1947-04-22, #3: Doctors' Trial (afternoon)

AFTERNOON SESSION (The Tribunal reconvened at 1400 hours, 22 April 1947)

THE MARSHALL: The Tribunal is again in session.

MR. HARDY: May it please Your Honor, after the completion of the Rose case on agreement with defense and the Prosecution and if the Tribunal desires, we would like to present the defendants, Ruff, Tumberg, and Weltz in that order, that is put their cases on. in that order, and after the completion of the case against Dr. Weltz then hear the case against the defendant Brack, based on the fact that the cases of Ruff, Romberg and Weltz are very similar, and it wouldn't interrupt the continuity of thought, and the evidence then would be more convenient for both the defense and the Prosecution, to be handled in that manner.

THE PRESIDENT: Do I understand that is agreeable to counsel for the defense? If so, that method of procedure will be satisfactory to the Tribunal.

GERHARD ROSE — Resumed DIRECT EXAMINATION (Continued)

BY DR. FRITZ:

Q: Various witnesses have repeatedly mentioned Stabsarzt [Staff Surgeon] of the Luftwaffe Graefe, who is alleged to have assisted Haagen in his work; who is this man and what did he have to do with Haagen?

A: In the Luftwaffe, as in all branches of the Wehrmacht, there were so-called expert commandos. These were offices of the University clinics, in University institutes, in which people from the armed services were sent for technical and special training for several years. — Of such, expert commandos for hygiene, there were three in the Luftwaffe, one in Graz, one in Heidelberg and one in Strasbourg. Only in the one in Strasbourg was the director of the Institute also a reserve officer in the Luftwaffe, but that was not of decisive importance. The commando might have just as well gone to another Institute as in the case of Graz and Heidelberg. Stabsarzt Graefe was such a medical officer, who had been detailed for expert training in hygiene. In this trial the question is of importance, what the legal standing of such a commanding officer was.

The question has frequently been decided on in German legal proceedings, because the act of detailing an officer has been a practice for more than a century, and thus the question of legal responsibility and other such questions have frequently been discussed in this connection. I am even in the position to describe such a case in detail which I experienced at the University of Heidelberg. I don't want to do that here unless the Tribunal expressly requires it, but at any rate the question has been decided in German law to the effect that the detailed medical officer is responsible to the Civil Institute, to the Director of the Civilian Institute, and that the Director is liable within the framework of the law for such errors as are committed by the detailed medical officer in the course of his duties. I grant that the question could still be disputed, but at any rate it is so laid down in German law.

Q: Now, after this discussion on the legal aspects of it, I ask you to state if you know how reports were made on these research assignments, the content of these reports, when they were made?

A: Such a report was prescribed. What the dates were on which Luftwaffe reports were to be made I do not know, because I never received a research assignment from the Luftwaffe. In the Research Department where I had to report, reports were given every six months. Haagen also sent such reports in, for example; on his yellow fever and influenza assignments, however, I saw no reports. In other words, his reports in these fields were certainly fragmentary.

Q: What were these reports?

A: Haagen was no better and no worse than other scientists in the matter of his reports. Lost scientists made reports when they needed funds or when they were told to do so. On such occasions Haagen sent short interim reports. Otherwise, he limited himself to sending from the printed material about 2 reports, regarding his work, and calling them his reports.

Q: What would generally be deduced from these interim reports?

A: Not very much from the interim reports. The assignment was reiterated in it and there was a statement that work was being done, but these interim reports were never very informative, because these were not matters that were suitable for publication and therefore the scientists were very reticent. On the other hand, so far as I am informed, there was never much pressure that such reports should be made, because if one knows scientists, one knows very well that then they have found something out, when they have discovered something, they will report on their own initiative in order to receive recognition for their work, and if they have made no discoveries it does nothing to improve the situation if long reports are sent in on their failures. Scientific research is not something like a factory where you want a monthly report on production. If no positive results are achieved that is too bad, that is a short statement, but nobody gets very excited about that.

