Q. Now these various research tasks that were assigned to you-were they assigned to you by Professor Dr. Rostock of the Reich Research Council?
A. Research assignments were not received by me from the Reich Research Council. These were merely inquiries about proposals which may have come from any side and on the basis of my experiences I had to state my opinion. I myself, however, did not receive any certain research assignments. However, this was not the case in the case of hepatitis. During the Hepatitis work, after having worked on that for a long time, 1943 or 1944, I don't remember exactly, the Reich Research Council gave me such an assignment. I did not ask for that assignment. It was merely handed to me.
CORRECTION SHEET - Page 2742
Q Just a moment, witness. I am not interested in the nature of your assignment at this point. My question is: were these inquiries or tasks assigned to you -- did they originate from Professor Dr. Rostock?
A These were inquiries. I said inquiries. I said nothing about any c*** tain assignments. At least I do not remember anything about them. I just sa** they were inquiries about proposals which came from one side and it was my du*** to make statements about their execution. I gave you an instance before. Any ** medical officer might have suggested a certain form of typhus treatment. I subsequently was asked whether it was also my opinion that this typhus treatment should be used generally; experiences were to be collected on that point. That is just an example. These also eminated from professor Rostock.
Q Regarding yellow juandice, what are the dangers and possible complications of Hepatitis?
A I already stated the danger of Hepatitis during my previous examination. With reference to the life of the patient, the danger is very small. The figures shown in literature about so-called mortality in the case of jaundice is loss than one thousand, Jaundice, in itself, with reference to the mortality figure is a harmless disease. Jaundice, on the other hand, cannot be avoided through any safeguard whatever its nature may be. There is no possibility of preventing the infection and extension of that disease. The average length of illness is usually four to eight weeks. There are very easy cases where patients are restored to health within a few days and there arc more severe cases where patients arc yellow for weeks and sometimes months. During the war we learned aftereffects and complications of this disease are very very rare. Patients usually become ill, they feel badly. Generally, they have no pain, but after a certain period of time, as I said, six to eight weeks, they are completely restored to health.
Q Does it not often cause severe damage to the liver?
A That was a belief which was held before the war. Such cases occurred before the war sparadically, that is singly. In the case of these single diseases, there are certainly a number of cases of infectious jaundice. In the same way, however, there are quite a number of cases
A These were inquiries. I said inquiries. I said nothing about any certain assignments. At least I do not remember anything about them. I just said they were inquiries about proposals which came from one side and it was my duty to make statements about their execution. I gave you an instance before. Any medical officer might have suggested a certain form of typhus treatment. I subsequently was asked whether it was also my opinion that these typhus treatment should be used generally; experiences were to be collected on that point. That is just an example. These also eminated from Professor Rostock.
Q Regarding yellow jaundice, what are the dangers and possible complications of Hepatitis?
A I already stated that the danger of Hepatitis during my previous examination. With reference to the life of the patient, the danger is very small. The figure shown in literature about so-called mortality in the case of jaundice is less than one thousand. Jaundice, in itself, with reference to the mortality figure is a harmless disease. Jaundice, on the other hand, cannot be avoided through any safeguard whatever its nature may be. There is no possibility of preventing the infection and extension of that disease. The average length of illness is usually four to eight weeks. There are very easy cases where patients are restored to health within a few days and there are more severe cases where patients are yellow for weeks and sometimes months. During the war we learned after-effects and complications of this disease are very very rare. Patients usually became ill, they feel badly. Generally, they have no pain, but after a certain period of time, as I said, six to eight weeks, they are completely restored to health.
Q Does it not often cause severe damage to the liver?
A. That was a belief which was held before the war. Such cases cured before the war sporadically, that is, singly. In the case of these single diseases, there are certainly a number of cases of infectious jaundice. In the same way, however, there are quite a number of cases which have nothing whatsoever to do with the infectious jaundice.
These are liver inflictions of another kind which have existed from the very beginning and which may have been caused by food poisoning or other poisons. During the war we learned that the infectious disease leaves no damage to the liver. That is the result of a number of liver punctures as they were performed in a number of cases. They were performed in order to be able to tell the patient concerned, with certainty, that the liver damage during the jaundice, is completely over.
