A. Medical Experiments (continued 8)

The Experimental Arrangements for the Sulfanilamide Experiments

It was shown by the evidence that the experiments for testing the effectiveness of the sulfanilamides were carried out in three groups. The first group included 15 men (habitual criminals). This group has nothing to do with the charges of the indictment and it is therefore superfluous to enter into this matter more closely.

The second group included 36 female prisoners who had been members of the Polish Resistance Movement and who, for this reason, had been sentenced to death by the German court martial in the General Government. This second group was divided into 3 subgroups of 12 experimental persons each. As to the particulars of the provisions for the experiments, I refer to the testimony of the defendants Gebhardt and Fischer in the witness box. Contrary to the first group, contact substances were used in this second group to accelerate the process of infection. The contact substances were inserted into the open wound together with the germs. Sterile and pulverized glass and sterile wood particles were used as contact substances. These contact substances took the place of earth and uniform particles and were to produce war-like conditions for the wounds, without, however, producing at the same time the general dangers created by infection of the wound by earth and parts of clothing.

As in the case of the first group, staphylococci, streptococci, and gas gangrene bacilli were used as agents. But the contention of the indictment that tetanus germs were also used is incorrect. On the contrary, the evidence has proved that the treatment of tetanus did not come within the scope of these experiments. There was all the less reason for this as it was realized long ago by German military surgery that the sulfanilamide preparations are not suitable for the effective prevention of traumatic tetanus. Here I refer to the directives for the chemo-therapeutical treatment of wound infection which were issued at the First Working Conference East of the Consulting Specialists in May 1943 (Gebhardt, Fischer, Oberheuser 1, Gebhardt, Fischer, Oberheuser Ex. 6)—that is prior to the performance of the sulfanilamide experiments charged in the indictment. In these directives it is expressly pointed out that the outbreak of traumatic tetanus cannot be prevented by means of the sulfanilamides and that tetanus anti-toxin has to be administered as usual.

During the presentation of evidence, only the witness Dr. Maczka maintained that tetanus was actually used in one individual case. This witness did not make her own observations of the case but drew conclusions based exclusively on the pathological picture presented by one of the experimental subjects according to her statements. In view of the fact that even according to the testimony of this witness tetanus bacilli were employed only in one individual case, the assertion of this witness can hardly be taken as a true representation of the facts, for if it had really been the intention of the defendant Gebhardt to determine the effect of sulfanilamides on tetanus too, one experimental subject would certainly not have been sufficient, and more experiments would have been necessary before a final decision regarding this question could possibly have been made.

The third group consisted of 24 experimental subjects who were not treated with any sort of contagion—unlike the procedure applied to the second group—but only had part of the muscle ligatured. The defendants Gebhardt and Fischer have given detailed evidence regarding these new experimental arrangements, how they originated, what considerations had to be regarded, and what part was played by SS Reich Physician Dr. Grawitz. With regard to these details I refer to the testimony of the defendants in the witness box.

The experimental subjects were treated with sulfanilamides as described by the defendants in the witness box. A few persons were not treated with sulfanilamides but were used as control subjects. But that did not mean that these persons were not treated at all. As the evidence has proved, all experimental subjects were treated, namely by surgical measures if the sulfanilamides did not prove effective against the inflammation. For this reason too the experimental subjects to whom sulfanilamides were applied, and where the inflammation did not pass away by itself, were given direct surgical treatment under observance of the generally recognized principles of surgery, particularly as developed in Germany by Gebhardt’s teacher Professor Dr. Lexer. This direct surgical treatment resulted in the scars which the court has seen on the experimental subjects questioned as witnesses. As explained by Professor Dr. Alexander, the expert produced by the prosecution, these scars are the result not of the bacteriological infection but of the operations performed in order to eliminate this infection. In the prosecution case, four experimental subjects were called to give evidence. In addition, the prosecution submitted a series of affidavits given by other persons used as experimental subjects. The statements of the four witnesses questioned in court coincide largely with the testimony given by the defendants Gebhardt, Oberheuser, and Fischer themselves in the witness box. For this reason alone it appears expedient and sufficient for the pronouncement of a just sentence and for the establishment of the true facts to base the sentence exclusively on the testimony of these four witnesses together with the statements of the defendants themselves. This is not only in accordance with the principle of direct and oral proceedings in court prevailing in any modern criminal procedure and which should not be departed from without urgent reason, but also such handling of the case seems suitable because the statements of the four witnesses are identical essentially so that they themselves, together with the statements given by the defendants, can be regarded as a safe basis for a finding—apart from one point which I shall go into later. In addition, the affidavits submitted by the prosecution not only differ in essential points from the statements made by the witnesses in court, but are inconsistent and contradictory in themselves as well. This is shown, above all, by the fact that in several of these affidavits contentions are quite obviously made which are not based on personal and factual observation, but have become known to these witnesses by hearsay. The affidavits, moreover, fail to represent the circumstances in clear chronological order, which makes the whole matter all the more doubtful, as it was proved by the evidence that in the Ravensbrueck camp experiments were obviously also performed by other physicians with whom the defendant in this case had no connection.

Considerable doubts also exist regarding the statements made by the witness Dr. Maczka. The prosecution has submitted two affidavits given by this witness as part of its evidence. When questioned in court, this witness could not maintain the most incriminating contentions which appeared in the two affidavits. Under these circumstances, the court has to consider whether it regards the statements of this witness as sufficiently reliable to enter into the judgment. I would answer this question in the negative, not only because she had to revoke the most essential points of her previous affidavits, but because a large part of her testimony was based not on her own observations, but either on information obtained from other prisoners or on conclusions drawn by her.

d. Evidence

Prosecution Documents

Doc. No.Pros. Ex. No.Description of DocumentPage

NO-228206Affidavit of defendant Fischer, 19 November 1946, concerning sulfanilamide experiments conducted in the concentration camp Ravensbrueck.371

NO-472234Affidavit of the defendant Fischer, 21 October 1946, supplementing his affidavit concerning sulfanilamide experiments.376

NO-1080 A, E, F219 A, E, FExposures of the witness Maria Kusmierczuk who underwent sulfanilamide and bone experiments while an inmate of the Ravensbrueck concentration camp. (See Selections from Photographic Evidence of the Prosecution.)901

NO-1082 A, C214 A, CExposures of the witness Jadwiga Dzido who underwent sulfanilamide and bone experiments while an inmate of the Ravensbrueck concentration camp. (See Selections from Photographic Evidence of the Prosecution.)903

Defense Documents

Doc. No.Def. Ex. No.Description of Document

Gebhardt, Fischer, Oberheuser 21Gebhardt, Fischer, Oberheuser Ex. 20Extract from affidavit of Dr. Karl Friedrich Brunner, 14 March 1947.377

Gebhardt, Fischer, Oberheuser 1Gebhardt, Fischer, Oberheuser Ex. 6Extract from report on the First Conference East of Consulting Specialists on 18 and 19 May 1942 at the Military Medical Academy, Berlin.377

Gebhardt, Fischer, Oberheuser 3Gebhardt, Fischer, Oberheuser Ex. 10Extracts from report on the Third Conference East of Consulting Specialists on 24 to 26 May 1943 at the Military Medical Academy, Berlin.378

Testimony

Extracts from the testimony of prosecution witness Jadwiga Dzido381

Extracts from the testimony of the prosecution expert witness Dr. Leo Alexander386

Extracts from the testimony of defendant Gebhardt388

PARTIAL TRANSLATION OF DOCUMENT NO-228

PROSECUTION EXHIBIT 206

AFFIDAVIT OF DEFENDANT FISCHER, 19 NOVEMBER 1946, CONCERNING SULFANILAMIDE EXPERIMENTS CONDUCTED IN THE CONCENTRATION CAMP RAVENSBRUECK

AFFIDAVIT

I, Fritz Ernst Fischer, having been duly sworn, depose and state under oath:

I am a doctor of medicine, having been graduated from the University of Hamburg. I passed my state examination in 1936. On 13 November 1939 I was inducted into the Waffen SS and after having served with a combat division as medical officer, I was hospitalized and then assigned to the SS hospital at Hohenlychen, as assistant surgeon.

In addition to my normal duties as surgeon at the SS hospital at Hohenlychen, I was ordered by Professor Gebhardt to begin medical experiments in my capacity as assistant surgeon to Professor Gebhardt on or about 12 July 1942. The purpose of the proposed experiments was to determine the effectiveness of sulfanilamide, which I was informed at that time was a matter of considerable importance to military medical circles.

According to the information which I received from Professor Gebhardt, these experiments were directed initially by the Reich Leader SS and the Reich Physician Dr. Grawitz.

Professor Gebhardt instructed me, before the operations were undertaken, on the techniques to be followed and the procedure to be employed. The persons who were to be the subjects of these experiments were inmates of the concentration camp at Ravensbrueck who had been condemned to death.

The administrative procedure which was followed in obtaining the subjects for the experiments was established by Professor Gebhardt with the camp commandant at Ravensbrueck. After the initial arrangements had been made, it was the general practice to inform the medical officer at Ravensbrueck as to the date on which a series of experiments was to be begun and the number of patients who would be required, and then he took the matter up with the commandant of the camp, by whom the selections of subjects were made. Before an operation was undertaken, the persons who had been selected in accordance with this procedure were given a medical examination by the camp physician to determine their suitability for the experiments from a medical standpoint.

The first of the series of experiments involved five persons. The gangrenous bacterial cultures for use in the experiments were obtained from the Hygiene Institute of the Waffen SS. The procedure followed in the operations was as follows: The subject received the conventional anesthetic of morphine-atropine, then evipan ether. An incision was made 5 to 8 centimeters in length and 1 to 1½ centimeters in depth, on the outside of the lower leg in the area of the peronaeus longus.

The bacterial cultures were put in dextrose, and the resulting mixture was spread into the wound. The wound was then closed and the limb encased in a cast, which had been prepared, which was lined on the inside with cotton so that in the event of swelling of the affected member the result of the experiment would not be influenced by any factor other than the infection itself.

The bacterial cultures used on each of the five persons varied both as to the type of bacteria used and the amount of culture used.

After the initial operations had been performed, I returned to Ravensbrueck each afternoon to observe the progress of the persons who had been operated on. No serious illnesses resulted from these initial operations. I reported the progress of the patients to Professor Gebhardt each night.

