This is the footnote in Document 9 submitted by Mrugowsky. One has to consider that among experts one often omits explanatory statements when one would assume that experts would know what is being meant. Naturally there comes about the danger of misunderstanding whenever these documents have to be appraised by laymen. Considering all these vaccines one, in addition, has to know that whenever dead vaccines are being produced particular value is attached to using virulent strains in order that these vaccines also contain the V-antogene - this is the abbreviation of virulent antogene. Whenever the expert speaks of particularly strong virulent vaccines one can be sure that he means vaccines from killed but very virulent germs, but even in the case of the physician who is not a specialist one cannot be sure at all whether the expression is meant in that sense. In the case of the laymen one has to ascertain exactly what it is he moans and, furthermore, whether his knowledge is sufficient in order to be able to distinguish these two concepts very clearly.
MR. HARDY: May it please your Honors, all this information the defendant is giving us unquestionably is material and is of value to the Tribunal. But, inasmuch as it is so technical I would think it advisable to have the defendant write this out in essay form and submit it to the Tribunal in the way of an affidavit so that we can all use it to further advantage and have it separate and apart from being in the record. And, introducing it in that form will serve a dual purpose of also saving the time of discussing it here if he will present it in such a form.
THE PRESIDENT: It might be more helpful to the Tribunal if that plan were followed. I don't know how much longer the witness intends to testify on that scientific matter.
PROFESSOR ROSE: I would have been finished in the time Mr. Hardy used for his objection. Naturally I am quite willing to submit a written paper on that matter in case Prosecution and the Tribunal would desire me to do so. However, I would be grateful if I could finish this paragraph.
DR. FRITZ: Professor, it was your intention to explain some other concepts, for instance the concept of control which plays a considerable part in this court room. That is, in case the high Tribunal would desire you to make a written report on that it may be better to do so than to take more time of the Tribunal.
PROFESSOR ROSE: If I include the explanations of the concept control I would take five minutes more to discuss it.
THE PRESIDENT: Counsel, witness may proceed in accordance with the manner in which they followed here before.
PROFESSOR ROSE: May I ask whether it is desired that, in addition, I submit these explanations in writing?
THE PRESIDENT: In the case of the Tribunal that will be unnecessary. The witness' statement is already in the record.
PROFESSOR ROSE: Yes, your Honor.
THE PRESIDENT: However, if counsel and witness desire to present such a written statement and have it introduced as a document they may do so.
WITNESS: Well, I was just saying that it is very important that, when examining a witness, one ascertains whether he really understands these concepts and can handle them as they should be handled. Generally, in the case of the layman and also in the case of the physician who had no specialist training one will arrive at the result that he will not be in a position to make a clear statement about these concepts. It is my impression that all the accusations raised against Professor Haagen originated mostly from this layman-like notion that a living typhus virus is a terribly dangerous and lethal matter without it becoming clear to the layman that an avirulent typhus virus vaccine is mentioned and is not a morbific organism in the every day sense of the word. If at the end I deal with the word "control" I want to say that with that, in a medical sense, the group for comparison is meant where the essential factor is lacking; namely, the one which is to be examined in the group for experiments. In order to know in detail what a control group actually constitutes, one has to know what the subject of the experiment is. Only then is one in a position to answer the question. Now, if Professor Schroeder answered to the question of the Tribunal "what a control groups was" and said that these are the people who were not vaccinated, this can only be explained by his lack of experience in experimental research work. Professor Schroeder is an experienced clinical physician. He is an uncontestable authority in the field of erection of hospitals in Germany. He was a leading man dealing with nursing personnel, but he just did not work in experimental medicine. What control group actually constitutes or what it can constitute I would like to illustrate by using four examples.
In the case of typhus experiments, that is, comparison experiments in Buchenwald, the experimental groups were those people who were treated with vaccines and afterwards were infected with a virulent virus. The control group comprises those people who were not vaccinated but merely infected. That is the case where the explanation is correct as given by Professor Schroeder. In the case of the therapy experiments in Buchenwald, the matter is entirely different. The experiments which Ding is said to have carried out with Rutenol and methylene blue were suck where the experimental group, as well as the control group, were not vaccinated. The experimental group, according to the documents of the prosecution, in addition to the symptomatic treatment received treatment with the drugs that were to be examined. The control group, on the other hand, only got the customary treatment.
