• was the oae responsible for ultimatelz eutti91 into draft fora th~ nature ''\ i !f /,,e agreement. ' I should think he wo~ltl--lle wu~n. the great firm of Sullivan au Cromwell, vllich is the international law fil"II of whica John Foster Dulles was a member at one time, I tnink. Mr Dean had a great head. He also, after this, went through a terrible experience as the United Nation's Representative in the talka at Pamunjoa with Kia, tae North Korean Communist. It lasted for two or tn-ee 79ars, didn't it? - Yea. It was a wonder that it didn't kill him. In a waz this illustrates the difficulties in managing a plant u complex as the Cornell Medical Center was becoming, let •~one existing, where parts of the machine still coat1Mned to function within their own liaits •• thez uader­ stootl th m drew tb.ea and meanin no disres ct to thea they ursued tlleir interests, but did~~t see a much lar1er view waich1 in this instance, aodified their positioa to their own advantage. ~ I recall it, t~ere were two phases of it, as tar as I• ■ concerned. One was the principles and. policies of medical education tna t you caaDOt paas on to so■e non.,..dical institutioa. Tae aecond is tllat I tbink I had a feeling that academic treed.011 as a way of lite, n.ot just as a manner of speaking, was in danger of being sold out, and. tbat oughtn't to happen. That you can decide very- e asily. The large uttera 1 u they are so otten1 are simpler to underatand and follow than the ramifications ot the personal relationships and the wiaaes of individual.a. Take the distance tr011 Ithaca to New York and the problem• wb.icb confronted their own Trustees with respect to this plan--where they didn't have the detail. It never got tu.rt.her in the Trustees than the Executive CCl!llllittee of tae Trustees, and three of thea, of course, were on the Joint Board-President Da7, Mr. PJecker, and Mr. Deaa. The distance between Cornell and New York is about two hl].-(dred and fitt7 ail.es whicll has been a severe--it's too long, and. cauee a severe isolation ot its own medical college. It's too long an umbilical cord. COlllllU.nicatioa was alvqs ltard. I suppose Dr. Hinsey had to go up there ever7 month perhaps, aaybe. I went just a few ti.Ilea. It was good ia the aanse tbat taez had someone present who was going to !9Sert a view representing the joint interests of everyone;otherwi.ae •••• That was the function. It was not a personal utter with•• That was the function of the office • .1 Yes but old habits-con.fro a void were hard to dro but you create ,!orua in which views were ex:ehanged with respect to this proposal, tile mani­ toli problw in &Df kind of aerger like this, or affiliatioa like this 1 which were unthougbt of 1nitially1 ~nd the aore talk you have, the aore opportunit7 zou give people to voice either objections, or variations on a theme until somehow the atfiliatioa emerges. I think myself' this kind ofrfroblem asserts the reason way Mr. Jackson and Mr. Dq in the first place thought it important to find someone to fill that spot 1 even though their actions might hav;e bell•,! the tact that tnez wanted s011eone like that. For ~ple 1 this seems to haYe been a e,roblea in wllich Nft' York H.oSJ?ital had no real interest, althougll ~ow the aev affiliation would affect_tlle existing yreement wu never thought about. Thia was one or the questions zou raised-if you're going to change the najure of tlle :mactd;ne, how does it affect the existing relationshipa be­ tween New York Hospital and Cornella and aobodz had thougat about those eroblems. I•• sure they thought about it, but the7 weren't pertinent-I uan the records don't show •uca talk about sqing this is soaething of no immediate concern to the New York Hospital any aore than the New York Hospital power plaftt was of concern to Memorial. There are plent7 of things in the combined joint operation that were not joint--there were elements in there, but the7 didn1t have to be dealt with in a combined tasldon. New York Hospital, I'• sure, probabl7 regarded Memorial Hospital as a part of this affair that would concern it most and its stake in the joint clinical departments. For the rest the7were r•ote troa it, and thereat was rather llasie biological re• eearcll on the chemistry-, biochemistey, cellular nature of cancer which the hospital participate4n only tbrougll clinical connections. Sloan B;ettering wu a basic researcll laboratoey. I don't tainlc this even went to the Board or Governor• of the New York Hospital. I suppose I talked to them about this at some tiae, but I don I t remember. I used to ieport to tnea, and or course there are three members of the Boar& of GoYernors on this Joint Board. Mr. Jacksoft, Mr. Whitney, and Mro Henry- s. Sturgis sitting there, or Mr. Hamilton Hadley, as Governors would see some implication in this for the hospital and shrug it orr perhaps. In addition, as I told you, Dr. Pratt, the Director 877 ot the Hospital, vu sitting in this meeting. Philosophically it's best to h&Ye people voice opinions thf to have tha foreclosed. We had another great institutioa in the aame region, aad that 1 s the Roeketeller Institute for Hedi.cal Beeearea. It ti s riiht across the street and ve constantly- noted the efforts to have informal association with th•. We actuall.T did have people come over from the Hospital or the Rockefeller i•titute and do work on some Ill tiente that had conditions which were of interest to thea. That never aeveloped into an affiliatioa, but the Rockefeller IMtitute tor Medical Researc}a 79arned to have an educational opport.nity and an educational course, and later, now, siace Dr. Detlev w. Bronk us gone there, it is aa incorporated university. It's no longer the Rockefeller Institute. It's the Rockefeller University, and it grants degrees. It was an eaq give and take between the Rockefeller Institute and New York Hospital in an informal way--they could go back and forth with ease, but there was nothing involved like this propmal that caae in of Memorial Hospital and. Sloan Kettering wanting to be a division of Cornell University oa the same level with the medical school. Onee the agreement is signed, and the agreement is signed--this newspaF9r clipPing photograph or it•••• No representative of the New York Hospital there. .f'• Yes, there is aa official agreement signed by Mr. Co011lbe 1 Dean Hinsey. ~ there, I thi,Ak-loolcing on. Yes--I wonder how-this is hard for you to assess since you were sitting there 878 at the desk, but with scaething like this, what effect does a successful pursuit of this have on the attitude or others in New York Hospital and ta• Cornell Medical School toward the Joint Administrative Board? Just a Jlinute--to go away froa that. Mr. H&Jlilton Hadley is a Governor, and he's in that picture. He was later the President of the Hospital, so he's sitting in signing this agreement too. I have no copy or that 1.1reement. There's none in the files. I No.There's none in the files. There is a series of amendments to the original agreement as signed1 and they are incorporated in the Joint Administrative Board Minutes. The agre•ent allowed for provision to work out greater detail after the original asreement was signed. I just wondered how the office, the Joint Administrative Board--whether it gained. It had been pretty much of a void tor sme time 1 but through an experience like this 1 it must have ;ained. Are you talking abou.t the 7ear? I know hwnan problems take tiae1 and this is 19500 Yes, this is 1950, but the Board bad gained a plent7 between 1947 and 1950. There were lots of things goinc 011 like tnia tllat hadn't gone on before-­ I aeaa things in which the B\ard was intereated--educationa.l thincs, budL1'ts, appoint.me nts. The Board. did assert 1tself in terms of these Minutes, but having even made u4e that position, tor a member--Chancellor Day to try to bypass ito Well, it's an interesting story. I think that it the Joint Board hadn't been in good operation at that time, 879 they~ould have succeeded in having this Sloan Kettering come in as an equal I ot tae aedical school. Its quite possible that instead of it turning out ~ that the Sloan Kettering is the Sloan ~ettering Division of Cornell University Medical School, it would have been the Cornell University Medical School D1"ri.sion. or Sloan Kettering. I A number of people won't agree witn that. Its probably too pess:illistic. This is related in a vaz1but there's the problem of beds and bed space1 and tbis 1 in turn, is related to the scarcity or nurses. I really don't want to get in to the nurses problem, because that becomes a continuing one1 an examination or the whole field of aursiy 1 but there were areas in the hospital that couldn't be opened because or the insutficiencz of the staff-­ sa,ehow o Tner e are hints and sugest1ons in these Minutes that the probl• of the supply of nurses prevents the openirtg up of new areas, beds. How to ue a bad makes a big change in this period. 1 1947 on-the whole nature of ward and ward patients begins to shift to semi-private. This is a sldllfull7 managed thing fraa the point of view of a teachillj institution. I don't know that you'd met it before in ~ust these terms. This is worth a word u to aow you noat 1 er how the idea is noated. to use semi-private bed see• and patients in a teaching institution. I don't know that it was done anywhere before. It was done infonnally before. MaOT, ma!lT bedside teaching sessions have been held on. private patients with the consent or the patient. Dr. Osler used to do it. Dr. Barker used to do it, and any good teaching pby"sician 880 probably could get the consent of his patient to use the patient for a teaching session. The patients are interested. They're awfully interested. in hearing about themselves for one thing, and the second tbing taey sense what the rest of us know; that better aedicine is practiced in tae presence of students than in their absence--not entirely always eo, but usually so. Take it as a general thing. It became apparent in Hew York Hospital that s011ething had to be done to illprove the incom.e of the hospital. That was probably the basic motivating force to change ward beds into private, or semi-private beds, but th~otner great infiuence was the hospital insurance plana~-Blue Cross. Blue Cross would make it possl. ble for a patient wllo without Blue Cross would have to coae in as a ward patient, to have )ds hospital expenses paid, if he comes in with the Blue Cross support, so the hospital had to move to make the accomodations available that justified putting in a charge allowable by Blue Cross. Blue Shielc, the first of the doctor 1 s fees-we'll leave that out. Blue Cross, the vast hospitalization insurance plans all over the country-, pay/ a certain aaount per day for a patient in a hospital, proYided the accomodations are ot such and such quality. Ward patients don't qualify tor that, although the warcl patient costs sometimes even more than one who is on a private 1ervice. At this time, really, the aospital costs were beginning to aount very-, very much. They were getting up to the amount, as I recall it, of twenty-two, twenty-three dollars a dq. ...' very much higher than that, so naturally Now its the managers or this hospital, all hospitals, were thinking ot what they coula do to put themselves in a position to get the income that would be available from Blue Cross, if accomodations were satisfactory, so we changecl hundreds of beds frca ward. beds into semi-private \leds in the hospital. The semi- 881 private accomodation was usually' a walled rom, but scaetimes you could get semi-private type accomodations by having sliding heavy screens. When a patient then is in a selli-private accomodation, the patient has certain rights that wouldn't have been regarded if' he'd been on the ward, and one of those rights is whether or not he'll be a subject for teaching and demonstration. That inunediate:cy- affects the educational program of the institution. You can readily" see how chatliing a ward bed into a semi-private bed is a •tter of great concern to the Joint Adllinistrative Boara. It is of immediate concern to the Cornell University Medical School whose students need the opportunit7 to see these patients. It is of immediate concern to the Cornell UniTersity Medi.cal Scb.ool because the aellbers ot the facult7 who have clinical appointments in the hospital are apt to be affected ver7 muck by the type or patient on whom they are carrying out their professional duties. A It is of creat importance to the clinic~l members of the hospital staff as well as of the medical school to have what you call adequate and varied "teaching material", if I can use such a phrase en I apply" it to a living patient for whm I have a tender regarci1 but "teaching material" is a stock phrase without any connotations of hardheartedness in it. We went through this at great length and difficulty at the New York Hospital. I was on the side of getting as man.y- semi-private beds added as possible and altering the situation so that the beds could contain patients willin.c to be used in the teaching program. One of those teaching programs Ter,.. seriously- affected. by this were the surgical patients. How are you going to train an intern, or a resiaent, and by the wa7 the training of the interns and resideats in this Center, as in all good centers, is quite equal to the 11'\is burden and interest in .'training of students. We train third and fourta 7ear/ '\ 882 students, perhaps about fifty in a class, on out-patients, in-patients, patients, but you have may-be two hundred interns aad residents in this whole cOJ1plex that are also in training. r eople tend to forget that. These poor interns and residents when I got there received a mere pittance in a salary, and they were mostly- getting married and having more and more childrea, ani that was another problem involving the educational joint interests or the place, but to go back to this semi-private bed business. You can see how it would tall to the Joint. Boar• to haYe some major sq in whatever arrangements were made, and I was on the side of more and more semi-printe beds, it possible, seeing the advantages of this to the hospital. jaturally', the hospital representatives would be on this side too. The repre­ sentatives in the joint center trom the medical school would have an interest and probably tend to be on the side of not decreasing the ward beds because they felt that would decrease the opportunity for teaching medical students. This went on for months with very strong peopleilike Dr. Guion at one time against doing it and sane of the surgeons, particularly the surgeons. This is a problem that comes up with the surgeon. The surgeon is going to, say, train an intern, or a resident, chien,- residents, on operations of either llinor or great dif'f'icult7, and he has to be really responsible for the outcome of the operation, but he allows the resident, or assistant resident, to pertorm the operation supposedly" under his eye. Sometimes they don't stay there, but the1 usually do. Well, that's more easily- arranged with a ward. patient who rather expects to be handled by saae of the lesser people on the staff under super­ Tision; whereu a person who is raying fott is going to see that he gets a proper serving. Well, 1ou cans ee what a complicated. tiling that would be. That ran 863 further, and this involved the joint situation al.so, because the Blue Shield 41surance paid the fee, the surgeon's tee, we'll sq, or even the medical tee. What are you going to do about that tee? Collect it? Who collects it? 0 The man who ~s the work is an unlicensed physician probably by this time., or at least unrecistered in the place. The Blue Shield retused to pay unless there was a surgeon's name on it. They wouldn't pay unregistered sur1eons. For a while they refused to pay a bill submitted by the hospital because that would appear as a hospital practicing medicine. The fees that came in fro• private patients like this went to a fund called the "full time fees :fund" which was under the administration of the Joint Administrative Board which was used not for the benetit specifically of the department frcm which the fees came because they would all have gone aostly- to surgery., but to the whole institution. That f'ull time fees fund was used by the Joint AdministratiTe Boar• for supplementation of~alaries, for the payment of premiums on mal­ practice insurance for the interns and residents because there were some very severe and successful suits against the interns and residents in various llospitals. Well, this is an example of a ramifying problem that starts with a good. idea of making a ward bed into a semi-private bed that will yield ten dollars more a dq, or sOJ1ething like that, and you've got the whole institutional arrangements involved in that simple mOTe. It also required structural alterations in the hospital both as to the walls and the nUJ11ber of people who could be on a noor, the character of the bathroou, the nursing, the food service, and the recreational areas on porches. None of it, inmy opinion, is separated at all from anything else. It all weaves into the educational philosophy- or the place., the spirit of the people, and. what it says in the 884 original Joint Agreement; to make the best possible teachiq opportunities in the midst of the best possible medical service. Was it ever accepted that semi-private patients ear se would be subjects for examination? Yes, we had great success with that. Isn't there a report on that? 0 Most of the re orts that are referred t are absent ust the es where th appear in the original co&, b11t tlle re2orts thems~,lves, exce2t for a finance report, or a Ce11ter Survez Report are not here. Well, we studied it at great length from a logistic point of view, a financial. point of Tiew, a psychological point of view. We had many bed.a set 1, apart for this. They were set apart as teacAing beds. That involved getting the consent or the faclllt7 member and the hospital. clinical member to conseat to the arrangements. Some men didn't want to do it. For those that dbd1 it worked out very well. Another influence that involved the policy of the hospital, the policy of the joint institution--the policy on the use of beds came out with a great outbreak or poliOillYelitis tha+ook place in New York-I forget in 19501 1949-1950. Nw York Hospital was reluctant to take severely ill poliOJllyelitia patients because it was perfectly obvious that if they don't die, they are going to be sick a long time. It requires expensive respirators, expensive rmrsing 1 and it requires the filling or a bed which might be occupied for •onths. That problem caae before the Joint Board as to w~ther facilities or '\ beds should be put to the use of the care of polio patients because they knew that they would be tied up for a long time. As a :matter ot fact, the Joint 885 Board and the hospital were vecy generous-probably inspired by the excellent work that Philip Stimson was doing on this subject--to take in polio patients, and we had practical17 a ward set apart for them. I think that lastea for nearl,- two 7ears. That was in res onse to a roblea that a eared. in the commu.ni t • Yes. or coarse, students haven't seen much or polioJll1'elitia, and that was of some v~ue in teaching. We 1ve gone just about an hour 1 and I think I'll turn you looseo o.K. I 1ll go see Watson Davis. Didn't I mention Watson in one of these talka? 886 Friday1 July 1 1 1966 A;...60, N. L. M. We 1Te talked a while--basc~ally i c, about the oTerriding 1 continuing Eroblea in this Cornell Medical School-New York Hospital complex-the question or finances, the increasi3 deficit in the hospita1 1 existing arrange~nta that had to be revised as in Urologr, not streamlining, but to eliminate certain duplication and save some funds which were in a sense, a drop in the bucket when compared. ' to the det~cit. This is ,a continuing question and clashes in the atmospb.ere s .from day one. Out or this there. are some problem that .r,d like you to !\ ,.., \ follow up today--the revision ft?,; bed space from ward. space to semi-private I whicn,did1 in fact, increase income for the New York Hospital. Another side ., of this finance p•cture is the continuing struggle O'Yer tae sharing or the eosts or the pszchiatric department which has its own history. The hospital had paid for its full bud§et 1 although bz this tillle the budget had been made a joint affair. It caae under the joint budget, .and out of tl'lat discussion a much wider process emerges, the Center Survez: wbich1 I SUSJ?!ct1 was an attemet to educate all participants as to what, in fact, they were deali3 with ~en it came to the question of what the hoseital does, how it functions, how the parts fit. 1'.,his is spread in the Minutes of January and Febru:irz of 1953, but the problem runs pretty much from before the time z:ou arriTe and all during the time when you were there. This is a real A.¢1,fl':c problem from the point of view of management, aainistratioa1 hwnan relations-the works, becaus.! the whole hUll&n storz is i,n every one or these issues. I don't know what 7ou 1 9:_care to say about them1 but it struck me as a kind or later handling on a different level of the kind and quality of problems that lou had on a much smaller basi• when at Yale. Here u 1 re now in a different osition-- 887 ou•re deali with Deans Presidents of UniYersities and Presidents of be Societz and gettig thea to caew a common diet with reference to knowledp about their own institution which is the important thing. \I I think you 1 Te seen what is the central poi:e at issue, and that is the financial situation existing between Cornell Universit7 and the Society for the New York Hospital. The problem of financing the joint combined institutions was there when they first combined. They didn't have enough aone7 then to do what tb.e7 want•• to do. 'rbey had to raise a lot of mone7 to build these buildings and both tor the aedical school and the hospital. They got .Uliona ot dollar• by" gifts at that tille from Mr. Harry Payne Wbi tney and. trom the Rockefeller Foundation some or which vent into the Society of New York Hospital and sone of which vent into the Cornell UniYersit7Medical Col1g•, I particularly' the Reckefeller gift of soaethi~ like a million dollars which at l.i that tiae had a string tied to it; that it aust be used to support the t\11 time system. The7 argued about expenses from the beginning--! should say in the late 1920s when they first began to get together. These questions became aore acute am difficult to settle when they c011pleted. the structures on 68th Street to 70th Street and moved the hospital and the medical school up to that location. At the same time they were doing that, the expenses were increasing very aucn, and the income was not. Thedeficits were customary over all the rears or this combined institution. They had :made previous attempts to find out what they llight do toteduce those deficits, and the characteristic behavior eftn before +- of Trustees and Governors to appoint someone to make a survey was exercised to th• place, and that vu Basil c. MacLeaR. B~ MacLean 888 had been tae Director of tae Strong Memorial Hospital in Rocaeater, and he was supposed to have been very- sharp in those 11atters of adllinistratiou. I remember reading Dr. MacLean•• report, but it didn't seem to me to have alJ1'­ thing in it that was very good. for the place. It dealt with details, and I don't believe that be understood eitho+h• apiri\, or the acope ot tile school and the hospital. I was brought there by Mr. Jackson largely under the banner ot being the deficit eradicator which, I quite hoaesU,. believe, would be a proper calling for an aainistrator. I bad nad experience reducinc deficits at Yale and knew what it aeant when 70u started to cut the salaries, maintenance expenses, and aeMice expenses in a great teaching institution which wu coupled with the care or sick people. I felt at Yale to do too auch of t.bat would destro7 the place, and. I felt at the New York Hospital-Cornell Medical Ceater that to cut as much as even ten percent, as I told some of tae p10ple, would cause the institutioas to fall in the gutter and. 'be o'bjecte of ilsgust rather than or charit7, that nobody would pick them up, that they would lose their staff, that they would lose their morale, and that they would lose their opportunity to make the contribitiou that were responsible for their being a creat hospital and a creat medical school. I had these two tlaought ■ in aind.; that it would be good if the deficit could be cut, and that - it would be diaast~rous it the cutting harmed the institutioDB. I don't think that's aabitendency, or san.ething that would make you entirel7 ineffectual, unless you tb.ink a very- ruthless, forceful, eapelling aainistrater-type or behavior was proper. 1 •a sure Mr. Jackson and the Governors knew from rq past that that wasn't th• kind of person I was. I didn't have aey- capabilities or doing a thing like tut. The story- of the finances and the d ef'ieits are all laid out in this report here which I think 889 would be good to list as you do some of these documents in the part where we're talking about them. /Report and Reconnendations Relative to Reduction ot the Deficit of the New York Hospital, October 301 l95"Jl There's no use rehearsing the whole detailed history that 1 a in this report of the Center Survey Committee of Mq 81 1953, a committee composed ot myself, Dean Hinsey, and Dr. Harry Pratt, the Director of the hospital, to 1 go OTer the whole center 1 s history, arrangements and mutual affairs. It s all in there, so there'• aot much use, in s,y opinioa, to try to sU1Rarize tne details. The deficit shows up aa being very large and of a size that can be manipu• lated. When Mr. Langbourne M. Williams Jr. wanted to throw in all the de­ preciatioa of buildings as well u equii-,ent, y-ou could make a perfectly huge deficit that exceeds an;r prospect of being 111.ped out. I never belieTed in putting in those depreciation figures. Yale UniTersit7 never depreciated.. The buildings were given to them in the first place, and they would be renewed by eifts. They didn't depreciate equipnent because they considered the wearing out of the equi}'.Bent as a part of operating expense, but Mr. Williams ued to call it the "vacu1.llll cleaner point of view." Vacuum cleaners de­ preciated pretty- quickly in his mind. I thought of them as just wearing out from use; in fact, I never understood depreciation in tne sense that big word. would imply. I think: that it would be some wise setting aside of' re­ serves for replacement of things that wear out, what one does ordinarily-, that that would have been a better way to look at it than to throw a big figure of depreciation in a budget, when actuall.J' it didn't depreciate. Taere was no money- set aside. They would depreciate one percent a year, we'll say. They didn't set aside one percent. a year to meet that cost of wearing out. They just put it in the budget. as something they ought to haTe done and couldn't do. I never was buffaloed by depreciation in the sense that soae people want to use it, but still it 1 s a talking point, and it can make a set or figures look terrorizinco These were difficult matters to handle, and, as I often have thought, it seems rather remarkable taat I was allowed to stq there during these periods. When I lef't after all this talk and work, the deficit was very much larger than when I went there. It hardly- sounds like successful adainistratiou. Oa the other hallfl, from what I know trm what people have written me and. evidences I have from relationships, the administration was successful to the d. egree tha 1t it brought the place a \ln:i ty- that it didn't have before• The me~~dical school and uniTersity- Trustees were given by the Joint Board. more information about tile whole center than they had ever had before, and I can sq that same thing about the GO"lernora, and when I speak ot tae Joint Boara, I am de­ personalizing myself because I was the mouthpiece, the instrument of bringing these things in verbal form to the Governors and to the Trustees nd supplying them also with a great deal ot written information. The two questions that you refer to; naJnely1 the reduction of the ward beds by- a hundrei and the attempt to bring out a sharing of expense of the Pay-M Whitne7 Clinic and the Department ef' Psychiatry between the medical school and the hospital involTed a great deal ot confiict from which, to tell you the truth, I didn't surfer in the usual sense ot being battered by a battle. I did suffer because of the implications of the actions contemplate•• I couldn't bear to think of that place going down in alJT way-. It had a won• • at derfu1 tradition and h1stor7, and it had a great capacity and productivety the tiM both in the medical school and ia the aospital. The hospital was un- doubtedly the more renowned of the two~artners in the joint operation, ao auch so that I can recall some of the Governors asking me whether the Cornell Medical Schoo}. was an;y good. I never heard the Trustees, or al\Ybod:y in the medical school ask whether the New York Hospital -.s any good. It was notabl7 good. The Cornell Kedical School was rounded in 1898, and it had to struggle ~ all the time and(relatively' .L y~oor, but it had a distinguished faculty, and it was a good scijool. I didn 1 t think until the end of 11f.Y time up there that the Governors really knew much about th• medical school and its accomplishment. The same might be said of the TrllStees at Ithaca, although they did show 0 aor• concern with the S~ciety of the New York Hospital periodically'. One tf the stated meetings every 79ar of the Trustees at Cornel~•• held in the Board of Governors• room in New York Hospital in New York City. I think that that was superficially a gesture to indicate a relationship between the two institutions, but I think it was also a measure of convenience because these Trustees had a great deal of business to conduct in New York, and they woula have had to coae down to New York City- at least once a y-ear to handle the atfaira of the university properly. An;yhow, tner41ere Govemora present tor parts or those11teetings--not the serious business part, but the social part, and it was a good thing to do. As it went on toward 1951 to 1953, the Governors appointed me to handle the-not the Governors. Excuse ae. The Joint Administrative Boari appointed me to handle the task which we have mentionedJ namely, the reduction tf the ward beds in order to decrease the deficit by bringing in more inccae for the hospital from the semi-private service that would be created by a change in the statu or beds. The process, a• you call it, by which that appointment comes about is this/4 The Goveraora notice that there is a great def'icit, and they talk it O"f'er witll officers of administratioa who clearly- 892 point out that the major factor in the deficit of the New York Hospital is the free care and. the underpaid services that the7 render to the sick poor of the city". The Governors are horrifiefl to think that they are going to have to reduce the gratuitous services that their institution renders, but the7~ut \ ~ know that it aust be looked into, so the Govemors asked the Joint Adainis• trative Board to direct the President ot that Board--President so-called-- to look into the matter and ccae in with some recaJ111.endations ae to how the income or the hospital can be increasecl by some three hundred thousand dollars a y-ear. The President of the Beard, ay"Self1 looks in to a good man., things, and. n• knows from his experieace an.cl .fr011 what he knows about other hospitals, 111iicb he sharpe1>11 up by Tl.sit ■ during the • - r , 1-- tille clurinc tho year, that there are two wqs that 7011 can reduce expenses of tree, or under­ recompensed costs of the sick poor. You can close parts of the hospital, or change the status of beds trom non-paying beds to pa7ing beda. At Yale I went through that 'flhen I was required, as Dean, to cut fift7 thousand dollars out or the first budget that I had to deal with. One thing I did with the approval. or t' the Board of Pe~nent Officers up there and after auch consultation was \ to close a whole ward in the Hew Haven Hospital. I think it remained closed tor a better part or the 7ear. Whether that did anything to reduce the deficit of the New Haven Hospital I don't know. Costs are aounting all the ti.ae in other wa7s, and when you close the ward, income falls off. It just seemed like a vicious cycle-if you're losing money on an operation and you cut off what money you have from that operation by discontinuing it, you're just going to lose ■ore mone7. Doesn't that eeem so? Yes 1 it doe•• 893 1 Well, we d.ecid.ed at New York that closing wasn't the thing to~o. The next rational thing for which you could find a paradigm and otber example ■ wu to change the bed. from a aon-paying bed to a paying bed by changing ward beds to semi-private beda. The change-aside .from the involvement of \I struct_\1'al matters such as plumbing, bathro011S, partitions, things like that-- involved the educational program for undergraduate students and particularly the training progrUls for residents and assistant residents, and particularly in surgery- because the people on a pay status would not ~ul:ait so readily to being, as we sq, workei up and then operated upon by a rybody-, by the residents, if they could help it, or assistant residents. They wanted to be operated upon by the chief men in the specialties, or the serviceso That was studied for ab.one tiae, and the details are in a printed report which I wish you would I list when you get to that--this one of uctober 30, 1951, on the Reduction of the Deficit in Hew York Hospital. I presentecl the decision I had reached to the Medical Board first because the proposal affected the clinical departllents most. fhe proposal was to re­ duce by- a hum.red bed8--to take about twenty out of udicine, about sixty soae out of surgery-, and perhapa twenty more out of obstetrics and gynecology-. The proposal didn't touch pediatrics-poor little pediatrics had things listed ~ as bed.a that were bassinets, and they bad reltively few beds. The Medical " Board gave prolonged consideration to this proposal. Members of the Board and I discussed it separately, and then in a long, long session, it was presented to the Boa.rd, discussed by the Board, and mosf of the full Minutes of that discussion are in this pam.phlet here. 1:o what extent is this process involving the change in designation of beds I t,eical of the time~ In my judgment, it a the hospital responaing to currents 894 outside the hospital. You could see th3t because at the same time we were considering aeana by which the hospital would be paid mere by the City of' New York, tor one source. The City of New York, we'll sq, set a per diea on the care of indigent patients--we'll say it was twelve dollars a day when it was eostiac thirty- dollars. We were all the time trying to up that amount rrom the City, and in addition, Blue Cross was paying a certain amount of medical insurance for a patient who had a policy with Blue Cross to meet the cost or this bed care, or his stay in the hospital. We had incessant arglllllents with the director•, man.agers, and financial people in Blue Cross to get them to see what it was costing the hospital and to get them to raise their pay to the hospital for their subscribers. '!'hese figures were so large that Blue Cross didn't dare raise the premiums on their subscriber contracts to giTe them enough money to gi.Te to the hospital what it said it needed, so it wouldn't be solTed. Tb.ere wasn't enough money, but it was increased by fifty cents a clay, or a dollar a day'. Dr. Pratt worked at that all the time, and I used to work at it. Those were indications of ■O't'ements in the population, or in the civil community ou~de the hospital, in relation to the hospital to meet the I costs of medical care and the more nearly they could meet that cost, the less the deficit would be, so that there was a constant effort to do that. That was aside from the change of the status of beds, except by changing the beds trm ward beds to s emi-priTate beds, you had more beds available for subscribers to the plans. I 1 d onl. like to make the comment about this pbetic as of 19511 in this comment here--the indication that the trend is going to be towari. voluntarz:1 or governmental plan•• 895 i~., Yes, it says ia there, which I wrote, that it looks as if~ the futUN there wouldn't be any ward patients and of course., now--this is July 1, 1966, and medicare begins today'., an enormous goverment outlq on medical care which is interesting to me in another way because the Kaiser Plan in which Mr. Jackson was interested at the beginning and which has been so successful, was promoted by Mr. Kaiser as something very tn>ical ot the .American Way of Lite, that they would rather support themselves than to have the government support them. That was said just the other day, expressed by Mr.