These guys know a lot more than I do, but here's my experience. I have a '59 235 that came with a 4-speed and 3:90 rear end. I found that I was in 4th gear at 25 MPH around town.
I got a set of 3:38 rear end gears from Patrick's in Arizona, and had a local gear shop (Pete's in Hayward) install them. What a difference! The truck is much more fun to drive, especially around town. I don't like to go on the freeway, but I can now. I live off a country road (yes, surprising in the SF Bay Area) and can still climb the grades with no problem. If I go to the City and have to start on a hill (and man, there are hills in San Francisco), I use first with no problems. Otherwise, I start in second.
The 3:38 with 4-speed sure works well for me.
Bob