NEW HORIZONS IN MEDICAL SCIENCE

...Even where cure is as yet impossible, the effects of many diseases can be eased and life extended...

...But the whole history of medicine demonstrates the contrary...

...The N1H investigators are concerned not only with the discovery of the specific causes of individual ailments and of possible means of treating them...

...It takes a staff of 5,200 employes, including hundreds of specialists in a broad range of the sciences, to run the National Institutes of Health...

...Another field in which there is intensive research and a spate of new ideas is that of obesity...

...The war spurred a sharp increase in research spending by the federal government, and this trend was further intensified after the war...

...The preparation of such immunologic agents has been greatly speeded up by the new technique of growing viruses in test tubes, which made possible the development of the Salk polio vaccine...

...I would hate to make a guess as to which will get there first...

...Much of it is basic research in cellular nutrition, in the role of proteins and hormones, in the chemistry and electric properties of the brain, in the structure of the viruses on the borderline between life and non-life...

...If we eliminate these two diseases, I wonder what people will die of...

...The immensely ambitious research goal in this field is to establish why and how the human organism ages, how disease processes can be disentangled from the aging process itself, and what can be done early in life to minimize the disabilities of old age and to retard its inexorable course...

...The remainder is allocated in grants to medical schools, teaching hospitals, and other research institutions...

...The tranquilizing drugs have opened up exciting vistas in the field of mental disease...

...By last year appropriations were $98,458,000...

...With more than 25 million Americans reported to be overweight and thereby far more prone to various degenerative diseases than they would otherwise be, obesity is unquestionably one of the nation's most serious health hazards...

...There is the feeling that we are probably on the eve of a great breakthrough in the effort to unravel the enormously complex mysteries of the human body and of the major diseases still besetting it...

...The battle of the bulge will not be won, they maintain, until medical science succeeds in establishing the underlying reasons why so many people get fat...

...It is, furthermore, implicit in the far-flung dimensions of the crash program of current medical research, under both governmental and private auspices...

...If you're talking about preventing premature death from these two disease entities," he finally replied, "I'd say it's a good horse race...

...James Watt, young and vigorous director of the National Heart Institute, whether the chances of a breakthrough in the near future are better in heart disease or in cancer, the nation's first and second causes of death...

...At the same time, the government poured increasingly larger sums into research...

...In effect, they are engaged in an ambitious attempt to overcome the growing fragmentation of medicine and to get an overall view of the multiple ramifications and complexities of the human body...

...In geriatrics, the focus is on some of the most subtle and complicated problems in medicine, involving the basic mechanisms of tissue chemistry and growth, function, and degeneration...

...The death rate from all causes in this country has been nearly halved since 1900...

...The patients, who come from all parts of the United States, are not charged a cent—the only requirement for admission is that their condition fit into studies being pursued by the research institutes...

...How soon the riddle of malignant growth will be solved is still anybody's guess...

...In 1940, NIH had a budget of $2,190,000...

...Much of the research carried on in row after row of laboratories is far beyond the comprehension of the layman...

...James A. Shannon, director of the National Institutes of Health, declared that if it is definitely established that arteriosclerosis is primarily caused by a defect in the body's capacity to handle fat, as is now geogl erally assumed by most investigators, " "it is a reasonable expectation" that drugs can be devised to correct, and perhaps even to prevent, this metabolic fault...

...Penicillin, along with the general raising of the standard of living which has cut down susceptibility to streptococcal infection, has within the past few years provided a specific preventive against rheumatic fever, which until recently was one of the main causes of heart disease...

...The research program of the Heart Institute is focused on developing knowledge pertinent to a better understanding of the structure, function, and abnormalities of the cardiovascular system...

...Nowhere else can you get the feel of the sweep and scope of today's medical research as you do on a visit to Bethesda, which appropriately derives its name from the miracle healing pool of ancient Jerusalem...

...Here are some: • According to Dr...

...Ten years later its appropriations had jumped to $52,146,000...

...Out of leads of this nature, which cannot be compartmentalized, ultimately come the weapons applicable against specific diseases...

...More than fifty new viruses have been isolated in recent years, and scientists are now busy trying to develop vaccines against them...

...The researchers themselves usually shy away from such sweeping ' claims...

...Watt, there is reason to believe that "the foreseeable future will bring very great gains against the problem of hardening of the arteries" and there is likewise ground for optimism in the related field of high blood pressure...

...As the sulfas, antibiotics, and hormonal compounds appeared on the medical scene in the middle 1940's, the pharmaceutical industry began spending huge amounts on drug development...

...By providing more and more money for research in medicine but nowhere near enough for training the people to do such research, our lawmakers have inevitably created a somewhat lopsided situation...

...Just before World War II, medical research expenditures in this country from all sources totaled less than $20,-000,000 a year...

...But they are convinced that the spectacular accomplishments of the past are merely a prelude to even greater achievements in the future...