--well, I read it in the paper•••• Someone commentin,; on medic~.~? Yes, this public figure said that he would rather pay his doctor than to have his doctor paid by the government because he felt that the doctor then would be worldrag tor him, and he had a sense of controllilll the roctor in a way, or at least being nearer to him. fhat also was a sentiment by' such fine doctors as Dr. Francis w. Peabody and others in the earlier days• They had said that they would rather have a man pay them two bits because the eJlchange or money between the doctor and the patient. rather ~nited them in a more re­ spectable relationship than if a man didn't pay anything for his care. With all du~ respect to philosoehical things, that can becane a fixed idea­ zou know_, the need for that r ela)ionship 1 or the need £or w,ard beds in edu­ cational matters for the school can become such a fixed idea tha~ ~he manage­ ment of the hos ital can't see its w all parts ot the complex to something whollz.new which m1,ht also help the deficit which is what I think that report did. This report was discussed very thorouchly in my presence and among the members or the ~edical Board first with strooe ~tatements of opposition, and very- plain statements that the chiefs of clinical depart.ments feared that it would reduce the opportunity for teaching, training, and research. It was presented by me to the medical faculty and explained, and they had the same sentiments. Though they weren't so deep~ concerned in the clinical research, 'i yet they had much concern with the medic~ education of third and fourth year I students, and even earlier the students are trained in the hospital too, and it's not so commonly known that these so-called pre-clinical departments a.re constantly making contributions that are of great value to the clinician. For instance, in biocharlstry al the New York Hospital-Cornell Medical Center Vincent du Vigneaud, a creat professor there who won a llobel Prize, discovered u the hormone that has to do with the contraction of the uter,'\s and was of very great importance in the obstetrical ~ctice of the Lying-In Hospital. They all expressed the same anxieties and the same opposition, but euriousl.7 enough the Medical Board endecl its discussion id.th ta• reco:mmendation that if ne other way could be found to\xreduce the deficits than to change these hundred beds from ward beds to semi-private, the Medical Board u heads of departments would do all they could to cooperate with the Goveraors to see that it went along tell.\ The medical school faculty ado{:t,ed the SaJJle resolution in the same worda 0 I look back on it as a very remarkable sort of ending. I111s present when those votes were taken, and I don•f recall a01body looking at me in an ugly fashion, and we continued to go along and working for the whole institu1ion as ever. The beds were changed to semi­ private fr0J11 warti beds, and the next report shows that two nundred and fift7 thousand dollars had come in, so it was all right. Was it possible for the hospital and the medical school to gain access to semi- 897 grivate beds for teaching purposes? This was another educational gambit in the sense that a patient will have more available to him if' he has more peoele around who are considering his cue. Well, the way that was managed was to solicit the interests of certain • surgeons, we'll say, who would be willkng to try to work under that scheme. \ Thereiwere sane surgeons there who wouldn't have anything to do with it, so i l we didn't try- to have their patients put in to these situations. It was an adjust.Jlent--like Dr. Preston Wacle who was very much opposed to this, a a&rYelous, fine surgeon, but he said that he would ii•ork with it, am he did., as did Connie Guion naturally--she 1 s so public spirited and understooa this, and although opposed, worked with it. Many other doctors in the place wouldn't have anything to do with it, and there was no attempt made to force them at this time to cooperate and collaborate. 'l'here was a time when• had '. t• offer a yes, or no choi¢ce _,, to the doctors who had private practices and etfiees in the hospital, but that's a different 11&tter. There was experience afforded which enabled them to re'fise their notion of what a ward patient did for education wh.en they can get it on semi-private. Once the idea waa noated. 1 it eut in being something whol:I,: new. Yes, the patients were well treat••• )hey were studied well, and a great i,,. many of It hem liked it. They telt actually" SOiie times that they had. been I - skipped on the rounds, or sc:ae study, and they complaine40 You know-the introduction of something new, or sanething not entertained ana it becomes new and novel 1 it takes a little time for it to become warm and. familiar, and then it is never a problemo 698 No, it was never a problem. That school, that combined joiit/~ operation ' \., was willing to try new things. We pro'bably won 1 t talk about the caapre­ hensive •dical care progrua that was clevelol,'B d by Dr. Barr and. Dr. Georce Reader in the dispensary- and other places-the Joint Boar& was behind that, and it oaae on rather late, but it involYed a great MarJT readjustments and changes on an educational basis. One or the implications of that is that the deficits, in part 1 were chargeable 0 to ~utpatient care 1 and the dispensarz--1ou know 1 and sme means had to be found to make the Outeatient Department more selectiYe in terms or the cases taken for educational purposes than to simpll have the continuation or tbe same people~. We spoke or that last time• Yes 1 but this was going on too--a new wa_y of thinkiy about it1 functioning with an Out_,eatient Department and dis.Pensarz. It parallels this other develoe­ •ent. I like that re ort and. the documents that are encled to it the way all P!rties were granted. a hearing to give vent to their philosophical point of View and once those are aire41 they see the neceasity of doing someth11!J about the deficit ev,;~n if it meant swallowing their philosophical Yiews1 or learnia& something new1 and this is 1reat. I I think this report is far more than an administrative doCUlllent. Its a history of thought, a history of feeling, and a history of relationships. K Riint1 This was quite successtul 1 and the zear 1 s el\Eerience did show an increase in income of a quarter of a millioru. dollars. While it didn't erase the deficit--no, it didn 1 t. The other 1 in a sense, wrangle is char1eable to 899 a relationship that sprang 11;e illitially between the P!l!! Whitney Psychiatrie Clinic and the Medical Schoel and the Hospital wherebz the head of the clinic 1 Psycbiatr1st-in•Clliet 1 and I guess the Professor of Pszchiatq in the Medical School were the same person. Oskar Diethela. ! verz sood fell•, but the point is that the assumption was that there were suffid.ent funds available to sustain it and therefore it becaae a roblem of sea• disinterest to the Dean of the medical school because this fellow had three hats that he wore. ~•ve put it in a crude way--perhaps 1 but the budget didn't o throu h the aedical school tbe medical art of it and the uestion that ultimately comes up is the sharing or funds again for this particular clinic. It too runs into deficits which appear on the Joint Board bu4iet1 and the problea is further stimulated by the committee, the Payne Whitney s Pszchiatric Committee, who also1 I gues•• were ~ . , A◄ hard-headed people, '\ who didn't like to look at red ink and so'!&ht aeans whereby they could escape the stain which coaes from it. In a& event1 it becames a pretty severe 2roblea1 though I suspect it's net effect is to mere• in the study of the whole center. The endowments for the Pay-ne Whitney Clinic came from the Payne Whitney family, Mr. Payne Whitney, in two allotments. One was ll/300ths of the estate, and the other was 8/300ths of the estate-I think they were something 'I l i like that. One was p~inly for the Payne Whitney Clinic, and the other one was a little ambiguously stated. The smaller one had a possibility or being interpreted as being a gift to the medical school for psychiatry- in the medical school, but it was kept by the Payne Whitney Clinic, so it looked as if 900 the funds for the Payne Whitney Clinic were all there from the gift.a and that the Trustees would ~ver be called upon to put aey money up for them, and yet the Payne Whitney Clinic was a functioning, teaching part of the medical school right from the start. They began to introduce pretty sooa psychiatry into the first year and~nto the second year too, and there were plenty of people fr011 this group in psychiatry in the third and fourth year. The administrative setup was complicated as you have indicated by the existence of the Payne Whitney Clinic COIDDlittee of which Mr. Edwara w. Bourne was chairman. That interposed a strong legislative and authoJtative body between the Joint Administrative Board, between the President of the Joint Administrative Board and the Payne Whitney Clinic and the Dean of the school and the Payne Whitne7 Clinic because the budget went first to the Payae Whitney Committee, and it was decided then. It did get over into the Joint Budget, but the medical school had hardly any look at it at all. No other department was so fenced off by a controlling board as was the Payne Whitney Cline, except, of course, the Westchester Division which we won't consider here-it was psychiatric, and it did some teaching, but it ran on its own. v The disc~sion of the Payne Whitney Clinic finances from the point of Ti.ew of the sharing of expenses between the university and the hospital, meaning the Payne Whitney Clinic, got veey acrimonious, and I think I say in that report on this Center Survey that there was more harm being done to the joint enterprise by the arguments and name calling over the Payne Whitney Clinic situation than by anything else and that something ought to be done to clear it up. We had no <lifficulties about it, as ~mcall it, in the Joint Boara, except one time when Mr. Bourne tried to get the President of the Board to get rid of Dr0 Diethelm. I don't know whether that shows in the Minutes or 901 not. He thought Dr. Diethelm ought to resign. In addition, he wouldn't raise Dr. Diethela ts salary-, and Dr. Diethelm's salary was much lower than that of medicine and surgery. We couldn't get it raised far a while. In addition, the Payne Whitney Clinic Committee declined to approve a budget for one year, but the Governors of the Hospital thought that was rather drastic, and they dis­ app~OTed it, although the committee hadn't recommended it. It was a pretty hard slugging match for a while. I think it more or less quieted down. When I broucht it up for final settlement I was pretty nearly finishing my term, and I don't remember what happened. J\ I infer from the notes that I h.ve read that it did reach a point where it got these Minutes conve a suggestion is made that the whole center be surveyed1 so that they were able to deal with this situation as part of a much larger study be muse of the views expressed by certain members who looked upon the medical school as 1 in effect, free loading. It was easier f'or them to make that comment than to scratch the surface and see whether that1 in fact, was so1 so they •re able te avoid dealing expressly with this psychiatry problea and deal with the whole center, as you did in this survey. LReport of the Center Survey Committee to the Joint AdministratiTe Board1 New York Hospital-Cornell Medical Center, May B, 195'fl That led to the appointment of this cmmd. ttee on the Center SurTey--Dean Hinsey, Dr. Pratt, and J17self. I It s one thi one I s own closet to ex r ~ss a view which soothe one's anxiety bz: 11&king the comment like "the medical school isn•t carryi.111 its own load1 and that's the cause of all our problems." It's quite 902 a different thing to set up a process whereby on.e can express this and express I it openly and publicly and then have the direction toward.1 "Let s find out.• It doesn't figure any more because once this report is completed., they can close their eyes if they want to 1 but if they want to talk about the center as a center, they've got to ;o to this report. I think so. In this sense 1 maybe 1 you were raising the level of discussion and argument by informing thw vario1111 members who had the ul ti.mate judgment to eitercise , I suppose that's the outcau. To tell you the truth, I don't remember being aotivated that way- 0 I think what I have here in this report is what any scholarly person., if I can call myself a scholarly- person., would d.eo It ku a bit of history-. It tells current events. It tells where th• problems are and it suggests solutions. When I read this 1 I got the i.llpression that what you had done for the center A as ! I whole was killii or an autopsy o No, the center was alive. !ou can 1 t d+• autopsy. ers. You talked to everyone you could. You held thirty odd meetin§s or so. You discussed it with two other parties. e We collected an enormous Ulount of ~orts. We haa great help from 903 Mr. John He Keig, the financial •••• The comptroller. Yes, the comptroller.} I think that I was the one vho~ad the most opportunit7 to go in and look at those things because both Hinae7 and Pratt were inhibited by their official position. Hinsey bad a curioUB appointment as an Alumni Trustee or Cornell which bothered Mr. Day. He ffe. Daif said at one tiae that he forget to tell the medical faculty that they mustn't do that. Hinsey was an Alumni Trustee or Cornell, or at least a faculty Trustee or Cornell. Pratt felt that he had so maqy stated obligations as Director of the hospital with special interests that he couldn't be i.lllpartial about saae of those things. Which is probably true 0 In the end here under reco11111.end.ations both of th• disqualify themselves from some parts of the recommendations. I think that we said in the beginning or this--attention is called to that in the beginning, and it does appear at the end too 0 But I think that what the process disclosed is that there isn't any solution - to it. The outcome of this report was general acceptance of the report as an ioforutive doc,_nt, •➔ think that people l.ike Mr. Hadl.q and Mr. Wnitll07 on the hospital side, probably Mr. Neal D. Becker and Mr. Dean on the university 904 side appreciated. it. In the timejremaining tor m;y tenure there, there was nothing brought up tor action on it. The opposition came fran Mr. Bourne, or at least the criticism euie .frCll .1.~. Bourne. He gave me a note saying that I was putting -vself in an impossible position by this report, a n.d he was disturbed by what I wrote about psychiatry in there. I think the Governors were surprised by the first statement in the con­ clusions, and I remember writing that; that the medical school was payinc its wq. I really think so. They didn't argue with me about that. They probably laughed. I don't think so because the traces were available tor them to turn to another recommendation ultimately; that the problem isn't tging to decide who is responsible tor what d ef'icit where 1 or cutting up the total portion into little compartments-you know1 and aiding one to the disadvantage 1 or at the expense of another. That wouldn't reduce anythinco B:1.ght 1 but the important thing was that both the medical school and the hospital ought to indul.ge1 for certain purposes, in a joint fund collecti!!§ scheme. The whole trend toward expenses is getting higher and higher all the time-the course or expenses is going up all the time, and the deficits will doubt\! ss do the same, and the need was for funu. It would be easier, in­ stead ot wrangling as to how we got there, to go out and s011ehow establish some means whereby we can have a joint claim1 or appeal for funds which will aid us. I think that does come out of this. In the last two or three years, the Society of the New York Hospital has gone out fund raising, and they haTe raised about fifty million dollars. As 905 tor as I knov, Cornell Universit,r di+t join theoe fund raising eftorta, aside from some special efforts of Dean Hinsey, and the new dean didn'3t do auch in that. They did aome though. Dean Hinsey- toward the end began to get quite substantial grants and gifts from the Olin Foundation. He knew the Olin manufacturers, and he got money for a new dormitory, money for the new library and for a new building in the place, and on his retirem.ert. now, five hundred thousand dollars has come in to make a Professorship of Anatomy in bis name. Also in the last year a gentleman named Mr. Israel Rogarsin all of a sudden out of the bll.2 gave five million dollars to the Society of the New York Hospital because, as heetplained it, he met the new dean who took him throufh the place and pleased and impressed him so much thal he gave five million dollars, but he gave it to the New !'brk Hospital. Now I•m sure-I don't know what's going on, but I imagine in the generous lfa1' that these tp:ings are done up there that that will spread over to the benefit of the clinical departments, the so-called joint departments. This process of bei91 Pres_!dent of this Board in a way is establishing.! process which thez can all follow, an 02en ended process. There isn't an answer anywhere. There's a continual look, a peek at what exists and how best we can adjust to meet this 1 or that1 and if everyone will sit down and talk up, out of the chaos perhaps of their own petty views, something broader in supEprt of the Center as an idea can em.ergeo That's _what's in these notes, what's in these reports. I don't know how the President and the Joint Board functions now1 but you must have put in some pretty deep piling for that verz 2rocess 1 and that's good-like educating your own rulers. I don't know how these things happened 0 I remember one period of rather 906 hopelessness in the process of carrying this Center Survey out to some con­ clusion. It came to me when I was in Chicago. I wandered into the Chicago Art Museum down on the lake front, and I sat down in a room in front or a picture by van Gogh. This is a gorgeous, golden yellow and pale green, light green picture or part of an apple orchard with yellow nowers and thinge in the field under it. It seems foolish to talk about it, but some solutions came out of the musing in front of that picture that I connected with sane of these staces--I still remember it. You know-it puts a tremendous premiua on discipline. Discipline of what? Sel:t'-discipliDB to keep your e-l! on the bird on the wing; name11,_ what to do ~ t the problem and not get involved in the baronial conflicts between Qi::ople who are othwrwiee decent people 0 I don't ,._..,ber an,Ything 1ike that, I didn•tbav• any operative function., except maybe in connection with the full time .tees and oi:erations carrying out some or the resolutioru, of the Joint Board, the change off of the doctors fr011 their private practice, operations in connection with the Professor or Radiology whose resignation had to be obtained-that's different from the operation of running a hospital and running a department. Perhaps the saving thing in the situation was my early appreciation of the so-called title of "the President or the Joint Board," sitting at the head or the table between the President of the University and the President or the Board of Governors " or New York Hospital both of when had enormous power in contrast to the meager trappings of the so-called President or the joint affair. Perhaps this 907 aroused a sense of humor that was salutacy. The analogy that I got when I read some of the early notes, having learned to !£now you real well--it was Daniel entering the lion's den--reallzo Daniel knew he was going in the lion's den. He could see wht they were doing. He saw the lions. I didn't see the lion's den. No1 but it didn't take you long to dig in alo9 certain lines, and that was tbe approach you had--if it was no aore than creating means whereb7 people can ve vent t at it is the •re feeli and thinki o They used to do that. I had a big desk in the room that was assigned to me--as I say, a big portrait of Valentine Seaman behind me on the wall, an admirable surgeon in the early days of the New York Hospital, and on the left hand side of that table was a pretty comfortable chair 0 I think it was occupied most all the time by som.ebod7 from one of the departAent•• The doors were alwal"S opea, and. the7 could come in and sit down and talk. You ran an appointment book--you had to attend meetings. Yeu had to see people at certain ti.Iles, but nobody had to call up first before they could coae ino I think we 1ve gone as far as we ought to go tociaz. Next time I•d. like to go be ond the hos ital as a hos ital to this of Hospital Care am then talt!,•• u IrTe got the other tw••f Is this on still? Yes 1 and then take another look at•••• 908 Wednesdaz, July 61 1966 A-60 1 N. L. Mo Are you tinished with these books? Y~s 1 though I want to look at this one again. That's a deep one, isn't it 0 Yes. Todaz we want to take a look at the nursing profession and its problems as they were revealed to you as President of the Joint Administrative Board. We have not had a chance to sEeak of nursing. We talked about the laboratorz, the need for a hospita.in medical education, and we•ve sort or not avoided it, but nursi Board one of the segments of that total complex was the nursing school, and while you've gb·en me sane books to look at which tell sea thing of its back­ ground, r·ts history1 the problems before the Joint Administrative Board were largelz financial, s011ewhat administrative, an effort to d etine more c1earl7 l!hat the nursing service for the hoseital was and what the schooL of nursing bad becOJlle. This is also riod short atter the war whea thffe 1 s this tremendous increase in the scope and cOJRplexity of medical care. There's a 1reat de11and. put on the nUMber of nurses that are available, and decreasinc numbers of nurses are being educated, and this shortage takes zou into surveying the field as you did in this study'. This is a period in which zou got deeply involTed in nursing 1 talked not a little witb some of the figures ,\. ', who were instrumental at tj1hls time in thinking about the field1 and you even \ wrote an essay here on the need for research in nursig L"The Role of the Nurse in Medical Progress" 50 American Journal of Nursing 601-604 (1950) .J This !8l open ~Pa Tein ot experience that you did have which is still of 909 rl.tal interest to you. I was interested. in the COllllllellt that you ucie before \urning this maci!;ine on with respect to the whole concept or the developn.ent ~f a hierarcey in the pretession. As or this tillle this -was still a 4eTeloping process. It had gone froa awrenticeship toward a profession at Hew York Hoseital. I doa 1 \ know where it was on that highway. Where nnrsing fits in the total scheae1 its relationship to research, and it has a history ot people too for whca you 1Te had a great regard--all or them. bendiy an oar, " I think1 in the direction of aore and better edtcation for nurses, more clinical coacern1 the use or their povers or ot those povers--particularl,- Dr. Welch and. Dr. Winslov1 but not limited to th••• Maybe what I have said will help to set the scene. I would like to go back of even the things you 1Te mentioned with regard to rq connections with nursing. I vividly recall thatrhen I was a medical student substituting on the wards at the Johns Hopkins and as an intern that I had the good fortune to have two head nurses who were remarkable women and who taught me a great deal in my owa medical, educational experience. They taught as bedside teachers almost as the professors did--they were acute in their observations. They-were able to express themselTes., and the1 knew more than just the s11perficial symptoms that they were administering to. That was followed b;r a really very early interest in F1orenc• Nightingale. I,lll glad to say that I was one or those who early appreciated the force and vipr and intelligence of this worra n and despised the picture of her as the "lady with the lamp 0 " I wan 1 t sq "despised" it, but it was so sweet and sott when she really was a driver. She was a coilllftanding officer. She, of course, was one of the early observers of the shortage or nurses because in the Crimean War, 1850, there was a great shortage of nurses with the British 910 C forces and with the French -?\rces that were fighting the Russians at that tille. norence Nightingale introduced many, many things-new things in nursing. She had some pecu1iar ignorances and a hard headed objection te the germ theory of disease. She believed that one disease could tum into another one because, as she said, in the hospital she saw pneumonia turn into typhus fever. What she saw was cross infecf.tons in the hospital, but she t took it as one disease changing tnto another. She was very clear headed, and she introduced public health nursing, cOJ1U11unity nursing-wonderful for the time--care of the sick and wounded. She organized the British Indian Medical Service. She was a creat advisor to the government of Great Britain showing what a trained nu.ree can do who is intelligent, able, and has the right con­ nectione. She did have the right connections. She was well bcr n, and she was close to some of the higher officials in the British Government. Fortunately after that, I had the good luck to know some remarkable nurses in the United States. Most of them came from what1as later called the Cornell Universit7-New York Hospital School of Nursinc, but it was the New York Hospital School of Nursing originally. I knew a little about Lillian Jald who had some social ideas about the Henry Street Settlement, Miss Irene Sutliffe who was the head of the nurses when Lillian Wald was in traininco The nurses who took care of the typhoid ~ients and the wounded from the \ Spanish American War in those great campa. on Long Island were able people, mostly trained in New York Hospital as nurses, and they ha1to suffer with the C. usual dowa the nose gla~e of the people who were so-called employing them. They were thinkers. They were origins. people 0 Among them also in World War I was Julia Stimson, Secretary Stimson 1 s niece. When I was at the New York e Hospital-Cornell Medical Center we found a marble statue 'f{f Ju1ia Stimson which was out on the grounds of the Philip Stimson family home--Fbilip Stimson 9ll being my classmate at Yale--and I persua~ed him to give this to me. We put I it in the hallway of the School of Nursing because its good for those women to see heroic figures just as it's good for the medical studeat to see the four doctors on the painting by John Singer Sargent, or some great medical figures. Another woman who caae up through that school, or had connections with the New York Hospital School was Miss .Ann:,e w. Goodrich. Miss Annit>. W. Goodrich was the first Dean of the Yale University School of Nursing which was endowed by a million dollars from the Rockefeller Foundation and which became the first school of nursing in the world that required a B.A 0 degree for ad:missicno Jumping ahead, I can say now that that school was rutblessl.y discontinued by President Whitney Griswold about 1955, 1956.-1 111 check the date when I get to it. Miss Goodrich was succeeded by a very able, pleasant and intelli­ gent woman. Taylor111 Yes, Dean Effie Taylor who is still living. She 1 s in her eigbtiee, ancl she'• tile one with whom I bad mo➔• do in Jlf3 early experience in affairs of nursing education because the budget df> the School of Nursing passed through the Office or the Dean or the Medical School. I was the contact for the School or Nursing with the corporation or Yale U,dversity. Although I had no Dean's prerogatiTes in that school, it was a tradition in the place that their budget and man;y of their affairs would pass through under the scrutiey- of the Dean of the School of Medicine. My next preceptress in nursing was Miss Virginia Dunbar at the New York Hospital•Cornell Medical Center. Miss Virginia Dunbar, a rabid devotee of 912 Florence Nightingale and a very intelligent, able, scholarly nurse, was the gentle but strong Dean of that university school of nursingo At that time, it required a degree for entrance, and it had a very intr~cate and thoughtfu1 curricu1um for the training of nurses, far beyond ~ust the practical stage of washing a patient's feet, making up the bed, cleaning the window sills, and emptying bed pall8. They cou1d do that part ot 1t. They had ideals and capacity way beyond the requirements that so many people illpose on nurses as servants and indentured students•-"indentured slaves" I aeant to say-o Those are background things, and I will emp11asiz• once more that running all through this is a shortage of nurses all through the country- and through most countries. There were increasing demand• on t h + l the tia•o There were a great man;y women going in to nursing, but they didn't stay- in nursing. When they had an opportunity to get married, they got mar~i•d• There was considerable attrition every year because of the activities of fatal fascina­ tion of the young men with whom these young women are associated. Curiously enough, nursing, in my opinion, has never been properly appreciated because it appears in the class of a handmaiden type of thing• I Its a servant type of functien in the opinion of m&DY' people who employ "' nurses, or benefit by care from nurses. They class them aostly as very valuable and usefu1 servan1B whicll reminded me to scae extent of my old Mammy. She was practically a member of the family', but she was a long way from being a member of the f amil:y'. The nurses in the New York Cornell School were a high grade, well selecte41 intelligent group of studentso Their facu1ty members were highly educated and able women too, so much so that there came to be a division between these highly educated nurses and the ordinary registered trained nurse, That l 913 divisioA led to inharmonious relations in some cases because competition was great, and murses that were wel+ducated tended to look down on the ones that were not so well educated. It was natural enough. Below the train.ad. nurse inmost of the places with which I was associated, particularly durin1 the period in New York, there was a lower, or a group of a, -called ir actical nurses. There were schools that trained, for a year at the most, girls to _., do the chores of nursing and to be comf'orte~'-s of patients and housekeepers, that type of thing, plus doing a 1reat deal of the manual, hard.1 unpleasant work of domestic hygiene and domestic care of patients in their dai~ life almost without regard to whether they were sick or not. Now, tae development tf the practical nurse was a natural thing and should not have been opposed, I think, by the highly educated nurse. Nurses, like doctors, ought to be organized in a natural sort of hierarchy", one in which there are a group or elite people who are the top and who can make contributions, give guidance and have enormous influence oa the people ccaing under thea. This group at the top is supported by a large, or more ftWllerous group, the less educated people, I and in this case it s the ordinary-, trained, registered nurse--the RN, and below the RNa ar+h~ practical nuraea. You find the same thing ill medicine- , ~ highly trained surgeons surrounded by less able operators, and they hav~ many assistants who are iri training and have as yet not cme on to a.,,- independent operationa. The nurses in the New Yot,k Hospital, if we might talk mostly about them now, had contributed a great deal over the ~•ars to the intellectual product of the Center. Tne paper to which you reterred that I wrote on the Nurse and Medical Progress wae prcmpted. by having seen publications, many ot them, in which the nurse was acknowd.edged. in the tootnote; whereas I knew that the lllll'se had really beea responsible fer the success of the investigation. or the success 914 of the obswrvation, and to give my talk sort of a twist of a slogan, I was inviting these nurses to get out of the footnotes and get their names up on the author by-line which is what they deserved. That has gone on--that idea, \ that they could do that by doing some really ori;il_,nallY designed, experimental research, to the extent that now research in nursing bas producJed this extraordinary volume LFaye G Abdellab & Eugene Levine, Better Patient Care Through Nursing Research (New York, 1965) 736.J which is in front of us new which ia as good an account of modern experimental aethod.s as I have seen even in aedical schools, or in some departments of physics. The idea spread. The other contact I had with building up opportunities for nursing education occurred when I cae dOWll in 1953, about, to be connected with the Surgeon General'• Office in the Department or the Army. At Walter~eed Army Institute at that time, there was a very able young captain in the AI"fffY" Nurse Corps named Harriet Werle)" who was inspired to do something to combine research in nursing conducted by nurses with arrangements for higher educa­ tion or nurses at this center and elsewhereo Through the years or work by Miss Werley who was a Major by- the time she retired, the result has been the develei-ent or a new school of nur,sing at the Walter Reed~Army Institute or Research, a school of which the present Surgeon General. is very proud and to which he is giving support and supplying the facilities or an unusual nature. In New York I was fortunate to know.,.,- friend Eli Ginzberg who is a sociologist and econC111ist or great depth and perceptioa. He made his reputation,. as far as we're concerned,in the Army at the end of World War II when he almost single-handedly demobilized the Medical Department o:f the ~ Anty. He broug~ it down 1'roa thousands or physicians to a well balanced demobilizatioa that everrt,ody admired very much. Thanks to that associatioft 915 which was always pleasant and mutually understanding, Mr. Ginzberg invited me to join aa organizatioa called the Committee on the Function of Nursing. There were some interesting people on that committee with very wide ranging \ ) inter~ss ,v all the way from public health and hygiene to economics and education. Studies were really centered in the Office of Mrs. Louise McManus at Teachers College, Columbia University-. We had many, maiv meetings and many discussions, and we proposed and produced a little book callee A Progra11. for the Nursing Profession which was rather disliked by some of the nurses bt New York because it was thought, I believe, to downgrade them somewhat. In my opinion, there's some good sense in this little book. It has in it this hierarchical idea that I was speaking about, and it brings out the shortage of nursing which was a national problem. It brings out also the ether prolonged persistent problem., and that is the economic condition of these women. Smetimes if nurses netted a thousand dollars a y-ear, they were doing well. It was rare to find a nurse that got as much as three thousand dollars a year. They lived on a pittance supported often by- their families, and often they supported their families--not their children, but their ailing and aging parents. How they did it is difficult to see. There wasn't enough money­ going to those women to give them a ride from New York to Albany once every­ ten years, or something like thato This condition has improved somewhat­ nurses are paid better now, and, as a matter of fact, nurses began to do something that is rather untraditional in nursing. They began to organize as a labor group. You have read recently or the nurses that dropped out ot the Bellevue Service because they thought they weren't getting paid enough. As rtter of tact, the doctors are ~DC to imitate them lately, When I 916 was In New York there was a John L,Lewis Unit #40 which picked up employees of all kinds, and they tried to get mrses into that section of the AF of L Union. The nurses did threaten to go on strike sometimes, but I think they realized that it was abhorrent to medical ideals that they should do that sort of thing. On the other hand_, the sympathies must be all with them because they were downtrodden and had very little subsistence. In the New York Hospital the nurses were paid, and they got their meals­ or at least they got two meals a day while they were there, but they had to caae in at all kinds of hours and work ditferent times• Their condition was appalling to me. For instance, they had to come in the mornings, go down to a basement that was fitted up with shabby old lockers and benches, and change their clothes from their street clothes to their nursing uniform!l. They had no good places to W&8h_, no mirrors, sort of a dungeon-like dressing roomo Fortunately there was some money left over from the Vincent Astor Fund, and Mr. Astor approved a recoJllllendatioa that that money be used to fix up quite a section of the basement for the nurses 0 Ve made it almost a beauty parlor, but they--even at that time they were suppressed, in the sense that they were not treated like respected human beings. We had many, many interesting talks in the faculty of the New York Hospital-Cornell University School of Nursing 0 I was invited to their faculty meetings, and after a while wefiad such a natural relationship there that I was taken into the discussion--I was going lo say I was almost regarded as a nurse-which was very nice. As a practical matter at the New York Hospital because of this shortage of nurses some two hundred and twenty-two beds were not opened. Yes, Int that didn't lastoo long, did it? 917 No 2 but the mere fact that zou had that many beds that couldn't be handled•••• Yes., I think the complement af employed nurses in the New York Hospital was about 750 on the payroll, and that 1s not cour,Jting the .faculty9 Most of the faculty were the supervisors. The Minutes disclose c~anges in hours, division of hours, changes in salaq, but the most ~~teresti!!J, change in the picture was the suggested division between nursing as an educational function and nursing as a service function in the hospital requiri!!I two people. Formerly both had been under .the aees of Miss Dunbar, but you got throlljhp or persuade~•••• I persuaded Miss Dunbar not to go on as the Director of the Nursing Service of the hospital. I thought that it was just as logical that she should be a Dean in her own right as •t was for Dean Hinsey to be the Dean of the Medical School. Nobody ever thought of having Dean Hinsey be Director or the hospital. Miss Dunbar had this double duty. The reason it was bad is that the hospital is the more overpowering, demanding, urgent., emergency type of demand; whereas the Dean ought to have time for renection and be able to be independent of the hospital., introduce innovations without too much con• sideration o.f the actual daily operations of the hospital. Also, it was necessary to try to .;.,et the School of Nursing to provide for its own faculty and facilitieso Most schools of nursing beg, borrow and wheedle their educational repasts, if' I can put it that wq. For instance, I taught nurses bacteriology at t, J~hns Hopkins. 