Japan to assist in the commission's work.77 Cannan decided that it would be best for the statistical program of the commission if senior statisticians from the Follow-up Agency took successive tours of duty in Japan. He hoped that Beebe would make the first formal tour, beginning in July 1958. When Beebe went to Japan, data from the commission would be sent to Washington, enabling some of the commission's work to be done by the Follow-up Agency staff there. The assignment strained the agency's staff. Perhaps for this reason, the agency, for the very first time, had no formal proposal before the Committee on Veterans Medical Problems when it met in December 1957.78

Reflecting at the end of 1957, Beebe noted that study findings often defied expectations. He pointed to the study of psychoneurosis that had been done by Norman Brill, using a sample of 1,500 Army and Navy veterans. Only a few of the men who had broken down could have been identified on induction. Their breakdowns reflected the stresses of war and could not easily be foreseen. Many men with an apparent predisposition to psychoneurosis served with distinction during the war. Upon follow-up, only 8 percent seemed to be severely disabled, and suicide was comparatively rare. These findings could not have been predicted in advance: it took a follow-up study to reveal them. Similarly, the studies of hepatitis and of scrub typhus addressed the question of whether an acute infectious disease set the stage for a chronic, degenerative process. Here too, only empirical research of the sort the agency performed could uncover the answers. Beebe noted also the extent to which the agency relied on statistical epidemiology, rather than clinical follow-up, and the fact that some of the agency's work involved using records from World War I.79

As Beebe recognized, the agency's studies followed no orderly pattern. In fiscal year 1957, for example, the agency contemplated studies on rheumatoid arthritis, multiple sclerosis, lesions of the intervertebral disk, infectious hepatitis, and coronary artery disease. In addition, the agency received requests to collaborate with VA hospitals on two clinical trials, one of "chemical adjuvants to surgery in the treatment of cancer" and the other of "anticoagulants and diet in the treatment of cerebrovascular disease." The former series of clinical trials became an ongoing effort for more than two decades. In the same year, the staff assisted in producing an article on a treatment for multiple sclerosis and helped to complete a monograph for the VA on peripheral nerve regeneration.80

Transitions in Personnel

The late 1950s marked an important transition in the agency's history. For the first time, the title of the agency in some official reports became the Medical Follow-up Agency (MFUA), although references to the Follow-up Agency were also common. Whatever the agency's name, the staff, with the aid of its clinical investigators, managed to complete five studies, including the study of Buerger's disease, in fiscal year 1958.

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