When the five persons first operated on were cured, another series of five was begun. The surgical procedure and the post-operative procedure was the same as in the initial experiments, but the bacterial cultures were more virulent. The results from this series were substantially the same as in the first and no serious illnesses resulted.

Since no inflammation resulted from the bacterial cultures used in the first two series of operations, it was determined, as a result of correspondence with Dr. Mrugowsky, the Chief of the Hygiene Institute of the Waffen SS, and conversations with his assistant, to change the type of bacterial culture in the subsequent operations. Using the new culture, two more series of operations were performed, each involving five persons.

The difference between the third and fourth series was in the bacterial cultures used. The Hygiene Institute of the Waffen SS prepared them from separate combinations of the three or four gangrene cultures which were available. In the third and fourth series, more pronounced infection and inflammation were discernible at the place of incision. Their characteristics were similar to a normal, local infection, with redness, swelling, and pain. The circumference of the infection was comparable in size to a chestnut. Upon the completion of the fourth series, the camp physician informed me that the camp commandant had instructed him that male patients would no longer be available for further experiments, but that it would be necessary to use female inmates.

Accordingly, five women were prepared for the operation, but I did not operate on them. I reported the change of situation to Professor Gebhardt and suggested that in view of these circumstances, it would be desirable to stop the experiments. He did not adopt this suggestion, however, and pointed out that it was necessary for me as an officer to carry out the duties which had been assigned to me.

The experiments, however, were interrupted for a period of 2 weeks, during which Professor Gebhardt told me he had discussed the matter in Berlin and had been instructed to carry on the experiments, using Polish female prisoners who had been sentenced to death. In addition, he instructed me to speed up the experiments since the Reich Physician, Dr. Grawitz, intended to go to Ravensbrueck soon to test the results of the experiments. Accordingly, I went to Ravensbrueck and operated on the female prisoners.

Since the infections which resulted from the first four series of experiments were not typical of gangrenous battlefield infections, we communicated with the Hygiene Institute of the Waffen SS to determine what steps could be taken more nearly to simulate infections caused by battle. As a result of this correspondence and a conference at Hohenlychen presided over by Professor Gebhardt, it was decided to add tiny fragments of wood shavings to the bacterial cultures, which would simulate the crust of dirt customarily found in battlefield wounds.

As a result of this conference, three series of operations were performed, each involving 10 persons, one using the bacterial culture and fragments of wood, the second using bacterial culture and fragments of glass, and the third using the culture plus glass and wood.

About two weeks after these new series were begun, Dr. Grawitz visited Ravensbrueck. Professor Gebhardt introduced him to me and explained to him the general nature of the work. Professor Gebhardt then left, and I explained to Dr. Grawitz the details of the operations and their results. Dr. Grawitz, before I could complete my report on the procedures used and the results obtained, brusquely interrupted me and observed that the conditions under which the experiments were performed did not sufficiently resemble conditions prevailing at the front. He asked me literally, “How many deaths have there been?” and when I reported that there had not been any, he stated that that confirmed his assumption that the experiments had not been carried out in accordance with his directions.

He said that the operations were mere flea bites and that since the purpose of the work was to determine the effectiveness of sulfanilamide on bullet wounds it would be necessary to inflict actual bullet wounds on the patients. He ordered that the next series of experiments to be undertaken should be in accordance with these directions. That same evening, I discussed these orders of Dr. Grawitz with Professor Gebhardt and we both agreed that it was impossible to carry them out, but that a procedure would be adopted which would more nearly simulate battlefield conditions without actually shooting the patients.

The normal result of all bullet wounds was a shattering of tissue, which did not exist in the initial experiments. As a result of the injury, the normal flow of blood through the muscle is cut off. The muscle is nourished by the flow of blood from either end. When this circulation is interrupted, the affected area becomes a fertile field for the growth of bacteria; the normal reaction of the tissue against the bacteria is not possible without circulation.

This interruption of circulation usual in battle casualties could be simulated by tying off the blood vessels at either end of the muscle.

Two series of operations, each involving 10 persons, were begun following this procedure. In the first of these, the same bacterial cultures were used as were developed in the third and fourth series, but the glass and wood were omitted. In the other series, streptococci and staphylococci cultures were used. In the series using the gangrenous culture a severe infection in the area of the incision resulted within 24 hours.

Eight patients out of ten became sick from the gangrenous infection. Cases which showed symptoms of an unspecific or specific inflammation were operated on in accordance with the doctrine and manner of septic surgery. The Lexer doctrine formed the basis of the procedure. The technique is that an incision in the area of the gangrene is made, from healthy tissue to healthy tissue on either side. The wound and fascian corners were laid open, the gangrenous blisters swabbed, and a solution of H₂O₂ (hydrogen peroxide) was poured over them. The inflamed extremity was immobilized in a cast. With most patients it was possible to improve the gangrenous condition of the entire infected area in this manner.

In the series in which banal cultures of streptococci and staphylococci were used, the severe resultant infection with accompanying increase in temperature and swelling did not occur until 72 hours later. Four patients showed a more serious picture of the disease. In the case of these patients, the normal professional technique of orthodox medicine was followed as outlined above, and the inflamed swelling split. Due to the slight virulence of the bacteria it was possible in the case of all patients except one to prevent the threatened deadly development of the disease.

The incisions were made on the lower part of the leg only in all series to make an amputation possible. It was not made on the upper thigh because then no area for amputation would remain. However, in this series the inflammation was so rapid that there was no remedy and no amputations were made.

Since after the tying up of the circulation of the muscles, a very severe course of infection was to be expected, 5 grams of sulfanilamide were given intravenously in the amount of 1 gram each, beginning 1 hour after the operation. After the wound was laid open to expose all its corners, sulfanilamide was shaken into the entire area and the area was drained by thick rubber tubes.

The infection normally reached an acute stage over a period of 3 weeks, during which time I changed the bandages daily. After the period of 3 weeks the condition was normally that of a simple wound which was dressed by the camp physicians rather than by me.

The procedure prescribed for the post-operative treatment of the patients was to give them three times each day 1 cc. of morphine, and when the dressings were changed, to induce an esthesia by the use of evipan.

In all the series of experiments, except the first, sulfanilamide was used after the gangrenous infection appeared. In each series two persons were not given sulfanilamide as a control to determine its effectiveness. When sulfanilamide and the bacteria cultures together were introduced into the incision no inflammation resulted.

My behavior towards all patients was very considerate, and I was very careful in the operations to follow standard professional procedure.

In May 1943, on the occasion of the Fourth Conference of the Consulting Physicians of the Wehrmacht, a report was made by Professor Gebhardt and myself as to these operations. This medical congress was called by Professor Handloser, who occupied the position of Surgeon General of the Armed Forces, and was attended by a large number of physicians, both military and civilian.

In my lecture to the meeting I reported on the operations frankly, using charts which demonstrated the technique used, the amount of sulfanilamide administered, and the condition of the patients. This lecture was the focal point of the conference. Professor Gebhardt spoke about the fundamentals of the experiments, their performance and their results, and then asked me to describe the technique. He began his lecture with the following words: “I bear the full human, surgical, and political responsibility for these experiments.”

This lecture was followed by a discussion. No criticism was raised. I am convinced that all the physicians present would have acted in the same manner as I.

Subsequent to my repeated urgent requests, I went to the front as surgeon immediately after this conference. Only after I was wounded did I return as a patient to Hohenlychen. I never entered the Ravensbrueck camp again. I protested vigorously against these experiments on human beings, endeavored to prevent them, and to limit their extension after they had been ordered. In order not to be forced to participate in these experiments, I repeatedly volunteered for front-line service. Insofar as it was in my power, I tried to dissuade Doctor Koller and Doctor Reissmayer from performing these experiments. I declined habilitation at the University of Berlin because I felt that it might result in my being obliged to carry on additional experiments at Ravensbrueck. After I succeeded in scientific discoveries of the highest practical importance, that is, the solution of the cancer problem and its therapy, I did not communicate this fact to Professor Gebhardt and did not publish this work in order not to be ordered again to carry out experiments.

Fritz Ernst Fischer

TRANSLATION OF DOCUMENT NO-472

PROSECUTION EXHIBIT 234

AFFIDAVIT OF THE DEFENDANT FISCHER, 21 OCTOBER 1946, SUPPLEMENTING HIS AFFIDAVIT CONCERNING SULFANILAMIDE EXPERIMENTS

3. At the conference of May 1943, which I described on page 12 of my affidavit (last paragraph) the following officials were present to the best of my recollection: Dr. Paul Rostock as chairman of the conference; Dr. Siegfried Handloser, who was then the Chief of the Medical Service of the German Armed Forces, who had sent out the invitations to the meeting; Professor Karl Brandt, who sat in the center of the front row; Dr. Leonardo D. Conti, the Reich Health Leader; Professor Dr. Sauerbruch; Dr. Frey; and Professor Heubner. The Medical Service of the Luftwaffe was represented by Dr. Hippke, who was the Chief of the Medical Service of the Luftwaffe; and by Dr. Oskar Schroeder. The Medical Service of the Waffen SS was represented by its chief, Dr. Karl Genzken. Dr. Helmut Poppendick, who was the Chief of Staff of the Reich Physician SS and Police, and Dr. Grawitz were also present.

5. It was made perfectly clear during the speeches made by Dr. Gebhardt and myself that the experiments were conducted on inmates of a concentration camp.

6. Six months after this, the 10th anniversary of the hospital at Hohenlychen was celebrated. Dr. Karl Brandt, Dr. Siegfried Handloser, Dr. Leonardo D. Conti, and Professor Dr. Sauerbruch were invited to the celebrations.

7. When the sulfanilamide experiments started, I was told by Professor Gebhardt, my military and medical superior, that these experiments were being carried out by order of the Chief of the Medical Office of the Wehrmacht and the Chief of the State Medical Office, with the initial order from Hitler, and I must therefore carry out these orders.

