CHAPTER I

Biomedical
Science and
the Culture

Donald S. Fredrickson

0

ne winter's night in Helsinki during the 197Os, I was
guest of honor at a dinner in the American Em-
bassy for a group of distinguished Finnish acade-
micians. The ambassador, under the nom de theatre
of Mark Evans, had been producer and host of a

popular television talk show in Washington. After dinner, brandy in
hand, I found myself responding to the announcement of the master
of ceremonies that I was going to explain how medical science was
supported in the U.S. by the National Institutes of Health.

My discourse wandered from intramural research to study sec-
tions and finally to public participation in the governance of science.
I noted that the national advisory councils are one example of such
public participation. I also pointed to the national commissions that
were devoted to the study of specific diseases such as diabetes and
arthritis. These were established by congressional orders and had
emerged from concerns of citizens suffering from those diseases.
Finally, I outlined the congressional hearings on the annual appro-

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
        1


priation for the NIH. As I described how the congressmen would
later invite testimony from lay witnesses about our performances,
the president of the Finnish Academy of Sciences abruptly rose from
his seat. He could not imagine such public interference in the
conduct of science in Finland, nor for that matter, in any other
European society. All the other listeners seemed to share his judg-
ment. There was a moment of silence as I groped about for a
metaphor to save the situation. Pointing at one of the tapestries on
the embassy wall, I likened the acquisition and organization of
wisdom to weaving. Consider the gathering of threads of knowledge
as the weft, I suggested, and the orthogonal warp threads stretched
in the loom as essential support for making the fabric. In my
country, I continued, the strength of this warp and the tension upon
it came from many sources, by no means limited to scientists.
Cur scientific research therefore was woven on a culture warp, I
ended, insisting that, despite the great number of hands involved in
the setting of the loom, production was actually amplified and
accelerated.

A distinguished task force of the Carnegie Commission on Sci-
ence, Technology, and Government concerned with long-term fed-
eral science and technology goals has recently issued a thoughttul
report1 The report's principal recommendation is the creation of
a forum of "individuals from industry, academia, nongovernmental
organizations, and the interested public to explore and seek consen-
sus on long-term [societal] S&T goals...." The National Academy of
Sciences (NAS) is suggested as a possible venue. This proposal for
obtaining better advice on a rational deployment of federal support
addresses a dilemma as old as the republic: that is, there is no
constitutional prescription specifically linking science per se to the
public purse. By opening with the traditional reference to Vannevar
Bush's Science: The Endless Frontier,2 the Carnegie report reminds
me of Bush's earlier experience in convening a forum of the elite of
industry, academia, and researchers to design a new departure in
federal policy toward science. Bush's report was written almost 50
years ago toward the end of World War II; His plan for creating a

BIOMEDICAL SCIENCE AND THE CULTURE WARP
       2


single agency to underwrite basic research in the private sector with
federal funds eventually resulted in the creation of the National
Science Foundation. Bush's original design, however, was upset and
materially changed by unforeseen interventions that illustrated the
limitations of any one group-however expert and well-meaning-
in defining societal goals. Although this history has been several
times told,3m6 it merits retelling. The generation that remembers well
the roots of today's system of support for biomedical research-and
the accompanying growth of our country's academic institutions to
their present size and research capacity-is becoming emeritus.
This tale also contains instruction on the nature, complexity, and
durability of the culture warp of biomedical science.

SCIENCE FOR WAR

The Establishment of the OSRD (1941)

Vannevar Bush was a Yankee of remarkable accomplishments. He
was an inventor (the Bush differential analyzer enabled the start of
modern computer analysis), an educator (dean of engineering at
MIT), and scientific leader (president of the Carnegie Institution of
Washington and director of the Office of Scientific Research and
Development (OSRD) (1941-1946)). In 1940 when war had broken
out in Europe, Bush discussed with some of his friends, including
Karl Compton, James Bryant Conant, and Frank Jewett, the need
to mobilize American science for preparedness in the event the
country was drawn into the hostilities. These men first convinced
President Roosevelt and Congress to form a National Defense Re-
search Committee (NRDC). This committee was established on July
2,1940, and was chaired initially by Bush.7 In June 1941, at Bush's
insistence, the President issued an executive order establishing the
OSRD to coordinate and supervise all research related to the na-
tional defense; Bush was named as director.8 The NRDC became a
subdivision of the OSRD, concerned with weapons development, and
Conant became the director. Keeping his office in the Carnegie
headquarters, Bush looked to the National Academy of Sciences

EMERGING POLICIES FOR BIOMEDICAL RESEARCH

3


(NAS) and the National Research Council (NRC) to assist in the task
of helping to select scientists or laboratories for projects with very
specific objectives and which were to be supported by contract. The
import and nature of some of the research involved can be judged
by the presentation of the Atomic Pioneers Award to Bush, Conant,
and General Leslie Groves by President Nixon in 1970.

Committee on Medical Research. Research in medicine was one
of the high wartime priorities. The Germans had cornered the
quinine supply, and new antimalarials had to be found. With only
sulfonamides to treat infections, new chemotherapeutic agents were
needed. Many other problems had to be tackled, such as improving
the treatment of shock, and methods of transfusion, augmenting
supplies of plasma and other blood products, understanding the
physiology of high altitude aviation, motion sickness, and anoxia,
and even developing new kinds of clothing.

In his memoirs: Bush recalled that he had felt then that "he had
nothing to do with medical research, and did not want to have...."
However, as Presidential Counselor Judge Samuel Rosenman pre-
pared the order setting up the OSRD, the Committee on Medical
Research (CMR) was added after the president, weary of an office
full of medical organizations each demanding to set up a medical
research committee, ordered that "he wanted this medical show put
under Bush and he didn't want to hear a damn thing more about
it.% Bush then established the CMR on his own terms. He insisted
that the CMR have strong attachment to the Division of Medical
Services of the National Research Council (DMS-NRC), even basing
it in the NAS building on Constitution Avenue. The more than forty
committees and subcommittees of the DMS soon began to function
as "study sections."8 DMS members sometimes initiated proposals,
outsiders initiated others. DMS reviewed each proposal and sent
them to CMR with a recommendation. CMR in turn sent its own
recommendations up to OSRD, where Bush's signature on the folio
indicated final approval. The contracts tended to be categorical,
with highly specific objectives. Their duration was short, sometimes
for six months, and never for more than a year before review for
possible renewal. The committees of the DMS were populated by

BIOMEDICAL SCIENCE AND THE CULTURE WARP
        4


high-level academics, including members of the NAS, and many
elite clinician advisors, about one-third of whom were members of
the "Old Turks," the Association of American Physicians.*O  The
chairman of the DMS, Lewis Weed, a professor of anatomy at Johns
Hopkins Medical School, wanted to head the CMR, but Bush wanted
a scientist of stature with impeccable qualifications. He personally
picked A. Newton Richards, professor of pharmacology, vice presi-
dent for medical affairs of the University of Pennsylvania Medical
School, and a pioneer in micropuncture studies of the kidney? Bush
later summed up his selection: "It was a fortunate choice...1 con-
cluded that, of all the able men I've known, [Richards] was the most
fully respected, yes, the most beloved by his colleagues, and by
everybody who knew him.`%

The members of the CMR were seven: one each designated by the
secretary of war, the secretary of the navy, and the head of the
Federal Security Agency (then the parent agency of the Public
Health Service), and four civilians appointed by the President. The
latter were Chairman Richards, A. R. Dochez, chairman of bacte-
riology at Columbia College of Physicians & Surgeons, A. Baird
Hastings, professor of biochemistry at Harvard Medical School, and
Professor Weed. Surgeon General Thomas Parran designated the
director of NIH to fill his chair. Initially this was Lewis R. Thomp-
son, who was followed in 1942 by Rolla E. (Gene) Dyer. Over its life,
the CMR dispensed $24 million in some 600 contracts to 133 uni-
versities, foundations, and industrial laboratories, involving the
research of over 1500 doctorates and 4000 laboratory personnel.'

The Dismantling of the OSRD W44-45)

Bush had always believed that OSRD must go out of business as
soon as the war was won. The exigencies of war were one thing, but
like many of his contemporaries, Bush appears to also have had
some deep-seated misgivings about government support of science
in peacetime. At Cold Spring Harbor in 1960, before an audience at
a dedication of a new laboratory building, Bush articulated the
Carnegie Institution's resistance to accepting government support
and described his fears that government subsidies would result in

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
        5


federal control over individual scientific efforts'l By August 1944,
Bush was certain that he would like to see OSRD wind down as soon
as the course of the war permitted and he let this be known to his
advisory committees and presented the President with a program
for the termination of OSRD. There was movement among the
leaders of th& armed services to maintain a capability for military
research. Secretary of War Stimson favored the NAS's assuming
responsibility for a Research Board for National Security to continue
contracts for defense science. However, because of the NAS desire
to protect its independent status and negative reaction from else-
where in government, nothing came of this.

The CMR was informed as early as August 3 of Bush's demobi-
lization decision and discussed at length its implications during its
next meeting on August 17. The navy representative said that his
service would not be able to take over any war research contracts.
The surgeon general of the army and Dyer of the Public Health
Service felt that the CMR should continue to the end of the war.
Because, as we shall see later, the Public Health Service had earlier
in 1944 received new research authority, Dyer also stated that the
Public Health Service would have no legal problem in continuing
projects appropriate to its functioning.12

Throughout the next twelve months, CMR sporadically requested
further instruction on demobilization, and Bush from time to time
assured Richards that OSRD and CMR were going to close but left
the fate of the contracts uncertain. The ambiguity of the situation
was suddenly increased in November by a fateful communication
to Bush from the President.

