6. BONE, MUSCLE AND NERVE REGENERATION AND BONE TRANSPLANTATION EXPERIMENTS

a. Introduction

The defendants Karl Brandt, Handloser, Rostock, Gebhardt, Rudolf Brandt, Oberheuser, and Fischer were charged with special responsibility for and participation in criminal conduct involving experiments on bone, muscle, and nerve regeneration and experiments on bone transplantation (par. 6 (F) of the indictment). During the trial, the prosecution withdrew this charge in the case of Rudolf Brandt. On this charge the defendants Gebhardt, Oberheuser, and Fischer were convicted and the defendants Karl Brandt, Handloser, and Rostock were acquitted.

The prosecution’s summation of the evidence on these experiments is contained in its final brief against the defendant Gebhardt. An extract from this brief is set forth below on pages 392 to 396. A corresponding summation of the evidence by the defense on these experiments has been selected from the final plea for the defendant Gebhardt. It appears below on pages 396 to 399. This argumentation is followed by selections from the evidence on pages 400 to 418.

b. Selection from the Argumentation of the Prosecution

EXTRACT FROM THE CLOSING BRIEF AGAINST DEFENDANT GEBHARDT

Bone, Muscle, and Nerve Regeneration, and Bone Transplantation Experiments

These experiments were carried out in the Ravensbrueck concentration camp during the same period of time and on the same group of Polish inmates as the sulfanilamide experiments. (Tr. p. 1458.)

The defendant Fischer made the following statement about these experiments in his affidavit:

The responsibility of the defendant Gebhardt for these experiments is also proved by the affidavit of Oberheuser. She stated:

The witness Maczka, a graduate of the Medical School of the University of Krakow and a practicing physician, testified that in the course of her duties as X-ray technician in the Ravensbrueck concentration camp she had occasion to observe approximately 13 cases in which experimental operations were performed on the bones of inmates. There were three kinds of bone operations—fractures, bone transplantations, and bone splints. Some of the Polish girls were operated on several times. In the case of Krystyna Dabska, Maczka took X-ray pictures of both legs and discovered that small pieces of the fibulae had been removed. In the case of one leg the periosteum had also been taken out. Zofia Baj was operated on in a similar manner. Janina Marczewska and Leonarda Bien were subjected to the bone fracture experiments. The tibia was broken in several places and in the case of one of the girls, clamps were applied while in the case of the other they were not. These operations impeded the locomotion of the girls operated on. Bone incision operations were performed on Barbara Pietczyk, a Polish girl 16 years old. She was operated on six times. During the first operation incisions were made in each tibia. During a later operation pieces of the tibia were cut out where incisions had been previously made. Maczka took an X-ray of the pieces of tibia that were removed. As a result of these bone operations, Maczka observed the development of two cases of osteomyelitis, Maria Grabowska and Maria Cabaj. (Tr. pp. 1445-7.)

A rather large group of muscle experiments were performed. Here again multiple operations were carried out on the same subject. Gledziewjowska was operated on most frequently. During the first operation certain muscles were removed and during subsequent operations additional pieces were cut out, always at the same place, so that the legs got thinner and weaker all the time. (Tr. p. 1447.)

Transplantation of whole limbs from one person to another was also carried out. Maczka testified that about 10 feeble-minded inmates were selected, taken to the hospital and prepared for operation. She knew personally that at least two of these persons were operated on. One case was a leg amputation. Following this operation, the experimental subject was killed and placed in a special room where the dead were kept. Maczka was able to observe the corpse and saw that there was only one leg. In the second case an abnormal woman was operated on by Dr. Fischer. When he left the operating room he carried with him a bundle wrapped up in linen about the size of an arm. He took this away with him. The prison nurse, Quernheim, informed Maczka that the whole arm with shoulder blade was removed from this woman. (Tr. p. 1448.)