Now, a third example - let us consider a nourishment experiment. Whenever the influence of a certain one-sided nourishment procedure is to be examined the experimental persons are those who arc getting deficient nourishment. The control group consists of those people who receive normal nourishment.
Fourthly, another example taken from the subject of this trial. The experiments with the apparatus for the decontamination of water. The experimental persons are those who received the water that was first poisoned and then decontaminate, and the control groups comprised those people who received ordinary drinking water. In the case of this letter experiment, the people in the control group are those who are undoubtedly better off, and in the case of the nourishment experiments one can only make a judgment when knowing exactly what kind of nourishment they were given.
In the case of the example I mentioned, the control groups would be better off, and when examining the Wehrmacht special rations the experimental subjects are bettor off since the Wehrmacht special rations are much better than the normal rations given to people.
This brings one to the conclusion that one can only conclude something from the word "control" when knowing the subject of the experiment. The word itself can easily be misinterpreted. What the word "control" means in the case of the correspondence of Haagen I shall illustrate when I get to that point.
BY DR. FRITZ:
Q. After this explanation of these basic concepts I should like to ask you to describe the vaccine of Professor Haagen as far as they are known to you according to the source which mentioned before.
A. I already referred briefly to the first experiments by Haagen which had as a result this vaccine Gildemeister Haagen. This is a vaccine from highly virulent strains which, either by heating or the addition of chemical material, were killed. Since these vaccines were produced from especially virulent strains and since new strains were always bred from the blood of the ill persons there occurred currently the laboratory infections in these laboratories.
Q. In order to illustrate Haagen's experiments would you shortly describe what is understood by an avirulent living vaccine?
A. Well, the basic discussion of any such vaccine need not be made by me in order not to take up time, but it will merely be necessary for me to illustrate the historical development of avirulent vaccines. The work of Haagen cannot be understood unless one knows the fundamental principles upon which it is built. The introduction of the avirulent vaccine from living germs constitutes the small pox vaccine. Its application is know by every family father who has children. He knows that when the baby is first vaccinated a pussy crust develops at this point where the vaccination was made; that this conditions remains for a number of days. He knows that tho child does not feel well during that period; that it really is ill and that, after a few days, its condition develops and he gets fever. Fever usually starts on the ninth or tenth day and can go up to thirty-nine to forty degrees. This original procedure by Jennor was improved as time progressed. The reaction to vaccination is a little milder today, but basically tho progress has remained the same. Now, we who have grown up and were later again vaccinated do not remember this old procedure because the revaccination takes a different course since at that time one has already built up a basical immunity which originates from the first vaccination. There is either no reaction at all or only a little red inflamed spot. It is very rare that any fever occurs. Now, in the case of Jenner's discovery we are concerned with an observation made accidentally. This principle was used in the case of the Pasteur rabies vaccine which I already mentioned before when explaining the concept virulence. This is the second example in medical history where one finds a living avirulent virus as vaccine.
The third step was the modern plague protection vaccination. This constituted something very significant because the first two examples I mentioned were virus illnesses and in the case of the plague this method was, for the first time, transferred to the bacteria illnesses. The basical discovery consisted of the fact that Guinea pigs could not be immunized with dead vaccines no matter how virulent these strains were before they were killed. The German scholars, Keller and Otto, succeeded in immunizing Guinea pigs with avirulent living plague bacilli. Since this thought to use living plague bacilli on human beings first was considered to be Utopian, the matter was dropped. Afterwards, as I already mentioned yesterday, the great American bacteriologist, strong, took up the thought he got this strain from Otto and Roller and then carried out those human experiments on the inmates of Billibit. This risk was succesful. The strain was avirulent not only for animals but also for human beings. There were fever reactions up to forty degrees but never did any plague illnesses develop.
