APPENDIX IV 
IX 
considered prophylactic in nature, and all dosages after 21 days were consid- 
ered treatment. 
In all cases, where no data were available or reasonably interpretable, the cell 
was left with “nd,” denoting no data. 
Limitations 
Limitations inevitably attach to trying to interpret and analyze incomplete 
and decades-old data sources. The documents contained a mix of English 
and Spanish written by multiple individuals with varying levels of fluency, 
proficiency with spelling, and penmanship. They reflect inconsistency in the 
spelling of individuals’ names and assigning the subject numbers, further 
complicating this investigation; for example, on one page, an individual’s 
name would be recorded as “Gomez,” but the next entry referencing the same 
person might be noted as “Gomes,” likewise for “J.O. Hernandez” and “Jorge 
Oscar Hernandez.” 
In addition, though Dr. Cutler’s final reports provide some information on 
timing and some experimental details, they are not comprehensive, as, for 
example, there are experimental results in the Research Notebooks that were 
not mentioned in the final reports. Conversely, Dr. Cutler includes over 10 
experiments in his Final Syphilis Report for which the Commission did not find 
corroborating evidence in the contemporaneous laboratory or clinical notes. For 
example, Dr. Cutler describes a superficial inoculation gonorrhea experiment in 
the Guatemalan Army on May 9, 1947, but there are no additional subject data 
available in the Cutler Documents to evidence this experiment. 707 The reason 
for this discrepancy is unclear; however, there is reason to believe that the 
Commission is not in possession of all of the clinical notes from the Guatemala 
experiments. For example, one of the clinical notebooks includes an instruction 
to please “[s]ee Miss [Alice] Walker’s record book.” 708 This referenced notebook 
is not among those included in the Cutler Documents. 
Additionally, the experiments described in these documents were conducted 
in the 1940s, at a time when diagnosis and treatment methods for STDs 
were not as settled as they are today, and the syphilis organism was poorly 
understood. Sixty-five years later, it is difficult to know what the researchers 
thought and understood about the diseases they were working with and the 
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