The amputation of the arm and shoulder blade mentioned by Dr. Maczka obviously refers to the transplantation performed on the patient Ladisch at Hohenlychen. As to this, the defendant Fischer stated in his affidavit as follows:

Gebhardt admitted that he, together with Stumpfegger, personally performed the bone transplantation operation on Ladisch. He testified further that Fischer only removed the scapula, shoulder blade, from the Polish female inmate at Ravensbrueck. (Tr. p. 4235.) It is impossible to raise the arm above the horizontal if the scapula has been removed. (Tr. p. 4235.) Gebhardt further admitted that Stumpfegger reported to him on the bone experiments in Ravensbrueck concentration camp. (Tr. p. 4235.)

The affidavit of Gustawa Winkowska corroborates the testimony of Maczka concerning the transplantation of whole limbs and establishes that the experimental subjects were later killed. (NO-865, Pros. Ex. 231.)

The witness Karolewska was a subject in both the sulfanilamide and bone experiments. (Tr. pp. 833, 836-7.) She was operated on a total of six times. The first operation was conducted on 14 August 1942 by Fischer. (Tr. p. 819.) Gebhardt inspected her early in September. (Tr. p. 821.) She was sent back to her block on 8 September 1942, but was unable to walk and remained in bed for a week. On 16 September 1942 she was again taken to the hospital and operated on for the second time by Fischer. (Tr. pp. 821-2.) She left the hospital on 6 October 1942 and remained in bed for several weeks. Her leg did not heal until June 1943 (Tr. pp. 822-3). She filed a written protest with the camp commander, together with other experimental subjects in February 1943. In August 1943 she was operated on literally by force in the bunker at Ravensbrueck. Both her legs were cut open. These operations were carried out on five other Polish girls under indescribably filthy conditions. On 15 September 1943 a further operation was performed on her right leg by a doctor from Hohenlychen. Two weeks later her left leg was operated on and pieces of the shinbone were removed. She stayed in the hospital for 6 months—until the end of February 1944. (Tr. pp. 828-9.) Karolewska identified the defendants Gebhardt, Fischer, and Oberheuser as having participated in the experiments on her. (Tr. pp. 818, 830.)

The defendant Fischer participated in these experiments until at least 23 February 1943. On that date he carried out a second operation on Zofia Baj. (NO-871, Pros. Ex. 227.)

The most disgusting series of operations were those carried out in August 1943 in the bunker. The Polish girls selected had revolted and refused to report to the hospital. The barrack block in which they had barricaded themselves was then surrounded by male guards who carried these women off forcibly to the camp prison, known as the Bunker, where they were held down by these male guards and forcibly anaesthetized without any pre-operative care, and with their bodies still in a filthy condition from walking around the camp. The experimental subject Piasecka stated in her affidavit as follows:

Piasecka stated that this operation was carried out by Dr. Villmann who was an assistant doctor at Hohenlychen. A few weeks later two other assistant doctors to Gebhardt came and operated on her right leg. (NO-864, Pros. Ex. 229.)

In his testimony Gebhardt attempted to disassociate himself from these experiments. He admitted however that he received information from Stumpfegger about the experiments. (Tr. pp. 4082, 4087-9.) Stumpfegger was a former assistant of Gebhardt’s and he stayed at Hohenlychen during the course of these experiments. Fischer assisted Stumpfegger and Gebhardt. (Tr. pp. 4230, 4090.) It is further established by Fischer’s own affidavit that the plan for the experiments was worked out with the knowledge and approval of Gebhardt.

c. Selection from the Argumentation of the Defense

EXTRACT FROM THE FINAL PLEA FOR DEFENDANT GEBHARDT^[43]

The Experiments Concerning Bone, Muscle, and Nerve Regeneration and Bone Grafting

The defendant Gebhardt is also charged in the indictment with particular responsibility in the experiments, whose object according to the indictment was the examination of the conditions under which the regeneration of bones, muscles, and nerves resulted, and under what conditions the grafting of bones was possible.

With regard to the general reasons why there can be no question of guilt, I refer to the statements I have already made in connection with the sulfanilamide experiments. These experiments, too, were occasioned by conditions of war and were to open up new ways of treating seriously wounded persons.

