1946-12-20, #4: Doctors' Trial (late afternoon)
1946-12-20, #4: Doctors' Trial (late afternoon)
THE MARSHAL: The Tribunal is again in session.
MR. HARDY: If there is no cross examination of this witness by the defense counsel, I propose now to call Dr. Alexander to the witness stand.
THE PRESIDENT: I understood before we recessed there was no cross examination of this witness by defense counsel. Is that correct? Proceed.
DR. LEO ALEXANDER, a witness, was recalled to the stand and testified as follows:
THE PRESIDENT: Dr. Alexander is reminded that he is still under oath as a witness in this Court.
DR. ALEXANDER: (Addressing Jadwiga Dzido). Please take off both shoes and both stockings, if you will.
(The witness removed her shoes and stockings.)
DIRECT EXAMINATION--Continued BY MR. HARDY:
Q: Dr. Alexander, have you examined Miss Dzido before today?
A: Yes, sir, I did, on several occasions and during the last three days.
Q: During your examination, did you have x-rays made of the patient's legs?
A: I did, sir.
MR. HARDY: At this time I will introduce document No. NO-1091 which is the x-ray of one witness, Miss Dzido. We will pass two copies to the Tribunal and one copy for the Secretary General.
BY MR. HARDY:
Q: Dr. Alexander, in the course of your diagnosis of these x-rays, will you kindly diagnose this x-ray in English and then repeat in German for the benefit of the defendant?
A: Yes, sir.
Q: Doctor, will you identify that x-ray which carried No. NO-1091?
A: Yes. This is the x-ray which included the lower two-thirds of the thigh bone, the femur and the knee joint, and --
MR. HARDY: I offer this x-ray as Prosecution Exhibit No.215.
BY MR. HARDY:
Q: Do you have any further explanation of this x-ray, Doctor?
A: Yes, sir. I would like to tie it in, if it is agreeable to you, with the chemical examination.
Q: All right, Doctor.
A: The most remarkable finding in Miss Dzido's case is at first marked atrophy of the right leg, including thigh, leg and foot. Will you please stand up, Miss Dzido. (The witness stood). And will you gradually slowly turn around? You can compare here the two legs and you notice the marked atrophy. You see the femur of this bone, of this leg, as compared to the other. This atrophy is predominantly on the calf but also includes the lower part of the thigh. Here, the thigh (indicating) as compared with the other side. The atrophy of the thigh is due to the fact that the lateral flexor group, including the musculus biceps, is absent which leaves the lateral epicondyles and the lateral prominence of the tibia without the tendinous insertion. You see this tendon here, strong tendon is absent on this side. The lower part of the leg, including the malleolar region and the dorsum of the foot show bluish discoloration, indicating interference with the circulation of the leg, probably due to loss of blood vessels. (The witness now faced the judges). Skin and musculature of the right foot, including the toes, are likewise atrophic. The right leg is furthermore disfigured by two ugly scars, one here and one here.
THE PRESIDENT: One where, Doctor, for the sake of the record.
DR. ALEXANDER: Here. (Indicating).
THE PRESIDENT: I know, but it **st go into the record.
DR. ALEXANDER: Take the lateral one and the medial one. The lateral one begins three inches above the knee, above the lateral epicondyles of the femur running down over the lateral part of the calf until two inches above the lateral malleolus. This scar is sixteen inches long. The width of this scar varies from one-eight inch to one-half inch. The lower part of this scar still snows inflammation and oozes sero-purulent discharge, indicating the presence of a sinus. Two and one-half inches medially to this scar and parallel to it is an equally disfiguring one measuring seven inches in length and partly three-quarters of an inch in width.
There are four small recent neat scars indicative of having healed by first intension over the right food and ankle These are incidental to transplantation of tendons to correct a foot drop. It is referred to as phalphesus (?) which was carried out by Dr. Gruca. There are a number of neurological disturbances in this location. The dorsiflexion of the foot is abolished.
