-by HEDY EPSTEIN
Following is the draft text of Hedy’s presentation “Medicine Gone Awry: Not to Heal But to Destroy was Their Aim.”
Nuremberg Trial – General
After World Was II the Allied Forces organized the International War Crimes Trial in Nuremberg, Germany, for the purpose of trying and punishing those who committed war crimes. The most prominent Nazis, such as, Goering, Hess, and others were tried before this international tribunal in 1945/46. Following this trial, the American government conducted, in the same Palace of Justice in Nuremberg, what were called the Subsequent Proceedings. One of these proceedings dealt with the trial of physicians who performed medical experiments on concentration camp inmates of various nationalities. I participated in this trial. My responsibility was to find documentary evidence to be used in the trial. I will be talking to you about this.
As is well known, Hitler and his cohorts lacked in moral principles. The had no respect whatsoever for human rights. The Nazis operated on the basis of the immoral principle that “necessity knows no law,” a principle enunciated by Bethmann-Hollweg, an attorney and Chancellor of Germany (1904 – 1917.) It is also known that the Nazis promoted the unscientific ideology of the inequality of human beings, known as the mythology of the “Master Race.”
A great percentage of the German population not only accepted Hitler’s preachings, but also participated in its actualization and profited from it. Industrialists and business people financed and supported Hitler. Teachers and educators participated, in that they drilled German youths in Hitler ideologies.
True, there was resistance among certain groups and individuals, among workers and intellectuals. There were clergy who courageously spoke out against Hitler. But one must ask: Where were the ethical principles of the German medical community?
The Hippocratic oath was shamelessly violated over and over again by Nazi doctors. Many others were guilty because of their silence, which amounted to complicity. Thus the German medical profession was disgraced. It is important to know that this disgrace was not just due to a few crazy, psychologically perverted practitioners. Approximately 350 German physicians participated directly in medical experiments, many hundred more were aware of what was going on. All of them were educated, trained medical professionals. They were not medical practitioners in the military, who perhaps saw it as their responsibility to follow orders issued to them. A medical doctor, perhaps more than anyone else, has the opportunity not to carry out inhumane orders. That is certainly what medical ethics demand. Certainly it is not too much to expect that an academically trained person knows and understands were the profession of medical doctor ends and where inhumane, criminal activities begin. This has practical application today when one considers technology and genetics, etc.
As far as I know, there were no German doctors who expressed or acted in opposition. The opposition of even a singe, courageous German doctor might have prevented the terrible cruel experiments about which I learned in the process of my research for the trial of the doctors in Nuremberg. For instance, had German doctors offered resistance before World War II started, against the murder of mentally ill and incurable patients – the euthanasia program – perhaps the entire idea and technique of the subsequent gruesome murder of people may have been delayed or even been prevented altogether.
Looking at the criminal medical experiments of that time, raises the question: Did these experiments have any scientific value? I believe they had no scientific value and were only of minimal significance for medical research. Among the human experiments charged in the indictment were the following: high altitude, sustained low temperature, sea water (potable), typhus and infectious jaundice, sulfonamide and bone grafting, cellulitis, mustard gas, collection of skulls of Jews, mass sterilization, euthanasia of racial groups and undesirable patients.
High Altitude Tests
Normally people cannot stay at an altitude in excess of 20,000 feet without oxygen. Tests showed that at 26,000 feet test persons suffered altitude sickness and loss of consciousness up to 25 minutes. At 46,000 feet test persons suffered intense altitude sickness, loss of consciousness with spastic and flaccid paralysis, catatonic, stereotypy and retrograde amnesia lasting several hours. One of the witnesses, Walter Neff, a prisoner himself, reported that her observed 180-200 prisoners who were subjected to this experiment and 70-80 of them died. The rationale – fighting in the mountains.