The evidence, however, has shown that the defendant Gebhardt, with a single exception, had nothing to do with these experiments. These experiments, insofar as they were concerned with the regeneration and grafting of bones, were carried out by Sturmbannfuehrer Dr. Stumpfegger. It is correct that Dr. Stumpfegger was assistant doctor in the clinic in Hohenlychen before the war, and to that extent subordinate to its chief doctor, Dr. Gebhardt. Dr. Stumpfegger, however, left in the early years of the war, and in the year 1942 became consulting physician to Reich Leader SS Himmler and later consulting physician to Hitler. The experiments carried out by him in Ravensbrueck were carried out on his own responsibility, and upon direct orders from the Reich Leader SS Himmler. Dr. Stumpfegger at that time was neither under the military nor the medical supervision of the defendant Karl Gebhardt. For the remainder, Dr. Stumpfegger limited himself to carrying out experiments in the removal and grafting of so-called bone splinters, the exact number of which can no longer be determined now, but which certainly did not exceed six to eight. These were aseptic operations, which constituted no danger to the life of the experimental subjects. The evidence has shown that the experimental subjects from whom the bone splinters were removed suffered no reduction in the function of their limbs. Besides, the examination of the transplantation process of bones achieved a research result that could not be attained from the animal experiments because of the variety of the stipulated regeneration areas caused by the location of the various species and for the other reasons given by Gebhardt.

The evidence has further shown that the experimental subjects were members of the resistance movement who had been condemned to death and who were in this way given an opportunity to obtain a pardon, and so to escape execution. In view of the fact that no direct responsibility for these experiments falls on the defendant Gebhardt, it is not necessary to go into the purpose of these experiments further at this time. It should, however, be emphasized once more that the experiments were to open up new possibilities in wartime surgery and restorative surgery on the wounded. In 1944, Dr. Ludwig Stumpfegger published the results of his experiments in the periodical for surgery the editor of which was Geheimrat Dr. Sauerbruch (vol. 259, issue 9-12) and this article was also made available to the public in book form. I have submitted to the Court (Gebhardt, Fischer, Oberheuser 6, Gebhardt, Fischer, Oberheuser Ex. 9) a review of this work in the periodical, “Clinic and Practice” of February 1946 and refer to this for the details.

The defendant Karl Gebhardt would certainly not have hesitated to admit his responsibility for these experiments if he had actually been more closely connected with them, and if the experiments had taken place at his behest or under his medical supervision. There would have been little reason to deny this responsibility since the experiments concerned were completely without danger; they resulted in no reduction of the function of the limbs, and, moreover, no fatalities occurred. Furthermore, corresponding to the general practice in Germany, the work of Dr. Stumpfegger under the scientific responsibility of the defendant Gebhardt would have been made public if he had been directly concerned with the experiments, and if they had been carried out under his scientific supervision. Nor did the evidence prove that there were any experiments carried out in connection with muscle and nerve regeneration under the scientific supervision and by order of the defendant Gebhardt. It even seems doubtful that any such experiments were ever carried out in Ravensbrueck. The witnesses called before this court were unable to make any statements about this matter and it may be taken for granted that in any case the defendant Karl Gebhardt had nothing to do with these experiments. There was no point in carrying out such experiments as, long before the war, the surgical technique had already been developed on scientific principles and set down in a system. It covers plastic surgical bone regeneration but does not advocate free transplantation.

The only new field of scientific research taken up by Dr. Gebhardt during the war was that of experiments connected with nerve operations. These experiments were, however, carried out on animals by the special order and under the scientific supervision of the defendant Gebhardt himself. I am here referring to the affidavits given by the witnesses Koestler (Gebhardt, Fischer, Oberheuser 22, Gebhardt, Fischer, Oberheuser Ex. 21) and Brunner (Gebhardt, Fischer, Oberheuser 21, Gebhardt, Fischer, Oberheuser Ex. 20), and to the statements made by the defendant Gebhardt himself on the witness stand. I am further referring to the report of the Third Session East of the Consulting Specialists on 24-26 May 1943 (Gebhardt, Fischer, Oberheuser 3, Gebhardt, Fischer, Oberheuser Ex. 10) which I have presented in Court and which proves that during this session he himself and the aforementioned witness, Dr. Koestler, spoke about grafting operations in cases of nervous paralysis. This is the same report to which the witness Dr. Koestler referred in his affidavit of 27 February 1947.

