Armed Forces Institute of Pathology: Its First Century 1862-1962/Chapter XIV

by Robert S. Henry

CHAPTER XIV

The Immediate, Imperative Objective

Within a month after the guns of the Second World War were stilled, Surgeon General Norman T. Kirk asked the National Research Council to study the situation and prospects of the Army Institute of Pathology and recommend the most advantageous use of its facilities, "both for the Army Medical Department and for the medical profession as a whole."

Dr. Lewis H. Weed, chairman of the Division of Medical Sciences of the National Research Council, to whom the request was addressed, turned the assignment over to the Committee on Pathology of his division, of which committee Dr. Howard T. Karsner of Cleveland was chairman and nine other distinguished pathologists were members. 1^[1]

On 1 December 1945— less than 3 months after receiving the assignment — the Committee filed its report with The Surgeon General of the Army. Approximately half of its 37 specific recommendations were to the effect that the Institute continue what it was doing, while the remainder represented new activities, or modification and strengthening of those already undertaken. These recommendations were divided equally between those having to do with increases in staff and with innovations in methods, such as, for example, the use of machine-accounting procedures in coding and filing.

"Today," said the report, "the Army Institute of Pathology is truly the central laboratory of pathology and medical illustration for the entire United States Army. The extraordinary amount and variety of material at the disposal of the Institute is unmatched elsewhere in the world. This material offers unlimited opportunities for the study of structural tissue changes and correlation with clinical observations. With proper development of facilities and personnel, the Army Institute of Pathology can become a guiding force in the furtherance of pathology in this country and the world." Accordingly, the "first and most important recommendation" of the Committee was that the name of the Museum be changed to the Institute of Pathology _ a change already in effect unofficially which, 6 months later, was to be made official by appropriate Army regulation. The second recommendation, that the Institute should become the central laboratory of pathology for the Veterans' Administration, was likewise already underway and was to be consummated in a matter of months.

Continued Efforts To Get a New Building

A third recommendation for a new departure concerned itself with the need of a new building. The building in which somehow the work of the war years had been done, the Committee said, "was built in 1887, fifty-eight years ago, and is no longer adequate * * * It is antiquated, overcrowded, obviously cannot be modernized, and there is no provision for experimental research." The Committee recommended, therefore, that "the Surgeon General proceed at once to secure authorization and funds for the construction of a building adequate in size and arrangement for the expanding activities of a modern army institute of pathology."

In this recommendation also, the Committee was putting its weight behind an activity that was already underway— the effort to obtain a new building for the Library and the Museum. This effort, which had been shelved in December 1941, in the face of the oncoming storm of war, had been revived in the planning stage before the war ended. On 14 December 1944, Col. James E. Ash advised The Surgeon General of the Army that it had just come to his attention that "entirely new plans for the building had been prepared," dated September 1944, but that no opportunity had been afforded the Museum to "express our ideas on plans for the Army Medical Museum portion of the building," and that the new plans had "omitted two of the floors that had originally been assigned to the Museum."

"We fully recognize the great importance of the Army Medical Library," he said, "but we do not hesitate to state that the Army Medical Museum, as it has developed over the past twenty years, has reached a point of equal importance, not only to the Medical Department of the Army but to the medical profession in general * * *. The enormous expansion of the pathologic and illustrative functions has justified our new designation as the Army Institute of Pathology as more exactly representing our real purpose * * *. The Institute is acknowledged as the largest center of pathological and medical illustra tive material in the world. Its place in the professional life of the country is limited only by the personnel and facilities allowed it * * *. We cannot feel, therefore, that we are so near the tail of the dog that we cannot have equal opportunity with the Library to plan for our new building, so long as the two institutions are to be housed together."