Q: From your testimony one gets the impression then that Haagen's reports to the Medical Inspectorate were infrequent, but the witness Eyer states here that he wrote reports for Berlin every three months. Can you clarify this contradiction?

A: First of all, the impression that Haagen's reports were infrequent in number is entirely correct, and if Miss Eyer says here that she wrote reports every three months, then I don't know where they went to. They certainly didn't go to the Medical Inspectorate of the Luftwaffe, because such an exemplary form of report would have been absolutely unique, and I should not have forgotten it. He would have been the "White-Haired Boy of Report Sending." The correspondence with the Reich Research Council that we have here seen does not give the impression that these reports were very frequent in number, but if one looked at the documents that have been put in evidence here regarding the various duties and obligations that he had, then you can explain Fraulein Eyer's attitude very well, because Haagen was concerned in his research with four entirely different things. First with the Ministry of Education, to which his Institute was subordinate, and from which he received his salary, and which paid his Institute and his assistants, and of course he had to send his reports thither.

Then he received research assistance from the Medical Inspectorate of the Luftwaffe. Thirdly, he received research assignments from the Reich Research Council, and in payment for their financial assistance they wanted to see a report now and then, and finally his work was supported by the SS, and so far as one can see from the documents three offices were concerned here, the Ahnenerbe [Ancestral Heritage], the Reichsfuehrer SS, and the WVHA. Thus in his scientific work there was a great number of offices with whom he was obliged to correspond. Then in his capacity as consultant he had to turn in semiannual reports to the Air Fleet Physician, which were then sent on to the Medical Inspectorate. Those were reports with fixed dates, and if he didn't send them in on the date assigned, there was trouble right away. Then there were also special reports on any official journies that he made. In addition to these official reports he had to turn in accounts, and there were fixed dates for that also. All these obligations to report can be seen clearly in the documents, and there is no wonder that the secretary comes to the conclusion that reports had to be sent off every three months, in view of this. For such a secretary in such a provincial institute, Berlin is a great big confused concept, and we have already seen here just how confused she was when she called me chief of the medical inspectorate of the Luftwaffe, and confused Professor Rostock with Professor Zeiss.

Q: What were your official relations with Haagen?

A: Our official relations in the military field are very clearly set forth; I was consulting hygenist and tropical hygenist with the medical chief of the Luftwaffe and from 1944 on was not alone in this, but was one of two, Haagen was the consulting hygenist for the Air Fleet Physician Reich. Handloser and Schroedor's testimony have already proven this and affidavits have also demonstrated that this position implied no relationship of subordination or superiority. I had no pow r to issue orders so far as he was concerned and I had no duty or right to report on official matters. Moreover the Prosecution, by submitting Exhibits Nos. 12 and 13, has made it clear. They are in Document Bock No. 1 and they are Documents Nos. 418 and 419. Those are the two organization tables in Luftwaffe research. I do not know if the Tribunal has those charts before them at the moment but I should be grateful if the facts that I am about to state will subsequently be checked on.

My name is set down on the left side of the chart in the group, "Science and Research of the Medical Academy of the Luftwaffe." Professor is listed as the subordinate of a Air Fleet Physician. This whole table of organization is pretty clear and everyone who knows how to read such a table of organization can see perfectly clearly that a relationship of subordination or superiority is not set down in such a table of organization.

I must point out one point, namely a serious error in one of these charts in connection with the names of Professor Haagen and Professor Zuckschwerdt, in both tables there is the notation University of Strassbourg.

I don't think we need any export to ascertain for us that the University of Strassbourg was not subordinate to the air ministry and certainly was not subordinate to the medical chief of the Luftwaffe.

Q: The Prosecution asserts you were Haagen's superior; is that incorrect, you say?

