Robert Waitz, MD, PhD, 1900–1978, haematologist, member of the French Resistance during the Second World War, prisoner doctor in Auschwitz-Birkenau (1943–1946, prisoner number 157261). After the war he became a professor of medicine at the University of Strasbourg and was Head of the Internal Medicine Clinic of the Strasbourg Municipal Hospital.
Marian Ciepielowski, MD, 1907–1973, physician and scientist, veteran of the 1939 Polish defensive war, involved in the underground anti-Nazi resistance in wartime Poland. A Buchenwald survivor, he is best known for sabotaging the camp’s vaccine production unit, described in detail in the article Sabotage at the Buchenwald SS Hygiene Institute. Dr Marian Ciepielowski.
The SS set up a number of research stations in Nazi German concentration camps to carry out pseudo-experiments on prisoners. All of these centers were supervised by the Hygieneinstitut der Waffen-SS (Hygiene Institute of the Armed SS1) in Berlin run by Prof. Mrugowsky.2 Each center was managed by an SS chief physician.
The research conducted at Buchenwald involved typhus. The experimental station was set up in one of the prisoners’ hospital barracks located in the middle of the large camp and isolated from the camp by a fence of double barbed wire. It was accessible only to persons authorized by the head of the block.
Block 46, which was large and built of stone, was designated as the hospital barrack for the experiments. It had four large rooms and was equipped like an expensive private clinic. It had spotless linoleum floors. Its 90 beds were solid hospital beds, not bunks. The bed linen was clean and had pretty coverlets and pillowcases in a blue and white check pattern.
There was a large nursing staff under strict discipline and absolute secrecy, so in practice Block 46 was almost like a monastery. The staff consisted almost entirely of prisoners who had been patients in the camp hospital, and they were compensated for the restrictions with a variety of perks and financial benefits.
Moreover, the meals served in this barrack were bigger and more varied, compared with the standard camp rations: milk (half a liter per patient), butter (50 g), white bread, an egg, marmalade or artificial honey, sugar, sweetened porridge, semolina or a milk noodle soup. The block also had all the necessary medications: thousands of ampoules and hundreds of thousands of tonic pills, cardiac tablets, blood circulation supplements, sedative opium derivatives, codeine, sulfonamides and glucose tablets. It should be emphasized that at this time there was a huge shortage of food and medications in the rest of the camp.
Block 46 was a hospital both for patients who had caught typhus in the natural way and a station for research on human subjects with experimentally induced typhus. Its chief SS doctor was Sturmbannführer Schuler-Ding,3 who was the head of the hygiene institute in Block 50, which comprised diagnostic and research laboratories and a center for typhus vaccine production for the German army.
Schuler-Ding rarely visited Block 46. He only gave instructions for the pseudo-medical experiments. The man who served as the administrative and medical head of Block 46 on a regular basis was its kapo, Artur Dietz,4 a former NCO who had spent years in an internment camp under the Weimar government. Although he was not a medical doctor, he examined patients, performed chest auscultation and prescribed medications.
Until March 1945, this hospital was out of bounds to prisoner-doctors. Later, one of us had the opportunity to examine typhus patients there on several occasions.
There were plenty of humorous incidents during our consultations with Dietz. Usually we discussed pulmonary and encephalitis symptoms. Dietz was chief consultant for typhus cases in the whole of the prisoners’ hospital. Prisoner-doctors like Prof. Karol Richet5 had to follow his recommendations.
Dietz also injected typhus from person to person.6 These injections were performed with blood drawn from a vein on the fourth or sixth day of the disease. Then the infected blood was injected intravenously or subcutaneously. And this is how the human guinea pigs or Kaninchen, as Dietz used to call them, were selected from three categories of prisoners:
- Prisoners serving sentences for criminal offenses (“green triangles”);7 most of them were criminals; their loss did not evoke concern on the part of the authorities. They constituted the majority of the experimental victims. A few of the male nurses in Block 46 were green triangle prisoners who had survived typhus injections. They followed Dietz’s rigorous orders and considered artificial human-to-human typhus infection normal because they had had it done to themselves.
