Document dnjmLvXo89Z27ep3Zz2oeer99

/ DR. CHR MEDICAL MEMORANDUM May 13, 1937 TTe sent a draft of a summary of the minutes of the Influenza-Pneumonia Commission meeting on April 23rd, to Dr. Muckenfuss, Secretary of the Commission, and now have his corrections for incorpor ation. Consequently, we are able to pass on to you and the other members of the Commission a copy of these minutes (attached). If, in looking them over, you see any modifications that should be made, please advise us. D. 5. Armstrong, M. D. Third Vice-President / (Summary) INFLOENZA-PNEDMONIA COMMISSION MEETING APRIL 23, 1937 - 10:00 A.M. PRESENT: (zbember3) (by special invitation) Dr. Rosenau, Chairman Dr. Frost Dr. Maxcy Dr. McCoy Dr. Muckenfuss Dr. Rivers Dr. Christiernin Dr. Dublin Dr. Armstrong Dr. Bullowa Dr. Felton Dr. Rogers Dr. Lanza Dr. Rosenau introduced the new members of the Commission. Dr. Muckenfuss consented to act as Secretary of the Commission. It was suggested that several copies of Dr. Rosenau*s summary of the work of the Cosnisaion up to this time be made and distributed to the new members. REPORT BY DR. MPCramTSSt Dr. Muckenfuss commented on the work done with the grant from the Metropolitan during 1936-1937, on Influenza and pneumonia. Certain pneumonia studies haws been carried on in various hospitals in New fork City, and when the work is finished we will have some index as to the adequacy of laboratory service. An account was given of the experimental work with the HnfimnM virus at Letchworth Village, in collaboration with Dr. Fr*&ciB 2- - - Dr. Armstrong pointed out that all of this work is not being financed by the Metropolitan. Our contribution during the past few years has been $5>000 annually. Dr. Muckenfuss was asked to give an outline of his plans for the following year, in order that the Commission could determine whether the appropriation should be continued. Dr. Muckenfuss stated that he would like to increase the scope of the work on Influenza, and would like to extend the experiment to Kings Park. Several members of the Commission voiced the opinion that $5,000 seemed Inadequate to carry on this program, and they believed that if the Commission felt there was enough promise in it, then it ought to be done more adequately. Dr. Muckenfuss said he had planned asking for the same amount as in the past, but that if it were doubled to $10,000 it would put the work on a safe basis, and it would be possible to carry the other institution as well. Dr. Rosen&u proposed that final consideration of Dr. Muckenfuss' appropriation be deferred until the other reports had been given. The members of the Commission agreed to this procedure. REPORT BY DR. FELTOtti Dr. Felton, in his report, described his experiments with the antigen, the study of antibody production in different age groups, the field study, and the chemotherapeutic studies. l?ith reference to Dr. Felton's studies on the pneumonia vaccine, . iid1' Dr* Dublin has seen Colonel Gentry and Colonel Saheyler, and believes there are very good indications that the Army will plan for the inoculation of the group in all the C.C.C. camps, and will do it under -3- a system which will permit a good control in the experiment. It i3 also possible that they will apply the antigen to the whole Army establish ment. Dr. Dublin stated that the Army people should be given a good deal of encouragement, and those of the Commission who have contacts with Colonel Sehwyler and Colonel Gentry, and the Surgeon General of the Army, could render a very valuable service in this regard. Dr. Frost asked whether there was as yet any chance of getting the Navy group, and Dr. Rosenau said that no progress whatever has been made. Dr. Armstrong again summarized, for the information of the Consulssion, that the contribution from the Metropolitan to Dr. Felton's work has varied in amount from time to time. Dnriag the last few years, this amounted to $5,000 annually. Last year, upon the recommendation of theCommlsaion, the appropriation was doubled to $10,000, partly because of the necessity for the purchase of special equipment that was required at that time. Dr. Felton was asked to say something about his proposed program for the next year, and he said it would be a continuation of the same thing -- chemistry of the antigen, the possibility of isolating or producing a universal antigen, and the chemotherapeutic studies. Dr. Armstrong asked whether an appropriation similar to that for last year could be utilized. Dr. Felton said this would be ideal, as it would allow him to work on all of the angles mentioned. Dr. Rosenau recommended that Dr. Felton's work be continued with an appropriation of $10,000, beginning July 1st, decision to be arrived at in Executive session. -4- RSPOBT'BY'DR. BPILOTTA: Dr. Bullowa had with him some reprints of recently published papers, which he turned over to Dr. Rosenau. He said that his work for the last ten years has consisted largely in the experimental use of various types of sera. He gave an account of the experiments he has been carrying on with a refined rabbit serum made by the Lederle Company, with a processed rabbit serum prepared at the Rockefeller Institute, and also experiments with horse serum. Dr. Bullowa has also been working, with