(Addressing Miss Dzido). Would you try to life up your foot like this. (Indicating). Although they are present, in view of the tendon repair, there is no longer any foot drop but the patient cannot lift the foot off the ground to any significant extent. The gait is disturbed by this loss of dorsiflexion of the right foot and lateral rotation of the right foot is likewise abolished.
(Addressing Kiss Dzido). Will you please try to do this, put the foot inward and outward. There is very little lateral rotation possible.
(Addressing Miss Dzino). Would you like to walk first? Would it be desire to have the patient walk?
You notice that during the gait the toes of the right foot remain planted to the ground because of the inadequacy of the lifting movement of the foot which is accomplished by the perineal nerves. These findings indicate paralysis, or loss rather, in this case of the perineal nerve. The right knee joint is diminished and the right ankle jerk is absent. Here you get a very good knee jerk and on this side a less active one. You see here very marked atrophy because of the loss of the whole flexor musculature. There is a good ankle jerk here. I never was able to retain one on the right. Sensory examination showed an anesthesia for fine touch on the dorsum of the right foot, which means the back of the foot. The pressure is felt. The lower two-thirds of the antero-lateral aspect of the right leg, as well as that part of the lateral and posterior aspect of the leg which is lateral to and between the two scars---this part and thus, which shows hyperesthesia for touch and not complete loss. All these areas show marked hyperesthesia for pain. In the medial part of the calf here sensation to touch is normal Thank you very much.
Q: Now, Doctor, I will give you all these x-rays together. There will be an addition to the one that he has, NO 1092, NO 1093 and NO 1094. Would you kindly identify these three x-rays first, Doctor, so that we can offer them as exhibits?
A: Yes. In 1092 is the x-ray of the leg, including the tibia and fibula.
MR. HARDY: That is offered at this time as Prosecution Exhibit No.216.
DR. ALEXANDER: In 1093 is an x-ray of the right feet.
MR. HARDY: That is offered as Prosecution Exhibit No.217.
DR. ALEXANDER: And in 1094 is another x-ray of the right foot, with particular attention to the metatarsal bones.
MR. HARDY: Document No. 1094 is offered as Prosecution Exhibit No.218.
BY MR. HARDY:
Q: Proceed, Doctor.
A: The first of the x-rays, the picture of the femur, shows marked osteoporosis of the lateral epicondylus. This is due to the fact of the removal of muscle and tendon attachments. It is an osteo-porosis of disuse because the normal pull of the tendon has been removed from this epicondylus. The epicondylus is the big prominence of the thigh bone adjacent to the knee joint where the large flexor muscles insert normally. Where that insertion has been abolished here, leaving the epicondylus without soft major tendons. This osteo-porosis is the obvious result of that, and marked osteo-porotic prominence with an arrow in this picture.
Q: Doctor, this x-ray you are referring to now is No. 1092?
A: This is No. 1091. The arrow points to the osteoporotic atrophy of the tibia. Number 1092 is the x-ray of the leg. It shows the fibula which is the smaller of the two Larger banes of the leg, about in the middle between the area just mentioned under the bracket called "B". On the side, looking toward the tibia is the osteoperiostitis of the periosteum. This group of marks are particularly severe in the smaller area which I have marked with the bracket "A" indicates a smaller area of the shaft of the tibia within the larger area of the disturbance marked as "B". This alteration is indicating and consists of an ordinary inactive Coxa, which in view of the osteoperiostitis of the periosteum was probably an osteomyelitis process. However, there is no active osteomyelitis at the present examination of the right foot, In pictures 1093 and 1094, it shows arthritic changes of the cuniform navicula joints with narrowing of the joint spaces and increased marginal sclerosis. This has been marked in the x-ray with an arrow pointing to the joint. The other prints are the same. The prints have come out too dark, but it shows the condition clearly in the film.
This arthritis is due to the immobilization of the right foot. Secondary to the muscles and especially the paralysis of the perineal nerve. It is evidently arthritis of an immobilization nature which one sees also by inspection of the patients foot.