Colonel Ash's letter to The Surgeon General closed with the recommendation that "a small committee of medical officers, who have the interests of both institutions at heart, be appointed to assist in the development of final plans and policies * * *." 2^[2]

Apparently this letter bore fruit, for on 24 January 1945, The Surgeon General set up a board to review all matters relating to planning and construction of a new Army Medical Library and Museum. Detailed for the board were Maj. Gen. George F. Lull, the Deputy Surgeon General, as chairman, Col. A. G. Love, and ex-officio the Directors of the Library and the Museum, and the Chief of the Hospital Construction Branch of the Surgeon General's Office. 3^[3]

Changes in Role of the Museum

"The objectives and responsibilities of the Army Medical Museum have changed radically in recent years," Colonel Ash informed The Surgeon General, "and several new divisions have been added. Hence the space planned for this institution in the projected new building is no longer considered adequate and must be increased from fifty to seventy per cent." In the Division of Pathology, the principal division of the institution, the material examined in the 3 years since Pearl Harbor had already amounted to "three-fourths as much as had been received by the Museum during its entire previous existence, which included three wars." The use of this material — over 50,000 cases a year derived from either important surgical operations or autopsies — in research and educational activities would require increased staff and more space. So it was, also, with the registries, which gave to medical officers of professional promise and qualified civilian physicians and specialists unexcelled opportunity

for training and research. More space was required, also, for the Army Illustration Service through which the Museum was receiving "vast quantities of significant illustrative material." The Public Museum, while it was "by far the largest museum of its kind," was described as "antiquated," with its exhibits

Figure 82.—Main exhibit hall of the Medical Museum in the 1930's. These crowded conditions continued and even worsened, until the Museum vacated its quarters in the old building, making more space available for other activities of the Institute.

"poorly displayed" due to "lack of space and wholly inadequate housing facilities^[4] (fig. 82).

The postwar relationships and associations among the several Army organizations devoted to particular features of military medical activities, and the prospective functions and development of each of them, became the subjects of active consideration, both by correspondence and conference, throughout 1945, before as well as after the cessation of hostilities.

Problems of Location

Much thought was given to the advantages and disadvantages of the several arrangements which might be made. Should the Library and the Museum share a new building, as they had shared the old for almost 60 years? If so, where should the new joint home be located— on the site southeast of the Capitol which had been approved in 1941, or at the Army Medical Center which had grown up around the Walter Reed Hospital ?

Or, should the long association of the Library and the Museum as joint occupants of the same building be terminated by providing separate buildings, either on adjacent blocks of land on Capitol Hill or with the Library location in that area and the Institute and Museum in the Walter Reed group ? Or, perhaps, the Institute and Museum should become part of an Army Medical Research and Graduate Teaching Center proposed to be located at Forest Glen, Md., where the buildings of the National Park Seminary for Women were occupied as an annex to Walter Reed General Hospital, for convalescents.

On one point, there was virtually complete agreement: that the building originally planned in 1941 would be entirely too small for the needs of the Museum and the Library, because of the "tremendous expansion of both institutions and the establishment of the Army Institute of Pathology," as The Surgeon General put it, in recommending to the Commanding General, Army Service Forces, a change in the basic plans for the proposed building. As necessary steps in orderly planning, it was requested that The Surgeon General be authorized to endeavor to secure approval of the National Capital Park and Planning Commission for an additional block of land in the proposed site on Capitol Hill."5^[5]

Permission was granted to start revised plans for the proposed building, and the architects, Eggers and Higgins of New York, came to Washington to meet with representatives of the interested Government agencies. The whole group adjourned to meet with Maj. Gen. U. S. Grant III, chairman of the Park and Planning Commission, who assured them that the Commission would "earmark" in its plan a plot of land on Capitol Hill, adequate for the purpose.

On the same day, 20 April 1945, at a meeting called by General Kirk, The Surgeon General, to discuss the status of the new building, the proposal to concentrate the educational activities of the Army Medical Department was introduced, and Colonel Ash urged that the matter should be referred to the Army Medical Research Board for its consideration before proceeding further with plans which would commit the Department to the erection of a building, or buildings, separated from its central educational activities. During the daylong series of meetings, three plans were considered — separate buildings for the Library and the Institute-Museum, to be located on adjacent blocks of land on Capitol Hill; or, in the alternative, to place the Library near the Capitol, and to transfer the Institute-Museum to a site close to the other educational and research organizations of the Army Medical Department, either on or immediately adjacent to the Walter Reed reservation or at the Forest Glen site, where it was contemplated that a great new medical research and training facility would be set up.6^[6]

At a meeting, held on 5 May 1945, of the special board created to deal with the relocation of the Institute-Museum, and after consideration of the real estate appraisals of the several sites under consideration, General Kirk decided that the Library should be located on a square block southeast of the Capitol, and that the Institute should be located on a site immediately south of the Walter Reed reservation.7^[7]

The reasons for this decision were stated in a letter from General Kirk to the Chief of Engineers, through Brig. Gen. J. S. Bragdon, Director of Military Construction. "The Army Medical Library," said The Surgeon General, "will continue to serve not only the Army but the medical profession of the world. Its usefulness is in some part dependent upon its accessibility to the public and to other major library collections. The building to house the facility should, therefore, be located on the site * * * adjacent to the Library of Congress which has previously been discussed * * *."