We physicians and also pathologists were very surprised at the changes of the liver as they occured during the jaundice period. They completely disappear within a relatively short period time. Pictures of the liver after jaundice has disappeared do not at all differ from the pictures of a normal liver.
Q What are the causes and conditions of death in Hepatitis?
A. In most cases, death during jaundice is not caused by jaundice itself, but by other diseases. For instance, if a person is heavily wounded, and then a so-called sepsis develops, and then he becomes infected with jaundice; the person concerned will die because of sepsis. In these cases where jaundice is added to another severe illness, one can always judge them as jaundice death cases. That is how it is done in literature. In reality, they are not dead because of jaundice unless one wants to put it that way. It is merely an optical science. A death case merely from jaundice is something which has never been observed with certainty.
Q Doctor, is there any difference between Hepatitis as it occurs in epidemics and sporadically and that produced by innoculation?
A May I repeat once more, did you ask me whether there was a difference between spontaneous disease and a disease caused by innoculation?
Q That is correct.
A Is that correct?
Q Yes. Is there any difference?
A. According to my opinion, there can be no difference. A differ once cannot be expected.
If the cause of jaundice against which I am innoculating is that very cause, the disease must be the same as the spontaneous disease. However, I have to add that there is a difference between an infection and a innoculation. You innoculate by means of a vaccine, that is to say, a dead excitor, a dead infector. During these innoculations, diseases of jaundice are not to be expected at all. If, however, the virulent cause is bein****red as in the case of animals and if it then infected into a human being, then the well-known jaundice comes about as it is known in its spontaneous cause.
Q Now witness, you have told me that during the course of the war, you did not know of a single case where a patient died from jaundice. How do you justify the fact from the document Dr. Nelte exhibited to you this morning? That is the letter from Grawitz to Himmler requesting permission to conduct these hepatitis experiments on human beings. These innoculations were to be made from virus cultures, and death cases were to be anticipated?
A I can only explain it by thinking that Grawitz, himself, was not sufficiently informed about jaundice, its cause and its danger. Grawitz was not a specialist in jaundice matters because Reichsarzt-AA, he was not in touch with practical medicine.
Q. Now, witness, is there any difference between hepatitis of man and that of experimental animals?
A. The differences are great. The animal, for instance-- well, let me start again, The animal experiments, the animal does not receive jaundice at all, does not contract it at all. The yellow coloring never appears in the case of tho animal. However, changes of the liver are noticeable in the case of the animal which was infected, and they arc very similar as in tie c so of a man who is infected with the same virus. Then there are further differences, I already said that yellow fever never has a fatal result, whereas in the case of animals, at any rate a part of them, die as a result of this disease. That is true as in the case of other comparisons between animal experiments and human experiments, namely that the external appearance of the disease in the case of man or animal by using the same virus can be completely different and in addition the danger of the animal disease and the human disease can differ completely, although one is concerned with the very same virus.
Q. Is hepatitis more dangerous in overworked or undernourished people?
A. Speaking on the whole the figures of the disease and its danger in the case of well nourished or undernourished people contracting jaundice are the same. When jaundice occurs as a complication of another severe infectious disease the cause of the original disease by virtue of the added jaundice is not influenced whatsoever. That is contrary, for instance, to other infectious diseases. I shall give you one example, typhus has a very definite course and we know mortality figures in the case of typhus. Now, if within such a typhus epidemic, and that is something that was frequently observed during the War, a jaundice epidemic comes into appearance in addition, so that people inflicted with typhus at the same time they are inflicted with jaundice then the typical cause of the typhus illness is not at all changed by this addition of jaundice and no larger amount of mortality figures can be observed during this typhus epidemic.
In the case of other infectious disease this is basically different, for instance if typhus diseased persons contract diptheria, which happens on numerous occasions, then this additional contraction of diptheria, this additional infection practically means a death sentence for the person concerned, whereas in the case of jaundice it is entirely different.