'fhey didn't have a .faculty that. could teach them anatomy, physiology, bacteriology, or pathology. Those were all taught by somebody in those departments ot the medical school. At Cornell-New York they had a mised 918 system. There were saae women on the nursing faculty who could teach some of the subjects, and they got more or them, but they taught subjects as a rule in the classrooms or the medical college 0 They didn't have at Cornell sufficient classroom facilities in this beautiful, big buildinc for the School o! Nursing. That was largely a dormitory- buidling. It did, however, contain a library which was very useful, anf t contained rooms in which nurses were given p{cdtical training. There would be a long room with a lot of beds ill it where they would learn how to make up a bed. The bed would have a dUJIJIIT in it, and they'd learn how to turn the dummy ever, the motions to go through bathing a dWlllllY. Tha tr s the way they teach the nurse on the human figure in the bed. Now, they had any number of these, but the:,- didn't have any laboratories­ chemistry laboratories, or anatomical laboratories• If they could get the endowment now, and if they could get financial 0 supp'{t, I think that there would be great opportunities for nurses to develop their own educational programs and get ahead, but the trouble is that they ean•t get .fiaa.ncial support 4 Recently, as I showed you, the New York Hospital­ Cornell Medical Ceftter has tried to raise 59 nillion dollars. Still, at the end of that campiagn which didn't quite reach that sum, they showed""~hat unmet, urgent needs there were, and one or those needs was for an endowment for the School of Nursing. I think they wanted,.,-what was it, five million. They didn 1 t get any at all. Why they don't get it--Miss Dunbar tried to analyze it, but in her letter to me she just asked the same old questions. She does make a report to the Joint Administrative Board in the sense or cOD1Renting on the aev experiment with ward aides-this aew hierarc& which was beginniDj to take shape and form. In part 1 the division between nursing as an educational function and nursing as a management function in the hospital is, 919 again, to separate into a greater heirarchY, or a recognized bierarchf•-the veq division of labor that is creepiy into the profession of nursing generally. Everyone talb 1 and I guess everyone was receptive on the Joint Administrative Board. How did the other people 1 the hospital people as hospital people re- 1ard the problems that Miss Dunbar presented? They were hostile people--the director and the financial side, the Governors-tb.eywe,so impressed by their need to care for patients that they didn't see how they could do these things, and they couldn•~. I want to put en this tape what I•ve said often to people, that I think the trouble with, or ~ one •f the troubles wi\h nursing is its n••• The name nursing is synoDiYJlloUS ia the language with a maid servant, or a servant. It has always been a person subject to the beck and call of people who needed help one way or another. I used to tell Miss Dunbar that if she could get some big nan, like orthopedics, 0 or orthodontia, or something, it w:uld take nursing out of this lowly connotation. ~ I have consulted classical scholars in Greek and Latin at Hopkins and at Yale to try to give me a name derived from Greek that would mean nursing. I got some funny words, but they won't take. I think if they could change the name nursinc and call nursing smething else, it would help thea, but to me it 1 s still a IIY'Stery- why' women who regard this as a proper profession, aren't putting more into this for nursing• You knov--I•Te been puzzled by that too 1 Implicit in this studz with Dr0 Ginzber1-it 1 s not merely wages and hours that are at stake; it's a symbol. "We live by spbols." What kind of symbol projects a person into this area. It isnt~. Part of the recommendation is that other professions have aided them.- 920 selTee by re-examinig their own function with reference to a patient, or to a medical problem; in short, thel underscored the research aspects, to build. a deeper urrlerstanding of an area. I don 1 t. know whether that 1 s possible. We've consulted other books here that are more recent and show that certainlf sc:me leadership in the nursing profession is J?ulling in the direction of greater concern for research in the field of nursing. ll It they could get deep and significant problems to work on, that woAld be good, but--and I sq "but" in this case meaning a contrast-they call observation of themselves research1 c•ocking problems, time and motion problems. On the other hani1 there are sc:me that go very deeply into the sociological aspects of nursing and the econOJ)ic aspects of it. In part1 the nature of numbers in the nursing profession f?Ut a erellli.um OR r~ designing hospitals, as we noted in the books you brought in here on the Kaiser hospitals• Indeed, they do 0 The shortage of everything has an effect on the design or hospitals, but with nursinc it's spectacular what that has done. The new Wa~ington Veterans Hospital, for example, has TV screens all around and interc011 phones so that a nurse can sit at the control desk of the center of a group of wards and see what a patient is doing and talk with themo She doesa't have to get up and run arourd • The design of noor space as in those Kaiser Hospitals is also built into the Hospital for Special Surgery in New York. They use a central cere and have radiating wards out like spokes in a wheel, so that the control is in the center, and the distances are cut downo h When it comes to leaders~ip in the profession, has it really passed to the 921 people who graduate from university schools, or is it still in the Tast bod{ or people in the profession, graduates of hospital nursing schools where th ive all da effort in return for a ca at the end fa three I don't knowo I'm afraid to answer that. I don't know for sure, but my impression is that the leaders are still coming from the women who have g,ne in for registered nurse training. There are relatively few or the high grade, educational institutions. It's supposed that this one at Yale now that took the place of the other school, which is training nurses to be worthy of getting a master's degree, is going to solve some of these leadership problems. They have very small classes, fourteen or fifteen in the whole school, and they go into long .s analyses of situations-a Ph,D.type of course, though it 1 s a master•~ degree school. They terminated the nursing; school in favor of a graduate nurses trainin~ progra.lll. Initially with support from the Rockefeller Foundation it had been an experimental program and a degree progra in nursing education. I don't know-somebody needs to shake the curtains somewhere. Shake the pocket book0 Maybe this isn't the route because it 1 s too well done, too refined• You 1 1•e pointing to the book on research in nursing. L.Abdellah & Levine, ~ op 0 citJ _That's an e~traordinary book. As I say, it has great depth, and it is incomprehensible to most of them, I thinko I would think so too. 922 But the Simmons and Henderson book is better, I think. /Nursing Research, A Survey and Assessment (New York, 1964) 1 64Y It is sCllle time since I really have looked at it, so 11 m not sure• That is the same Henderson who is concerned with this listing of studies 0 This volume is very good from the point of view of the bibliography at the end of each chapter as to what has been done 1 or for further reading and so on, but--you know1 you have to have a floor before you begin to chew1 which is h why I raised the question as to wether the RN is still the typical development ~ as distinct from the professional nurse trained in a university setting. I gather we 1 re still on the roado There may be smething in the sex of the nurse that is impeding vigorous I develoµnent. It s been very remarkable to me and perhaps it may be somewhat ignorant to say it, that so few women have reached positions of cormnand and. leadership in some of the professions and some of the creative arto. Women seem to me to be excellent sometimes in painting, or at least they have a degree of excellence, but not in the genius line. There's only one famous musician that I can.f ecall among the woo,en, and that is Chaminade. There have been lots of women who have come through Medical Schools and there are very few women, if any, that are heads of~partments. There are practically no women .5 surgeons. Dr. Helen Tausig-Blalock's associate on the "blue baby" at Hopkins I,. was a good one, but Blalock was the leader there. Now these women in nursing are all by themselves, and mqbe they reinforce the characteristics of women in these situations; whereas if they had a few men on their faculties, they might have a different management, or a different approach. There are very few women on faculties of medical schools. The only one I knew well is '!I 923 Florence R. Sabin lilo was at the Rockefeller Institute after being at Hopld.m 1 then went out to Denver and led the public health movement in the State of Colorado in remarkable fashion, but that 1 s rare. What was the attitude cf doctors toward nurses? It's not one-or it doesntt seem to be one of any aid toward raising •••• In my opinion, doctors respect nurses so long as they are subservient. Tho doctor wattt;o help. He doesn't want to ~bothered w11h the :,earning• ot the nurse for higher education. He wants good, solid help all the time, de­ pendable, and he does that without being disrespectful.. It's a sort of superiority without disrespect. Doctors are very dependent on nurses. The, couldn't get along without them. And yet some of the leaders, some of your heroes--one an;ywq, Dr. Welch1 later Dr. Wielow in conjunction with Josephiae Goldmark1 labored an ear in. favor of greater educational oppcrtunities all the timeo e But I don 1t think that any of th}\s• people meant that every mrse should be so highly educated. No 1 except that there was and should be a place for an educated nurse. What we have done is jumped back and forth between educational and .t'inancial support, and why don't they get it--maybe that is somewhat connected with what 1 •■ talking about; the woman aspect, the management of the whole There is mentioned in the Minutes of the Joint Administrative Board the turn,.. 11 924 over which is a constant thing. It may nuctuate from time to time. This is in the order of the beast, but if yous eparate the function from the eerson, I still don•t get it in as big a place as New York Hospital-Cornell Medical Center is with their concern for higher standarda 1 except that perhaps most people are still RJf oriented. At any rate 1 it 1 s an interesting problem. You didn't tell me who the nurses were in your own orientatioft at the Johns Hopkins. I can 1 t remember their names. I remember the head nurses on several warda--two~arda anyhow--very able wo•n• Not a little helpful? Very help:f'ul, very positive. Of course, Miss Elsie M. Lawlor, the head of the School of Nursing at Hopkins had. much respect., but I was talking abo11t the nurses there on the ward, and there were two who helped ae a great deal-­ :f'rigbtened me also. One nurse, Il\!llllember, wanted everything to be just right and in place all the time. That extended to the tightness of the sheet on the bed.a. Sometimes she was so perfect in that and so insistent oa the smoothness and tightness that she alm08t produced footd.rop in the patientse 'I'he Sllllle wcman hated to see any medicine taken out of the medicine cabinet because she'd have to get the bottle filled again, or it would look a little eapt71 but curl ously- enough, those things didn t t interfere with her intellectual qualities. She was good0 In the professien there is a built in mechanism for silence and subservience­ you know. Take a volunteered observatien th.at might be helpful-I don't know that very ma& doctors would necessarily be receptiTe to this. It certainly 925 isn't in the pattern. They are ver., receptive, but they put them in the footnotes. I can use as an example, ambulation. I remember when that came in. Patients were very anxious about being gotten out of bed the day after hKving their abdominal wall cut open, after a severe operation. The surgeoa was usually too busy doing other operations to sit by their patient's bed and encourage the patient to get up and walk around when the patient probably thought he'd collapae and die. Well, all that fell to the nurses, and it 1 s the n.urses that were the observers and the supporters of the patiente in those stages. Now every hospital has a special recover., ro0111 into which patieats are takea after ope~ation1 and they are kept there for a day or two, or less, under the superTision and observation of nu.rs••• Doctors are in and out, but it is the nurse who is watching the patient through all those crises, and the doctors ,-.\ depend on it. The nllll"Ses often make ver., shrewd observations about ,Autritional states and rashes that they see in patients. They can make diagnoses. They 1ve seen plenty of things. The doctor ti.n thanks them, goes ahead, and does what he thinks is right for the patient. It it ~ecomes a publication, he may mention the nurse in a footnote, but not necesearily. Miss Dunbar mentions the experience of two nurses that she knew--one where there was a language barrier, where the ftllrse in order to care for a patient had to somehow bridge bet,:een what she understocd. care to be an.d what from a different cultural back round which sn•t disclosed the atien.t thou jl.t nursing care should be-the difficulty of language and the kind of tenacious that the nurse showed in ha in in there in order to take car .f the f;atieat. The other one was a study;, and a very interesting observation in the 926 letter was that the nuree who made the stucy thought that making the study removed her from patient c~re--spending so much time thinking about it 1 though she arri.Ted at the conclusion that the fact that she spent time squaring her observations with experience aided patient care. Well 1 this has taken us into two different things--not only the management, but manpower studies. I don't suppose there is a solution to it anywhere, just accumulating evidence as to where we're drifting 1 or moving 1 hopeful that at some time something Ji.1 \ emerge 1 as the design of hospitals emergedo The male nurse is an interesting figure in these things, but he is apt to be, in 'fff3" opinion, less male thaa he should be. There are male nurses in the Arwy. There are male nurseB on maro- genitourinary wards where much handl,ing of genitalia is necessary with catheterization of males with bladder trouble, urinary and kidney troubles. Usually there is a male nurse in such a situation. There are also male nurBes right in the ordinary nursing course h of things, who associate with .female nurses and hardle patients wit~ all sorts of conditions. I do not believe that outside of the Army and outside of the genitourinary situations that male nurses are increasing, or coming to any special importance. In the Army they have a great many of them. The Arm1 seems to know how to use this secondary, relatively little trained, medi. cal assistant. Army Medical Corps men are pretty good, am they'•e never been to medical school. The Navy does it too. The Navy has submarines, small boats with no doctors at all on them. I should think that with the increased specialization that one hae in d~~ it would require_.more in the,wa, of insight and specialization of the nurses-­ you know 2 to at least communicate. That may not be. I mq not understand 927 the specialization of doctors. Most specialists--you 1ll find a specialized nurse who has been with them a long time, who uNderstands the least gesture, or understands the very small symptoms to observe. At one time most of the specialty of anesthesiology was in the hands of women. Many of them were anesthetists, but the advances in anesthesiology- have cane from male anesthetists like Dr. Joseph Fo Artusio at the New York Hospital-Bornell Medical Cente7 a bright 7oung man. Artusio has 1 de-.,eloped a system by which the anesthesia can be controlled--a sort of feed back mechanism from brain waves; put electrodes on the brain, and you can tell how much oxygen you have in the blood, or when it becomes too much anesthesia, cut it off, or open it up and give more. He has contributed a ireat many other things of that electronic nature an,rig:i.n1 coming into the ordinary as well aJthe special surgical practices. Out here at the National Institutes of Health~ year or so ago~ they built a .Jb1e n!W surgical operating suite \ in which there are seven or eight channels of vital signs coming to the operator on oscillographs, or screens of all kinds, especially with open heart surgery-. That takes the place of observation by nurses and assistants, but curiously enough, however, when you get all that help, you have to have more nurses 4 Yes 1 _they have standby teams up there which include nurses 0 The view then is that increased specialization in medicine with doctors hasn't had an attendaat drive for a kind of specialize~..knowledge and astuteness for nurses. 928 A great many of them--they stay in some specialty. 'rhe nurses in ob- stetrics are practically a constant staff. The nurses in * n surgery that I,Te seea were pretty constant too. The pediatric nurses who get to know children rather tend to continue along the same line. But has that worked itself into a course, a body of information? That's what I meant--in other word.e 1 it is an associtaion with a specific doctor where he is accessible and where a nurse learns to work with this particular doctor, but as a nurse, if she had to go from hospital x to hospital z, it wouldn't be the kind of knowledge that would be necessarily useful. In a way--they have nursing manuals and nursing textbooks on pediatrics. They'll write a textbook on infectious diseases, and they 1 ll bring out the things tm-i the nurses shoupb do. I know about them. Very often their chapters are written by doctors• I hope that the drive for more universitz schools of nursing continueso I can't think of anything else we ought to do with nurses, I can•••• Yes I mt I think that I s enough on ntr ses • 929 Thursday, July 71 1966 A-601 N. L. M. Ie toda • What ha ned to Wedn.esda ve I been? I•m sure i"tte Thursday.,. A ~ell, you've sketched togq a series of things that you call extracurricular activities. I had some sketched also1 and this lcind of activity has had continuity, apart from the rationale you gave before, in your life. As Professor of 0 acteriology at Rochester you felt the necessity for buidling e­ .footpaths to the local community. One way was to become aware Bf their \ or anizations an art of them. It was on a little different level at Yale with the State' of Connecticut 1 How is this progression and experience ~ltered by your being part of a big 1 throbbing metropolis lile New York City? q~rcwn.stances to which we ha\l!'i already" referred. created a kind of electricity, a difference of view1 with local organizations, particularly in the medical fielda which required sudd.en1 emergencz: measures to try to obtain a meeting of minds. Thereta more to this than just extracurricular. It was part1 I think1 of the whole design of the job; to deal in a kind of public way with organized voices in the community. Itve liisted sane. You've got some others. IJ I don't care particu.larlz how yo~ take them AP• t; but this has been, I think, a feature of your own experience, certainly from Rochester days and even before at Hopkins and particularly there in the medical history field--"action•s a function of in_te rest. 11 As I look,back on this, I do not see myself in a~ o r i ~ role in undertaking tasks for the cOlllilllnity in relation to the medical institution of which I was an officer. This had been characteristic of the leaders of the 930 profession that I bad been associated with as a student. It was characteristic or Dr. Welch. It was characteristic of Dr. Thayer who also did things in public affairs in relation to medicine. It •s something engrained in the tradition of the forward moving school; to know that they belong to the stream or activity of their nation and their local communities. This is something that started, I suppose, ia the day's when life was more leisurely. There cl were ollly so many- daily l\uties to be performed., and those men had time for consultative arrangements and meetings. As it went on, however, the tradition grew so strong that you were expected by the community and by your organiza­ tion to undertake affairs of this t\ kind, and you really couldn't resist the invitations to join in with the efforts. As a matter of fact, you often didn't want to resist thea because they were extremely interesting and re­ warding efforts, coupled with very pleasaat and interesting friendships, so there was a recompense not measurable by any monetary emoluments. The latter were not forthcoming at all. This effort in public affairs was alwayl!I done without pay by most of the men. It got so frequent in a big medical center that even in the days of the late 1940s and 1950s when I was at the New York - Hospi"4-1-Cornell Medical Center, it was sometimes very difficult to have a faculty meeting because all the faculty members were out on conmittees. That was true somewhat and beginning to be true at Yale• Well, what I thought I should like to do in this talk today is to point out the common elements in these uo:iertakings aad to list four or five of thea that I was engaged in while I was Presirleat of the Joint Administrative Board. The comm.on elements a.re what !'ve already expresaed, the sense of rendering service to the social and professional affairs of the community outside of the smaller institution to which a man belonged. The other common element was a natural interest in the problems that were being studied 931 and the way that very able men went at the solution, or sought the solution of ~ these problems. 111 mention one of them in passing because we've already •poken about it, ~nd that is the cOlllllittet•aded bT Eli Giazberg called tho Comnuliee en the Function of Nursiq which produced this little book called A Prograa for the Nursing Profession. 'We've already talked enough about that and its relation to situations in nursing 0 Really the first one that I became involved in outside the walls of the palace of the Popes at AlVignoa at •••• York Street? York Streetl York Avenue and 68th Street. This was called the Public Health Research Institute of the City of New York, Annual Reports of which I now have before me. I see that I was made a member of its Research Council in July, 1947 1 which 1s only a few weeks after I arrived. I suppose the arrangements for this must have been made before I arrived at the New York Hospital...Cornell Medical Center. This Public Healh Research Institute is a remarkable organization in its relation to the City of New York. It was established by Mr. David M. Heyman, the very wealthy, Jewish President of the New York Foun:lation who had a power of persuasion and a power of friendly relationships with a succession of mayors of the City of New York from La Guardia through O'Dwyer and even to the present. He persuaded the City to put up a considerable sum of money in 1947; namely, two hundred thousand dollars to be used for the s~pport of research by the Public Health Research Institute without entangling the Institute in the politics and in­ fluences of the City Government. The City was able legally to entrust this sum of money to the Public Health Research Institute of the City of New York without requiring a detailed accounting. The money was supplemented by 932 relatively small gifts, some from the Nutrition Foundation at Columbia University and some from other grants--grants from the New York Foundation. They were all small irants; as a matter of fact, the total income was two hundred and thirteen thousand dollars when the City appropriation was two hundred thonsand dollars, so the City was really carrying the work of the Institute. This Institute had a Board of Directors composed of public spir.i.ted men in New York of whom. Mr. Heyman was the President. A very fine man named Mr. Edwin F, Chinluad was Vice-president and Treasurer. Lazarous Joseph was a member, and William O'Dwyer, the mayor at that time, was a member, &l'ld that Board of Directors ran this Institute largely with respect to scientitic matters and personnel, the investigators employed in the Institute, on the recommendation of the Research Council. This Research Council was a forth­ right, rather ~trong Council containing people that we knew about from other sources--D~. Th0J11as M. Rivers was chairman of the Research Council, Dr. George 1~, and other people who were engaged in research largely in tne fields cf infectious diseases and nutrition. This R~aearch Council has con­ tinued to the present. Tuey met several times a year. I see here, for example, the Research Council of 1950-19511 where George Baehr is a member. ,, Itm a. member. The Nobel Prize winn~er, Dr. Vincent du Viineaud1 a 1reat bio- chemi~t, was a member. Michael Heidelberger in immunochemistry, John G~ Kidd1 the Professor of Pathology at Cornell, the vecy wise Walter W. Palmer, the Professor of Medicine at Columbia, Dr. Tom Rivers, and Dr. DeWitt Stettin of the Bureau of Laboratories of the Department of Health of the City of New York were members. This was a very interesting and pleasant connection fo+e• It brought \ me into contact with people w'lh were doing interesting things, people who were ♦ 933 carrying on studies in basic science which at the same time were recognized to have an import for the control of infectious disease in the population. For example., this group did some work on the influenza viruses to bring them in use as vaccines. They did extremely good work on the development of the rabies vaccine., a virus which they used for the prevention of rabies in the City of New York and Staten Island by immunizing dogs, and so forth and so ono Many interesting things were conducted very much like the way the Rockefeller Institute proceeds w1 th its investigations., the way the departments at Cornell, or Yale, or any good scientific school would do it• What kind of laboratory did thel have? They had a building at the foot of 16th Street. It was an old hospital building. It was three stories high, about a quarter of a block long, shabby, much chopped up with partitiom that had been put in for ro ome, d.eerepit ·, / elevators at the start, but habitable. Moneyw.,as put in to furnishings for laboratory work, plumbing, equipment. I think the Public Health Research Institute is still there in the same building., although there was much talk of their moving to another place. /.itovlfb To \~1 f\v,;uur 41.1t, .:lS'ih 'STQ.o-i7 Did the Research Council initiate programs, or did thel simply pass on progrilll1s presented to it? This~is not a grant-in-aid thing like the Childs Fut-a,. This is a Research $ Institute that has its owa program. The program came from the staff member~ in consultation with the Research Councilo The Research Council didn't re­ ceive applications for grants from outside., or programs submitted to it 0 It did receive information from the Bureau of Laboratories of the City on problems 934 that were important for investigation for the City, serological problems and others. It grew very mu.ch in finances. About the time I left their budget was upwards of seven hundred thousand dollars a year with very large grants from the National Institutes of Health given to the Research Institute of the City of New Yorlc in\(esponee to an application made by the Institute to some council in the Nation.al Institutes of Health just like a university I/ would do. Now, I belie,e, the budget has gone up to a milliom and a half with very large supplemental grants from Nm. ~~~, This seems to me an excellent example of how!min.ded businessmen, philan- '\ thropists, and educators, men interested in the health of their communities could devise a plan by which untrammelled, able, scientific investigators could wnrk on problems almost of tl:Bir own choice, practically of their own choice, without any interference from the political authorities of the City which was putting up moat of the money. one of the novel things about its history was the way they negotiated a re­ lationship with the City1 a continuing relationship over a long period of time--fifteen years, I believe it was. It was a contract. So that it never had to come ue for review. It was a contract over a long period. It did come up for review once when I was there, and it was a worrisome t:imeo This fifteen years would appear to pull the Institute out of the vicissitudes of a yearly wrestling match. 935 Yes. !~thought it was an admirable arrangement, and I think it:s done some useful work. I think that's about as much as I want to say on that subject. You haven't mentioned Tom Rivers since he delivered that speech of his at the Philadelphia meeting. He's an old friend. Tom Rivers was chairma, of this Research Council for quite a number or years, and at the same time he was head or a Department of Virology- at the Rockefeller Institute. He -was the outstanding virologist in the country in a l way, a very able person, high strung, profane, so frank that its a wonder that he maintained friendships with &l\Ybocy o Everybody knew Tom's methods, and his manners, and they let bia bark. His reports on the scientific side are very good--those Annual Rlports. Hets clear beaded and frank. I think we mentioned Tom Rivers in World War ll when he took that big Navy ~abora:.ory- to Saipan. Yes, jnet in passing. You used to meet with him once a month on this board-- wel11 I don't.