Furthermore, I wish to draw the attention of this Court to the lecture given by the defendant Gebhardt in the same report on “Gymnastic Therapy and Mobilization of the Joints” which is also based upon clinical experience in Hohenlychen and also has nothing whatever to do with medical experiments on human beings. The evidence has further proved that the defendant Gebhardt was concerned with the transplantation of bones in one case only. This experiment was the free transplantation of a shoulder blade from one person to another. The defendant Gebhardt has given a detailed account of this on the witness stand and I am referring you to his statement on this point. Generally speaking, the following has to be added: The free transplantation of bones from one person to another is one of the great problems of restorative surgery which has yet to be solved. For decades, physicians have been trying to find a solution to this problem. As early as the end of the First World War, Geheimrat Lexer, the great teacher of the defendant Gebhardt, conducted experiments along these lines in 23 cases, aiming at the replacement of completely destroyed bones. The terrible injuries which occurred during the Second World War made this problem still more urgent and it is, therefore, understandable that in view of the progress Dr. Stumpfegger had made in his research, he was ordered by the Reich Leader SS to make use of this research result in the direct transplantation of bones. The defendant Gebhardt himself did not take any steps in this direction. He himself has stated his fundamental attitude as to this question and I refer to his own statements. Only in one case did he give his approval, viz: when Dr. Stumpfegger carried out the experiment of transplanting a shoulder blade. The order to do this was given by the Reich Leader SS. This experiment was justified in this particular case as it took place for the benefit of a patient in serious danger. The experimental person from whom the shoulder blade was taken was also a member of the resistance movement and she, too, thus escaped execution. Furthermore, the shoulder blade in question belonged to a hand restricted in its function.

d. Evidence

AFFIDAVIT OF SOFIA MACZKA^[44], 16 APRIL 1946, CONCERNING EXPERIMENTAL OPERATIONS ON INMATES OF THE RAVENSBRUECK CONCENTRATION CAMP

Information concerning the experimental operations which took place in Ravensbrueck concentration camp.

The operations were carried out in the period between the summer of 1942 and the summer of 1943. The operations were conducted in the camp hospital, under the direction of Professor Dr. Gebhardt, SS Brigadefuehrer. Professor Gebhardt was the head of the Hohenlychen sanatorium at Hohenlychen (Mecklenburg). The operations were conducted with the help of Dr. Fischer, who was Professor Gebhardt’s assistant. There was also another assistant whose name I do not know. The following camp doctors participated in this matter: Dr. Herta Oberheuser, Dr. Rolf Rosenthal, Dr. Schiedlausky; all German nurses who were employed there at the time and two German prisoners (Schutzhaftgefangene), Gerda Quernheim and Fina Pautz, gave assistance. Polish political prisoners in protective custody, from the transports from Warsaw and Lublin, numbering 74, were chosen as victims. All those who were chosen were young, healthy, and well-built women. Many were college or university students. The youngest was 16 years of age, the oldest 48 years of age. The operations were to be carried out for scientific purposes, but they had nothing to do with science. They were carried out under horrible conditions. The doctors and the assisting personnel were not trained properly medically. Conditions were neither aseptic nor hygienic. After operations, the patients were left in shocking rooms without medical help, without nursing or supervision. The dressings were made according to the whim of the doctors with unsterilized instruments and compresses. Dr. Rosenthal, who did most of the dressings, excelled himself in sadism. In the summer of 1943 the last operations were carried out in the “bunker”. “Bunker” is the name of the horrible prison in the camp. The victims were taken there because they resisted, and there in the cell their dirty legs were operated on. This was the “scientific atmosphere” in which the “scientific” operations were carried out.

