History of Medicine
Commentary by Dr. Martin M. Cummings on his testimony before the U.S. Senate Appropriations Subcommittee concerning the National Library of Medicine, for fiscal year 1968
From interviews with Dr. Cheryl Dee, 2009, 2011
Excerpts of U.S. Senate subcommittee testimony concerning the National Library of Medicine, followed by an interview with Dr. Martin M. Cummings, Director Emeritus, National Library of Medicine, reflecting upon the testimony
DEPARTMENTS OF LABOR AND HEALTH, EDUCATION, AND WELFARE AND RELATED AGENCIES APPROPRIATIONS FOR FISCAL YEAR 1968
April 18, 1967
U.S. SENATE . . . Subcommittee of the Committee on Appropriations
Senator Lister Hill, presiding.
COMPUTER SYSTEM INSTALLATION
We're requesting, Mr. Chairman, a new, more efficient computer system. We have almost exhausted the time available on our current computer equipment whose design was frozen 6 years ago. The original system has met expectations for its 5-year period of operation. However, more advanced equipment is required to handle the expanding workload and to allow direct, online communication with the computer through remote terminals, a needed feature available in other modern systems.
TOXICOLOGICAL INFORMATION SYSTEM DEVELOPMENT
An important new responsibility, Mr. Chairman, has been assigned to the library in the past year. The President's Science Advisory Committee in its report, "Handling of Toxicological Information," published in June of 1966, drew attention to the urgent need for a better coordinated and more comprehensive computer-based file of toxicology information than is now currently available. Recent congressional hearings and legislation express wide public concern for this need.
Responding to the PSAC report, the President asked the Secretary of Health, Education, and Welfare to be responsible for developing and operating a computer-based toxicological information system.
In the foreword to the report, the President said:
The number of chemical compounds to which people become exposed is already vast and increasing daily. This is the result of steadily advancing industrialization, changes in agricultural practices and advances in the biomedical sciences. All segments of our population are exposed either deliberately or in the course of daily living to many such compounds.
Senator Hill. Many of these compounds that we thought were so fine have some distinct disadvantages, is that right?
Dr. Cummings. There have in some cases beenprofound adverse effects on living systems, be they man, animal, or plant life.
Senator Hill. I recall not too many years ago when they started feeding chickens antibiotics.
Senator Hill. There's one question that doesn't have to be studied, the chicken doesn't taste nearly as good as it did in the good old days.
Dr. Cummings. I'm not sure I can make the best professional judgment on that.
Senator Hill. I'm not a professional, but I think I can pass judgment by saying they don't taste like they did in the old days. See, when the farmer brought that chicken into the town, you brought a chicken, a fryer, and a broiler. You put it in the chicken coop in the backyard. When you got ready to eat him, you went out and wrung his neck, soused him in some hot water, took his feathers off, took the insides out of him-he tasted a whole lot better than it does today; is that right?
You say you're not qualified to say?
Dr. Cummings. I have never had the chore of plucking a chicken.
Senator Hill. You never plucked chicken?
Dr. Cummings. The chicken always came in cellophane. It reflects a difference in our ages, Mr. Chairman.
Senator Hill. Well, I don't know what I took up here and-with that evidence before me, I will not make any admissions.
FOOD AND DRUG ADMIINISTRATION ADVERTISEMENT REGULATIONS
Dr. Cummings. Well, Mr. Chairman we are requesting----
Senator Hill. But we do have these problems, don't we?
Dr. Cummings. We do. There are, of course, the hidden problems of the chemical environment which is hard to smell or taste, but have very serious effects on the health of man and animals.
Senator Hill. I notice the Food and Drug Administration is going to issue some regulations about some of these advertisements. You saw that I suppose?
Dr. Cummings. Yes I saw that in the newspapers.
Senator Hill. In other words, they advertise what this new compound or this new drug will do, but they don't say anything about some of the harmful effects that may come from it.
Dr. Cummings. This is unfortunately true.
Senator Hill. That is what it is. I don't look at TV much but you cannot turn on the TV that they don't give cigarette advertisements [saying] "they are mild."
All right, go ahead, doctor.
Interview with Martin Cummings, MD, Director Emeritus, National Library of Medicine, 1964-84; interviewed by Cheryl Dee, PhD, 2009, 2011.
Toxicology Information Service
Dr. Dee. Dr. Cummings, will you explain the impact of this testimony on the beginning of the toxicology information service?
Dr. Cummings. This is an important part of the history of the National Library of Medicine and its involvement in the development of the Specialized Information Services.
The background to these important hearings needs to be reviewed. The original idea for the creation of a toxicology information service came from Senator Hubert Humphrey from Minnesota. In 1965 the Public Health Service established a program to identify drugs and chemicals which had adverse effects on man and the environment. There were many discussions trying to decide whether this was the responsibility of the Food and Drug Administration or the National Institutes of Health.
Senator Humphrey sent a senior staff member to meet with me and my staff sometime in 1965 suggesting that the National Library of Medicine was a most appropriate institution to develop such an activity. Dr. James Shannon, then Director of the NIH, agreed and made the recommendation to the Secretary of the Department of Health, Education and Welfare that NLM be asked to create the toxicology program.
There was at the time, a lack of clarification of what needed to be done and who should assume the responsibility for developing the program when Senator Humphrey became Vice President of the United States. In his position as Vice President he brought the toxicology problem to the attention of the President's Science Advisory Committee. The President's Science Advisory Committee reviewed all aspects of the problem and made a strong recommendation that a toxicology information program be established and the task was assigned to the National Library of Medicine.
