She said yes. Then she was asked if she knew if this vaccine, like yours, was made from living attenuated virus; she said that the Blanc vaccine was not used because of its dangerousness. Is that so what she says?
A. This statement of hers is also incorrect. I am sorry that Blanc is not here personally in order to refute this statement. It is absurd. Of course, Blanc's vaccine was made of living attenuated virus and had already been used to a large extent. Several million persons in North Africa were inoculated with this vaccine. There exist publications on this subject, too. The use of living attenuated virus is moreover quite old. The smallpox vaccine is the oldest we know that there is, Pasteur's hydrophobia rabies vaccine and the yellow fever vaccine, all of these are made with living attenuated virus; also the Calmette's tuberculosis vaccine, Strong's plague vaccine, etc. All of these having living virus in them.
Q. You mention Blanc's work, Professor. May I ask whether in completing your vaccine papers and in studying literature you made use of these French works on the subject?
A. Yes, I did, particularly on the work of French researchers because they seem worthy of emulation and to that extent I think that Miss Schmidt is correct.
Q. Miss Schmidt stated that you had used French works on this subject; this testimony is in the transcript of 9 January 1947, page 1380 of the English transcript. Witness, aside from Miss Schmidt, whose testimony I should like to leave for the moment, we also heard from Fraulein Olga Eyer. We had her on 15 January 1947, page 1755 ff of the English transcript. She said that you vaccinated with virulent vaccines. To that extent I believe she is correct, isn't she?
A. Yes, she heard me say that myself because she was my secretary and took care of my correspondence.
Q. Did Fraulein Eyer have medical knowledge? Did she have any specialized training in medicine?
A. No, Fraulein Eyer had no medical training, nor was she a medical technical assistant, nor was she trained as such. She was simply a secretary and in this capacity, because she had to do a lot of writing for me, she heard and used lots of medical expressions and terms. I am sure that she did not always understand these terms, because it is very difficult to do so unless you have the necessary medical training.
Q. Fraulein Eyer also admitted that before the Tribunal. She was asked whether she knew the report you had dictated and she said on page 7070 of the English transcript, "I wrote the reports but I don't know what was in them. I am not an expert and I have never studied medicine."
Now, another point regarding Fraulein Eyer's testimony. She stated correctly that you worked with virulent, that is living vaccines, but she further stated that this virulent vaccine brought about the disease. What do you have to say about that?
A. When Miss Eyer is speaking of virulent vaccine, this corresponds to what I said in my affidavit yesterday. These are living virus but they are not pathogenic for human beings, so she is correct in speaking of the living virus because that was what it was in the vaccine, but that this virulent vaccine should cause the disease is completly erroneous and simply proves again how difficult it is to use the terms correctly and what little value such testimony can have.
Q. Now, Professor, something most confused that the witness said was, when being examined by Mr. Handy, she said, "Yes, virulent vaccine was used." Then Mr. Hardy asked, "Well, if you say virulent vaccine, do you mean virulent virus?" Then she said, "Yes, I meant to say virulent virus." I assume that Mr. Hardy was referring here to pathogenic virus, although this would made this matter much clearer. Perhaps you can say something about this testimony?
A Here the ideas that Fraulein Eyer has are completely mixed up. Every living vaccine does contain living and virulent virus, as I have already said. However, the important fact and the decisive element of the question is that this virus is no longer pathogenic for human beings. We have got to distinguish between "virulent" and "pathogenic" for human beings. Only the latter causes illness in human beings.
Q It is your opinion then, Professor, that this witness' testimony gives only a very confused picture of the real situation and that the 'witness' knowledge did not suffice to correctly understand this difficult problem of virus and vaccine?
A Yes, that is what I want to say. Let me say also that Fraulein Eyer had no idea of what was going on. As a specialist, I must regard her testimony here as completely worthless.