The Jhosevelt Letter of November 17,1944
The President's letter to Vannevar Bush requested answers to four
questions. The first was how the scientific achievements of the
OSRD during the war could be called to the attention of the public.
The fourth requested plans for increasing the number of research
workers. But the two others that thereafter received the most
attention asked how federal support for scientific research in public
and private institutions-in medicine, on the one hand, and in the

BIOMEDICAL SCIENCE AND THE CULTURE WARP
        6


rest of science, on the other-might be continued in peacetime, a
radical reversal of longtime government policy.13

Before turning to the answers and the drama of their develop-
ment, one should pause to wonder why Franklin Roosevelt had come
to write such a letter to Bush. Roosevelt was not hostile to science,
but did not possess any discernible science policy. In addition, he
had just been through his fourth presidential election and was
bearing a crushing burden of running a war and planning for peace.
Historians have tended to shy away from one available explanation.
In a 1960 biography of Albert Lasker, John Gunther wrote that Mrs.
Mary Lasker, just commencing her lifelong advocacy of government
support for medical research in 1944, sent a note to FDR requesting
the government to consider continuing medical research in peace-
time. The letter went to the President through Anna Rosenberg, a
member of the War Mobilization Advisory Board who had an office
in the East Wing of the White House. The President is said to have
then passed it on to Judge Rosenman, who in turn drafted the note
to Bush.14 In 1961 Calvin Baldwin, a former NIH colleague of mine,
while doing research at Harvard on the origins of NIH, wrote a letter
to Judge Rosenman, asking him about the authenticity of this story.
The judge replied that he knew "nothing at all, one way or another..."
about Gunther's reference.15 This reply, along with a request for her
recollections, was sent to Mrs. Rosenberg. It elicited a prompt letter
in reply:

John Gunther's reference . . . as to how the National Institutes of Health
came about is completely correct. I remember clearly this incident
because I often thought about how the Institutes grew and became so
important....Judge Rosenman did so many things at that time that he
may not recall this particular letter, but I distinctly remember it.16

In his authoritative source on the origin of the National Science
Foundation, J. Merton England has sifted the other evidence indi-
cating that sources closer to Bush were at least also involved.17
Carroll Wilson, an OSRD administrator, responded to a series of
queries on the subject that "Bush did not write it [FDR's letter] nor
did he ask for it, but he had the opportunity to see it before it was
sent and made some suggestions which were incorporated." England

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
        7


further noted that "at least there is evidence that the letter came
from outside the OSRD" and suggests a prominent possibility as
Oscar Cox, a lawyer who had worked with Bush on setting up the
NDRC and OSRD. Other sources indicate Bush met with Cox and
the OSRD general counsel concerning the draft letter.

Whatever his involvement and personal opinions on several of the
questions in the letter, Bush was a loyal public servant and a superb
organizer. He quickly mobilized four teams of advisers and widely
canvassed his powerful friends to help him frame answers for the
President.

The Bowman Committee. Bush first turned to Isaiah Bowman to
organize a committee to answer the President's broadest (third)
question. Bowman, a geographer and member of the scientific elite,
was president of The Johns Hopkins University as well as vice
president of the NAS. An advocate of government support of science,
Bowman had been chairman of the NRC during Roosevelt's first
term. In an effort to stimulate federal subsidy of research, he had
been instrumental in inducing F'DR to form a Science Advisory
Board (SAB). The short-lived SAB (1933-35), chaired by Karl
Compton of MIT, was a chimeric creature of the NAS and a source

mj@: whatcall     of great controversy within the NAS be-

the Government     cause F'DR had blithely overridden the NAS

donowmdinthe    hard-won and jealously guarded preroga-
futuretoaid      tive to appoint its own committees.18 As we
--by
publk and prtvate     shall see later, the SAB also became a ve-
organ-. . .7=    hicle for conveying an early pitch for more
          funding for the Public Health Service.
The membership of the blue-ribbon Bowman Committee included

at least two distinguished researchers, the inventor and industrial-
ist Edwin Land and physicist I. I. Rabi, then at MIT. Seven
members were deans or presidents from the galaxy of research
universities. Industry was further represented by the director of
Bell Laboratories and the chairmen of Standard Oil of Indiana and
Dewey and Almay Chemicals. Also among the members were one
or two government officials, including the director of the U.S. Geo-
logical Survey. There were no biomedical people aboard and, at its

BIOMEDICAL SCIENCE AND THE CULTURE WARP
        8


first meeting, the Bowman Committee noted that clinical medi-
cine-subject of a direct presidential question-was assigned to
another committee. The members set aside the social sciences as "to
be handled as a special issue" and elected to confine themselves to
peacetime research in the natural sciences, agriculture, and engi-
neering in academic and nonprofit institutions.1g

The final report of the committee--included as one of the main
sections of Bush's report-provided a thoughtful and extensive
assessment of the state of research in the U.S. during the depression
of the 1930s.2J8  It noted that, while industrial research had sur-
vived well and was continually increasing, the growth rate of private
sources of financial support for nonprofit institutions had gone into
a serious decline. Such sources included the Rockefeller and Carnegie
foundations and their related funds that had accounted for much of
the growth of the major research universities since the turn of the
century and also had established two great nonprofit research insti-
tutes, the Rockefeller Institute and the Carnegie Institution. Over
the decade of the 193Os, expenditures for research by colleges and
universities had risen feebly, from only $21 million in 1930 to $41
million in 1940, while expenditures by nonprofit research institutes
had actually fallen from $5.2 million in 1930 to $4.5 million in 1940.
There was a sense of frustration, perhaps particularly among re-
searchers in many of the natural sciences. The committee observed
that medical research had been able to attract more private support
than any other discipline and that it was only the American medical
schools that could compete with the great European universities in
both fundamental as well as practical or applied research.

The Bowman Committee found the temptation of peacetime gov-
ernment support to be a source of great anxiety, largely centering
around the fear that federal aid would mean the imposition of
federal control.

It is the firm conviction of the Committee that centralized control of
research by any small group of persons would be disastrous; if this small
group were backed by the power and the prestige of the federal govern-
ment and open to political influence, it would be catastrophic...`8

The possibility that scientific freedom could thus be corrupted

EMERGING POLlClES FOR BIOMEDICAL RESEARCH
        9


was accompanied by worry that federal aid might drive away the
existing sources of funds, that private endowments might cease, the
great foundations might turn to other fields, and states might
reduce support given their large institutions. In the end, however,
the pluses outweighed the negatives. The Bowman Committee mem-
bers swallowed their fears and recommended that a National Re-
search Foundation (NRF) be created under conditions that would
minimize the perceived hazards. It would have to be governed by
a board of scientists and their sympathizers, who would choose-
and control-a compliant federal director.`*

The Medical Advisory Committee

A day after receiving the President's letter, Bush informed Richards
that he felt the CMR was overburdened and that he needed to get
other opinions to help him answer the President's second question.2o
Bush asked the CMR to give him a list of possible advisers, which
it worked assiduously to assemble. After the CMR had compiled a
primary list of ten, it drew up a list of 150 more exports who might
advise Bush. When this was done, someone, perhaps as an a&r-

$5k?COd:Wlth      thought, advanced a resolution to the effect

partkular referenoe to   that, if a federal employee were included, it
thewarofscknce     should be Gene Dyer. No sooner did this
against disease, wilat
canbedonenowto    pass when the army and the navy repre-

organ~apro$ram    sentatives complained that should one ser-
for continuing . .the    vice be included, all should be.21 It was then

wok which has been
done in medkine and
related sclences?~

decided that only names of civilians would
be forwarded.
Within a few days, Bush wrote Walter

Palmer, Bard professor of medicine at Columbia, and Homer Smith,
professor of physiology at NYUt2 requesting them to be chair and
secretary, respectively, of his Medical Advisory Committee (MAC).
The other members Bush chose were equally well-known academi-
cians: William B. Castle, Edward A. Doisy, Ernest Goodpasture,
Alton Ochsner, Linus Pauling, Kenneth B. Turner, and James J.
Waring. Two invitees, Arthur Bloomfield and H. S. Gasser, declined.
The advisers, who included five members of the NAS, a Nobel

BIOMEDICAL SCIENCE AND THE CULTURE WARP
        10


Laureate (Doisy, for physiology or medicine in 19431, and one future
Laureate (Pauling, for chemistry in 1954), were as blue-ribbon as
the Bowman Committee and included more working scientists.
Bush then wrote Richards to inform him of what he had done and
reminded him,"it is well understood that OSRD and CMR go out of
existence at the end of the war ."23 At the same time, however, CMR
instructed division chiefs to present proposals to run beyond June
30, 1945.8

Not everyone believed that the opinions of the MAC would be
useful. Bush's friend Frank Jewett, an industrial engineer of distinc-
tion and director of Bell Laboratories, was president of the NAS
between 1939 and 1946, and he offered Bush the following candid
opinion:

If medical science is going to struggle with each one of these [diseases]
as it takes the center of the stage (as I assume it will) its problems will
exist forever. As fast as one specific thing is conquered another will crop
up... as in the case of medicine, it seems to me questionable if a `must'
case for Federal support can be sustained as the only solution."

On March 8, 1945, the fu-st plenary meeting of the advisers
gathered in Bush's office in Washington.25 Homer Smith had already
tipped the hand of the MAC in a letter to BushF6  Walter Palmer
nevertheless read a prospectus written by Turner that gave the
MAC opinion as unanimously favoring a separate agency for medi-
cal research, something on the lines of the British Medical Research
Council (MRC). The MAC predilection for the British MRC as a
model was understandable but perhaps only partially on target.27T28
On the plus side was the fact that this medical science agency was
relatively venerable (having been established in 1911) and from the
first was operating with an absolute minimum of government inter-
ference. The highly university-oriented MAC members did not ap-
pear to realize, however, that a high proportion of MRC funds have
always been committed to a large intramural program, which in-
cluded The National Institute for Medical Research and a cadre of
full-time employees in laboratories located at universities, but inde-
pendent of them, such as the celebrated Molecular Biology Labo-
ratory at Cambridge.

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
        11


Bush, much displeased by this threat of insurrection, asked the
MAC members if they had contacted the Public Health Service
(PHS), since the interrelationship of such a new body and the PHS
would have to be clear in order for Congress to go along with it.24
Palmer and Smith indicated that their view had been endorsed by
350 representatives of 75 of the nation's medical schools, research
institutions, pharmaceutical industries, and philanthropic founda-
tions. Bush's staff, however, backed him up with a barrage of inter-
office memos harshly criticizing the MAC position;2g the Director's
disapproval continued to trickle down to the drafters through Bush
confidantes in New York who were assigned to help with the comple-
tion of the MAC report. The final revision of this document, submit-
ted to Bush on April 15, was accompanied by a letter from Palmer
that stated, "it becomes more and more evident to us in New York
that our recommendations for an independent agency may be too
idealistic and impractical... n30 The final version of the MAC report
that is published with the Bush Report nevertheless still contains
the separatist views. Bush ignored the proposal and insisted that
medical research would be retained in the new agency he had in
mind. However, a number of the lyrical phrases about the achieve-
ments and promise of medical research in the MAC report were
selected by Bush as part of the text of the body of Science: the
Endless Frontier.  The full MAC report, like the extensive reports
of the Bowman Committee and the committee on scientific man-
power (headed by Henry Allen Moe), was included in the appendices.