8. Dr. Herta Oberheuser and Dr. Schiedlausky assisted me in the sulfanilamide experiments.

9. As a result of these experiments, three people died.

[Signed] Fritz Ernst Fischer

TRANSLATION OF GEBHARDT, FISCHER, OBERHEUSER

DOCUMENT 21

GEBHARDT, FISCHER, OBERHEUSER DEFENSE EXHIBIT 20

EXTRACT FROM AFFIDAVIT OF DR. KARL FRIEDRICH BRUNNER, 14 MARCH 1947

I only heard of the sulfanilamide experiments on human beings at Ravensbrueck after their conclusion through the public report made by Professor Gebhardt and Dr. Fischer before the Third Conference East of Consultant Specialists of 24 and 26 May 1943 at the Military Medical Academy, Berlin. I attended this conference as Stabsarzt in the army from a military reserve hospital in Berlin. Later on I read a report in the directives. Professor Dr. Gebhardt did not speak to us about this point subsequently. On the other hand, the existence of this sulfanilamide experiment was known and was not kept secret, although even foreigners were continuously to be found among the assistants, as, for instance, the Swiss surgeon, Dr. Meyer, during my time.

TRANSLATION OF GEBHARDT, FISCHER, OBERHEUSER

DOCUMENT 1

GEBHARDT, FISCHER, OBERHEUSER DEFENSE EXHIBIT 6

EXTRACT FROM REPORT ON THE FIRST CONFERENCE EAST OF CONSULTING SPECIALISTS ON 18 AND 19 MAY 1942 AT THE MILITARY MEDICAL ACADEMY, BERLIN

Directives for the chemo-therapy of wound infections

The treatment of war wounds with sulfanilamide preparations in order to combat wound infections seems to have prospects. In stock now in the medical stores are: prontalbin-marfanil powder, prontosil, neo-uleron-albucid, eubasinum, sulfapyridine-cibazol, and eleudron pills.

Traumatic tetanus cannot be prevented by these preparations; tetanus antitoxin must therefore be given as usual.

Chemotherapeutics are not a safe precaution against gas oedemata. The collection of further experiences in this field is especially desirable.

When treating war wounds, an operative arrangement of the wound must first be made by removing the dead tissue and opening all cavities of the wound. Then the remedy is applied with a powder distributor or with dredging boxes, in dosages of from 5-20 grams according to the size of the wound. This is repeated whenever a change of dressing is necessary. Independently of the change of dressing, and spread evenly over the day, the patient is given 8 grams on the first day, 6 grams on the second day, 5 grams on the third day and on each of the fourth, fifth, and sixth days, 4 grams of sulfanilamide preparations per os (if necessary, rectal or intravenous injections). Then the drug treatment is discontinued and started again if necessary. The earlier this treatment is begun the better are its chances.

Local treatment with the available sulfanilamide powders together with an internal treatment with albucid, cibazol, eleudron, eubasinum, globucid (particularly for gas oedema), marfanil-prontalbin, protosil is suggested.

If, in rare cases, secondary reactions occur such as nausea, vomiting, diarrhea, buzzing in the ears, headaches, skin rashes, or icterus, these remedies must be discontinued at once. A blood transfusion may be useful.

PARTIAL TRANSLATION OF GEBHARDT, FISCHER,

OBERHEUSER DOCUMENT 3

GEBHARDT, FISCHER, OBERHEUSER DEFENSE EXHIBIT 10

EXTRACTS FROM REPORT ON THE THIRD CONFERENCE EAST OF CONSULTING SPECIALISTS ON 24 TO 26 MAY 1943 AT THE MILITARY MEDICAL ACADEMY, BERLIN

5. SS Gruppenfuehrer and Major General, Professor Gebhardt, and F. Fischer.

Special Experiments on Sulfanilamide Treatment

CONCLUSIONS

“1. The development of suppuration on the soft parts caused by bacteriae cannot be prevented, even if sulfanilamides are applied immediately, locally, or internally.

“2. It could not be proved that the course of an inflammatory illness caused by aerobic organisms on abscesses and phlegmons of the limbs was influenced by sulfanilamides. We were of the impression that combined gas gangrene therapy took a milder course under the influence of sulfanilamides.

“3. Surgical measures are indispensable for a successful treatment of inflammations.”

Additional Remarks

The sprinkling of sulfanilamide powder on wounds can be injurious, if, by so doing, the fundamentals of surgery are infringed, if, for instance, the powder basis is not dissolved by the tissue fluids, and if the discharge of secretions is hampered by coagulation. The wounds treated with sulfanilamide powder show a slight tendency to exudation.

Hypothesis of Functions

The inflammation on the mesodermal soft parts shows a tendency towards necrosis at an early stage. The necrosis is the seat of the bacterial culture. Its surroundings show thrombosed vessels. Access to it by chemo-therapeutic reagents is very difficult.

Directives for the Application of Sulfanilamides

Experiments (Gebhardt-Fischer) showed the following results: Even the immediate internal and external application of sulfanilamide preparations cannot prevent a suppuration of the soft parts due to ordinary suppurative organisms. It could not be proved that the course of the inflammatory disease caused by anaerobions is influenced by sulfanilamides. The sulfanilamides seemed to have an easing effect on the course of combined gangrene therapy.

Disorders caused by sulfanilamides (Randerath) are relatively rare. They occur directly as liver disorders including acute yellow liver atrophy, as kidney disorders, and as agranulocytosis. Therefore, as far as is possible under front-line conditions, the white and red blood count should be controlled. The decrease of the body temperature caused by an infection of the central regulatory system may be looked upon as an indirect disorder, so that the temperature curve permits no conclusions as to the development of the wound infection. Furthermore, local powder treatment may lead to an occasional increase in the depth of the wound infection. Direct injury to the tissue at the spot where the preparations were applied was not observed.

The endolumbal application of the sulfanilamides (Mueller) must also be rejected for the treatment of meningitis, since it leads to serious disturbances in the region of the spinal cord and may result in paralysis.

The clinical discourse (Frey) emphasized the decrease of optimistic and the increase of critical opinions. The clinical doctor considers the principal disorders to be anorexia, nausea, and increasing exhaustion. Early application in the wound itself is essential for the efficacy. The enteral or parenteral inducing of sulfanilamide drugs cannot prevent wound infections, but can favorably influence its course.

The following rules for practice therefore result: All surface wounds, that is, grazing shot wounds, sulcus-shaped wounds and large gaping wounds of the soft parts should be sprinkled as soon as possible with sulfanilamide powder. The powder treatment is of no use if the depths of the wound are not reached. It is ineffective to powder the small wounds caused by the penetration and exit of the bullet. The powdering of the skin is senseless and may cause eczema. Deeper wounds must be treated in the quickest and most thorough manner. After this, the wound can be additionally treated with sulfanilamide powder which must reach the deepest cavities. It is not advisable to powder granulating wounds.

If the powder treatment cannot be applied during the first hours or does not seem to suffice, a pororal application of sulfanilamides should take its place or be performed supplementarily. Front-line conditions will not always allow intravenous injections. According to the danger of a wound infection, the wound should be treated for a short time with large doses of sulfanilamides (6-10 grams during 3-4 days, not more than a total of 50 grams). On the whole, small doses are insufficient and therefore have no influence on the course of an infection, but if applied too long they may be injurious. Suitable preparations are preferably eleudron, cibazol, and globucide. If possible, the treatment should be applied by a medical officer.

Wounds endangered by gas oedema—and this means all large and deep muscle wounds—should, in addition to the local and oral treatment with sulfanilamide, also be treated with gangrene serum. At subsequent operations, for example resection of the ribs, empyema of the chest, secondary sutures, and late amputations, the new wound caused by the operation may be powdered adequately with sulfanilamides when bleeding has stopped.

The thoroughness of the surgical wound treatment should in no way be lessened even by the additional application of sulfanilamides.

Abdominal gunshot wounds can also be treated with sulfanilamide powder (about one tablespoon) or the sulfanilamide may be induced into the abdominal cavity in the form of an emulsion.

EXTRACTS FROM THE TESTIMONY OF PROSECUTION WITNESS JADWIGA DZIDO^[40]

DIRECT EXAMINATION

Mr. Hardy: Witness, what is your full name?

Witness Dzido: Jadwiga Dzido.

Q. Do you spell that J-a-d-w-i-g-a, last name spelled D-z-i-d-o?

A. Yes.

Q. Witness, you were born on 26 January 1918?

A. Yes.

Q. You are a citizen of Poland?

A. Yes.

Q. Have you come here to Nuernberg voluntarily to testify?

A. Yes.

Q. Would you kindly tell the Tribunal your present home address?

A. Warsaw, Garnoslonska 14.

Q. Witness, are you married?

A. No.

Q. Are your parents living?

A. No.

Q. What education have you received?

A. I finished elementary school and high school at Warsaw. In 1937 I started to study pharmacology at the University of Warsaw.

Q. Did you graduate from the University in Warsaw?

A. No.

Q. What did you do after you had finished school in the University of Warsaw?

A. I started studying pharmacology at the University, and then when I was studying the second year, the war broke out.

Q. What did you do after the war broke out?

A. In 1939 I was working in a pharmacy during the holidays.

Q. Were you a member of the Resistance Movement?

A. In the autumn of 1940 I entered the Resistance Underground.

Q. What did you do in the Resistance Movement?

A. I was a messenger.

Q. Then were you later captured by the Gestapo and placed under arrest?

A. I was arrested by the Gestapo on 28 March 1941.

Q. What happened to you after your arrest by the Gestapo?

A. I was interrogated by the Gestapo in Lublin, Lukow, and Radzin.

Q. And what happened after that?

A. In Lublin, I was beaten while naked.

Q. Did you then receive any further treatment from the Gestapo, or were you released?

A. I stayed in Lublin 6 weeks in the cellar of the Gestapo building.

Q. Then were you sent to the Ravensbrueck concentration camp?

A. On 23 September 1941, I was transported to the Ravensbrueck concentration camp.

Q. Were you told why you were sent to the concentration camp in Ravensbrueck?

A. No, I was not told.

Q. Were you ever given a trial in any German court?

A. Never.

Q. Who sent you to Ravensbrueck concentration camp?

A. All the prisoners in the prison at Lublin were sent there, and I went with them.

Q. Now will you tell the Court, Miss Dzido, in your own words what happened to you after you arrived at Ravensbrueck?

A. When I arrived in the Ravensbrueck concentration camp, I thought that I would stay there till the end of the war. The living conditions in the prison were such that we could not live there any longer. In the camp we had to work, but in the camp it was not so dirty, and there were not so many lice as used to be in the prison.