- Volunteers, i.e. prisoners who were so emaciated physically and morally exhausted that they volunteered for the “treatment” even though they were aware of the dangerous effects of typhus injections, but knew that if they survived the experiment, they would stay in Block 46 for the next three months, be well fed and not have to work. So, they would choose this type of suicide that offered a chance of survival.
- Sadly, political prisoners were also selected for these experiments—but not on a voluntary basis. Their numbers depended on the number of experiments to be carried out at any given time. Here Kapo Dietz played the key role in selecting the human guinea pigs. He used the camp loudspeaker to summon inmates who had been selected to assemble in front of the gate of the camp or the gate of the hospital, from where they were taken to Block 46.
The experiments had two aims. The first was to preserve and propagate the bacterial strain, and the second concerned the experiment in the strict sense of the word. The strains came from naturally infected typhus patients. They were propagated by infecting lots of new patients with them, sometimes as many as 25 to 30 times. These new infections were always done on two people simultaneously.
A record was made for each patient of the origin of the strain administered to them (Bu for Buchenwald, Or for Ordruff, etc.). The strain number was given in Roman numerals and the serial number in Arabic numerals, e.g. Bu 11/17, Bu IV / 11, etc.
The strains were collected from the victims’ blood on the fifth day after infection and used to infect guinea pigs (cavies), which were then used in animal experiments as the starting point for the production of a typhus vaccine for the German army, using the method developed by Giroud8 of the Pasteur Institute.
The human experiments were conducted simultaneously on a large number of prisoners. That was how the following issues were examined: time of incubation, the severity of the disease depending on the dose injected and the injection site, the Weil-Felix test9 and its results, the agglutination curve for Ebert bacteria10 and variants of paratyphoid, reactions to medications, in particular the effects of Bayer tranquilizers on typhoid encephalopathy.
Just before the liberation of the camp, preparations were going on in the research station to conduct an experiment on a large scale to examine the effect of serum collected from patients who survived typhus. Substantial amounts of serum were kept in the refrigerator and 25 prisoners were to be injected with a first dose.
A total of 950 prisoners were artificially infected with typhus in Block 46. The experiment’s records showed that prisoner no. 930 was infected on January 24, 1945. The injections continued until the camp was liberated (April 11, 1945).
Vernicle. Artwork by Marian Kołodziej. Photo by Piotr Markowski. Click the image to enlarge.
We managed to trace and follow 14 cases of experimental typhus, make brief notes on our observations, and draw the temperature curve for 7 cases. Unfortunately, we could not take any photos of the detailed records of the injections signed by the SS-Sturmbannführer in charge of the experiment.11 The Germans destroyed the records of the experimental station before the arrival of American troops.
To sum up, we must draw the following conclusions:
- The possibility of infecting a person with the blood of a typhus patient collected on the fifth day after infection and injected intravenously or subcutaneously, was confirmed.
- The period of typhus incubation varied from 6 to 8 or 10 days. However, the average incubation of 10 days does not give a proper picture of the experiment. In practice, the period of incubation can be divided into two groups.
In the first group, incubation lasted from 6 to 9 days, and the average was 7 days.
In the second group, with an incubation period typically of 14-18 days, the average was 16 days. Thus, we had two distinct groups, and the average period in the second group was double the value in the first group. An incubation period of 16 days is like the 14-day incubation time in spontaneous typhus.12 This group included four cases of subcutaneous typhus injection and only one case of intravenous injection.
In a few cases during the incubation period, a slightly raised temperature was observed for a short time on the eighth day (case no. 590) or on the eleventh day (case no. 651) after injection. The patient seemed to be well and for the time being no typhus symptoms were reported.