The Designs for the Purse

Who Should Run It? In seeking to immunize the new research
agency from noxious influences of government management, the
Bowman Committee specified that the new autonomous and inde-
pendent body to be created by Congress should be "composed of men
of the highest integrity, ability and experience, and with thorough
understanding of the problems of science." They were to be "empow-
ered to give sustained, far-sighted assistance to science with some
form of assurance of continuing support." The Bowman Committee
also recommended the establishment of a National Science Board to

BIOMEDICAL SCIENCE AN0 THE CULTURE WARP
        12


concern itself with a global surveillance and rationalization of gov-
ernment support of science, a need that the Carnegie Commission
has so lately readdressed in its 1992 report.* The MAC recom-
mended that its National Federation of Medical Research should be
administered by a board of trustees appointed by the President, with
Senate confirmation, and a technical board of experts with aides and
committees to oversee distribution and watch how the money was
used. Everyone feared a strong administrator and demanded a
passive one, beholden to the board.

How to Give Away the Money. The Bowman Committee and the
MAC converged on one recommendation. The bulk of the funds was
to be given to the universities to be locally administered at the
discretion of the institutions. Such an arrangement, opined the
MAC, "could relieve the central agency of the overwhelming task of
administering small grants-in-aid." The Bowman Committee ar-
gued that funds should be available to accredited universities, col-
leges, and engineering schools "in a manner which will be virtually
automatic." Once accepted in the plan, and as long as its bookkeep-
ers knew the money was going for research, "[the institution] would
expect to receive the grant as a regular annual appropriation." The
Committee also felt the board must "be freed from the burden of
investigating a large number of potential recipients [proposals] and
judging the merits and defects of each." Each advisory group laid
plans for provision of fellowships and grants, but these were to be
smaller shares of the annual outlay.

One of the features of the Bowman Committee recommendations
(that did not occur to the MAC) was the preference that universities
obtain their money only on a matching basis. Was this to mean that
the "Bowmanites," emboldened by the potential of the federal trea-
sury, were regressing to the memories of an earlier pre-depression
period? In the heyday of the Rockefeller Foundation, in 1910-1920,
matching had been the primary mode of philanthropy. Abraham
Flexner, who had a large role in assisting the Rockefeller philanthro-
pies, had operated by a set of firm principles.31 The first of these
stipulated that "a large foundation should operate on a large plan,
making its gifts by wholesale and not by retail." One of his corollary

EMERGING POLICIES FOR EIOMELXCAL RESEARCH
       13


rules was that "a foundation can best justify its strategic position in
our society by stimulating gifis from others, through the device of
requiring that its gifts be matched." In recent times, the NSF has
employed matching or Zeuerage in some of its large award programs.
Given the tightness of money in 1945, it would have been an
inequitable way to start a new government program based on merit.

How to Cut a Pie

Bush proceeded to finish his reply to the President in the first week
of June, 1945. His proposed NRF would have five divisions and be
run by a board to whom the director would report. His divisions and
their projected budgets (in $ millions) were:

                1st yr      5th yr

Medical Research              5          20
Natural Sciences              10          50
National Defense              10          20
Scientific Personnel and Education   7          29
Publications and Administration     1.5          3.5

Totals                   33.5        122.5 z

Release of the Report

On June 14, Bush met with President Truman for about 15 minutes
to gain the President's reaction to the report and obtain permission
for its release. The President had read and liked the report.17 The
report was released to the press on July 19, 1945.32,33 On the ARC
radio network, the popular commentator Raymond Gram Swing
was highly laudatory, and the press was generally favorable. The
New York Times, however, ruffled feathers by an editorial position
that the NRF seemed an inadequate instrument for overall govern-
ment science planning. For this, publisher Arthur Hays Sulzberger
received a rebuke from Conant,% and from his privileged view as a
member of the Advisory Committee of the OSRD, James Phinney
Baxter III advised the publisher that "Bush and Conant in the past
five years have had experience vouchsafed to few of the difficulty of
getting enough freedom inside the government structure to permit

BIOMEDICAL SCIENCE AND THE CULTURE WARP
       14


scientists to do their work effectively."35

The President was by now in Potsdam. His first meeting with
Josef Stalin occurred shortly before he was informed of the success-
ful first test of the atomic bomb at Alamagordo. This testimony to
the potentially awesome power of government-funded S&T also
must have been much on the mind of Vannevar Bush throughout
this same period, for as OSRD director he was intimately involved
with secret discussions, at the highest level, on how a successful
experiment should be used to bring the war most quickly to an end.36

The description of the OSRD activities during the war, which was
the first request in FDR's letter, had been of considerable impor-
tance to Vannevar Bush because he sought to counter a barrage of
criticism directed at OSRD by Senator Harley Kilgore (D-W.Va.).
Since 1942, Kilgore had attempted to pass legislation directed to-
ward both tightening the government management of OSRD and
broadened federal sponsorship of research, under conditions that
Bush and many others steadfastly opposed.17 By the time the Bush
report was formally submitted to the President on July 25, a fresh
draft of a new bill was released by Senator Warren Magnuson (D-
Wash.); it filled Bush's prescription for the new science agency.32

Other Ambitions

Under a section entitled "Means to the End," Bush placed in his
report stringent views on the competition for what was to be the
National Research Foundation:

There are within Government agencies many groups whose interests
are primarily those of scientific research...These groups should remain
as they are...they cannot be made the repository of new and large
responsibilities for science which belong to the Government and which
the Government should accept....Nowhere in the governmental struc-
ture receiving its funds from Congress is there an agency adapted to
supplementing the support of basic research in universities2

The National Institute of Health
In the early 194Os, there were over forty government research
laboratories, and work in many of these was supported by OSRD

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
        15


contracts. Temporary laboratory buildings for this purpose had been
erected on the lOO-acre campus of the National Institute of Health
in Bethesda, Maryland. The several hundred scientists in this
facility were engaged in research in basic sciences, such as chemis-
try, physiology, nutrition, and microbiology. Scientists in other labo-
ratories were concerned with the applied sciences, some related to
"control" activities associated with the mandates of the United
States Public Health Service. A large number of the scientists were
PHS career officers, who worked alongside civilian scientists, a
tradition maintained today. Many of the scientists had entered the
PHS immediately upon receiving their advanced degrees. Some had
acquired most or all of their scientific training in the PHS. Very few
were trained for, or interested in, clinical medicine. Although a few
were internationally recognized specialists in their disciplines, the
majority of the scientific workers were on career paths less glamor-
ous than those of the professors and academicians from the great
universities and medical schools who made up the Bowman and
MAC groups of advisors.

Nevertheless, the NIH scientists of the 1940s were no less jealous
than the professors and academicians of the academic freedom
accorded them at the NIH. They adhered to the proud and solid
tradition of the Hygienic Laboratory that was opened in 1887 by the
Marine Hospital Service, and which had been the predecessor of the
NIH. Some of the older staff members had been among those
opposed to the attempts of Senator Joseph Ransdell (D-La.1 in the
late 1920s to expand the Hygienic Laboratory.37 Ransdell was pur-
suing a dream of creating a great medical research institution in
which hundreds of scholars would work on the underlying basis of
all the diseases of humankind. The scholars would be generously
equipped, have access to a big library, and be surrounded by an army
of research fellows and other trainees.38

Intramural opposition to Ransdell's ambition had existed within
the scientific leadership of the Hygienic Laboratory. Arthur Stimson,
head of the PHS Division of Scientific Research, was negatively
inclined. Gene Dyer, a PHS-trained expert in rickettsia and acting
director of the Hygienic Laboratory, thought that the expansion of

BIOMEDICAL SCIENCE AND THE CULTURE WARP
        16


a good laboratory should "... [proceed] in the light of a slow or
deliberate growth rather than growth of a mushroom type.n37

`l'he Ransdell Act finally passed in 1930, but unfortunately at the
very time when the nation was in the trough of the Great Depres-
sion. The legislative prize was reduced to a change of the name of
the laboratory, a few hundred thousands of dollars for a new build-
ing, and the right to accept gifts. Authority for fellowships was
granted, but with little in the way of funds to support them. Un-
seated at the next election, Ransdell dedicated several years to a
fruitless pursuit of support, receiving a deaf ear from corporations
and private givers alike.36

In the cadre of PHS officers at headquarters in the 193Os, how-
ever, there were some who were much less conservative than the
majority, and they desired that considerably more attention be paid
to the service's ability to fulfill its mandate to guard the public
health. One group was particularly interested in the field opera-
tions. Another, smaller group was more desirous of enhancing basic
and clinical science. Much later this difference of opinion would be
expressed in the dominance of the bench scientists and bedside
clinical researchers in Bethesda, with the more traditional public
health field workers migrating to other posts. The latter group was
exemplified by Joseph Mountin, an ebullient epidemiologist and
inventive scientist who was considered by his peers as a "genius in
the field."3g Mountin became the "father" of what is today the
Centers for Disease Control, an offshoot from NIH that moved to
Atlanta in the early 1940s.

Thompson and Parran

Among those who dreamed of a great expansion of the scientific
capabilities of the PHS in 1930, undoubtedly the most active was
L. R. Thompson, who had just become chief scientist of the PHS. A
kindred spirit was Thomas Parran, who had come to Washington in
1926 as head of the Division of Venereal Diseases. Both Thompson
and Parran were visionaries, comfortable with the New Deal phi-
losophy of federal activism that would come to Washington with the
election of Franklin Delano Roosevelt in 1932.   The names of

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
        17


Thompson and Par-ran, along with that of Gene Dyer, are little-
known to the present generation of medical scientists. Yet they
constituted the trio of Public Health Officers destined to realize
Ransdell's vision with creation of the modern NIH.

Thompson. Lewis Ryer Thompson, known universally as "Jimmie,"
was born in 1883.40-42 His first job after graduating from Louisville
Medical College was that of a quarantine officer in the Philippine
Constabulary. A&r joining the PHS in 1910, his schooling in
epidemiology, stream pollution, and disease control was highly
practical and confined to field investigations. Thompson came to
Washington in 1921 and was made the first chief of Industrial
Hygiene Investigations in the PHS Division of Scientific Research.
By the time he succeeded Stimson as chief of the latter division in
1930, he had already compensated for a lack of academic scientific
training by a steadily growing mastery of the operations of the
Congress and the federal bureaucracy.

Parran. The eventual achievements of Thomas Parran place
him today in the first rank of all the surgeons general of the United
States. He described himself as "coming from an impecunious, but
proud background" in southern Maryland, and he never attended a
formal school, receiving all of his education at home from an aunt-
in-law before he entered St. John's College in Annapolis.43 He gradu-
ated from Georgetown University Medical School in 1915. "Those
days," he later recalled, "there were only three places in the country
where a young physician could do good research, the Mayo Clinic,
the Rockefeller Institute, and the Hygienic Laboratory. The Public
Health Service was about the only place where one could do good
research and receive some, what I call proper, pay for it."42 Entering
the PHS in 1917 after a year's internship in a private hospital in
Washington, Parran obtained some microbiology training at the
Hygienic Laboratory and soon after concentrated on field work in
venereal diseases.