...In the pediatric sphere, much of this research is centered on premature birth and on congenital malformations, the two conditions which still take a heavy toll among the newborn...

...Others will explore in greater detail the developments of specific areas of progress in medical science...

...The control of rheumatic fever means that children who develop strep throats can now be saved from becoming the chronically ill heart patients of tomorrow...

...NIH conducts laboratory and clinical research in its own laboratories at Bethesda and supports, through grants, research and training in the nation's medical schools, universities, and other research centers...

...The total annual medical research outlay today—by government, industry, voluntary health agencies, philanthropic foundations, and academic institutions—is estimated at more than $300,000,000...

...By instinct and training, they • are conservative people who operate, step by step, by a process of careful deduction and who recoil from broad generalizations...

...On the face of it, the exploration of these obscure problems would appear to have little to do with the desperately ill patients across the corridor from the laboratories...

...I recently asked Dr...

...But it can go a long way toward providing the trained technical manpower, the research facilities, and the tools to bring about such a cure...

...But most of these experts also agree that our weight-reduction programs, based largely on scolding and threatening people, have generally been a failure...

...Dr...

...Money alone cannot buy a cure for heart disease or cancer...

...David A. Wood, director of the Cancer Research Institute at the University of California and president of the American Cancer Society, feeb that the prospect for control of cancer "has become very real indeed within the last decade...

...For in seeking to extend knowledge of the basic mechanisms of life, the scientists in the component agencies of NIH are constantly finding subtle interrelationships in body processes and functions...

...Research in the Institute of Arthritis and Metabolic Diseases ranges over the whole vast field of the processes of metabolism and their relationship to the nervous and hormonal systems...

...For the current fiscal year they have been nearly doubled again and amount to $182,807,000...

...Substantial progress also is reported in the complex field of the remaining unconquered virus diseases, which include the common cold and other respiratory infections...

...and, once you find out exactly why something goes wrong, the antidote cannot be far away...

...The odds of life against death have been turned immeasurably in our favor...

...Many researchers are convinced that the tranquilizers now available are only the advance guard of more effective and safer drugs which will be developed as science learns how the brain and nervous system operate normally and what causes disease through alterations in their chemical makeup...

...While some pieces of the cancer puzzle are still missing, he said, "there is no longer any doubt that these, too, will be supplied...

...Watt looked thoughtful for a couple of minutes...

...There are reports that some NIH beneficiaries are getting more money than they have ideas for its effective expenditure, but overall the trend is hopeful and affirmative...

...Many mysteries continue to elude the medical scientists, and they are still confronted by vast areas of ignorance...

...Radically new concepts of the causes of obesity are holding out the promise of the eventual development of effective drug therapy for overweight...

...This conviction grows out of these two basic tenets of science: in the long run, no scientific problem is insoluble when enough resources, time, and effort are concentrated upon it...

...While in theory each institute is allotted a definite segment of scientific investigation, in practice the boundary lines frequently become blurred...

...Particularly striking is the manner in which Congress has kept on boosting the annual appropriations of the National Institutes of Health...

...Watt thereupon conceded with a chuckle that his speculative flight of fancy was probably a trifle premature...

...This is still not much more than Americans spend each year for chewing gum...

...The influence of NIH thus reaches far beyond its own busy laboratories, and there is a constant cross-fertilization of ideas between the scientists at Bethesda and their colleagues elsewhere...

...Medical authorities are beginning to have some second thoughts about the usefulness of these so-called "emotional aspirins," which within the brief span of less than three years have jumped to the forefront of the nation's pharmaceutical best sellers...

...TWERE is an undercurrent of ex-citement, of big things in the making, these days at the National Institutes of Health in Bethesda, Md., the general headquarters of the nation's vastly stepped-up drive against disease and premature death...

...In its exploration of the insidious riddle of malignant growth, the Cancer Institute is attacking such problems as cell chemistry and mechanisms, the influence of hormones on growth processes, the effect of nutrition on tumor growth, tumor-host relationships, and the manner in which the body becomes susceptible to or resists cancer-inducing substances...

...Greenberg is the American journalist twice honored by the Lasker Foundation for distinguished writing on medicine and is the winner of the Associated Press Managing Editors' Association award for his articles on the problems of the aged—The Editors...

...In talking to some of the top NIH investigators I received the definite impression that the payoff may not be far away in the battle against heart disease, cancer, the mental disorders, the viral illnesses, and a host of other ailments...

...It is generated far more by the dramatic discoveries in the NIH laboratories and in many other research centers throughout the country, and by the groundwork these discoveries are laying for still further advances...

...It does not sound too fantastic, however, when considered within the context of the things which leading scientists at Bethesda and other medical research institutions see ahead...

...This integrated approach and the emphasis on the close link between fundamental biological research and the application of its findings in the actual treatment of the sick is dramatically illustrated in the Clinical Center...

...Particularly grave was the neglect of the basic sciences, wherein lie the ultimate solutions to all medical problems...