- Mild symptoms of typhus: a rash appeared on the third day, or sometimes already on the first day. The peak came on the third to fifth day; with hemorrhagic symptoms on the sixth to tenth day. Usually it was a dense rash all over the body. Encephalitis was generally observed (in twelve out of fourteen cases) and was one of the symptoms, but not a complication of typhus. Cardiovascular collapse (tachycardia, a fall in blood pressure, muffled heart sounds,13 cardiac murmurs, embryocardia,14 etc.) were common (in eleven out of fourteen cases). Spleen enlargement was a permanent symptom.
- The prospects were very unfavorable: ten patients died and only four recovered.
Nine out of the ten prisoners injected intravenously died; only one of the four injected subcutaneously died. The most common cause of death was encephalitis or cardiovascular collapse.
Death occurred from Day Seven to Day Thirteen, with an average for Day Eight or Nine. The mortality rate was high, higher than during an epidemic. Patients aged around 40 had a negligible chance of survival.
- From the hematological point of view, in many cases we observed a rise in the number of neutrophils.15
- The agglutination titer for Proteus 0X1916 varied over a wide range of values, usually increasing between the eighth and tenth day of the disease. High titers were also observed on the fifth day. In case no. 686, the titer was 1/50 on Day Seven; in some cases a double rise was observed in the titer.
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For technical reasons, we cannot present an aggregate table for the 14 cases here. Such a table should show the number of the prisoner infected artificially; the number, age, day of infection and injection data pertaining to the blood donor; the strain symbol (e.g. Bu II/3); the patient’s age; his general condition at the time of the injection (e.g. “fairly good,” “average”); the incubation period in days; the day of the onset of the disease; the type of rash (e.g. +++ on Day Five / pinpricks and mottled spots17); the temperature rise; development of the infection and the Weil-Felix test results.
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Thousands suffered and lost their lives to obtain such insignificant results in experiments not based on any scientific principles and conducted by incompetent staff. The same happened in other experimental stations and research centers, which were a typical feature of all Nazi German concentration camps, with their characteristic lack of respect and contempt for human beings and a complete denial of human rights.
***Translated from the Polish article: Waitz, Robert, Ciepielowski, Marian. “Doświadczalny dur wysypkowy w obozie koncentracyjnym w Buchenwaldzie.” Przegląd Lekarski – Oświęcim. 1965: 68–69. Originally published in French as: “Le typhus experimental au camp de Buchenwald.” La Presse Medicale. 1946(23), 322-324.
1. In 1943 the Hygiene Institute of the Armed SS started to produce typhus serum for its own use in Block 50. The institute’s department for medical experiments on inmates was housed in Block 46. See the source.a
2. Joachim Mrugowsky (1905–1948), a Polish-German bacteriologist who conducted experiments on humans at Sachsenhausen concentration camp. He was head of the Hygiene Institute of the Waffen-SS, Senior Reich Hygienist at the Reich, SS-Physician, SS and Waffen-SS Colonel. He was found guilty of war crimes in the Nuremberg Doctors’ Trial and executed in 1948. See the source.a
3. Erwin Oskar Ding-Schuler, SS surgeon at Buchenwald, where he carried out criminal experiments on prisoners. Arrested by U.S. troops on April 25, 1945; committed suicide on August 11, 1945. Ding-Schuler changed his surname to Schuler just before the end of the war. See the source.b
4. Arthur Dietzsch (1901–1974: his name is misspelled in the Polish article), kapo and male nurse in Block 46 at Buchenwald. Long-term prisoner of various German detention centers since 1920, eventually transferred to Buchenwald, where he served as a male nurse in the camp’s experimental station for pseudo-medical experiments involving artificial typhus infection. Dietzsch also worked closely with the inmates’ underground resistance group in the camp. Wikipedia article in English.a