Q Now in conclusion I want to quote something else she said. She answered my colleague Dr. Fritz' question saying: "As I have already said, I don't know enough about this." This statement, which seems to be the most decisive thing she said, is on page 1778 of the English record.
Now, to go along chronologically, professor, when we stopped we were discussing your activity in connection with the epidemic at Natzweiler. You said that you carried on the serological examinations in your institute. Did you confine yourself to this, or did you do anything else in the camp in connection with the epidemic?
A Yes. I have already told you that the camp commander asked me specifically to help render the camp sanitary. The camp, it is true, did have a delousing station but it was not large enough to take care of this acute situation. Particularly, the prisoner physicians drew my attention to this fact many times. When I was asked, then, to help them in this crisis, I made available to them a good disinfecting station that was in the Institute and which I had taken to Natzweiler. This substantially increased the delousing capacity in the camp so that it certainly contributed to protecting many of the prisoners from typhus and thus from certain death.
I also gave my assistance to the surgical department by turning over sterilization apparatus. I had one steam and two dry sterilizers which I made available. There is some correspondence on this.
Q I shall have to bring up a few documents, Professor, which the prosecution put in in connection with the work at Natzweiler, apparently to prove that you carried on human experimentation in Natzweiler.
The first one is on page 85 of the document book, document number NO-134, Exhibit 301. This is a letter from you to Obersturmfuehere Dr. Krieger, Concentration Camp Natzweiler. You speak here of sending two fever thermometers, and you ask him to send you a list of those vaccinated, stating their age and when they were vaccinated. What does this letter refer to?
A This letter you arc mentioning refers to the fact that the camp had no or too few clinical thermometers and the prisoner doctors asked me to supply some. I then sent them two.
Then, in the case of the six persons vaccinated who are named here, these are camp personnel whose serological examination I wanted to enter into the records. They had been vaccinated with dead vaccines, and, as I have already told you, I was keeping an exhaustive serological record of all these vaccinations. They had nothing to do directly with my vaccinations in the camp.
Q I turn now to the next document at page 100 in the document book XII. This is NO-133, Exhibit 311. This is a letter from you to the camp surgeon at the concentration camp Dachau of 21 October 1944. You are asking that fever graphs be sent to you that were drawn up by a Dutch doctor in Natzweiler. What were they?
A This Dutch doctor was a prisoner doctor who had helped me with my vaccinations at Natzweiler, and who was in charge of the fever graphs. I, of course, wanted to have those graphs in the autumn for my records when the camp was moved.
It was very important to me to have these graphs, and I sent for them and got them.
Q Now the third document I want to bring up is on page 102. This is document NO-136, Exhibit 313. This is a letter of yours of 16 November 1944 to the camp surgeon of the concentration camp Natzweiler, Untersturmfuehrer Rode. You are asking here for one autoclave, one steam vesel, and one round dry sterilizer. Does this apparatus have anything to do with your alleged human experimentation?
A No. As I have said, this equipment was that which I had made available to the surgical department, and after the camp was dissolved, I wanted that back because it was valuable apparatus, particularly since we had had a direct bomb hit on our institute and lost a lot of equipment. This apparatus had nothing at all to do with human experimentation. I stress that this was apparatus used exclusively in the surgical department.
Q You said that your vaccinations were carried out in December of 1943 and January of 1944. Thus they occurred before the epidemic which, according to your testimony, took place in the spring and summer of 1944. In the course of the epidemic, could you ascertain whether the vaccine you had used on the prisoners was effective?
A Of course we could. All the prisoners were in the camp and none of these prisoners fell sick of typhus during the epidemic.
Q What was the course of your work in typhus vaccines after February 1944?
A I might return to the vaccinations of the winter of 19431944. Contrary to our expectations, some of those vaccinated had more severe reactions to the vaccination. Thus it could not yet be used on a large scale. My work, after these first vaccinations, was directed toward developing the vaccine by storing it away for a longer length of time toward further attenuating the vaccines so that the reactions would not be so severe. We reached, that aim in the summer of 1944. Then, as I have said, we had the fortunate result that of those whom we had vaccinated in the winter, none of them fell sick of typhus.