A: Yes, the Prosecution assorted that repeatedly but the assumption is erroneous and proved in no way. The relations between Haagen, and myself was perfectly clearly laid down, according to German organizational procedure. The Prosecution bases its assumption on the affidavit which Professor Schroeder signed and of which he has specifically stated here how he wanted it to be understood and that it did not have the importance that the Prosecution ascribes to it.

Q: Mr. President, in this connection, I should like to put in Rose Document No. 8, which is on pages 24 to 27 of Document Book Rose No. 1. This will be Rose Exhibit No. 29. This is Professor Dr. Hans Otto Luxenbergers' affidavit of 2 February 1947. I should like to read a short passage from it, starting with paragraph 2 on page one of the document.

At present I am a specialist for nervous diseases in Munich and consulting psychiatrist of the Catholic Youth Welfare.

Up to 1941 I worked in the German Psychiatric Research Institute, one of the Haiser-Wilhelm-Institutes, attacked to the University of Munich. As the Nazis regarded me as politically unreliable, I had to leave this institute in 1941. In January 1941 I was called up to the German Luftwaffe, at first as assistant physician.

I worked until 1944 with the Medical Inspectorate of the German Luftwaffe in Berlin as an expert on phychiatric questions, and then in summer of 1944 became Commander of Instruction Groups at the Luftwaffe Medical Academy in Berlin, and at the same time consulting psychiatrist with the Chief of the Luftwaffe Medical Services, with the rank of Oberstarzt [Colonel, Medical Corps.].

Then on the next page of the Document, I read under No. 2:

The consulting specialists with the Chief of the Luftwaffe Medical Services had a purely consultative function. The consulting specialists with the Air Fleet were not subordinate to the consulting specialist with the Chief of the Luftwaffe Medical Services, but to the respective Air Fleet physician. They were not obliged to take orders from the consultants with the Chief of the Medical Services.

The personal relations between Professor Rose and Professor Haagen, who was consultant hygienist with Air Fleet Physician Reich, were, as far as I can remember very bad. I therefore think it unlikely that they worked together on a scientific basis. I can also remember that Professor Rose repeatedly said in my presence that he did not know what Professor Haagen was really doing. He was apparently making no headway at all with the production of a now typhus vaccine.

That will conclude my quotations from this Document, but I shall return to the rest of it later.

Q: You explained your official relations with Dr. Haagen; now will you please explain your personal relations with him?

A: Our personal relations were cool, we were very different sorts of persons; I had contact with him only in an official capacity.

I never had an outright conflict with Mr. Haagen. Externally, I had perfectly normal relations with him, but neither of us had much doubt about the inner conflict between us. I took it ill of Professor Haagen in the scientific field that he concerned himself solely with development research during the war, with now research assignments, instead of using his indubitably groat knowledge in the technical field in order to concentrate on purely production problems. I looked upon this as a misuse of his capabilities, because although I was convinced that his scientific goals were perfectly correct, I was also convinced that he would not succeed in a practical solution during the war, because experience in all these problems had shown that the period of development took years. Also the Medical Inspectorate embraced this point of view, although it had no influence directly on Dr. Haagen's work. The Medical Inspectorate tried again and again, by giving him new assignments, to begin him on production, and always gave him now assurances, but no civilian sphere where the Medical Inspectorate could give no orders or directives, but simply request.

Q: However the Documents show that you sent him information; why did you do that?

A: I held that to be my duty, that pertained to my office. If I found out anything new, of which I had to assume that it was not generally known, that should be brought to the attention of those interested and those who were participating in the matter.

Actually what my orientation on the matter was can be seen from my report on the Copenhagen trip when I communicated this important matter to the Typhus Research Institute and specialists, with no regard as to whether or not they were Luftwaffe, Army, or Civilian institutes in the Reichs Ministry of the Interior, or University Clinics.

I sent this report to all those who might be interested and it was in this way that Professor Haagen also received his report.

Q: What can you say on the basis of your official and other knowledge about Professor Haagen's typhus research?