...There is hardly a disease of any consequence which has not engaged the attention of the staff of the Clinical Center since it first opened its doors in 1953...

...With this year's multi-million-dollar NIH budget nearly double last year's and twenty times bigger than ten years ago, there is a marked quickening of pace in the huge powerhouse of medical research operated by the federal government just across the line from the District of Columbia...

...In the search for the underlying causes of psychiatric disease, the Institute of Mental Health is exploring factors ranging all the way from the biochemical mechanisms in the brain to the environmental influences on behavior...

...With the bacterial ailments now largely under control, the Institute of Allergy and Infectious Diseases is concentrating on the viral and allergic conditions, which are still taking a heavy toll of disability...

...The National Institutes of Health, consisting of seven institutes devoted to specific areas of medical science, is the research arm of the Public Health Service in the U. S. Department of Health, Education, and Welfare...

...It shows that this so-called pure research has time and again produced knowledge applicable against specific diseases, that what scientists find under their microscopes is likely before long to be passed on to you through your doctor...

...Many ailments not long ago considered incurable can now be cured...

...Behind the medical investigators, as they seek to push back still further the frontiers of the unknown and to comprehend the basic processes of life, lies a record of stupendous achievement...

...The past few decades have truly been the golden age of medicine, with progress far greater than in all the previous 2,300 years stretching back to Hippocrates...

...This has lent new impetus to an intensive research drive to find the link between mental disease and some definite chemical defect in the body which medicine can try to cure—or even to prevent—with drugs...

...Until just a few years ago, most lines of medical research in the United States were starved for funds and forced to proceed on a hit-or-miss basis...

...There is hope," said Dr...

...The infectious diseases have been virtually conquered...

...The uncanny ability of the tran-quilizing drugs to turn off psychotic symptoms, just as insulin can eliminate the symptoms of diabetes, provides the most important clue yet uncovered to what many medical scientists believe is the underlying organic nature of mental disorders...

...Less than one-third of the NIH funds are spent directly at Bethesda...

...Watt, "that within the next five to ten years we will not only get the answers to the underlying causes of arteriosclerosis and hypertension, which in itself would be a tremendous advance, but that the effects of high blood pressure will be brought under control...

...And there is a great deal more than that—something intangible but of immense promise—an atmosphere of great expectations...

...I suppose our ultimate goal is to have people live a full life to the maximum of their biologic capacities...

...They also are exploring the intricate interrelationships between diseases and among various tissues and organs...

...But progress within the past few years in the diagnosis and treatment of cancer already has made it possible to cure fully half of the cases if the malignancy is detected in its early stages...

...Other means of saving lives and of adding years of health and usefulness are likely to come before long from the research attack on the diseases and biologic processes of the two extremes of the life span—infancy and old age...

...The atmosphere of optimism which quickly percolates to the visitor to Bethesda therefore stems only in part from what the scientists themselves are willing to say...

...The result is that the NIH is reported to be having some difficulties in spending its whole appropriation for the current fiscal year...

...There is striking agreement among medical authorities that control of obesity is the most practical means now available for preventing or retarding the onset of the chronic diseases, which have been rising in incidence with the steadily mounting proportion of middle-aged and older people...

...The Institute of Dental Research conducts fundamental investigations on the causes of tooth decay and on diseases of the gums, oral bones, and other supporting tissues...

...There is a constant quest for better surgical procedures and improved methods of hormonal and radiation treatment...

...Average life expectancy last year reached the Biblical limit of three score and ten...

...In the cancer field, the picture is more complex...

...The field staked out for the Institute of Neurological Diseases and Blindness covers the normal function of the nervous system and its abnormalities in such disorders as cerebral palsy, multiple sclerosis, epilepsy, muscular dystrophy, and conditions causing blindness and deafness...

...In this remarkable combination of hospital and research facility, which has 500 beds and twice as many laboratory units, laboratory and clinical specialists work in close daily association in a search for answers to both abstract scientific questions and practical problems in the treatment of patients...

...In fact, as a result of the effectiveness of new drugs for lowering blood pressure, the hypertension death rate has actually declined in the last two years...

...But the controversy which the tranquilizers have stirred up has tended to obscure their vital importance not only in the management of severely disturbed psychotic patients but also as a tool in the investigation of the chemistry of the brain and of the basic causes of mental illness...

...A writer on medical affairs for the Providence Journal and Evening Bulletin, Mr...

...While Congress has been extremely sensitive to the mounting public interest in medical research, its generosity in appropriating research funds has unfortunately not been carried over to the equally pressing task of financing adequate facilities for the training of research personnel...

...Investigations being pursued here include such abstruse subjects as the biology of cell growth, the nature of chemical balances within the body, and the possible role of viruses in the development of cancer...

...Clustered here on a 300-acre hillside are 18 buildings housing the institutes making up NIH, topped by the 14-story brick and glass Clinical Center, the biggest and most unusual laboratory-hospital of its kind in the world...