Therefore, I wished to continue with my vaccinations and asked for a larger number, namely, two hundred persons to be vaccinated so that I could carry out the vaccinations.
Q I assume, Professor, that you made this request through the same channel that you have already mentioned, namely, Professor Hirt.
A That is correct.
Q Now, Professor, please take a look at two documents put in by the prosecution. The first is on page 88 of the document book, document NO-123, Exhibit 303. This is a letter from you to Professor Hirt of 9 May 1944. There is an appendix, another letter of 27 June 1944, from you to Hirt. This is document 127, Exhibit 306, and this is on page 84. Please take a look at those two letters, Professor, and tell me whether you were thinking of them when you just gave your testimony.
A.- Yes, I was referring to these two letters.
Q.- I turn now to Document NO-123. You mentioned there a study by you regarding your work with dry typhus vaccine. You say that your work showed that this vaccine had highly anti-infectious results. I understand that you mean that this vaccine was a protection against the disease itself. You used the same expression in Document NO-128, your report to the Reich Research Council, of 21 January 1944, and I believe I am correct in assuming that this concept is the core of the Prosecution's charge. The Prosecution believes that to test the efficacy of this vaccine the persons vaccinated were subsequently infected with virulent or as you call it pathogenic virus, and this deduction is supported by what you say in Document NO-127, because here you speak of subsequent infection with virulent typhus germs. Now in order to clarify this point will you please explain to the Tribunal in what way you tested the anti-infectious effects of the vaccine, or at any rate how did you wish to test this on 9 May 1944?
A.- This is such an important question that I must go into some details in order to answer it, and above all to make myself comprehensible. If I contrast the antitoxic to the anti-infectious effects, then I must refer to what I said at the beginning of my examination. A virus made from killed, which is a virulent virus, I differentiated from the vaccine made from living, virulent virus, and said that in virus diseases the Killed virus, the killed vaccine, does not protect the person vaccinated against contracting the disease. In other words, it is not anti infectious, Put merely a means of reducing the severity of the disease. In other words, it only reduces the toxic effects of the germ. However, the purpose of anti-infectious vaccinations is to prevent the person contracting the disease at all. In other words, it is both anti-toxic and anti-infectious. The anti-infectious effects of the vaccine, however, result from the fact that like a natural infection, it immunizes the hu man body against subsequent infection with the same disease.
To substantiate this we have billions of cases of vaccination with other living virus. Let me point out this is one example: The vaccination with smallpox virus. What I am saying here is that we know that we have a certain -- we have an absolutely certain anti-infectious protection. From this example you can see that living virus would result in such an anti-infectious vaccine. This immunity results if there are enough antibodies in the blood or tissues. These antibodies cancel out the effects of the germ that enters the body when a person contracts the disease. This virus is effective because its antigens are retained. The antigen is introduced into the body and is able to protect the body against subsequent infection, protect it against the toxity of the disease germ. These antibodies are formed in the tissue and are then emptied into the body fluids, namely the blood or blood serum. These protective bodies in the blood we can demonstrate the existence of by the necessary Serological examination swiftly. That means that the vaccine content of antibodies rapidly decreases, but we know that the absence of antibodies in the blood is no proof that the body is not immune, no protection against new disease. That is very important for understanding this whole problem. The important factor is the immunity of the tissue, namely its content of antibodies. This content, however, cannot be proved directly but has to be proved indirectly in a serological way in that the titer values are analyzed before and after any subsequent vaccination. Then if the content of antibodies in a typhus vaccine sinks, we still cannot draw any conclusions regarding the degree of immunization of the person involved. But we can undertake a subsequent vaccination and from it draw enormously valuable conclusions. Two things can possibly happen in such a subsequent vaccination. First, the titer values will again rise, that is to say, the organism has reacted to the new vaccination by creating new protective bodies which have been emptied into the blood. This would have been a person who had previously not boon fully immunized.
