plated an end to these emergency activities. At the beginning of the year, Dr. Lewis H. Weed, the chairman of the Division of Medical Services, reported that all of the committees would be discharged by the end of June. At the same time, negotiations were under way to forge a new relationship with the surgeons general of the Army, Navy, Public Health Service, and Veterans Administration. Weed expected the division ''to be intimately concerned with research problems undertaken by the principal federal agencies concerned with medicine.'' 2

On March 12, 1946, Major General Norman T. Kirk, the surgeon general of the United States Army, wrote to Frank B. Jewett, the president of the National Academy of Sciences, and suggested that conferences be held to discuss a new advisory relationship between the Academy and the federal medical agencies. Within three weeks, a preliminary conference took place in which the participants agreed that "strong efforts" should be made to continue the services of the National Research Council. An ensuing conference on postwar research held on April 18 at the National Academy of Sciences attracted 43 people, among them some of the nation's leaders in medical administration and medical research. Dr. Edward Churchill, a professor of surgery at the Harvard Medical School, chaired the meeting. Those in attendance included Louis Dublin, who had done pioneering work in health statistics with the Metropolitan Life Insurance Company; William Menninger of the famous psychiatric family; Barnes Woodhall, a distinguished clinician and medical researcher from Duke; and John Whitehorn, the chief of the psychiatry department at Johns Hopkins.3 Faculty members from the medical schools at Northwestern, Western Reserve, Columbia, Vanderbilt, Pennsylvania, and Yale also attended.

Even in the presence of so much senior medical talent, Colonel Michael E. DeBakey of the Army's Office of the Surgeon General, a surgeon who subsequently came to international fame in his field, played the key role at the meeting. A memo that he had sent to General Kirk on March 5, 1946, served as the basis for the discussion. In this memo, DeBakey pointed out that "an enormous amount of material" had accumulated in the medical records kept by the armed services. "It can fairly be said," he wrote, "that no similar amount of material has ever been accumulated, and it is doubtful whether a similar amount will ever again be available." DeBakey proposed to turn this material to "practical use by the establishment of a clinical research program, including a follow-up system to determine the natural and post-treatment history" of the diseases and conditions treated during the war. DeBakey offered the example of peptic ulcer as a condition that might be studied. A follow-up of cases identified during the war would establish the conditions under which the ulcers led to perforation, hemorrhage, and other complications. Such an exercise could enable clinicians to settle such questions as whether "benign peptic ulcers undergo malignant changes." Investigators would also be able to ascertain the long-term effects of various forms of treatment. "These and other data, departing from a given base line and followed up over long periods of time, dispassionately and in the absence of special pleading,



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