Low Temperature Tests
The test persons were immersed in water, either naked or in full flying uniform, winter or summer. A life jacket prevented them from sinking. The water temperatures ranged from 36.5 to 53.5 degrees Fahrenheit. In some tests the back of the head and the brain stem were above water. In others, the brain stem and cerebellum were submerged. Temperatures as low as 79.5 degrees in the stomach and 79.7 degrees in the rectum were recorded electronically. The test persons died inevitably when the body temperature had declined to 82.5 degrees, despite rescue attempts. Rationale – flyers shot down over the channel – how long can they survive?
These experiments took place in the fall of 1944, near the end of the war. The German air force and navy were interested in the development of a method to make sea water potable since fliers might get shot down or make forced landings on the high sea. During the tests the test persons received only sea rations. Tests lasted from six to twelve days. Gypsies were used as test persons, though there was some question about their use since they were not considered “racially comparable” to the German population. Among the symptoms were: nervousness, a state of agitation, rising in some cases to frenzy. The delirious were tied to their beds. Some showed apathy and loss of consciousness, others had symptoms of heart trouble. Test persons suffered from gnawing hunger and dreadful thirst, which was only made worse by drinking the salt water. In desperation some test persons drank dirty water used in mopping the floors.
Knowledge of the typhus experiments is based essentially on the ward journals kept by an SS Captain, Dr. Ding-Schuler. Experiments were continuously conducted between January 1942 and April 1945. Persons were deliberately infected. Typhus epidemics existed independent of these experiments in various concentration camps at various times. The following manners of infections were used:
Two cc of fresh blood from typhus patients injected intravenously, intramuscularly, or subcutaneously. Others were infected by scarification or cutaneously by means of a vaccinating lancet. Those infected intravenously contracted typical and severe cases of typhus and died of circulatory failure. The other test persons had only minor complications, without showing the clinical picture of the disease.
In a letter to the SS leadership, a complaint was made about the suitability of the prisoners as test persons. Of 100 selected, 18 died on the way and only 12 of the remaining were in a physical condition that made them suitable. They could be restored to good health, but that would take three months. The writer therefore requested 100 more prisoners between the ages of 20 and 40, in good health and of physical quality that will make them good test material.
Infectious Jaundice Virus (Hepatitis Epidemica)
No clinical experimental documents dealing with the research on the virus of infectious jaundice were found. All that was established – from an exchange of correspondence – was that a demand was made for experiments on human beings to clarify the mode of transmission. There were no witnesses who had personal knowledge of such experiments. An article in the Munich Medical Weekly in 1942 makes reference to a thirty year old woman, inflicted with a not very extensive tubercular infection of lymph glands. She was given a cup of soup, containing 100 cc of urine from a patient and a little later again 25 cc of urine from another patient. Already after the last dosage “the tubercular lymph gland involvement began to flare up.”
Sulfonamide and Bone Grafting
These experiments, I believe were only carried out on women, began in 1942. A clinical summary of the operations carried out was given in a sworn affidavit by a Polish woman radiologist who was a political prisoner and worked as an assistant in the X-ray ward of the concentration camp hospital. According to her, infective operations and experimental aseptic operations were carried out.
In the first group the soft part of the calf was opened and the open wound infected with bacteria. Staphylococci, malignant edema, gas bacilli and tetanus were introduced. Some of the test persons died within a few days, others were ill for as long as a year, were crippled, but survived. Why? To test the new preparations of the German pharmaceutical industry. But the results of the treatments went uncontrolled or were controlled in such an inadequate and superficial way that they were of no value. In other similar experiments wood and glass were introduced into the wounds. Rationale – soldiers wounded in the field.
The second group consisted of bone, muscle, and nerve experiments. On the operating table bones of both legs were broken with a hammer into many pieces and then repaired either with and sometimes without bone clips. The legs were put in a cast for a few days and then remained without a cast until healed. In still other experiments bone transplants were made with entire pieces of the fibula being excised.
The muscle experiments consisted of several operations in the same place of the thigh or lower leg. In each subsequent operation additional sections of muscle were removed. On one occasion a piece of bone was implanted into the muscle.