A: First of all, my sources; since the Prosecution has made me responsible for Dr. Haagen's work, I have made considerable effort to ascertain precisely what he did do and I can now give you information on Haagen on the basis of the following sources; On the basis of his publications; on the basis of what I knew through private conversations with him, and then from my memory of the reports he sent to the Luftwaffe, which, however, correspond very closely to his publications; and then from the documents put in evidence in this trial. You have to distinguish between two sections in Dr. Haagen's scientific research, first when he worked with Gildemeister at the Robert Koch Institute. There he concerned himself with the production and manufacture of vaccines from virulent viruses, which, however, had been killed. I shall not dilate on the results of his work. They are in part mentioned in the annual reports of the Robert Koch Institute. Then Haagen became a Professor in Strassbourg on the 30 October, 1941. This was before the question arose of testing these vaccines at Buchenwald because so far as we could see from the documents now, this matter was set in motion only in the winter catastrophe of 1941-1942, nor did I over hear that Haagen participated in anyway in these Buchenwald experiments and if there is mention there of a vaccine according to Gildemeister and Haagen, this is simply meant to describe the method of production, but does not moan that Haagen actually had anything to do with it himself. I know nothing to the effect that Haagen worked after 1942 in Strassbourg on typhus. I think that he first of all concerned himself with the construction of his institute, which at the beginning was not in a condition to be worked in. At any rate I know of no positive results from that period. Now, Haagen hoard Ding's report. In the discussion he said, and others also said the same thing, that these Ding experiments clearly proved that with killed typhus vaccines you could not achieve any anti-infectious immunity from typhus.

This problem could only be solved through the development of the living avirulent vaccine, and in future on this principle he carried on his work after 1943.

Q: It might be well, Professor, if you stated in a clear and understandable form the difference between those two types of vaccine, because it seems to me that it is of importance in order to understand Haagen's work in Strassbourg.

A: Yes, that is of absolutely decisive importance, and in order to understand all of the documents it is almost impossible to understand this whole question without knowledge of the basis reports of the camp Natzweiler. The testimony given here in this field was given by persons who are not specialists and you cannot understand that testimony at all because the concepts are so confused in their testimony that at the end it is impossible tell what the witness was talking about and what he meant to say. Let me then start with the concepts of virus, virulent and a virulent, and vaccine. First in order to clarify impartial the question of a virulent, and an avirulent virus, I asked three times that Professor Blanc be called as a witness here, who is an international expert. However, the Tribunal refused this application and now it must be satisfied with the testimony of one of the defendants in this matter. First of all, originally the word "virus" meant any infectious organism. In modern medicine the concept of virus has been limited to a special group of the most microscopic sort of organisms, which have a group of characteristics in common. The characteristics are as follows: These organisms cannot be seen with the light microscope. Consequently the term "ultravisible" or "ultramicroscopic organisms". Furthermore these organisms pass through a filter through which, bacteria cannot pass, consequently the term "filterable" virus, and finally these organisms cannot be bred in artificial media, although bacteria can be so bred. To the group virus, so far as this trial is concerned, there belong the following: The germs that cause hepatitis — epidemica, yellow fever, and influenza.

The case of the germs that cause typhus is still in question. Many researchers consider them virus although they are microscopically visible, and other researchists give an intermediate position between bacteria and virus. At any rate the typhus germs have a special name. They are called Rickettsia after the American Ricketts and for this trial the following rickettsia are important, ricketttsia prowazek, the germ that causes epidemic typhus, or louse typhus, and the rickettsia moseri or rickettsia murina, which cause endemic or rat typhus. It is not disputed that the rickettsia have many characteristics in common with the virus.

Q: Now what is a vaccine?