However, if we vaccinate a person in whom the titer values have sunk and the titer values do not then rise after the subsequent vaccination, then this proves that the person was completely immunized. It proves that the body does not create any more antibodies, and consequently no more antibodies appear in the blood. In order to ascertain this, you do not have to carry out an infection with a humanly pathogenic virus, but you can use an attenuated, apathogenic virus such as we had in the virus. It was with the use of such a virus that the ascertainments were made of which this document speaks. These subsequent infections are referred to as "infections" both by me and in literature, but the virus in question is always an attenuated, apathogenic virus. These are the scientific insights I have felt it necessary for me to state in order to allow this problem to be correctly evaluated.
In Natzweiler also with the persons who had been vaccinated we carried out this subsequent testing in a few weeks after the first vaccinated received a subsequent third vaccination, and then we conducted the necessary serological examinations. It turned out that all of these, all those who had been vaccinated, did not have any rise in titer values after the subsequent vaccination, proving that they had already all been immune.
For purposes of comparison we now add the group of 40 persons who had been vaccinated by skin scarification and we used them as a control group. I believe I need not go any further into these scientific matters. Further practical proof of the anti-infectious protection is to be found also in the fact that none of those vaccinated fell ill of typhus during the epidemic.
Q.- Witness, before I continue in our discussion of those documents, an intermediary question: you said that in the way described, you tested the efficacy of your now vaccine in the laboratory already in December 1943 and January 1944. You further stated that your scientific con clusions prove to be correct according to what happened in the epidemic at Natzwelier, but I don't see why in June 1944 you planned, as can be seen from document NO-127, to start a new experimental series with 200 persons.
Why did you do that?
A.- You are overlooking the fact, counsel, that above all, it was my intention to develop and to carry out vaccinations throughout the whole camp in order to render the whole camp immune so that there would be no further danger of typhus. And I also wished to eliminate this source of danger for the civilian population of Alsatia.
A (continued) Since we could not carry out a larger production in the summer of 1944; I could not do this on a large scale, but I nevertheless felt that I could vaccinate 200 more. Thus making use of the experience we had from the first series, we wished to compare the general reactions that would occur in this second series.
Q Now, witness, turn to Document NO-127. You said that probably there would not be such long lasting reactions as there were in the preliminary experiments. Now, when you use the expression "preliminary experiments", what do you mean and what is your reason for thinking that there the reactions would be less severe?
A The preliminary experiments referred to are the first group that was vaccinated in the winter of 1943-'44 in which we ascertained that the reaction had to be reduced before the vaccine could be further used. This we did by storing the vaccine away for a longer period of time. I now had this stored away vaccine available because I had done no further vaccinating. In the meantime, I was able to store this vaccine away, and when we used it again, we saw that the reaction was considerably less severe.
Q But, Professor, let me put this to you: in the next paragraph you speak of subsequent infection with virulent typhus germs, and you say that this was necessary in order to prove dearly the anti-infectious effects of the vaccine. But you just said that you wanted to test the anti-infectious effect by subsequent vaccination and serological examination. Now how can these two things what you just said on the stand and what is stated here in this document be brought into any sort of an agreement with one another? It looks to me like a contradiction.
A I admit that when you see this statement from the prospective of this trial, it does look a little suspicious, and I can't hold it against a layman for reading into my words a meaning that was not intended. To explain this sentence, I may return to what I said to explain the terms anti-infectious immunity and subsequent infection. When I say subsequent infection, I am referring to the subsequent vaccination with living virulent virus containing vaccine, namely the third vaccination that I carried out in this group.
Q Professor, you are making synonymous the word "infection" with "vaccination", using vaccines from living -- namely, virulent--virus. Is the fact that you are making these words synonyms an invention of your own, or is this customary usage in literature and in science?