Parran and Thompson shared instinctively a commonality of
interests in promoting the Public Health Service and were thus
effective boosters of the fledgling NIH. They were willing to pull the
tail of the establishment to further this ambition. An early act of

BIOMEDICAL SCIENCE AND THE CULTURE WARP
       18


collusion occurred immediately after passage of the Ransdell Act,
when Thompson and Parran were among those dispatched to sur-
vey the proposed site of the new building at 25th and E Streets in
Washington. The two returned with a dismal report, protesting that
many times the available amount of space would be needed. Surgeon
General Hugh Cumming and NIH Director George McCoy vigor-
ously disagreed and were supported by their superior, Treasury
Secretary Andrew Mellon, who felt that the several acres on the site
would be enough for at least fifteen years.44

In 1930 Parran left Washington for Albany. New York's Gover-
nor Franklin Roosevelt had requested Surgeon General Cumming
to detail an officer for the position of State Health Commissioner,
and Parran was chosen. Parran was highly regarded in New York
and proved to be an activist in awakening the state to the danger
of denying that venereal disease was a serious health problem. On
one occasion he said that he was abruptly taken off the air by CBS
and replaced by piano music for uttering the word "syphilis" in a
speech.38 More important, as he worked among the hospitals and
people of New York, Parran had experiences that reinforced a
growing conviction that no time should be lost in starting a vigorous
assault on the chronic diseases.

As the mortality among the young declined with increasing con-
trol of the infectious diseases, there was a reciprocal and sharply
rising proportion of the burden of illness and disability in degenera-
tive heart disease, cancer, and mental illness. Parran soon also
realized that the campaign must begin with more research on these
diseases, including clinical investigation, a view that much of the
medical community felt was highly premature.

`Ihe friendship that evolved between Governor Roosevelt and
Parran led in 1936 to Roosevelt's appointment of Parran to succeed
Cumming as surgeon general. Long before he returned to Washing-
ton, Parran was kept busy drawing up plans for health reorganiza-
tion in the administration of the newly elected President of the
United States.

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
        19


Jimmie's Capers

The Science Advisory Board. Thompson, described in a 1934 news
clip as a "silver-haired official with golf-tanned arms...a cool official
in a cool office on the third floor of the Public Health Service
Building...,"45 made the most of this office, which was conveniently
located in the surgeon general's headquarters in the Treasury De-
partment, the parent agency of the PHS from its inception as the
Marine Hospital Service in 1798.

Thompson was in the halls of Congress before 1930 when Senator
Ransdell needed a hand during the birth of the NIH.46 The record
abounds with instances when Thompson was able to make key plays
in attempts to benefit PHS science.47 For example, in 1934 Thomp-
son was present when Compton's Science Advisory Board met with
the Bureau of the Budget and Secretary of Agriculture Henry A.
Wallace. Wallace, who had been brought up in a family business in
developing corn hybrids, had more of a scientific bent than most
persons who attain a cabinet post. He remarked that he favored "a
very limited amount" of federal money as grants to universities for
research. This statement caused Thompson considerable anxiety
because he feared that the PHS might miss a possible opportunity
to increase its own research funds in the wake of such a program.
Wallace's subsequent suggestion to the President that the SAB
membership include medical orientation allowed Thompson oppor-
tunity to engineer, through Secretary of the Treasury Henry A.
Morganthau, two appointments. One of these was Parran, the other
was Milton Rosenau, a Harvard epidemiologist and director of the
Hygienic Laboratory between 1899 and 1909.

Thompson went further, again apparently inducing Secretary
Morganthau to suggest to chairman Compton that the SAB detail
a subcommittee to examine the research strength of the PHS.47
Compton graciously agreed to do so and assigned the study to a
Committee on Medical and Public Health Problems, consisting of
the three physicians who had been newly appointed to the SAB,
Parr-an, Rosenau, and NAS member Simon Flexner, nearing the end
of his long and distinguished term as director of the Rockefeller
Institute.@ Thompson, unhappy with a copy of a draft report of the

BIOMEDICAL SCIENCE AND THE CULTURE WARP
       20


study he received from Rosenau, arranged to draft the report him-
self and sent it to Parran for approval of the other two members.46

The report of the committee on medicine and public health,
released in March 1935, was all of twelve double-spaced pages and
has to be regarded from today's perspective as a fairly naive "puff-
piece."4g The report began by listing some of the more outstanding
discoveries of the PHS, which included important work on typhus
and discovery of the cause of pellagra. Following this brief recital,
however, the report abruptly ended in a recommendation that the
funds for the scientific work of the PHS in the coming year be
increased by $2 million. There was no plan or analysis of how this
money was to be used, although it was a huge sum in those days,
considering that the total budget of the PHS was $10 million, and
most of it dedicated to maintaining the Marine Hospital Service. The
final report of the SAB itself, which expired in December 1935,
avoided mention of the health subcommittee's efforts.48Jo The Na-
tional Academy of Sciences wasted no time in replacing the SAB
with a successor Government Relations & Science Advisory Group,
a move that prevented the White House from again appointing an
NAS committee, thereby overriding the academy charter estab-
lished by President Woodrow Wilson.51 The NAS just as promptly
took steps to assure that non-NAS members Parran and Rosenau
were not appointed to the SAB successor.52

NIHMoves to Bethesda. The PHS received no answer to its plea
for increased funds through the SAB. Thompson also had no success
in inducing the administration to take on one of the list of seventy
"initiatives for new PHS research," which he released in August
1935.53  Nevertheless, his connections and public relations skills
paid off handsomely when, in the mid-193Os, another letter to the
President came to his attention. This time it was an offer from the
Luke Wilson family in Bethesda to donate some of their land to a
worthy government purpose. Thompson arranged through Surgeon
General Cumming to visit the Wilson family. At first, Thompson
had in mind an animal farm for the NIH, still located in two adjacent
buildings on the crowded site in Washington. As they grew to share
Thompson's enthusiasm, however, the Wilsons eventually donated

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
        21


nearly 95 acres, the bulk of their estate, for relocation of the entire
NIH from its Washington location.3g

In 1937 Surgeon General Parran made the NIH his scientific
division and appointed Thompson as director to succeed George
McCoy, the nation's leading expert in leprosy, who had stubbornly
resisted further expansion of NIH." With Part-an's White House
connections, enough money was found to build two buildings. Parran
turned the first spade in January 1938, and the cornerstone of
Building One was laid in July. The trowel was given to Secretary
Morganthau by the surgeon general.

The earliest NIH buildings bear the mark of Thompson's predi-
lections in several ways.  In 1936 Thompson had extended his
attendance at an industrial hygiene meeting in Geneva to a three-
month tour of state-supported research institutions in Europe and
Scandinavia. His reports to the surgeon general were scholarly and
analytically sound, as well as candid. He considered the Pasteur
Institute to be a "benign dictatorship under Roux," the "salaries
entirely inadequate," and the laboratories poorly supported.55 One
is compelled to believe, however, that Thompson had also carried
back some favorable images of the world-famous institute, when one
observes the mansard roofs and sizes of the first buildings con-
structed on the NIH campus. They too much resemble (in Georgian
style) the architecture of the Pasteur and DuClaux buildings that
face each other across the rue Dr. Roux in Paris. A further sign of
Thompson's laboratory orientation is the official names he gave to
the now-familiar first buildings on the campus: "Industrial Hygiene"
for Building Two, "Public Health Methods" for Building Three, while
Four and Five were the "Infectious Disease Buildings."

Cancer

The evidence that Congress was ready to use federal money to back
medical research in public and private institutions-without benefit
of the views of a Bowman Committee--was apparent before 1945.56
Indeed, there had been vigorous congressional tugging on the bio-
medical science culture warp since the 1920s. By 1944, there was
enough evidence of increasing tension-in the moves to expand the

BIOMEDICAL SCIENCE AND THE CULTURE WARP
        22


MH-to give pause to those laboring to create a single agency for
federal support of all science. If a relatively modest sector was being
reserved for medical science, its subject matter was primed to
expand explosively and could leave the fledgling NRF a shambles.
The ultimate complicity of the medical academicians of the CMR
and MAC in Bush's unitary theme can partly be attributed to Bush's
strong personality. But possibly it was also related to a prevailing
opinion that "public health research," as represented by the NIH,
was mainly sanitary engineering, vaccination, and vital statistics,
and not serious "fimdamental" medical science.  Whatever the
               cause. the NRF architects were deaf to

umanltv's Most Deadly
L
`I... a monster that is

    I
the drums beating in the Congress.
In 1927 Senator Matthew Neeley (D-

more insatiable than the    W.Va.) introduced a bill 6. 5589) to

guMotlne, more destructive
to life, health and
happhssthanthewofid
War . . . more Imsl9tlble
tlmnthemlgMlest
army."
Sewtor Matthew Nwley,
May 1929. -

authorize a federal award for the cure
to cancer. Rebuffed, a year later he pro-
posed authorizing generous funding for
the NAS to determine how the federal
government should engage this enemy,
which he described as "humanity's most

deadly scourge" in a vivid polemic before the Congress.55 At that
time, Ransdell pointed out to Neeley that the PHS had been study-
ing cancer since the early 1920s (including a cancer research unit
at Harvard Medical School) and reminded him of the augmentation
of such research already inherent in his drafts for upgrading the
Hygienic Laboratory. The passage of Ransdell's bill in 1930 tempo-
rarily deflated the congressional pressure to mandate the support
of a single disease.

When he became surgeon general, Pan-an was aware of both the
concerns of Congress and the urging of a small but powerful group
of public supporters. He therefore provided the Congress with the
outlines of a national program for cancer control, which he believed
must include stepped-up clinical research.57 At about the same time,
Dudley Jackson, a Texas internist, induced Congressman Maury
Maverick (D-Tex.) to ask the MH Director to help draft a bill for
establishment of a National Cancer Institute (NCI), but no answer

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
        23


came from director George McCoy. Maverick persisted without such
support and in April 1937 submitted a bill to create a cancer
institute. It was just a few days after that a bill was submitted by
Senator Homer Bone (D-Wash.), who had been assisted by Parran.
A companion bill was submitted from the House by Congressman
Magnuson.

At a joint hearing on the Cancer Act, Senator Bone remarked:

I have received hundreds of letters urging passage of this bill. People
all over the Nation are interested in any move to make real progress
toward discovering the causes of this disease.%

His cosponsor, Senator Roy Copeland (D-N.Y.), added:

The (bill is) introduced in the Senate jointly for myself and fir every
member of the Senate. In the 15 years during which I have been in the
Senate, I have never known such a thing to happen before.5l

On July 27,1937, the House approved the Senate's joint National
Cancer Act, and President Roosevelt made it law on Au&St 5.5g The
new institute was fitted with a National Advisory Cancer Council
(NACC), similar to the National Advisory Health Council (NAHC)
established for the MH in 1930. The NACC was to approve extra-
mural grants made for cancer research. This key provision of the
National Cancer Act did not receive adequate funding until about
1945.