Q. What special facilities are necessary to treat hepatitis adequately?
A. The methods of the treatment of hepatitis can only be done on the basis of symptoms. I already mentioned earlier that there is a specific kind of therapy, -- that there is no specific kind of therapy, such as serum therapy. Many persons inflicted with hepatitis who are not severely ill received no treatment whatsoever, and in parts continued their civilian and military duties. In other cases they were told to go to bed and received a light diet. Sometimes there was some warm treatment. On the whole treatment of drugs showed no particular success in the case of jaundice.
Q. Considering the physical conditions of concentration camp inmates, and the hygienic conditions cf concentration camp hospitals, wouldn't it have been more dangerous to perform hepatitis experiments on concentration camp inmates than on well nourished volunteers?
A. In all the camps, and that included concentration camps, jaundice illnesses, spontaneous illnesses occurred to a large extent. I mentioned the jaundice epidemic, for instance, in prisoner of war camps. These were persons with a very much deteriorated constitution. They had endured hard a battles and they had a very bad nourishment, and even in the case of these spontaneous epidemics within the camps a higher mortality figure than the one already mentioned, or after effects which had complications of jaundice did not become known.
In the case of an entire division in Russia, which was sent from the Crimea to Northern Russia, I personally saw high disease rates of human beings who had deteriorated in health, who were undernourished, overworked and exhausted, and where the cause of jaundice was secondly the same as in the case of other human beings with good conditions of nourishment and who lived under good conditions.
Q. Are states of mental confusion or delirium ever associated with hepatitis?
A I personally didn't see it.
Q. Are any lasting or disappearing neurological changes ever associated with liver disease, and if so are they also associated with cases of hepatitis, especially in individuals who are undernourished or deficient in vitamins?
A. May I ask once more, what kind of a condition are you suggesting?
Q. I will repeat my question. Are any lasting or disappearing neurological changes ever associated with a liver disease, and if so are they also associated with cases of hepatitis, but especially in individuals who are undernourished and deficient in vitamins?
A. I know of no disease or nerve degenerations, and that is probably something that you mean by the neurological conditions, rather I didn't know of any such cases in dealing with hepatitis, and they are never described in literature. No matter whether the people concerned are healthy or strong, or whether in any way undernourished, and whether there is a deficiency in vitamins, we only know one disease that is a liver disease during the course of which at the same time neurological symptoms appear. This disease firstly is very rare, and secondly has nothing at all to do with hepatitis epidemica. We are not concerned with an infectious disease, but we are concerned with a primary simultaneous degeneration of liver tissues, and brain nerve tissues. For the most part these diseases are mostly hereditary.
Q. You have compared the liver punctures with the lumbar spinal and the sub-occipital puncture; isn't it true that with the various kinds of spinal puncture you only remove the fluid which surrounds the spinal cord or brain, while with the liver puncture you actually enter the organ itself; isn't that dangerous?
A. There are two cases here. In one case you take away some juice where tissues are available at the same time. That is in the so-called spine puncture. In the other case you only take tissues away. Now, you could compare the liver puncture with the so-called gland puncture. In that case organs are being punctured in order to take out certain small parts of tissue. Both kinds of punctures are considered harmless, as the gland puncture is today used in hospitals and clinics for diagnostical reasons.
Q Didn't you, yourself, once describe jaundice as a serious sickness owing to the damage done to the liver?
AAs long as jaundice exists there certainly is a damage of the liver to be noted. But, a s I said, that these damages necessarily are restored to the proper order. During the first period when we saw jaundice epidemic appear to a greater extent we occasionally received reports about patients who showed changes in their liver for a longer period than was customary. In the case of those patients, however, we were net concerned with damages which resulted from jaundice but there are certain jaundice cases, as I stated before, which have nothing at all to do with infectious jaundice. Jaundice is an optical symptom which is valid for quite a number of jaundice illnesses and only a part of the jaundice illnesses are in compliance with the so-called infectious diseases.
Q You have stated, doctor, that the disease lasted from four to eight weeks. Now, is salvarsan used for the treatment of jaundice?
A Salvarsan was not used for infectious jaundice but there is a kind of jaundice which is a symptom of the so-called syphillis and furthermore there is a jaundice which originates as a result of the salvarsan treatment of syphillis. All of these are various jaundice diseases. Salvarsan itself, when dealing with infectious jaundice is net used unless, of course, syphillis exists simultaneously. Then syphillis, although jaundice is there, has to be treated with salvarsan.