"The Army Institute of Pathology and the Army Medical Museum will continue to serve both the Army and the civilian medical profession. Their service to the Army will be closely related to the functions of the Army Medical Center. Their service to the civilian profession will be handled to some degree directly but in larger degree by mail. Their proper function requires immediate access to hospital beds. It is, therefore, desired that the institute of pathology and the museum be separated physically from the library and studied in relation to the Army Medical Center."

The Surgeon General felt, however, that "additional major investment in the Army Medical Center," such as would be involved in the proposed new building, "should be carefully considered in relation to future requirements." Study was requested "looking to the development * * * on an unrestricted site" of a new Army Medical Center, of which a new 1,000-bed hospital and the new Institute-Museum building would "form a present nucleus." The site for the proposed center should be on the northern outskirts of Washington, where ready communication with the new medical centers of the U.S. Public Health Service and of the Navy would be available. Forest Glen was suggested as an "excellent site for this project." 8^[8]

In connection with the studies for the future location of the Institute and Museum, Colonel Ash suggested still another alternative— the physical separation of the historical portions of the Museum's collections, which would be turned over to the Library to be housed in its new building near the Capitol, and the more strictly medical functions of the Museum, which should go with the Institute of Pathology, to be located at either Walter Reed or Forest Glen.

The Army Medical Museum, Colonel Ash wrote in a letter to The Surgeon General, "is a responsibility that cannot be lightly overlooked in spite of the facetious onus that has been attached to it through the years, 'the pickle factory.' It constitutes a part of the cultural background of medicine at least equal to that of the incunabula and rare books of the Army Medical Library. It contains the largest collection of historic microscopes in the world, and the collections of medical coins, models and stamps, ophthalmoscopes, stethoscopes, and so on, are equal, if not more comprehensive, than any others. This material should have its place in the so-called cultural development in which the Library is to share and not be transferred to a comparatively inaccessible place * * *. At present there are about two hundred thousand visitors a year to the Museum, and while it is true that many of these come out of curiosity, the possibilities to the medical department of acquainting such a large group of civilians of all walks of life with its activities cannot be taken lightly."

Just as he felt that much of the Museum was more closely related to the new Library, Colonel Ash felt that the Institute of Pathology was more "logically concerned with the teaching and research programs of the medical department than it is with the activities of a hospital." After all, the colonel pointed out, "the Institute at present serves the Twentieth General Hospital in Assam, India, in the same way that it serves Walter Reed Hospital in Washington," since the Institute "should not have to be concerned with 'run of the mill' pathology." The pathology of a i, coo-bed hospital, he said, would add little to the teaching or research resources of the Institute, which had "the material from all the army hospitals and the large amount from the civilian specialists with which to work * * *." 9^[9]

So matters simmered for 6 months, while consideration was being given to the place of the new building in the scheme of things in a postwar world. In that time, a series of meetings relating to the future of Medical Department research was held by the Army Medical Research and Development Board. One such meeting, held on 20 December 1948, was "occasioned by the knowledge that plans for the Army Institute of Pathology, which is and will remain an important element in the medical research program, had progressed to the point that it had become essential to establish a general plan into which the Army Institute of Pathology may fit logically and effectively." Col. Roger G. Prentiss, chairman of the Board, reported to The Surgeon General that it was unanimously agreed that there should be an Army Medical Research and Graduate Teaching Center, one of the major elements of which was to be the Army Institute of Pathology, and that it should be located at Forest Glen. 10^[10]

The basic plan of the Board was approved by Surgeon General Kirk, but to his approval there were added "reservations and understandings" that "plans for the Army Institute of Pathology must go forward without delay and no effort at implementation of plans for a Research and Graduate Teaching Center shall be permitted to interfere with the more immediate and imperative objective of a new Institute."

