1946

Women’s Medical College’s abortive merger into Jefferson Medical College (Peitzman, 179-1781). Approximately one-half of all hospital beds in U.S. occupied by psychiatric patients (Valenstein, 169). NIH transformed and expanded into the peacetime CMR (Committee of Medical Research) (Rothman, 51ff.). Cooperative investigations of effectiveness of streptomycin in treatment of pulmonary TB conducted by VA and PHS, the latter with a control group: “ . . . the PHS’s studies of streptomycin served as an example of scientific progress in therapeutics. Along with centrally controlled randomization, their use of objectively measured indicators of progress and blinded assessments of therapeutic outcomes constituted adherence to a program of methodological reform in the postwar era” (Marks, 113ff., quote at 127; Dowling, 163). Dowling claims the VA study, in which “ each patient was used as his own control (50 days before streptomycin treatment compared with the course during 120 days of treatment), with x-ray films read by doctors unfamiliar with the cases” became “a landmark in clinical medicine” (Dowling, 164-65). British Medical Research Council also conducted blind trial of streptomycin for pulmonary TB, and its celebrated 1948 report of the trial contains “the earliest clear description of concealment of the allocation schedule . . . The reason that the Medical Research Council’s controlled trial of streptomycin for pulmonary tuberculosis should be regarded as a landmark is thus not, as is often suggested, because random number tables were used to generate the allocation schedule (as shown above, random allocation had been used at least a decade earlier). Rather it is because of the clearly described precautions that were taken to conceal the allocation schedule from those involved in entering patients” (Chalmers, 1162).