Altogether 900 persons were vaccinated in this series of experiments that is with these living plague bacteria. Naturally, not all of them were people condemned to death. That would have been impossible. And I don't know even whether they were all inmates of a penitentiary. It doesn't say so. in the paper. From what I know of Billibit, this is a place used for about three or four thousand inmates. Strong didn't report about any serious incidents, but in spite of that there was a great prejudice among expert circles against that procedure. In the year of 1911 when Strong combatted Plague in Manchuria he did not dare to apply this procedure outside the American controlled territories, although he already made this discovery already in the year 1905. It took more than 20 years, up to the year of 1926, until this prejudice was overcome, even in expert circles, and the procedure was developed by Frenchmen and Dutchmen to an extent that it was used on millions of human beings. Since two decades it is really dominated the entire plague protection vaccination. As an example from this trial I must say that in the paper by Strong, there is no mention made about the voluntary aspect of the experimental subjects, or even if mention had been made of that no person would have believed it. This work originates from the year of 1905, and the custom to have inmates of penitentiaries to sign statements regarding their voluntary nature appears only a few years later, according to American literature. But let us revert to the avirulent vaccine. The next avirulent vaccine was the famous Calmette vaccine against tuberculosis. This consists of the introduction of living but avirulent tuberculous baccili. It is rather widely spread in Europe with the exception of Germany, and at the moment propaganda is being carried on in America in order to introduce this vaccine there. The matter was stopped in America because in the case of one of these vaccinations there had been a terrible accident. The virulent culture was mistaken for the avirulent culture and 70 children of those who were vaccinated with that strain died.
Although this really had nothing to do with the entire procedure, but was an error, a negligente error in the laboratory, this accident created that prejudice. - Next is a virus illness, the development of the avirulent yellow fever vaccine, on the basis of the work carried on by the Rockefeller Foundation in New York. In the case of the first test of this vaccine I happened to be an experimental subject myself, a voluntary let me say. - Now here we have the avirulent typhus vaccine. The first was a vaccine from living attenuated murine rickettsia. A Polish and two French researchers worked on that procedure, using various methods. Best known is the vaccine according to the Director of the Pasteur Institute at Morocco; here the witness Edith Schmidt testified that she knew of than procedure, but that it was not applied because of its dangerousness. But apparently there are hygienists in Franco who are of a different opinion than this technical assistant, because this vaccination was carried out in Morocco in hundreds of thousands cf Cases on natives and the white population. It is admitted that this vaccination can cause very high fever, out on account of the great danger of typhus this is put up with just as we agree that cur children go through fever reaction in the case of vaccinations against smallpox. This scientific development as I described it, as I think only in a very short form, is the exit point of Haagen's scientific work. Haagen, according to Blanc's example started with a vaccine from living attenuated murine rickettsia. He didn't use Blanc's technic, but he applied the same technic, which already has proven itself in the living avirulent yellow favor vaccine. This is the technic of the dry vaccines. A very complicated apparatus is necessary, but they have the advantage of being more durable than living vaccine which are produced according to a different procedure.
Technically, it is of greatest difficulty to lend any endurance to any living vaccine. The examination of such a dry vaccine from living attenuated murine virus showed the same results when Haagen carried it out as was found in the Case of Blanc. A number of persons suffered no considerable increase of temperature, others had to suffer fever for a number of days.
Q. Professor, you were just speaking of the examination of dry vaccine of Haagen's; what do you understand by examination of vaccines?
A. In this case, we are exclusively speaking about the examination of its tolerance on human beings, computability, and the question as to how severe by the fever is conditioned by this vaccination, in other words the severity of the vaccine reaction. This is the point which is very decisive in the case of the living a-virulent vaccines. In the case of these vaccines this question of reaction is very important, because if you have a tolerable vaccination reaction it is sure that the protective effectiveness is also more favorable. This is absolutely clear, according to general experience. Now and again it is examined subsequently, but today one can say with certainty from the outset. Now the vaccination reactions in the case of most living vaccines are stronger than in the case of the dead vaccine; but as I have already said, the immunity is more favorable, this is taken into account, since this procedure is only applied in the case of especially severe illnesses. Naturally the hygienist as well as the physician prefers any vaccine, which causes reactions, but it is clear that a condition, which is only brought about by a severe disease dangerous to life, can only be brought about artifically, by certain subsequent reactions, such reactions as fever, head-aches, etc., one must always consider the gain. One must always consider that this constitutes a protective injection against an infectious disease which is dangerous to life.