the help of Dr. Uucksnfuss, on the question of the pneumonias due to streptococcus, and he gave some observations regarding sulfanilamides. TTith reference to plans for the ensuing year. Dr. Bullowahas in mind the following: 1. Study of the blood stream 2. The problem in connection with the use of rabbit serum 3. Study to determine adequacy of serum dosage 4* Correctness of typing By way of general information, Dr* Armstrong stated that as far as the Sletropolitan is concerned. Dr. Bullowa'a work has been a minor one relatively. Our appropriation has been $1,000 a year, but this year it amounted to $2,750. On being asked whether this latter amount would carry him along satisfactorily. Dr. Bullowa said that it would help tremendously, but would not be adequate for all of the things that he outlined. It was decided by the Commission that Dr. Bullowa's appropriation would be considered at Executive session, along with the others. -5P-EPORT Y DP,. ROGERS: (rf. Y. State Pneumonia Demonstration) Before Dr. Pagers gave bis report, Dr. Armstrong gave a brief picture of the position of the Metropolitan in connection with the :iew York State Pneumonia Demonstration. Working with the State Department of Health, the State Association of Public Health Laboratories, and other groups, we agreed to make a contribution of $20,000 (matching a similar appropriation from the Commonwealth Fund), to underwrite a rather exten sive educational program, The State Department was fortunate in securing Dr. Rogers to head up the work, and Dr. Armstrong thought it might be of interest to the Commission to have a word from Dr. Rogers as to how the work was going. Dr. Rogers stated that during the last winter they have been par ticularly interested in developing their lay educational program. The State Medical Society, the Department of Health, and other agencies con cerned have cooperated immensely in this program. 40 out of 56 upstate county medical societies have held meetings, and 5 comity medical societies have held second follow-up meetings, on this subject. 6 of the 14 nursing districts in New York State have held special institutes on pneumonia, and numerous reports are being received by Dr. Rogers of independent meetings which various nursing and medical groups are originating. With respect to typing stations and serum distributing stations, the number has been substantially Increased in both instances. Dr. Rosenau, in behalf of himself and the other members of the Ccwaiasion, thanked Dr. Rogers for giving this very interesting talk. Dr. Armstrong said that it seemed that our demonstration in New York State from one a has been completed. He called attention to the fact that last week the state legislature passed a hill, which Governor Lehman has proba'M'" 6- signed by now, appropriating $400,000 mniinlTJ. presumably in part for an educational program in New York State. TThether re ghni* need to con tribute anything further to th_3 work from that angle remains a question. Dr. Armstrong suggested that this and other matters might be dis cussed at lunch, and Dr. Rosenau invited the members of the Commission to luncheon. First, however. Dr. Armstrong asked that they look at the charts on the walls, which refer to the exhibit being prepared by Dr. Dublin, Dr. Cecil, and Dr. Armstrong for the A.U.A. meeting, with the advice and help of Dr. Rogers. At the A.U.A. meeting this will reach a large cumber of physicians throughout the country, and is similar to exhibit material which is being used by state medical societies, and health agencies in all parts of the United States and Canada. At the A.M.A. meeting, in addition to the exhibit, we have been fortunate in arranging for an adjacent typing booth under Dr. Bullosa's supervision, and another room in which talks and lectures will be given by Dr. Rogers, Dr. Heffron, and others, on pneumonia. The meeting adjourned at 1:00 P.M. for lunch, where Dr. Armstrong gave an informal account of our contacts with national developments in the field of pneumonia control. He referred to conferences with the Public Health Service, the American Medical Association officials and others, and indicated that there was a strong probability that a national program would be developed somewhat along the lines of the New York State pattern. He also stated that the Company hopes to have available by the next pneumonia season a popular one-reel sound motion picture on pneumonia. . o. --<scutive Committee Afternoon Session - April 22$ l0?'' -( Present: Dr. wsenau, Chairman Dr. Huckenfuss, Secretary Dr. ?rost Dr. livers Dr. '~axcy Dr. Arcstrone Dr. Dublin Dr. Christiemin The appropriation for Dr. 