A Every vaccination with a vaccine that contains living virus in an infection person. That I must emphasize very clearly. For this reason alone, I had no misgivings about using the word in this context; moreover, I must emphasize, I didn't intend to let the persons who read my letter see clearly into my intentions and what I was doing, so that I used this expression here with no misgivings at all.
Q Now, Professor, why were you being so secretive about this?
A. Well, I knew that this problem or similar problems were being worked on elsewhere, but I didn't know whether or not my letter would fall into the hands of persons who would be interested in the way I was approaching the problem; and because these were important new scientific discoveries, which I of course wanted to reserve the right to evaluate, I phrased myself somewhat unclearly to keep my secrets to myself. To determine anti-infectious immunity, I carried out the serological examinations that I already mentioned. These serological examinations have been carried out in other virus diseases -- in smallpox, above all, and it had proved itself in animal experiments. I carried out examinations in this matter of smallpox for ten or twelve years and had proved the anti-infectious immunity by such indirect methods.
Q Professor, is this synonymous use "infection" with "vaccination", "subsequent vaccination" and "subsequent infection", customary in literature? If so, perhaps you could give the Tribunal an example.
A Yes. In literature also we find these two words used synonymously, so that I had no misgivings in using this word. As example, I can give you the title of a French work by Blanc, Noury and Baltazard, in the publication of the French Academy of Science.
This is Volume 201, page 1226, year 1935. The titel reads: "Prescance et premunition an cours du typhus exanthematique et an cours d' une infection inapparante par 1c virus biliaire."
Q Fitness, please speak more slowly, otherwise the correct terms will not get into the record.
A The translation: "presence and premunition are very difficult to translate. "In the course of typhus exanthematicus and in the course of an invisible infection by virus combined with gall." The two words used in the title, "preseance" and "premunition", are difficult to translate. They mean roughly, the continuance of the germ to exist in the organism, and pre-immunization. I might read a brief excerpt from this text: "Nine of those vaccinated were examined by infection with pure virus. One reacted to this virulent inoculation." The authors here are using "inoculation" and "infection" synonymously. They then continue: "From numerous subsequent experiments, we have ascertained that the vaccine virus (virus vaccine) remains in the organism of the person vaccinated for 25 to 30 days." I quote further: "The subsequent inoculation was carried out at the moment when the persons vaccinated had an in apparent infection (infection inapparante). Comparison experiments shew that a vaccine killed with phenol provides no immunization against a virulent infection (infection virulente), and it was this time that the inoculation took place." Here these French authors are obviously using "vaccination" and "infection" synonymously. Thus you can see in what context the word "infection" can be used.
DR. TIPP: Mr. President, the work that the witness just cited is unfortunately available only in French, but I believe that what you have heard from it already is enough to serve our purposes. If you wish, however, I can have the work translated.
THE PRESIDENT: If counsel believes that any such extracts for any such work can be held to the Tribunal, they can be translated and submitted as a document.
It is not necessary to take the time of the Tribunal listening to a witness read them from the stand. Anything like that can be more simply submitted. How much longer; counsel; do you anticipate this examination of this witness will continue?
DR. TIPP: One hour at the most tomorrow.
THE PRESIDENT: I will hand to the clerk two extra copies of this German document which are not necessary for the Tribunal. The Tribunal will now be in recess until nine-thirty tomorrow morning.
THE MARSHAL: The Tribunal will be in recess until nine-thirty o'clock tomorrow morning.
(The Tribunal adjourned until 19 June 1947; 0930 hours.)
Official Transcript of the American Military Tribunal in the matter of the United States of America, against Karl Brandt, et al, defendants, sitting at Nuernberg, Germany, on 19 June, 1947, 0930-045, Justive Beals, presiding.
THE MARSHAL: Persons in the courtroom will please find their seats.
The Honorable, the Judges of Military Tribunal 1.
Military Tribunal 1 is now in session. God save the United States of America and this Honorable Tribunal There will be order in the courtroom.
