HEALTH ACTIVITIES OF THE GENERAL GOVERNMENT. COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE, The committee met this day at 10.15 o'clock a. m., Hon. James R. Mann (chairman) presiding. The CHAIRMAN. The committee will be in order. We have before us hearings on the health activities of the Government, and the message of the President, his last annual message, in relation to the bureau of health, which may be inserted in the record; also a message of the President transmitting communications from the Secretary of Commerce and Labor, the Commissioner of Fisheries, and Dr. H. R. Gaylord, director of the New York State Cancer Laboratory, in respect to the necessity for an active investigation into the subject of cancer in fishes, which may also be inserted in the record; also House bill 3039, introduced by Mr. Sabath, for the establishment of a national tubercular sanitarium in the State of Colorado for persons afflicted with tuberculosis, which may also go into the record; as may the following bills likewise: House bill 4814, introduced by Mr. Sabath, covering the same subject; House bill 9421, introduced by Mr. Grant, for the establishment of a national tubercular sanitarium in the State of North Carolina for persons afflicted with tuberculosis; House bill 19547, introduced by Mr. Plumley, by request, to regulate the appointment of pharmacists in the Public Health and Marine-Hospital Service of the United States, etc.; House bill 5695, by Mr. Simmons, to further protect the public health, and imposing additional duties upon the Public Health and Marine-Hospital Service; House bill 24827, also by Mr. Simmons, establishing a department of public health, and for other purposes; House bill 24828, by Mr. Hanna, establishing a department of public health, and for other purposes; House bill 24875, introduced by me, providing for a public health service; House bill 24876, introduced by me, by request, to establish a bureau of health; and House bill 24549, by Mr. Creager, establishing a department of public health, and for other purposes. Mr. Stenographer, you may insert all these matters in the record: MESSAGE OF THE PRESIDENT OF THE UNITED STATES COMMUNICATED TO THE TWO HOUSES OF CONGRESS AT THE BEGINNING OF THE SECOND SESSION OF THE SIXTYFIRST CONGRESS. * BUREAU OF HEALTH. For a very considerable period a movement has been gathering strength, especially among the members of the medical profession, in favor of a concentration of the instruments of the National Government which have to do with the promotion of public health. In the nature of things, the Medical Department of the Army and the Medical Department of the Navy must be kept separate. But there seems to be no reason 3 why all the other bureaus and offices in the General Government which have to do with the public health or subjects akin thereto should not be united in a bureau to be called the "Bureau of Public Health." This would necessitate the transfer of the Marine-Hospital Service to such a bureau. I am aware that there is a wide field in respect to the public health committed to the States in which the Federal Government can not exercise jurisdiction, but we have seen in the Agricultural Department the expansion into widest usefulness of a department giving attention to agriculture when that subject is plainly one over which the States properly exercise direct jurisdiction. The opportunities offered for useful research and the spread of useful information in regard to the cultivation of the soil and the breeding of stock and the solution of many of the intricate problems in progressive agriculture have demonstrated the wisdom of establishing that department. Similar reasons, of equal force, can be given for the establishment of a bureau of health that shall not only exercise the police jurisdiction of the Federal Government respecting quarantine, but which shall also afford an opportunity for investigation and research by competent experts into questions of health affecting the whole country, or important sections thereof, questions which, in the absence of, federal governmental work, are not likely to be promptly solved. [House Document No. 848, Sixty-first Congress, second session.] To the Senate and House of Representatives: I transmit herewith communications to me from the Secretary of Commerce and Labor, the Commissioner of Fisheries, and Dr. H. R. Gaylord, director of the New York State Cancer Laboratory, in respect to the necessity for an active investigation into the subject of cancer in fishes, and I respectfully request an appropriation of $50,000 for the purpose of erecting one or more laboratories at suitable places and to provide for the proper personnel and maintenance of these laboratories. Were there a bureau of public health such as I have already recommended, the matter could be taken up by that bureau, and if in the wisdom of the Congress it should be provided in the near future, all such instrumentalities as that for which appropriation is here recommended may be placed in that bureau as the proper place for research in respect of human dis eases. I have directed the Secretary of Commerce and Labor and the Secretary of the Treasury to forward an estimate for the