Q. Would you please continue describing Haagen's experiments?
A. Haagen at first did not arrive at any other results than Blanc when conducting these experiments. This is the situation as one can see it from his report to the Reichs Research Counsel, dated 21 January 1944, under paragraph 2. This is Document No. 138. I am afraid it must be an error, I think this is contained in Document Book No. 13, page 87.
This is also the situation which I described when I gave my lecture in Basle on 17 February 1944. This vaccine was only used in the case of conditions where there was great danger and where on the other hand it did not matter if the people suffered fever for a few days and had to stay in bed. During war time, one cannot do that in the case of the troops who are committed in the front line; one cannot put a squadron of bombers to bed just because they were vaccinated against typhus. Therefore, Haagen endeavored to find a method which would alleviate this vaccination reaction. He first had just meant to vaccinate with a dead vaccine, for instance the vaccine of Gildemeister-Haagen and then vaccinate again with the living avirulent vaccine. This thought was really very logical, after it had proven itself that these dead vaccines influenced the course of the illness very decisively. Hence the assumption was justified that it would have a favorable influence on the vaccination reaction with a living a-virulent vaccine.
May I ask whether I have explained this point clearly; naturally the gentlemen of the Tribunal are not acquainted with this question very well, but I think it is of decisive importance.
THE PRESIDENT: I think the witness has explained his ideas on the subject.
Witness, how much longer will your explanation on this particular branch require?
THE WITNESS: I believe that this would be a good point to recess, because after this basical explanation I shall turn to the explanation of a number of individual documents, and will then describe what these documents actually mean according to the explanations which I have now given.
MR. HARDY: Your Honor, in keeping with what I suggested some 40 minutes ago, if the defendant still has another half hour or more to continue on in this technical language, it seems to me the suggestion of an affidavit would suit our purposes much more conveniently.
THE PRESIDENT: It seems there might be considerable merit in that suggestion. Counsel, how much further in the course of your examination of the witness, will these technical explanations be produced?
DR. FRITZ: Only one more question, I think. The defendant just said himself that after having made these general statements he will explain the individual documents which are also supposed to incriminate him.
MR. HARDY: That may be well and true, Your Honor, but just 40 minutes ago we heard we were only going to hear this for five minutes longer, and now we have been listening to it since 10 minutes to three o'clock.
THE PRESIDENT: If the witness is now approaching that point which effects his particular case, I think the witness should be permitted to testify orally in that matter.
The Tribunal will be in recess until 9:30 tomorrow morning.
(The Tribunal recessed until 0930 Hours, 23 April, 1947).
Official Transcript of the American Military Tribunal in the matter of the United States of America, against Karl Brandt, et al, defendants, sitting at Nurnberg, Germany, on 23 April 1947, 0930, Justice Beals presiding.
THE MARSHAL: Persons in the court room will please find their seats.
The Honorable, the Judges of Military Tribunal 1.
Military Tribunal I is now in session. God save the United States of America and this honorable Tribunal.
There will be order in the courtroom.
THE PRESIDENT: Mr. Marshal, you ascertain if the defendants are all present in court.
THE MARSHAL: May it please your Honor, all defendants are present in the court.
THE PRESIDENT: The Secretary-General will note for the record the presence of all defendants in court.
Counsel may proceed.
GERHARD ROSE - Resumed DIRECT EXAMINATION (Continued) BY DR. FRITZ (Counsel for the Defendant Rose):
Q. Professor, yesterday you were giving a description of the medical basis of Dr. Haagen's work. You already explained that Professor Haagen was working on a new living avirulent typhus vaccine. Would you please, briefly, explain the connection between his plans and the document which I am going to discuss with you and put into my next question.
A. I repeat very shortly, I had described that in the case of a vaccination with a living avirulent vaccine, we are basically concerned with similar events as occurred in a genuine infection and that, therefore, the expressions and phases used must in many things be very similar and sometimes even be the same. It is naturally understandable that laymen misunderstand these terms, and it is not surprising at all that the prosecution also considers a number of documents as being suspicious while in reality they are completely harmless.
