“ETHICALLY IMPOSSIBLE” STD Research in Guatemala from 1946-1948 
Dr. Cutler later reported a 17.9-percent transmission rate for this method. 494 
Scarification and Abrasion 
On September 24, 1947, after six 
contact and injection experiments 
in the Psychiatric Hospital, the 
researchers began abrading the 
membranes of psychiatric subjects’ 
penises to improve the syphilis 
transmission rate. 495 But, like the 
artificial gonorrhea inoculations, 
this technique raised some serious 
doubts with Dr. Cutler’s supervi- 
sors at the VDRL. On September 
8, Dr. Mahoney reminded Dr. 
Cutler “we have delayed setting 
up a field trial of the prophylactic 
agent in the hope that the Guate- 
mala work would give precise data 
which would support, even in a 
small way, the experimental find- 
ings in animals.” 496 Dr. Mahoney 
felt that both scarification and abrasion were “drastic,” were “beyond the range 
of natural transmission and [would] not serve as a basis for the study of a locally 
applied prophylactic agent.” 497 Dr. Mahoney told Dr. Cutler “unless we can 
transmit the infection readily and without recourse to scarification or direct 
implantation, the possibilities of studying the subject are not bright.” 498 
In another letter the same day, Dr. Mahoney continued: 
“I wish you would give some thought to the future of the work 
in Guatemala. In the event of the prophylaxis angle proving to 
be impossible of resolution, we will have left only the serology 
study and the work in penicillin therapy. We would surely have 
difficulty in selling an expensive project of this kind to the Public 
Health Service.” 499 
This male patient in the Psychiatric Hospital was exposed to 
syphilis twice and was treated with penicillin. He also was 
involved in the serological testing for syphilis. His age and original 
diagnosis, and reason for hospital treatment, are unknown. 
From the National Archives and Records Administration 
62 