5. Charles Richet, a French medical scientist. https://books.google.pl/books?id=7ckwDAAAQBAJ&pg=PA367&lpg=PA367&dq=Charles+Richet+a+prisoner+of+Buchenwald&source=bl&ots=tJmoFAWF9k&sig=ACfU3U02VyAwsgl4gxqX8wK_NPVdNQ006w&hl=pl&sa=X&ved=2ahUKEwjT4u6vpYz3AhVNiYsKHc1zDjcQ6AF6BAgdEAM#v=onepage&q=Charles%20Richet%20a%20prisoner%20of%20Buchenwald&f=false.a
6. A healthy prisoner was artificially infected with the blood of a prisoner suffering from typhus. Normally, typhus spreads when a person is infected by Rickettsia typhi bacteria through contact with the feces of infected body lice getting into a cut on the skin. Buchenwald prisoners infected with typhus artificially with an injection of an infected person’s blood faced a life-threatening situation. The aim of “artificial infection” was to preserve and propagate Rickettsia strains. In normal conditions, lice were used as the carriers of the bacteria needed the production of a vaccine but in Buchenwald prisoners were used instead of lice to produce the vaccine.b
7. In Nazi German concentration camps prisoners convicted of criminal offences wore a green triangular badge on their prison gear.c
8. Paul Giroud (1898–1989), French physician and biologist, head of the laboratory at the Paris Institut Pasteur, 1930–1938. In 1940 Giroud and René Panthier developed a typhus vaccine. Wikipedia link.a
9. The Weil-Felix reaction is a test used in the diagnosis of rickettsial infections. In countries with good medical resources it has been replaced with new serological techniques. See https://www.ncbi.nlm.nih.gov/books/NBK559225/.a
10. Perhaps Karl Joseph Eberth (1835–1926), a German pathologist and bacteriologist. In 1880 Eberth described a bacillus that he suspected was the cause of typhoid. In 1884 pathologist Georg Theodor August Gaffky (1850–1918) confirmed Eberth’s findings, and the organism was given names such as “Eberthella typhi,” “Eberth’s bacillus” and “Gaffky-Eberth bacillus.” Today the bacillus that causes typhoid fever goes by the scientific name of Salmonella enterica subspecies enterica serovar Typhi. https://en.wikipedia.org/wiki/Karl_Joseph_Eberth.c
11. Erwin Ding-Schuler (1912-1945). See Document No. 859 in the records of the Nuremberg Doctors’ Trial, dated November 29, 1946 and available online: http://nuremberg.law.harvard.edu. See also Ilana Löwy’s article, “Typhus in Buchenwald: Can the Story Be Told?”a
12. Here “spontaneous typhus” means natural infection. In artificial infection by the injection of infected blood, the incubation period was shorter.b
13. Heart sounds or tones, examined during traditional phonocardiography (auscultation), are commonly referred to as sonorous or muffled. These subjective auditory impressions are difficult to describe. Experienced medical practitioners tell them apart on an intuitive basis. Currently, this skill is gradually becoming less important and disappearing thanks to various modern techniques to describe cardiac pathology, such as heart echo tests, which present a visual image of the heart tones on an acoustic spectrum. New electronic devices for recording heart tones have been developed on the basis of the acoustic spectrum.b
14. Nowadays the term “embryocardia” is no longer used in the treatment of adults and is reserved exclusively for antenatal treatment. The heart rhythm typical of a fetus is much faster than that of an adult.b
15. Neutrophils are a type of white blood cell (leukocyte) and act as the immune system’s first line of defense.b
16. The OX19 mite (Proteus vulgaris) agglutination test developed by Edmund Weil and Arthur Felix was the first non-specific test used to diagnose typhus. See Note 10.b
17. Waitz and Ciepielowski probably mean the mottled lesions which develop when the rash has grown and takes the form of spots. There is a similar term in dermatology, lentigo, meaning a pigmented, light or dark brown, flat or slightly raised lesion with a clearly defined edge, but these lenticular spots are not the same as the macular rash observed in typhus.b
a—Translator’s notes; b—notes by Maria Ciesielska, Expert Consultant for the Medical Review Auschwitz project; c—notes by Teresa Bałuk-Ulewiczowa, Head Translator for the Medical Review Auschwitz project.
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