Q. Did you have the desire to alleviate Haagen's vaccination reaction which came about from murine in his small pox vaccine rickettsia; did that have anything to do with your correspondence with Haagen?
A. Yes, the letter refers to this question which Mr. Hardy could not understand when submitting his documentary evidence and about which he wanted an explanation from me. This is document 122 to be found in Document Book No. 12 on page 82. I think that I should have to read this letter once more, considering it is significant, although it was already read once by the prosecution. I draw your attention to the date which is the 13th of December 1943. It says:
"Dear Mr. Haagen.
Many thanks for your letter of the 8th of December. I don't think it is expedient that in addition to the application which you have already made, another special application is made to the SS Main office. I request that in the case of getting the people to be vaccinated for your experiment that you requisition a corresponding number of persons for vaccination with the Copenhagen vaccine. This has the advantage, as also was shown in the Buchenwald experiments, that the testing of various vaccines simultaneously gives a clearer idea of their value than the testing of one vaccine alone."
Then follows the end.
Q. How is it that this letter isn't signed by you yourself?
A. I cannot remember with certainty that I dictated this letter, but judging by its form it is quite possible that it originates from me. It was customary whenever I went on official trips and my typists hadn't finished their letters, that I left it to them to sign them, that is, in every case where the letter was not directed to any superior agency. I think that this letter is absolutely genuine.
The contents of this letter fit into the connection of the situation at that time, and it is quite clear to me. Professor Haagen, as well as the five other agencies which are mentioned in the distribution list, received the annex to my report about my trip to Copenhagen and I mean the annex which refers to the Ipsen vaccine, Rose document 22, volume number 2, pages 15 to 19. He had then worked with a dry vaccine from living attenuated murine virus. He tried to find some way in order to alleviate the vaccination reaction. As I explained yesterday, he intended to do that by carrying out preliminary vaccinations with a dead vaccine.
I may emphasize that this thought was not new at all. These experiments have already been made before in the case of other living vaccines, and the best known method of that nature is the sero-vaccination which was introduced at the beginning of the yellow fever vaccination when one had no harmless yellow fever vaccines yet. Then, yellow fever serum and vaccine was vaccinated simultaneously. Since the end of 1943 Haagen worked with a vaccine from murines, and that can be seen from his report to the Reich Research Counsel to which I pointed out yesterday, he must naturally have been very interested in the Copenhagen vaccine because that one was produced from dead nurine virus. Haagen at that time obviously had planned an experimental series where he would make prevaccinations with a number of dead vaccines and would then be able to test to what extent they were in a position to alleviate the reaction of his living avirulent vaccine. Originally he only intended to use such vaccines for his pre-vaccinations which were already generally applied with the Wehrmacht.
In this letter he put the question and suggests to start a series of experiments with the Copenhagen vaccine for the same purpose. In my answer I obviously make suggestions to the contrary and object that he should start a special series of experiments for that purpose. I say that it would be far more expedient to have these serios running simultaneously and my indication to the Buchenwald vaccination is a matter of course for the biologist, because in Buchenwald the effectiveness of various vaccines upon the course of the illness was tested in the case of an infection with virulent virus.
Haagen, on the other hand, was dealing with the problem of influencing the vaccination reaction with living avirulent vaccine. The parallel aspect of these two testings running together was even more desirable in the case of Haagen, since Haagen's vaccine was still in the stages of development, it had in no way been standardized and he couldn't have large supplies.
Q. You were just discussing vaccinations and you described then as infections with attenuated living vaccines. But we are concerned with infections on human beings in this trial and that constitutes one of the main counts of the indictment.