• know how frequentlz t~ Research Council met • I knew him at Hopkins. He was a class ahead of me when I started at ~ Hopkins. He develo~I a mll:I cular dystrophy so that the m\E cles in his fore­ I ..,, arms dwindled so that you could almost put your fingers together between the M....:~<:1.1:.S . bones of his forearm. His •. -.. ·~tween his thumb and his first finger and wrist, part of the phalanges and metatarsal, were all withered. He left Johns Hopkins in his second y-ear rather expecting to die. He got over this re­ markably enough, am he came back with great vigor and carried on. He r1ed 936 a tew years ago. He must have been very uncomfortable. Inspite of all that muscular trouble, he was a good tennis player. He lived out at Forest Hills and played out there. I remember hia as having given you some early instruction. on the nature ot people where you suggest ideas te them. I told yo+bout that when he was with me in the department. Had he mellowed sinse these dqs? I never thought or Tam Rivers mellowing. I think his consonant is a B instead et an M• It 1a good that human kind can thrGW to the surface a man like Tm Rivers. He was very attractive. He could say what he wanted. Everybody adlll.i.red him, and be did exeellea:i work. Well, shall~• paas on to another ,one? Another one et these public affairs that I 1d l,ike to speak about could come next becaw,e it was an early appointment, and that 1s the Committee on Public Relations of the New York Ac&deJ\Y ot Medicine. A group of publications 1"\E , that I had been reading studying, before I went to~ew York Hospital-Cornell Medical Center, reading thea carefullT because of their enlightened point of view and their influential effect on developing aedical improvement were the Reports or the New York Academy' fL Medicine Committee on Medicine and the Changing Order called Medicine in the Changing Order. Do you know those? ,~t I ought to get them for you. The chairman, Dr. Malcolm Goodridge, was one1 937 ~ J umbe~ or the Board of Governors of the New Y~rk Hispital, and he had around him a great group of forward thinking people-...Haven Ellerson) George Baehr, ethers of tl'e Academy of Medicine which is an honorable body with a long history and quite abo-ve the kind of politicking that went on. in the County Medical Society-. This was called the Avademy or Medicine of New York which is a scientific, philosophical body--atld I mean "philosophical" in the sense of the natural philosophers of the 18th Centur,---that was above politicso It ' had to deal with politics in many ways because tt got involved in supporting bills for the improvement of medical practice in New York State. It had many practical activities as well as some intellectual ones. It dealt, for example, with imprOYements in the treatment of tuberculosis. It ranged over the whole field of current medical practice) if it wished to. It went over very in­ tricate scientific fields having to do with the control of communicable disease and having to do with the legal, professional statW'l of groups of specialties in the professions, or large portions of the medical professions. This Public Relati0ms Committee met in a great, long roCllll, the vaulted ceiling room of the handsome Academy building, 103rd Street and 5th Avenue) al»ut once a month. It must have been forty members or more. Carefully pre­ pared papers were presented, short papers, but very thoughti#o There wa~ u . very free discA_ssiollJ sometimes strongly expressed opinions, and I felt it was a great honor to be invited to join this committee. As I say, it had a very great innuence on the movement forward of changes that were required for medicine to meet the needs of a changing order. l 111 get those books for you. "Pu die Relatione" has come to have a certain kind of meaning. There's nothing Madison Avenue in this situation. IiII :] I' 938 ~ think it!s important to point that out. Well, public relations for this committee meau just what the honest English word meaM--relations between the public and medicine, relations be... tweeen medicine and the social changeso The public relations were the kind of relations that yotaw, in mind when you speak of relatives, or members of your I own family, or relatives in a dynasty, or something like that. It had no tinsel on it, and it was truthful. You indicated that legislative matters came before this canmittee. This committee watched all the bills that came through Albany that had to do with medicine. There were a flock oft hem every 7ear. They were changing conditions of licensure. Tnere were bills dealing with phases of 1-t all sorts of medical practice a\d medical social economic arrangements. I forget the details, but they had a Legislative Col1111littee1 and when bills were coming up before the legislators in Albany, this committee would consider them and through the secretary- or the AcadeM71 we'd send a statement to the Governor, or to the sponsors of the bill•-usually to the Governor. Did you meet through this canrnittee--aot necessarily through this committee-­ Dr. Hilleboe {Jir. Herman Ertresvaag Hillebo.!7 as Commissioner of the State? When did Hilleboe come in as Commissioner? /J.94:fl 11 ve known him so lo"€ I forget. He was down here dur~gg the tuberculosis •••• LisOt-114•,:.1bJ: ~ The new drug for tuberculosis? (That was just coming in then at tf\.at time • .J\ 939 He may have been down here. 'This was during GoverBor Dewey 1 s term1 and eerhaps the Commissioner before Hilleboe was in office--whose name escapes me-Wadsworth. No. Wadsworth was the head of the Laboratory at Albaey--Augustus Wadsworth, a long time friend of miae, very dignified, a tall, handsome man-power in his physique and power in his persoaality. This Committee fuactioned by having visitors with it occasionally--they'd come in and tell the Committee about something that was going on. Maey of its studies were made by members of the Committee, or by people on the staff of the Academy• A~(xample of the kind of thing they ~uld halldle through, we'll say in this case, a subcommittee was a move by a group of fine women, mostly in New York City, to secure the passage of a bill for the recognition and licensing of what were called Clinical Psychologistso Clinical Psychologists belong in the heirarchy of medical assistants, so to speak, that we spoke of I ll yesterdayo Its their purpose to try to adj~t people to the situations of life in which they find themselves, although they, as adjusters, are not trained in psychoanalysiso There's a whole branch of psychology that has to do with behavior that doesn't need to be tied in with psychoanalysis. These clinical psychologists are advisers to school teachers. Most schools have saneone like that on the staff of the schoolo They are right in, closely knit with social workers. They're dealing with problems of people who are poor--I'm sure that; I don't know this for a fact, but the ''war against povert.y• is bound to draw into it. ranko these people who are able/and in­ terested to have poor people improve their lot so that they're not so poor afterward.a. Now, they were fought tooth and nail by the psychiatrists of the state, and this wae a bitter, long lasting episodeo I think I was on the 940 subcommittee dealing with this and wrote some of the reports. I was in favor of the recognition of the clinical psychologists, but the medical psychiatrists said that nobody should get into this kind of work that didn't have both a medical degree and special training in psychiatry. 'fhese women didn't have either, but they were good people. The outcome was a sort of a compromise. I don't know~hat the present situation is. The clinical psychologists are r ecognized now. Yes-thez opened up a whole new field reallz• That was an example of the kind of thing this Public Relatioe Cmnmi.ttee would do. Another case was the time when isoniazide, the new chemotherapy of tuberculosis, was coming in and being tried out at the big tuberculosis hospital-I think it was on Staten Island• I think there is one there. The name has gone out of my head. I remember the episods very much because after this drug first came in, it was spectacular what happened. People in the tuberculos.ii.s wards could sleep at night for the first ti•e since they'd been there. All the coughing stop~d. The s~ptum cups that 1V used to overnow with this tuberculosis sputum over night almost--great amounts of that that the sick pulmonary tuberculosis patients would bring up--wer• almost dry after this drug was used. It was spectacular and like all aew drugs somehow or other they work wonders at the begianing, and then they begin to show their limitatiollB. One of the limitatioe in the isonia­ zide therapy is the appearance of resistance forms of the tuberculosis bacillus. Other compounds had to be tried, but it seemed to give promise of eliminating tuberculosis because it would be a very powerful tool to reduce the spread of tubercle bacilli. If it didn't cure, but greatly reduced 9U the spread of tubercle bacilli that were being sprayed around by persons with millions of them coming out of their lungs, it W> uld reduce the in­ fectious potential. That 1 s always been an important principle of preventive medicine. People don't easily understand the relation between therapy and prevention. An ouace of prevention is worth a pound of cure is an old trite sayine., but some- I times a pound of cure will give you many pounds of prevention because its (\1 ~- ,, wiped out'.""the source. You see that in some cases of syphilis and gonorrhea-- if you can clean up the source of infection, you've done a better job than you can do with a lot of preaching. If you can cure a local native population of malaria so that they don't have any more parasites in their blood, the mosquitoes have to look for something else to doo That drug therapy for tuberculosis was going on, and that was of interest to the COD1111ittee on Public Relations which, I sq, was rather a focal point for social, economic, professional, and scientific considerations of medicine in relation to the community. Itw as iUided by Dr. Haven llaerso11 who was a very emineat figure in public health and preventive medicine in ~ New Yor._k. I think that I s about all I can say about that. How does this compare with the Committee on Public Health of the Medical li Society of the Co!nty? \ The Committee on Public Health of the Medical Societ7 of the Councy- dealt with regulations aad a few local conditions. It also dealt with side issues that could be called things that belong in the field of public health. One that came doWl'l on me very hard was the quem:.ion of discrimination in the State of New Yorko The Courcytt referred the question as to whether there was dis- crimination against Jews and Negroes to the Committee in Public Health just when I had been made the Chairman just coming in, and their intention was to tight Cornell. They had accused Cornell Medical School of discriminating. The movement to prevent discrimination got very strong in New York State, to such an extent that you couldn't ask the student what his mother 1 a name was. Anybo~ knows that if he tells his mother 1 s name, that•s where you find out 1 whether it s a Jewish name. The father's name had been changed, but if you ask,''What•s your mother's maiden name?", that discloses. Tha1•s not allowed l by the law after a while. No longer were you able to ask for a photograph of a candidate for admission because that would disclose whether he was a Negro, or it might have disclosed whether he was a Jew. They thouglit that there was a quota against the Jews, fifteen p!rcent or so, and a real strong discrimination against Negrees. There was some peculiar, mystical fifteen percent of Jews in practically all the medical schools, and each of them said that they made no conscious discrimination. The ratie of the fifteen percent in a medical school represents a larger nUJ1ber than the ratio of the Jews to the whole population. If there~ere tew Jews in the community, fifteen percent is a large number. There were millions and millions of others--non..Jewish--and the percent of students taken from that crowd are relatively less than the ones from the Jewish, but it is curious how it happenedo I suppose there may be some unconscious selection of the ones who interview for the school, but it c•e out around that figure, fifteen percent, though the people who are admitting don't know the number they have admitted. It's a mystical thing. As I say, you don't have a current dope sheet. Did the COJ1mittee i11Vestigate what this ratio was? No. They accused Cornell and other schools of discriminating and had violent open meetings on the subject. Usually the attendance at those night meetings would be a couple of hu:1dred. When thi:s question was up, there would be four or five hundred people there. The Committee on New York Hospitals branched over into the relation of institutions to medical practice, and some of their efforts to keep the New York Hospital frcm deve\oping a diagnostic clinic are the things that gave me trouble. 1 •ae mentioned those that came up. Partly they were heard in front of that Committee on. Public Health. Did it get into public health matters as public health matters? Yes, it was interested inlwater supplies. One big prob:U,m constantly was ! ' air pollutton. The Academy and the County both were concerned with air pollution because air pollution in New York was very, very bad. 'l'hey had a Commission et the City of New York under Dr. L.Greenberg, a distinguished public health official and others. New York City had huge incinerators down on the East River which would blow their fumes and ny ash over the City. I lived on 72nd Street in a penthotll!Je--not too far from the incinerators on, we'll say, 78th Street and the East River. On the little terrace up top there would be not only what you 1 d call natural fiy ash, but sometimes there would be pieces of bloody bandages and other things that would come up through the nues and be blown over. There was a good deal of sulphur dioxide in the flllles, and that ate up the n;rloa stockings of ladies too fast. It was quite a problem. these fumes from New York came not only from those incineraters, but the enormous electrical generating plants. Con-Edisono 944 Yee, Con-Edison--black smoke all over. That stuff would bl•w across h over into New Jersey--Jersey City and Ho~oken across the river--which had its own local contribution to make to the air pollution, and then it 10uld blow back across the Hudson and up through Westchester and into Connecticut. This problem goes far beyond the County of New York, far beyond the County Medical Society, but it was of interest to them. It looked as if you might have to violate the Constitution of the United States by getting some kind of a treat7 between Connecticut, New Jersey and New York. Not one of them could control this by itself. So far as you canrecall 1 were there any studies of New York City dust going on in laboratories in New York? The natural fall? Yes, they scraped it off--particles in the dust, silicate, coal particles. We 1 re getting away from this county medical society nowo We brought up air pollution. Did the Puolic Health Research Institute--were they thinking about and working on the natural fall of dust? I don't think anybody there was, but the whole subject is interesting to an:y group or organization that has got public health in its title. Auto­ mobile exhaust was an interesting subject to all these public health organi• zations. The stuff that accumulates in the Holland Tunnelf tQrry--like material from automobile exhaust contains benzpyrine which is a strong carcinogenic cOlllpound. You can produce cancer in animals by injecting the stuff you get out of the Holland Tunnell--by scr;ving it up. That alarms people for a while. What they breathe of it may, or may not hurt the lungs--probably does. In London you can collect benzpyrine by letting a piece of moist paper lie 945 on the window sill. There's plenty of it. New York's water supplies have always been watched by any of these bodies in public health. Croton Reservoir has to be protected. For example, there have been outbreaks of typhoid in New York~ity in the paat attributable te the deposit of typhoid-bacillus-containing-feces on the banks of the reservoir in the winter. When the thaw comes, thi,~ashes in, and tney have been faced directly with that kinil of thing. Are we finished? No 1 this machine was just beginning to squeal. It's all ri~ht. I 1 11 hold on to it for a whileo Well, I have no more to say about those things, I tbinko This sounds very much as though the County organization was more of a wrestling, offensive-defensive kind of group than the Academy was. Yes. The Academy- is, we 111 say, on Mount Olypmus. This group of people are down in the gutters. This is the group that sent you up to Harlem to become a member. Yes 9 I•m being a little bit excessive when I say that they are in the n· gutter. Therewere excelleat people in the Co~1l,v Society but they were more interested in the mundane problems of every day life, the doctors who are making a living, than this other camnittee. They didn 1 t have that trouble, or that problem before them. What about the Hospital Council? Do you have that down there? Yes, the Hospital Council of Greater New York was another body composed 946 of businessmen, leaders of the profession, and some hospital administrators. Its purpose, as I recall, was to try to supervise the hospital situation in New York City and Brooklyn in order to obtain a balanced arrangement of beds and staff that would serve best the community in which the hospital was located. It made a number of studies of plane of people lilofanted to add to hospitals, or to build new hospitals, to try to advise them on what would be the best thing to do for that location. We were even asked by some people on Long Island to look over their situation, and Long Island at that time was beginning to build sane community hospitals, or~ hospital~. Very pro­ found and careful studies were ma.de by the staff of the Hospital Council of Greater New Yolk: u~der the direction of John Pastore, who is the man I thought would make a good director of the New York Hospital. Pastore was very intelligent. He came from the family cf the Pastores, one of who1~s the Governor of Rhode Island and the other 1~ a Senator from Rhode Island--lots of talent, ability and energy in this family. P3store had been on the staff of obstetrics at the New York Hospital-Cornell Medical School some years before this. He had made a reputation of being rather a '1; '1 martinet. Aside from his appearance of being/somewhat,unkept Italian, he ~ \ had a reputation that was unfavorable to himself as a person in a group, but alone as the director of the Hospital Council of Greater New York, you didn 1 t have to bother about those other tbingso He had a budget to manage, a staff to work with, and problems put before him coming from communities and coming from what Dr. Baehr knew, what I knew, or what the State knew. One of their main functions was to advise the State on the distribution of the Hill~.»urton money which gave them a very important position in the cooununity. Every year we had long meetings on what recommendations we'd send 9h7 to Albany Oft the distribution or Hill-Burton money, on new construction, or repairs. Again the Council Board was a group composed or public spirited men who worked for no salary, or pay in connection with it. The staff was paid, but the Board wasn't. I think I was a member of that organization practically all the time I was in New York, from 1947 until I left in 19530 Ia a waz1 this Hospital Council or Greater New York was to take a greater Hew York point of view toward hospitals too 1 the service as a whole. Yes. They extended out beyond Brooklyn and even to the middle of Long Island almost. 'What is that city in the middle or Long Island, back of Mr. Whitney 1 1! place? M.anhasset? Manhasset is where Mr. 'Whitney lives. Back of it? I don't meaa back of it--in toward the center there's a city. Jamaica. I I think its beyond Jamaica, or south L_Mineoly--this oughtn't to be on " the tape. The point is that they had a point of view to sustain plus a staff to gain the wherewithal to really consider it 0 They had to deal with de~omination.al hospitals as well as municipal hospitals, and the private non-denomination.al hospitals. Some of the cases 948 were of such a nature that the Council had to avoid the conflict, we'll say, of the Catholic, or the Jewish elements in a city who wanted a hospital, and the Council didn't think it should have that kind of hospital. Then the Council would be accused of being anti-Semitic, or anti-Catholic. Was there any atteJJ1Pt to tie together what was available in the waz of equipment in these various hospitals? No-not that I know of. I don't think that 1s a practical thing anyhow. Or in the sense of affiliation with central or anizat.iono It didn't have that function. I imagiae that would be handled by sort of word of mouth and personal things. If it were known, you would know it, that the New York Hospital was overstocked with respirators, and poliomyelitis existed in the cOlll'llunity1 they would either send the patients to New York Hospital, or borrow a respirator. They couldn't exchange x-ray apparatus. ~'m ttdnkiag of the ex­ pensive, big pieces. This Hospital Council didn't deal particularly with the technical aspects of hospital practics. The Council had some influence on the Blue Cross plans, and soae questions were brought up whea the rates were under consideration. The Council furnished infomatiea, but didn't take a position in favor of any- particular hospital to get its rates raised. They took the question of rates as a general thing. Now, I have down here two other things--the National Manpower Commission and the Commission on The Financing of Hospital Care. That 1 e that oae over there--the three volumes. Do you want those? 111 !' 1 949 I think we can dispose or this one rather quickly. There's a very interesting discussion there about the poor 0 Yes. The Commission oa the Financing of Hospital Care was established in November., 1951, as an independent, non-governmental agency, as a sequal to a previous commission which was called just a COlllJll:ission on Hospital. Care, an organizatien largely set up by the .American Medical Association and the American Hospital Association. This Ccmaission on the Financing of Hospital Care was supposed to be 1 in 1951., a much broader commission. It was placed under the chairmanship or Mr. Gordon Gray who was President of the University of North Carolina at that time9 The membership was really very interesting-­ Lewis Strauss was a member, Ed Crosby, director of the Johns Hopkins Hospital was a member, Robin c. Buerki who at that time was director of the Pennsylvania e. Hospital. He went later to t~ Ford Foundation in Detroit. Howard Rusk was a member, the great one on rehabil.jtation--I won't read the whole list., but it was an interesting list. The most interesting member to me was Mrs. Agnes Meyer who came on some­ what at a later time and was with me on the subcommittee I was on that had to do with the financing of care for the people wqh couldn't pay anything, or the underprivileged and unpaid people. This Commission on the Financing of Hospital Care had many consultants, many widespread relationships, and many, many meetings, most difficult meetings, because the membership contained representatives or most conservative opinion, so conservative that they couldn't see the government doing anything for hospitals. Some of the members were officials in high class insurance who thought that private insurance could supply everything that was needed for making the patient able to get a 950 policy that would ray for_ the cost of his illness, or the cost of his hospital care at least. !>e~ like Mrs. Agnes Meyer, who was notably a liberal person, a facile writer, intelligent, enthusiastic, sensitive to the needs of people, who had written several books, one of which I had read about this time called Journey Through Chaos which deals with the plight of the , poor people in the defense industries in World War II, people living in tu~'1-ed down shack towns. I had known Mrs. Meyer before, and I had known her dis­ tinguished husband, Eugene Meyer, for a number of years, partly through Yale connections and partly through happenstance of personal dealings. Mrs. Meyer and I used to sit together at these meetiniS and uphold about the same point of view against such a person as Dr. Morris Fishbein, the editor of the Journal of the .American Medical Association, who, in fact, was the determiner of the policy of that association and succeeded in keeping it in a most conservative and retroactive--not retroactive •••• Regressive. Yes, regressive--reach way back. This commission had a large staff, and I think the costs of its studies ran about five hundred thousand dollars 0 It put out three volumes of reports, but had enormous files of statistics and the staff that worked them over. I see by the preface of the book that after deliberations, the commission came out with one hundred and eighty-on.e principles and recommendations, so there must have been a considerable variation in its statements. In my opinion, the effort stopped with the publication of its reports as far as a concrete event can be found; on the other hand, this brought into more consideration " the knowledge, information, and ideas relatave to the great problems of financing hospital care by individuals and the great probleJ118 of financing hospital care by the institutien that furnished the care. Both were in trouble all the time. We talked about the deficits of the New York ,·n Hospital, the deficits of other hospitals.. J.hey1ere all well known. The third volume talks about the deficits or•••• Yes, the non-wage and low income grou~-that 1 s an interesting lot of people who haven't any means of meeting their bills. This stud;y of the non­ wage, low income group brought out very clearly the need of assistance from the federal govermnent; as a matter of fact, it is almost the basic discussion of what we now call :medicare 0 I suppose this report went in and out of th~minds of the people ltl o were I I dealing with the problems of government support, state and federal support, of medical care. Also it fitted in with some things that were going on in England at the time because the reforms started by Lloyd George, altering the whole system of medical care in England, were coming more and more into OJ.)3 ration during theee years o I found that the more significant of the volwneso Well, it's a thinnish book tooo To ~et this far, it probab3l had to go through this commission. It may even represent a minor~ty view. Yes, there are statements at the end of this book opposing some of the 1111 I, 952 statements that the committee took. It was the most controversial field. These ~re good. '!'hey help chart a .,,. M I "journey through chaos "--to b orrow Mrs. 'leyer s phrase. on a eoint in time where the situation was examined and certain recommendations I came out 1 and its hard, confronting the problem anew 1 not go go back to these studies as points of departure. To me it was a valuable thing too because, although I was not in the New York Hospital-Cornell Medical Center environment while I was struggling through these meetings. I was spiritually in New York and learning a great deal that was of value to what we were trying to do in New York. I would think in all the things that you have mentioned so far as "extra- curricular" that it was like washing the s ame shores from different points of - view. I call them 11 extramural. 11 They're not extracurricular. I wrote it down extracurricular, but I meant to say extramural. I was thinld.ng about the walls of the institution, but when you say extracurricular., it means some other course 0 I just meant th~t there was ap.ot here that you could absorb and thus broaden ' your own eoint of view even confronting the complexities the New York Hospital...Cornell Medical Center wereo Oh yes, yeso They all fit in. We 111 talk of it another time-the manpower studies Wl.ere we were dealing with shortages of professional people as well as nonprofessional. It's a few Jlinutes to three. We've gone a little over an hour. 954 Friday1 July 81 1966 A-60 1 N. Lo M. Yesterdaz we sampled some additional eJg>erience_!! thai l£U.J!ad apart from the Joint Adainist.rative ·Boa~d1 experiences that added to insight and living and working in a camn.unity as complex as New York1 working with various agencies !_!! the city, both professional and scientific, agencies charged with the accumulation or information about certain aspects of health--hospitalization and so on1 even collBtruction1 in an effort to have some basis where they could exercise judgm.eat _11,2re properg:. One of these additional experiences went ond the metro olitan area. It was a n.e k:iftd of stu which was ccming to the fore reall.y1 the study of what we haw by way of huaan resources. This was related in part1 I think, to General Eisenhower becoming President of Columbia Universitf and his views with respect to the number of people -mo had been rejected urner the Selective Service process. This was a study of what talents we have 1 where to find thea1 how to maintain them, how to use them--the National Manpower Council established at Columbia with support from a number of interested manufactu··rers •••• And the Ferd Foundation. And the Ford Foundation. There's quite a list of manufacturers who were in­ terested in this. What intrigues me most about it is the fellow who 1 in effect, terminated, cut dawn in a short space of time the Medical Department of the Surgeon General's Office 1 Eli Ginzberg1 the approach he had1 the r,rocess followed 1 the way ia which this council worked. As I understand it, there was a staft that made for continuous preparation, and the Council itself met to renew1 or think about 1 talk about, discuss and coae up with 1111 955 recanmendations. This is a new area so far as human endeavor is concerned-- te hink of human resources. I don• t know what 011 want to s abo11t it but this is a way of looking at experience that yo11 hadn't had before. wben the study that you refer to was undertaken around 1950, or there­ abouts, it had nothiag to do organically with the demobilization of the Army which had taken place in the late l940s--1946 and 1947. I•m putting this in to correct, or expand a phrase you used when you referred to Ginzberg in the suie sentence as being one who worked out the reduction of the Medical De- partment in demobilization, and this study of the possible shortages an.d maldistributicn.s of people and p,rm nnel in the United States. The two are "' not connected except that Professor Gizberg had a chance in the demobilization \ I to try his talents out on a very practical, painful basis. Hes ,., a remarkably intelligent man, and that experience gave him greater capabilities than he had beforeo He was interested in the study of manpower through the fact that he is an economist, and he is interested ia business administration in the United States. He holds a Professorship of Business Administration at Columbia. He might have influenced the President of Columbia to undertake 'I this study, for all I know, because Professor Gi~,berg was in it from the 4'J beginning. Various things are said as to why General Dwight D. Eisenhower, who was then President of ColUJ11bia University, got so interested in a stuey of human resources in the country. One of the reasons given is that he was shocked to find how many young men in. this country were disqualified for service in the Arar:, because of mental, emotional, or physical deficiencies. He also, as a soldier, was shocked by the rumors that were going around toward the end of the war that maybe the country didn't have enough men of military age to 956 fill in for replacements and make up the losses that were occurring ia the war with Germany and Japan. I think that was a real anxiety because at the time of the Battle of the Bulge, Ueneral Eisenhower was greatly worried I as to whether he could get enough soldiers to meet that German offen~Vl. I ,_. !•ve read somewhere else that at the end of the war--I think in the report of ~ the Chief of Army Transportation--it was stated that about thernd of the war there was not one full division left in the United States, a really full and equipped, ready, trained division. Frm. a military point of view there were anxieties about the numbers of people that would be serviceable for all sorts of things--both military and civilian--in the country. There was a realization of this probi•, of this situation among indus­ trialists because they needed to know a great deal about what was called the work force, the labor force in the country. We don't know what the labor I force is in the country-. Its a variable affair. It has to do with employ- ment, has to do with the sex ef people. At one time they include all women in the labor force, and at another time they doa•t. One time they will in­ clude school children in the labor force, and when the schools OJ:eft, they go out of the labor force. It seems to me those things also make you cautious as to what conclusion you draw from. the statements of unemployment rates, or unemployment ftUJ11bers. They're seasonal, and they vary a good deal. Well, there are thousands of questions connected with the characteristics of the people in the country- who would be needed for one thing, or another, or who would be able to supply manual labor, or intellectual labor, or artistic labor--all sorts of capacities. As I say, I don't know for sure how the stuq,r of the manpower of the country became so interesting to the President of Columbia that he backed it !II 957 and made a project out of it sanctioned by the university and well supported by fuNds that were drawn into it. The coDlllittee tha~\{as appointed was very interesting in its composition. There were industrialists, economists, llistorians, public servants 1teCharles P. Taft, a very shrewd friend of 7ours named Robert M. Mac Iver. I for""fu.nately was a member thanks to the friendship with Eli Ginzberg, I'm sure. This Council had an unusually able b chairman, Mr. James D. Zellerbach who was a rich man from the tillerlands and " the vineyards of California--the Crown Zellerbach Corporation, manufacturers tf paper and paper products was his main business, but he also cultivated the grape. The Council started meeting in New York with the aid of a very able staff headed up chiefly by Henry David, who was the staff man wi o did the footwork and managed the office of the Council. The procedure followed was to hold a full meeting of the members et the Council who would carry on a discussion guided by a previously prepared agenda and by the study of some staff papers that had been prepared and sent tut in advance on the topics that were to be considered on the day of that aeeting. Those discussions~tayed in binds quite well, but there was no limitation. on what anybody wanted to sq, and occasionally, naturally, the discussions ran far beyend the subjects of the agenda. The meetings lasted all day--sometimes into the evening, sometimes several days. One mode of conducting the meetings was to remove the Council from New York and take it up to the Harrilllan E~ta te in middle New York. This Harriman place /_Ardea Hous!7 built by Averell Harriman 1 s father lfdward Henry Harrimay was like a Rhineland castle, a great, big ornate house on a granite ledge with a wonderful view over the rolling countryside, steep cliffs near the walls of the building, ornate carvings. It was old-fashioned in many ways 958 at the time we occupied it for several days for a meeting bec~use it was built back in the 1890s, somewhere back there--great big bathtubs in which ,ou could swim, or settle into a marble bathro0111 fioor with plumbing fixtures that were as large as steam valves for some kind of engines. You entered the place through a chapel. Whether thatwas always the way I don't knew, but you came in through a chapel, through dark oak carved pews and rather Gothic-like beuas leading into a vaulted ceiling. The other rooas in the building were enormous places where you could have good sized meetings. There was a very large dining room. The meetings at the Harriman estate by the Council were populated by the members of the Council plus all of the staff, plus a number of Visitors, plus quite a number of consultants that were brought in. This was a very thorough schooling for the members of the Council and proVid.ed an opportunity for a very thorough investigation of the subject, or discussion of the subject. Eli Ginzberg and his staff were very clever in what they did for these meetings, in the manner in which they managed to have their expert papers embodied in the discussions, embodied in the book that was published en A Policy for Scientific and Professional Manpower (New York, 1953) in such a way that the members of the Council bad the feeling that they were doing it themselves. It was very cleverly done, but if you look at the book, you can see that it is really divided into staff papers and some of the louncil 1 s discussions. I think it took the better part of two years to produce this first book from the Council which bears the impriat of 1953. It took fully that. I kmow it was not published until I was down here in Washington as Technical Director of Research in the Office of the Surgeon General. 