Q: Doctor, can you determine from your examination -
A: (Interposing) 1094, have I mentioned it shows the same as 1093 in a slightly different exposure. The marks are the same pointing to the most marked arthritis between the cuniform navicular joints.
Q: Doctor, in your opinion, from your examination of this patient can you determine what was the purpose of the experiment?
A: It appears that in this experiment a highly infectious agent was implanted, probably without the addition of a bacteria static agent such as sulfanilaide, and for that reason the infection got out of hand and became very extensive.
Q: Do you mean, Doctor, it is highly possible this patient could have been considered as one of the control groups?
A: Yes, probably one of the control group. The two previous patients both mentioned white powder which has been used in their wounds, which was probably one of the sulfanilaides, and while this patient as well as the subsequent patient, knew of no use of the white powder. Therefore, I assume that they may be of the control group. They have bean injected or implanted with the bacteria culture without the subsequent use of sulfanilaide. From the general appearance, it is suggestive of a Streptococcus in this case. The way it is spread makes it likely, and the fact that the spread is mostly lengthwise.
Q: Could you say, Doctor, the reason for the spread in this case was because of the lack of treatment, where as the other patients had been treated after being operated on, is that correct?
A: Presumably. The other patients were given sulfanilaide in the wounds sometime after the wounds were made; presumably to test the efficiency of the use of sulfanilaide on the battle field such as we started to do it in the United States Army.
Q: Now, Doctor, you, as a psychiatrist, can you say what psychological effect these operations had on the patients?
A: I think that it was that of deep humiliation which was the most remarkable reaction in all these women. I would say it was rather a resentment against humiliation. The use of the name "guinea pig" -- they are all high spirited girls. They were all soldiers. This girl is of a superior intelligent a student of pharmacy, a woman of culture, and speaks very good English which she feels is not good enough to testify in it. This whole treatment caused a deep humiliation, and. on the other hand, it also aroused a fighting spirit, and the remarkable thing is that this prisoner showed how she rebelled against this treatment. She was one of a group which was forcibly operated on. Here is a woman who fought like a wild cat in a concentration camp against this treatment, and who had to be held down by to or more SS men.
Q: Thank you Doctor.
MR. HARDY: I have no further questions to put to Doctor Alexander, at this time, Your Honor.
THE PRESIDENT: Do any of the defense counsel desire to cross examine Doctor Alexander?
CROSS-EXAMINATION BY DR. SEIDL:
Q: Only a few questions, Doctor Alexander. Are you able to state exactly which scars came from the, transplantation in 1945 in Warsaw?
A: Yes. In 1945, the operation involved two things: Transplantation of the tendons. You can still recognize those wounds because the tissues still show. That was done to lift the foot up. This girl has a marked loot drop, more marked than the first witness and these tendons lift the foot up, and fixed it in that position (indicating). In addition, the witness told me that the upper end of the scar here was treated cosmetically. The main scar from the knee down to here, was not touched, and specifically the open side was not touched.
Q: Is it possible that to biceps is lacking because it was used in this transplantation in Warsaw?
A: I did not obtain that history. I can ask here through the interpreter.
DR. ALEXANDER: Will you please ask the patient these questions:
DR. ALEXANDER: Do you feel this tendon here, the big tendon on the side?
MISS DZIDO: No.
DR. ALEXANDER: Here.
MISS DZIDO: Yes.
DR. ALEXANDER: Now, on this side, do you remember whether you still had this tendon when Doctor Gruzer operated on you in Warsaw?
MISS DZIDO: No.
DR. ALEXANDER: It is very unlikely that one would use a bicep tendon for transplantation. It is more likely that the tendon was snipped off during the acute state of the infection.
Q: That is your assumption?
A: Yes.
Q: Now something else, you are of the opinion apparently that this big scar on the back of the calf was necessary in order to combat the gangrene surgically?