In nerve operations sections of nerve were removed.
Dr. Herta Oberheuser, the only woman defendant in the trial, insisted that “only Polish nationals in full health” were used for experiments.
When learning of these experiments, Dr. Grawitz, Head Physician of the SS, stated the conditions did not sufficiently approximate conditions at the front, “the operations were mere flea bites,” that the purpose of the experiments was to test the effect of sulfonamides in gunshot wounds, therefore actual gunshot wounds would have to be inflicted.
When prisoners reached a state that made their imminent death likely, they were often killed by injections of gasoline, frequently administered by Dr. Herta Oberheuser. She used a 10 cc syringe and made the injection into an arm vein. The test persons reared up and suddenly collapsed. The time from the injection to death was three to five minutes with the test persons fully conscious to the last moment. Oberheuser stated the test persons were “all hopeless cases, incapable of cure.”
In these experiments cellulitis was created by artificial means to compare the effectiveness of allopathic and homeopathic therapeutic agents.
The purpose of these tests was to find the best therapeutic measures to combat mustard gas lesions. These measures were to be of practical service to German troops and perhaps to all German people. The prisoners slated for these experiments had to be in good nutritional conditions and ofter were placed on full rations for a few days before tests began. The prisoners were stripped naked, a drop of liquid was smeared on their upper arms. The test persons had to remain standing for one hour with their arms outstretched. After ten hours burns began to appear all over their bodies wherever vapor from the gas had reached. Some went blind. The pain was excruciating. Deaths occurred after the fifth or sixth day. Their bodies were dissected. The lungs and inner organs were completely eaten away.
Collection of Skulls of Jews
In a letter to SS Reichs Leader Himmler, Professor Hirt, Professor of Anatomy at Strassburg University, expressed research goals and a desire to accumulate a collection of skulls of Jewish-Bolshevist commissars. He stated that “voluminous collections of skulls exist of almost all races and peoples. Only in the case of Jews does science have so few at its disposal that no valid results can be arrived at from their study. The war in the East now affords us a chance to make up for this deficiency. By securing the skulls of Jewish-Bolshevist commissars, representing a repulsive, but typical species of sub-humanity, we stand to acquire tangible scientific research material.” He then spells out how this should be done, making sure “the head must not be injured.” This motivated Himmler to assign Ahnenerbe (Ancestral Heritage Society) to set up an “Institute for Military Scientific Research” to coordinate and support Hirt in every way in carrying out his skull collection. Himmler created Ahnenerbe in 1939 to develop “historical and scientific” studies of the Nordic Indo-Germanic race.” Sievers, Executive Secretary of Ahnenerbe, was entrusted with the direction of the institute. Sievers used to be a book dealer.
French forces liberated Strassburg near the end of the war and found many unprocessed and some partly processed corpses and processed skulls. Hirt disappeared and killed himself. Sievers was tried in Nuremberg, pleaded not guilty, but was found guilty and hanged.
Hitler’s interest in “eugenic” measures was in keeping with the whole program of the Nazi Party. As early as July 1933 the “Law for the Prevention of Progeny with Hereditary Disease” was promulgated. This was the starting point of development that led to the enforced “mercy death” for the incurably ill and insane in the 1930s and during the war to plans for exterminating races declared to be inferior, namely, Poles, Russians, Jews and gypsies. Relatives of patients considered socially unfit for life, who lost their lives as part of the euthanasia program received form letters.