THE PRESIDENT: Mr. Marshal, will you ascertain whether the defendants are all present in Court?
THE MARSHAL: May it please Your Honors, all the defendants are all present in Court?
THE PRESIDENT: The Secretary General will note the presence of all the defendants in Court.
I should like to ask the Prosecution if they have any idea concerning the number of witnesses who will be called by the Presecution in rebuttal?
MR. HARLY: Off hand, Your Honor, I can recall that I intend to call perhaps five more witnesses in rebuttal in behalf of the Presecution. Those witnesses will not take more than an hour on direct examination on each occasion. There may be more or there may be less, but I should say approximately five.
THE PRESIDENT: The Tribunal was only inquiring for an approximation of the time. It is necessary that the Tribunal expedite the close of the evidence to the greates possible extent. The Tribunal will be in session at least Saturday morning. Whether or not an afternoon session will be held Saturday will be announced later. Counsel may proceed with the examination of the witness.
The witness is reminded that he is still under oath DR. HAAGEN (Resumed) DIRECT EXAMINATION (Continued)
BY DR. TIPP:
Q Professor, yesterday we stopped when we were discussing Document No. 127, page 94 in Document Book 12. We last discussed the way in which you tested the effects of your vaccine against the disease itself, that is the anti-infoctious immunity and also what plans you had for the future in this direction. Perhaps by way of transition you could clarify this concept in two or three sentences?
A Tp prove anti-infectious immunity we have two possibilities. One, of course, is observation of the vaccinated person during an epidemic. The other is a laboratory procedure, which I may, perhaps elucidate briefly, This group of those already twice vaccinated was given a third subsequent vaccination of the cultural vaccine. This third vaccination was not carried out in order to give additional protection by way of vaccination, rather its purpose was by serological means to ascertain any changes in the titer values after the entrance into the body of the antigone. he are here not interested the effects of the pathogenic components, but only the effects of the antigenic components. Since the purpose of the third vaccination was not immunization but rather a test of immunization, I had no misgivings, following the example of other authors in speaking of this as an infection or subsequent infection, but I must again emphasize that this vaccine contained no components pathogenic to human beings of, after this renewed introduction are formed, which will manifest itself in a new increase in the titer values as determined by the Weil-Felix reaction, this proves that the body had not been completely immunized theretofore. The body tissues reacted by manufacturing new anti-bodies which then entered into the blood. If the titer value in this subsequent immoculation remains unchanged, then we can draw the conclusion that the organism has complete immunity. The tissue formed new anti-bodies, and therefore none appeared in tho blood. That is a synopsis of what I said yesterday.
Q Then Professor you say that the subsequent infection, mentioned in Document NO 127, with virulent typhus germs was to be a subsequent vaccination with your virulent, that is to say living, typhus virus vaccine which was not pathogenic for human beings, is that correct?
A Yes, that is correct.
Q Then you make synonomous the two terms, "subsequent infection" and "subsequent innoculation"?
A Yes.
Q And I asked you yesterday whether the interchange of these two words or concepts was a special on your part, or whether the interchange of these two words or concepts can be found in literature; you answered this question in the affirmative saying that the interchange of these words was customary in literature, and to prove this you cited a French paper. Now, Witness, you speak French, and consequently it is to be expected of you that you might have used French terms here, but it is not to be expected that the Tribunal or the other defendants and defense counsel are so familiar with French as to understand these technical terms. Therefore, it would be expedient if you would briefly repeat in simple German what it was you stated yesterday using the French terms.
