Gusen prisoners suffering from tuberculosis and their treatment in the camp

In the Nazi concentration camps, incurably ill prisoners requiring treatment for more than three months and prisoners who were so emaciated and debilitated that they were unfit for strenuous physical labour were deprived of the right to live. According to the Nazi Germans, tuberculosis was a chronic disease which was prohibited in their concentration camps and had to be countered rigidly and ruthlessly, especially as it was incurable in the terrible conditions.

The camp executive associated tuberculosis with cachexia and general ill health. Consequently, they considered every emaciated and starved prisoner a TB case due to be exterminated. Of course, such prisoners made up the overwhelming majority of the camp’s inmates. New transports arriving in Gusen consisted mostly of prisoners who had already been confined in prisons and tortured during Gestapo interrogations, so their bodies were skeletal and extremely debilitated. On arrival they were immediately sent to work in the quarries or penal companies. Poorly clothed, hungry, beaten, and brutally exploited, they soon lost all their strength and became Muselmänner. Work in the harsh subalpine climate in the quarry, where clouds of dust made breathing difficult, made prisoners suffer from upper chest infections and prone to bronchopneumonia and pleurisy. Pulmonary tuberculosis wrought havoc in the camp.¹

In 1940–1941, the first years of Gusen’s existence, the camp health service had nothing to do with medicine, as those who looked after the sick had no knowledge of disease and its treatment. The hospital kapo and his helpers “diagnosed” TB solely on the basis of a prisoner’s appearance, and then the diagnosis was confirmed by an SS doctor who did not examine the randomly diagnosed potential TB patients.

As a matter of fact, all the prisoners in the camp hospital had to be examined, and should have had a sputum test for Koch’s mycobacteria and an ESR test, and, from the end of 1941, a chest X-ray. But during the first phase of the camp, there was only a primitive laboratory in Block 29, located in a room shared with admissions, a surgical dispensary, and a pharmacy, and equipped with the most rudimentary reagents and a microscope, so it could not carry out the duties imposed by the official regulations. At that time, lab tests were conducted first by Dr Albin Garbień² under the supervision of the SS doctor Schildbach,³ and later by Hubert Skolik.⁴ Dr Garbień worked as a hospital cleaner and was employed part time in the laboratory.

TB prisoners were generally called “invalids.” They were selected by block leaders from among those who wanted to see a doctor and prisoners in the worst condition, and sent to Barrack 32, known as “invalids’ block,” where they waited to be killed.

The mass murder of “invalids” was conducted in various ways. Their extermination in the camp hospital followed a well‑organised scheme, while in the invalids’ barrack the killings were the result of fairly impulsive and spur-of-the-moment decisions. In the early phase of the camp, TB patients were sent to Block 31 or to an isolated section in Block 29 called the Bahnhof (railway station). There the invalids lay naked on the floor in their excrement. As they did not receive any food, most of them died from hunger and emaciation. The barrack orderlies hosed them down with cold water.

On orders of the camp’s chief physician and his subordinate SS doctors who were in charge of the Gusen hospital, “mass jabbing” was conducted in the afternoon or after the evening roll call. A patient selected for a “jab” was brought or carried on a stretcher to the dispensary, put on the operating table and killed with an injection of 100-250 g petrol or hydrogen peroxide straight into the heart. The executions were carried out by the SDGs (Sanitätsdienstgrade), kapos Zach and Roth, or by Käfferbeck, a Stubendienst⁵ (barrack orderly).

Dozens of prisoners were “jabbed” every day. Once the group of those due to be killed got too big for this method of killing, the butchers started a system of mass murder. On Christmas Eve 1941, for example, they exterminated scores of patients from Block 31. Late in the evening, the victims were taken out of the sickroom one by one. Käfferbeck and his helper stood in the doorway. One of them stunned the prisoner by hitting him on the head with a wooden club, then the other one quickly immersed the prisoner’s head in a barrel of water. After the prisoner had been drowned, his body was thrown on the pile of corpses. The executions were supervised by an SDG and the hospital kapo Roth.

Another murder operation was conducted in the early spring of 1942. On the order of chief physician Hauptsturmführer Kiesewetter, coffee laced with potassium cyanide was served for breakfast to 70 patients in Block 27.