A: I do not know. The case looks to me like streptococcus. The way it is distributed -- for gasbrand it as not complete enough. Of course it is difficult to distinguish that but the next patient you see a typical gas bacillus scar and it looks different than this one. This looks like streptococcus, but it is probable that one or two cuts were made in order to control the infection surgically.
Q: Do you know Doctor whether the patient was treated with sulfanilaide?
A: No, the only thing is she is one of two patients who did not mention white powder. That is all I know.
DR. SIEDL: I have no further questions.
THE PRESIDENT: Any further questions by the counsel for the defense?
(Apparently none)
There being no further questions the witness is excused.
MR. HARDY: The prosecution request that the witness Maria Kusmierczuk be called to the stand at this time.
THE PRESIDENT: The Marshall will summon the witness Maria Kusmierczuk.
THE PRESIDENT: I remind the interpreter that he has been sworn in this cause.
THE INTERPRETER: Yes.
THE PRESIDENT: You will now administer the oath to the witness.
MARIA KUSMIERCZUK, a witness, took the stand and testified through an interpreter as follows:
BY THE PRESIDENT:
Q: The witness will state her name.
A: Maria Kusmierczuk.
Q: Raise your right hand and repeat:
I swear that the evidence I shall give shall be the truth, the whole truth, and nothing but the truth. So help me God.
(The witness repeated the oath).
THE PRESIDENT: The witness may be seated.
DIRECT EXAMINATION BY MR. McHANEY:
Q: Will you state your name, please?
A: Maria Kusmierczuk.
Q: Your last name is spelled K-u-s-m-i-e-r-c-z-u-k?
A: Yes.
Q: You were born on 1 January, 1920, at Jagerndorf.
A: Yes.
Q: You are a citizen of Poland?
A: Yes I am.
Q: Have you come here voluntarily to testify?
A: Yes.
Q: What is your present home address?
A: Raciborska Street 1.
Q: What education have you received?
A: I've finished the secondary school; and I am a student of the University.
Q: Have you studied medicine?
A: Yes, I am studying medicine.
Q: Were you studying medicine at the University in Vilna before the war broke out?
A: Yes, I was in Vilna. I was studying mathematics and nature at the University of Vilna.
Q: You are now studying medicine at the University in Odansk?
A: Yes.
Q: Were you working in the underground movement in 1940?
A: Yes.
Q: Where was this.
A: Zamoshtsh.
Q: Were you ultimately arrested for your activity in the underground?
A: Yes.
Q: What were you doing in the Polish underground?
A: I was messenger; and I was assigned to the chief headquarters.
Q: Were you tried by a court after you were arrested?
A: I have never been tried by a court.
Q: What was done with you after your arrest?
A: I was arrested by the Gestapo and then put into the prison in Zamoshtsh where I was for ten days. During those ten days I was interrogated by the Gestapo. Then I was put in the prison in Lublin, where I stayed until the 23rd of October 1941.
Q: What happened then?
A: Then I was sent to the concentration camp Ravensbrueck.
Q: What work did you do at Ravensbrueck?
A: I did the usual physical work. Then I worked in the workshop putting soles on shoes. I worked in this workshop until I was taken for the operation.
Q: When was that?
A: On the 7th of October, 1941.
Q: 1941 or 1942?
A: 1942.
Q: Were other girls taken with you at the same time to be operated on?
A: Yes. In the hospital it turned out that there were also other girls taken at the same time.
Q: Will you explain to the Tribunal how you came to be selected for this operation and what happened during the course of it?
A: On the 7th of October when I was sleeping, I suddenly heard my name called, my number called. A police woman came; took me; and didn't tell me where I was going. Following her, I came ......./..... to the hospital.
I discovered in the hospital that there were eleven other girls who had to disrobe and were examined by Dr. Oberhauser. After the examination we were put to bed. A German nurse shaved our right legs. Then we were given injections which stunned us. Then I remember that I was put on a hospital cot and taken to the operating room. There I saw Dr. Schiedlauski and Dr. Rosenthal, who gave me the second injection. I remember that I had to count to twelve; and then I don't remember anything else.