"Establishment of the Army Institute of Pathology at Forest Glen," he added, "is contingent on authorization for the simultaneous construction of a new hospital at that site. In the event of failure to obtain such authorization the Institute will be constructed in the general vicinity of the present Army Medical Center." 11^[11]

As things turned out, failure to secure authorization for the new hospital was to cause the abandonment of the Forest Glen project, but for nearly 3 years the proposed research and graduate training program, to be located at Forest Glen, was very much to the fore in the plans of the Army Medical Department.

Speaking at a Washington preview of an exhibit prepared by the Army Medical Illustration Service for showing at the convention of the American Medical Association in San Francisco, Surgeon General Kirk made public announcement of the project on 3 June 1946 (figs. 83, 84). The 12-year program of construction at an estimated cost of $40,000,000 which was envisaged had yet to secure War Department and congressional approval. 12^[12]

In December 1946, while plans for the relocation of the Institute of Pathology and the Museum were still hanging fire, Colonel Ash reached the age of

Figure 83.—Maj. Gen. Norman T. Kirk, The Surgeon General, U.S. Army, outlining, to a press conference, plans for a new medical center.

retirement as Director of the Institute, but continued in a civilian capacity for the National Research Council as the Scientific Director of the American Registry of Pathology.

The new Director of the Institute was Col. (soon to be Brigadier General) Raymond Osborne Dart, who in addition to having served as Curator of the Museum in the mid-1930's, had been Assistant Director of the Institute-Museum during the last months of Colonel Ash's administration.

In addition to a new Director of the Institute, there was a new Surgeon General, when Maj. Gen. Raymond Whitcomb Bliss was appointed in mid-1947 to succeed General Kirk who had reached the statutory age for retirement.

Building Plans Reviewed

The new Surgeon General shared the interest of his predecessor in the development of the Forest Glen medical center. In a statement for the press, re

Figure 84.—Colonels James E. Ash and Raymond O. Dart look over the message of an exhibit prepared for showing at the American Medical Association Meeting in 1946, as Maj. Ruell A. Sloan, Curator of the Army Medical Museum (left), looks on.

leased on 22 June 1947, he outlined the plan to make Forest Glen "the greatest medical center in the world." It was contemplated that the group of picturesque buildings in a sylvan setting, which had been the home of a school for young ladies, would be used until buildings better adapted to the work of research and graduate training could be secured. The first of these new buildings were to be the ones used for the Institute of Pathology and its associated Museum, and the new hospital which was to be a key facility in the project.^[13]

A year after General Bliss's announcement, and 18 months after that by General Kirk, the congressional approval necessary for getting started was secured when, on 12 June 1948, President Harry S. Truman signed the measure which became Public Law 626, 80th Congress, 2d session, and which authorized the spending of $600,000 for "complete plans and specifications of an Army Institute of Pathology building, including all necessary auxiliary facilities," to be located at Forest Glen, Md.

The Chief of Engineers, whose office was responsible for the planning and erection of the building for the Institute, assigned the work to the District Engineer Commissioner who, on 13 October 1948, contracted with the firm of Faulkner, Kingsbury, and Stenhouse, Washington architects and engineers to draw preliminary plans, relying upon the availability of funds under the provisions of Public Law 626.

By this time, the Forest Glen site had been abandoned, due to a ruling by the Bureau of the Budget and other Federal agencies concerned that no additional hospital beds for the Army should be constructed in the Washington area. Since the Institute could not conduct its program of research and teaching without access to the clinical facilities of a hospital, the Director of the Institute and its Scientific Advisory Board had, in December 1947, recommended to The Surgeon General that the new Institute be set up as a "self-contained unit" on the grounds of an existing hospital in the Washington area. 14^[14] The logic of the situation pointed directly to the Walter Reed General Hospital as the hospital; to the area of the existing Army Medical Center as the site; and to the $600,000 authorized by Public Law 626 as the fund for planning the new building.