The genesis of the sterilization experiments can be accurately traced. In the course of the war the Nazis and their ideology showed less and less restraint in the trend/goal toward the destruction of certain peoples. Several sterilization approaches were used: sterilization by medication, by X-ray, and by intrauterine irritation, surgical removal after X-ray. Sterilization was to not only conquer, but destroy “the enemy.” By 1941 it was an “open” secret in higher Party circles that the entire Jewish population of Germany and in the occupied territories was to be exterminated. In a 1941 letter to SS Reich Leader Himmler, from Vista Brack, Chief Administrative Officer in HItler’s private chancellery, he was not a physician (defendant in Nuremberg, death sentence) reported that “one installation could sterilize 150-200 persons per day, 20 installations some 3-4,000 per day.” He then goes on to give cost estimates. In summary, he states “the present state of X-ray technology and research without question permits mass sterilization by X-ray.” He describes how this can be done inconspicuously. The person to be “processed steps up to a window where he is asked questions or fills out certain forms. The official behind the window operates the X-ray equipment. I met a victim of X-ray sterilization while in Nuremberg.
The trial, knows as “The Case Against the Nazi Physicians,” since referred to s the Nuremberg Medical Trial, began in late 1946 when 23 German defendants were indicted before the war crimes tribunal in Nuremberg. Twenty of them were physicians, three of them were administrators, whose offices and work brought them in close touch with medical affairs. They stood accused of terrible crimes, involving murder and incredible experiments on human beings. The tribunal before which they were tried was established by authority of the four powers occupying Germany and under an enactment known as “Control Council Law Nr. 10,” one purpose of which was to “establish a uniform legal basis in Germany for the prosecution of war criminals and other similar offenders.” The tribunal was presided over by the following judges:
Walter B. Beals, Chief Justice of the Supreme Court of Washington State
Harold L. Sebring of the Supreme Court of Florida
Johnson T. Crawford, of the District of Oklahoma
The alternate judge was Victor C. Swearingen, former assistant attorney general of Michigan
The trial opened on December 8, 1946. James McHaney, an attorney from Little Rock, Arkansas headed the prosecution staff. He was assisted by attorney Alexander G. Hardy from Boston, Massachusetts. General Telford Taylor was Chief of Counsel.
In his hours long opening speech, Telford Taylor summarized the charges against the defendants. He said the proceedings will show that in most cases the purpose of the medical experiments was not to heal or to save lives, but instead the purpose was to find ways and means to destroy human lives. He went on, all of the defendants have in common a total lack of consideration, a total absence of human compassion and a total readiness or willingness to misuse their power over poor, unhappy and defenseless persons, who were deprived of all of their rights by a criminal government devoid of all pity. He also pointed out that the defendants were among the highest ranking leaders of the 3rd Reich, they were not military warlords, who started or kept the war machine rolling, nor were they leading industrialists of the war industry, nor were they politicians who brutalized the souls of the German people. But they and their actions made if frighteningly clear what the barbaric basic ideas of the Nazi ideology can lead to.
The defense counsels of those standing trial were Gernan, former members of the Nazi Bar. The defendants uniformly declared themselves as “not guilty.” I still shudder today when I recall how Karl Brandt, Hitler’s personal physician and responsible for the euthanasia program, blared his shrill, sharp, pointed military tone “Nicht schuldig” and “Jawoll” (not guilty and yes indeed) into the courtroom. German citizens were allowed in the visitors’ gallery in the hope that they would learn about the true face of the SS when hearing about their criminal acts.
I would like to just briefly describe a few of the defendants, some are personal observations.
Waldemar Hoven, camp physician in the concentration camp Buchenwald and Captain in the SS. It is said that whenever he infected a few dozen concentration camp inmates with spotted fever, he walked out of the operating room, cigarette in hand, whistling the melody of a German song, whose words are “…and once again a great day has gone by…”
Then there was diminutive Rudolf Brandt, Himmler’s personal assistant, who was so nervous and fearful during the trial, he was unable to eat the prison food and had to be put on a special diet, food he liked, so he could stand trial. He later was found guilty and received the death sentence.
Dr. Herta Oberheuser, physician in the women’s concentration camp Ravensbrueck. Her face was devoid of all emotion, her lips tightly pressed together. Even when one of the witnesses identified her as the person who operated on her, she remained completely unmoved.
