ETHICALLY IMPOSSIBLE” STD Research in Guatemala from 1946-1948 
The visiting physicians observed the intentional exposure experiments. Dr. 
Van Slyke complained that Dr. Cutler had not confirmed that the commercial 
sex workers were in fact infected with gonorrhea at the time of exposure. 382 
Discussing these concerns later, Dr. Arnold suggested that Dr. Cutler not 
“put on any more shows unless you are sure of everything” so as to avoid “an 
unfavorable impression.” Alternatively, Dr. Arnold suggested that Dr. Cutler 
“do a little blanket stretching.” 383 
In addition, the volume and frequency of exposures to the commercial sex 
workers raised some concern. Dr. Cutler’s superiors advised that the commer- 
cial sex workers should have sexual intercourse with men several hours 
apart 384 or just several times a day 385 to maximize transmission rates. But the 
sex workers involved in the experiments had intercourse with different men 
sometimes less than a minute apart, seeing a large number of men in a very 
short time. 386 For example, one commercial sex worker whom the researchers 
infected with gonorrhea had contact with eight soldiers 387 in 71 minutes. 388 
Transmission rates remained low. According to Dr. Cutler’s final report, in 
total in the Guatemalan Army, only five infections resulted from 138 expo- 
sures of 93 men (3.4 percent) to 12 commercial sex workers over the course of 
the normal exposure experiments which ended in July 1948. 389 
Artificial Inoculation 
Shortly after beginning the sexual intercourse experiments to induce gonor- 
rhea infection, the researchers also began “artificial inoculation” experiments, 
mirroring techniques employed in Terre Haute (see Figure 8). The researchers 
conducted these artificial inoculation gonorrhea experiments in the Guate- 
malan Army beginning in April 1947 (two months after they started the 
sexual intercourse experiments). 390 They employed two procedures for arti- 
ficial inoculation: “superficial” and “deep” inoculation. The swabs used in 
superficial inoculation were from the bacterial laboratory. For deep inocula- 
tion, the researchers used toothpicks wrapped in a small amount of cotton. 
For both procedures, the swab was moistened with pus from an “acute case of 
gonorrhea in the male.” 391 In a superficial inoculation: 
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