appropriation here recommended, in accordance with the procedure provided by law. The very great importance of pursuing the investigation into the cause of cancer can not be brought home to the Congress or to the public more acutely than by inviting attention to the memorandum of Doctor Gaylord herewith. Progress in the prevention and treatment of human diseases has been marvelously aided by an investigation into the same disease in those of the lower animals which are subject to it, and we have every reason to believe that a close investigation into the subject of cancer in fishes, which are frequently swept away by an epidemic of it, may give us light upon this dreadful human scourge. THE WHITE HOUSE, April 9, 1910. WM. H. TAFT. DEPARTMENT OF COMMERCE AND LABOR, OFFICE OF THE SECRETARY, Washington, D. C., April 8, 1910. MY DEAR MR. PRESIDENT: I have read the letter of Commissioner Bowers to you on the subject of cancer in fishes, and have also had an interview with Doctor Gaylord. I join in the recommendations of the Bureau of Fisheries, because the inquiry into the disease can no doubt be most advantageously pursued by investigation into the same disease as it is found to prevail in lower animals. A further reason for the investigation is that cancer among some of the species of fish seems to have reached such proportions that we are confronted with the problem whether we shall control the disease or abandon the hatcheries. The subject is one which appeals to the judgment so strongly that I can not believe Congress will entertain any doubt as to the propriety of the appropriation. Very sincerly, yours, The PRESIDENT, The White House. CHARLES NAGEL, Secretary. To the PRESIDENT: DEPARTMENT OF COMMERCE AND LABOR, With reference to the data for a special message on the subject of cancer in fishes submitted to you by Dr. H. R. Gaylord, director of the New York State Cancer Laboratory, I would say that the bureau regards this matter as of great importance and concurs in his statements. Your attention is respectfully called to the accompanying extract from my last annual report to the Secretary of Commerce and Labor, outlining the joint investigations already undertaken and showing the position of the bureau with reference to the continuation of this work. I feel that unless this situation is handled energetically, promptly, and by a highly efficient staff of specialists, the fish-cultural operations of the bureau and of all the States will be seriously handicapped and placed in such a position in the mind of the public as to greatly impair its usefulness. The bureau has been giving to the subject all the attention which the resources and facilities permit, but it is fully realized that the conditions already disclosed demand a special laboratory and staff for the determination of the cause and prevention of this most serious malady. If Congress will promptly authorize the construction of the necessary laboratory, at an estimated cost of $50,000, to be located on an advantageous site to be selected later, and provide for its proper personnel and maintenance, there is every reason to believe that our fish-cultural work will soon be relieved of this great impediment, and coincidently there will be acquired information that will be invaluable in the elucidation of the cancer problem as related to human beings. This work can, of course, be properly conducted only in this bureau, and I would suggest that your message should specify that the proposed appropriation be made for this bureau, under which conditions we are assured of the continuation of the joint investigation already referred to with the New York State Cancer Laboratory, which is the only institution that possesses several years' experience with this particular phase of the cancer problem. Very respectfully, GEO. M. BOWERS, [Extract from the Report of the Commissioner of Fisheries to the Secretary of Commerce and Labor for the fiscal year ending June 30, 1909.] STUDY OF FISH DISEASES. The bureau has continued to give attention to the diseases to which fish, particularly when under domestication, are liable, and during the past year has devoted special consideration to the occurrence of cancers and other tumorous growths. Tumors in fish have been known for many years, and the bureau has from time to time collected specimens of various kinds of tumors from different species of fish. Owing to the activity that has characterized the investigation of cancer during the past ten years, cancer in the lower animals, and in fact in all the vertebrates, becomes a subject of great interest. Certain types of cancer appear to be more frequent than others in domesticated fish, and cancer of the thyroid gland has been observed at various times in trout and salmon at government and other hatcheries. Of late the disease seems to be on the increase, and the bureau has undertaken a thorough and systematic investigation of the entire subject of cancer in fish, and to this end has availed itself of the services of the director of the New York State Cancer Laboratory, who will pursue his studies in conjunction with the regular work of that institution. The forest, fish, and game commission of the State of New York also will cooperate