Other defendants looked as inconspicuous as the kind of people who might sit next to you on a bus. Like for instance Gerhard Rose, with his funny little red beard. He was the Chief of Tropical Medicine at the Robert Koch Institute. When he was arrested in his home, he already had his suitcase packed, but not in preparation to come to Nuremberg. He was waiting to be picked up by someone else, he was supposed to come to the U.S. to do research here. Can you imagine his surprise and protestations when he learned why he was being picked up and where he was going?
Then there was Paul Rostock, with the typical jovial expression of a little self-important bureaucrat. He was Chief of the Office of Medical Science and Research.
The trial was conducted in German and English. It lasted 139 days. Judgement was rendered on August 19, 1947. Sentence was pronounced on August 20, 1947. The trail proceedings run to over 11,000 pages. Thirty-two witnesses gave oral evidence for the prosecution and fifty-three, including the twenty-three defendants gave oral evidence for the defense. Almost 1,500 documents, consisting of affidavits, reports and documents were received in evidence.
Sixteen of the 23 defendants were found guilty, seven not guilty. Seven were sentenced to death by hanging (3 of them non-physicians) (Karl Brandt, Gebhardt, Rudolf Brandt, Mrugrowsky, Sievers, Brack & Hoven) Life imprisonment sentences were imposed on five (Handloser, Rose, Schroeder, Genzken, Fischer). Herta Oberheuser, the only woman, 20 years, as well as Becker-Freysing. Beiglboeck 15 years. Poppendick 10 years. The other seven were acquitted & freed. (Rostock, Blome, Ruff, Romberg, Weltz, Schaefer & Pokorny).
To the very end none of them acknowledged that had done any wrong. The hangings took place on June 2, 1948 in the prison in Landsberg, the very place where Hitler had been imprisoned in the early 1920s and where he wrote his book Mein Kampf.
Karl Brandt, Hitler’s personal physician, had boasted he is “one German the Americans will never hang.” He offered his body for medical experiments. His offer was rejected. Next to the gallows he made his final speech, stating his conviction that his sentence was “nothing but political revenge…It is no shame to stand on this scaffold. I served my Fatherland as others before me.” He was 43.
Mrugrowsky shouted, “I die as a German officer sentenced by a brutal enemy and conscious I never committed the crimes charged against me.” He was 42.
Gebhardt, the 50 year old former head of the German Red Cross said, “I die without bitterness, but regret there is still injustice in the world.”
The last words of the others were not reported.
What Did I Do During These Proceedings?
Together with others I worked as a research analyst, looking for the documentary evidence to be used in the trial. We worked in a suburb of Berlin in what was a former Nazi document center, which was located deep underground in a clearing in the woods. A colonel in the the American army was in charge of the document center. He was of German origin. His brother was an officer in the German Army during the war. This colonel hated us. Perhaps he was opposed to the trials which took place in Nuremberg and perhaps he did not want the Nazi atrocities to become public knowledge, and maybe he hated us because most of us were former German and Austrian Jews who had fled from the Nazis. We never really found out why he hated us. In any case he made life very difficult for us. Some documentary evidence mysteriously disappeared at times. Was he responsible? We never found out. There were two ways to get in and out of the document center, by elevator and by stairs. He had the stairs bricked shut. Sometimes for hours he cut off the electricity. We sat helpless in the dark, could not work nor could we get out because the elevator used electricity. Despite that we did our work. We complained to Nuremberg. Since the center was under military administration, Nuremberg was powerless to do anything.
When we arrived the archive was in chaotic condition. All the documents had been removed from their hardback file folders and were in boxes on the floor. GIs, who spoke no German, removed the documents and placed them back in the file folders. Of course, they did not know what they were doing therefore the documents were filed away in no specific order and we had to search through them very carefully. While my primary task was to look for evidence to be used in the trial of the doctors, other co-workers searched for material to be used in other trials that were going to take place on or about the same time, namely trial of German industrialists who produced weapons and war material, I.G. Farben, and German judges. For instance, if I found a document that I felt was of importance for the trial of the doctors, I wrote a brief summary of the document and sent it together with the document to my superior, James McHaney, who headed the prosecution staff of the Medical Trial. If he felt the document was relevant, he had it translated by the Translation Division. Thus, most of my work was done in Berlin, though at times I was in Nuremberg and sat in on some of the court sessions.