A I said as a model for 'the terminology I used I had taken another authors, and I mentioned as an example a paper by the French scientists, Blane, Noury, and Baltazar, in the publications of the French Academy of Science. This is a volume 201, page 1226 of the year 1935. I shall repeat the title once again in German; "Presence and premunition in the course of typhus exanthematicus and in the course of an inapparent infection from a virus combined with gall." Again a brief excerpt from text: Nine of those vaccinated were tested by being given an infection with pure virus. "In the others words, the authors are here equating infection and innoculation. They continue, "From numerous later experiments we found out that the vaccine virus remained in the organism for 25-30 days. The subsequent innoculation was administered at the time when the vaccinated persons had a hidden infection. From comparison it was ascertain that a virus killed with phenal had no effect on a virulent infection.
I believe that is all I have to repeat of this particular work. Now, if one looks at this paper critically, one sees immediately that the authors undertook an infection with a pathogenic virus. In other words, they did exactly what we are charged with having done here, namely infecting human beings with a pathogenic virus. I have said several times that such experiments with pathogenic virus were not undertaken by us.
MR. HARDY: I presume, Your Honor, that the defense counsel will have these excerpts in French translated into the English and German languages and submitted to the Tribunal, in accordance with the instructions of the Tribunal yesterday.
DR. TIPP: Mr. President, I did not understand the Tribunal to request that this should be put in evidence. I thought the Tribunal said if I wished to submit it I could do so. If, however, it was the wish of the Tribunal, I shall have the document put in evidence.
THE PRESIDENT: Defense counsel correctly understood the suggestion made by the Tribunal. Does the prosecution desire that this be translated and made a part of the record?
MR. HARDY: Your Honor, it seems they are making quite an issue of it. I think it would be well that it be translated into the English language so that we can interpret it in our briefs as well as Dr. Haagen's interpretation.
THE PRESIDENT: Very well, the defense counsel will comply with the suggestion made by the prosecution.
DR. TIPP: Very well, Your Honor.
BY DR. TIPP:
Q. Professor, I think the subsequent inoculation question has been definitely clarified by now. I should like to take up in Document NO-127the further conception of what you stated there. You write:
"This time 150 persons will be used for the vaccination and 50 for the control inoculation."
Then, you also write that illnesses must be expected. Now, what do you mean? The prosecution understands under the concept "control inoculation" persons who were not vaccinated and were then given the disease so that they could be compared with the persons who had received vaccinations Tell us whether you used the term "control persons", let us say, in the same way as Ding used it. Tell us just what you did mean by the term "control persons" and what your plans were?
A. First of all, let me say that this was only a plan and that vac cination was never actually carried out.
I intended the following: I wanted to vaccinate two groups of 150 persons twice in the normal way, namely, by intramuscular injection. This group, after a lapse of four weeks, was to be given a subsequent vaccination through scarification, such as is carried out in smallpox vaccination and which I explained yesterday. This scarification was to be a third inoculation to test the immunizing effect on the first two, as I also described yesterday. Now, the control group for this was to have a single vaccination, using the scarifying method. This would have made it possible to test the scarification reactions of those who received the third subsequent vaccination with the results of those who received only the single scarification vaccination. Thus, when I speak of the group of non-vaccinated persons, I am speaking of this latter group, namely, the people who received only one vaccination with the scarification method, those who had received no previous vaccination, so we would have to count on the reaction to the vaccination.
This is what I mean when I say here in this document that we must count on sickness. These sicknesses I refer to are, of course, the reactions to the vaccinations, but, of course, they are not any such thing as a manifest typhus disease itself, which of course our attenuated vaccine could not produce.
Q. Witness, you just told us this sickness referred to was a reaction to the vaccine, in other words, a fever, headaches, fatigue, etc, such symptoms as are well-know to everyone who has been vaccinated. Then, why do you speak of sickness at all in this letter, if these are simply the reactions that are to be expected from the vaccination?
A. My letter was probably read only by laymen, who would probably have no idea what the term "reaction to vaccines" meant. It was therefore easier to speak of sickness. Moreover, these prisoners were being used for work and were not to be kept away from work any longer than was absolutely necessary, Since I did not have enough experience with vaccination by scarification, I did speak of the possibility of such a reaction in order to be absolutely covered.