'iuckenfuss of the Uew York Cit Department of Health Laboratories was discussed first. Last year he was granted -"5000 to carry on his work, which was his initial request for this ye?r. However, Dr. Rivers stated that there were many reasons for raising it to v10,000. Dr. lluckenfuss, himself, stated th: t after further experience on the present set-up he would be in a better position to know exactly how much was needed. Dr. Armstrong suggested that Dr. iluckenfuss submit a definite request about the first of June. These questions Eire taken up at the Vfelfare Committee meeting of the Board at the June meeting, so that if by that time Dr. Uuckenfuss feels that he would like to modify or amplify his pro gram for next year, we would be guided by an expression of opinion of the Commission. In other words,the Commission mi-ht now put its approval on such additional activities by Dr. Huckenfuss, if it erred to do so. Upon further discussion, it was unanimously recommended (Dr. Muckenfuss not voting) that Dr. Uuckenfuss receive a grant of *10,000 a year for work to be done under his supervision. -3- Clie question of tiie renewal of the agrrcyriatisr. to Dr. "rltor. was token up next. It appeared to be the consensus of :i.-.icr. of the Co--.ission that Dr. Peiton wes a brilliant, if difficult Individual, ?:ho had made vet" definite, original and worth-while contributions in `he ..atter of sera, antigens, etc. Although he could not be tied tom any routinize.tion of his work, it was believed that his work was sufficiently significant, to renew our contribution to him in the car o" tlC,000. Dr. Rivers made the notion that ~e .'rant him this sun, which was concurred in by ell the members of the Executive Committee. A motion was made by Dr. Rivers and agreed to by all the members of the Committee that Dr. Sullowa's aonrooriation for the fiscal year be at least 2,750, although it may be increased, depending upon circumstances that may develop in the fall. 'Ris appropriation, contrary to the others on influenza and pneumonia work, is on a calendar year basis and comes up in the late fall.) This appropriation will cover his clini cal work in applying the serum in pneumonia cases cominj up in his hospital. Although he does no original laboratory research work of his own, his close relationship with Dr. tluckenfuss and Dr. Park and the Rockefeller Institute rill afford a focal point for the practical application of some of their experiments. 'Jew Tork State Pneumonia appropriation - Dr. Armstrong raised with the Commission the question cf its formal endorsement of this appro priation which we have been making for the past two years. Re stated thet we wished to be guided by the advice of the Commission as to ".hat we --Q-- -i-ht do, or whether c -rr.iticrJ. der.onsfcrr.ticn .cion; the liras :f :he 'Tew York Strte pneumonia crjcpian is worth while ur.:'. -rrrcrted. 'lecause ;f the ve'r- stror.j possibility of lev error lehror. si^r.inr the pneumonia serum bill in the amount of *100, '.OZ for u-etr t:"sr York, it nay not he necessary for us to continue cur appro triaaicr. to- the Her York State Pneumonia Control Campai-n after the termination cf our present _rnnt, or rt any- rote we may be able to reduce the anouna of our contribution of "20,"00. If we i-re even able to cut it down by 05OCO, we ici^ht be able to _ive Dr. Huckenfuss aore than the a5000 he definitely needs now. The Governor signed the bill on April 27.) It was believed that this Hew York State program is a practical outgrowth of all the other activities of the Commission. It also ;ives an oppor tunity to learn more about the epidemiology of the disease, and there fore is directly in line with our work. Dr. Posenau therefore raised the proposition that if it nas the sense of the -roup that this appro priation was approved in spirit, its continuation would be recemended and the details worked out later. Since there were no votes to the contrary, our participation, if found necessary, was unanimously and enthusiastically supported. * * -> * The members of the Commission were told by Dr. Armstrong that we have the approval of our Board of Directors, bejinninv with our next fiscal year on July 1st, to present a very modest honorarium, amountin; to .'100 for each of the members and 300 for the chairman, -10- ir. recognition of the tine spent in these annual meetings, and in girlnr advice on this program. The chairman expressed his jrs.tifi- cction and that of the other Commission members, in "hose behalf he stated that it had always been a pleasure and satisfaction for the nenbers to come to the meetings. It -ts of course exclaimed no the r.ew members that over and above this honorarium, we would meet their travelling expenses for attending these meetings. Dr. Hosenau asked the Commission for its opinion as to the frequency with which the Commission might meet, and in a general way it was felt that one or two meetings a year, in the fail, midwinter, or spring* would be adequate, leaving for the interim other meetings arising out of emergencies. Dr. Hosenau- will take up the arrangement for a suitable time in the fall for a possible meeting, through correspondence. Dr. Hosenau told the members that he planned to go to '"ashington and see his friends in the Navy, who he believes will be very much impressed if they knew the Army was interested, and might try the experiment in the Navy. fie will also visit Dr. Felton and talk to him along the lines suggested by the Commission. He will be receiving an increased amount this year for new work, out of which it was thought he could use CiOOO or $5000 for a good assistant to help keep records straight, etc. These two activities by Dr. Rosenau had the endorsement of the members. * * * COPI SENT TO: (5-13-37) Dr. Roaen&u Dr. Frost Dr. Uaxcy Dr. McCoy Dr. Muckenfuss Dr. Rivers Dr. Christiernin Dr. Dublin