Then I remember the moment when I was again in the hospital room. My comrades were lying in the same room. I felt that my leg was bandaged and I couldn't move it; and I felt severe pain. During the next few days I developed high temperature. I remember that my leg was bandaged. I remember in the first days that Oberhauser used to come each day and give me injections. Then my leg was bandaged. They used to take me to the dressing room. I was put up on a dressing table. A sheet was put over my eyes. I felt only that the bandage was removed and I felt an inhuman pain. I tried not to scream in order to see what happened to my leg. I remember that it felt as if somebody would cut off something on my leg.
Dressings were changed twice a week, if my memory serves me well. During the next changes of dressings when my temperature was not so high, I noticed that the dressings were made by the doctor whose name, as I learned it afterwards, was Dr. Fischer. I know also that for a long time the dressing were made by Dr. Fischer, because when pus drained from my leg and the air was foul with odor, I asked that my dressings might be changed; and I was told that I must wait until Dr. Fischer arrived.
I remember also the fact that three weeks after my operation I and all my comrades were taken cut of the room and carried into the operating room. Then I was lying in a separate room with the bandage taken off on a high table. After two hours of my lying on this table and looking at my leg, that made a very deep impression on me because I saw in a flash even pieces of my bone.
The doctors came. In the front walked a doctor, very stout and tall, wit spectacles. He took a hammer-like instrument and tapped the bone in my leg. I tried to look at this man and keep his face in my mind. I know that this man was Prof. Gebhardt. -859
Q: Witness, do you think that you would remember this man's face today?
A: I think so, but I must look before.
Q: Will you please get up and walk over to the defendants' dock and see if you recognize this man Gebhardt as being there?
(Witness walking to dock.)
Q: Will you point to him, please?
(Witness pointing to Defendant Gebhardt.)
Q: Thank you. And will you now point out Oberhauser?
(Witness pointing to Defendant Oberhauser.)
Q: And Fischer?
(Witness pointing to Defendant Fischer.)
Q: Thank you. Will you sit down now.
MR.McHANEY: I would like for the record to show that the witness properly identified the Defendants Gebhardt, Oberhauser and Fischer.
THE PRESIDENT: The record will so show.
BY MR. McHANEY:
Q: Now, Witness, when did you leave the hospital after this operation on the 7th October 1942?
A: My wound was so big that I had to stay in the hospital about half a year. At the beginning of the month of April 1943 I left the hospital wearing crutches.
Q: Now, your wound was not healed then at that time?
THE INTERPRETER: Will you kindly repeat the question?
Q: Your wound was not healed then when you left the hospital?
A: My wound was not healed when I left the hospital.
Q: Were you able to work?
A: I was not able to work and I was not able even to walk. I stayed in the block till the 1st of September 1943. On the 1st of September 1943 I went again to the hospital because pus was draining from my wound and the wound was not healed yet. I stayed in the hospital about half a year wit hour being able to get up.
Q: That was until early 1944 that you remained in the hospital?
A: I left the hospital in February 1944. I don't remember the exact date; but the wound was not healed yet and there was a small wound from which pus drained. On the 15th of September Dr. Treitel, to speak of the healing of my leg, grafted the skin taken off my thigh on to the wound. I stayed in the hospital till February 1944 but when I returned back to the block I could not walk well. My leg was entirely healed at the end of June 1944.
Q: Now did this skin grafting operation take place on September 15, 1943?
A: Yes.
Q: Now, going back to the original operation, when did you first know that an operation was to be performed on you?
A: When I was put to bed and my legs were shaved, then I thought that I would undergo an operation.
Q: Did you ask them what they were going to do to you?
A: No, I didn't ask.
Q: Why not?