Q You said this morning on direct examination that one could treat hepatitis, if I understood you correctly, on the same day of the incubation period. How is that possible? An incubation period is known as the period preceding the actual manifestation of the disease.
A I didn't speak about jaundice in that connection but I spoke about typhus. I was asked about the foetus which dealt with the treatment of typhus with acridene. I was asked that question by the defense counsel of Poppendick and in connection with that work in the case of two types of illnesses, the treatment was started on the first and third day of incubation. This, however, is impossible in the case of jaundice because one never knows when the patient concerned was infected.
In the case of typhus it is sometimes possible since we know that typhus is usually only transferred by lice. Now, if I, for instance, deloused the human being today I know that he has no more lice and if on the next day I found a louse on his body I can assume that this very day was the very first incubation day. Whereby, of course, it remains unclear whether this louse really transferred typhus rikettsia that is something that one doesn't know but this holds not true in the case of jaundice.
Q Doctor, you have conveyed the thought to me that liver puncture is not considered to be dangerous. If so, why is it necessary to obtain an operative permit in writing from the patient or next of kin for the purpose of all kinds of puncture? Spinal, liver or glandular in all German hospitals by those physicians who carried out such puncture?
A In the case cf punctures which are used for diagnostical and prognostical purposes it is customary that one tell the patient that I am going to perform this or that puncture and that really settles the matter.
If one wants to be particularly careful but that isn't customary at all, then you can ask him to give you a written certification as is the case in a real large scale operation. In most cases, however, one just tells the patient. "I intend to do this or the other", and under the circumstance you give him the reason for your doing these things in order to help the patient but a writted confirmation of the patient is usually not applied for.
Q. Now, witness, this morning you mentioned at great length Dr. Dohman Like yourself, Dohman was attached to the Military Medical Academy, wasn't he.
A. Yes.
Q. And Schreiber was also his superior?
A. Yes.
Q. Now, you have stated that Haagen reproached Dohman after one of these scientific meetings at which Dohman had, as I understand, said how far he had advanced in his research work. Now, were you in the presence of Haagen and Dohman when this discussion took place?
A. During these Breslau hepatitis conversations Haagen, Dohman and all those who were concerned in Germany with hepatitis research were present.
Q. I am referring, doctor, to the episode where Haagen reproached Dohman and if I am correct it took place after the actual meeting had convened. That is, I mean they were, so to speak, on their way home. They talked to one another and you were in the circle of Haagen, Dohman and yourself. Is that correct?
A. Whatever was discussed there was actually discussed during the congress. Schreiber ordered this so-called division of work during that congress or rather proposed it.
Q. Schreiber proposed this collaboration on the part of Haagen and Dohman?
A. Yes, Schreiber proposed it.
Q. Now, you have stated that Dohman did actually go to Strassbourg to work on this hepatitis with Haagen. Is that correct?
A. Dohman went to Strassbourg and he was ordered to do that by Schreiber.
He had to go to Haagen there and a comparison between the viruses as were bred by Dohman was to be carried out with the ones that were bred by Haagen.
Q. How do you explain the fact, doctor, that Schreiber sufficiently arranged the collaboration of Haagen and Dohman when in Exhibit 193, presented to you this morning by Dr. Nelte, the second sentence states: "I" - meaning yourself - "have requested General Schreiber to assign Mr. Dohman to me as of 15 July for a limited period of time to begin with." Who arranged this assignment of Dohman to work with Haagen?
A. Haagen and Schreiber arranged the collaboration of Dohman and Haagen add I belonged to that group too and in addition to the formation of this collaboration of work Dohman had to, of necessity, get into contact with Haagen. Such a meeting had to be arranged by Schreiber and he had to detail Dohman for that purpose. I spoke to Schreiber after the Congress. I told him that these two people would have to get together. Then Haagen invited Dohman in a letter to come to Strasbourg. I had arranged with Schreiber that this channel was to be in accordance with what had already been established during the Breslau meeting; namely, that Dohman went to Haagen.
THE PRESIDENT: The Tribunal will now be in recess until 1:30.
(A recess was taken until 1330 hours.)
