ETHICALLY IMPOSSIBLE” STD Research in Guatemala from 1946-1948 
disease. 171 The conventional arsenic therapy generally required 18 months to 
complete and had many unpredictable side effects. 172 
As Dr. Cutler was beginning research in Terre Haute in October 1943, Dr. 
Mahoney announced these results to a “jam-packed session” at the Amer- 
ican Public Health Association’s annual meeting. The initial results were so 
promising that one researcher called the work “probably the most significant 
paper ever presented in the medical field.” 173 Dr. Mahoney, in collaboration 
with Dr. Moore and several others comprising the newly established NRC 
Penicillin Panel, quickly began a much larger clinical trial involving 1,400 
subjects. 174 Eight months later, in June 1944, the U.S. Army adopted peni- 
cillin as its standard treatment for syphilis. 173 In September 1944, Drs. Moore 
and Mahoney and their colleagues published results for the larger trial that 
confirmed their earlier findings. 176 
Despite this success, many questions remained. Researchers wondered 
whether penicillin therapy left subjects immune to further infection or at risk 
of re-infection with the same or a different strain of the disease. 177 Uncertainty 
lingered too about penicillin’s long-term effectiveness. Blood tests showed that 
penicillin eliminated syphilis spirochetes (a type of bacterium) in the short 
term, but could not confirm whether the disease disappeared entirely. 178 
Researchers and policy makers alike were also seeking to improve methods 
to prevent syphilis with post-exposure prophylaxis. Describing these facts in 
his 1933 “Final Syphilis Report,” Dr. Cutler reported that Drs. Mahoney 
and Arnold felt that a prophylaxis consisting of a simple orvus-mapharsen 
wash might meet with more acceptance than the calomel ointment, which 
at the time was routinely prescribed. Animal studies conducted in the labo- 
ratory repeatedly showed orvus-mapharsen’s effectiveness. 179 Furthermore, 
Drs. Arnold, Cutler, and another researcher, Dr. Sacha Levitan, a PHS Senior 
Surgeon, conducted “small scale studies” of the orvus-mapharsen solution 
on “ships where relatively high rate [sic] of venereal infection was expected 
among the crews.” 180 But these results were inconclusive. 181 Consequently, Dr. 
Cutler later reported, they felt that small controlled experiments on indi- 
viduals “exposed to a high risk of infection” were required to determine if 
orvus-mapharsen could be effective, “particularly in the Armed Services.” 182 
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