Q. What work did you do in the camp, Witness?

A. I did physical work inside or outside the camp.

Q. Were you ever operated on in the Ravensbrueck concentration camp?

A. I was operated on in November 1942.

Q. Will you kindly explain the circumstances of this operation to the Tribunal?

A. In 1942 great hunger and terror reigned in the camp. The Germans were at the zenith of their power. You could see haughtiness and pride on the face of every SS woman. We were told every day that we were nothing but numbers, that we had to forget that we were human beings, that we had nobody to think of us, that we would never return to our country, that we were slaves, and that we had only to work. We were not allowed to smile, to cry, or to pray. We were not allowed to defend ourselves when we were beaten. There was no hope of going back to my country.

Q. Now, Witness, did you say that you were operated on in the Ravensbrueck concentration camp on 22 November 1942? [See photographs, pp. 898-908.]

A. Yes.

Q. Now, on 22 November 1942, the day of this operation, will you kindly tell the Tribunal all that happened during that time?

A. That day the policewoman, camp policewoman, came with a piece of paper where my name was written down. The policewoman told us to follow her. When I asked her where we were going, she told me that she didn’t know. She took us to the hospital. I didn’t know what was going to happen to me. It might have been an execution, transport for work, or operation.

Dr. Oberheuser appeared and told me to undress and examined me. Then I was X-rayed. I stayed in the hospital. My dress was taken away from me. I was operated on 22 November 1942 in the morning. A German nurse came, shaved my legs, and gave me something to drink. When I asked her what she was going to do with me she did not give me any answer. In the afternoon I was taken to the operating room on a small hospital trolley. I must have been very exhausted and tired and that is why I don’t remember whether I got an injection or whether a mask was put on my face. I didn’t see the operating room.

When I came back I remember that I had no wound on my leg, but a trace of a sting. From that time I don’t remember anything till January. I learned from my comrades who lived in the same room that my leg had been operated on. I remember what was going on in January, and I know that the dressings had been changed several times.

Q. Witness, do you know who performed the operation upon your leg?

A. I don’t know.

Q. Now, you say that you had dressings changed. Who changed the dressings on your leg?

A. The dressings were changed by Drs. Oberheuser, Rosenthal, and Schiedlausky.

Q. Did you suffer a great deal while these dressings were being changed?

A. Yes, very much.

Q. Witness, will you step down from the witness box and walk over to the defendants’ dock and see if you can recognize anyone in that dock as being at Ravensbrueck concentration camp during the period and during the time that you were operated on?

A. (Witness points.)

Q. Will you point to the person again that you recognized, Witness?

A. (Witness points.)

Q. And who is that, Witness?

A. Dr. Oberheuser.

Mr. Hardy: May we request that the record so show that the witness has identified the defendant Oberheuser?

Presiding Judge Beals: The record will so show.

Mr. Hardy: Do you recognize anyone else in that dock, Witness?

Witness Dzido: Yes.

Q. Point out who else you recognize, Witness?

A. (Witness points.)

Q. Who is that, Witness?

A. This man I saw only once in the camp.

Q. Do you know who that man is, Witness?

A. I know.

Q. Who is that man, Witness?

A. Dr. Fischer.

Mr. Hardy: Will the record so show that the witness has properly identified the defendant Fischer as being at the Ravensbrueck concentration camp?

Presiding Judge Beals: The record will so show.

Mr. Hardy: Witness, do you have any other details to tell the Tribunal about your operation?

Witness Dzido: (No answer.)

Q. Witness, how many times were you operated on?

A. Once.

Q. When Dr. Oberheuser attended you, was she gentle in her treatment toward you?

A. She was not bad.

Q. Witness, have you ever heard of a person named Binz in the Ravensbrueck concentration camp?

A. I know her very well.

Q. Do you remember what time your friends were called to be operated on in August of 1943?

A. Yes.

Q. Will you kindly tell the Tribunal some of the details there and the names of the persons who were to be operated on?

A. In the spring of 1943 the operations were stopped. We thought that we could live like that till the end of the war. On the 15th of August a policewoman came and called ten girls. When she was asked what for, she answered that we were going to be sent to work. We knew very well that all prisoners belonging to our transport were not allowed to work outside the camp. The chief of the block where we were living was forbidden under capital punishment to let us outside the camp. That’s why we know that it was not true. We didn’t want to let our comrades out of the block. The policewoman came, and the assistants, the overseers, and with them Binz. We were driven out of the block into the street. We stood there in line 10 at a time and Binz herself read off the names of 10 girls. When they refused to go because they were afraid of a new operation and were not willing to undergo a new operation, she herself gave her word of honor that it was not going to be an operation and she told them to follow her.

We remained standing before the block. Then several minutes later our comrades ran to us and told us that SS men have been called for in order to surround them. The camp police arrived and drove our comrades out of the line. We were locked in the block. The shutters were closed. We were 3 days without any food and without any fresh air. We were not given parcels that arrived in the camp at that time. The first day the camp commandant and Binz came and made a speech. The camp commandant said that there had never been a revolt in the camp and that this revolt must be punished. She believed that we would reform and that we would never repeat it. If it were to happen again, she had SS people with weapons. My comrade, who knew German, answered that we were not revolting, that we didn’t want to be operated on because five of us died after the operation and because six had been shot down after having suffered so much. Then Binz replied: “Death is victory. You must suffer for it and you will never get out of the camp.” Three days later, we learned that our comrades had been operated on in the bunker.

Q. Now, Witness, how many women, approximately, were operated on at Ravensbrueck?

A. At Ravensbrueck 74 women were operated on. Many of them underwent many operations.

Q. Now, you have told us that five died as a result of the operations, is that correct?

A. Yes.

Q. And another six were shot down after the operation, is that correct?

A. Yes.

Q. Do you know why those other six were shot, Witness?

A. I don’t know.

Q. Witness, were any of these victims asked to volunteer for these operations?

A. No.

Q. Were any of them promised freedom if they would submit to operations?

A. No.

Q. When you were operated on, did you object?

A. I could not.

Q. Why?

A. I was not allowed to talk and our questions were not answered.

Q. Do you still suffer any effects as a result of the operation, Witness?

A. Yes.

Q. Were you ever asked to sign any papers with respect to the operation?

A. Never.

Q. When did you finally leave Ravensbrueck?

A. On 27 April 1945.

Q. Have you ever received any treatment since you have left Ravensbrueck in the last year?

A. Yes.

Q. Tell us what treatment you have received.

A. Dr. Gruzan in Warsaw transplanted tendons on my leg.

Q. When did he do that?

A. On 25 September 1945.

Q. Do you have to wear any special shoes, now, Witness?

A. Yes, I should wear them, but I can’t afford to buy them.

Q. What are you doing now, Witness? Are you working now, or what is your occupation?

A. I am now continuing my studies which I started before the war.

Q. I see. I will ask the witness to identify these pictures.

Mr. Hardy: This is Document NO-1082a, b, and c. I will pass these up to the Tribunal for your perusal. Were these photographs taken of you in Nuernberg in the last day or two, Witness?

Witness Dzido: Yes.

Q. Witness, would you kindly take your stocking and shoe off your right leg, please, and will you step out to the side and show the Tribunal the results of the operations at Ravensbrueck? (Witness complies.) That’s all, Witness, you may sit down.

Mr. Hardy: I have no further question on direct examination, your Honor.

Presiding Judge Beals: Is there any defense counsel who desires to cross-examine this witness?

Dr. Seidl (counsel for defendants Gebhardt, Oberheuser, and Fischer): I do not want to cross-examine the witness; however, I do not wish the conclusion to be drawn that my clients admit all the statements made by the witness.

EXTRACTS FROM THE TESTIMONY OF THE PROSECUTION EXPERT WITNESS DR. LEO ALEXANDER^[41]

DIRECT EXAMINATION

Mr. Hardy: Dr. Alexander, have you examined Miss Dzido before today?

Witness Dr. Alexander: Yes, sir, I did, on several occasions during the last 3 days.

Q. During your examination, did you have X-rays made of the patient’s legs?

A. I did, sir.

Mr. Hardy: At this time I will introduce Document NO-1091 which is the X-ray of the witness, Miss Dzido. We will pass two copies to the Tribunal and one copy to the Secretary General. Dr. Alexander, in the course of your diagnosis of these X-rays, will you kindly diagnose this X-ray in English and then repeat in German for the benefit of the defendants?

Witness Dr. Alexander: Yes, sir.

Q. Doctor, will you identify that X-ray which carried Document NO-1091?

A. Yes. This is the X-ray which included the lower two-thirds of the thigh bone, the femur, and the knee joint, and—

Mr. Hardy: I offer this X-ray as Prosecution Exhibit 215.

Q. Doctor, this X-ray you are referring to now is Document NO-1092?

A. This is Document NO-1091. The arrow points to the osteoporotic atrophy of the tibia. Document NO-1092 is the X-ray of the leg. It shows the fibula which is the smaller of the two larger bones of the leg, about in the middle between the area just mentioned under the bracket called “B”. On the side, looking toward the tibia is the osteoperiostitis of the periosteum. This group of marks is particularly severe in the smaller area which I have marked with the bracket “A”, which indicates a smaller area of the shaft of the tibia within the larger area of the disturbance marked as “B”. This alteration is indicative and consists of an ordinary inactive Coxa, which in view of the osteoperiostitis of the periosteum was probably an osteomyelitis process. However, there is no active osteomyelitis at the present examination of the right foot. In pictures 1093 and 1094, it shows arthritic changes of the cuniform navicula joints with narrowing of the joint spaces and increased marginal sclerosis. This has been marked in the X-ray with an arrow pointing to the joint. The other prints are the same. The prints have come out too dark, but it shows the condition clearly in the film.

This arthritis is due to the immobilization of the right foot. Secondary to the muscles and especially the paralysis of the perineal nerve. It is evidently arthritis of an immobilization nature which one sees also by inspection of the patient’s foot.

Q. Doctor, can you determine from your examination——

A. (Interposing) 1094—have I mentioned it?—shows the same as 1093 in a slightly different exposure. The marks are the same pointing to the most marked arthritis between the cuniform navicular joints.

Q. Doctor, in your opinion, from your examination of this patient can you determine what was the purpose of the experiment?

A. It appears that in this experiment a highly infectious agent was implanted, probably without the addition of a bacteria static agent such as sulfanilamide, and for that reason the infection got out of hand and became very extensive.

