Healing the sick, caring for them, and finding methods of preventing illness are among the highest type of activity engaged in by mankind. Especially is that true in the case of a disease like cerebral palsy which attacks children, and which is not normally fatal - a fortunate fact but one which carries with it a lifetime of heartbreak, unusual financial burden, and incomparable physical inconvenience. I am pleased to be among people who have enlisted their time, talent, and financial assistance in alleviating such conditions. And I am pleased to speak on a subject so close to your interests - and to be able to bring you information certain to be well received. No one relishes delivering bad news; every speaker welcomes the prospect of bearing good tidings.
As you know, the National Institutes of Health located in Bethesda Maryland, just outside of Washington, D.C., are composed of seven independent institutes. These various institutes concern themselves with such specific areas of medical research activity as arthritis and metabolic diseases; cancer; dentistry; heart disease; mental health; microbiology; and neurological diseases and blindness. The National Institute of Neurological Diseases and Blindness includes within its area of activity all those diseases in which the nervous and muscular systems of humans are affected, including cerebral palsy. The Institute, along with the rest of the medical profession, has long been troubled by the difficulties experienced by medical research in attempting to conquer cerebral palsy, which is perhaps our modern world's most mystifying and least understood malady - and one of the most tragic. Although it is a disease contracted by adults as well as children, its most staggering aspect is the fact that nearly 10,000 babies are born in the United States each year with cerebral palsy - 1 every 53 minutes! This may mean awkward and involuntary movements, lack of balance, irregular gaits, guttural speech, grimacing, drooling, spasticity, failure of muscular coordination, tremor and rigidity or some degree of mental incapacity. So far as medical science knows, the causes appear to be equally varied: congenital brain malformation; injury to the motor centers of the brain before, during or after birth; incompatibility of blood factors; head injuries or high fevers during infancy; cerebral hemorrhage; and premature birth. The feelings of inadequacy and futility with which we non-medical people approach cerebral palsy certainly echoes the professional view of its complexities as well as its tragedies. Only an equally complex, comprehensive and many-sided campaign against cerebral palsy can ever turn the tide. It is a disease that must be prevented - and to be prevented it must first be understood.
Tonight it is my great privilege to announce - and one could not conceive of a more appropriate audience to which this first public announcement could be made - that the National Institute of Neurological Diseases and Blindness outside Washington, D.C. is now planning to launch an all-out attack against the dread spectre of cerebral palsy. In the language of the National Institutes of Health, a "collaborative study" of cerebral palsy is to be undertaken by the medical world under the aegis of the Institute of Neurological Diseases and Blindness. Thus, as it has done in similar instances in the past - namely, in the testing of the effectiveness of penicillin in controlling syphilis, in an attack upon tuberculosis and a search for its cures, and in the reduction of the abnormally high incidence of blindness in premature babies - the Institute will mobilize all of its research resources, together with those of private associations, including your own United Cerebral Palsy, hospitals, and medical schools, into a powerful task force to conduct an intensive research campaign. What might take 50 to 100 years of research under normal conditions can thus be accomplished in a 5 to 10 year period of highly concentrated effort.
The Institute's personnel, under the direction of Dr. Pearce Bailey, and the non-governmental participants such as United Cerebral Palsy have already worked out a tentative "protocol" prescribing the method of approach and the role to be played by each participating individual and agency. This protocol is at present being circulated among those who are to play active roles in the war against Cerebral Palsy for additional refinements, and the actual working program of attack will get underway in the near future.
Permit me to give you a dramatic example of what I mean by this "task force" attack that is about to be launched on cerebral palsy. Although considerably simpler than the problems involved in understanding, preventing, and caring for victims of cerebral palsy, the case of retrolental fibroplasias - a particular form of blindness - provides an inspiring illustration of the "collaborative study" in action. For years doctors had been aware that premature babies tended to develop retrolental fibroplasia. In 1942 this observed tendency was carefully studied and noted in medical periodicals. Considerable thought and attention had been given to the problem without much success when a young doctor from Washington, D.C. approached the National Institutes of Health and declared that his studies and observations led him to conclude that the blindness was a direct result of the oxygen administered to premature babies in an effort to assist them in their early days. Despite the fact that the theory did not have any particular acceptance in the medical world, a research grant was awarded the doctor by the Institutes and he continued and expanded his studies. The information he gathered was sufficient in the judgement of the Institutes of Health and expert medical boards to warrant an exhaustive study and experiment along the lines suggested by his efforts.