A: Because it was impossible to ask anything in the concentration camp. We used to get, as answers to our questions: "Halt's Maul" -- shut up.
Q: Were you in good health at the time of this operation?
A: I was quite healthy, only under-nourished and exhausted because of hunger reigning in the camp.
Q: Did you ever make any protest against this operation?
A: I protested against operations, but after my own operation when living conditions in camp allowed me to do it.
Q: They did not ask you to consent to this operation before you were operated on, did they?
A: I was not asked anything by anybody. When I was taken to the hospital I was sure that I was going to be shot down, because I remember that all my comrades belonging to the same transport who had been shot down were taken out of the blocks in the same way.
Q: Now, do you know approximately how many women were operated on experimentally at Ravensbrueck while you were there?
A: Yes, I remember quite well. Seventy-five Polish women were operated.
Q: And did any of them die as a result of these operations?
A: Yes. I remember quite well that five of my comrades who had been operated on died. After my operation two of my comrades died. One was lying near me in the hospital and the second was in the same room. The name of the first was Krokopsky Kasimira, and the second Ketzel Sofia. Besides died Bruce Alsky, Evinov Itchinila and Kruska.
Q: Now, were you women who were subjected to these operations known in the camp as "guinea pigs"?
A: Yes, the very well known name was "guinea pigs" to describe us.
Q: Now just before the end of the war, did they make -- did the Germans in Ravensbrueck make any effort to gather together all of you so-called guinea pigs?
A: Yes. At the beginning of the year 1944 all operated women were put into one block. On the 4th of February 1945 I remember that the chief of the block road off our names written down on the list. He told us that we were not allowed to leave the block the next day. We knew that this procedure on such a list meant execution and we knew that we would probably be executed because we knew that six of our comrades had been shot down before.
We knew also, for certain, that the Germans would try not to let any witness who knew about the operations get out of the camp alive.
Q: Well, witness, were you girls able to avoid detection because of the great confusion in the camp in the last days of the war?
A: Yes, that is what I wanted to say.
Q: Now, were you ever promised freedom if you agreed to undergo this operation?
A: Never, no.
Q: Did you say at any time that you would prefer to be shot instead of operated on?
A: Yes.
Q: Now, you mentioned that six of these women who were operated on experimentally were shot. Are you telling the Tribunal that these six persons were killed in addition to the five who died as a result of the operation?
A: Yes.
Q: Have you had certain pictures taken of you since you came to Nurnberg?
A: Yes.
MR. McHANEY: I am handing to the witness for identification seven pictures marked "NO-1080, A through G."
(Documents were submitted to the witness)
Q: Are those all pictures taken of you here in Nurnberg?
A: Yes.
MR. McHANEY: The Prosecution offers document No-1080, A through G, as Prosecution Exhibit 219, A through G.
Q: Now, witness, will you please remove your stocking and shoe from the leg on which the operation was performed? Now, will you stand up and step out to the side, and will you turn around slowly? Will you turn around again please? (The witness complied.)
MR. McHANEY: You may sit down now.
Q: Witness, have you undergone any operational treatment since you left the Ravensbrueck Concentration Camp?
A: Yes, I underwent an operation in Warsaw.
Q: And what was the nature of that operation?
A: This operation was performed by Professor Gruzak.
Q: And what did he do?
A: The operation consisted of transplantation of a tendon which would hold the falling foot.
Q: Was this operation successful?
A: This operation did not succeed. There was some infection in my leg that caused the tendon to fall out.
MR. McHANEY: I have no further question at this time, Your Honors.
THE PRESIDENT: Have counsel for the defendants any cross-examination of this witness?
(No response)
MR. McHANEY: We can call Dr. Alexander to the stand now, and I think perhaps he can make a start on his report.
THE PRESIDENT: Very well.
DR. LEO ALEXANDER, a witness, having been previously sworn, took the stand and testified as follows.
MR. McHANEY: I will ask that the record show that Dr. Alexander is still under oath and is the same Dr. Alexander who has testified earlier today.