TB patients and invalids not in the hospital were put in Block 32 (the invalids’ barrack). They lay on overcrowded bunk beds or on the cold floor, or stood for long hours outside the barrack, rain or shine. They were given smaller soup rations than other prisoners. The block leader Karl Schrögler⁶ and his helper Sepp did not distribute any bread to them, convinced they would soon die, and their rations would let other inmates continue their hard labour. Schrögler killed patients by drowning them in a barrel of water or using other ingenious methods.

A large number of weak inmates died during the disinfection of the camp conducted in autumn 1941 and winter 1942. The Slupecky company of Linz was commissioned by the camp authorities to delouse the camp. At 4 a.m. on the appointed day, all the prisoners had to leave their barracks naked, leaving their clothes und underwear on the bedding, and stand in the roll call square. Bedridden patients were carried out on stretchers by their fellow inmates. The windows of the barracks were made airtight, and then the company staff had the barracks filled with cyclone B gas. The naked prisoners stood outside for long hours, exposed to the severe chill of the morning and later to the scorching sun. In the evening, they had to go through a personal delousing procedure: they were immersed in a bath of caustic disinfectant. Subsequently, they all lay completely exhausted in the roll call square. Many did not endure this disinfection “treatment” and died; others developed pneumonia and colds. During the camp disinfection carried out on 2 March 1942, all the Soviet POWs (a total of 164) were gassed in Block 16, along with nearly 300 invalids gassed in Block 32.

Deathpath’s Echo. Marian Kołodziej. Photo by Piotr Markowski. Click to enlarge.

The largest one-off mass murder operation on TB prisoners was carried out by transporting them to a so-called sanatorium. It was preceded by 35 mm X-ray examinations performed in the summer of 1941 by an SS team from Linz using a mobile device. The X-ray examination covered all the prisoners in the camp, i.e. about 5,000 people. Shortly thereafter, the camp authorities received an order to put the invalids, a total of 2,000 people, on a transport. They assured the selected prisoners that they would be sent to a sanatorium, where they would be treated, given better food and would not be forced to work. This order concerned all the patients in the hospital and the emaciated prisoners (Muselmänner) from the other barracks, as well as a certain number of inmates shortlisted by the camp secretariat. All the prisoners selected for transportation were divided into four groups and placed in four separate barracks, 20, 21, 21, and 23, where they were to wait for departure. Weeks passed and they were still in the camp. They had been exempted from work because they were unproductive, so they received reduced rations (a quarter of a litre of soup and 250 g of bread a day). Forced to stay in the barracks, they huddled together, shivering with cold, with the windows open, or stood in rows for hours in the lane before their barracks. They were dying one by one.

Yet, it was the so-called death baths (Totbaden) that took the heaviest toll of invalids over a longer spell of time. Every night after the evening roll call in the late autumn of 1941 and winter of 1942, invalids were hurried off to “bathe.” Groups of about 300 prisoners would be forced to stand in a concrete basin under ice-cold water from a multiple shower head system. The drains were plugged up and prisoners were so cold they could not keep up on their feet, so they fell and drowned in the knee-deep water or froze to death. Block leaders and kapos cordoned the basin off, and pushed in any who “did not want to take a bath.” The SS-men, Camp Commandant Chmielewsky, and Oberscharführer Jentzsch,⁷ nicknamed the Bademeister (bath attendant), watched it all, urging the functionaries to do their business.

The invalids were sent to the “sanatorium” in early 1942. Since many of those shortlisted for the transport had died, the list was supplemented with the names of other prisoners selected on a random basis from the other barracks and hospital. The way the transport was organised looked suspicious. Several camp ambulances arrived at the roll call square and were loaded up with as many prisoners as could be packed into them. Corpses were loaded up as well. The ambulances made several rounds a day and transported a total of 1,132 prisoners. Jentzsch’s “baths” rounded the number up to 2,000. For all of them the camp’s political office issued death certificates with bogus causes of (natural) death. After a few days, we heard that all the invalids had been transported to Hartheim, a euthanasia centre 10 km away from Linz. All the selected prisoners were gassed there.

At the peak of the mass murders the camp’s commandants were Obersturmführer Karl Chmielewsky and Fritz Seidler; and the SS doctors of the Gusen hospital were Schildbach, Krüger, Ramsauer, Herschel, Richter, Jung, Van den Hoff, Kiesewetter, Haas, Adolf, and Vetter. The most brutal was Kiesewetter, whose term of service as a hospital doctor was the longest. They all were subordinates of Krebsbach, Mauthausen’s chief SS physician. The hospital kapos were Franz Zach, Heinz Roth and “Kassandra” Bobrowski.