But such a simple solution ran against the specificity with which Forest Glen had been designated as the site upon which the building was to be erected. Public Law 626, the Comptroller General ruled, on 19 November 1948, provided funds for drawing plans and specifications for a building at Forest Glen, Md., and nowhere else. 15^[15]

Extensive and detailed studies were made of the functions and needs of the various segments of the Institute's operations; visits were made to a score of the most modern laboratory and technical installations, military and civilian; and, in the light of all these studies, preliminary plans— all that could be done within the existing limitations upon availability of funds— were carried forward. These plans were submitted by the firm of architects-engineers to the responsible representatives of the Chief of Engineers and The Surgeon General and by 1 June 1949 had received approval. 16^[16]

In the existing state of the statutes and the rulings of fiscal authority, this was as far as the project could be carried at the time, but studies by the Institute staff and its Scientific Advisory Board continued in anticipation of legislative relief.

Meanwhile, and in fact all through the period of agitation and disappointment in the attempt to secure a new building, energetic efforts were underway to make conditions more tolerable in the "old, unsightly, and overcrowded" building which still housed the Institute and the Museum, along with the Library. Once more, there was a general shuffling and rearrangement of offices, laboratories, file and record rooms, and other spaces, so as to bring related activities closer together in the four stories and basement of the building without an elevator.

In part, this rearrangement was made possible by the fact that in August 1946 the Institute had secured from the Public Buildings Administration the use of Chase Hall (fig. 85), across Independence Avenue from its location. Chase Hall was a temporary building which had been used during the war as the barracks of the SPAR's, the women's Reserve contingent of the U.S. Coast Guard. It was allocated for Museum use upon the condition that the Museum materials which had been given wartime storage in the National Guard armory warehouse on the waterfront be removed without delay — which meant that the Museum had to begin moving in before the necessary alterations were completed, with the result that much of the material had to be moved more than once, and some exhibits had to be shifted about as many as five times, as the task of rearrangement proceeded (fig. 86).

On 7 May 1947, the Museum, or rather some parts of it, was opened to the public in its new location at the former SPAR barracks (fig. 87). On the first day, the Museum received 137 visitors, and by the end of the month of May, it had been visited by more than 8,500 persons, indicating that the institution had not lost its hold on the public interest. 17^[17]

Additional space was secured 18 months later in another somewhat dilapidated building located on Independence Avenue, Tampa Hall by name, the occupancy of which the Institute and Museum shared with other Government agencies. 18^[18]

Scientific Advisory Board of the AFIP

In this period, also, the Scientific Advisory Board of the Army Institute of Pathology, appointed by The Surgeon General, held its first meeting on 3 March 1947. Dr. Balduin Lucké, back in civilian status as professor of pathology at

Figure 85.—Sixth home of the Museum, Chase Hall, temporary quarters which were occupied for 13 years, 1947-1960.

Figure 86.—Materials awaiting inventory as the Medical Museum moved from warehouse storage to Chase Hall. Most of the items shown are part of the Huntington Collection of Comparative Anatomy.

Figure 87.—A corner of the exhibits of the Museum as shown in Chase Hall.

the University of Pennsylvania, was elected chairman, to serve 1 year, and Dr. Robert A. Moore of Washington University, St. Louis, was named as secretary. At a second meeting, held on 13 April 1947, the Board discussed the plans for the new Institute of Pathology, its functions, and its administrative status, and recommended to The Surgeon General that facilities be provided for "research in pathology in the broadest sense," that the personnel of the Institute be "free to conduct research on an individual basis, in addition to participation in major problems of the Army Medical Department," and that the Director of the Institute "should be responsible directly to the Surgeon General."^[19]

The reasoning behind these recommendations is expressed in the Annual Report of the Institute for 1947, submitted by General Dart, as follows:

Research in morbid anatomy constitutes but one of the phases of pathologic investigation. If research problems in pathology are to be properly correlated with medical problems as a whole, laboratory investigation and animal experimentation are indispensable. These phases of investigation are not available to members of the staff on the present premises of

the Army Institute of Pathology This deficiency is keenly felt by members of the professional staff who are trained to think and work in broader terms, but who cannot exercise their abilities and tendencies in this direction under the present circumstances. The solution of medical problems is rarely, if ever, achieved by methods employed in morbid anatomy alone, helpful though they may be in pointing toward the right approach. The importance or the Army Institute of Pathology as the national center of pathology would make it mandatory for this Institute to take the lead in pathologic research. This, however, can only be achieved by proving the necessary facilities for all phases of pathologic study and investigation to members of a qualified staff. 20^[20]