THE PRESIDENT: The Tribunal reminds the witness Dr. Alexander that he is still under oath.
DR. ALEXANDER: Yes, sir.
DIRECT EXAMINATION BY MR McHANEY:
Q: Dr. Alexander, have you made an examination of the witness now on the stand; that is to say, Miss Kusmierczuk?
A: I have.
Q: And was an X-ray made, under your direction, of the leg of this witness?
A: Yes, sir.
Q: And is that the X-ray which you now have in your hand, namely, document NO-1095?
A: Yes, sir, it is.
MR.McHANEY: I submit document NO-1095 as Prosecution Exhibit 220.
Q: Now, doctor, will you proceed to give a report on your examination of this woman?
A: This patient's right leg is disfigured bu a deeply scarred excavation (indicating), the bottom of which is the lateral aspect of the tibial bone (indicating) -- this is hard tibial bone-- from which the entire peroneal and anterior tibial muscle groups have been peeled off or sloughed off.
If you look at the other leg, (indicating), what you see here is the tibial and peroneal muscle, antetibial and antepersoneal muscle group. From this side (indicating), one cannot feel the bone directly; on this side --(to the witness), will you turn around -- there you see the bone is completely denuded. All this is hard bone surface, covered by skin only. This (indicating), is the bone directly, fibular as well as tibial. You can feel both bones. This is the fibular bone and this is the tibial. You cannot normally feel these bone here (indicating), because they are covered by muscle. The muscle has been peeled off, leaving the bone at the bottom of the cavity.
The lateral soleus muscle is likewise destroyed. That is this muscle hero (indicating), which gives this very curious sharp drop from the calf. As you see, if you look at it in this way, you see here the lateral soleus muscle, which gives the calf its graceful curve. Here is the medial and here is the lateral. The lateral gives this lateral, graceful, normal curve. Here (indicating) you see the curve is sharply interrupted by this angle, due to the fact that the lateral soleus muscle is gone as a. whole.
The muscles of the upper calf, apart from the lateral soleus, are preserve The upper calf here is preserved. This mutilating scar begins two inches below the lateral epicondyle-- here (indicating) -- and extends downward to the lateral malleolar region, including the dorsum of the right foot, until here (indicating). At its upper end, the scar is half an inch wide.
In the middle of the leg the scarred area measures two and three quarter inches in width. Here (indicating). This is two and three-quarter inches. In the lower half of the scar the skin is directly concrescent with the periosteym of the lateral surface of the tibial and fibular bones. This is bone (indicating).
Now, the neurological, examination.
(to the witness): Will you please try to do this?
(demonstrating).
(The witness complied).
The patient is unable to dorsiflex the foot, which means to elevate the foot upward.
(To the witness): Try to do it on the other side, if you will.
(The witness complied)
Try do do it with the other leg, if you will. Just show that you understand this. Like this. (demonstrating).
(The witness complied).
Now try to do it here (indicating).
Dorsiflexion is completely gone. The big toe cannot be dorsiflexed either.
(To the interpreter): Will you try to tell her to dorsiflex the big toe, to pull the big toe up?
(The interpreter complied).
You notice this indicates that among the muscles of the peroneal and anterior group, the extensor hallucis longus is likewise missing; that is, the extensor muscle of the big toe. The small toes can be somewhat dorsiflexed and spread.
(To the witness): Try to wiggle the small toes, if you will.
(The witness complied).
You notice that the residual dorsiflexion of the small toes of the right foot involves only the end phalanges--that means the tips only--indicating that this residual motion is entirely carried out by the small muscles of the foot, and that the extensor digitorum longus is likewise missing. All these disturbances reveal themselves in the gait of the patient.
(To the witness): Will you please walk a little bit?
(The witness complied).
You will notice again that during gait the right leg is not elevated, but remains glued to the ground, as it were.
(To the witness): Will you please do it again? Thank you.
(The witness complied).