AFTERNOON SESSION (The hearing reconvened at 1330 hours, 10 February 1947)
THE MARSHALL: The persons in the court room will please find their seats. The Tribunal is again in session.
DR. SEIDL (Counsel for Defendant Oberhauser): May it please the Tribunal, the defendant Oberhauser asks to be permitted to leave the courtroom at three o'oclock in view of her physical condition.
THE PRESIDENT: The request of the Defendant Oberhauser, extended through her counsel, will be granted. The defendant may be excused from attendance in the court room at three o'oclock.
PROF. GUTZEIT - Resumed CROSS EXAMINATION (Continued) BY MR. HARDY:
Q. Witness, I am still uncertain about your answer to my question concerning the incubation period. I repeat that the incubation period is known as the period preceding the actual manifestation of the disease. Now, you have told me that not in connection with hepatitis, but in connection with typhus, that you can determine on the second day of the incubation period what treatment would be necessary. I want to ask you to answer very briefly, how could you tell that a person has the disease unless you infected them yourself during this incubation period?
A. In the case cf typhus the infection is transmitted by means of an infected louse. If, therefore, in the case of a patient who was previously free from lice, and if I find a louse in a typhus epidemic, then I can safely assume that this louse, on the day on which I have discovered it, that is, if I exercise a daily control ever the infections on the patient, and if the louse has transmitted the infection to the person on the day I have discovered it only, I say that I can assume that.
Q. First of all, doctor, how big is a louse?
A. A louse is about 1 1/2 millimeters long and approximately 3/4 of a millimeter wide.
Q. It is rather difficult to find a creature of that size on a person, isn't it?
A. Our soldiers and also the nursing personnel have managed to do that hundreds of thousands of times during the war.
Q. Then, doctor, after you find the louse, then you have to assume that the louse is carrying the disease, don't you?
A. I say that in a period where cases of typhus occur, that is, within a limited epidemic where also other patients are suffering from typhus, and in that case it can be assumed that the louse which is discovered is infected. Of course, this may be a mistake. Mistakes can occur. But on the whole, the suspicion exists that these lice are infected. That has a definite reason because the louse must have been transmitted to the patient by another person, when I have determined that on the day before I have discovered the louse, no lice at all were present.
Q. You also have to assume that the louse has infected the person or the patient?
A. That is what I have assumed.
Q. Actually, based on all these assumptions, isn't it far fetched for you to state that you can decide what treatment to administer to a person during this incubation period? You would not know whether that person had contracted that disease at that early stage, would you?
A. That is correct. It is correct that I cannot know that with certainty but I can harbor the suspicion that the louse has infected the patient. And when I have such a suspicion, then if I have any remedy for it, if I believe that the medicine can be already effective against typhus during the incubation period, then I can apply this medicine from the first or the second day of the incubation. Of course in this case it is not certain if the person in question really gets typhus or that he is infected by typhus. I can only see that when the disease, that is to say, the fever, begins in the case of typhus. That is approximately eight to ten days later.
Q. Now the question of hepatitis. As I understand it, then it would be impossible for one to administer treatment for hepatitis on the second day of an incubation period; is that correct?
A. In the case of hepatitis?
Q. Yes.
A. In the case of hepatitis I cannot determine.
Q. Now, before the afternoon recess, witness, we were discussing the collaboration of Dohmen and Hagen in which you participated, making your suggestion to Gen. Schreiber, and so forth. Did you report to the defendant Handloser on this collaboration between Dohmen and Hagen?
A I have not made any suggestion at all. I have not made any suggestion. I have not suggested that Dohmen and Haagen should work together. This collaboration between Dohmen and Haagen was discussed at the General Hepatitis Conference which I have already mentioned. It was suggested by the President of this Conference while formulating working methods.
Q I do not wish to quibble with you about whether or not you suggested the collaboration of Dohmen and Haagen. I have previously referred to the second sentence of your letter from Haagen where you stated you requested a general to assign Dohmen to you as of 15 July for a limited period of time to begin with.
Now I ask you, did you ever report to Handloser in regard to the collaboration of Dohmen and Haagen? Answer yes or no.
A I did not have to report about this collaboration at all because during the Conference, this collaboration had already been determined. Professor Handloser was also present.