The mass murders stopped in mid-1942, when Gusen was turned into a military industrial estate producing armaments and aircraft components. The way the hospital was run changed as well. Kapo Zach died of tuberculosis, his successor Roth was killed, and “Kassandra” poisoned himself.

The next hospital kapo was Emil Sommer, a Sudeten German, while Dr Antoni Gościński, a surgeon, was appointed chief physician of the prisoners’ hospital. Doctors with specialist qualifications who had worked as cleaners or nurses, or had been employed in other commandos, were appointed chief physicians in charge of the various wards. The ruthless extermination of TB patients and invalids stopped. TB patients were put in a sickroom called the “TB ward” in Block 29. They received slightly better food rations. Their diet consisted of soup thickened with flour, semolina, potatoes with some sauce, a small portion of white bread, margarine, and a slice of sausage. Patients were treated with a medicament marked “No. 101” consisting of bitter, tiny dark red granules kept in dark half-litre or litre bottles; its distribution was supervised by the SS doctor. Each patient was given a tablespoon of these granules three times a day after meals.

Before taking a dose, the patient had to have a sputum test for Koch’s mycobacteria, an ESR test, a blood count, and a urine test. Only sputum-positive patients with a chest X-ray confirming TB could be treated with this medicament. The lab tests and X-rays were repeated at three-week intervals, and medical records were made of patients’ temperature, weight, and general condition.

Dr Adam Konieczny, an internal medicine specialist from Poznań, was head of the internal and TB ward. His assistants were Dr Józef Markiewicz, and Sylwester Królak⁸ after Markiewicz’s transportation to another camp. Medical students Mieczysław Lisiecki, Józef Sabura, Ryszard Frajtag, Pablo Del Rio⁹ and Ventura Gibal served as orderlies.

From late 1941, Zbigniew Wlazłowski, a medical student from Kraków, carried out the medical tests and X-ray examinations, assisted by Michał Morozek, a boy of 15, and Władysław Kostujak, a pharmacy technician. Professor Tomašek, a bacteriologist from Brno, worked in the hospital lab for a few weeks before he was transferred to another camp. At the time, the lab was located in a special room in Block 28. Its equipment included a Siemens mobile X-ray apparatus and several physiotherapy devices. The hospital and its tuberculosis ward was supervised by an SS doctor, Hauptsturmführer Böhmichen.

The prisoner doctors knew very well that the sudden change in the hospital management and the fact that the killings had stopped were not done for humanitarian reasons, but suspected it was because a new drug code-named “No. 101” was being tested on humans. Their speculations turned out to be right; after about a year an order came to close the TB ward, send the healthier and stronger patients to work, and exterminate the weaker ones.

The No. 101 experiment involved about 300 patients who were sputum-positive or had lesions in their lungs. Many of these lesions were infiltrative with signs of decay in one or both lungs. Others were only fibrotic. Most of the patients had a fever and typical TB symptoms.

The medical and lab personnel in the hospital worked very hard, coping with huge responsibilities and risks. During the first phase of the hospital’s existence, when the medics could work only as orderlies and cleaners, the assistance they could give was very limited and had to be offered secretly. They had only an indirect influence on the decisions of the kapo and his assistants, who had no medical qualifications or training, but sometimes sought and accepted medical advice. In some cases, prisoner-doctors managed to convince the kapo or SS doctor that a given prisoner did not have TB and could return to work after a short spell of treatment. Sometimes their interventions on behalf of prisoners presented as friends or colleagues were successful. The prisoners working in the lab doing sputum tests had a very difficult task. They knew that a positive result would inevitably lead to the patient’s death. Moreover, these tests were often supervised and checked by an SS doctor.

Although the number of sputum-positive patients was very large (sometimes even 30-40), mycobacteria were reported only in the specimens collected from patients in the worst condition, who were dying in any case and whose sputum-positive tests would not affect their chances of survival, which were practically nil anyway.

Once prisoner doctors and medical students were allowed to work officially in the camp hospital, they began to keep double records: the true data and fabricated documentation, keeping the practice a strict secret from the SS authorities and unauthorized prisoners, in order to treat a larger number of TB patients who would have died otherwise. Patients with changes in the lungs confirmed by bacteriological and X-ray evidence had double test results. One record, intended for the kapo and SS doctor, gave a bogus diagnosis, e.g. pneumonia or pleurisy. The other one, with the real results, was kept by the prisoner-doctor.