The Hawley Board

An even broader concept of the place of the Institute of Pathology in the general scheme of military medicine after passage of the National Security Act of 1947 resulted from the appointment and deliberations of the Committee on Medical and Hospital Services of the Armed Forces. This Committee commonly known as the "Hawley Board," was named in December 1947 by James V. Forrestal, the first Secretary of Defense, with Maj. Gen. Paul R Hawley, who had served as Chief Surgeon, European Theater of Operations and later as Chief Medical Director, Veterans' Administration, as chairman,' and the Surgeons General of the three armed services as members. The committee was charged with the duty of making a "thorough, objective and impartial study of the medical services of the Armed Forces with a view of obtaining, at the earliest possible date, the maximum degree of coordination, efficiency and economy in the operation of these services." 21^[21]

Early in its deliberations, the Hawley Committee approved and recommended to Secretary Forrestal the relocation of the Army Institute of Pathology in such a way as to make it of the greatest possible service to all three of the Armed Forces. These recommendations reaffirmed the points, made by the Scientific Advisory Board of the Institute, regarding the status of the Institute as a self-contained independent unit, the need of facilities for experimentation, and the direct responsibility of the Institute to The Surgeon General of the Army, all of which were "urgently recommended" to the Secretary. The Committee, however, reserved decision on the thorny questions of the name and the location of the proposed new Institute. 22^[22]

On 4 February, the Hawley Committee named a subcommittee to study these questions of name, location, and organization. General Dart was chair man of the subcommittee, with Capt. William M. Silliphant, MC, USN, and Maj. Robert A. Patterson, USAF, MC, as members. After eight meetings, the subcommittee filed its report on 25 March 1948, together with seven inclosures, discussing in greater detail the questions of organization, function, and operation of a pathology service for the Armed Forces. The report recommended that the Army Institute of Pathology be located on the grounds of the Walter Reed General Hospital reservation, as an independent command, directly under the command of The Surgeon General of the Army, but with the control of the broad administrative and professional policies lodged in a board composed of the Surgeons General of the three forces; and that in recognition of the joint responsibilities of all the services, the name be changed to either the Military Institute of Pathology or the Armed Forces Institute of Pathology.

The subcommittee's report on name and location was not accepted by the Hawley Board which, at its meeting on 9 April 1948, instructed the subcommittee to confer further with representatives of other medical and hospital establishments in the Government service. The result was a supplemental report of the inability of the subcommittee members to agree on a location, resulting in separate and dissenting reports, with the Army representative favoring the Army Medical Center as a site; the Navy representative favoring the grounds of the National Naval Medical Center at Bethesda, Md., and the Air Force representative taking the position that a "new Armed Forces Institute of Pathology * * * should not be compromised by secluding it on a post of any one service" but that the organization should continue as an Army installation, furnishing service to all the armed forces and other interested agencies. 23 ^[23]

On 4 October 1948, the Hawley Board filed its report on the Army Institute of Pathology in which, "after long and thoughtful evaluation of all the matters involved, and after further exploration of possible alternative solutions" the Committee concluded that the recommendations of the subcommittee in its original report constituted "the most acceptable and most practicable basis for solution of the problem."

The report of the Hawley Board on this subject was approved by Secretary Forrestal on 21 February 1949, with the request that its recommendations be put into effect as rapidly as possible. Outstanding among the recommendations for joint action were the declarations that the Institute should become "the central laboratory of pathology for all of the Armed Forces," with the appropriate change of name to the "Armed Forces Institute of Pathology"; that the Institute be relocated on the Walter Reed reservation; that it should be an independent unit directly under the command of The Surgeon General of the Army, although "broad administrative and professional policies" would be determined by a joint Board of Governors consisting of the three Surgeons General; that the Director of the Institute should be selected by the Board of Governors; that the major fields of training in the Institute should be in advanced pathological studies; and that the "experimental facilities of the Institute be adequate and sufficiently comprehensive to permit any type of investigation which may be important in the study of morbid anatomy and disease processes.24^[24]