EXTRACTS FROM THE TESTIMONY OF DEFENDANT GEBHARDT^[42]

DIRECT EXAMINATION

Dr. Seidl: The experiments on Polish internees were carried out in such a way that, first of all, three series of experiments were performed on three groups of 12 persons each. Is that correct?

Defendant Gebhardt: Yes. What I wanted to solve by means of this second experimental group was the task given me in my orders, namely, the testing of the drugs prescribed. I definitely hoped in these experiments, which produced gangrene, that if there was anything in the sulfanilamide drugs, which I had reason to hope, then the advantages connected with one or the other drug would become apparent, and I would be able to discontinue the experiments. Of course, I could not stop at the initial instructions. I really had to go on to a localized and definite infection, and for that there is an internationally known precept, not discovered by us, which is to produce a locus minoris resistentia—that is to say, the place of least resistance—where germs combine with contact substances. So we did not insert dirt, glass, or earth, cruelly; the dirt in the wound was represented by sterile glass silicate; soil and textiles which would enter a wound were replaced by us through sterile cellulose, finely ground. You all know that if you cut yourself and a nonsterile piece of glass remains in the wound, if you do not move the spot, it will heal with the glass inside without any aggravated symptoms. The only effect it has is to produce a catalysis for the germs and a local obstruction to the flow of blood, and possibly to damage a few cells slightly. In other words, we produced inflammation in the safest way possible for such an experiment. That is an unquestionable scientific train of thought in this sphere. We proceeded in just that manner and in addition, we gave our sulfanilamide, or zeibazol 1., eleutron, and nitron. Two control persons, however, were not without protection, because they were taken care of in the old established way.

Now, don’t suggest that I should know the schedule or that there was some schedule regarding the supply of sulfanilamide used. A schedule is always bad in medicine because it is no longer original. One thing is characteristic, however, with sulfanilamides and that is that you give a big dose at the beginning, and here there is a question of whether it is correct to introduce it locally or to leave it open. Someone might mix it, somebody else might have a different combination and that is how we did it. I would be a bad scientist if I were to write down for you now that I knew exactly that they were all given in a certain manner on the third day, or that they are all like this and this now. It states expressly in Thomas’ statement, of course, that any prearranged table for the administration is wrong, and that we also cannot prescribe the correct way to apply these drugs. It was obviously clear that there was a strong impression made by sulfanilamides and, even in the first group, we were astonished to find a certain result, which is useful for the idea as such, but not for practical purposes. Among other things we immediately and simultaneously sprinkled a mixture of germs together with sulfanilamide powder into the wound. That was the only exception made in the first group and it didn’t produce any results at all. Now, if I were a bad scientist then I would have assumed that that, in itself, was a success. No matter whether it was the ultrasepsis or the powder we had used, I would have been satisfied, and I would have said, “Everybody now has to take a little bag of sulfanilamide along with him and powder the wounds with it immediately because we know that if they are inserted simultaneously into the wound—the germ and the drug—then there will be no inflammation.” Only in complete ignorance of wound conditions and war conditions could one adopt that point of view. The disadvantage of the sulfanilamide bag is that a man who is badly shot isn’t in a position to act; he would be lying somewhere badly wounded and not be able to do anything. On the other hand, of course, the position is that the surface of the wound can easily be powdered, but of course not right down to the very bottom of the wound, and we know particularly well that sulfanilamides when applied wrongly in this way have caused injury.

Q. The second group consisted of the 36 women, 3 times 12 women?

A. Yes. Infection, plus contact materials.

Q. Is it true that the Reich Physician SS, Dr. Grawitz, on 3 September 1942, when inspecting Ravensbrueck, demanded that the experimental conditions had to be made more severe in order to create conditions similar to wartime conditions?

A. At the beginning of September, on the basis of my report, I was called to Grawitz to report on the results which might be expected. Grawitz, and as I shall explain later, Stumpfegger, came to me at the beginning of September. Since Grawitz was coming to Ravensbrueck I turned up on the same day, so that Fischer could demonstrate the patients under my protection. That is the impression probably created repeatedly by the testimony of witnesses; they have to wait for a time, and then I say “These are the patients whom I operated on.” I assume the same description was given each time. Grawitz was able to prove to me that the effects were circumscribed and not of a war nature. And he was able to prove to me that I had obtained no clear medical information, only assumptions, and the clinical conditions resulting might perhaps be expected after surgery at home. For another reason, which can be seen from the documents, the argument became rather violent. Grawitz turned to Fischer, who presented the cases to him. At any rate he then said, unfortunately, that a speedy clarification had to be reached and that wounds similar to combat wounds had to be created, that is, a gunshot wound infected by earth and matter. Of course, I did not accept these conditions and I looked for some way to get the experiment into my own hands so that, using all safeguards, a higher degree of infection might be brought about, and the cases might still remain under my control. I did not want to give up and say, “I have not reached any conclusion,” thereby impliedly giving permission for wounds similar to combat wounds to be inflicted elsewhere. And so we arrived at the idea of tying off the arteries of the third group, which is also a customary means of bringing about a locus minoris resistentiae in international experimental technique.

Q. You did not carry out the order then?

A. No.

Q. Then how were the experiments continued in order to create severe local inflammation in warlike wounds?

A. We kept to our old technique, the infusion, that is an incision on the outer side of the calf far from the joint, where it is not under pressure, and where the cast does not hurt it. In other words, we chose the most suitable place according to all medical considerations. Then we administered the infection in a place where the circulation of the blood had been reduced.

Q. What do you know about the deaths, and why was there no amputation in these cases?

A. I believe that I can remember the three deaths very well. But I only remember three—I have always testified that—with all the things that have happened in the meantime and all the patients I have taken care of. It was not that Fischer or I overlooked an amputation, and it is certainly not true that an amputation can save the life of the patient in all cases of gangrene. As I remember the case histories, the most serious patient had a large abscess on the hip. Probably the corresponding glands had been affected. The infection on the calf and the abscess on the hip—what can I amputate? One can amputate when the infection is limited to the calf. We did not have such cases because we forced the infection to the place where we wanted it, but we were not able to prevent the infection spreading to a different area and running into the blood vessel as does happen occasionally. There are infections of the veins, and then the patient dies suddenly, and it is a definite risk to perform an operation because the power of resistance is on the borderline, hanging by a hair. If we perform such major operations to save the patient’s life, then you may assume that we would have undertaken an amputation, or would you assume that a surgeon of my experience does not know when he has to amputate? Unfortunately that is the first thing that an operative surgeon like Fischer learns in wartime, to amputate in time.

As far as I remember, the deaths were from an abscess of the glands, an inflammation of the veins, an inflammation of the blood vessels, and one died from general sickness, in spite of all transfusions. This happens in cases of infection when there is no possibility of stopping the infection by local surgery. But one cannot conclude that any medical measures which should have been taken were overlooked, because just by seeing a case history from a distance one cannot decide that at such and such a moment the patient should have been operated on. I am convinced that in these three cases which Fischer reported to me exactly, which I saw, and in which the therapy was discussed, that we certainly did not overlook anything. As far as one can humanly say, we did what we considered necessary.

I wanted to publish this result or to report it to the public from the beginning. Therefore, it was obvious from the very beginning, if you did not assume that I had any humane or surgical motives, that I did everything in order to be able to publish the results.

6. BONE, MUSCLE AND NERVE REGENERATION AND BONE TRANSPLANTATION EXPERIMENTS

a. Introduction

The defendants Karl Brandt, Handloser, Rostock, Gebhardt, Rudolf Brandt, Oberheuser, and Fischer were charged with special responsibility for and participation in criminal conduct involving experiments on bone, muscle, and nerve regeneration and experiments on bone transplantation (par. 6 (F) of the indictment). During the trial, the prosecution withdrew this charge in the case of Rudolf Brandt. On this charge the defendants Gebhardt, Oberheuser, and Fischer were convicted and the defendants Karl Brandt, Handloser, and Rostock were acquitted.

The prosecution’s summation of the evidence on these experiments is contained in its final brief against the defendant Gebhardt. An extract from this brief is set forth below on pages 392 to 396. A corresponding summation of the evidence by the defense on these experiments has been selected from the final plea for the defendant Gebhardt. It appears below on pages 396 to 399. This argumentation is followed by selections from the evidence on pages 400 to 418.

b. Selection from the Argumentation of the Prosecution

EXTRACT FROM THE CLOSING BRIEF AGAINST DEFENDANT GEBHARDT

Bone, Muscle, and Nerve Regeneration, and Bone Transplantation Experiments

These experiments were carried out in the Ravensbrueck concentration camp during the same period of time and on the same group of Polish inmates as the sulfanilamide experiments. (Tr. p. 1458.)

The defendant Fischer made the following statement about these experiments in his affidavit:

“After the arrival of Doctor Stumpfegger from general headquarters in the fall of 1942, Professor Gebhardt declared before some of his co-workers that he had received orders to continue with the tests at Ravensbrueck on a larger scale. In this connection, questions of plastic surgery which would be of interest after the end of the war should be clarified. Doctor Stumpfegger was supposed to test the free transplantation of bones. Since Professor Gebhardt knew that I had worked in preparation for my habilitation at the university on regeneration of tissues, he ordered me to prepare a surgical plan for these operations, which, after it had been approved he directed me to carry out immediately. Moreover, Doctor Koller and Doctor Reissmayer were ordered to perform their own series of experiments. Professor Gebhardt was also considering a plan to form the basis of an operative technique of remobilization of joints. Besides the above, Doctors Schulze and Schulze-Hagen participated in this conference.

“Since I knew Ravensbrueck I was ordered to introduce the new doctors named above to the camp physician. I was specially directed to assist Doctor Stumpfegger, since, as physician on the staff of Himmler, he would probably be absent from time to time.

“I had selected the regeneration of muscles for the sole reason because the incision necessary for this purpose was the smallest. The operation was carried out as follows:

“Evipan and ether were used as an anaesthetic, and a 5 centimeter longitudinal incision was made at the outer side of the upper leg. Subsequent to the cutting through the fascia, a piece of muscle was removed which was the size of the cup of the little finger. The fascia and skin were enclosed in accordance with the normal technique of aseptic surgery. Afterwards a cast was applied. After 1 week the skin wound was split under the same narcotic conditions, and the part of the muscle around the area cut out was removed. Afterwards the fascia and the sewed-up part of the skin were immobilized in a cast.” (NO-228, Pros. Ex. 206; Tr. p. 774.)