Q Thank you. Were you in attendance at these various Military Medical Meetings for Consulting Physicians? In fact, you spoke at one such meeting did you not? Is it true that reports were made at these meetings on results of experiments in various fields of medical research?
A In the course of the conferences of consulting physicians, lectures were given about the experiences and also about the examinations which had accumulated. In this connection, I have also reported at some of these meetings about what had been discovered with regard to Hepatitis up until that time by various work.
Q Then it is true that the experimental conditions were explained by the reporting physicians, is it not?
A During the conferences, as far as I knew, the experiments were only discussed insofar as the cultivation of bacteria in the experiments on animals were described in the form of a lecture and address.
Q Witness, during the war, did you ever hear anything concerning experiments on concentration camp inmates, that is, from your own knowledge, from reports or meetings, or conversations with other people, or from rumors or any other source whatsoever?
A I cannot remember that I have heard anything concrete about the execution and also about the results of such experiments.
Q Since you are familiar with jaundice research in Germany, you probably know of the work of professor Doctor Dresel, Director of the Hygiene Institute of the University of Leipzig, do you not?
A May I ask to hear the name once more?
Q Dr. Dresel, D-r-e-s-e-l.
A I have seen this name in literature. As far as I can recall, experiments on animals were involved in this case. I believe that canaries were used as animals.
Q Did he not cultivate a jaundice virus from persons suffering from Hepatitis, and succeed in transplanting it to animals?
A So far as I know, and as it was always done in other jaundice experiments, he took the infectious material from infected persons, and injected it into animals. He then continued to transmit this disease from one animal to another.
Q Doctor, do you not know that he carried out experiments on concentration camp inmates?
A I have never heard that.
Q In connection with Dohmen's work on Hepatitis at Sachsenhausen you have told this Tribunal that those were more or less experiments of appeasement. Why should Dohmen care two phennigs about the feelings of Grawitz in this connection?
A Grawitz wanted the cultures which Dohmen had cultivated in the animal experiments. He wanted to obtain them from Dohmen. He wanted Dohmen to given them to him. As far as I know, he personally wanted to have hepatitis experiments carried out. Dohmen had refused to leave these cultures with Grawitz. Grawitz was unable to obtain these cultures. Dohmen did not want to let these cultures out of his hands because he did not want to lose control over them. He ordered Dohmen to do these things himself. I have already described that this morning. 273
Q You state that Dohmen did not want to turn his cultures over to other people so he would not lose control of them. Why would Dohmen waste his time examining eight Polish Jews condemned to death in Sachsenhausen to see if they, perchance, had jaundice?
A I did not completely understand the last part of your question.
Q I say, why would Dohmen waste his time examining eight Polish Jews condemned to death in Sachsenhausen to see if they, perchance, had jaundice? Pas this act to appease Dr. Grawitz?
A Yes. Things were such that Dohmen carried out the work in order to avoid having to turn his vaccines over to Grawitz. I have already said that Dohmen had sabotaged Grawitz' order to carry out such experiments. That is the reason he worked at Sachsenhausen.
Q At Sachsenhausen in connection with Dohmen's work, you cannot swear that Dohmen did not infect those inmates, can you?
A Dohmen has always told me repeatedly about this work. He told me he was only deceiving Grawitz in carrying out his work there.
Q Do you not think, Doctor, that Dohmen might be a little reluctant to publicize his activities in Sachsenhausen?
A Otherwise, he used to tell me all about the results of his work. After all, the collaboration consisted cf the fact that he handled the bacteriological part of the Hepatitis Research, and I handled the clinical part. Whenever I discovered something important, or remarkable, within this field of work, then I would inform Dohmen of this fact. Whenever Dohmen reached some results, then he would inform me of them. Both of us were members of the Army. This jaundice work could not be separated into two parts. One of us had to report the result to the other, and vice versa. I believe that if Dohmen had infected people at Sachsenhausen, then on the basis of these infections, causes of the disease would have to have been discovered at Sachsenhausen. That would have been a result which would not have been without importance for the higher research field, and I believe I would have found out about it.
Q Doctor, were you ever in Sachsenhausen with Dohmen?