959 The first copy of the book was brought down for presentation to President Eisenhower who met members of the Council in the rose garden next to his low ceilinged office ia the Executl.ve Wing of the ~ite House. He seemed pleased, but perhaps a little uneasy, because the dust cover on the volume of the copy given to him was a fiaming red, and he did say, "Why did you give me this red book? 11 It looked as if the communists might have had an influence on the Council and indeed some of the things that are said in this report are not only liberal, but they go rather into the future possibility of social rearrangements in the country. or course, it 1 s not a communist book, and the President was only joking when he pretended to be frightened by the color ot the cover. The deliberatiollB of the Council showed that there were great shortages of people in certain capacities in the country, that there was a great need for the accumulation of knowledge of the compesition of the population, that a great requireaent was having as exact figures as possible in order for ailitacy planning, or industrial planning to go forward. I suppose this is not by aft1' meaas the first study of this kind. I'm sure it isn't. I think John Stuart Mill long ago did something of this kind. Every nation ha+ooked over its human resources from time immemorial. This may have been what people call a more sophisticated type of study. Well, it eugh~ to get better as time goes oa. You find out what deficiencies there were in. previous studies, and you can then do something more exact in the next study-. This Manpower Council, it was called, the National Manpower Council, published a number of other books. They studied--yes, Wc,man Power (New York, 1957) and problems of Student Defermeat and National Manpower Policy (New York, 1952). The Council studied in the coming years 960 problems of the Negro, problems ff the Uneducated--I don• t mean their personal problems, but the problems of national usage that came from characteristics of these groups I mentioned. Eli Ginzberg is a very pro­ lific writer and a very clear thinker, and he is continuing to write and talk about human resources with very influential eloquence and knowledge. On this list of the Council from what minds qid lou get a real push1 ~~n if ~ it was sanething you could~? You mean leaVing out Ginzberg and the staff. And meaning 110 disparagement to these that remain unmentioned, but--you kno~, in any discussion, there are some live wires. Well, Professor Robert Maciver was a very live wire, carried a high charge which sparked at the least approach to some other conducting sub­ stance--! ■ean the mil'ld of somebody- near hill.. The only woman on the Council was Sam E. Southall, and I can remember her speaking to the point on a good many things, but I don't remember exactly what she may have said. Jacob S Potolsky, President or the Amalgamated. Clothing Workers or America, was an intelligent and expressive man with firm opinions, but reasonable though. I think I approached him thinking he was a labor leader from the Garment District lbo would have very fixed ideas. Thatwa.s not so. As a matter of fact, -~ I aft some other people at the New York Hospital-Cornell Medical Center got \ ~ interested in the possibility of getting the Board of Governcrs to '\lect Mr. Potofsky as oae of the members. That board--this is a di&ression, but I will forget it if I don't mention it now, the Board of Governors thought it ought to broaden its representational characteristics by having importat men from religion, from sectarian religion and from labor en it. ·rhey started in by thinking that they would elect first Rabbi Stephen Wise who was a very- fine man. You know of him in New York? Thats eemed too small a thing to do and possibly offensive to other pre­ lates in the district, if you took only one branch of the church for repre­ sentation, so they elected Cardinal Spellman /Jrancis Cardinal (Joseph) Spellmay and the Bishop or the Episcopal Church, Bishop Henry Knox Sherrill, known to me from the Institute of Nutrition days, a friend of mine at Yale a lo~ time. Rabbi Wise didn't accept, but we did have the benefit of Cardinal Spellman and Bishop Sherrill. Of those two Cardinal Spellman was the more faithful in attendance at the meetings and had a great deal of genuine interest in hospital administration, particularly in matters of finance and insurance. He said some very shrewd thin.gs. Bishop Sherrill who had been on the Board of the Massachusetts General Hespital and who im­ pressed the Yale Corporation very much while I was Deaa there by the things he oaid about aecli.cal edncatioa a+• management of such a hoopital as the New Haven Hospital, took relati-wely little part in tne affairs of the New York Hospital-Cornell Medical Center, and he didn't attend many meetings. Were you able to get the labor leader representation? No. He's an interesting fellow--Jacob Potofsky. 962 The other people on the Council that I recal.1--of course, Mr. Zellerbach was an 1.Jllpressive person with a quick mind. Philip Youag, who was the Chairman of the Civil Service Commission in Washington came to a number of aeetings and said a good many things out or his experience because he's had to do with many- personnel problems through the Civil Service Cormnission. A un that interested all the members of the Council was Dr. Wilbur c. Munaecke lbo was the vice presideat of the »arshall Field Enterprises in Chicago, a very substantial man. We even had good physical advice from the fountainhead or physics who was at the same time anf economist and a student cf human behavior, a wise man and an attractive man, Lee A. DuBridge. Do you know him? He was president or the California Institute of Technology at that time. I,m looking at the printed list or the members, and these are the ones I aostly recall. ' I aVDice here that one men we looked for very much wasn't I\.., appointed until March or 1953, and didn 1 t participate in the study that we're discussing on professional manpower policy and that was Douglas Soutllall Freeman. I doft 1 t remember that he was ever at a meeting, but I wi.:h I•d seen him. General Lee is one of my heroes. He wrete •••/Lee and His Lieutenants? Yes 1 a good four volume work. Was it the Council that determined the recommendatiens1 or did thez merely' pass on the recomm.endatuons as presente~ te them by th! start? Was it give and take? Yes, it was a give and take. The staff would draw up--a recommendatioa-­ at any er these big Council meetings, you must have something on a piece of papero To carve up. Yes, carve up, or hammer at. I learned that at these :mee.tinf of these A.. important bodies and used it, as I will tell later, on this st11dy of medical educatioa and research that was done by the co:mmittee appointed by Mr. Marion. B. Folso:m later on in 1958. When we reached an impasse, so to speak, where nobody could agree on. the wording of a resolution, a move was made--I don't mean a aotion, a move, an action was taken to get somebody te write down what he thought the group was intending to say and then get copies made, pass that all arout.id and chew it up. That's slow. When we were in Washington finishing up the report on medical education and research '}f (!! tor Mr. Folsom, the Secretary of HEW allowed us to have the help of five six stenographers, secretaries. They would come into the room when we were in a state of indecision, and they would sit down and take down quickly what one man was saying, or another was saying, or what the group thought it might want to say, go out and make ten or fifteen copies, come back--it made a little break too in. the discussion which was not too harmful and which let the dust settleo When you have somethin~ to look at with a pencil1 or in talk1 it's a lot easier to go about refining it instead of throwing air back and forth. Was this the way this Council worked? Yes, they worked over those recom:mendations. It you'll notice•• the front of the book--"a statement by the Council with facts and issues pre­ pared by the research staff." They separate them right on the title page. I left New York before this book was published, although the study had been completed before I le:t't--not quite completed. I lost contact with the 964 ~ people working 011 problem8 er human resources, got i.Junerse~ in the medical research affairs of the Surgeon General, and I really don't know what impact, as they say, all these volumes have had.. There have beea doze as of studies or man.power since then. For example, Dr. Leroy E. Burney, when ne was Surgeoa General of the Publlic Health Service, appointed a committee to study aedical manpower. In our committee for Mr. Folsom we have a good deal to say about manpewer. By accident just the day before yesterday I happened to wander around in one section of the shelves on B level of this National Library of Medicine, and I found books of hearings in the Department of Labor, Department of Agriculture, various ones like those small typographically manufactured tOJlles by the Government Printing Office, books tour iaches thick, a thousand pages, labeled "manpower." They came out just in the last year or so. We :mentioned the National Research Council way back. I was ea the committee on getting up a roster of the scieatists ef the countl'7•-that•s a favorite pasC:-tiae. '-' At the time you draw up the list fer the National Research Council, this kind of thinking and approach wasn't, so far as I am aware, part et the body of material zresented in um;versities in courses. It's become a rubrie 1 or a way in which you can present material, or preseat problems in a university !ettin.g. It was not part of the scheme as of the ti.Jlle you were making the lists. I was thinking about the value of those lists the other day in connection with this history of preventive aedicine that l•m writing. They have in the llilitary a classification system. . Its called--every officer gets what's I'\ called an MOS number. That means the Military Occupational Specialty. There was none ot that when World War II started. In 19401 when Ueneral Simmons euae down into the Surgeon General's Office to be head of the newly established Subdivision of Preventive Medicine, he had only two men on his staff, and he had to build up his staff. He had ne MOS numbers to look over, but he was the best personnel officer on his owa. He knew everybody in the country, or he kn.ew how to find out about what kinds of characters there were, what their capacities were. I read a very serious book recently on personnel management in the military forces, and the author says perfectly plainly that you just eaa•t depend en MOS numbers, or lists to tell whether this man is really tbe un you~nt. MOS numbers and classifications in these lists don't take into consideration the emotional content. That's that volume. Yes, that I s this vol11111.e, Report of Working Group oa Human BehaVior under Conditions of Military Service, but that's much later. That is much later. In a way without the classification system, or the listing that you came out with in the National Research Council--sae fumbliy effort to deal with this great sprawling thing called America that has talent •••• Leonard Candchael was head ef that working group at that tille. He s was a psycholegist, always iatere~ted in behavier, and he rather &uided that sort of study. I don• think the classification s stem was acce ted until 1943 was it? It was a start as this is a start to get thinkiag en an overall basis as to what u have available and how o enhance it. I don't su ese we cans ueeze any more out of this 1 except that this is the kind of committee _!_n2:.!_l!l_s~­ ~ ~ .P~.oEl~_in a process that you hadn't really necesarily had before-­ the cross section of humanity that is on that Council was a new thing 1 new insight, like Potofsky. I don't recall your dealing with a labor leader before. It wae a very broadening exi;e rience. Let me hear you say about picking teams. People have been picking teams ever since there was a Roman Legion. You get it down on paper, and it won't wash. Yeu have to see it run around a track for a while 1 and then these indetenniaant things that make all the difference come to the surface, and you have to make adjustments. I think that's simply because nothing we ever do has the stamp of finality on it. It's really open ended1 but at least you have better pliers, or maybe a set of eyes. I think we could leave the extramural, I believe. Yes. Except for oae thing. It's not really extramural. Let's just deal with 1946 and 1947. In part 1 we've already mentioned something about it 1 but not with the kind of precision that we eught to 1 and this was getting out of the Surgeon General's Office and the basis oft which you left. I found something this morning, and you also found some things, whereby you were made a con­ sultant to the Secretary of War in July. 19461 and in that capacity cane to serve as the first president of the reorganized Army Epidemiological Board, reorganized after World War II 1 and you were its president, something that we 967 everlooked at the time. Francis Blake was the first president of that board• or the early board during the war. Yeso But here in 1946-1947. Yes, in July, 1946 to 1947, I was president of the Army Epidemiological Board. I should like to just have a chance to correct that date somehow or other. Maybe it was July, 1947 to 1948. I•m aot sure. There's a contra­ dictioa. Well, the reason I hesitate to say that it was July, 1946-yes, it's all right. I was still in uniform, but I had been separated officially from the Army in Mayo I had a hundred and eighteen days of terminal leave, and I was staying around the place. I didn't go away during that leave, so I worked practically in a civilian status. The reason I speak of this was that we had an unwritten rule in that board. that nobody in government service could be one of the board. For instance, Topping LDr. Norman H. Toppin,17 was a very valuable man in rickettsial disease studies, but he was an officer of the Public Health Service, and we never put him on. You look over the lists or the directors of the Commissions and the members of the Commissi. ons, and 1ou don't find a soldier, or a military man, or a Public Health Service m.an, er a Navy man, ~nd we thought we'd have to--I don't know that we had it written down anywhere, but I know that was a rule that guided me and General Simmons and Dr. Blake. The board could be assisted by a military man the way I assisted it by bei11g its so-called administrator in a uniform, and how Major Aims C. McGuinness, wry assistant, carried a great deal of the work of 968 the board, but he wasn't a member of the commissions either. Or the way we described how sipplies were available, or laboratories could be The fact that I was appointed a consultant to the Secretary of War when I reverted to this civilian status was simply following what this board itself had established. These co11SUltants to the Secretary of War didn't exist before we got the twenty dollar a day people we talked about earlier in the composition of the Commissions. There was, however, in the Surgeon General's Office a military rank of consultant. I think I explained earlier--Brigadier General Hugh J. Morgan was a consultant. It was called the Consultant's Division, the Consultant's Service. The head of surgery, Brigadier General Fred w. Rankin, was a consultant. The head of psychiatry, Brigadier General William c. Me11l1dinger, was a consultant. They didn't have a civilian appointment as a consultaat. All the civilians have a regular civil service appointment. It even carried the Social Security Number when that came ia, but the consultants we're talking about named themselves because they had a sort of Harley Street snobbery estimate of their positiou in the service. This was disadvant~geous to Preventive Medicine because none of the Preven­ tive Medicine officers called themselves consultants, and~heyweren 1 t included in the Consultant's Division in the Surgeoa General's Office, so much so that after the war when we formed a society that called themselves "Con­ sultants to the Armed Forces", we had to organize a cam.piga to get the by­ laws changed to admit Preventive Medicine people of great distinction to that society. I happened to be one of the founding members, so I had no trouble o Until the by-laws were changed, I couldn't get John H. Dingle, or Thomas Francis Jr., or Colin MacLeod, or any of those people bec~use they didn't have this particular title of consultant. This record that we have before us shows that I was president of the Artfr/ Epidemiological Board, as it was called, from July, 1946 to July, 1947. I got separated frcm tne A.nrry officially in May, 1946. I terminated mr military status in September, early September, when my one hundred and eighteen days were up. I went to try to pick up things in New Haven, and I see that one of the things that came back to ae--was rejuvenated, I•u say-­ was Director of the Commission en Epidemiological Survey which is the same thing I had in 1941, when it started. There was a blank thereafter f:rom 1948 to 1953. When I went to the Joint Administrative Board, apparently it was a 11 ttle too much extra to try to keep up membership on the Commissi. ens and the board, so there was a blank in there. We didn't want to go any further than that because things get a little com­ plicated. The note I read this morm.n.g was oa a citation for a medal. It listed these dates and said1 in effect, that you were in this capacity as consultant to the Secretary of War and you were president of the reorganized board after World War II. Now the "reorganized board" I den' t know anything about--we have clusters of papers over here, the history .from those who participated during the war. Did anything happen. to tbe board when it was reorganized after the war from the point ef new of procedure? It was reorganized because at the end of the war the Surge•• General appointed a research board--Research ard Development Board. Did you find any­ thing about that in the papers? Where did you say it was mentioned? It's mentioned here. "The recommendations in this report have not been acted 970 upon. The Research amd Development Board•••• " That Research and Development Board is iB the DepartmeAt of Defen~se. f nR."1 & . & «1-1 , ~ ·1 1.1."1 A t1 A · °l)t,f(baf>J3 J "'"' General--well, I have his name.~! dian•t expect te get these ltoards criss- crossed like this today. The Surgeon General also had a Research and Development Board even before the war., and he revised it in line with the Research and Development Boards that were being created in the Department of the Army an~he Department of Defense. General Prentiss., a ver:y nice man, a man who did not have com.pelling ambitions tc, make all Jl'Ople alike, took ever in the Surgeon General's Office and did have some effect on the procedures or the Arsy Epidemiological Board and how it was organized. For a year or two., about 1946, at the end of the war, Prentiss was doing things to draw the Army Epidemiological Board into the scope and control of his Research and Development Board, and we opposed thato He was followed by this man we have mentioned before who assured me that he didn't have any idea of changing the board too much., and that's Colonel William S.Stone whose papers we looked over one day. But there were no real changes of any consequence at that time. The change that is coming we'll talk about maybe another ti.Dle when I get 1ou the Charter, the change to the tri-eervice function of the board. It got a Charter um er Dr. MacLeod I s guidance .from the Department or Defense lb ich made it the Al'lled Ferces Epidemiological Board. It was to be regarded as a board serviceable to the Anrt1, Navy, aad the Air Force. Its executive secretary was appointed for a term of five years and to be successively an An,ry Medical Officer, a Navy Medical Officer., and Air Force Officer and around aad around like that. The Charter tells about the primary interest of the Armed Forces Epidemiological Board in Preventive Medicine. The Board started in Preventive Medicine. It still is. Although it is the Al"lled Ferces Epidemiological Board, it's interested in a great many things, and it is still concerned with aiding the Surgeon. General to form policy- for the control of communicable disease. It deals with immunization procedures. It deals with all the etiological factors or any disease that is camnunicable including aow accident prevention. There's an epidemiology of accidents which is very- interesting and developed by John Gordon., an. epidemiologist at Harvard, who was a Preventive Medicine Officer or the European Theater of Operatiorus under General Hawley. It 1 s amazing to see the epide¢ology of non-contagious con.ditions coming to the fore mere and mereo There's aa epidemiology- of accidents. They can treat apParently any set of human experieaces frm an epidemiological and ecological point of view, se there is a Commissioa oa Accidental TraUlla which is a very important tb.ing to the Ars:, because now in peace time in the Army fa. th~ flea ths from automobile acciden.ts exceea anything else. It now exceeds the death from aviation. training in peace time, very important for loss of I time, expense, and disability. Its a long story, aad we're getting somewhere with it, but there 1 s a crisscross or interested agencies in the Defense De­ partment and parts of the A~· are in.fluencing congressmen to even pass a rule that the Army Medical Service must not make an;y contributions to the expenses of a commission dealing with accidents among troeps. The charter also makes the Armed Ferces Epidemiological Board the tri­ serTice organization, motivated and functioning as if the unification of the services was, in fact, a matter of existence and not a matter of desire, but--and I mean this but this time--the Secretary of the Anny is made the managi~g agent of the Armed Forces Epidemiological Beard, and the A.rmy 972 thffiugh the Surgeoa General's Office pays all the expenses of the several million dollars a year of the investigations conducted by the commissions of this Board. One of the troubles the Board is having is that the Air Force has never put upr~ore than a few nickels, the Navy hardly anything at all, though they are getting extremely good service out of the Board. I think myself that it was a mistake, in a way, to make this Board a s-ervant of three masters. It functioned extremely well when it had only a I loyalty to the A"1."l'fIY and to the Surgeon Generalo Now its supposed to be loyal to three Surgeons General, and it is-it does a lot of :orktror the Navy aad Air Force, and it knows that it doesn't get much, if any, support in finances from them. There are constant difficulties arranging for those things, and the Navy said that this Charter doesn't compel them to put up any money, that the Secretary of the A:nrr3' is the managing agent, and management must be coupled with the burden of expense. I think psychologically however, the mere fact that it's got a three headed authority to serve has dilur~ its loyalties. 1 •ve told them many times that I think they would have been better off if they'd stayed an arm of the Army. Hevertheless, it's I increased greatly in its monetary allotments, and its become involved in aa ... enormous proliferation of research agencies--I'd just say in the Army alone­ tremendous. I was thinking of this critical zear--er what appears to me to be a critical zear 1 the one following the termination of hostilities of World War Ilo In z:our first chapter ill PreventiTe M.ediciM 1 in reading it you run across a crisis to which there is a response of research--you have the yellow fever commission as an example. You always face a period of non-crises~ medical research sort of goes back into an indistin€'!ishable mass until some- 973 thing aew in the way of crisis comes along on the horizon to wb.~ch it must respoftd. Here it would appear that in 1946-19471 with the terminatioa of hostilities there was an eff~rt to keep this research stable and ongoing and prevent its falling back into a sort of morass. In the history of investigative boards in the Arrtr:r, it was perfectly apparent that adYances have been made in time of war. That is certainly true of the boards tha"1 Sternberg put up--the Walter Reed Board, the board to study tropical diseases in the Philippines aftd Panama following the Spanish American War. They, however, didn't go down to nothing right after those wars. l'he Philippine Board stayed a good many years, and the Board in Panama was functioning as late as 1938. What I meant was that concern with continuity is1 I think, more aeearent as a consequence of World War II than it would be, let's saz, in the Spanish­ American War. Sternberg may have wanted continuity of research in the sense that malaria, yellow fever, tropical disease is important even in 1903 1 and he should have had access to continuing knowledge and research, but here you must have faced the problem whether war time research would recede and how to greserve it--Prentiss, for exaMEle. One worry was how to preserve the interest of the directors and members of the commissions. I kept asld.ng what we were going to substitute for patriotism when the war was over. The closer they got to the erd., the more they began to think of returning to their natural academic pursuits without having obligations to get work done for urgent military situations. Holding them together was made possible by the continuation of appropriations for the Board, and appropriations increased. Fortunately we were able to ride on the 974 waves of aroused interest in scientific research in the whole country. ' During World ,~ar II was the beginning of the great burst of government supported research in the United States, in the Ar,q-, Navy, and the Public Health Service, and in civilian agencies too-Atomic Energy COlllDlission. Certainly the research effort was not at all demobilized the way the military effort was demobilized. The military in characteristic Angio-Saxen fashion just dropped down to bare bones, or dropped from a giant to a dwarf. You said earlier that you resisted efforts on the part of the Researcn and • Develop:nent Boards, which were sprtngin_g up as a ld.ad of tent, to submerc• the Az:my Epidemiological Board under some new heading 1 to preserve its continuity, or preserve its momentum, if possible, and the role and function which it suppliedo After you cut off connectiol'lS with the Army Epidemiological Board and were President of the Joint Administrative Board, the Koreaa War came on--you kl"low 1 and while that war was something where a debate raged as to whether it was wise, or ~ether it wasn't wise1 nonetheless we were there, present--and performing. We didn't talk about the effect it may1 or may not have had on the workigs of the New York Hospital, or the medical scientific manpower, or having this AJ!'l Epidemiological Board preserved in such fashion that it could be useful and function. Sternberg, I think, would have wanted ~he s.me thi~. The Ar-, Epidemiological Board was not called oa very much in the Korean period 0 It\w asn•t, No, the Walter Reed Army Medical Center developed a great research 975 capacity of its own. There was some use of a few members ef a few commissions, particularly the one on Enteric Infections because dysentery and diarrhea were so prevalent particularly among prisoners of war on an island called Koje-de. That's where General Dean was pulled into the compound by- the cODUm.1aists, the North Koreans, the pirisoners oa that islan.d. Do you remember that? No, it wasn't General Dean. General Deaa was captured north ot I()f},1tJ. - <';t-~. 'f'~~:.s I &l>b ]_) Pusan. Another general down there; rougfit he I d walk into the compound and have a talk with these men. They pulled him in and kept him a prisoner within the compound themselves with the other prisoners for a while. The dysentery was very bSd. One member of the Commision on Enteric Infections of the Board was sent over--Dr. Albert V. Hardy. He worked with Colonel Richard P. Mason on dysentery on Koje-do. Did you ever read about Koje-do? No 1 but I did bump into it in something in the papers this morningo The other main mysterious disease in Korea was hemorrhagic fever, and that was studied largely by members of the Army Medical Center. Another great research institution that had been formed over there was the 405 General Medical Laboritory in Japan which is very good. Let's call a halt today and get back into the basis for this a little bit better. I'll get a copy of the Charter of the Board0 976 Wednesday1 July 20 1 1966 A-60 1 N. L. M. In order to clarify your relations, both formal and informal, with the Surgeon General's Office in the Army1 I think it's important for you to put in at least some indication--we were discussing this before we turned the machine on--the kind of relationship you'd had with the Surgeon General's Office during the period of the Joint Administrative Board of the New York Hospital-Cornell Medical Center. I think this will clarify the relationship and provide a bridge for us to leave New York Cit7 and think in terms of the Research and Develo1,111ent Board that had emerged in the Arluzo When I weat out of the Arrq in September, 1946, and moYed some things to New Havea, I was uncertain. as to whether or not I would return permanently to New Haveno My formal connection with the Army Epidemiological Bea rd and its commissions ceased in the late spring of 1947. This is not to say that I didn't know what they were doing. I had many opportunities to talk with the board and commissions, but I had no more responsibilities relative to the activities of the board and the commissions. Nevertheless, I did have a formal and continuing contact with the Office of the Surgeon General through the Research and DeveloJEent Division from 1946, un:til an indefinite time approaching the el'Ji of my term as President of the Joint Administrative Board in 1953. This contact with the Research and Development Division was in the form of two coatracts for the production of two histories. One was to be a History of the Army Epidemiological Board, and the other one was to be a History of the United States of America Typhus Commission. I agreed to write these histories, and I took with me to New Haven, and als• brought to New York, files of records of the Typhus Commission and some files of the 977 Anay Epidemiological Board• These contracts provided for some secretarial assistance and travel expenses occasionally- and incidental expenses connected with the work. The con.tracts didn 1 t include eaolument £or me as a producer or the histories. They were administered in the Sur1eon °eneral 1 a Office bf ColQnel Will1.aa s. Stone in Research and Developnento Although they- were centracts for work in Arm:, Medical History-, they)were not, at that time connected. with the Historical Division, except through the personal associations that I bad with Colonel Joseph H. McNinch, or Colonel Calvin H. Goddard, or people in the Historical Division because I used to go in there and get out some of the records that I needed for the production of these histories. They were especially helpful to tae, especially a lady nllllled Mrs. Josephine P• Kyle. Well, I worked spasmodically on those histories and produced two rather long outlines of what they/were going to be• I think you 1ve fo11nd them ia these papers. Colonel Stone 1 a remark about the Typhus Cemmissi•n., u I remember, was that the outline was longer than the expected history. That was rather an exaggeration because I finally wrote for VolUJ18 VII of the History of Preventive Medicine Series in 1955, an account of typhus fever in the Army and in ttie world llhich is eosential.l;r th+i•toey of the United States TyphWI Commission_ [f.t was published in 196!!7 That's much longer than tho pages of my abstract~ How m&tV" printed pages is it? Thatts it in your hand. Well, altogether this one including epid8lf.:ic typhus and murine typhus is about a hundred printed pages. That publication meets my obligation to produce a history or the Typhus Colllmission, but as yet I have not written a history of the Army Epidemiological Boa.rd. Itm planning to put in Volume I or the Preventive Medicine Series that Irm nw writing a considerable section 978 ~ oa the Army Epidemiological Board which will be,CCOn.densed history- of it. The contracts helped me to get the files in order, especially the file+f the United States of America TyphiE Commission becaus~ll thoss files are well arranged and in order and have been put in the Archives Section of the Historical U~it of the Army Medical Service. Each one of those thick files has a table of contents inroftt of it, dated and with a short accourt. of what 1 s in it, a one line account. J The other relations I had during this period with the ~geoa General's Office were iftformal, personal, administrative and professional. For in­ stance, in 1950 1 to work on the material for the history- of the Army Epi­ demiological Board, I came to Washington and took a room at the Hay Ada.ms House. I had my files there such as I needed, and I stayed a month. I worked a great deal in the Surgeon General's Historical Unit in the main Navy Building at that time, and I saw a considerable amount of the affairs of the Surgeon ueneral's Office that were in process. This was about the beginning of the Korean War. The Surgeon General then was Major General Raymond W. Bliss lhom I had known for a long time. The Deputy Surgeon General whom I had known for a long time, was a long time friend, Major General George E4 Armstrong who succeeded General Bliss as S~rbeon V Uenera]. and after 1 that went in to a job at the New York University-Bellevue Medical Center which was very much like the job I had as President of the Joint Adlllini.strative Board. We had many associations of a personal nature through those activities. I didn't become very deeply involved with anything to do witn the Korean War--they talked to me a good deal about things that were going on, but that was too early for the emergence of the kinds of problems that would 979 call for epidemiological surveys and epidemiological board type work. How- ever, as the Korean War went on, I knew of several of their main problems and had something to do {m th discussions of how they would ~~tack them. ~ 1 -._,., One of the main problems was the blood substitute problem. What could you use in place of jaundice producing plasma, for example? So the~<1'veloped dextran. Well, dextran is a carbohydrate {j,olysaccharidi/ with which I was familiar because at the New York Hospital-Cornell Medical Center, one of the bacteriologists had been able to isolate this substance from a peculiar streptococcus, and it was a valuable addition to the knowledge of dextrano Blood substitutes were interesting for discussion and for tractical purposes and, as I say, I had some talks about them, although I had no official con­ nection with the Office of the Surgeon General in handling the problem. One problem that arose in Korea that required Epidemiological Board type ef work was dysentel'}I among the Korean prisoners of war, particularly on the island of Koje-dou The Board, particularly its Commission on Enteric In­ fections, actually helped out in the investigation of that. The other problem was hemmorrhagic fever, a peculiar disease that occurred in a regioa north of Seoul mostly, usually fatal, often