A. Well, I described yesterday that the application of an avirulent vaccine from a biological point of view is a kind of infection but an infection which can be controlled and which is not dangerous. As for the legal aspect of any such infection, you find the smallpox vaccination, the yellow fever vaccination, and all other vaccinations which I have already mentioned are infections in the very same sense but they gave gone outside this sphere of juridical judgment. No prosecutor would entertain the thought today to make any accusations because of a smallpox vaccination because he would undoubtedly make himself ridiculous. The typhus vaccination, on the other hand, hasn't progressed that far as yet. I admit that. Haagen in his work in this field knew of the Frenchmen Blanc and Legres and a number of others as predecessors, and he was in a much safer ground in his work than Strong, for instance, when developing his plague vaccine. Strong said expressly in his report that he was surprised at not finding any stronger reaction and not encountering any incidents. Haagen, throughout the years, could always base himself upon experiences which were available to him, and I'm referring to experiences which had been made during the last forty years, and, in addition, he could base himself on the technique which had been developed, especially in the production of virus vaccines. In addition, there was his very special personal experience as a virus expert. All these were factors which gave him the assurance that any serious incidents could not occur. Certainly, his procedure is not fully ripe as yet, but there is no doubt that within four or five years it will be the generally applied procedure in the case of typhus. If Americans are trying to follow that procedure, too - such as at the Rocky Mountain Institute or the Rockefeller Institute in New York - I am sure that this stage will be reached within a period of two years already. In its present stage, however, it is possi ble to find somebody who would give an expert opinion and therein consider this procedure as being doubtful and that, I am sure, you will find if you take a surgeon as an expert in this field who knows little about the development of a typhus vaccination.
If you want to create any martyrs in this procedure, this will be the last opportunity. In three years' time the public will no longer tolerate that. I can only say that Oberstarzt Kowalzek, who was with the Luftwaffe, has already clearly suggested that this French procedure be applied generally in the Luftwaffe. After this, he vaccinated himself and. the members of the German Armistice Commission in Morocco according to this procedure. The Medical Inspector at that time did not decide to introduce that procedure because he still considered the reactions to be too severe considering time of war. He assumed that in peacetime such reactions could perhaps be tolerated by the troops but that that could not be done under conditions of war. Accordingly, I saw no reason whatsoever to voice any misgivings about the fact that Professor Haagen was dealing with a procedure which was recognized and, to a considerable extent, was already practically applied. Certainly, in more than a hundred thousand cases.
MR. HARDY: Your Honor, the defendant has now been on the stand over two days. This morning he is spending twenty minutes merely approaching the point where he is trying to attack the integrity of this Tribunal and acting in a manner which is not appropriate here and I feel that the defendant should answer the questions asked of him and not delve into the question of whether or not the Tribunal knows this case or whether or not the prosecution has weighed the facts in this case. That is for the Tribunal to decide and not for the defendant to decide.
THE PRESIDENT: The witness should answer the questions more directly without so much diffusion in his answers. The witness may file, as it was stated yesterday, a supplemental affidavit to his testimony, if he desires to do so, but this particular phase of the trial has lasted quite a while and I think the witness - questions should be asked him - propounded to the witness which he can answer more definitely and that the wit ness should endeavor to answer the questions as directly as possible.
I would say further that counsel will have ample opportunity to argue the questions, both on the fact and on the law. He may file briefs and submit oral argument to the Tribunal. A great deal of the time taken up by the witness is really a matter which can be properly argued to the Tribunal, from the facts, by his counsel.
BY DR. FRITZ:
Q. Haagen tested the compatibility of his vaccine on human beings. Couldn't he ascertain that by testing it on animals?
A. The pre-testing, where animals are possible, was actually carried out by Haagen, as can be seen from his reports. He had plenty of animals available. The decisive question as to what the vaccination reaction is on a human being can only be ascertained by testing it on a human being.
Q. Why didn't he test it on himself or on his collaborators?
A. This is impossible for the simple reason that, in order to find out what a vaccination reaction is, one needs a larger number of persons. In addition, the persons in his environment were already vaccinated against typhus and for the most part had already experienced typhus themselves because of the work in the laboratory.
Q. Why did he have to go into a concentration camp in order to carry out his tests?
A. The reasons which caused Haagen to go into a concentration camp I don't know since I didn't discuss that matter with him, but they are very obvious. For one, there are technical reasons which led him to do that, and then there are purely practical reasons. Whenever one did carry out any such test vaccinations, one would carry it out on persons who would benefit most in case they were successful. The free population of Wester Germany and Alsace was not at all subject to typhus danger at that time. The concentration camps, however, were definitely in danger. The witnesses from Natzweiler who testified here, Holm and Grangend, told us in detail that a typhus epidemic had broken out there and that the persons who were vaccinated by Haagen definitely benefited from this vac cination.