At this juncture there was a need for appropriations to acquire staff and other support to develop the program and so we made a request to the Senate and House Appropriations Committees for funds to fulfill the purpose established by the President's Science Advisory Committee. It was in this context that in 1967 hearings were held before Senator Lister Hill's Committee where we found his support despite some objections from the Bureau of the Budget.
This I believe is the background that does not appear in the Congressional Hearings and I think it is important to understand how this program was established.
Historically, antibiotics were used in the treatment of diseases of men and animals and the introduction of pesticides and other agricultural chemicals were used in farming and related industry and these led to the appearance of toxic manifestations of overuse of these new chemical compounds. I believe it was this general set of factors which lead Senator Humphrey to become concerned with the problem. I think also that Senator Humphrey had an interest in the pharmaceutical industry since his father ran a drugstore. Literature also began to have an increasing amount of reported adverse effects of drugs which made the adverse effects more evident than in the past.
Dr. Dee. The discussion between you and Senator Hill regarding the chore of chicken plucking was an unexpected subject.
Dr. Cummings. The chicken plucking exchange is an example of what made the Senate Testimony a high point of my year.
Dr. Cummings's International Experience
Dr. Dee. I'd like to follow-up our discussion from the 1966, FY 1967 Testimony, when you explained Senator Lister Hill's support of your qualifications with extramural programs. Would you tell me a little more about your international background related to your NLM responsibilities? 1
Dr. Cummings. From 1960 to 1964 when I was Chief of the Office of International Research at the National Institutes of Health we monitored and coordinated all of the NIH grants and contracts overseas. In this position I developed more knowledge of the international grant process and I made many international contacts.
The international programs at NIH came as a result of interest in international medical research on the part of President John F. Kennedy. John F. Kennedy wrote internationally related legislation as a Senator and he pursued an international medical research interest when he became the U.S. President.
During my years as Chief of the Office of International Research I was overseas most of the time. I went to many countries working on the international medical research interests of NIH.
Dr. Dee. What are some of the countries you visited in your international work for NIH? The extent of your travel provides an understanding of your international experience before you came to NLM.
Dr. Cummings. I have some documentation that can tell us.
-Israel, India, Indonesia, Hong Kong, Ghana, Chile, Peru, Costa Rica
-New Zealand, China, Malaya, Israel
-Polynesia, Guatemala, Colombia, Peru, Japan2
Dr. Dee. I have always wanted to hear more about your international travels. 3
Dr. Cummings. Actually, my international work goes back to 1946 when I was working for the Public Health Service. I was trained in bacteriology and tuberculosis and worked in Denmark. As a professor of microbiology at the University of Oklahoma I was also doing international work. I collaborated with many foreign scientists with my work on sarcoidosis and tuberculosis. Much of my research on sarcoidosis and tuberculosis was published during this time.4 I also obtained international experience and I made a lot of contacts when I represented the United States at various medical meetings overseas.
My international experience was relevant to the National Library of Medicine's policy to assist other libraries abroad. Relationships with other countries continued to grow to the point that I hired Mary Corning to work with international programs. Mary Corning and I worked together to establish MEDLARS and MEDLINE in other countries.
As of 1983 we shared our databases with thirteen international centers located in Australia, Brazil, Canada, Colombia, England, France, West Germany, Italy, Japan, Mexico, South Africa, Sweden, and Switzerland. Through these major centers, MEDLARS services were extended to some 140 nations around the globe.
One of the biggest opportunities to use my international background was with my collaborative work between the National Library of Medicine and the Pan American Health Organization. I designed and planned the regional medical library and I negotiated with the President of Brazil to give us space in the Federal University of Rio de Janeiro, Brazil, for the library. Together NLM and PAHO established a regional medical library in São Paulo, Brazil that served every country in Latin America. The National Library of Medicine did not fund the regional medical library, PAHO funds paid for it.
I was given the Abraham Horowitz Award, the highest award given by PAHO, for my work on the regional library.
Dr. Dee. Dr. Cummings, in what other countries did you work with NLM besides Brazil?
Dr. Cummings. I worked with England, Australia, Israel, and Sweden on the international level.5
 Interview with Dr. Cummings, 2009.
 Dr. Cummings's personal documents located at his residence, Plymouth Harbor, Longboat Key, Florida. June 9, 2011.
 Discussion between Dr. Dee and Dr. Cummings at lunch at Dry Dock Waterfront Grill, Longboat Key, Florida, June 30, 2011.
 See Dr. Cummings's pre-NLM research publications, for example, Cummings, MM, and JF Hammarsten, "Sarcoidosis." Annu Rev Med 1962;13:19-40. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13882620/, or Cummings, MM. "Pulmonary Sarcoidosis." Med Clin North Am. 1959 January; 43(1): 163-170. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612425/
 Personal Communication. Email from Dr. Dee to Dr. Cummings and Dr. Cummings's reply to Dr. Dee. July 8, 2011.
- Humphrey, Hubert Horatio, Jr., (1911-1978). Biographical Directory of the United States Congress. Senate Years of Service: 1949-1964; 1971-1978. https://bioguide.congress.gov/scripts/biodisplay.pl?index=h000953</li>
- Shannon, James, (1904-1994). "Dr. James Shannon (1904-1994)" https://history.nih.gov/exhibits/bowman/BioShannon.htm
Institutions and Programs
- NLM Specialized Information Services. https://sis.nlm.nih.gov/
- Pan American Health and Education Foundation, Abraham Horowitz Award. https://www.pahef.org/en/ourwork/48-leadership.html
Articles and Oral Histories
- Adams, Scott. "Review of Mary E. Corning, A Review of the United States Role in International Biomedical Research and Communications: International Health and Foreign Policy.." Bull Med Libr Assoc. 1982 April; 70(2): 268.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC226699/