All operations were carried out on the leg and all under anesthetic. The operations were divided into two main groups:

1. Operations for infecting the patient.

2. Experimental aseptic operations.

The soft part of the calf of the leg was opened and the open wounds were infected with bacteria which were introduced into the wounds. The following were used: staphylococcus aureus, oedema malignum (clostridium oedematis maligni), gas gangrene bacillus (clostridium perfrim gens), and tetanus. Weronika Kraska was infected with tetanus. She died after a few days. Kazimiera Kurowska was infected with gas gangrene bacillus; she died after a few days. The following were infected with oedema malignum: Aniela Lefanowicz, Zofia Kiecol, Alfreda Prus, and Maria Kusmierczuk. The first three died after a few days; Maria Kusmierczuk survived the infection. She was lying ill for more than a year and became a cripple, but she is alive and is living evidence of the experiments. Mostly pyrogen stimulants were employed. The wounds were stitched after the infection and serious illness began. Many of the patients were ill for months and almost all of them became cripples.

Why did Professor Gebhardt, with his education, carry out these experiments? To test the new drugs of the German pharmaceutical industry; mostly cibazol and albucid were used. Even tetanus was treated in that way.

The results of the treatment were not checked, or if they were, it was done in such an inadequate and superficial manner, that it was of no value.

The aseptic, experimental operations consisted of bone experiments, muscle experiments, and nerve experiments.

The bone experiments were checked by X-ray photographs. As ward attendant I had to do all the X-ray photographs. In this way I was given the opportunity of gaining an insight in this matter. The following were carried out: (a) bone breaking; (b) bone transplantation; and (c) bone grafting.

a. On the operating table, the bones of the lower part of both legs were broken into several pieces with a hammer, later they were joined with clips (for instance Janiga Marczewska) or without clips (for instance Leonarda Bien) and were put into a plaster case. This was removed after several days and the legs remained without plaster casts until they healed.

b. The transplantations were carried out in the usual way, except that whole pieces of the fibula were cut out, sometimes with periosteum, sometimes without periosteum. The most typical operation of this kind was carried out on Krystyna Dabska.

c. Bone grafting. These operations were with the school of Professor Gebhardt. During the preparatory operation two bone splints were put on the tibia of both legs; during the second operation such bone splints were cut out together with the attached bones and were taken to Hohenlychen. As a supplement to the bone splint operations such operations were also carried out on two prisoners in protective custody who suffered from deformation of bones of the osteomyelitis type. These two were not Poles, one of them was a German who was a Jehovah’s Witness, Maria Konwitschka, and the other was a Ukrainian, Maria Hretschana. It was interesting for Professor Gebhardt to see how the diseased bones would react to such an operation.

The muscle experiments consisted of many operations, always on the same spot, the upper or lower part of the leg. At each further operation larger and larger pieces of muscles were cut out. Once a small piece of bone was planted into a muscle (this happened to Babinska). During nerve operations parts of nerves were removed (for instance Barbara Pytlewska).

What problem did Professor Gebhardt and his school wish to solve by these experiments? The problem of the regeneration of bones, muscles, and nerves.

Was the thing carried out? No. It was not checked at all, or only insufficiently. I do not know what was done at Hohenlychen with those pieces of bone, muscle, and nerves which were cut out and taken there.

What was the fate of the patients after they left the hospital? Almost all of the patients became cripples, and suffered very much as a result of these operations. Even more severe was the moral torture inflicted on them since they lived under the conviction that they would all be shot in order that they should not be evidence of these murderous operations. The camp authorities—Commandant Suhren, Adjutant Braeuning and Chief Supervisor Binz—ensured through their orders that the victims should not forget that they were condemned to death. In the meantime, six of the patients were shot after surviving the operations.

As a supplement to these operations I am submitting a description of “special operations” which were carried out at the same time.

A few abnormal prisoners (mentally ill) were chosen and brought to the operating table, and amputations of the whole leg (at the hip joint) were carried out, or on others, amputation of the whole arm (with the shoulder blade) were carried out. Afterwards the victims (if they still lived) were killed by means of evipan injections and the leg or arm was taken to Hohenlychen and served the purposes known to Professor Gebhardt. Ten such operations, approximately, were carried out.

During the whole of the time these operations were carried out, I was employed as a worker in the ward and investigated this matter risking my own life, with the idea that it was my duty, if I were saved, to tell the truth to the world. I conclude my statement with two questions: What kind of recompense can the world offer to those who were operated on in such a manner? What kind of justice has the world for those who carried out such operations?

Stockholm, 16 April 1946