“ETHICALLY IMPOSSIBLE” STD Research in Guatemala from 1946-1948 
After the subject was abraded and inoculum applied as described above, a 
small amount of the prophylactic was “placed in the meatus” and the rest 
of the material was “thoroughly rubbed into the glans, foreskin, shaft of the 
penis, and onto the pubic hair by the physician.” 519 
As “[cjomplete results of any given experimental procedure were not available 
for at least 4 months following inoculation,” Dr. Cutler wrote: 
“With limited time available for completion of the project it was 
thus not feasible to delay four months between each experimental 
run so as to plan successive experiments on the basis of knowledge 
gained from the predecessors. Thus it was necessary to anticipate 
results upon bases of early observations and to move ahead on 
the strength of incomplete experimental data with knowledge that 
final analysis would be made of the completed work so that any 
errors in the early hypothesis would be shown up.” 520 
Oral Contagion and Cisternal Punctures 
The researchers also decided to undertake other types of inoculation in the 
Psychiatric Hospital, including oral ingestion of syphilitic material. For this 
work, the researchers were curious about the ability of the syphilis spirochete 
CISTERNAL PUNCTURE 
Seven women in the Psychiatric Hospital were 
exposed to syphilis via cisternal puncture, the 
injection of syphilis into the spinal fluid from 
the back of the skull. 
Dr. Cutler wrote in his Final Syphilis Report 
that the reason they inoculated the women 
in this fashion was to determine the 
effectiveness of the “blood-spinal-fluid” 
barrier, as well as to attempt to “shock” the 
women out of their epilepsy. 
Diagram of a cisternal puncture. 
From Alexander G. Reeves, M.D. and Rand S. Swenson, 
M.D., Ph.D., “Disorders of the Nervous System’’ 
Two of the women subjected to cisternal puncture developed headaches and one lost the 
use of her legs for a period of time. Five of the seven women were eventually treated, one 
received penicillin only as a prophylaxis, and one never received any penicillin. One of the 
women who received penicillin later died. 
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