The cancer movement thus was now established within the NIH.
The restless anxiety of its fervent supporters would reappear again
and again in the future, creating tension with the attempts of the
NIH leadership to maintain an integrated program of research on
human biology and disease. Such separation early manifested itself
in a movement to have a hospital for cancer alone in Bethesda. More
serious was the barely averted schismatic movement in the early
197Os, arising from efforts to increase cancer fi.mding.`j"

On the other hand, parochial stimulation of more support for
cancer frequently has proved to be a boon for the whole of biomedical
research, because of the "Venetian structure of NIH" created by the
early grants program officers. This means that on the surface each
of the major disease categories is visible; beneath, the support is

BIOMEDICAL SCIENCE AND THE CULTURE WARP
       24


largely miscible, allowing growth of all the biomedical disciplines.61
By 1944 "The Most Deadly Scourge" had become the strongest
thread in the medical science culture warp.

PublicLaw78-410.

When the U.S. entered World War II, the Public Health Service had
to turn its attention to greatly expanded responsibilities, but plan-
ning for increasing capacity was not entirely neglected. In 1942
Dyer succeeded Thompson as NIH director and assumed his seat on
the CMR. Though ailing, Thompson became in charge of legislative
matters and for several years concentrated on assisting Congress-
man Alfred Lee Bulwinkle (D-NC.), who was chairman of a subcom-
mittee of the House Interstate and Foreign Commerce Committee
that was seeking to straighten out the "messy structure" of public
health laws. Hearings, beginning July 1, 1944, on a Public Health
Service Act featured a long appearance by Parran and a good deal
of careful chairmanship by Bulwinkle to reassure some conservative
Republican members that several new authorities proposed for the
surgeon general were not novel but derived from existing law.62 In
this way, the National Cancer Act became particularly helpful
because Congressman Bulwinkle could point out that if the law
allowed NC1 to award extramural research grants, of course this
authority should also be given to the NIH. In the language of the
new legislation, the NCI-at Parran's insistence--was bound firmly
into the family, as a ninth division of the NIH.

Section 301 in this act gave the PHS, through the surgeon gen-

"(d) Make grants-inaid to
unhferslties...and other
publk or pdvate instiim
tions, and to individuals for
such research projects as
areremmmkdbythe
NAHC or WCC."
Fmm !hctbxt JOI.,
PI&k Law 78410 (1944)

eral, almost unlimited authority to per-
form and support extramural biomedi-
cal research. The new powers derived
from what became Public Law 78-410
had yet to be tested before the President's
November 1944 letter initiated the actions
of Vannevar Bush.

             The surgeon general had also not ne-
glected other plans for peacetime expansion. Two weeks before the
President's letter to Bush, Parran issued a "Ten Year Postwar

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
        25


Program" for the PHS. It was cast in the frame of the activist New
Deal adherent that he was. The plan advocated that "...there be
available to everyone all medical and health services," public funds
for implementation of a national medical care program, and, inter
alia, public support of research. Plans for $23 million in new con-
struction were detailed for the first postwar year. The top priority
was allotted to a 500~bed hospital on the NIH campu~.~~

Letter to A. N. Richards. When the intent to demobilize the OSRD
was taken up in the August 1944 meetings of the CMR, Gene Dyer,
emboldened with the brand-new strength of P.L. 78-410, had ex-
pressed the view that the Public Health Service could take over
contracts appropriate to its functions. A week later, with the concur-
rence of the surgeon general, he wrote a letter to Richards,64 pointing
out in detail the new authorities now held by the surgeon general
and committing the PHS to assume the financial and scientific
responsibilities of the (expiring) CMR. Dyer offered to appoint the
personnel from DMS now advising the CMR to an advisory commit-
tee created for the National Advisory Health Council.

The letter was annexed to the minutes of the next CMR meeting,
and referred to by Bush in a letter to Richards on September 18.`j5
The PHS position was supported by some members of the CMR staff.
James Moore, a top staff executive, wrote Bush's executive officer
that if OSRD was to go, the CMR should be continued by a govern-
mental body, "alternatively the NAS+NRC [sic] or the USPHS."
Moore was fully aware of the new PHS authorities but noted that
PHS policies would have to be "retooled," especially the relation-
ships between the PHS research and that supported by extramural
grants.66 Perhaps because Bush was now busy with preparing a new
agency, the CMR-and the PHS-waited for months for some signal
of further demobilization. By May 1945, the DMS division chiefs
decided to recommend that all contracts be transferred to other
agencies at the end of the year. In June, Bush asked the CMR to stay
fluid but by August 24 he sent Richards a set of principles by which
the contracts should be organized for possible demobilization. These
guidelines specified that military projects should be transferred to
the military. Nonmilitary projects should be divided into one of

BIOMEDICAL SCIENCE AND THE CULTURE WARP
       26


three groups: (1) projects for private sponsorship by groups willing
to be responsible for them; (2) projects properly within the scope of
the PHS and which the PHS is willing to undertake; these would
carry the funds budgeted for their continuance during the current
fiscal year; and (3) projects which could best be furthered under the
auspices of a federal agency will be continued with the expectation
that such a federal agency will be created by the Congress.64 Vannevar
Bush's precise deadline for release had passed into the hands of
Congress.

LEGISIATIM CONFLICT

Different Concepts of an NRF

Four days after Senator Magnuson and others had introduced
S.1285 to establish in law the Bush blueprint for the NRF, Sen.
Harley Kilgore (D-W.Va.1 and several colleagues introduced S.1297,
a bill with a different model. This bill reflected what some consid-
ered a more populist or "socialist" view of government support of
science, ideas that Kilgore had been revising and refining since 1942
in a legislative attempt to have the government more actively
control the OSRD.67 Kilgore's scheme called for a strong director,
government retention of patents on discoveries arising from govern-
ment-supported work, a distribution of 25 percent of the funds to the
states for their tax-supported and land grant schools, not less than
15 percent of the total for medical research, and inclusion of the
social sciences.68 Most of this was anathema to Bush, but President
Truman let it be known in a public statement that he favored the
inclusion of the social sciences and certain other aspects of the
Kilgore bill. Bush wrote's long letter to President Truman discuss-
ing the two bills and his opposition to Kilgore's version. He also
complained to the President that, although he was nominally the
science advisor, he had not been consulted by Truman before his
recent message to Congress on science and research. The President
and Bush had a conference on these differences,6g but, as Bush
complained later, he and the President never had a comfortable
relationship.s

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
        27


The Scientists Mobilize. Overwhelmingly in favor of the Magnuson
version, the scientists and institutional leaders organized to support
it. Many of them testified in Congress, wrote the President, and
signed petitions to back Bush.70

In November, as the hearings bogged down, a Committee Sup-
porting the Bush Report was founded by Isaiah Bowman. Its
members tended to be the scientific elite including the MAC. How-
ever, the scientists were not of one mind as to tactics. Within a short
time, another committee organized by Harold Urey and Harlow
Shapley and supported by Einstein, Fermi, and Oppenheimer backed
a compromise bill." The Bowman committee sent a letter to the
President endorsed by its adherents. By December 1945, the sig-
natories numbered 1377 academicians. More than half (727) of
these were deans, department heads, professors, and staff of medi-
cal schools; others were biologists (295), chemists (1501, and physi-
cists (104). This letter opposed the inclusion of the social sciences
as well as the appointment by the President of a strong director; the
letters also insisted that the governing authority should rest with
the board.6g

One of the many who testified in Congress for the Magnuson bill
was Milislav Demerec, director of both the Biological Laboratory
and the Carnegie Department of Genetics at Cold Spring Harbor:

Moreover, it has been found in practice that placing fundamental
research under the control of agencies that anticipate practical appli-
cations seriously limits and restrains the freedom of thought essential
for basic advances.71

These sentiments could not have gone unnoticed in Bethesda.
There was no doubt, however, that many basic scientists were
alarmed that a section of the Magnuson bill included a Section 5,
that read:

(1) A Division of Medical Research: Programs relating to research in the
biological sciences, including medicine and related sciences.

To soothe the basic scientists' fears, Homer Smith wrote a letter on
behalf of the Medical Advisory Committee pointing out that the
MAC "had never considered the biological sciences within its ~cope.`~~
After the hearings, a compromise bill (S.1850) was approved by both

BIOMEDICAL SCIENCE AND THE CULTURE WARP
       28


sides. It appeared that the OSRD was to be transferred to a National
Science Foundation. The compromise bill passed the Senate, but the
House adjourned while the bill was still before a committee.73

Contracts E&leased

As the Congress deliberated through August, time seemed to be
running out. The division chiefs pushed for transfer of the contracts
lest they all expire before a new agency was created. They would use
the classification that Bush had ordered. In the first week of Sep-
tember 1945, Dyer received notice from A. N. Richards:

In order that disposition of active CMR contracts can be arranged, it is
desirable that a meeting of the CMR Division Chiefs and yourself or
your authorized representative be held...at the NAS on September 5Y4

The minutes of the next CMR meeting on September 6 are anticli-
mactic.75 There is attached without comment an annex reading:

2. Disposition of our Contracts. DIV I Medicine Recommended for
Transfer to US PHS. Medicine, (39 contracts) for $662,000; blood
studies, (5) for $65,000; chemistry, (2) for $12,000.

The total of all CMR contracts outstanding came to $2,127,000,
about two-thirds of which were marked as reserved for "to new
foundation," or "to be kept by CMR."  The minutes were bare of
details and suggested none of the high drama as related by A. Baird
Hastings. This charter member of the CMR delighted in describing
the final moments thus: "As Richards offered up each contract, only
Gene Dyer made a bid, and afterwards he calmly walked home with
the bundle."76

THE BATON IS PASSED

Ambivalence
It is obvious that the transfer of the CMR contracts to the NIH on
September 6 were not perceived, either by the scientists in general
or the biomedical community in particular, as the beginning of the
Millennium. Presumably most still believed that the Bush model
would emerge within the next Congress. None could foresee that

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
        29


during 1946 the legislators would have to concentrate on the cre-
ation of a new government keeper to husband the mixed blessing of
atomic fission. The establishment of the Atomic Energy Agency also
put in place an unforeseen new mission agency for science. A year
later, President Truman, determined to have an NSF director re-
sponsible to him and not to a board, vetoed the NSF legislation. The
accouchement of NSF was beset with unbearably prolonged labor
pains.

