Unsolved Problems 



As President Roosevelt observed, the annual deaths from one or two 

 diseases are far in excess of the total number of American lives lost in battle 

 during this war. A large fraction of these deaths in our civilian population 

 cut short the useful lives of our citizens. This is our present position despite 

 the fact that in the last three decades notable progress has been made in 

 civilian medicine. The reduction in death rate from diseases of childhood 

 has shifted the emphasis to the middle and old age groups, particularly to 

 the malignant diseases and the degenerative processes prominent in later life. 

 Cardiovascular disease, including chronic disease of the kidneys, arterio- 

 sclerosis, and cerebral hemorrhage, now account for 45 percent of the deaths 

 in the United States. Second are the infectious diseases, and third is cancer. 

 Added to these are manv maladies (for example, the common cold, arthritis, 

 asthma and hav fever, peptic ulcer) which, though infrequentlv fatal, cause 

 incalculable disability. 



Another aspect of the changing emphasis is the increase of mental diseases. 

 Approximately 7 million persons in the United States are mentally ill; more 

 than one-third of the hospital beds are occupied by such persons, at a cost of 

 $175 million a year. Each year 125,000 new mental cases are hospitalized. 



N ot with St an ding great progress in prolonging the span of life and in relief 

 of suffering, much illness remains for which adequate means of prevention 

 and cure are not yet known. While additional physicians, hospitals, and 

 health programs are needed, their full usefidness cannot he attained unless 

 we enlarge our knowledge of the human organism and the nature of disease. 

 Any extension of medical facilities must he accompanied hy an expanded 

 program of medical training and research. 



Broad and Basic Studies Needed 



Discoveries pertinent to medical progress have often come from remote 

 and unexpected sources, and it is certain that this will be true in the future. 

 It is whollv probable that progress in the treatment of cardiovascular disease, 

 renal disease, cancer, and similar refractory diseases will be made as the result 

 of fundamental discoveries in subjects unrelated to those diseases, and perhaps 

 entirelv unexpected by the investigator. Further progress requires that the 

 entire front of medicine and the underlving sciences of chemistrv, phvsics, 

 anatomy, biochemistry, phvsiologv, pharmacology, bacteriology, pathology, 

 parasitology, etc., be broadly developed. 



Progress in the war against disease residts from discoveries in remote and 

 unexpected fields of medicine and the underlying sciences. 



Coordinated Attack on Special Problems 



Penicillin reached our troops in time to save countless li\es because the 

 Government coordinated and supported the program of research and develop- 

 ment on the drug. The development moved from the early laboratory stage 

 to large scale production and use in a fraction of the time it would have 



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