fatal, which was a mystery. I mention these things to indicate that I was not during this period entirely ,;eparated from the Surgeon ~eneral's Office, or the Boarc:t. I knew a good many people in the various divisions of the Surgeon N General's Office, particularly in Preve~tive Medicine, where my friend, /\ Colonel Tom F. Whayne was head of Preventive Mediciae. He'd been with us in the war at one time. Arthur Long succeeded him there in Preventive Medicine. In the Historical Division I knew the successive chiefs of that-­ Colonel Joseph Hamilton McNinch, Colonel CalVin H. Goddard, and a good maey 980 people on the staff. I had 1011g time friends among the clerical people that C I 1d see in the SurgeNt General's Office whenever I was down there--like Miss Omar Short who really goes back to service under my relative, Colonel Gorgas, in the Record Room. The Chief of the Finance Division in the Surgeon General's Office, Mr. Nephthune Fogelberg was a friend and a man I saw very often. The Chief of the Medical Statistics Division, Mr. Eugene L. Hamilton was one we consulted frequently in connection with these histories. So even though I was away and not officially connected, I really saw a fair amount of what was going on in the Surgeon General 1 2 Office. As the time of my retirement from the Joint Administrative Board approachedJ namely, the earl of June in 1953, in my 65th year when according to the order of appointment I was due for retirement, I naturally began to think about the future--what would a man do at sixty-five when he retired from his job? I had never been sick. I was healthy and able to go on working. I didn't know. I had no particular plans until May, 1952, when very unexpectedly Colonel, later Brigadier General, John R. Wood, wrote me a letter offering me the position of Technical Directer of Research and in the Research and Developnent Division, as it was called at that time, in the u Office of the Surgeon eneral of the Army. Colonel Wood knew that I was obligated for practically full time work at the New York Hospital-Cornell Medical Center until I retired, but he did suggest that if there was anything I could do on a part time basis, it would be accepta.ble, or at least would make an acceptable arrangement. The correspondence which we haw reviewed shows that the idea of offering :me this job was put in the mind of Colonel Wood by :m_y- old time teacher and friel'Jd. 1 Dr. Milton c. Win.ternitz, who was then Director of the Childs Fu~d, succeeding me, and he was also connected with 981 some continuing work at the National Research Council. He wasrn and out of Washington; in fact, he took an apartment here in Washington, and he and I his wiftoved down here for the NRC work. Apparently Dr. Winternitz thought I could do the job in the Surgeon General•s Office as Technical Director of Research, and that it would be possible te make a part time arrangement covering the period from May- 1 1952, until I could coae to Washin.gtea, sq after July 1 1 1953. After thinking that over, a4or course talking it over veey carefully with Mrs., Bayne..Joaes, I decided that it was just the thing I wanted to do, a very interesting and unexpected pleasure 0 She was pleased with it too s because she was from Baltimore and she had friend in Washington and looked '\ forward to coming to Washington with much interest. The proposal for part time work for the remainder •+he time--the last half of 1952, and the first half of' 1953, was not frightening because, as Is ay, I knew all these people, and they knew that I w<JUl.dn't be pushed around to do things that were not possible. The vacancy had occurred by' the tngic death of Dr., Francis Gilman Blake whom we have mentioned often as one of' the founders and first President of the Array Epidemiological Board. Dr. Blake had moved in to the Research and Developnent Division ia the Office of the Su.rgeoa General early in 1952, te be the Technical Director of Research. Unhappily he died suddenly in the office, or shortly after he had a heart attack which occurred in the office, and I think he died within a tew hours 4 It began to frighten me somewhat because Dr. Blake and I had leap frogged, or followed each other. He followed me as Dean of the Yale Medical School and I followed him as President of' the Array Epidemiological Board. He then became I Technical Director of Research in the Officejof' the Surgeon General, and he died, and I was asked to follow him. I thought that perhaps this was the 982 moment to put a termination to this following. Don't you think so? It does give you pause. Was this a recent office that had been established? Dr. Blake was the first Technical Director of Research, and as a matter of fact the Research and Development Division as constituted at that time had a name that had been hallowed by time and protected by neglect for many, many years. At this time, however, they really wanted to make a Research and Development Division because therewa.s a great upsurge of research of all kinds in the country, in the Army, imthe government, the Department of \J Defense, and there was a great desire for the S1-(ge on General to continue the kind of research that had been done particularly by Preventive Medicine on communicable diseases during the war. The plans were to continue the Arm::, 0 Epidemiological Board which came under the Surge"A_n General's Research and Development Division and escaped being included in the Research and De~elop­ ment Board that Colonel Roger G. Prentiss had gone into which was largely controlled from on high and outside. The future looked very gor>d and interesting as outlined in this letter of May 29, from Colonel Wood to me in which he tells me about what the e functions, or what he calls the "p~sition descriptioa" for the Technical Director of Research. What he actually told me was that I could name my own ticket which is probably what he meant by this long page cf words. I came down in 19.52 and in the first half' of 19.53, about once a month, w oul.d spend a day or two, mostly talking. I carried on some correspondence about the work from New York, but not very much. It was, as I say, sort of a godsend, an unexpected thingo • How much influence ta its development did the Korean War have? In my opinion the Koreatt War had no inn11en.ce on this development. It was already underway, so to speak, in the office from the time World War II ended. This was a carry-forward of what Preventive Medicine had been doing all through the war. I don't believe that there was any real break. Itm not sure when this Research and Development Board and Division was appointed0 I don't know either. It wouldn't be in that list I gave you because--! could go and get that~ fillY don't you. . I Hold it then. J Maybe i \ s in there. From a list that had been compiled for me by Major Albert c. Riggs Jr. several years ago, I find that on 17 Aagust 1945, the Army Medical Research and Development Board in the Office of the Surgeon General was established, and at that time it was under the command of Colonel ~:ioger G. Prentiss lb o is lis}ed as chairman. On July 8, 1946, this board had the same title, but it passed under the chairmanship of Colonel Williams. Stone. Colonel Stone continued as chairman for about a year when Colon.el John Don Longfellow took ever as chairman. ' June of 1948, Colonel Stone returned as chairman, Then an and then on 21 August 1950, Colonel John R. Wood was made the chairman or this board, and that's where the connection cmes in, but, as you'll see, this was continuous right fran the end or World War TI on. through without any relation to the Korea• opBration at all. To go through with the other people who were there during the time I had connectioa with this AJ."/llY Medical Research and Development Divisioa, I can recall that Colonel Wood was succeeded by Colonel Richard P. Mason on 984 1 August 1954, and that Colonel Robert L. Hullinghtr st succeeded Colonel Mason on July 1 1 1956, and on 23 August 19.58, Brigadier General Josph H. McNinch succeeded Colonel Hullinghorst and became Commanding General of the newly established Medical Research and Development Command which was estab­ lished as a Class II activity under the Surgeon General. The main point of that, aside from the record of the people and the times, was that it was a continuing activity. That 1 s the folder you let me see before 0 Yes, this goes over into the AmD1'• This is outside the Surgeon General. I must put that in another file. That's the Army Scientific Advisory Panel. This was as a civiliaa in the Surgeon General's Office. Yes 0 I was a civilian. I retired in the grade of Brigadier General 0 Then not long after that--n.o, I retired as a Brigadier General in December of 1949; as a matter of fact, yeu have te retire. Something happens when you become sixty. I became sixty in 1948, and I can remember that I got a letter tran the Adjutant General on nry birthday saying., "Sir: You 1 v-e reached f\ the age of st~tutory limit for general officers, and we hereby transfer you to the honorary reserve• Hapw Birthday O 11 They must have a tickler, one of these circular tickler files so that when 7011.r birthday is coming up, you get a letter. What I was getting to was not only was I retired in the grade of Brigadier Generai, but it wasn't so long after that that th~Secretar7 of Defense wanted to have a ready reserve of ' all able bodied general efficers, so he called the chiets of services aad asked 985 to have the retired general officers recommissioned in the reserve. I was slow about doing that. I thought that maybe if I got into that, maybe I 1 d get into conflict of interest, or I might be called out when I was more inter­ ested in working as a civilian in the medical research part of the Surgeon General I s Office. I couldlfi' t carry through the plan of remaining aloof be­ cause General Armstrong told me, "Go on over to the Adjutallt General." I was the onl)" retired general officer in good physical condition who i hadn't gone over al'ld gotten recommissioned in the reserve, so~ went ~ver, and I still have a commissioa in the Reserve, so that's why I have u.s.A.Ro after my name--United States Army Reserve. That's gone aside frem what we started to talk about. What did you find 'When you weat down there in 1953--the scope1 dimensioft that the task preseated? I I will attempt to answer that question, although its hari for me to " separate activities specifically by years when they've been continuous from one year to another. I don't know of any break, but what I fou,1d--I can recall two main things. The program of the Research and Development Division was enlarg•ng all the time, getting more money for research con­ tracts and projects. The staff was greatly enlarged. The Division in- cluded a surgical research branch, a medical research branch, and a neuropsychiatric--! mean a psychological research branch under Colonel Charles s. Gersoni. This was very interesting, tackling modern problems of hearing, visual processes, acuity, and sensory phenomena in manners that were aew to me and extremely interesting. The Tisual studies, for example, had to do with depth perception, dimensional perceptions, and those observatioas, of course, were applied to aiming devices. This psychology branch in the Surgeon 986 General's Office, while studying the physiology of these aspects of vision, was also helping to make gun sights., reticules for firing tank guns. So (> much of the So.rgeon General's deep physi~logical work undertaken for scientific and medical purposes actually contributes to the offensive power of the forces. The other tactile studies were carried on by Professor Frank A. Geldard at the University of Virginia Psychology Laboratory where they were putting a little vibrating pack about the size of a nickel on different parts of the body, and these could be set in vibration by electronic, radio signals so that these little things planted on the shoulder, across the chest., could be given alphabetical designations so that they could send a message that way. The first one that we sent, Ir emember., was "What hath God wreughtl" which was what Alexander Graham Bell, or somebody said. That was done in the b~sement of this building at the University of Virginia. A soldier was lying on a table in a room somewhat away from the sending device, and he spelled that out-he got that message, ''What hath God wrought l 11., although he was rooms away from where the message was sent, and he heard nothing. It was just little tickling sensations on different parts of the body, labeled 'l> ot.> of . alphabetically. The point of getting that kind of work~ some urgency perhaps at that time did have a relation to the Korean War, although the take 1 off point had occurred in World War II, and that was how to rr.ake it safe for mine detectors., men using mine detectors to signal what they found. They do mine detecting in the dark, and they couldn't use flash lights to flash messages. They'd be intercepted, but this was something to help the mine detecting soldier communicate., and it was very interesting. I think it had some practical significance. It's obvious-the importance of studying 987 hearing and the apparatus that's connected with equilibrium and balance and all sorts of things. These are useful to pilots, or people in machines that are going fast, and it's enormously important now in this space business-­ witness Colonel John Glenn. The method--I•m ~etting into beyond just this casual part time work now. Do you want to go ahead with that? You asked me what I found there. I haven't got there yet in the real position0 Suppose I get thereo All righto Retirement from the Joint Administrative Board at New York was a very heart rending affair and very pleasant too. It's hard to part with friends. I have very fine statements from my friends about what had been going on in the 5tlC years Ira been there. The ending, however, was an enormous feast at the Links Club attended by Mr. Whitney, most of the Board of Governors, some of h~e Trustees of Cornell, Cardinal Spellman, members of the faculty, and one of the things I remember-I thought at the time of Dr. Winterni tz who had retired from several positions. He told me that it was always good to retire often because they gave you a good dinner when you retired. That's been my experience too. Itlil.s easy to come on down to Washington in early July, 1953. We did it by car and moved temporarily into a most delightful house oa Wisconsin Avenue, the Dolly Madison House in the Friendship School region. It was J... tf ~Al\l~~fl.!~}'_J 'r1Rs, ~lfoti.lb: owoed by our triend,(Mrs. Cary T. Grayson, the widow of Admiral Grayson. I\ This is a large Georgian House built about 1800, I think, and Dolly Madison 988 used to stay in it, a very handsome dignified place set in grounds of about ten acres right there in the middle of Washington, lawRS and terraces in the back sloping down to 37th Street, N.w. Then there was not too much building there. There were box trees that were as big around as a kiosk at a fair, sycamore trees three feet in diameter shedding leaves everywhere, a very pleasant place, a very handsome place. We stayed there nearly a month, and then we rented a house down on 27th Street just below Dumbarton Avenue, just above Rock Creek Park close to the bottom of Rock Creek Park,·just above M. Street. Well, to return to the Surgeon General's Office--it didn't require any holiday to refresh me for the new work because it was familiar work, and I have throughout my life taken very few holidays. I didn't go off on holidays \.'v very much. The work in the office--to go back to where I was saying \hat I ' found--the devision of the office into branches of special designation, of special interest which I have named. In addition, the Array Epidemiological Board as it was called then until October, 1953, was administered frc::rn one of the branches of the Research and Development Division. They may have called it the Epidemiology Branch, but the Board had its separate office and management with an executive secretary and adminis~tor and a president who I was not i~residence. A very able woman is still the mainstay of the daily I processes and much of the policies of the Board; namely, Miss Betty Gilbert who is now administrative assistant. The Board finances were held pretty closely under review by t~ Research and Development Division, and that has been a source of constant trouble. The Board never knew what money it would have to spend in)ayear. We~d tell them to go ahead and decide on what projects they wanted to support, and the Research and Development Division would try to find the money. That led to various troubles which we might as well speak about now because they're perennial; namely, the variability in the budget of even such a great organization as the Defense Derartment and a lesser organization in the Surgeon General's Office. Apparently the higher ups thought nothing of suddenly cutting the budget in half in the middle of a year. It went up and down, over and over again. With a planned thing all of a sudden you 1 d have to take a million dollars, or more out of the processes. I never knew the art of managing a budgel· under those situations, and I didn't try to get into that side of it very much, except for my side as Technical Director of Research, to l~ok into the scientific value of the proposals for work, the competence of the people who were going to do it, the evaluation of the possible results from the work, and including, in my functions, the explanation of this to the authorities that had something to do about supporting it; namely, the Chief of the Division and often the Surgeon General himselfo This budgeting up and down the scale of funds was very hard. It could be rather dangerpus at times because it was all on an annual basis in the first place, and being on an annual basis the closing and beginning of a fiscal·year of appropriations didn't correspond with the calendar year. The Congress often did not make its appropriations that you ought to have ready for the oncoming fiscal year, July 1st of any- y-ear--sometimes they lapsed until September, as you know, from the way the Congress functioMo Some of u the appropriation bills they don't pass until September. Fort~nately for the Board's side of the work, the universities carried the expenses for that time and were reimbursed latero The other kind of work in the Research and Development Division was also 990 contractual, but it didn't go through the Boardo It went through those branches that I mentioned with advisory and supervisory committees. Those contract supported things also felt the variations in the budget, but somehow or other they got along. Th~ivision also was supporting the research at the Walter Reed Army Medical Center. That I had little to do with even as Technical Director of Research. It was intimated that that was not my business. The Army Medical Center had a highly competent management and was practically independent of the Research and Development Division in the Surgeon General's Office, although they made catalogue like reports to the Surgeon General. Nevertheless, the Army Medical Center formed an Advisory Scientific Board of which I was a member, and we knew actually what the~w,re~oing. The other important relationship in lilich there were a number of problems was the relationship with the National Research Council. For some years the Army, Navy, and the Air Force had been paying the National Research Couwcil sums in varying amounts for scientific advice, advisory services. The Navy and the Air Force paid relatively little. The Army was paying about two hundred and fifty thousand dollars a year. When I got to the office, I found that the usual procedure had been for the project officer on the staff of the Research and Development Division to look over the proposals that were coming in and reports and send them routinely over to somebody in the National Research Gounci1 for eval.uation, canments and advice, Tha4'8• an easy W",f to do, but it did not develop a competence in the Office of the Surgeon General's I , Research~ _ection, so one of the things I set out to do was to try to get the I branch chiefs to develop a competence to pass judgment on these things and not depend entirely on the National Research Councilo The other difficulty that arose was that the National Research Council, 991 perhaps seeing the rather{~upine attitude of the branch chiefs and the chief of the division and not being loath to have an importance in an oi;:e rating field, began to take charge of the supervision and conduct of contract re­ search of the Surgeon General's Research and Development Division., so much so that, for example, in the blood research program which was chiefly con­ cerned with blood substitutes, perhaps some twenty imrestigators under con­ tract were reporting to the person in the Natiora 1 Research Council who had these coatracts under her supervisiono This person when I got there was not only receiving the reports directly, in a manner that prevented the Surgeon General.'• Research Office from~eing them until that person was ready to release them, or to send an abstract, but this person was also promising future contracts to other applicants for financial support. Gradually Colonel Tyrone E. Huber and I worked hard to develop a com­ petence in the office. We rlid so. We formed some coilllllittees on nutrition, for example, on liver diseases, and on resistance of insects to DDT, a big program--pesticides 0 We had no large i:rogram ia malaria attthat time, although resistance to antimalarial drugs was begianing to be noticed, and the chemo­ therapy of malaria was in a stage of reVival, after it had lapsed at the end of the war when they thought they had solved all the problemso That field of :f U\'TilS\lf oF RtscA~l!t-1 work was conducted largely by the Walter Reed .ArJq · · . -;.:_not much (\~ downtown. This kind of work that the Technical Director was doing there was \ to stll.dy all t~ se projects, to write reviews of them, and comme~t to the '\,; project and branch chiefs, but the director himself didn't really direct and didn't go into aftY experimental research on his own 0 Let's stop today--all righti 992 I think so. I 1m right at the end here. 993 Thursday1 July 21 1 1966 A-601 N. L. M. Yesterday we got you to Washington. In looking through these appointment books 1 I find you attended all manner of advisory cemmitt.ee meetings--all manner of them. You went to Denver, to Cbicago--you were pretty busy. You were also scheduled to go to Fort Bli5s 1 but that was cancelled. This was by way of orientation, I guess, to get some relationship to new things that were bein~ developed. I wanted you to indicate, if you would by way of illustration, some of the things that came before you as idea. As I under­ stand, in part, the job was to advise on new programs, or program. You in­ dicated this morning that there were some distinctions in the total program that you wanted to explain and clarify which we didn't put in yesterday--as between "in-house" aad "ex-house" work1 to fix more precisely those areas with which you had to deal. I showed you a stua, ywsterday-the Camp Kil.mer Study. I found that you went up there a couple of times. I showed y-ou aa idea on the ineffective soldier which1 I think 1 demonstrates the broadened thinking within the Ang as to what to do with ite reeources. It 8 hard to " fix this in time 1 I know1 from 1953 to the present. I read a report this 1 morning that's most recent, and it s alive with new ideas, but suppose you begin with this clarification of the "in-house" and the "ex-house" work1 and ou can cane u with some illustrations as to how deas passed through 1 it will be helpful. \ Well, what I wanted to say was~hat as the Technical Director of R~search I found that the administration orfresearch activities by the Research and Development Division in tre Office of the Surgeon ~eneral was rather sharply divided into concern with what were called 11 in-house 11 operations; namely, 994 tile research conducted in the laboratories or the Medical Depart.m.e1:1t, and I ean't avoid attaching to the other activities the odoriferous epithet "out­ house.• We always tried to avoid calling, or contrasting betweeri ''in-house" I and "otit-howse." It., s difficult to avoid it. I think we had "in-house" and •extramural operali ions. 11 The "in-house" operations were research projects, tor example, conducted at the Walterreed A'rSY Institute of' Research, or at the 406 Medical General La:,oratory in Tokyo, or under the encouragement of the 1 Research and DeTelopment Division research conducted in the General Hospitals or the Medical Departaent. That was a relativel.7 new developaent which we I tried to foster because it s good for a hospital to be engaged in soae re- 1earch, even though it isn't too serioua, or important. The amounts of money invoiTed were not great; in r act, thef were small, but the establishment of these experimental laboratories and the conduct of experilllental investigations by' aeabers or the statt ot tbe b.ospital put a new kim of lite into their intellectual associations, and it brings forward occasional]J" some able young medical officers ldlo otherwise would have gone on in clinical routines. That was done at Fort Bliss, at Fitzsiaons. We had a large undertaking at Fitzsillom General Hospital. The Ar,q ,.! Medical lu.trition Laboratory was located there and that was stri~ an "in-house" operation on a very- large scale. In addition, there was a tradition or investigation which was enlivened aml enlarged in the 19.50s for research • on tuberculosis and related problems at that hospital because F'Jtzsiaons General Hospital was the main tuberculosis hospital in the Ar'flT• I will digress here a llinute to mention more about this Army Medical Nutrition Laborat.or)"o It was originally housed in Chicago in connection with the food l processing operations or the Quartermaster General in a building reght near the slaughter houses, a rather stinking location but it was fairly productive. Then it wu moved--shortl.7 before I went inJ no, after I went in as Technical Director of' Research it was 19oved from Chicago to coBTerted barracks buildings on the groums ot the Fitzsimons General Hospital. It was a great center of nutrition research in the Arfl1' and did extraordinaril7 good work on m.any­ phaaes orfthe chemistry of roods, chemi&try or food additives, accessories like vitamins, and. on the function of organs in the body umer various nu­ tritional conditions. One large undertaking there was to study the ef'fect of diets of different kinds on human beings who came into that hospital under the auspices of tbe Arm:r Medical Nutrition Laboratory as volunteer human subjects for prolonged dietar,- experiaental research. -J.'hese were retigious objectors Liennonitey who were under control ot the bishop or their diatrict and were handled by hill. They were brought into this work through a contract arranged by the Anq Medical Research and DeTelC)Jml8nt Division and the University of Colorado Medical School in Boulder and Denver, Colorado, through the good offices of the President of the Universit7, Dr. Ward P. Darley. It was not possible fer the Arsy to pay these experimental volunteers directly', so we arranged tor a contract with the University of Colorado Medical School by which these volunteers would be regarded as employees ot the medical schoo,l. _, They got a regular stipend for their work. I think that is going on at the present tille and marry, man;y men have been used for the study of various diets and food effects in various conditions. A very interesting and illlportant outgrowth of' the work of the Army Medical Nutrition Laboratory began in about the second year of the Korean War. The Surgeon ueneral heard that there were nutritional defects in the : ,· Korean troops. How great they\w ere was not known, so the Surgeon General 996 through the Research and Developaent Division and other connections sent over to Korea special investigators one of whoa was drawn into this work troa the Public Health Service, Dr. William Heney Sebrell, who is now the head ,i (', i' ot the Nutrition Inatitu.te at Colllllbia--lfutrition lnsti tute having a sort of I Ialish background, it I sight say, because it happened after the Yale lfutrition Institute was not approved. other investigators including Dr. Harold R. S&ndstead and Major Carl J. Koehn were sent over. They exam.ned 1 1 H these Korean R. o. K. troops, to"j,..d that they- were so malnourished, under- nourished, and lacking in proper food that they thought that the Korean Arrq couldn't SUBtain a week's fighting it they were pushed. They came back and aade their report to the· Surgeon '-'eneral, and I can rea•ber 0eneral Haya aaying,"This is not onl.7 top secret, but it has to be kept under lock tor o~ people who need to know to see it.• That was an alal"lling situation. Shortly- after that the news got around that the Surgeon General had conducted an important irivestigation in nutrition in Korean troops. .Ambassador Willia Christian Bullitt heard about it on the Island ot Taiwan, and he was interested because he bad a place on tbe shore and nearly got shot one eTening by a Chineae Hationalia+oldier Go waa patrolling the beach who didn't aee ver'7 well. It turned out that the man didn 1 t sea very well be aause he bad what•• known aa n.igbt blindness, and n.igb'f blindness ia due to a deticienc7 in vitamim A. It turned out that there was a considerable deficiency in vituain A in the Chinese ~ationalist troops on Taiwan. Immediately' a request was 11ade tor an investigation, and a non­ of'ticial i12Yestigation was made b7 Dro Herbart Pollack, a noted pbysiciao and a student ot nutrition. As this know4edge spread around that the Surgeon General was interested and bad a capacity in this field, requests tor nutrition 997 1tudies becUle so mrmerous that the Surgeon General couldn't possiblJ aeet the requireaents, or the demands, or the requests. Dr. Howard T. Karsner, who was the Technical AdYiser ot Research for the Bureau of Medicine and Surgery in the NaVT, a position like the one I had in the Ara:,, and I went to the Assistant Secretary or Detenae tor Health and Medical Affairs, Dr. Frank B. Berry. We told him about this ditticulty, and ~ wondered it the Department of Defnse couldn't do something to enlarge the '\ capacities to conduct nutrition irrrestigatioM with a Yjew to strengthening aeasuraa tor national security. Dr. Berry did this, am he succeeded in obtaining from the Department ot Deten1e tairly large sums of money tor the conduct or nutrition studies prillarU,- uaong soldiers, priaari~ among soldiers ot and.ea o! countries who were allies ot the United States. Tber+as then formed, growing out or this r1'igift&l. operation ot the Anq Medical Hutrition Laborator.r, the Interdepartne ntal COlllllittee on Nutrition for National Defense. It wu ude an Interdepartmental Collllittee in the 1950s, I think, certainly by 19Sh, aade an Interdepartmental COllllittee bec&us• it was necessary to bring to 'bear on these adainistrati•• as well as scientific probiems, thoughts troa the State Department, Departaent~t Agriculture, the Arrq, Na'VJ' and the Air Forces, the Public Health Semce, and other goYerraental agencieso The lational Research Council too, non-goveroaental, but it was very aucb concerned because they had a big section on mtrition. The Interdepartmental Coami.ttee on llutrition tor National Defense, organised first under the chairmanship or Dr. Sebrell, enlisted the interest ot practically all the nutritionist• in all the universities in the United States. SOll8 two hundred or the■ have ser'f'ed. The plan that •s devised-­ and it is still being carried on-was to organize a group of nutrition in- 998 vestigators, clinicians, agron011ists, agriculturalists, chemists, economists, into temu, equip them thorougbl1', and send them over in a plaM to a country to make an investigation primarily of the nutritional state of the troops in an allied country-outside the Iron Curtain, of course. It was realized even before the work was undertaken that 7ou. can't know anything about the nutrition in troops unless ;you knew something about the nutrition of the populations trom. which the troops are drawn. So ~he stuey soon expanded to a studT of the nutrition., we'll sq, of the population of Iran, or Pakistan, or parts of India, or Spain. Over the 7ears since this began, twent7-two f e countries have been aurve7ed in this aanner. he sttidies were conduct1\d b7 theee te... in the countries during a period of about ninet7 daye. The United States teaa~ as aatched by natiTe nutritionists, chemists, officers and other people interested in the subject who would work side by side with the Aaerican investigators in the fielda, in the clinics, in the laboratories, and learn the aethoda. At the end of this period, the .Allerican group pulled out and left all the equipaent as a gift to the country and left a trained group of people, trained in modern aetbods ot nutrition investigation. Thia American groa.p would then come back to the United States, make a very thorough statistical analysis of all their findings, and prepare a report of some fifty to a hurnred pages. Thia dratt ot the report was sent back to the eount?7 tor renew b7 their officials, State Department, rulers, whatnot, and reviewed in this cou:itry. This report contained pages ot reoOllllllendations as to what should be done to imprOYe the food supply or the country, the qualit7 ot the food, to correct conditions ot anemia, vitamin deficiencies, that had been found to exist among the people as civilian people as well as among the soldiers. Those recomaendatione were studied in draft form and finally a final report was put out some of' which was published, mostly- mimeo- 999 graphed and actually utilized in the countries by their officials to improve their conditions. It was a veey intelligent and useful sche•, you see, or doing a piece or work for the benefit of the countey while at tm same time giving that country a capacity to continue that work with their own people and their own resources. I von 1t go into all the difficulties ot the funding of this operation. Suttice it to say that the Departaent of Defense had to drop out of giving aucb aoney to it when the Director or the Bureau or the Budget noticed how auch the stuq or civilian conditions was going on. It made th• think that it wun•t a proper activity or the Department of Defense to be so much engaged 1 n civilian studies. .lt a certain period, it vu well refinanced through AID partl.J,, and partly b7 the Natioual Institutes of Health which always had been contributing to the funds and the laboratories, the equipaent and in­ formation gathering or this Interdepartmental COlllllittee. It is still con­ tinuing. I describe it this wa:r, u an instance of how a great thing can grow frcn a very nall little acorn. I think persons from the ArttT Nutrition Laboratoey at Fitssiaons Hospital have worked on nearly every team that bas been·sent abroad, and have aade a big coatribution.t It's still referred to a■ ,an Interdeea:rtmental Comittee. I That was the naae or it.. Its not called the Interdepartmental Cam.it.tee : ~t~bi:i)A~i't\&h.)