The two major science advisory councils responsible to the NIH
were equally nonplussed by the opportunity that had been thrust
upon their agency and the challenge of shaping future biomedical
research. On September 29, nearly a month after the CMR contracts
had been moved, a joint meeting of the National Advisory Health
Council and the National Advisory Cancer Council was convened.
The agenda featured a debate over the new Division of Medical
Sciences of the NRF in the plan proposed by Vannevar Bush. Dr.
Parran informed the council members of the transfer of CMR grants
to NM that had very recently taken place. In a seemingly routine
performance of its statutory duties, the NAHC reviewed and ap-
proved the renewal of the contracts Dyer had brought home as well
as the seeking of a supplemental appropriation of about $900,000
that would be necessary to meet this obligation.

However, when the question was considered of whether the
Public Health Service should take on the responsibility for grants
in medical research, the majority of the members were against the
idea on the grounds that the responsibilities for such grants were:
(a) too great an added burden for the PHS, and (b) more appropri-
ately belonged to the agency administering similar programs in
other scientific fields, including the basic sciences related to medical
science. A subcommittee consisted of the leading basic scientist on
each council: Andrew Ivy, the famed physiologist from Chicago, and
the biochemist William C. Rose, a pioneer in essential amino acids
at the University of Illinois. The two were appointed to draw up a
resolution. The drafters produced a statement that both advisory
councils thought the PHS should retain its independence and ex-
pand its ozun [emphasis mine] research. The resolution passed.77

BIOMEDICAL SCIENCE AND THE CULTURE WARP
        30


Appropriations Test. Gene Dyer, the son of a clergyman, went to
Kenyon College and the University of Texas Medical School. He had
most of his years in the PHS in the Hygienic Laboratory and there
had acquired a national reputation as an expert on epidemic typhus.,
Old-timers at NIH describe him as an introspective man, reserved,
polite, and the "quintessential bench scientist." Most seemed quite
unaware of the tiger poised behind this dignified facade. Guided by
Parran, Dyer was unperturbed by the criticism and ambivalence of
both the NIH advisory councils and the greater biomedical commu-
nity. He immediately turned to "get funds for them" (the contracts)
and "see to it that the program was put into the hands of scientists
and kept there honestly."78

The OSRD had convinced the Bureau of the Budget that money
should be transferred to the Public Health Service to cover a one-
year renewal of the contracts it had taken home. The House
appropriations subcommittee, however, objected to this tactic, and
insisted upon hearing a proposal for a supplemental appropriation
to the PHS Fiscal `47 budget that had previously been approved. On
April lo,1946 Dyer appeared before Congressman Albert L. Engel
(R.-Mich.), the ranking minority member of the appropriations sub-
committee responsible for the Federal Security Agency, which in
1939 had become the location of the PHS. Engel, who had been
intimately involved in the funding of the work on the atom bomb and
other high technology projects through service on another appro-
priations subcommittee, was thoroughly familiar with the OSRD.
Thus the following colloquy between the two men, here presented
in its entirety, can be passed off as merely a good example of the
genre of congressional theater known as `making a record." To
those, however, who like to savor the historical symbolism of Ameri-
.can biomedical science passing from a shallow and uncertain bay
into deep and unlimited waters, the following has a Homeric quality:

Mr. Engel:  What was the supplemental of $1,178,000 for in FY `46?

Dr. Dyer:   $817,000 of that was a supplemental appropriation for
      research grants.

Mr. Engel:  Grants-in-aid to the States?

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
        31


Dr. Dyer:

Not grants-in-aid to the States, but. . . for research work.
We took over contracts for OSRD at their request.

Mr. Engel:  What is the OSRD?

Dr. JIyer:  The Of&e of Scientific Research and Development. That
      was the office which handled the atomic bomb research,
       medical research and other research.

Mr. Engel:  What was the date you took over this work?

Dr. Dyer:   On the 1st of January (1946).7g

Philosophical Adaptations

The surgeon general established a Division of Research Grants in
1946. Dyer chose C. J. Van Slyke, a former field worker in venereal
disease control, to take responsibility for the grants. One of the
reasons for Dyer's choice was that Van Slyke, a gruff and capable
man, was free because he was just recovering from a myocardial
infarction and Dyer thought the job would not take too much of his
day. Van Slyke, in turn, chose Ernest Allen and a few other helpers.
They wasted no time in assembling study sections. By mid-1946
10 study sections were established and more added rapidly to make
21 by the end of the year. The sections covered basic science disci-
plines such as pharmacology and bacteriology; diseases, like syphilis
and malaria; and systems, such as cardiovascular, which included
both basic science and clinical medicine.

From the first day, the study section membership was siphoned
from elite pools, including many advisers from the DMS committees
that had assisted the CMR. Of the 75 medical scientist members
of the NAS in 1946,12 were members of the first study sections.*,81
James A. Shannon, then at the Squibb Institute, was the chairman
of the malaria study section, and Johns Hopkins' E. Cowles Andrus
chaired the cardiology section. These were roles they had played for
the CMR. About 1000 proposals were received the first year, and
the amount awarded came to $5.5 million.

Among the dozen or so study fields in the first year, syphilis was
the leader in dollar volume of grants, followed by cardiology and
physiology. The leading states in terms of number of grantees were,

BIOMEDICAL SCIENCE AND THE CULTURE WARP
       32


in descending order, New York, Massachusetts, Illinois, Pennsylva-
nia, and California.80

The ascent of the annual NIH obligations for extramural research
grants was swift. The approximately $4 million in fiscal year 1947
rose to $15.6 million in fiscal year 1950, to $36.6 million in 1955, and
by 1960 was $203 million. This last figure represented two-thirds of
all NIH obligations in 1960 ($338 million).82
By 1948 officials from the Bureau of the Budget and the Federal
Security Agency were urging NIH to resist cloning of the institute
model for any more diseases. 83  A Mental Health Institute had
already been authorized, with pressure on the Congress from pro-
fessionals and laymen. 84 A single anecdote may suffice to illustrate
the ferment of the late forties. Leonard Scheele, who served as
director of the Cancer Institute from July 1947 until he was ap-
pointed surgeon general in April 1948, later recalled his participa-
tion in the following notes as recorded by his interviewer:

Mary Lasker [asked] `Len, why shouldn't there be a Heart Institute?
Len wrote the bill [slightly revising the National Cancer Act]... Dyer
gave OK...,Parran blessing... Lasker got bill to Senator1 Styles Bridges...on
President's desk `for weeks'.85

There were many others in addition to Mrs. Lasker who contrib-
uted to the accelerated pluralization of the NIH. This was a period
of giddy growth that saw both heart and dental institutes arrive in
1948. Before long, many citizen activists urged a willing Congress
to eventually extend the attack on all diseases, as had been Ransdell's
dream. These expansive adjustments of the culture warp are themes
for other essays and beyond the scope of this story.

Project orhstitutiond Grants. Almost reflexly, Van Slyke and his
team had adopted the project grant as the principal basis for the
extramural program. There is very little evidence that the Congress
initially planned this approach, although it has been pointed out by
Donald Price, who was on the scene, that Congress recognized it
would have a difficult time making awards to institutions with their
different public and private, sometimes religious origins. It was
easier to let the peer review process make the choices with delega-
tion of the final responsibility to the advisory councils that also had

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
        33


public representatives.B6

It is often pointed out that project grant had become the pre-
ferred mechanism of support by the largest philanthropic organiza-
tions before the war, after the bulk grant to institutions had become
both boring and no longer financially feasible. One of the impresa-
rios of such support for small groups of gifted investigators was the
Rockefeller Foundation's Warren Weaver, a member of the Bowman
Committee.87 He and his fellow foundation administrators had
promulgated a "best science" tradition that has dominated funding
of science for this century. The probable reason for the NIH project
grant choice was that NIH wanted to take over where the OSRD had
left off, to choose individuals or small groups of investigators for
individual awards. In Van Slyke's 1946 description of the intent of
the NIH extramural program, he described it as resting "on the
integrity and independence of research workers, and their freedom
from control, regimentation and outside interference."ss Dyer later
echoed these sentiments: U . ..emphasis is placed not on the goal, but
upon the scientist pursuing interests as distinct from bureaucratic
control over those interests."8g Doubtless they firmly believed these
concepts, but they also were aware that the scientific community
was scrutinizing them carefully for any of the dread signs of the
predicted inability of a government mission agency to run a grants
program adhering strictly to the already established "best science"
tradition.

Roger L. Geiger viewed this community reaction as a natural one.
The Depression had ended the dependence of the university basic
research on philanthropic sources; the superimposition of any fed-
eral funding agency on the existing system would be intolerable if
it failed to allow the scientists and their institutions "to retain
freedom of scientific research, peer control and the autonomy of the
universities."gO To be sure, the `autonomy' of the universities was
initially altered greatly by the NIH granting practices. A peer-
regulated decision process operating distal to the universities was
put in place to determine which of their faculty members would be
supported to do research work. The institutions would not make that
decision at home.

BIOMEDICAL SCIENCE AND THE CULTURE WARP
        34


At first, neither the early NIH administrators, who were busy
establishing their credibility as effective heirs of the OSRD, nor the
outside community, which was busy monitoring the NIH perfor-
mance, were paying proper mind to the future. It seemed likely that
in the long run the strictly categorical, highly targeted project grants
appropriate for the OSRD would not give the ideal coverage of
science that could be obtained on broader long-term support for the
best minds. This may have justifiably bothered some supporters of
broad institutional support even though the NIH approach pleased
the rank and file of scientists. With the exception of the needs of
fledgling scientists and others caught between grants, most scien-
tists today probably believe that the university is not in the best
position to allocate support to its faculty investigators strictly on
merit. However, in 1955 there was a short-lived attempt to resur-
rect the arguments for institutional-based funding held by the
Bowman Committee and the MAC.

Brief Revolt. Soon after she took over as overseer of the Public
Health Service in 1953, Secretary Oveta Culp Hobby of the Depart-
ment of Health, Education, and Welfare ordered an outside study
of the NIH research programs. In accord with its recent mandate,g1
the National Science Foundation, which had at last been created in
1950, was given responsibility for the study. The agency convened
a special committee for this purpose consisting of university scien-
tists under the chairmanship of C. N. H. Long, dean ofYale's medical
school. The committee recommended that the NIH extramural grant
program be severed from the intramural program. Furthermore, the
Long committee indicated that the desired mode of research support
was through "unrestricted institutional grants" to the school. How-
ever, events had overtaken this simpler vision, vintage 1945.