With the approval of the Secretary of Defense, the way was cleared for a profound change in the status, organization, and functions of the Army Institute of Pathology. To work out the mechanism of the change, on 17 May 1949, Rear Adm. Joel T. Boone, MC, USN, Executive Secretary for the Interim Medical Coordinating Committee for carrying into effect the recommendations of the Committee on Medical and Hospital Services of the Armed Forces, appointed General Dart, Captain Silliphant, and Major Patterson as the sub-committee to deal with the recommendations relating to the Army Institute of Pathology. 25^[25] In effect, the subcommittee was designated to work out the detailed "constitution and by-laws" of the new Armed Forces Institute, putting into effect the change in its status— a change which was effected, insofar as the Army was concerned, with the issue of the Department of the Army's General Orders Number 32 on 6 July 1949, with an effective date of 1 July.

There remained another massive obstacle to the achievement of the new Armed Forces Institute— congressional authorization and appropriation for the new building which was so desperately needed. That obstacle, too, was to be overcome— an accomplishment in which many men had a hand, but which could not have been overcome as it was nor when it was, without the determination, the drive, and the persistence of General Dart whose "prime objective" it was.

1. 1 Members of the Committee, in addition to Chairman Karsner, were: Doctors Marion A. Blankenhorn, University of Cincinnati; Paul R. Cannon. University of Chicago; William II. Feldman, Mayo Foundation, Rochester, Minn.; Robert A. Moore, Washington University. St. Louis, Mo.; Alwin M. Pappenheimer, Columbia University. New York; I. S. Ravelin. University of Pennsylvania; Arnold R. Rich. Johns Hopkins University, Baltimore, Md.: Henry A. Swanson, Washington, D.C.; and S. Burt Wolbach, Harvard University.
2. 2 Letter, Col. J. E. Ash to The Surgeon General, 14 December 1944. On file in historical records of AFIP.
3. 3 Office Order 20, Surgeon General's Office, 24 January 1945.
4. Correspondence, Col. J. E. Ash to The Surgeon General, 7 February 1945. On file in historical records of AFIP.
5. 5 Correspondence, The Surgeon General, to Commanding General, Army Service Forces, 19 February 1945. On file in historical records of AFIP.
6. 6 Office Memorandums, 19, 20, 21 April 1945. On file in historical records of AFIP.
7. 7 Memorandum, Office of Chief of Engineers, 5 May 1945, Lt. Co!. L. C. Urquahart.
8. 8 Letter, The Surgeon General, U.S. Army, to Chief of Engineers. 12 May 1945.
9. 9 Letter, Col. J. F.. Ash to The Surgeon General. U.S. Army. 22 May 1945.
10. 10 Memorandum, Col. Roger G. Prentiss to The Surgeon General. U.S. Army, through Deputy Surgeon General George F. Lull, 21 December 1945.
11. 11 Sixth indorsement, dated 6 January 1946, to Memorandum of 21 December 1945, cited in footnote 10.
12. 12 New York Times, 4 June 1946.
13. New York Times, Washington Post, Baltimore Sun, 22 June 1947.
14. 14 Annual Report. Army Institute of Pathology, 1948, pp. 11. 12.
15. 15 Annual Report, Army Institute of Pathology, 1949, pp. 24. 25.
16. 16 Idem.
17. 17 Annual Report, Army Institute of Pathology, 1047, p. 23.
18. 18 Annual Report. Army Institute of Pathology, 1948, p. 6.
19. Annual Report, Army Institute of Pathology, 1947. pp. 14, 15.
20. 20 Annual Report, Army Institute of Pathology, 1947.
21. 21 Memorandum, Secretary of Defense James V. Forrestal, 1 January 1948, subject: Memorandum for Dr. Paul R. Hawley.
22. 22 Recommendations of members of the Hawley Board, to Secretary J. V. Forrestal, 5 January 1948.
23. 23 Supplemental reports to Committee on Medical and Hospital Services of the Armed Forces.
24. 24 Interim Report of Hawley Board, approved by Secretary James V. Forrestal in memorandum to Secretaries of the Army, the Navy, and the Air Force, 21 February 1949.
25. 25 Letter, Rear Adm. Joel T. Boone to General Dart, Captain Silliphant, and Major Patterson, 17 May 1940.