\'AL 1 tor National Def'eme any- 110re. I} is now called the(Ciiimi~utritio11 ' ~ tor National Developaent. because •Natioaal. Detease" bas a war-like connotation. la the DepartaeM of Dete1111e 1 the, !"",T at~ •ereaented? The C«-aittee is under an executive director who is in one of the sections 1000 e. ot th~ National Institutes of Health. I all a consu1tant still to the Surgeon General of the Public Health Service for nutrition, particu1arly in connection with this project. The A.rs¥ never did have an.y official executive aembership, Dut people from the !ray alway-s attend the aeetinge, different people from 1ections of the laboratories and from the Medical and Research Development Comand--and Navy people, Air Force people cane to the meetings and get the reports. Well, 1t 1 s another example of how i:aportant nutrition became not only for the strength of a fighting force, but for the strengthening of the source frma which the force coaes. Alls orts of interesting problems of taste and acceptability of foods have caae up. For instance, the population and soldiers on Taiwan lack Titamin B and A, B particular]¥, becau13e they a1'e mostly polished. rice, and ~ the ~poble• came up how could you put these vitaains in polished rice? 1 'L'ney ! '.....,-' did get vitamin cakes, but they were yellow• The additives make their rice look yellow, and they didn't like t.he yellow look of the rice, but they would eat it. The other thing that w found on Taiwan was that the sweet potatoes that are abundant on the Island of Taiwan have large amounts of the very- vitamins that the people eucht to be taking--B group and others, but sweat potatoes are called "pig rood", and they wouldn't eat the sweet potatoes. Maybe they've educated th• to feat it since then. Food preferences are custanary. I told 70u, I think, earlier how I just can't bear to eat honey. - Yes. People get conditioned to preferences and dislikes in various ways. Soae of thea are religious, but some of them are just accidental. Well, J. 1 ve dealt 1001 with the "in-house" and "out-house" problem. I didn't expect to go so far afield as to talk about the Interdepartmental Committee on Nutrition for National De.tense, but it belongs in the same picture, the same frame. The studies at Fitzsiaons General Hospital extended beyond nutrition and tuberculosis, although the tuberculosis work was vecy necessary- because tuberculosis material fraa these large wards goes down into the sewer. You can get tubercle bacilli out of the sewage disposal plants up to a certain point. More than that, howeYer, the virua o.f poliayelitis can be gotten out ot that sewage even to the last et.fluent sometimes. I1aasn' t killed by passage through the ordinary .filtration and decomposition processes that go I on. I lli.ght put this in the record-I suppose it a known--the effiuent or the sewage ot the Fitzsimons General Hospital was used to water the golt course, and when they .found that the virus of poliomyelitis could be obtained occasionally from that sewage ernuent that was used to water the golf course, there was a good deal or annet7 because not only were the adults playing golf, but children or the officers were romping around on the .fairways • . It... was aleo a favorite golfing ground for Dwight D. Eisenhower. You can see how a huable piece o.f investigation that deals with viruses and sewage can have political blport as well as utters ot health. We were able to improve ~ u the sewage out there suffio~nt]¥ so that neither t~bercle bacilli, nor viruses are coaing through &IJ1' more, but for a period of a couple of years there wu auch worry. That waa carried on by a laboratory-, a bacteriological laborator, reall7, that waa part or Fitzsiaone Hospital, right next to the Medical Nutrition Laboratory, and it was aided bf liaison with the Departaent of Bacteriology at the University of Colorado Medical School as well as, of course, much consultation across the country. It is perfectly obvious that none of 1002 these things that, r,. talking about are an isolated affair, or an event. It 1 s e part of the wblf-e fabric of lite in the country-. Did I have anything else down here? Yes. There's one laboratory I wish you'd talk about. The Armored Force Medical Laboratoey about which I think we have a con­ siderable amount of material in some or these papers, but it was of great im­ portance and still is. It began in the 1940s really, or 1941, through some suggestions from General Si.Jlmons, through very hearty cooperation and under­ standing by' the intelligent surgeon or Fort Knox where the .Arllored Force Headquarters were at that tiae, Brigadier General Albert w. Kenner, who alaost got to be Surgeon General. General Kenner was the surgeon, however, of the Expeditionary- Force of General Patton, landing in Morocco, Casablanca, and he then had a very- high position, after the Surgeon General 1 s matter passed by, in the headquarters of public health affairs and •(ti.cal affairs in SHA.EF in the European Theater of Operations. General ~enner 1 s successor, Colonel Thaaas J • Hartford was also a back.er of preventiYe :medicine ideas and of experimental studies. 'the thought that prompted the establishment ot this laborator;y at Fort Knox was the practical Jlilitar;r one of finding out the best conditions for the construction ot vehicles, such as tanks, that aust be devised according to anthropometric measurements and the physiology of drivers and gunners e who were in the tanks. The Araored wee seelftB to have started by taking a platform, putting a cannon on it, and covering it with steel sheets without thought or how the poor tellow inside wae going to move around and actually survive the :motions ot the tank. I have ridden in a tank and have tired a ninety millimeter gun, a fairly modern tank, toward the end or World War n, and I noticed then some of the smaller things that hadn't yet been attemed 1003 to. When the ninety milliaeter gun goes off the tank sort ot rears up on its hind legs and sort of fiops a bit, and you get quite shaken up. Well, when you're firing that gun, your chin rests in a cup, and there's a little band in front or your forehead to hold your head steady so that you can sight the gun. When the gun fires that hits you like Cassius Clay. Also on..,- right hand side was an 8lllftunition rack, just two or three strips ot metal bent at right angles to make a sort of open work box. Well, that had a veey sharp edge, and the gull recoil shaking the tank, made that U1Runition rack q\lite intimate with my right arm. The temperature in tanks, the ventilation or tanka, the noise, the traU11&tic experiences of a tank going across rough ground, or going up over a slant and then suddenly pitching forward as they do-­ all had r10t been studied at this time. The Armored Medical Research Laboratory was built in\r ecord tillle--less than a year-a fine building with laboratories in it. Fortuna.tely they were able to get an extremely capable director, a research director, and a capable start, and they did superior work, far beyond just 'What Itve talked about so rar. The work extended to ph)"Siological studies, personality studies, and even now if you go and see the laboratory at Fort Knox, the Armored Medical Laboratoey, 1ou'll find a sprawling group of barracks about a Iii.le long in one direction and JDB.Tbe a halt aile across on that length, full of laboratories of neurophysiology, a visual laboratory, visual studies, radiation studies, studies or x-ra7 effects, plus the studies of x-ray mechanisa. For instance, out of that laboratory was dev-eloped a very saall C!O.ol\ ~'/ portable x-ray machine that was activated by a small capsule of ... ,):1 .:, CoQ1H.'J 6, radioactive-I think it's <r 0. >:>-'··• 11 11 look it up to be sure. That •\ machine could be carried around and do x-rays of wounded men on the field. 1004 This laboratory contributed to general aedicine, to physiology and to physics-­ a very good thing. During this period there were meetinss of what was called an Advisorz: COllllllittee on Psychephysiology out there. A.. We've spoken or that-p&7cho-physioloa is concerned with reaction times, Visual affairs. That psycho-physiology laboratory so improved the reticules ueed in sighting tank guns that some General down there said that it had paid for itself over and over again by increasing the accurac7 or tire. The naae of the director should be in this record, and that's Colonel Willard f. Mackt.e. He's still an active investigator. I think he lives in Florida now, a very able person. There was I think a new laborator established at Natick Massachusetts. That's a Quartemaster Laboratory. Wasn't one or them an A.ray Medical •• •• To go back to the Armored Laboratory-I want to mention that 1 t had a jungle rocn. It bad a temperature control room, a big room where you could reduce the temperature to freezing, or you could make it hot and humid like a New Guinea jungle. It. was big enough to take a tank and let the tank waddle around in it full of soldiers and see what would happen to them. It also gave 7ou an opportunity to march the soldiers around in various environ­ mental temperatures with all their packa and all their equipnent, and to study fatigue. These studies were monitored, the effects were monitored by electrical de'Vices attached to the soldier that would give his heart beat, bis respiration, 1005 and, much to the disgust aad discomfort of the soldier, an electric thermo­ couple thermometer in the rectum so that you'd know what his temperature was. The soldiers didn't tancy that too auch. It was in this jungle room that the atabrine studies that I mentioned once before were carried on, so that it wae used not only for simple fatigue studies, but it was also used to study the action of a drug under different environmental temperatures applied to huaan beings • At Natick tne Quartermaster built a greJ big series or laboratories among which were physiological laboratories of various kinds, including even larger environmental laboratories such as the Fort Knox one for producing heat and cold in the environment. There's always been a war between the Surgeon I.Ieneral and the Quartermaster General to determine, if possible, I under whose jurisdiction these experiments should cme. Its the point of ... View of the inrgeon ueneral that anything concerning a human being is medical. Of course that can't be applied ful]J'"o The Quartemaster also has problems that concern human being• very extensively', not only for diet and food, but tor clothing. You can't make the proper clothing unless you know something about the physiological effect.• of the clothing. The Quartemaster also has a large solar laboratory where you get temperatures of seven, or eight thousand degrees tromrenections from the sun. Those are necessaey--they don't apply that much heat to a man, but they do need to know what radiation will do to a hmnan being. All the Quartermaster problems, most of them, have a medical implication, if you tale the point of view that anything that has to do with the physiology of a hwnaa being is a aedical subject. There are medical officers assigned at Natick, and at the ti.Ile I was there, they were assigned undethe Quarteraaster. Since that tiae, I understand that the 1006 Surgeon "eneral actually has aore to say about what goes on in the medical experiments, and there is an arrangement rather like, or even better than the , R Medical Research ~aboratory under the Chemical Warfare Se~ice at Edgewoodo Colonel Wood who became ueneral Wood who brought me down here was the head ot the Medical Research ~aboratory or the Chemical Corps, but that was under the Chief Chemical Officer not under the Surgeon General, although the 1.1 Surgeon eneral supplies the medical personnel. Ground studies becaae increasingly important 0 Climate studies are very important. lne ones that seem to me the most The Surgeon ueneral and difficult and arduous were the ones in arid lands. the Army Epidemiological Board usually had sc:aebod7 studying the effects or radiation and beat out in the Desert Training Center. The cold studies were done mostly in cold places. In maneuvers in Alaska there were many studies @ ot the effect or artic temperatures on clothing and the ability or men to I\ surrl.ve in the cold, or how should you heat the barracks, at what temperature, whether there are layers of temperature in the barracks in the cold--all sorts ot problems. Ot course, the interest in those studies is not confined to the Arm:,. The Air Force is equally interested in everything 1 •ve said, and they ha'\'e some wonderful laboratories in which these environmental effects are studied. Physiological effects are studied extensively by the Aeronautical Research ~aboratories of, the Air Forces at various places. The Navy is intensely' interested specially, for example, in conditions produced by the blackout ot a ship in the tropics. If you black it out by closing most of the ports, the ventilators are not equal to carrying the load of carbon dioxide and other exhalations of the many men that some of 1007 I these ships carry, and the temperature goes up astonishingly, and its humido I 1ve talked with officers who have been in a blacked-out ship in Singapore, or down in those regions--very, very trying. r I should think so. You entioned before we turned the machine on toda -dust studies 1 n Texas. Coccidioidom;ycosis. That was largely in the San Joaquin Valley in CaJ.ifornia--the dusty airfields. What I think Is aid about Texas is that there is a sharp line toward the eastern border of Texas where coecidioidomy­ cosis stops and another fungus infection, histoplasmosis takes over, but that's sort of a line or vegetation. It changes frcn a sort or arid land to a more verdant land. The main studies on coccidioidomycosis were ma.de at the Air Force fiying fields in California. I think that zou mentioned this 1 that since 1953 1 there were efforts t~ study coccidioidomycosis in another area becaase I think that earlier stu,2Z had drawn lines prettz clo~e to El Paso. Yes, lots of people are working on it besides Charlie Smith--Chester w. ~ons in the Public Health Service bas been at it fer years. There are different kinds of fungi. In Arizona they had the necessity for studying it because that particular study involved the possible infringement of the GeneTa Convention. The Japanese who were taken out, removed out of California in 191'1, were moved into campe in Nevada and in Arizona, and in Arizona they­ built some hospitals for these men who\iwere really prisoners ot war in a way. A good number of them developed eoccidioidomycosis in the hospital because they were exposed to the dust ladea with the spores of this fungus, or the 1008 infective f'om of the fungus. That, I think, was overcme by moving thea out of the hospitals and putting the+ome place else. Anot~er thin,g zou indic~ted bet:_ore we turned this on was the develo~nt and ~lllli;ficatio~ that come from a man whom you first met at Yale drag&ing an electric eel bz the tai~. I mentioned that because you had said--1ou used the phrase "lack of continuit7• in some of' these prograas., snd I mentioned one that had iong I eontinuity, to my knowledge of over seven years, and that was a contract with Dr.David lachmansohn, a great biochemist at Columbia University. I met him first when I was a Dean at Ya1e, and I facetiously said that I saw him coming down Cedar Street leading an electric eel on a string. He wasn't leading the eel. He was carrying the eel. He came to see Dr. John, F. Fulton because the shock, the electric discharge from such an eel, is con­ ditioned by an activit7 of the central nervous system, particularly the passage or an impulse, am a charge can accumlllate through the chemical reaction that accoapanies the nerve impulse. Nachllansohn did discover that this aediator or the nerve impulse was that it passed what is called a synapse at the end or the nerve. This was a rea~jion between acetyl choline and choline- I esterase, an enzyme that breaks acetyl choline down. He worked on that for 7ears. His marvelous Harvey Lectures are on the subject. He worked in Dr. Fulton's laboratory for a while and then down in Collll1lbia. In World War II--the end of it-our investigative teams in Germany had discovered, or found that the Gerfflana had a veey lethal gas called nerve gas. It has various names. I ca11•t give them all--tabun is one. It was a phosphory-lated compound. It rroduces unconsciousness and convulsions--death. 1099 The 28th of January I thought I ought to seek the aid o:f an able friend of mine in Washington, Dr. R. Bretney Miller. He kindly cane to see me, took my temperature, and found that it was high, and he looked over the records in my book where I had accounts of practically normal temperature every morning and a hundred and two and a hundred and three above in the evening. He couldn't find anything the matter with me except that the fever existed. He called a comsultant, a Dr. w. Dabney Jarman who is interested in the genito-urinary tract., and he couldn't find anything wrong. He called in Dr. Worth Daniels who saw me, however, only after I was admitted to the Washington Medical Center. In the Medical Center, I had all sorts of examinations without being able to provide my £riendl.y physicians with any clue as to what the trouble was. Fortunately, however, Dr. Miller had taken a blood culture when he first saw me, and im two or three days that was re­ ported as positive for this gamma type of streptococcus. He took another one which was also positive in number two sample, and then sent me over to the Johns Hopkins Hospital. I went to the Johns Hopkins Hospi4la in a taxi cab with Mrs. Bayne...Jones i ,' carrying the culture of the streptococcus. At Johns Hopkins I was admitted to the Marburg Pavilion, or ward which js the ward for private patients., practically in the same location where I had\s erved occasionally as an intern, a substitute intern, in 1913, and 1914. Marburg hadn't changed at all. The only change that had been going on was that they were erecting the Children's Center just outside the wall, and across my window there were rising these enormous steel beams with hammering that was even louder than the machine guns that I had heard during the waro The culture was positive at Johns Hopkins twice so I had four positive blood cultures to my credit. Then a very in- 1100 telligent Professor of Medicine, a friend of mine named A. McGehee Harvey, took charge of nv- case and ordered that I lie on my back and have a needle in my vein attached to some rubber tubing which was attached to a gla~s jar which was attached to a pole about six feet high on the side o:f the bed filled with a solution of penicillin. I got about ten million units of penicillin a day intrav•i•ly for throe weeks or more. Thar all right be• cause the blood culture was no longer positive after a. few days of that, and I•m regarded as a cured case of trouble that was thought to be quite dangerous. The physicians and the ethers who were taking care of me were really alarmed, but I thought it was all very amusingo Perhaps I wasn't in the right condition of mind to appreciate ito I told stories and I quizzed the interns on \ = medical histryb1 and to rrry amazement I found that mist of them had never heard of William Henry Welch. That's a little surptising--even in the condition you were in. It's astonishingo How in the Johns Hopkins the great founder of the place could have passed out of memory in such a short time as far as the in- ;-4 comipg youne-er people were concerned& I told them a good deal about Dro Welch and other peopleo They listened patiently, but apparently they were not too much interested. This was a long and tiresome business, but not uncomfortable, except when the penicillin leaked out of the vein in my arm and caused some irritationo ItWJ.s unco~fortable when they started to search all through my body for a focus of infection. They couldn't find anything in the kidney, or the lungs, or the liver, or the teeth, or the skin, or\a nything to be the source. We concluded that the s'j{urce of th.is infection might have been a dental phrophylaxis where it is known this type of streptococcus can get into 1101 the tissues from the scraping of the gums. I came out of that, came home to Washington, and took about several million units of penicillin per day for the next month. Since then there has been no rec 11rrence a.t all. This was only my second serious sickness in my lifetime that I remember" The other one was the infectious hepatitis that I got in 19161 when I was with the 5th Maryland Infantry in camp at Laurel, Maryland 9 Tne fever spells t':l~t you mentioned in World War I were, I think, what we called trench fever. During thiR illness of mine much hardship was produced for Mrs 0 °ayne~ Joneso She h~d the house in Washington to look aftero She came over on the \ bus to ffJe me .~ten, and firwXly she got a room in the motel across from the Johns Hopkins Hopsital and could stay~in .oaltimore 0 Itwis a bliwtery seasono There were four or five hea-iTY snow storms, ice storms, and it was very difficult travel for her im the bus. Of course, she cc•lldn 1 t see well enough to drive a car. 8he ~er~elf was not feeling well at this time. !ctually she had an attack of pain which was hard for peoµle to diagnose, but which she and some oth8rs were fairly well convincerl i~dic~ted gall stones, although the x-rays taken at that time didn't show the stoneso t'..ater on at the George Washington University Hospital she ver-J wisely insisted that these x-ray5 be repeated with what they call soft x-rays, and I think she's responsible for making her own diarncs is of finding: gall stones. Then the!'eafter, she had an operation whichlr eht!.ved her from the attacks, a very skillful operation done by Dr. Vincent H. Iovine at the George Washington University Hospital~ How much this spell of fever eoing back into August may have inOaenced my judgment and behavior especially in relation to the troublesore times of the Board on Cancer and Viruses, I don't knowo I don't think it did, but I 1102 lost ~bout fifty three pmrnds in weight, and I might have lost some of that weirht from what little brain I have--! don't know. It is a uni~urrence in /OU!_iife...-that' s for sure 0 Yes, I had never been really sick before. Let me t1ll'~~~r, "n.d we 111 talk some more abou~__s_moking~ All right? Yes., 1103 Thurs~..i.._c!_ul_y: 28, 1966 A-60 1 N. ~ • On September 27 1 1962 1 z:2u r er.eiver_! a telee,hone call from the Surgeon General Luther Terr and there was a foDowu ommunication a written com- m1mication1 to you with re_sp~c~ to .~his Surgeon Gene_ral 1 a Advisorz Committee on Smokigg and H~lth. So far as ,I am aware 1 that:..Js t_l2e firs1:_ be~inning f_or zou1 thoi~h I know that it had a ~~er context and EE!~~ags you may i~ to comment about t11,at 1 and.~hen go into the wo~~-the committee, and, as lol! know, my in~~t 1 the .w¥:--:well1, _a_s I P_l!t _it bef~e we turned this machin~ on1 you're primary source material for the manner in which committees function, the way 1 r. which a grcmp-:_:in thi/:3 case, ten able men--have set before them a probl~m1 I gather the scope and dimension of~~ was not really seen at the ~5:_me the problem was set 1 anu how this group handled it~ material handled its work and dischar edits function the in bet~een ,.I these people. I don't want to smoke any more of the substance than thato I•11 turn 1:0•::.,_loose on 'This problem. As I had long been connected with investigations of cancer$ ~t least since 1937, I was aware during that period of the number of studies, called retrospective studies, which since 1939, had numbered twenty-niw'3 that pointed out the toY.ic effects ,f smoking tobacco, particularly cigarettes, and the indicaticn that smoking tobacco ~,as defi 1itely linked with the occurrence of cancer of the lungs, so there was a body of information before scientific and other people a good many years before this committee of the Surgeon General of the ~blic Health Service was called into existenceo There were notable studies in the British Research Council, in D9 rnr.ark, Sweden, American N Cancer Society, Americ~n H~ar.t Association, and others poiting out the dangers \ 1104 of smoking tobacco. Before our committee began to work1 the British had actually published a bock on this subject called Smoking and Heal~!'!• We took their title and put it on the name of this committee which was to advise the .... Surgeon eneral on smoking an,.ealth. Early in 1954, the tobacco industry research committee was established by represen·tatives of the tobacco manufacturers to sponsor a program of re- i search int,o questions of tobacco antea.lth. It had a scientific director., a scientific advisory- board, and an office for this research committee in New York which wafl m.eking grants. This was under the guidance of Dr. c. c. Little. They collected an immense amou11:. of information an+ad a number of studies, and while I cannot say, don't want to say, that they were biased because the scientists observed freely and said what they thought, there was an i~pression that Dr. Little and his associates were using the Tobacco Research Conmdtte~ of the tobacco industry- as a mechanism for propaganda directed against the idea that tobacco smoke could cause disease and in favor of the fact that sMoking was innocuous, or in favor of the sort of advertising used by the tobacco industryo The Public Health Service became engaged in an appraisal o~the data on smold.ng and health on June, 1956, when the Surgeon ~eneral organized a study, !.•i an in:v-estigation, which reviewed a nwnber of inde~dent studies and had a I joint, association with the 1~ational Cancer Institute, the National Heart Institute, the American Cancer Society, and the American Heart Association. ~ ,, Those groups were impreswd with this possibility, or the evidence of the possibility that there was a causal relation between excessive cigarette . ~ smoking and cancer of the lung. The rport of that study camnittee impressed I\ the Surgeon General Leroy E. Durney so much that he issued a statement on .::, July 12, 1957, reviewing the matter and declaring, and I 1 ll q~te this,"That 1105 the Public Health Service feels that the weight of ~vidence is increasingly pointing in one direction that excessive smoking is one of the causative factors of lung cancer." That 1 s a sensible statement, but it didn 1 t have enough strength to be I N influential. It,, s correct, but less important than it might have been, comi. from such a high authority as the Surgeon Ueneral of the Public Health Serviceo It expressed, however, what ma~ be regarded as the official position of the Public Health Se:r'Vice; namely, that cigarette smoking ie associated with in• creased chance of having cancer of the lung. rhere was no change in that statement of the Public Health Ser.vice position from 1957 on, but little was done until about the middle of 1961, when the President1~f the American Cancer Society, the .American Public Health Association, the American Heart Association, and the ~ational Tuberculosis Association sent President John F. Kennedy a prett) strong statement aivising him that he ought to form a presidential committee to study the widespread implication of the tobacco smoking problem~ The President didn't want to undertake this kirtl of a study, and I might say here frankly that the high officials of the government dread tampering with . an industry t\\E'.t was known to be a four billion a year industry., something l like~hat, employing eight hundred thousand people, pouring tax money into the ,t, 0 gf\vernment and inw the states, and having very str~g political co~nections, se I think probably the truth is that the President put this recommendation from these societies and organizations asideo N In April, 1962, after a good deal of other discussion, Surgeo~ General Luther Terry made a more detailed proposal to the Secretary of Health, Education and Welfare to set up a committee which ultimately was called the Surgeon Liener~•• s Advisory- Committee on Smoking and Health. Well, you a,e, 1106 our committee was not a presidential committee. It was created by the ... Secretary of HEW on recommendation of the Surgeon General. Dr. Terry outlined +. I what he d like to ha,re done, new studies of various kinds..-an examira tion of the whole subject. On June 7, 1962, Surgeen ueneral. Terry announced that he was establishing an expert committee to undertake a comp~ehensiice review of all data on ,cmioking and health. It is to be noted that he limited this to the comprehensive review of data. The adVisory committee was not supposed to conduct research, or to support research in experimental laboratories. I think thatl8s a wise thing because the whole subject is so complex and the time required to obtain knm-rledge from studies, experimental studies, was so great that it never would be finished in the time available. However, con­ tractual services and study services, for the assistance or the committee, for supp\ying new data for the committee's consideration was possible, and as I111 point out, or I migijt as well mention it here, the canmittee entered N into a \umber of contracts with experts in va.rious parts of the country to produce reports, to make actual pathological studies and in addition without a contract secured the extension and early completion of the extraordinary ·\ epi~~iological studies that Dr.N-at the Americam Cancer Society. Are they refer~ed to here? No, that's not it. I hope you can turn this tape off until I find the name,. All right 0 For example, the American Cancer Society altered its own investigative program and did work for the Advisory Committee without any compensation, and 1107 this was the work largely done epidemiologically by Dr. Cuyler Edward Hammond who for years has been working on what you call retrospective and pro~pective studies of very large groups. The relrospective studies are made by taking a large number of histories. Prospective studies take a group and follow the members year after year for a number of years. In Dr. Hammond's group what was underway qt this time was a study of two million individuals of different ages, races, sex. He put atsde his planned work and put these data from this , l.., huge group on his computers in 1962, and supplied the committee with information it could not have received in &Di,Y' other way. Some people are interested in the early lesions of the lung in smokers. Special studies on that1ere made for the c0111mittee by a group in Buffalo at the cencer establishment there LRoswell Park Memorial Institut!7, so the committee was not entirely limited to the reviews mf published data, or data already in reports, but could collect with the help of other people. As I ( say, we did no~go in to investigative worko Fortunately we did get some I direct help through confidential communications from Liggett and Myers. Liggett and Myers at that time were very much interested in the effect of tobacco smoke on the trachea and were developing the filter that went in to the Lark cigarette. Dr. Louis F. Fieser was an adviser to Liggett and Myers in Boston and was able to arrange getting at their material. The com.~ittee was a little worried that somehow or other its interest might lead to an investment in Liggett and Myers, but I don't know of any conflict of interest arising, but the stock went up during that period. Those are antecedents and jumping a little ahead to the way the committee dealt with this problem of examining data. 1108 The Surgeon General of the Public Health SerTice announced about July, lq1.o., I think;-·· Well, at least he b1d a meeting around July 27th at which a list \ of more than a hundred and fifty scientists and physicians working in the ~ ...... ' field of bi~· ogy and med~iiJne was compiled. Out of that they were able to select a committee of ten. Contributing to the process of selection was a man who became medical coordinator for the committee; namely, Peter Vo v. Hamill, and he also did much in travel, in visits to those whose membership was desired on the committee to explain to them what it was all about\and to enlist their interest. He made a great contribution in that part of the process of forming the committee. It is to be mentioned also that the Surgeon veneral had announced that this study would be in two phases. Phase I was to be the assessment of the nature and. magnit11de of the health hazard by this expert advisory committee 1.1 and to produce a report to be submitted to the Surgeon eneral, containing evaluations and conclusions. Phase II was to be recommendations for actions on these Cf)nclusions, but there were to be nod ecisions on how phase II would be conducted until phase I wa~~inished. Phase II led, of course, into . economic and legal considerations of great magnitude. Wi,at would be done ;;, would affect the industries, affect part of the national ec~nomy, affect international relationship, possibly disturb ia bor relationships as well as the laboring individ11als.. It was so important from a governmenta~standpoint th~t I doubt whether any clear notion of ever undertaking phase II through this mechanism was envisioned by the Public Health Service. To undertake phase II you'd have to have an interdepa.rtmental type of committee representing the Departments of Conunerce, .....ibor, A.g:cicultureJ cer­ tainly toe Treasury, and certainly the Office of the President of t.he Uriited 1109 States i.tself. It was made perfectly plain to the scientific advisory body now being appointed that it. need not concern itself with phase II; in fact, the Surgeon Lieneral was very plain and frank and emphatic in telling the members of this committee, after they assembled, that they1ere not to give any more than incidental attention to the economic aspects of the tobacco problem as contrasted with the scientific aspects of tobacco smoking. Never~ theless, when the committee began to meet it received some reports from the representatives of governmental agencies that had interest in this subject and it also had sitt.ing arourrl the wall behind the table at which the ccrnmittee memberF ultimately met representatives of those agencies who were privileged to listen to the discussions oft his committee, and. who of course would ra­ port back to their headquartP.rs. Among those men who were there were repre- ' sentatives of th~Office of Science and Technology of the Executive Office of h the President. Well, that was a high scientific body. Dro enneth Clark, Dean of the School of Arts and Sciences of the University of Col~rado, was quite helpful in some discussione ::'or a while. The other representatives were from the .federal Trade Cornmission, t.he Foo<i and Drug Administration, the Department of Agriculture and the Department of Commerce. I think those representatives attended only about three meetings of the committee because we asked that the :,ractice be discontinued., It di dn 1 ·t, s Eiem to allow us to have the freedom of r:iscussion that W:l needed, if we had a group of observers sitting behind us capable of and required to report to outside agencieR as to what was afoot, so those gentlemen gracefully accepted the discontinuance of the occasion for their attendance. Now, shall I talk about the committee itsE::lf? lllO We'll deal with the members of this committe3 alphabetically starting with myself'. I was a late comer to this committee., in a sense. :Most of the others had received their appointments before minee Surgeon ueneral J:erry, however, wanted me, 1=1 s he told me, to be a consultant to him and to represent him in a way without any official representation., but to let him have some close connection through a member of the committee. The title given me in addition to the title of member of the coromittee was special consultant to the committeetstarr. That was a little embarrassing at first because that statement was interpreted by Dr. Hamill as meaning that I was a staff member under his direction which was not what Surgec.n lreneral ~rry told me. I was in Washinrton, of course, and could go in and out of the office., so I received in these first meetings some assignments as though I were a member of the staff. I was able to get Dre namill te excuse me from those aastgrnnents be- cause that was not npart of my function. Toward the end of the work of this committee, I put in practically full tL~a with the staff i~the office eetting the report in order. The next man to mention is Dro Walter J. Burdette who was head o!" the Department of Surgery at the Ut~h University School o\ Medicine in Salt Lake City. Dro Burdette is about six feet two inches tall, very lanky, slow of ::, speech, intense, a very scholarly man whova~ not ~nly a good surgeon, but he was also and is one of the leading animal geneticists in the country. 