The responsibility of the defendant Gebhardt for these experiments is also proved by the affidavit of Oberheuser. She stated:

“The experiments with bone transplantations were carried out, as far as I can remember, at the end of 1942 and beginning of 1943 by Dr. Stumpfegger of Hohenlychen. I helped Dr. Stumpfegger in the same way as I helped Dr. Fischer with the sulfanilamide experiments, and as I have described already in paragraph 4 of this affidavit. Before the operation I had to examine, as in the other case, the condition of health of the selected persons. The operations consisted of the removal and transplantation of a piece of the bone from the tibia. Fifteen to twenty persons were used for these experiments.

“The persons necessary for these experiments were requisitioned by Dr. Schiedlausky from the camp commander.

“Dr. Karl Gebhardt was in charge of the sulfanilamide experiments and bone transplantations. I do not know whether he himself performed operations of this type. But I know that all these experiments were performed under his direction and supervision and upon his instructions. He was assisted by the doctors already mentioned, Dr. Fischer and Dr. Stumpfegger, and also by Drs. Schiedlausky and Rosenthal. Also only healthy Polish prisoners were used for these experiments.

“I cannot remember that a single one of the experimental subjects used was pardoned after the completion of the experiments.” (NO-487, Pros. Ex. 208.)

The witness Maczka, a graduate of the Medical School of the University of Krakow and a practicing physician, testified that in the course of her duties as X-ray technician in the Ravensbrueck concentration camp she had occasion to observe approximately 13 cases in which experimental operations were performed on the bones of inmates. There were three kinds of bone operations—fractures, bone transplantations, and bone splints. Some of the Polish girls were operated on several times. In the case of Krystyna Dabska, Maczka took X-ray pictures of both legs and discovered that small pieces of the fibulae had been removed. In the case of one leg the periosteum had also been taken out. Zofia Baj was operated on in a similar manner. Janina Marczewska and Leonarda Bien were subjected to the bone fracture experiments. The tibia was broken in several places and in the case of one of the girls, clamps were applied while in the case of the other they were not. These operations impeded the locomotion of the girls operated on. Bone incision operations were performed on Barbara Pietczyk, a Polish girl 16 years old. She was operated on six times. During the first operation incisions were made in each tibia. During a later operation pieces of the tibia were cut out where incisions had been previously made. Maczka took an X-ray of the pieces of tibia that were removed. As a result of these bone operations, Maczka observed the development of two cases of osteomyelitis, Maria Grabowska and Maria Cabaj. (Tr. pp. 1445-7.)

A rather large group of muscle experiments were performed. Here again multiple operations were carried out on the same subject. Gledziewjowska was operated on most frequently. During the first operation certain muscles were removed and during subsequent operations additional pieces were cut out, always at the same place, so that the legs got thinner and weaker all the time. (Tr. p. 1447.)

Transplantation of whole limbs from one person to another was also carried out. Maczka testified that about 10 feeble-minded inmates were selected, taken to the hospital and prepared for operation. She knew personally that at least two of these persons were operated on. One case was a leg amputation. Following this operation, the experimental subject was killed and placed in a special room where the dead were kept. Maczka was able to observe the corpse and saw that there was only one leg. In the second case an abnormal woman was operated on by Dr. Fischer. When he left the operating room he carried with him a bundle wrapped up in linen about the size of an arm. He took this away with him. The prison nurse, Quernheim, informed Maczka that the whole arm with shoulder blade was removed from this woman. (Tr. p. 1448.)

The amputation of the arm and shoulder blade mentioned by Dr. Maczka obviously refers to the transplantation performed on the patient Ladisch at Hohenlychen. As to this, the defendant Fischer stated in his affidavit as follows:

“As a disciple of Lexer, Gebhardt had already planned long ago a free heteroplastic transplantation of bone. In spite of the fact that some of his co-workers did not agree, he was resolved to carry out such an operation on the patient, Ladisch, whose shoulder joint was removed because of a sarcoma.

“I and my medical colleagues urged professional and human objections up until the evening before the operation was performed, but Gebhardt ordered us to carry out the operations. Dr. Stumpfegger, in whose field of research this operation was, was supposed to perform the removal of the scapula at Ravensbrueck and had already made initial arrangements for it. However, because Professor Gebhardt required Doctor Stumpfegger to assist him in the actual transplantation of the shoulder to the patient Ladisch, I was ordered to go to Ravensbrueck and perform the operation of removal on that evening. I asked Doctors Gebhardt and Schulze to describe exactly the technique which they wished me to follow. The next morning I drove to Ravensbrueck after I had made a previous appointment by telephone. At Hohenlychen I had already made the normal initial preparation for an operation, namely, scrubbing, etc., merely put on my coat, and went to Ravensbrueck and removed the bone.

“The camp physician who was assisting me in the operation continued with it while I returned to Hohenlychen as quickly as possible with the bone which was to be transplanted. In this manner the period between removal and transplantation was shortened. At Hohenlychen the bone was handed over to Professor Gebhardt, and he, together with Doctor Schulze and Doctor Stumpfegger, transplanted it.” (NO-228, Pros. Ex. 206.)

Gebhardt admitted that he, together with Stumpfegger, personally performed the bone transplantation operation on Ladisch. He testified further that Fischer only removed the scapula, shoulder blade, from the Polish female inmate at Ravensbrueck. (Tr. p. 4235.) It is impossible to raise the arm above the horizontal if the scapula has been removed. (Tr. p. 4235.) Gebhardt further admitted that Stumpfegger reported to him on the bone experiments in Ravensbrueck concentration camp. (Tr. p. 4235.)

The affidavit of Gustawa Winkowska corroborates the testimony of Maczka concerning the transplantation of whole limbs and establishes that the experimental subjects were later killed. (NO-865, Pros. Ex. 231.)

The witness Karolewska was a subject in both the sulfanilamide and bone experiments. (Tr. pp. 833, 836-7.) She was operated on a total of six times. The first operation was conducted on 14 August 1942 by Fischer. (Tr. p. 819.) Gebhardt inspected her early in September. (Tr. p. 821.) She was sent back to her block on 8 September 1942, but was unable to walk and remained in bed for a week. On 16 September 1942 she was again taken to the hospital and operated on for the second time by Fischer. (Tr. pp. 821-2.) She left the hospital on 6 October 1942 and remained in bed for several weeks. Her leg did not heal until June 1943 (Tr. pp. 822-3). She filed a written protest with the camp commander, together with other experimental subjects in February 1943. In August 1943 she was operated on literally by force in the bunker at Ravensbrueck. Both her legs were cut open. These operations were carried out on five other Polish girls under indescribably filthy conditions. On 15 September 1943 a further operation was performed on her right leg by a doctor from Hohenlychen. Two weeks later her left leg was operated on and pieces of the shinbone were removed. She stayed in the hospital for 6 months—until the end of February 1944. (Tr. pp. 828-9.) Karolewska identified the defendants Gebhardt, Fischer, and Oberheuser as having participated in the experiments on her. (Tr. pp. 818, 830.)

The defendant Fischer participated in these experiments until at least 23 February 1943. On that date he carried out a second operation on Zofia Baj. (NO-871, Pros. Ex. 227.)

The most disgusting series of operations were those carried out in August 1943 in the bunker. The Polish girls selected had revolted and refused to report to the hospital. The barrack block in which they had barricaded themselves was then surrounded by male guards who carried these women off forcibly to the camp prison, known as the Bunker, where they were held down by these male guards and forcibly anaesthetized without any pre-operative care, and with their bodies still in a filthy condition from walking around the camp. The experimental subject Piasecka stated in her affidavit as follows:

“I resisted and hit Trommer in the face and called him a bandit. He called some SS male guards who threw me on the floor and held me down while ether was poured over my face. There was no mask. I fought and resisted until I lost consciousness. I was completely dressed and my legs were filthy dirty from walking in the camp. As far as I know my legs were not washed. I saw my sister during this time unconscious on a stretcher, vomiting mucous.” (NO-864, Pros. Ex. 229)

Piasecka stated that this operation was carried out by Dr. Villmann who was an assistant doctor at Hohenlychen. A few weeks later two other assistant doctors to Gebhardt came and operated on her right leg. (NO-864, Pros. Ex. 229.)

In his testimony Gebhardt attempted to disassociate himself from these experiments. He admitted however that he received information from Stumpfegger about the experiments. (Tr. pp. 4082, 4087-9.) Stumpfegger was a former assistant of Gebhardt’s and he stayed at Hohenlychen during the course of these experiments. Fischer assisted Stumpfegger and Gebhardt. (Tr. pp. 4230, 4090.) It is further established by Fischer’s own affidavit that the plan for the experiments was worked out with the knowledge and approval of Gebhardt.

c. Selection from the Argumentation of the Defense

EXTRACT FROM THE FINAL PLEA FOR DEFENDANT GEBHARDT^[43]

The Experiments Concerning Bone, Muscle, and Nerve Regeneration and Bone Grafting

The defendant Gebhardt is also charged in the indictment with particular responsibility in the experiments, whose object according to the indictment was the examination of the conditions under which the regeneration of bones, muscles, and nerves resulted, and under what conditions the grafting of bones was possible.

With regard to the general reasons why there can be no question of guilt, I refer to the statements I have already made in connection with the sulfanilamide experiments. These experiments, too, were occasioned by conditions of war and were to open up new ways of treating seriously wounded persons.

The evidence, however, has shown that the defendant Gebhardt, with a single exception, had nothing to do with these experiments. These experiments, insofar as they were concerned with the regeneration and grafting of bones, were carried out by Sturmbannfuehrer Dr. Stumpfegger. It is correct that Dr. Stumpfegger was assistant doctor in the clinic in Hohenlychen before the war, and to that extent subordinate to its chief doctor, Dr. Gebhardt. Dr. Stumpfegger, however, left in the early years of the war, and in the year 1942 became consulting physician to Reich Leader SS Himmler and later consulting physician to Hitler. The experiments carried out by him in Ravensbrueck were carried out on his own responsibility, and upon direct orders from the Reich Leader SS Himmler. Dr. Stumpfegger at that time was neither under the military nor the medical supervision of the defendant Karl Gebhardt. For the remainder, Dr. Stumpfegger limited himself to carrying out experiments in the removal and grafting of so-called bone splinters, the exact number of which can no longer be determined now, but which certainly did not exceed six to eight. These were aseptic operations, which constituted no danger to the life of the experimental subjects. The evidence has shown that the experimental subjects from whom the bone splinters were removed suffered no reduction in the function of their limbs. Besides, the examination of the transplantation process of bones achieved a research result that could not be attained from the animal experiments because of the variety of the stipulated regeneration areas caused by the location of the various species and for the other reasons given by Gebhardt.