in this work. The inquiries already made have shown that the subject is very important and will require thorough study covering a considerable period of time. Careful investigation has been made in two localities where the disease is so prevalent as to constitute an epidemic, and the work will be extended so as to include a systematic examination of wild fish in open waters, as well as the young and adult fish in government, state, and private hatcheries. At Buffalo, N. Y., where it is proposed to conduct experiments on fishes, arrangements have been made for the installation of two aquaria on the closed-circulation plan, with full provision for refrigeration and aeration of the water. The bureau is fully alive to the far-reaching importance of this investigation, and will devote every energy and facility at its disposal for the prompt and thorough elucidation of the problems of the cause and prevention of this most serious malady. [Memorandum given to the President by Dr. H. R. Gaylord, director of the New York State Cancer Laboratory.] One woman out of every eight, beyond the age of 45, dies of cancer, and the mortality among men is only somewhat less. This terrible disease has increased of late years in all civilized countries. In the United States from 9 deaths per 100,000 of population in 1850 it had risen in 1900 to 43 deaths per 100,000. In the registration area of this country in 1906 it was 70 per 100,000. This astonishing increase has raised the deaths from this cause so that now approximately half as many die of cancer as tuberculosis. The cause of cancer is not yet known, but investigations of the most promising character are being pressed under the inspiration of entirely new ideas, and in this work American scientists are taking a leading part. The most fruitful of these new lines of investigation has to do with experimentation on and the distribution of cancer in lower animals. Domestic animals of various sorts are subject to the disease. In the United States as well as continental countries cancer in man is most prevalent in the well-wooded, well-watered, and mountainous regions or in poorly drained areas with alluvial soil. These facts have attracted the attention of scientists to the possible prevalence of cancer in fish. We now know that fish are subject to various types of cancer, certain varieties being subject to epidemics of cancer which have destroyed thousands in a single summer. The disease has spread to such an extent that it already constitutes a menace to the propagation of this variety of fish. It is a further astonishing coincidence that the distribution of this variety of fish and the concentration of cancer in man in this country are almost identical. A map of one might well be taken as a map of the other. The matter therefore calls for prompt and energetic action, not only in the interest of fish culture, but of humanity. An investigation of the conditions obtaining among fish offers the best opportunity for determining the conditions under which cancer is spontaneously acquired, and it is believed that a careful study of these conditions will not only enable us to eliminate the disease from among fish, but to gain information of an invaluable character for humanity. For this purpose an appropriation for a laboratory for the study of fish diseases, and funds for its maintenance, should be provided at once. [H. R. 3039, Sixty-first Congress, first session.] March 22, 1909, Mr. Sabath introduced the following bill, which was referred to the Committee on Interstate and Foreign Commerce and ordered to be printed. A BILL For the establishment of a national tubercular sanitarium in the State of Colorado for persons afflicted with tuberculosis. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That the Secretary of the Treasury be, and he is hereby, authorized and directed to acquire, by gift, purchase, condemnation, or otherwise, a site, comprising not less than twenty thousand acres of land, in the State of Colorado, and cause to be erected thereon suitable modern sanitary buildings, including heating, lighting, and ventilating apparatus, and furnish and equip said buildings with modern sanitary furniture, medical and therapeutic appliances, for the use, accommodation, and treatment of any persons in the United States afflicted with tuberculosis. SEC. 2. That for the purposes hereinbefore mentioned the sum of two million five hundred thousand dollars is hereby appropriated out of any moneys in the Treasury not otherwise appropriated. SEC. 3. That the Secretary of the Interior is hereby authorized, empowered, and directed to make all necessary rules, regulations, or orders in respect of the admission to and abiding on the premises of said national tubercular sanitarium of all persons whatsoever; to prescribe the details of management and to authorize the board of managers to prescribe all details of regulations for the cure or treatment of all persons afflicted with tuberculosis. SEC. 4. That the Secretary of the Interior is hereby authorized, empowered, and directed to appoint a board of managers of not more than five persons, of whom a majority shall be physicians of at least ten years' general practice. The members |