James A. Shannon, then the NIH director, thundered against
such a fission of NIH. A new HEW Secretary, Marion Folsom,
appointed his own investigating committee, headed by Dr. Stanhope
Bayne-Jones, who had been another Yale dean. Senator Lister Hill
(D-Ala.), now in the chair of both the Senate authorizing and appro-
priations subcommittees with jurisdiction over NIH, asked an edu-
cator, Dr. Boisfeuillet Jones, to conduct his own study for the

EMERGING POLICIES FOR BlOMEDlCAL RESEARCH
        35


Congress. Both reviews disagreed strongly with the NSF study
committee. The committee report, never officially published, lies in
the archives.W

Basic v. Applied Research. In 1947 nearly everyone in the aca-
demic community appeared to share a canonical belief that, as Bush
implied in his report (and Demerec and others had echoed in testi-
mony and private sentiments), an agency doing applied research
could not be entrusted with handling basic research. In fact, one of
Bush's five principles for operation of the new agency was that it was
not to operate any laboratories of its own2 As Homer Smith's
disclaimer 72 revealed, the members of the MAC in 1945 seemed
astonishingly unaware of the concept that between the most fun-
damental biology and clinical research there stretches an uninter-
rupted continuum. From ancient times, medicine has always been
one of the best tutors of biology. Yet the former cannot survive
without constant refreshment from the deeper wells of fundamental
discovery. The several founders of the modern NM left little written
evidence that they understood completely how close was the inter-
relationship, but in their actions they helped anneal forever the
linkage between basic and applied biomedical research.

The story of how they built the largest laboratory in the world
for unequivocal demonstration of this linkage is too long to tell here.
It is important to note, however, that it was during the same
appropriations hearings in which Dyer had carried the OSRD con-
tracts over the great divide, that he and Parran also pledged to
return the following year to obtain a commitment to build the NIH
Clinical Center. The opportunity to do so had been opened by the
insertion of another clause into Section 301 of P.L. 78-410 that

"VI mrwrposesofstudy,  allowed patients to be admitted for pur-

admlt and treat...petsons   poses of research only.
not otherwise dlglble. . . "   In the planning for the hospital, Parran
sectlcn 30% Public law 78410  and Dyer instinctively had to defend what
           is today recognized as a major principle of

biomedical research, i.e., that maintaining the unity of biomedical
and behavioral research in the immediate environment of clinical
studies is the most effective way to understand disease. Repeatedly

BIOMEDICAL SCIENCE AND THE CULTURE WARP
       36


these two pioneers had to intervene to convince cancer and mental
health researchers that one hospital was better than three.

Ground was broken in 1948 for an enormous new focus of the
intramural program-a house that was described by one of its
principal architects, Jack Masur, as containing "500 beds wrapped
in a thousand laboratories." Construction would cost more than
twice the sum expended by the CMR during the entire duration of
the war. It frightened many of the MH scientists at the time, just
as Ransdell's plan had done decades before. Arthur Kornberg was
one of those who left and provided a reflection on why in a recent
book:

The decision to go...turned out to be [two] errors in judgement. First I
believed that the advent of the Clinical Center and the disease-oriented
institutes would stifle basic research at NIH...%

Many in the academic community were angered by the building
of so colossal a facility. Their representatives on the MAC had
already expressed their opinion to Bush, which he had included in
his report.

"...we should set out to improve the research staffs and facilities of the
present medical schools before we undertake the establishment of new
institutions."

Now that the full support of the government had swung to
biomedical research, this reading of the situation by the medical
elect was too narrow.

When the Clinical Center opened in 1953, clinical investigation
in America had indeed moved a great distance from the turn of the
century. In 1910, a time when philanthropy provided what govern-
ment would not, the Hospital of the Rockefeller Institute was opened
as a unique model for the world.s4 The timing was right. Clinical
research laboratories appeared in teaching hospitals in the North-
east: Philadelphia (1885), Baltimore (1907), New York City (1910-
201, Boston (1922-25), and had become incubators for clinical re-
searchers.27 By 1950 one c o u Id say that the gap between the bedside
and the laboratory was nearly closed. The difference ultimately
provided.in Bethesda was an interface between basic science and

.

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
        37


clinical research of such overwhelming density that the conversion
of clinical investigation from an avocation to a Ml-time profession
was greatly accelerated.g5  The virtue of fostering fundamental
research in the vicinity of clinical medicine soon became a necessity
for the advances against chronic diseases that had finally begun.
The return of increasing numbers of scientists from the Clinical
Center to the medical schools helped scatter across the nation, and
to many parts of the world, the paradigm of how best to focus the
knowledge available on human diseases.

Vannevar Bush deserves the high esteem that history has accorded
him for singular achievements in times when the culture of Ameri-
can scientific endeavor and the associated institutions were chang-
ing from a predominately private mode to a public one. Those who
assisted Bush in this transition made important contributions to
laying out the defense of the scientific method and of the limits of
its adjustment to the forces that support it. In doing so they
positively influenced the transition to a partnership with the state
and passed on passionate instruction on principles that endure
today. Credit for the effective translation of these principles is owed
to a small group of PHS officers, like Thompson,96 Par~an,9~ Dyer,
and Van Slyke, who had the vision, character, and sense of public
duty necessary to make the system work.

The culture warp too endures. Inseparable from the support and
the substance of the weaving of knowledge, it will forever be a part
of scientific inquiry. The complex network of forces involved in the
public support and associated governance of biomedical science have
together achieved a remarkable result in America.

Nevertheless, as the tapestry thickens and becomes more intri-
cate, so does the warp. Capricious adjustments in the loom have
become common. Too often, unthinking or selfish moves are made
that increase the tension and the danger of snags that may seriously
threaten the integrity and completeness of the fabric of knowledge.
Because the loom belongs to civilization, anyone who attempts to
change the function to suit his own design can put at risk all the
generations yet to come.

BIOMEDICAL SCIENCE AND THE CULTURE WARP
       38


Notes

1. Report of the Carnegie Commission on Science, Technology and Government. Enabling the
future: Linking science and technology to societal go&. Washington, DC: Carnegie
Commission; 1992.

2. Bush V. Science, the Endless Frontier, A Report to the President on a Program for Postwar
Scientifi Research. Washington, DC: National Science Foundation; 1960.
3. Preparation of this essay has included inspection of evidence in the National Archives, the
Archives of the National Academy of Sciences, and the History of Medicine Division at the
National Library of Medicine (NLMHMD ) along a trail blazed by Donald Swain' and later
extended by Daniel Fox: and Stephen Strickland.6 The search has included the NIH
Central Files (NIHCF).

4. Swain DC. The Rise of a Research Empire: NIH, 1930-1950. Science. 1962;138:1233-1237.
5. Fox DM. Politics of the NIH Extramural Program, 1937-1950. J. of History of Medicine and
Applied Science. 1987;42:447-466.

6. Strickland SP. The Story of the NIH Grants Program. New York, NY: University Press of
Americql989.

7. Baxter III JP. Scientists Against Time. Boston, MAzLittle Brown;1946.
8. Irvine S. Organizing Scientific Research for War. Boston, MALittle Brown;l948.
9. Bush V. Pieces of the Action. New York, NY:Morrow;l970.
10. Harvey AM. The Association of American Physicians 1886.1986. Baltimore, MD:Waverly
Press;1986
11. Watson EL. Houses for Science: A pictorial history of Cold Spring Harbor Laboratory. Cold
Spring Harbor, NYCold Spring Harbor Laboratory Press;l991.
12. National Archives RG 227 OSRD, Records of the OSRD, Records of the CMR; Minutes, Box
8, 8\3\44 to 12\21\44, Folders Aug 3, 1944 and Aug 17, 1944.
13. Roosevelt FD. Letter to Vannevar Bush. JAMA. 1944;126:904.
14. Gunther J. Taken at the Flood. New York, NY:Harper Brotherql960.
15. Rosenman, S. Letter to Calvin B. Baldwin, Jr., April 5, 1961.
16. Rosenberg AM. Letter to Calvin B. Baldwin, Jr. April 27, 1961.
17. England JM. A patron for pure science: the National Science Foundation's formative years,
1945.57. Washington, DC:National Science Foundation;l982.
18. Cochrane RC. The National Academy of Sciences: The First Hundred Years 1863-1963.
Washington, DC: National Academy of Sciences; 1978.
19. Archives of the National Academy of Sciences. Bowman Committee report on federal aid to
research activities, 1944-45. Folder Executive Of&e for Emergency Management:
osRD;1944-45.

20. National Archives RG 227. OSRD, Of&x Chm NDRC and Dir. OSRD, corr. re Report to
  President 1941-46 Box 2 `Science the Endless Frontier." Folder General: Committee #2.
Letter Vannevar Bush to A.N. Richards, November 18, 1944.
21. National Archives RG 227 OSRD, Records of the OSRD, Records of the CMR Minutes Box
8 8-3-44 to 12\21\44. Minutes of December 1,1944.
22. Ibid. Box 8 CMR. Letter from Vannevar Bush to Walter W. Palmer, December 7, 1944; letter
from Vannevar Bush to Homer W. Smith, December 20,1944.
23. National Archives RG 227 OSRD, Records of the OSRD, Records of the CMR, Box 9 CMR
Minutes of Jan. 18, 1945. Letter Vannevar Bush to A.N. Richards.
24. Archives of the National Academy of Sciences. Folder Executive Oflice for Emergency Mgt.
OSRD 1944-45. Letter Frank Jewett to Vannevar Bush, June 6, 1945.
25. National Archives RG 227 OSRD, OfIice Chm NDRC and Dir. OSRD, corr. re Reports to
  President Box 1 "Science the Endless Frontier." Folder "General" 1\11\45 to 4\15\45.
26. Ibid. Letter Homer Smith to Vannevar Bush, March 6,1945.
27. Medical Research Council Jubilee 1913-1963. Brit Med J. Nov 23, 1963.
28. Kohler RJL From Medicinal Chemistry to Biochemistry. Cambridge: Cambridge University
  Press; 1982.

29. National Archives RG 227 OSRD, office Chm NDRC and Dir. OSRD, corr. re Reports to
Bush, President Box 2 "Science the Endless Frontier." Folder "General" Reports. Memoran-
dum "L.F.K" May 12, 1945.

30. National Archives RG 227 OSRD, office Chm NDRC and Dir. OSRD, corr. re Repoti to

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
       39


President 194146. Box 1 Folder "Misc. 4\15\45 to 5\16\45.", Letter W.W. Palmer to V.
Bush, April 25,1945.

31. Flexner A. An Autobiogmphy. New York, NYSimon and Schuster; 1960.
32. Archives of The National Academy of Sciences. OSRD Release, July 19, 1945. Folder
Executive CXBce for Ememmy Management: OSRD: 1944-45.
33. National Archives RG 227 OSRD, G&e Chm NDRC and Dir. OSRD, corr. re Reports to
President 1941-46. Box 1 "Science the Endless Frontier." Folder "General, Pres. letter
  11\17\44."