Thus a group of investigators in 18 hospitals in various parts of the United States, supported by the National Institute of Neurological Diseases and Blindness, the National Foundation of Eye Research and the National Society for the Prevention of Blindness, commenced an intensive one-year experiment. The results of the experiment indicated quite clearly that in fact there was a direct relationship between the time spent in high concentration oxygen by premature babies and the incidence of blindness (retrolental fibroplasia) among those babies. Although oxygen in many cases is essential to survival of premature babies, it was found, the period of exposure to high concentration oxygen must be held to the barest minimum to reduce the chances of retrolental fibroplasias. As the result of this "task force" attack, the incidence of that type of blindness, although not completely eliminated, has decreased from 40% to 2%! Interestingly enough they also discovered that premature babies do not generally need the sustained high concentration of oxygen formerly thought necessary for survival.
It is not contended that these facts would not have been discovered if there had not been a collaborative study, but rather that many children would have had to spend their lives in darkness while the normal course of research was confirming the theory over a period of years. This striking example illustrates well the "task force" approach to a specific medical problem.
Another aspect of the collaborative study requiring comment is its financial support. As I am sure most of you are painfully aware, we in the Congress are called upon to appropriate a lot of your money each year for various purposes. I must confess, however, that when it comes to appropriating funds for the support of medical research in this country, I am pleased to cast my vote for such appropriations. We should not permit worthy experiments to remain unperformed - it is clearly in our national interest to finance those experiments essential to our understanding of the human body and the many diseases that afflict it. I was grateful that my amendment in the last session of Congress to increase appropriations for medical research was approved without objection when it was made clear that many worthwhile projects would not otherwise by undertaken.
Any nation which can spend 2 1/2 billion dollars for scientific research and development for military weapons and equipment - as the United States will do in fiscal 1956 - certainly can afford to invest more of its national wealth in broadening our base of medical knowledge and making discoveries which will give the people of our country and the world healthier, more useful lives.
The United States Senate can justly take pride in its attitude towards medical research. When the Executive Branch of the Government requested slightly over $89,000,000 for fiscal year 1956 for the medical research programs of the National Institutes of Health, this exact amount was approved by the House of Representatives. The Senate, however, wanted to know if more could be done; and with a little effort we unearthed the fact that many worthwhile scientific experiments approved by non-governmental expert councils had not been included in the recommendations made to the Congress by the Executive Branch. Acting on this information, the Senate voted $112,000,000, an increase of $23,000,000. In conference with the House the entire increase did not stand, but a substantial part of it - $ 8 1/2 million - did. In the case of the Institute of Neurological Diseases and Blindness in which we are particularly interested tonight, the Department of Health, Education and Welfare requested $8,111,000; the Senate approved $11,850,000; and in Conference the final figure agreed upon was $9,861,000.
No discussion of cerebral palsy in Boston would be complete without reference to Mrs. Abraham Pinanski and Dr. David Cogan, both of whom have just recently been appointed to serve on the National Advisory Neurological Diseases and Blindness Institute Council. Mrs. Pinanski has a long record of active service on state and local hospitals and Public Health Advisory Committees. Dr. Cogan, a noted investigator into the causes of blindness, has served as a consultant to the National Research Council, the Public Health Service, the World Health Organization and other groups interested in eye disorders. I believe I mentioned earlier the role played by the Advisory Councils to the various institutes. These experts are selected to sit as a group and to evaluate all proposals for research grants and to advise the specific institutes as to which experiments are worthy of financial support. The heavy responsibilities borne by the members of these Advisory Councils makes the selection of the members extremely important. The Nation's top talent is called upon and we in Massachusetts take special pride in the fact that two of the twelve members of this particular National Advisory Council are Bostonians.
I hope no one will interpret what I have said here to mean that the government should or wants to do the job alone. I know of the splendid research program being supported by the American people through their contributions to United Cerebral Palsy. I also know of the ambitious plans you and leaders of industry have made for your new Research and Educational Foundation. By all means, these voluntary efforts should be continued and, in fact, increased in view of the intensive campaign to be waged against cerebral palsy.
The cause which has enlisted your talent and generosity is heartwarming; the healing of children doomed in the past to a lifetime in the shadows - the comforting of their families on whom the burden falls with special severity. This surely is a work worthy of all your efforts and all your sacrifices. Their gratitude and that of the people of this state and the country is with you.
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