This clandestine practice was greatly facilitated when the TB ward was opened and the mobile X-ray device started operations. When the doctors realised that the No. 101 treatment was useless, and only caused nausea, vomiting, headaches, diarrhoea, aching bones, and loss of appetite, they applied other methods of treatment.

In strict secrecy from Hauptsturmführer Böhmichen, the SS doctor in charge of the experimental therapy, the prisoner doctors stopped giving their TB patients No. 101 and reverted to the conventional methods of treatment. Depending on the patient’s condition, Dr Konieczny and Dr Markiewicz used the pneumothorax technique, while Dr Antoni Gościński and Marian Filipiak removed ribs or cut the vagus nerve. As the hospital conditions and food were relatively good, patients recovered fairly quickly. It was not difficult to convince Dr Böhmichen, who was too lazy to supervise all the patients, that the recovery of the TB patients had been facilitated by No. 101. Böhmichen was so pleased with the results that he agreed to provide better food, vitamins, as well as more calcium chloride and glucose injections to support the treatment. The double records and results of the sputum and the blood tests and the X-rays helped to make the hospital’s secret activities successful.

After the TB ward was closed, the SS camp authorities again wanted the hospital staff to kill TB patients, which made the prisoner-doctors modify their work. Patients diagnosed with TB and given fabricated test results were now sent to other hospital blocks, where they were treated by prisoner-doctors privy to the secret information. On recovery, these prisoners were assigned to easier jobs and supported by inmates’ self-help groups. Thanks to that, many lives were saved and numerous prisoners suffering from TB survived and after liberation could leave for home.

Translated from original article: Wlazłowski, Z., “Gruźlica płuc i postępowanie z chorymi na gruźlicę w obozie koncentracyjnym w Gusen.” Przegląd Lekarski – Oświęcim; 1968.

1. In 1938 a hard labour concentration camp was set up in Mauthausen near Linz in Upper Austria. It was infamous for its quarries. In 1940, a sub-camp of Mauthausen was built in Gusen, where prisoners, mostly Poles, were forced to do extremely hard labour in the construction of a German underground armaments plant. In the following years the Nazi Germans established dozens of sub-camps with various industrial plants. Over 139 thousand prisoners of different nationalities were confined in them. There were also ca. 25 thousand non-registered prisoners who were killed straight on arrival. In the previous [i.e., 1967—Website Editor’s note] issue of Przegląd Lekarski – Oświęcim Dr Wlazłowski published detailed information on the Gusen prisoners’ hospital, supplemented with a selected bibliography. This paper describes the 1940–1945 period.^a
2. See Albin Garbień’s biographical note under the link.^b
3. Schildbach is mentioned in Pike, D.W. Spaniards in the Holocaust: Mauthausen, Horror on the Danube. Abingdon-on-Thames: Routledge; 2003.^b
4. See an article about Hubert Skolik under the link (article in Polish).^b
5. The kapos and orderlies were described in detail in Dr Wlazłowski’s article “The Gusen camp hospital.”^b
6. “Karl Schrögler, a 42-year-old German who was a block senior in Gusen 1, boasted that he had killed 1,500 inmates. He was convicted of drowning two Yugoslavian and one Polish inmate, between March and September 1943. He gave the men a bath in a tank of water into which had put chlorine. After a few minutes he pulled his victims out and dropped them on the concrete floor. When he was block senior of Block 32, he drowned large numbers of inmates in a communal bath large enough to hold 400 people and in which the water was 50 cm deep. It is thought that approximately 6,000 inmates were killed in this way. He also regularly beat inmates with a rubber hose filled with sand.” Source: http://traugottvitz.simplesite.com/437599291.^b
7. Follow the link to learn more about Bruno Jentsch (article in German). More information about the infamous “Death Baths” is available in the article published on the Mauthausen Memorial website (under the link).^b
8. Probably a reference to Sylweriusz Królak. Cf. an article on the history of the association of the former political prisoners of Gusen (article in Polish).^b
9. More information about Pablo del Rio can be found in de Miguel, C.H. Los últimos espanoles de Mauthausen. Penguin Random House Grupo Editorial Espana; 2015.

a—original Editor’s note; b—Translator’s notes.

      

A publication funded in 2020–2021 within the DIALOG Program of the Ministry of Science and Higher Education in Poland.