with funding. By 1930, Gamble was chairman of the board of the Philadelphia Maternal Health Centers. He sought a simpler method of contraception, one that did not require a costly doctor's visit as fitting a diaphragm did, and that was inexpensive and immediately available. In January 1964, Gamble was diagnosed with leukemia. Expansion In 1930 he hired Elsie Wulkop, a social worker whom he had known at Massachusetts General Hospital, to work in Detroit. During the next four years she helped to open clinics in Michigan, Indiana, Missouri, Kansas, and Nebraska. In the late 1930s Gamble urged the unification of Margaret Sanger's Clinical Birth Control Research Bureau with the competing American Birth Control League. In 1939, the two organizations became the Birth Control Federation of America. He funded early research for the Southeastern Pennsylvania League's work to identify effective spermicidal jellies. After the American Medical Association (AMA) said in 1937 that contraception merited a physician's attention, Gamble's research became the basis of the AMA Standards Program for testing contraceptives—which was the measure of the AMA for endorsing contraceptive products, and finally the basis for state and federal legislation. In 1937 he began to fund education and distribution of birth control supplies through the North Carolina State Board of Health, making North Carolina the first state to incorporate birth control in a public health program. This influenced five nearby states—South Carolina, Alabama, Florida, Mississippi, and Virginia—to incorporate birth control into their public health programs. In the 1930s Gamble was president of the Pennsylvania Birth Control Federation; a vice-presidents and member of the Executive Committee of the Board of the American Birth Control League; medical field director of Margaret Sanger's Birth Control Clinical Research Bureau, and treasurer and member of the board of Robert Dickinson's National Committee on Maternal Health. In 1938, Gamble left Philadelphia and the University of Pennsylvania and moved to the Boston, Massachusetts, area and funded eight field workers who at new community-supported birth control clinics in Montana, Tennessee, the East Coast, and the Midwest. During this decade, he and his fieldworkers helped establish birth control clinics in 40 cities in 14 American states. In 1949 Gamble offered Frank W. Notestein, director of the Office of Population Research at Princeton and future president of the Population Council, a small sum to translate birth control pamphlets into Japanese. This led to correspondence with Dr. Yoshio Koya, director of Japan's National