A: Originally the word "vaccine" was only used for the vaccine against small pox. Then it was used as a general expression for living vaccines generally, that is vaccines from living germs, until the habit has arisen that vaccine is used for anything that can be considered a vaccine today. At any rate a vaccine is always a material that is designed for protective vaccination and it is impossible to just exchange the terms vaccine and virus as it was often done in testimony here in this court room. The example as to how the testimony can be changed by this exchange is the testimony of the witness Olga Eyer, during her cross-examination by defense counsel this witness, as the record shows, all of the time spoke of a living typhus vaccine of Professor Haagen. She explained expressly that as a clerk she didn't know very much about these matters but throughout her entire testimony she maintained this expression on "living vaccines" and as a secretary of Haagen she must have written this hundreds of times, this being this main subject.

During the re-examination at the end Mr. Hardy put a very simple short question to her, "You meant living virus, didn't you?" The witness answered this question without any question in the affirmative and therefore, contradicted her entire evidence; namely, what before had referred to vaccinations, had not suddenly become infections. So, I think it is quite justifiable that finally after this trial has lasted for months it is being clarified what we are talking about. Laymen and even a number of physicians are still mixed up about vaccines and serum. This has occurred here in the documents but not in such a form that it in any way frustrates our search for the truth and that is why I forego explaining this concept — to shorten these proceedings. At any rate, with very rare exceptions, vaccine is used as a protective vaccination as a preventive means, and a serum, with very rare exceptions, is used for treatment after the illness has already started.

Q: What kinds of vaccines are there?

A: One distinguishes between two main groups. There are vaccines which come from bacteria toxins and from chemically changed toxoids. The vaccine against scarlet fever, diphtheria, and gas gangrene are examples. In this trial the protective vaccination against diphtheria and gas gangrene are mentioned. The second group, the vaccines from morbific organisms themselves. They again can be distinguished by subdividing into two sub-groups. 1. A vaccine from dead morbific organisms. An example from the contents of this trial — you have vaccines against cholera, against typhoid, and para-typhoid and the typhus vaccines according to Weigl, Gildemeister and Haagen from animal lungs and the liver vaccine according to Ipsen. The second group a.re vaccines from living attenuated morbific organisms. An example from this trial is the vaccine against small pox, against yellow fever, then the plague vaccines with which Mr. Blome dealt. Then the Calmette vaccine against Tuberculosis and the Haagen vaccine against typhus. Finally, the typhus vaccine of the Frenchmen Blanc and Legres.

As the last we have the influenza vaccine.

Q: Would you please explain the expressions virulent and avirulent?

A: The expressions as they are used today cannot he derived from the word virus as the smallest morbific organism, as it is used today. These expressions originate from old times where one used the word virus in order to designate the infectious organism. Virulence is the capacity of a micro-organism; no matter whether virus or bacteria; to bring about illnesses. A strong virulence has the capacity to bring about death or severe illnesses. A weak virulence has the capacity to bring about mild or no symptoms at all. Avirulence is the lack of capacity to bring about any illness. One must note that the expression virulence does not say much in itself. If one wants to be correct one also has to add "virulence for something or other." A strain can be highly virulent for an animal but completely avirulent for a human being. The Prosecution; for example; in examination of the witness Gutzeit; had difficulties in believing his testimony. From the fact that when infecting with hepatitis virus all mice had died he concluded that such hepatitic virus in the same way must kill human beings. That is not the case at all. For instance; in the famous Pasteur rabies vaccines virulence of the rabies virus was increased to such an extent that guinea pigs died within five days, whereas originally the death only came about after three weeks to two months. But, the increase of the virulence as it affected the rabbit is connected with the simultaneous attenuation of the virulence as it affects the human body, which made it possible that this so-called passage virus be used for vaccination on a human being. An example from this case: the typhus strain matelska which was supposed to have lost its virulence for human beings according to Ding's diary in Buchenwald is highly virulent for the guinea pig according to the statements contained in the Ding article in the Periodical for Hygiene.

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 are 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 later 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 the 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 the 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 basic 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 basic 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 of 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 our 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 basic 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.)