It remains glued to the ground. It is somewhat better with shoes on, where some support is given.
Knee jerks are active and equal; right ankle jerk is present but diminished.
The knee jerk is here (indicating); the ankle jerk is very lively here. There is a little bit of it, indicating that the gastrocnemius tendon is still there and the muscle barely functioning.
The scar itself and a small area one and a half inches wide laterally adjacent to its middle part--here (indicating), the scar itself is in this area here--are anesthetic for touch and pain. However, the patient describes painful paresthesias in the anesthetic part laterally adjacent to the middle third of the scar. Here, apparently, there may be a small neuroma probably growing there from some of the remnants of nerve tissue.
The entire dorsum of the right foot shows hypesthesia for pain.
The dorsum of the right foot, the scar itself and the small area laterally adjacent to its middle third are anesthetic to fine touch but feel coarse touch. The vibration sense over the lateral malleolus is diminished. That of the medial malleolus is preserved. As demonstrated before, gait is disturbed by inability to dorsiflex the right foot.
Q: Doctor, can you briefly give us your findings with respect to the x-ray picture?
A: Yes sir. There are three groups of findings. First of all, marked "A" on the x-rays there is a bone defect, semi-circular in shape, involving the lateral part of the tibia, 1.2 centimeters in diameter, located at the lateral aspect of the tibia 4½ centimeters above the ankle joint. This cavity is consistent with an infective process with a cavity resulting either from an absorbed or removed sequester, or from removal of part of bone with subsequent infection, surrounded by sclerosis of the bone; immediately proximal to this defect, marked "B" in the x-ray photographs, is a bony bridge between the fibula and tibia. This entire picture is characteristic of previous osteomyelitis.
Furthermore, the distal half of the entire fibular shaft over a stretch indicated by "C" on the photograph, the fibular shaft is thickened with marked thickening of the periosteum, indicating r pair following osteomyelitis I repeat, here is the osteomyelitis of the fibula (indicating). Here is the bone defect (indicating), the cystic defect resulting probably from the removal of sequester or probably removal of part of bone with subsequent infection; above it, marked "A", the hole in the bone which is about here roughly (indicating), and above it the concrescence between fibula and tibia, to compensate for the weakening of support below, or just simply concrescence due to the infectious pusses, production of the periosteum, inflamed periosteum which, in a stage of repair, will lay down new bone between; of course, abnormal bone.
Q: Doctor, finally can you give us your opinion as to the purpose of the operation which this woman was subjected to?
A: The completeness with which muscles have sloughed off indicates that this probably was an experiment with gas bacillus, with one of the gas bacillus.
variety or oedema malignum variety, and again this patient did not mention any powder that was used in conjunction whit the original inoculation. This patient did mention the formation of blisters which make it likely that this was a case of oedema malignum experiment, a gas bacillus experiment, and that probably streptococci did not play a role, at least in the acute stage. The sharp demarcation to individual muscle groups and the completeness of their destruction is more typical of the activity of the anaerobes. The anaerobes is the group to which gas bacilli belong.
MR. McHANEY: I have no further questions, your Honor.
THE PRESIDENT: Do counsel for the defendants have any questions to propound to the witness, Dr. Alexander, on cross examination?
(No response).
THE PRESIDENT: Apparently there are none. Is counsel for the prosecution finished with the witness/
MR. McHANEY: He may be excused as far as the prosecution is concerned, your Honor.
THE PRESIDENT: The witness may be excused and the Polish witness is also excused. I think counsel for both parties understand that some time ago the Tribunal announced that it would, tomorrow at 12:30 o'clock, adjourn until the morning of Thursday, January 2. I suppose you can use the morning, Mr. McHaney, in reading records from the book?
MR. McHANEY: Yes indeed, sir.
THE PRESIDENT: The Tribunal will now recess until 9:30 o'clock tomorrow morning.
(The Tribunal adjourned until 21 December 1946 at 0930 hours.)