The evidence has further shown that the experimental subjects were members of the resistance movement who had been condemned to death and who were in this way given an opportunity to obtain a pardon, and so to escape execution. In view of the fact that no direct responsibility for these experiments falls on the defendant Gebhardt, it is not necessary to go into the purpose of these experiments further at this time. It should, however, be emphasized once more that the experiments were to open up new possibilities in wartime surgery and restorative surgery on the wounded. In 1944, Dr. Ludwig Stumpfegger published the results of his experiments in the periodical for surgery the editor of which was Geheimrat Dr. Sauerbruch (vol. 259, issue 9-12) and this article was also made available to the public in book form. I have submitted to the Court (Gebhardt, Fischer, Oberheuser 6, Gebhardt, Fischer, Oberheuser Ex. 9) a review of this work in the periodical, “Clinic and Practice” of February 1946 and refer to this for the details.

The defendant Karl Gebhardt would certainly not have hesitated to admit his responsibility for these experiments if he had actually been more closely connected with them, and if the experiments had taken place at his behest or under his medical supervision. There would have been little reason to deny this responsibility since the experiments concerned were completely without danger; they resulted in no reduction of the function of the limbs, and, moreover, no fatalities occurred. Furthermore, corresponding to the general practice in Germany, the work of Dr. Stumpfegger under the scientific responsibility of the defendant Gebhardt would have been made public if he had been directly concerned with the experiments, and if they had been carried out under his scientific supervision. Nor did the evidence prove that there were any experiments carried out in connection with muscle and nerve regeneration under the scientific supervision and by order of the defendant Gebhardt. It even seems doubtful that any such experiments were ever carried out in Ravensbrueck. The witnesses called before this court were unable to make any statements about this matter and it may be taken for granted that in any case the defendant Karl Gebhardt had nothing to do with these experiments. There was no point in carrying out such experiments as, long before the war, the surgical technique had already been developed on scientific principles and set down in a system. It covers plastic surgical bone regeneration but does not advocate free transplantation.

The only new field of scientific research taken up by Dr. Gebhardt during the war was that of experiments connected with nerve operations. These experiments were, however, carried out on animals by the special order and under the scientific supervision of the defendant Gebhardt himself. I am here referring to the affidavits given by the witnesses Koestler (Gebhardt, Fischer, Oberheuser 22, Gebhardt, Fischer, Oberheuser Ex. 21) and Brunner (Gebhardt, Fischer, Oberheuser 21, Gebhardt, Fischer, Oberheuser Ex. 20), and to the statements made by the defendant Gebhardt himself on the witness stand. I am further referring to the report of the Third Session East of the Consulting Specialists on 24-26 May 1943 (Gebhardt, Fischer, Oberheuser 3, Gebhardt, Fischer, Oberheuser Ex. 10) which I have presented in Court and which proves that during this session he himself and the aforementioned witness, Dr. Koestler, spoke about grafting operations in cases of nervous paralysis. This is the same report to which the witness Dr. Koestler referred in his affidavit of 27 February 1947.

Furthermore, I wish to draw the attention of this Court to the lecture given by the defendant Gebhardt in the same report on “Gymnastic Therapy and Mobilization of the Joints” which is also based upon clinical experience in Hohenlychen and also has nothing whatever to do with medical experiments on human beings. The evidence has further proved that the defendant Gebhardt was concerned with the transplantation of bones in one case only. This experiment was the free transplantation of a shoulder blade from one person to another. The defendant Gebhardt has given a detailed account of this on the witness stand and I am referring you to his statement on this point. Generally speaking, the following has to be added: The free transplantation of bones from one person to another is one of the great problems of restorative surgery which has yet to be solved. For decades, physicians have been trying to find a solution to this problem. As early as the end of the First World War, Geheimrat Lexer, the great teacher of the defendant Gebhardt, conducted experiments along these lines in 23 cases, aiming at the replacement of completely destroyed bones. The terrible injuries which occurred during the Second World War made this problem still more urgent and it is, therefore, understandable that in view of the progress Dr. Stumpfegger had made in his research, he was ordered by the Reich Leader SS to make use of this research result in the direct transplantation of bones. The defendant Gebhardt himself did not take any steps in this direction. He himself has stated his fundamental attitude as to this question and I refer to his own statements. Only in one case did he give his approval, viz: when Dr. Stumpfegger carried out the experiment of transplanting a shoulder blade. The order to do this was given by the Reich Leader SS. This experiment was justified in this particular case as it took place for the benefit of a patient in serious danger. The experimental person from whom the shoulder blade was taken was also a member of the resistance movement and she, too, thus escaped execution. Furthermore, the shoulder blade in question belonged to a hand restricted in its function.

d. Evidence

Prosecution Documents

Doc. No.Pros. Ex. No.Description of DocumentPage

NO-875230Affidavit of Mrs. Zdenka Nedvedova-Nejedla, M. D., of Prague, concerning experimental operations conducted on fellow inmates at Ravensbrueck concentration camp.400

NO-861232Affidavit of Sofia Maczka, 16 April 1946, concerning experimental operations on inmates of the Ravensbrueck concentration camp.402

NO-579288Phosphorous burns artificially inflicted on inmates of the Buchenwald concentration camp. (See Selections from the Photographic Evidence of the Prosecution.)904

Defense Documents

Doc. No.Def. Ex. No.Description of DocumentPage

Gebhardt, Fischer, Oberheuser 6Gebhardt, Fischer, Oberheuser Ex. 9Extract from “Clinic and Practice”, weekly journal for the practicing physician, regarding bone transplantation.405

Gebhardt, Fischer, Oberheuser 21Gebhardt, Fischer, Oberheuser Ex. 20Extracts from affidavit of Dr. Karl Friedrich Brunner, 14 March 1945, concerning scientific experiments conducted at the clinic of Hohenlychen.407

Gebhardt, Fischer, Oberheuser 22Gebhardt, Fischer, Oberheuser Ex. 21Extract from affidavit of Dr. Josef Koestler, 27 February 1947, concerning Dr. Gebhardt’s activities.408

Testimony

Extracts from the testimony of prosecution witness Miss Karolewska409

Extract from the testimony of the prosecution expert witness Dr. Leo Alexander.417

TRANSLATION OF DOCUMENT NO-875

PROSECUTION EXHIBIT 230

AFFIDAVIT OF MRS. ZDENKA NEDVEDOVA-NEJEDLA, M. D., OF PRAGUE, CONCERNING EXPERIMENTAL OPERATIONS CONDUCTED ON FELLOW INMATES AT RAVENSBRUECK CONCENTRATION CAMP

1. I, Zdenka Nedvedova-Nejedla, M. D. came to Ravensbrueck concentration camp in a transport from Auschwitz on 19 August 1943, and I worked in the sick bay as a doctor prisoner from September 1943 until 30 May 1945. In the beginning I worked in the Department for Contagious Diseases at Station No. 1 and the Ambulatory. Besides this, I was in charge of Sucking Block from the fall of 1944 until May 1945.

2. Of the victims of experimental operations, I nursed personally Helena Piasecka, who was suffering from chronic osteomyelitis after completed operation of both shin bones. I knew that these operations were performed under Professor Gebhardt’s supervision by Doctor Fischer, and a woman, Doctor Oberheuser, from the SS Hospital Hohenlychen, but I do not know which one of them had operated on Piasecka. The operation was performed in the “bunker,” camp prison, where there were not even the most primitive sanitary installations and even fewer aseptic installations. Her general condition was good, but the defect in both bones made her an invalid for life. Before the operation Piasecka was completely healthy.

3. All women on whom experimental operations had been performed were placed in one block and they were generally known as “rabbits,” so that I saw the effects of the operations on those women who had survived them. In each case of abbreviation of limbs, muscular atrophy of the highest degree set in, proving a grave injury of nerves during operations and deep indrawn scars where parts of muscles had festered away.

4. From lay reports of nursing personnel without any special training, I tried to construct the types of experimental operations.

a. Culture of virulent germs (streptococci, staphylococci, maybe even tetanus and gas phlegmon) were injected subcutaneously, intramuscularly, and even directly into bones. These were the attempts to produce osteomyelitis experimentally. The resulting sepsis was checked by daily examination of the blood and urine to test the effectiveness of new medicaments of the sulfanilamide group.

b. Parts of long bones, as much as 5 centimeters (fibulae and tibiae), were removed and in some cases replaced by metal or left without connection. These operations were probably to prove the inability of bone to grow without periosteum.

c. High amputations were performed; for example, even whole arms with shoulder blade or legs with osiliaca were amputated. These operations were performed mostly on insane women who were immediately killed after the operation by a quick injection of evipan. All specimens gained in operations were carefully wrapped up in sterile gauze and immediately transported to the SS hospital nearby (Hohenlychen presumably), where they were to be used in the attempt to heal the injured limbs of wounded German soldiers.

5. Operations were performed on 1 Yugoslav, 1 Czech, 2 Ukrainian, 2 German, and about 18 Polish women, of whom 6 were operated on by force in the bunker with the help of SS men. Two of them were shot after their operation wounds had healed. After operations, no one except SS nurses was admitted to the persons operated on, whole nights they lay without any assistance and it was not permitted to administer sedatives even against the most intensive postoperational pains. From the persons operated on, 11 died or were killed, and 71 remained invalids for life.

6. The report mentioned in paragraphs 3 to 5 was prepared on the basis of evidence given to me at Ravensbrueck in the autumn of 1943 by these fellow prisoners: Sofia Maczka, M. D., Poland; Isa Siczynska, medical student, Krakow, Poland; Jola Krzyzanowska, medical student, Krakow, Poland; Krisa Iwanska, medical student, Krakow, Poland; Emilie Skrbkova, medical student, Praha, Czechoslovakia; and Inka Katnarova, M. D., Hradec Kralove, Czechoslovakia.