9enetics N is his ma.in field. His primary interest i~ cancer was on a genetic basis-- \ aside from his surgical work and his experimental worko That led to some difficulties later on between Dr. Burdette's poi)t of view and the poi~t of view of Dr. ~e.onard M. Schuman and others who saw this problem from the epidemiological aspect. Dr. Burdette and I had been friends on an almost 1111 affectionate basis since about 1935. He had been the most brilliant student 1 at the University of Texas tru;i.t they'd had in the history oftthe place. He d t\l'.\PW. ,»co had nothing but straight A Ain everything he took down there. C " Once when I was in Austin and saw the Vice Chancellor who was particularly interested in medical education, I told him that I had a Dean's choice in the Admissions Committee at the Yale University School of Medicine every now and then, as I have mentioned before, and that I would take anybody that he could send in without any quest:ton. After a while when I got back, he wrote me about Walter Burdette and sent mf' his record, and we admitted him immediately to the Ya.le Medical School, so that he could go through the Yale Medical School with equally high medical grades, if we gave them~ Burdette worked at Yale, and he worked at various places, New 0rleans too, and got to be an excellent surbeon and keeping up all the time his profound work on genetics. Re pt1blished a big b, ok on genetics., He contributed a great deal to the work of this r.ommittee as he was assigned the chapter on Cancer of the Lung particularly. He wrote a. hundred paees or more on that chapter, and when it wae circulated, itas found not to be satisfactory, so we had a very painful hard time. In other words, he neglected the epidemiological aspects -which he didn 1 t know about, and he and Schuman locked horns O M~st of the committee were on the~ide of Schuman. Neither one of those me~thdraw easily from a position that he has t~ken., : Sometimes Schuman would ~isagree with half of a sentence that Burdette had written, and the two would sit down with me in a room, and we'd talk for two or three hours and come out with the ~ame adherence to the wording .. It was very difficult ~t times. Also it was hard on Burdette to have his chapter turned down, and we nearly lost him. He began to think that he should resign lll2 because he wasn't contributing anything. Fortunately he was persuaded to stay on, and the chapter in the report on CaNcer is a ~ombination of Burdette Schuman and others, and it is excellent. That decision to alter his chapter was made at a part of a very long meeting at the Washington Motel that I men­ tioned to you at another time. A most charming and wittfnd valuable member of the committee to be mentioned next was Professor William Ga Cochran who was a Professor of \ sr~tistics at Harvard Universityo His field was mathematical statistics with application to biological problems. He took a rather original and active view of the statistics of the effects of smoking on the human economy and body and wrote the chapter that deals with the statistical treatment in1he \ final report~ Itf\s a profound mathematical analysis. It has original mathematical considerations of his own t~at he introduced into ~his. He wa~ I very faitt\ful in all of his attends.nee at the committee, and as I say produced this extraordinary chapter on mortality, largely on mortality and populations. The contribution that he made, I think, is probably more impressive than what was b~ought out about cancer of the lungs following cigarette smoking. He showed that the mortality of smokers, the death rate of smokers-ju~; a second. I•m looking for the figures because I can1 t remember themo Without getting the figures at the momant--~I might Jay them in later-the mortality of smokers was many times greater than the mortality of people who didnl't smoke, male and female, but particularly noticeable in the males. This is so striking a general effect that the committee thought that perhaps it ought to be emphasized more than it has been 0 For example, in the discussion in this final report on excess mortality, the mortality ratio among smokers is very much higher than among the non-smokers, lll3 and very large p')pulations -were used in this study, figures .from large pop•.1- lation.s. Cochran was a wit, a very nice person to talk with, lively and picturesque. I will say what he ~aid about a part of the report that Itcl writt~n that had to do with the difficulties that the COOl!ilittee faced in proceeding on a wide front where its regimental segments had to have an area cleared by another unit on the same line before it could move forward. It was very difficult to arrange any echelons. That held us up for some time and in the preface that I wrote, I brought those facts out, and Cochran said to me, "B..J, reduce the lamentations" which is an illustration of his cheerful point of view. He didn't want to be any cry baby. The picture; does have a sardonic quality about :tt, doesn 1 t it--the face? He's not really sardonic, or sarcastic--ironic. (X most interesting., intense ~ember of the committee was Dr. Emmanuel Farber, Cii.a.irman of the Department of Pathology of the University of Pittsburgh. ~e knew a great deal about the pathology of emphysema, irrita­ tions of the trachea, the bronchial tree, pulmonary changes and was alwayR insisting on the liberty of the scientist, ~articularlY himself, to reach an independent conclusion. He stood up for the independence of our committees against the threatened inroads of the staff of the Office of the Surgeon General and held a position of genuine indapendence throughouto Ha worried us because he was so strict at one time in the interpretation of wordtl that he would hardly admit, evsn though he saw the rerults that were attributed to smoking~ that you cou.ld use the word "cause." I wrote Chapter 3 of this report called "Criteria for Judgment" which showed that we really meant that smoking was pi:lrhaps a primary cause in cancer of the lung, an important cause in emphysema and an important cauAe u perl:laps in some others$ but that we co,tl.d well r€a1ize the m~ltaplicity of causes that were operative. It was an easy conception for me. If you will remember what I told you about the textbook of bacteriology when I reviseo it with nr. Zinsser and not only was able to bring in itleas about b~cterial variation and show that the monomorphic conceptions of Koch and others were too strict, but that there were pleomorphisms, in the same way there was a multiple etiology of many diseases. Tubercle bacillus alone doesn't cause ' tuberculosi~. Smoking alone doesn't caus~ cance4of the lungg You have the genetic constitution and all sorts of things, so that this helped in the "Criteria for Judrment. 11 While not giving away anything ~t all, A.nd we'll speak of it later, it satisfied Dr. Farber, and he didn't make any objections • tor3igning the report, which was a unanimous document. Farber was always cheerful and tense, and forthrighto Dr. Louis Fieser, a member of the COl!'Jllittee, was the Professor of Organic Chemistry at Harvard. His field for years had been the chemistry of carcinogenic hydrocarbons, methylcholanthrene, dibenzanthracene, benzpyrine-­ all that group. I had known him from early d'lys particularly from the beginning of the Childs Fund in 1937 1 because the Childs Fund was interested in carcinogenisis 1 a.nd I think that one of our Mrly grants was to Fieser's I department. He s a chemist with a very wonderful senne of what they call n I stereoisomerisms. He saw Molecules in shape and forms moving aroundo He s ,I " made a great ~any models that ar1s0 helpful telling where hydrogen and oxygen are in the molecule, He 1 s a great synthetic ~hemist, and hets probably the greatest organic chemist in the universities of his timeo His con­ tribution to the report 'fas the chapter on carcinogenisis, particularly the lll.5 carcinogenic compcunds. In toba~co there may be seven hundred ccmpounds in tobacco smoke~ He knew a great deal about the chemistry of that, ~nd some of those compounds in tobacco smoke, particularly the tars, produce cancers in animals regularly when you inject it. Well, what about all the otter compounds--! think there are seven hundred of them that he had to l:Lst and we talked about-~not all in dataile Fieser was constant in his 2,ttandance, but he was also constant in e smoking cigarettes. He would smoke ab\ut four packs a day, so much so that our committee got a little worried about him and said,''Lollis, you'd better cut down a little bi t.,t• He did cut down for a while and stopped the fncess&nt cough he had for a bit, but he went back to it,. Justast year, however., he really got reformed .. He d evelore) a cancer of the l1rng. He had an ore ration. A small cancer of the bronchus was removed, ~nd thereby he'd come down the sawdust trail and was converted. He wrote an account of his case which h~ distributed widely because he thought that he was fated to be a horrible example that would aid propaganda against smcking. I Jidn't answer his article or write to him, as some people thoa;;ht I should, because I dontt think, scientist as he is, that he was being entirely objective about it. He had been working ~dth carcinto­ genic hydrocarbon..~ for thirty or more years. I have been in his laboratory-­ I we 111 say that he's working on bempyrine, and it s still on his desk. He'll put his cigarette down on the desk and pick it up and smoke it and how much benzpyri~ he picked ur on his cigarette and put in his mouth is not known, but whether it was his smoking or not, he lived in the atmosph€re of~arcino.. genie hydrocarbons "t\nd whether that caused his cancer is not entirely clearo However, it was the kind of cancer that is usually seen in the bronchus of lll6 heavy smokerso The next one to speak ~bout¥-s another old friend of mine named Jacob F11rth who is a Professor of rathology at Columbia University and Director of the Pathological Lab~ratory of the Francis Delafield HoR~ital-that 1 s the cancer hospital at P & s, corresponding to the Memorial Hospital Center down on 68th Street. The Delafield Hospital had city support mostly, with some i out/fde support. Jacob Furth is a profound student of cellular changes, is an international figure, Austrian by birth, I think, and still has foreign constructj.on of speech and was a little difficult to understando He was a very valuable member of the C0111Inittee in bringing critique to bear on pathological grading of tmnors that was promot,ad by Dr., L. Kreyberg of Dem'.lark. He was a very a.rgument'ltive man, who was difficult to comrince and difficult to understand always because pf his foreign type of speech. However, he was as agreeable as anybody else on the com~ittee and worked out all righto He made his contribation. Dr., John B. Hickam. who was chairman of the Department of Internal. Medici Tl! a'l:, the TJniver si ty of Indianapolis 1 was as signed a very dif fi cult part of our study; namely, what is the effect of tobacco smck1.ng on the heart and s!. the blood vellels. His specialty is cardiovascular physiology. He worked i1\ very hard on that without being able to come to a very definite conclusion., If you'll eive me a moment, I want to get some words that satisfied himo If you'll turn that off a minuteo Its eemed from his studies that there was sooe connection between cardiovascular disease, but it was not possible to make a flat statement so that the conckusion of his chapter is that male cigarette smokers have a 1117 t; higher death rate from coronary artery disease thh non-smokers, males, but it 1\ is not clear that this association has causal significance. I think he really thought it did, and he 1s gotten some more information since this wa.s publisbed. Hickam is a numerous man too, not as sharp as Cochran, but a sparkle, quick to appreciate nuances in speech, followed everything alertly, would not talk very much, but what he said was worth listening to. I think you can see that in his face 0 The next one to mention is Dr. Charles LeMaistre which you know how to It s right in front of JT1eo " He was the Professor of Internal Medicine at the Texas Southwest Medical School in Dallas. He had t~est pulmonary disease study laboratory and i department in the South. His field of interest for the Col1l1llittee on Smoking and Health was the very important subject of emphysema, a condition in the l 1,mgs where tb~walls bet.ween air spaces break dcwn, end a patient becoY11es very I short of breath anri finally dies of a kind of suffocationo Nou, as Dr., r.eMaistre went forward with his studies, it became more and more apparent that chron:i.c bronchitis and cough and so forth was relat.ed to ci 611rette smoking and the emphysema that followed long cigarette smokig ;~ 11as p:":'obably I causally related. Cigarette smoking seemed to be the main thing. LeMaistre was a very cautious man. He was an enormous help in the expressiveness of the committee, would say nothing for a long time and then he would hand me across the tabl~ ~ written sentence, a piece of paper which said in a few 1118 words what people had been struggling to say for the past hour or more. Ther,are men like that at committee meetings, that sit and digest it all and finally often E,llSS it on to somebody--they did to me because I wa3 the sort of unofficial committee chai~man, whereas the official chairman was an Assistant Surgeon ~eneral of the Public Health Service. LeMaistre was devoted to this work, to the medical work in Texas and, as I say, had a very fine clinic and laboratory for the study of pulmonary disease of some of this type in hl.ll1lan beings. A tragedy came to all of us in the work of this committee, the death, the assassination of President Kennedy on November 22 1 1963. LeMaistre came from Dallas, and he was shocked that this happened in Dallaso He was ashamed of Dallas and so was his son• Los;ti of people were., They really took it very personally" Ha was quite d.ist~rbed at the assassination of President Kennedy. 'V Aside from the general political importance, it in~olved his relationship to I his home. Hes gone back to live in Dallas anQ has now just become a Vice Chancellor for Medical Affairs of the University of Texas. He will pass into administration, and studies of emphysema will lose therebyo See how serious he looks in his picture. VerY sensitive too 41 Yes. A remarkably productive member of the committee that -we 111 mention next is Dr. Leonard M. Schuman, Professor of Epidemiology at the University of MinnP-sota School of Public Health, in Minneapolis. He 1 s interested in health in relation to environment, but he's interested in the whole field of epidemiology so that epidemiological studies were assigned to him before the lll9 connnittee itself realized what secepe was involved in that--epidemiclogy of -- cancer of the lung, epidemiology of cancer of the lip, mouth, stomach--we went into all of those things. The~required a great deal of study of reccrds anrl data. We were assisted in getting the record by th! National Library of Medicine, The director assigned Mr, Charles A.Roos to prepare bibliographies for us. Ee prepared bibliographies .fran the recorded literature on cancer and smoking and other environmental things, perhaps six thou.sand, seven thousand titles, Those W"lre distributed to members of the committee. Members could t.h.en ask for a copy of t~1.: article, and Mr. Roos would see through the T., I • ''- .uibrary s staff that the art11cle was xeroxed, We had a Xerox machine, and Ei.lthough the law said that you shc-tld not make more than one copy of a copy­ righted article, we made enough copies to distribute to all members of the col11l'Tlittee., Schuman probably got the bulk of it because he had to study all these conditions. He was a little slow in getting ahead with this worko He's a man who does aoout f'!eventeen things at once, but when the ptjr.ssure was on, V he worked hard, at home, at the meetings, and harder still on the telephonP-o Some days he would call up and dictate the result of his past several days study, and the dictation might take four hours on the phone, so it piled in, and that's one way to get it down and done, Schuman, a very intelligent ~an, differed from an equally intelligent man, Burdette on aspects of cancer, particularly with relation to the lung, and I think his point of view won out because he upset Burdette a good deal by bringing forward opinions that oelittled the genetic basis of the develop,,­ ment of cancer. To Schuman the ~omrnittee owes much of the material that is in Chapter 3 tha.t I wrote called "Crit,eria for Judgment." It's not a bad idea, I think, to put in this tape recording what the criteria. include and show you 1120 that -;..e d.idn 1 Ii deal r~iinply wi t,h percentage statistics in reaching a con- ' clusion. There are five criteria that are :ised for jud6•ment. One is called "the consiRtency of the association." rr, we'll say, cancer of the lnng follows hAavy cigarette smoking over and over and over again in relation to the nlllllber of cig~.rettes and so forth, that's a consistent association. It isn't a proof, but it is nne of the things that helps you to interpret. "The strength of the association" is a factorial sort of a m•Atter as to whether the association occurs, we'll say, in 10%, or 100%--a very importantfhing. "The specificity of the association11 was also examined as a criterion for judgment. For instance, the fam.or 1inhalation of cigarette smoke 1would bear on specificity of t.he r elationship1 or the tempe,:ature of the burning of the cir;:irette, the length of the cigarette-all those are specific factors that had to be studied. 11 The temporal relationship of the association" means whether it is something that happens quickly, or whether there's a span of time over which the thing occurs. Mostly in cancer the indication period in human beings is abont twenty years. How long would you have to smoke before it would start the process in that twenty years? We don 1 t know exactly, but there is a temporal association, and in cigArette smoking it can be shown by pathological ~tudies that if the heavy smoker does stop smoking, the pre... cancerous le~ions will disaprear provided that they haven 1 t gone too far. Then the other one is "the coherence of the association" which is another way of saying that it should make sense. Well, yous ee, that it. wasn't a study based on rates, or percentages only. Association is used there as a sort of broader term than rates. Cochran handled the mathematical side of those things but st.c.\Y·ed away from Chi Square computations on which people base so much of their opinion 1121 as to the validity of a conclusion. Schuman's m;:iterial had to be worked over a good deal, but it was very V"llnable and, as Is ay, it certainly broadened tne point of view of the geneticists. e One more man to be mentioned is Dr. Maurice Ho Se!\ver;3 of the Department of Pharmacology at the 0niversity of Michigan at Ann Arbor, e square built, positive man who for a long time had been studying pharmacology of various types of addictiono His point of vie., about smoking was that it was not an addiction. It mi~ht be habit forming. It might have some slight withdrawal symptoms, but the smoker is not as dependent on cigarette smold.ng as a Marijuana addict is, or a man who is addicted to morphine, or alcohol. Seevers guided the coITir:1ittee thro.igh this ditficuJ.t !'jeld of addiction, habit of smoking and some studies of the relation of the p~ycholcgy of individuals as well as psychical strQcture to their habits of smoking. Seevers was a distinguished man, during the course of the cormnittee work he took a little \ trip to Japan and got the Order of the Rising Sun. He'ts later become the chairman of the American Medical Association's Committee on Tob~cco and Heal~h. Hickam and Lemaistre ar~also on that .American Medical Association lommitttl~ o After our c~...11rnittee finished its work, the American Medical Association which had been rather conservative in its attitude toward the possibility that smoking would cause disease, and the American Medical Association was sometirr.es suspected of being subservfont to the tobacco industry because pages of the AMA Journal and other journals are lucrativ~ly adorned with advertisements provided by the smoking people, particularly the sexy ads that Madison Avenue helped them to put out. After our committee finished, tha American Kedical Association set up a comrr~ttee to make grants for studies of tobacco t:i.nd heal.ir,t' and appropriated five million dollars for it. They drew 1122 Hickam, Seevers, and LeMaistre on as members and now lo and behold, I•ve just ircepted an invitation from Dr. Seevers, the chairman of that committee, 0 to be a eeneral chairman of a four day session 'If that comnittee and all of the holders of grants under it at Colorado Springs in October. It's interesting that the rP.lationships formed in this committee here in ~11 ashington continue in various ways. I don't suppose that they will ever separate tlS consideri.ng what ll."e went through together. That doe~ what I want to with the members of the committee, and there is a fair amount of information Pbout the -work of the comroitteeo I think there ~-s one area that you migtt go into, and that's the amplifj_cation given to this on the ;part of tli' e committee--freewheeling discussiono Yerl., I wanted to t:1rn back to that in a little broader way than you said. The Surgeon uenaral Lut~hr Terry was the chairman of this corumitteea ', v He then delegated hi~ chairmanship, so to speak, to Dr,. James M. Hundley who was an Assistant Surgeo~, Ueneralo nro Terry appeared, I thin~, at only two meetings in which he talked generally about the point of view that the committee might have and said repeatedly that no power on earth would make him put pressure on this canmittee to get its work done in a certain time, or he hoped that it would be done--once they said six months, and then they said a year, and then he tried to drop off sny deadline. He repeatedly assured the committee that he didn't expect it to sacrifice scie ntifj_c thoroughness, completeness and accuracy for the sake of meeting any particular deadlineo As 1 111 point out later, the next sentence gives a little escape from that bold burst for freedom. Hes aid nevertheless the committee appreciates the importance of completing it$ work in a re3sonable time and is following a 1123 work schedule which would+emit them to meet the target date mentioned earlier. According to Mr• Celebreze LHon. Anthony J. Celebreze, Secretar.r, Department of Healt.h, Educe.tion, and Welfare] that target date ~Tas by the end of the year 1961--I think, w asn{t it? No. 1963. I might as well go on ae to what happened over the deadline--along where tha Prerident cmes in• . In September oi\1-963, Pre:=::ident Ke.nnedy was asked at--ihat ties in with his assassination. I must know the cAteo Well, President Kenned7 was asked4•~o May 23, 1963. Was that the date of his assassination? No 1 the date when he was asked at his press conference •••• May 23, 1968, he was asked at a press conference when the corn.it.tee wou.ld make a report? Here it is. Well, May 23, 1963, is a general statement about the general sensitivity of the subject, but later on he was asked in 1963...-It:rr, not sure of the date-­ when the committee would make the report. He hedged the first tilne that question was put to him and said1 11 I~ll let you know in abcut two weeks." At the end. of that time--in two weeks, he said that, the committee would report in aovember which was a great shock. Following that Surgeon ueneral Terry wrote the President a letter saying that the committee c0uldn 1 t possibly do it in November of 1963, but promising a report by the end of the year. The committee was at that time not consulted by the Surgeon General ... anu was floudering in a morass of detail and difficult things that required A, 1124 decision and dicn•t see how it could finish its report by the end of the year, 1963. Neverthe).ess, it did under the vigorous management of a new staff director who had been appointed to take the place of Dr. hamill; namely, Eugene H. Guthrie. We really worked after 'be got on there. Sometimes we would have meetings four days lorig--day long and night long. Dro Terry also ' e: assured us several times that ke would n1\t l~t aey pressure bear on us to formulate one kind of opinion rather than another, -which he lived up to. He couldn't help himsGlf over this othe::.· part. The infiuence that came to bear on the C()TII!T1_ittee 1 s acttons came through Dro H11ndley who sat at the head of our table as the chai~an of our meetings from the start in a rather school masterly manner. He took rather positive stands on administrative matters, but was not well enough informed about the scientific, medical side,g of it to participate in the disC"ussion, or to have much influence. He was., of course, from the start very much concerned about the production of the report. So was the cornmitteeo Sowa, Dro Hamill. What are you looking for? Hanrl.11 1 s final leaveo I would like to say a word or two more about the way the comrnittee progressed throuc;h the fielc1s of study that it had outlined should bP. done• I have indicated alreaey that most studies could not go more than a certain way until a part of thP. front had been cleared by another section of the committeeo 'l'he committee dealing with the at"sessment of carcinogenic actions in material in smoke had to clear its mind over a great deal of conflicting information before it could say anything positively that would be useful to tl-ie man, we'll say, who was studyi'1g carcintJir.a of the lung 112$ in relation to smoking. Actually there was a great deal of difficult-I'll say, noundering to get by certain points. This was so much apparent that sOJ11.ebro.y advised Dr. hamill to acc0pt the assistance of an expert on ?11Bnagement N from 4,other section of the NIH, a very mild mannered lady. She knew how to draw diagrams and ~chemes, ~nd she came over and presented to the committee a now chart that was on paper which stretched across two black boards.-­ beantiful diagrams of subjects moving !lp until they coalesced in one main conclusive statnment. We calle1 it the "laundry list" and didn't pay much attention to it because it didn 1 t fit the situation. About that time, however, two things had happened. Abont ~rril JO, 1963 1 ,.;hen Dr. :-iundley had become considerably worried about the slowness of progress of ~he COilll~ittee's deliberations, the carunittee decided that it would rather have .s. private talk about its affairs in the absence of Dro Hundley and asked him if he WCl1.lrJ kindly not come in to a meeting that the committee wanted to have in privacy., He did this, and the canmittee ilid meet, had a closed meeting for an hour or so, decided pre t.ty cle:s.r1.y bo•or it w&nt:?d to proceed, and tl19n invited Dr. Hundley to returno I was asked to give Dr. Hundley a su.'l!Illary of what the deliberation3 had been which was in a way a declaration of independence along the lines of Dr. Farber's reiterated state­ ment that the committ~e report had to be a report by the co!llJ'l1ittee. Hundley said that if we couldn't do it, i.e•a have the sr,~ff do ito That would have been fatal. Part of the staff of the National Institute~ of l{r 0 cllth wanted to write part"3 of thi~ committee report, or mi[:;ht havtl :1ad a chance to writ~ all o.f it if Hun:J.ley haii 1)een followcdQ That cleared the ~,1:J.";{ thoagh, and it can be said that the report aa finally issued is the cc,nmitee's renorto Shortly after that--where's tho Hami11 sickness? Oh yes. Shortly after 1126 that, or at least several months after that D;.~. Bamill began to be worn out by this curio .1s and dJfficalt workj_ng of the committee. 1 He deYeloped s.flllptoms of fatig11e and odd pains, so much so that he was rather incapacitated and emotionally di.sturbed. sc th.;.t on Jn1.y 31, 1963, Dr. Hundley issued 6. statement to the committee that it had been neces3ary to plac~ &a Hamill on indefinite convalescent sick leave and that he had bean replaced by Dra Eugene Guthrie. Dri> :Surene Guthrie was a career service officer who was in charge of the Division of Chronic Diseases of thP. Bureau of State Services, an important thing. Guthrie knew a great deal, was a man of vigor and tact ~nd worked well with the committee 0 He looks 1ike a vigorous fellowo Yes--he is, isn•t heo It s rii:~ in the photograph. Yes, if it hadn't oeen for Dr. Guthrie, I don't believe th~twe ever would have gotten the report. He knew what to do, and he could cut ttro·.1g,: red tape. He even got the Government Printing Office to print sections of this report that would be scattered t,hro,1gh the volume later on. The Government Printing Office usually wouldn't touch a manuscript unless it was complt:ete, but we were printing whil€ y;e\were writing. "W'nat time is it? 1 1 :m gP.tting .,ut of' vcice, but I 111 try to finisho Don't ~ro .1 think this is enoueh 1 on the committee? I think 1 111 wind it up if that's ~nough on the procedu~es of the com- 1127 mitt~e--I thir.k 1 111 wind this t1p by telling what happened to1-1ard the end of 1963, and January of 1964. Is that the press conference? :'his I don 1 t know" We had it. It's right at the top of a page in my handwriting. Lot me tur11 t.hie off and find it,. The committee's report w~s printed by the Covernment Printing Office. Itts a docume~n of J37 pages and composed of fifteen r.hapters with a very i ,I impressive list of acknowledgem~nts of people who were helpful to the committee. There m~1st be two hundred names or more on that list--eight printed pages. The report contains an introduction and ell the sUlTIIllaries and ~onclusions are brought together in a chapter, and then the other chapters ... deal with cancer of the lung, cancer of the--well, ~I 111 just lay in these chapter headings. It will be of some use--maybe 0 The main chapters were "Consumption of Tobacco Products in the United Statos"; "'I'ne Chemical and Physical Characteristics rf Tobacco and Tobacco Smoke"; "!ba.rmacology and Toxicology of Nicotine 11 ; "Mortality"; "Cancer 11 anct/that' s chiefiy cancer of I the lung, but it ;::::,so took in cancer of the liEB and the mouth, stomach and other organs; 11 Non-!Jeoplastic Respiratory Diseases, Particularly Chronic Bronchitis and Pulmonary Ertphysema";, "Card:i.ovascular Diseases"; a miscelle.neous chapter on "Other Conditions"; "Ch.:i.racteriztlati.on of the Tobacco tlabit and the 1\.... Beneficial Effects of Tobaccon of which not many coula bP. mentioned; "Psycho.... Social Aspects of ::moking" and the "Morphological Constitution of Smokers"c- All of this is objectively presented in this volume without any propagandi:;.ing. No effect is made in here to ad,'ise anybody to do anything o It was simply a presentei.ion of the facts thoroughly documented with long bibliographies and tables and clv1ptars supporting the ststements that are made11 1128 The r eport--I may be exaggerating al:>out this--uut I think four hundred thousand copies of this report were printerl and aistributed, some sold and some freeo It went all over the world and was thoroughly reviewed in all sorts of jo~rnals and articles, lay journals, trade j0~rnals, governmental journals, the deliberations of governmental bodies. I think I can say \dth assurance that nothing in this report has been controverted by the tobacco e industry, or arw '1,..t'..1er workers on ths subject since 1.t was first pat out in 19640 A .:(ew questions have been asked, but th,; conclusions and the presen­ I tation have hardly been q•1estionedo It s an honest an.:i objective report. It ts r.iain effect was appa.rently to reduce the cons•.nnption of cigarettes for &. few months and then t.o stimulate the consumption of cigarettes afterwa.rdl! because billions of cigarettes made and smoked ha.ve gone up some billions since then. I~.a.s not the concern of the committee to suggest legislation. That's part of phase II, b11t some legislation was suggested and some has gone into effect. It is requi~ed n~w to ~ut on a cigarette package that it micht be a hazard to health--just a ge:-ieral hazard to health. It doesn't mention e cancer of t,he lungso There have been suggestions--Seno.tor Nuberger and others \ ~ould bring in rath~r drastic and restrictive bills. Nothing like that has hr.ppened yet. The British hne gone further than we have in this country. They have actually put up some penalties and have done some things to reduce cigarette sv.old.ng. This report was presented in a big press conference. It was presented to the Surgeon General of the Public Health Service in a big press conference in the large auditorium of the United States State :!:epartmento All members I of the committee were presented Thekoom was full of reporters, observers, and visitors, ~nd t~e committee sat down in the ~ow of chair~ on the bib stageo 1129 Surgeon General terry presided 4t the lectern. H+a,de statements and then questions were asked by pf'\ople in the audience, and he would call on i::ome member of the committee who seemed competent to answer. It la3ted about an houro It was not unfriendly--mostly an informational affair. After that the ti canmittee was taken by the SurgeoJ\ General to the very pleasant dining room of the Officer's Club of Fort McNair where it had a delicious luncheon and a few littl.,, spe~ches,. W~s_tpe comrrittee discharged with the presentation of its ~eport? i' Yes, the committee was discharged with the presentation of its\repcrt, and f another group came on whose nane I 111 have t0 get from downstairs on C Level. LNational Interagency Co1mcil on Smoking and Healt!l7 They are situated there on C Level now. They have been collecting information and having correspondence about cigarette s:r11old.ng, keeping up with the literature and issuing a littll'l propaganda and perhaps tr.,ring to influence some legislation, They are still working, but they have no organic Msociation with the previous advisory committee, although they do call in for consultation some of its members from time to time., Surgeon General William H., S:bewRrt 1 the new SurgeQim General of the Public Health Service., seems to be a little :more emphatic as to what the Public Health Service might do in ?n ed.11cation~.1 manner in support of studies at various places than Dr. 'l' erry was. Dr., Terry's rlacision for his activities was that th~ be0~ thing to be done was to put~~ an educational program--rather horelAc:is for the Surgeon u,:meral to move t11e government to do anything that interferes with a large segment of the gr.oss national 1130 I Its ver difficult for a into the field to erase this reoort as thoueh it didnTt existo No. They can't do that. I just noticed that this report doesn't have any date., Did you notice th'.:1.t'i - Yeso No printing dateo Yes--19640 You can always find out on the ll'l.st page., Well., that's ito You're exhausted. Yeso I have only one ~ore thi~ for you to do--that 1 s written. The next t~r:,g f2llowin.g the transcript I'd like for ;(OU 1~0 comment on the process having the transcript will tell won't be available in the transcript, but available in terms of the exgsrience we've had as to how we•ve cone l'l.bout ';!Jhat it is we've doneo You mentioned that the other dayo