I’d like to share with you some of my personal experiences as anecdotal information. Both before and during the trials, the defendants and certain witnesses (on loan) were housed in the Palace of Justice in Nuremberg. As I mentioned earlier the defendants were represented by German attorneys, most, if not all of them, former members of the Nazi Party. Occasionally when they met with their clients or witnesses, they were accompanied by a representative of the prosecution. One day I accompanied a German defense counsel as he interviewed a potential witness on loan to us by the British who were going to prosecute him later. Normally the defense counsel would have introduced me right away as a member of the prosecution, but he did not this time. He also had forgotten to bring with him some documents and went back to his office in the Palace of Justice to fetch them, leaving the witness and me alone. The witness was behind bars. The witness assumed I was the attorney’s secretary and asked me to mail a letter for him, a letter he did not wish to go through prison censorship. He promised to have me richly rewarded for doing this. I accepted the letter. When the German attorney came back, he apologized and introduced me as a representative from the prosecution. The witness was in shock. Despite his apologies and his pleas to return the letter to him, I kept the letter. It became a significant part of the evidence.
Another strange occurrence: some of the lesser significant persons in jail were after a while allowed to make weekend visits with their families. They had to be back on Sunday evening. One of them, who arrived punctually on Sunday evening was met by an American soldier who spoke no German and the prisoner spoke no English. The guard would not let him into the jail. So he had to spend the night somewhere in Nuremberg and was allowed back in only the following morning. He was reimbursed for his expenses when he presented a receipt.
Again on a more serious note, I would like to leave you with these thoughts, which are an outgrowth of my work in Nuremberg. Not only did I learn, but I hope the world has learned what happens when individuals permit themselves to be ruled by a false political ideology under the defense of political or personal expediency and superior orders. In one instance, Karl Brandt, Hitler’s personal physician, also in charge of the euthanasia program, spoke of “preeminent government interest” to which a physician must submit. Nazi fanatics thought of the SS (many of those tried were members of the SS) as a new aristocracy. Karl Gebhardt, President of the German Red Cross, stated the “SS was an instrument for the best and the worst.” This, the worst, became the model under which these individuals no longer made their own, the ultimate ethical and moral decisions, but followed orders, thus giving up all personal responsibility. What is the lesson to be learned from this? No one, not even when confronted with a dictatorial government, should permit him/herself to try to escape personal responsibility, especially not doctors who have given an oath which requires them to help and to heal people. Freedom, frivolously surrendered, comes home to roost in the shape of tyranny.
Fuehrer, tell us what to do! We’ll follow you. Fuehrer, order us to do whatever you wish! We’ll follow you blindly.
That is the route that can lead to Auschwitz. Don’t ever permit anyone to make you follow him/her blindly! That’s my advice to you. I understand the risk involved if you follow this advice. It’s usually easier to blindly follow authoritarian orders, and when things go wrong, to say: Those were their orders. That’s not my fault. That’s the simplest way out. But is it?
Always take responsibility for what you do. In fact, feel responsible even for what you fail to do.
I know there are some situations where you may think that certain things should happen, but why should I become involved? Someone else should do something about it. Perhaps you should be the someone else.
Realize & understand always, your personal sense of responsibility.
The philosopher/writer George Santayana said: “Those who ignore the lessons of the past, are condemned to repeat its errors.”
You, as future doctors, must not forget this lesson. As you enter the Hippocratic fellowship remember and be determined never to let such things happen again. View your patients not as cases, nor as numbers tattooed on an arm, as the Nazis did, nor as a number on a chart or a wristband, but as human beings.