TRANSLATION OF DOCUMENT NO-861

PROSECUTION EXHIBIT 232

AFFIDAVIT OF SOFIA MACZKA^[44], 16 APRIL 1946, CONCERNING EXPERIMENTAL OPERATIONS ON INMATES OF THE RAVENSBRUECK CONCENTRATION CAMP

Information concerning the experimental operations which took place in Ravensbrueck concentration camp.

The operations were carried out in the period between the summer of 1942 and the summer of 1943. The operations were conducted in the camp hospital, under the direction of Professor Dr. Gebhardt, SS Brigadefuehrer. Professor Gebhardt was the head of the Hohenlychen sanatorium at Hohenlychen (Mecklenburg). The operations were conducted with the help of Dr. Fischer, who was Professor Gebhardt’s assistant. There was also another assistant whose name I do not know. The following camp doctors participated in this matter: Dr. Herta Oberheuser, Dr. Rolf Rosenthal, Dr. Schiedlausky; all German nurses who were employed there at the time and two German prisoners (Schutzhaftgefangene), Gerda Quernheim and Fina Pautz, gave assistance. Polish political prisoners in protective custody, from the transports from Warsaw and Lublin, numbering 74, were chosen as victims. All those who were chosen were young, healthy, and well-built women. Many were college or university students. The youngest was 16 years of age, the oldest 48 years of age. The operations were to be carried out for scientific purposes, but they had nothing to do with science. They were carried out under horrible conditions. The doctors and the assisting personnel were not trained properly medically. Conditions were neither aseptic nor hygienic. After operations, the patients were left in shocking rooms without medical help, without nursing or supervision. The dressings were made according to the whim of the doctors with unsterilized instruments and compresses. Dr. Rosenthal, who did most of the dressings, excelled himself in sadism. In the summer of 1943 the last operations were carried out in the “bunker”. “Bunker” is the name of the horrible prison in the camp. The victims were taken there because they resisted, and there in the cell their dirty legs were operated on. This was the “scientific atmosphere” in which the “scientific” operations were carried out.

All operations were carried out on the leg and all under anesthetic. The operations were divided into two main groups:

1. Operations for infecting the patient.

2. Experimental aseptic operations.

The soft part of the calf of the leg was opened and the open wounds were infected with bacteria which were introduced into the wounds. The following were used: staphylococcus aureus, oedema malignum (clostridium oedematis maligni), gas gangrene bacillus (clostridium perfrim gens), and tetanus. Weronika Kraska was infected with tetanus. She died after a few days. Kazimiera Kurowska was infected with gas gangrene bacillus; she died after a few days. The following were infected with oedema malignum: Aniela Lefanowicz, Zofia Kiecol, Alfreda Prus, and Maria Kusmierczuk. The first three died after a few days; Maria Kusmierczuk survived the infection. She was lying ill for more than a year and became a cripple, but she is alive and is living evidence of the experiments. Mostly pyrogen stimulants were employed. The wounds were stitched after the infection and serious illness began. Many of the patients were ill for months and almost all of them became cripples.

Why did Professor Gebhardt, with his education, carry out these experiments? To test the new drugs of the German pharmaceutical industry; mostly cibazol and albucid were used. Even tetanus was treated in that way.

The results of the treatment were not checked, or if they were, it was done in such an inadequate and superficial manner, that it was of no value.

The aseptic, experimental operations consisted of bone experiments, muscle experiments, and nerve experiments.

The bone experiments were checked by X-ray photographs. As ward attendant I had to do all the X-ray photographs. In this way I was given the opportunity of gaining an insight in this matter. The following were carried out: (a) bone breaking; (b) bone transplantation; and (c) bone grafting.

a. On the operating table, the bones of the lower part of both legs were broken into several pieces with a hammer, later they were joined with clips (for instance Janiga Marczewska) or without clips (for instance Leonarda Bien) and were put into a plaster case. This was removed after several days and the legs remained without plaster casts until they healed.

b. The transplantations were carried out in the usual way, except that whole pieces of the fibula were cut out, sometimes with periosteum, sometimes without periosteum. The most typical operation of this kind was carried out on Krystyna Dabska.

c. Bone grafting. These operations were with the school of Professor Gebhardt. During the preparatory operation two bone splints were put on the tibia of both legs; during the second operation such bone splints were cut out together with the attached bones and were taken to Hohenlychen. As a supplement to the bone splint operations such operations were also carried out on two prisoners in protective custody who suffered from deformation of bones of the osteomyelitis type. These two were not Poles, one of them was a German who was a Jehovah’s Witness, Maria Konwitschka, and the other was a Ukrainian, Maria Hretschana. It was interesting for Professor Gebhardt to see how the diseased bones would react to such an operation.

The muscle experiments consisted of many operations, always on the same spot, the upper or lower part of the leg. At each further operation larger and larger pieces of muscles were cut out. Once a small piece of bone was planted into a muscle (this happened to Babinska). During nerve operations parts of nerves were removed (for instance Barbara Pytlewska).

What problem did Professor Gebhardt and his school wish to solve by these experiments? The problem of the regeneration of bones, muscles, and nerves.

Was the thing carried out? No. It was not checked at all, or only insufficiently. I do not know what was done at Hohenlychen with those pieces of bone, muscle, and nerves which were cut out and taken there.

What was the fate of the patients after they left the hospital? Almost all of the patients became cripples, and suffered very much as a result of these operations. Even more severe was the moral torture inflicted on them since they lived under the conviction that they would all be shot in order that they should not be evidence of these murderous operations. The camp authorities—Commandant Suhren, Adjutant Braeuning and Chief Supervisor Binz—ensured through their orders that the victims should not forget that they were condemned to death. In the meantime, six of the patients were shot after surviving the operations.

As a supplement to these operations I am submitting a description of “special operations” which were carried out at the same time.

A few abnormal prisoners (mentally ill) were chosen and brought to the operating table, and amputations of the whole leg (at the hip joint) were carried out, or on others, amputation of the whole arm (with the shoulder blade) were carried out. Afterwards the victims (if they still lived) were killed by means of evipan injections and the leg or arm was taken to Hohenlychen and served the purposes known to Professor Gebhardt. Ten such operations, approximately, were carried out.

During the whole of the time these operations were carried out, I was employed as a worker in the ward and investigated this matter risking my own life, with the idea that it was my duty, if I were saved, to tell the truth to the world. I conclude my statement with two questions: What kind of recompense can the world offer to those who were operated on in such a manner? What kind of justice has the world for those who carried out such operations?

[Signed]Dr. Maczka, Zofia

Dr. med. Zofia Maczka

X-ray specialist from Krakow. Former political prisoner in protective custody No. 7403 at Ravensbrueck, now in Stockholm, Serafimerlasarettet, Roentgen.

Stockholm, 16 April 1946

TRANSLATION OF GEBHARDT, FISCHER, OBERHEUSER

DOCUMENT 6

GEBHARDT, FISCHER, OBERHEUSER DEFENSE

EXHIBIT 9

EXTRACT FROM “CLINIC AND PRACTICE”, WEEKLY JOURNAL FOR THE PRACTICING PHYSICIAN, REGARDING BONE TRANSPLANTATION

Editors: Dr. Herbert Volkmann and Dr. V. E. Mertens, Munich 2, Alfonsstrasse 1

No. 1 Munich, February 1946 Volume 1

[page 12]

Discussions and extracts

[page 14]

Surgery

Ludwig Stumpfegger—Hohenlychen: The free autoplastic bone transplantation in the restorative surgery of limbs—experiences and results.

During the past 10 years, 471 free autoplastic bone transplantations were carried out in Hohenlychen. Recent research results clearly showed that apart from the osteoplastic activity, a metaplastic formation of new bone occurs in the tissue. The newly formed bone trabeculae between transplant and old bone begin to connect with those formed in the osteoid tissue in the seventh week, and in this way constitute the bone connection between the graft and the original bone which have completely grown together in the ninth week. After the twelfth week no old bone can be detected in the entire region of the original graft, but only new bone trabecula. The question of the ever present hematoma can be answered in this way: a blood extravasation, lying in the gap between the transplant and the old bone, and not being subject to pressure, represents an adequate stimulation to the mesenchymal germinal tissue formation, while the large hemorrhage represents a negative stimulation and permits only a scarry connection of the transplant and the defective stump. The periosteum is no more important than the other layers, it is transplanted with the bone, because in connection with the bone it has osteogenetic properties, but above all it effects a speedy supply from the surroundings. A careful technique must be employed to spare the tissue layers, and bleeding must be stanched. Foreign bodies in the shape of wire slings to hold the transplant usually heal well into the body. Firm fixation in a plaster cast safeguards the result. When the graft has taken, a careful start with remedial exercises may be made in the third or fourth month. The clinical use of free bone transplantations is discussed with the help of numerous examples and many X-ray illustrations. The first task of the bone transplant to bridge over a gap in the bone is to provide sufficient support for the defective stump and, therefore, it has to be fairly strong. Bone splinters in the lower arm have roentgenologically completely taken after 1-1½ years, those in the tibia after 1½-2 years. The free bone transplant, some distance from the joints, has proved to be particularly valuable with the usual dislocations of the shoulder and the hip joints. The overlapping bone ridge prevents the bone from coming out of the articular cavity. In the course of years, the piece lying in the soft parts is considerably reduced, so that only a small bone ridge remains. The graft effects a regeneration of the damaged edge of the articular cavity and in this way prevents further dislocation. Bone transplants in bone gaps after removal of growths are subject to special conditions of taking. Hyperemic phenomena in the zone of the tumor edge in the form of a mild inflammation, possibly also fermentation processes, accelerate the taking of the transplant compared with the process in healthy tissue. Increased local resorption processes, occasionally with spontaneous fractures, infrequently prevail, but they again are apt to heal well. In wounds which heal with difficulty owing to suppurative inflammations, there is a great danger of the transplant being pushed out. When the whole transplant region is inflamed, total sequestration cannot be stopped. If suppuration remains localized, partial sequestration of the transplantation must be awaited. (German Surgical Journal, 1944, Vol. 299, H. 9-12. H. Floercken-Frankfurt am Main.)