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It is a pleasure to have a chance to talk with you about our new rasearch

program.

we, is vtmg important - EvKi I doubt if you have ever heard of it,

a sabbatical leave from Columbia University at the School of Hygiene and Public Health

of Job Hopkina.  While there, I was offered thie new position.  At firat, I almost said

"now, for what could be done about birth defects?

Thomas Rivera and Dr. Theodore Boyd, it became obvious that I knew nothing about several

hopeful leads already know, nor of many mom to cone.

that I accepted the position oasrnight.  The next day, I ventured forth to buy 8-

modern texts on bacteriology and virology, 8 specialty that did not even exist when I

was in medical school.  I found two beautiful books, lavishly illustrated, on fine paper,

and of such quality that you knew they were already classics the day they wen published.

From the size of them, I expected them to be $15 or $20 each, and so was pleaeantly

surpriaed that om cost $7 and the other $8.0~.  Hot until I joined the National

Foundation on July Ist did 1 find that you - The, Foundation - paid a sMlar BRIoullf. saoh

time a book was sold.

commended to the seoond year medical students.

training of all the young physicians in this country,

First, let ne tell you about tin activity of the Hatiowl Foundation which,  to

kt year, I spent

Afhr further discussion with Dr.

-

The future sounded 80 challenging

*

In all 85 Amcarican nedioal schools, these two VO~UIUQ~? are re-

             Thue, you am direotly ai- Fn the

     We know t.Ut you are vitally interested in the reamh program.  In the rsaent

amy conducted by the Colmbia Univereity Institute of Public Opinion, one of the

questions asked of 3000 people in 30 different pa- of the United State8 wa8 "Haw do

you think the National Foundation funds should be rjpent

education, or repsearch"?

for dcal care, profeaeional

67 per cent answered wRe8mh should come First".

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Polio rcsaarrrroh, of cowee, uontinues.  The Salk vaccine is very good, 90 to 92

per oent effective in preventing paralytia polio, but we wi6h that figure were 100 per

aent. Efforts to Improve its potency and to deternine the best dwage schedules am
constantly under way. The Sabin Uve-vlrus polio vaacine researoh is continuing.  The
raafety of tNs om1 vacolne for people of all ages ~oene~ to be established, though

virulence after passing through several human intasstinaz tracts,  The degree of its

efffciency in premnting polio awaits analysis of reports reraeived from all over the world.
Early rtsporlx from Eethonia sud Lithuania are very encouraging.
safety and efffcvcy of a live-virus vaccine has been proven beyond doubt, and one

o

Until such tifltQ a8 the

.#

beaornes licensed, of course the Salk mcaine should be adninistgred to everp"n9, t38pWw

to thoee between six mnths and 40 years of age.

Researoh on EXHO and Coxeackie virusee continma, with the production of many

new antisera against the many types, by Dr. Herbert Wanner of Kanscrw City.
are sent all over the world by you, The Foundation, to help In the diagnosis and study

of these infections.

Theaca antireere

Researclh In rheumatoid arthrltirs is espeaially difficult.  So far, no aniaal

has been found to whloh tha diseaee can be given, and thus studied.  There ie, at gree~nt,

no experimwhl. model. Substantial funds are bein(: invested In the study of aethods of

attacking this diaeme.  Rheumatoid arthritis is uloaely related to other connective
tissue diseases auch 88 salsrodertaa and lupus erythematosur.  My patient8 With rheumatoid
arthritis have been found to have a protein In their blood not found In people who do not

have the disease. Whether %Me proteln 18 part of the cause, or an effect, of the dimmse,

le not known. At preaent, It is thought that the patient himnself msry produce 8- aubstanoe,
to which his body then reacts adversely, causing the dilseaas symptom.  It is quite possible
that researoh in rheumatoid arthritis Will lead to the solution of 801158 problem coMlgon

to all allergla dlseaoes.