34. Ibid. Letter J.B. Conant to AH. Sulzberger, August 14, 1945.
35. Ibid. Letter J.P. Baxter III to AH. Sulzberger, August 26,1945.
36. McCullough D. Truman. New York, NY: Simon and Schuster; 1992.
37. Harden VA Inventing the NIH: F&e& Biomedical Research Policy, 1887.1937. Baltimore,
MD: Johns Hopkins University Press;1966.
38. NLMHMD. Box nho. Unpublished mannmript by Wyndam Miles on the establishment of the
National Institutes of Health. p 16.

39. Armstrong BF. A Profile of the United States Public Health Service, 1798-1948. Washing-
ton, DC: DHEW Publication No. 73-369; 1973.
40. National Archives. RG 443. Records of L.R. Thompson, National Institute of Health 30-43.
Box 197, Folder Ypersonal history/I-R Thompson."
41. National Archives RG 443. General Records, National Institute of Health 1930-46. Box 4
Folder "Cornerstone, Bethesda, June 30,1936." NLMHMD. Box nho, Statement by Jimmie
Thompson, Director of NIH, Placed in cornerstone of Building One, May 26, 1938.
42. Obituary, Lewis Ryer Thompson. JAIUA. 1955;157:60
43. NLMHMLJ MS C 203, Box P-V Interview with Thomas Parran, Rosen, George. Transcripts
of Gral History Project.

44. Harden V. Inventing the NIH:Fedeml Biomedical Research Policy, 1887-1937.
45. National Archives. RG 443. Records of L.R. Thompson, National Institute of Health 30-46.
Box 197, Folder `Personal History/Dr. Thompson." Clipping fmm United States News,
August 13, 1934.

46. National Archives RG 443. Records of L.R.Thompson. National Institute of Health 30-46.
Box 197, Folder "Discussion of S. 1171."

47. National Archives RG 443, Public Health Service Records 193046. Box 189. Folders
"Science Advisory Board, corr. with Parran," and "Corr. with Rosenau."
46. Archives of the National Academy of Sciences. Ex.B. Science Advisory Board, Committee on
  Medicine and Public Health. Letter fmm Henry Morganthau, Jr., to Earl T. Compton,
November 14, 1934. Letter fmm Karl T. Compton to Secretary Morganthau, November 27,
  1934.

49. Archives of the National Academy of Sciences, Science Advisory Board, Committee on
Medicine and Public Health. Report. Mamh 1, 1935.
50. National Archives RG 443 General Records NIH 193046. Box 55 Folder "SAB."
51. Cochrane (17) provides details on the Science Advisory Board and Swain (4) sketches the
PHS involvement, Thompson's role is revealed in (46) and (491.
52. Archives' of the National Academy of Sciences. Executive Board SAB, Committee on
Medicine and Public Health. Letter from Albert Barrows to Karl T. Compton, January 10,
  1936.

53. Archives of the National Academy of Sciences. News release from Public Health Service,
August 22, 1935. Executive Board Science Advisory Board, Committee on Medicine and
  Public Health.

54. Armstrong (361 and Harden (36) describe reactions of the old guard to Thompson's
persistent attempts to "change the NIH into a major medical machine to fight chronic
diseases." Director McCoy observed to his deputy Dyer that "we've got two buildings and
NIH needs no more space than that."

55. National Archives RG 443 Records of L.R. Thompson National Institute of Health 30-46.
Box 197 Folder "Dr.Thompson's European Reports."
56. Yaremchuk W. ( The Cancer War: The Movement to Establish the National Cancer Institute,
1927-1937. Ph.D. diss., New York University, 1977.) has assembled the rhetoric and actions
of this emotional period.

57. National Archives RG 443 General Records, NIH 1930-43 Box 6 Folder "Cancer." Carl

BIOMEDICAL SCIENCE AND THE CULTURE WARP
       40


Voegthn, NIH cancer researcher in a letter to SG Gumming, in 1929 strongly disagrees with
the position of Dr. James Ewing, of New Yorks Memorial Hospital that more fundamental
research must precede clinical res&mh in cancer. Letter Surgeon General Parran to
Senator Homer Bone, Mar& 19,1937.

58. Joint hearings before a Subcommittee on Cancer Research of the Committee on Commerce,
and Subcommittee on Cancer Research of the Committee on Interstate and Foreign
Commerce, U.S. Senate; 5th Congress, 1st Session. July 8, 1937; Washington, DC.
59. Jimmie Thompson confided in his message left in tbe cornerstone of Bldg l(40) that, under
the direction of the Surgeon General, he wrote the Cancer bill, took care of "the arrange-
ments for the hearings, which Senator Copeland kindly left in my hands," and wrote as well
the House report on it. Ironically, Mr. Luke Wilson had died of cancer in June 1937. The
family granted another ten acres for construction of a building for the cancer institute, on
the NIH grounds.
66. Rettig RA. Cancer CNsade: National Cancer Act of 1971. Princeton, NJ: Princeton Univ.
Press; 1977.

61. Fredrickson, DS. "Venice" is not sinking (the water is rising): Some views on biomedical
research. JAUA. 1982;247:3072.

62. NLMHMD Box nbo, Folder 194445 legislation. House Committee on Interstate and Foreign
Commerce; Senate Committee on Labor and Education, Summary of P.L. 78410, based on
HR 4624 (BulwinkIe) July 1,1944; Washington, DC.
63. NLMHMD C 264 Parran, Thomas, M.D. Proposed Ten-Year Postwar Program of the United
States Public Health Service, November 1,1944; Washington, DC.
64. National Archives RG 227 OSRD, Records of the CMR, Minutes Boxes 8 and 9 Folders
Aug 17 minutes and =Aug 31,1944. Letter from Rolls Dyer to A.N. Richards, August 29,
  1944.
65. Stewart I. p 314-316.
66. National Archives RG 227 OSRD, O&e Cbm NDRC and Dir. OSRD, corr. re Reports to
  President 1941-46 Box 2 "Science the Endless Frontier" Folder "General Committee 62."
  Letter J.E. Moore to Irwin Stewart.

67. NLMHMD Box nbo Comments on S. 2721, RiIgore Bill to establish OK Tech. Mobilization
in letter from Surgeon General Parran to Asst. GenI. Counsel, FSA, December 14, 1942.
68. Archives of The National Academy of Sciences. Memorandum fmm the committee supporting
the Bush report, 1945. Folder Executive OtBce for Emeqency Management: OSRD 194445.
69. National Archives RG 227 OSRD, ORice Chm NDRC and Dir. OSRD, corr. re Report to
President 1941-1946; Box 1 "Science the Endless Frontier" Folder `Truman October 13,
  45."

70. Archives of the National Academy of Sciences. Memorandum to signatories of letter to
President Truman, December 1945. Folder Executive office for Emergency Management:
  OSRD 1944-45.

71. S 1297 - Testimony of Dr. M. Demerec. Hearings on Science Legislation S 1297 and
related bibs, Parts 1-4, Ott 8 - Nov 2, 1945; Washington, DC.
72. Archives of The National Academy of Sciences. Memorandum from Homer Smith, undated.
Folder: Executive O&e for Emergency Management: OSRD, 1944-45.
73. Stewart I. p 320.
74. National Archives RG 227 OSRD Records of the CMB Box 32 General Records 194946.
Folder "Dyer, R.E."

75. National Archives RG 227 OSRD Box 11 Minutes of the CMR, 1941-46. Folder: "September
6, 1945."

76. Hastings AB. Personal communication.
77. National Archives NAHC Min 691. Minutes of joint NAHCNACC meeting September 28,
  1945.
78. Strickland. pp 21-50.  Van Slyke, who was selected by Dyer to start the grants program,
summarizes the start of the NIH Extramural Program.
79. Hearing Report Committee for Labor, FSA, and related independent offices appropriations,
US House of Representatives; April 10,1946, Washington, DC.
80. National Archives RG 443 F&cords of the National Institute of Health 193048. Res Grants.
  Box 1422. Folder "Research Grants Office."

EMERGING POLICIES FOR BIOMEDICAL RESEARCH
        41


81. Archives of The National Academy of Sciences.  Annual Reports of the National Academy of
Sciences, 1935 through 1948.
82. Data from Robert F. Moore, NIH DRG.
83. NIHCF file b&g 248. Memorandum fmm A.F. Siepert to the file, April 23, 1948. Meeting
with FSA Program Planning OtBce.

84. Grob GN. The forging of mental health policy in America: World War II to New Frontier. J
i-fist Med and Allied Studies. 1987;42:6.

85. NLMHMD MS C 202 Box 22. Armstrong verification papers. Interview with Leonard
Scheele by B.F. Armstmng.

86. Price DK Endless Frontier or Bureaucratic Morass? Doerlolt~s. 1978;107:75.
87. KohIer R.E. The Management of Science: The experience of Warren Weaver and the
Rockefeller Foundation Program in MolecuIar Biology. Mincrva. 1960;14:279-306.
88. Van Slyke CJ. New Horizons in Medical Research. Science. 1946;104:561.
89. NLMHMD MS C 203  George Rosen Collection of oral History Transcripts.  Interview
with R.E. Dyer by Harlan Phillips. November 13, 1953.
90. Geiger RL. To Advance Knowledge The Growth of American Research Uniwrsities 1900.
1940. New York, NY: Oxford University Press; 1986.
91. Executive Order 10521, signed by President Eisenhower on March 26, 1954, ( CFR, Title 3
The President, 1954-1958 Compilation 183-185) empowered the NSF to review scientific
programs of the federal government.

92. NLMHMD Records of the National Science Foundation's Special Committee on Medical
Research, 1948-1975.

93. Komberg A. For the Ime of Enzymes. Boston, MA: Harvard University Press; 1989.
94. Corner GW. A History of the Rockefeller Institute 1901-1950, Origins and Growth. New
York, NY: Rockefeller Institute Press; 1954.

95. In his book, Ward 4. Cambridge, MA: Harvard University Press; 1958, James Howard
Means writes: When research workers of the MGH visit Bethesda, Maryland and see the
Clinical Center of the National Institutes of Health, they say `Ah!, a 509&d Ward 4.' "
96. In his cornerstone memoir (49), Thompson wrote: "I do not know of any other officer of my
own times and I doubt if there will be many in the future to have the pleasure, excitement
and good luck to be personally instrumental in the development of an institution such as the
  National Institutes of Health...."

97. Ralph C. Williams in his The United States Public Health Service, 1788.1950. Richmond,
VA: Whittel & Shepperson; 19511, describes Thomas Par-ran's personal ranking of his
considerable achievements. He gave the highest ranking to: first, the strengthening of the
research programs of NIH and increasing extramural support of research; second,
establishment of the NCI; and third, leadership of national venereal disease control. He
was also a principal architect of the World Health Organization and responsible for the
organization of the CDC.

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        42