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prostitution and of all rapid treatment centers where all venereal disease patients could be hospitalized 
for free treatment.” John Cutler. (1955, February 24). Final Syphilis Report. PCSBI HSPI Archives, 
CTLR 0000640. Dr. Cutler also performed several syphilis serology tests for the U.S. Air Base in San 
Jose, Guatemala, on men stationed there. John Cutler to the Commanding Officer, U.S.A. Air Base, San 
Jose Guatemala. (1946, December 21). Correspondence. PCSBI HSPI Archives, CTLR 0001245. 
Blood samples from the Air Force were used for a study on the “Neurath inhibition phenomenon,” which 
was developed to aid in the serodiagnosis of syphilis. Originally tested by the VDRL Staten Island, the 
Neurath procedure was then carried out by the researchers in Guatemala “on a number of individuals in a 
population group giving a high percentage of positive reactions. . .” Blood specimens for this study were 
obtained from children in the Orphanage, school children in San Jose, and syphilitic adults in Guatemala 
City. U.S. men stationed at the Air Force Base in Guatemala were used as a control “to demonstrate 
whether reagents used and the performance of the procedure in Guatemala would elicit the same type of 
results as those obtained when the tests were performed in this country on individuals in the United States 
population.” Falcone, V.H., et al., op cit., pp. 264-265, 269. 
Insofar as the serology experiments were part of medical care, conventional practices in the United States 
would not have mandated any written or formalized consent for testing. Faden, R.R., Beauchamp, T.L. 
(2009). The concept of informed consent. In Vaughn, F. (Ed.). (2009). Bioethics: Principles, Issues, and 
Cases. New York: Oxford University Press, p. 146. However, while available records show three children 
in the Orphanage received treatment for congenital syphilis, there is no record of treatment for the other 
children. Fevitan, S., et al., op. cit., pp. 380-381. 
PCSBI. (2011). Subject Database. 
John Cutler. (1955, February 24). Final Syphilis Report. PCSBI HSPI Archives, CTLR 0000643. 
There were still outstanding questions regarding whether persons with untreated syphilis were resistant to 
infection with a different strain of syphilis, or whether persons with treated latent syphilis were immune 
to reinfection. If both of those questions held true, and many of the prisoners had syphilis already, there 
would be few men that would make adequate prophylaxis subjects. John Cutler. (1955, February 24). Final 
Syphilis Report. PCSBI HSPI Archives, CTLR 0000646. 
Ibid. 
John Cutler. (1955, February 24). Final Syphilis Report. PCSBI HSPI Archives, CTLR 0000648. 
Ibid. 
However, it does not appear as though the prisoners were subjected to more invasive serological testing 
methods used by the researchers later in other populations, such as lumbar or intra cisternal punctures. 
John Cutler. (1955, February 24). Final Syphilis Report. PCSBI HSPI Archives, CTFR_0000652. 
It is not clear when the research began, however Dr. Cutler wrote to Dr. Arnold in June 1947 to tell him 
they were going to San Jose to “work again” with the children. In the same letter, Dr. Cutler explained 
that testing in the Orphanage was more preliminary (“We have begun with the orphanage, but have barely 
touched it, so that there is nothing to report”). Unsigned [John Cutler] to Richard Arnold. (1947, June 5). 
Correspondence. PCSBI HSPI Archives, CTLR 0001240. 
Ibid; PCSBI HSPI Archives, CTLR 0001240; Levitan, S., et al., op cit., p. 379. Data analysis continued 
until the early 1950s. Stout, G.W., op cit. 
This number is made up of 515 children from the Orphanage, 151 children from the Port of San Jose, 277 
“Indian” children from Totonicapan, and 441 “Ladino” children from the “highlands” of Guatemala. Stout, 
G.W., op cit., p. 238. 
Ibid, pp. 238-239. 
John Cutler. (1955, February 24). Final Syphilis Report. PCSBI HSPI Archives, CTLR_0000649. Dr. 
Cutler’s records do not reflect why congenital syphilis would be readily apparent to the researchers, but 
there are many clinical symptoms of congenital syphilis that differentiate from sexually acquired syphilis. 
Stokes, J.H., op cit., pp. 1094-1114. Dr. Funes repeated this rational in his article on the children, arguing 
that “to study false positive reactions to the serologic tests, it is necessary to select a group that is not 
sexually mature and in which the probability of acquired syphilis is minimal” [translation]. Funes, J.M., et 
al., op cit., pp.14-18. 
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