    Naturally, msearuh in birth defecte interest8 me more than the other two

fields. I ham had the good fortune to be pm8ent at over 17,000 deliveries in the pat
28 yearrs. About l6,OOO of these births rasultd In noma1 CUM.  One thowand did

not. f knaw all too well tb sinking feel- the doatore euKf nus-808 have when the notherfa

flrst question Plnrst be anmered - @No, your baby is not normal".  Abut one half of the

defects can be distgnosod in the delivery room.  The other half become apparent during

%he firet pas of life.
physicians and nure88 showfng how certain defects can be diagnoaad within the first 10

kt October, we were given a grant of mney to me,& a gl0vi.e fhr

rninutes of Ufe, evm though the abnormalitleo do not show In the appserance of" the baby.
About half of such Internal defeuts can be treated aucoesefully wLth surgery the fbet

4

'

day or two of life.

liluch reseomh has been done in animals in the field of %m&tology.  Many aubstancee

are know which will lead to defgctive young in many ~peaIe8.
to ,jump to conclwlona that the 8~~16) resulter will hold true for human babies.  An&&.

We mwt be very careful not

is apt to be damaged. We know that in human beinga it la unllkdy that a defeat can bs
produced later than three nonth8 after 6111 egg has be- fertilimd by IO spna.  In fact,
the main atmature, of the develophg nervow syah is carrrpleted four weeks aftcar

fertilisetion. Whether or not spa blfida will be prssrnt lr dtaflnitely decided by tho

end of the firat month. Defect8 In other eya%e~w may still take place a little later.
It would be very desirable to have a truly early test for pregnanay, me that ie 8CUUratCS
24 to 48 hours after fertilisation, so that more might be done to avoid known hnanrdsr,

-

At present, only a few influences during pmgmnoy am dSflnite3.y thought to be

retsponslble for humin birth defecta.  Thekre i% atrong suspicion that expoaurcs to radiation

in early pregnancy ia not good,  The msults of pma;nanclea In progrem at the tine of tho
bonking of HiroshlBLB are not yet known because of the frequeany of firebcowb marriages

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hips so cmon in Birnlnghm, England?  This laat year it wa~ shown in Hew York state

that a high inaidenor of birth defectrs occurred in areas in -oh the rwk6 had high

radioactivity.  Palnataking observation, rooord keeping and 8ndZLysi.6 say aolvs ~oma of

the myateriara in this field.

These are the present tipproachw.  So far tn3.8 yew, bb700,rxK) has been awarded

for research in birth defecte.  We need new ideas even though they my be costly to

develop.  A two-pronged drive is under way.

recognirsed research scientirste to turn the* attmtion nou to the proorsing prob2tnns of

cause and prevention of birth dt:feota.

tZne prong h being used to get able, mU-

-

The other is abed at stirring the imagination of

~ientia- to Find unexp~~ted MW pathe to POUOW.

With the punds fm th. Mmh

of Mnma we shall aupply them dth the pemonnel aund nratericrls they need.

The money spent on bmic msmrch is grated by national hreadqusulters M3y after

epproval by Medical Advisory Somaittees consfsting of nationally recogniaed rrroisntiskt

and diicaticmal leaders.  At our mstw last month, 70 such ~uut served a8 volunteer6 on

these committees.

earnest discusallon and thoughtful consideration by them men are appliuationa for grant#

approved.

Among thean were four Jniversfty Presidents and sexwin Deans.

(3nlg afbr

You may well be discouraged by tha siss and aclaJrilexity of thh problm.  I am not

at all diecouragsd. After ee~alng what ma accompliehed by the Foundation betwwn 1938,

when a polio vim had just bean seen, and the present d8yr #hen a polio 8pldad.a ibl almocst

and could be a thing of the past, I have the, greatest oonfidenae that we can solre the

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Some day, den pou read that *thg came of cleft plat@ hm bean fo1u#2*, that

"olub feet need not exirt" or that "prokction agPinst Mdiatian has beon foundfi, you

wiu. be thrilled, because pw know you voluntarily chose to Lut your efforts and money

Into %he Maroh of Diratrs, and hslped hundreds and thousMdar of other people to come to

the 8- deoielon.