ENDNOTES 
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319 PCSBI. (2011). Subject Database. Overall, there were 18 subjects involved in the intentional exposure 
experiments who were under the age of 18 (including a 10 and 15-year-old soldier, a 16-year-old sex 
worker, a 15 -year-old prisoner, and 14 psychiatric patients ranging in age from 14 to 17). The youngest 
subject involved in the STD exposure experiments was a 10-year-old soldier who was a member of the 
Honor Guard. As part of the experiments, he had sexual intercourse three times with a commercial sex 
worker infected with gonorrhea and was superficially inoculated in his penis with gonorrhea-infected 
pus once. The subject’s age was recorded in two separate places. Cutler Documents. (1947). Gonorrhea 
Experiment #1. Clinical notes, protocols, and subject note cards. PCSBI HSPI Archives, CTLR 0001738, 
CTLR 0001743, CTLR 0001748, CTLR 0001769, CTLR 0001770; Cutler Documents. (1947- 
1948). Guatemala Journal Studies with the Military (GC). Clinical notebook. PCSBI HSPI Archives, 
CTLR 0000561; and Cutler Documents. (1947-1948). Gonorrhea Experiments: Military. Lists and clinical 
notes. PCSBI HSPI Archives, CTLR 0001971. Studies have shown that sexual intercourse before the age 
of 13 is possible. CDC. (2010, June 4). Youth Risk Behavior Surveillance-United States, 2009. Available at 
http://www.cdc.gov/mmwr/pdf7ss/ss5905.pdf (accessed August 10, 2011). 
320 This is according to contemporaneous Cutler notes. PCSBI. (2011). Subject Database. While treatment 
with penicillin or sulfathiazole was recorded for many of the subjects, some of the subjects involved were 
released or escaped before treatment; homosexual contacts may have spread the disease further than the 
researchers charted; and some subjects not showing clinical manifestations of the disease were never 
treated, despite testing positive. 
321 For the original plan of Dr. Cutler’s study, see Section “Initial Study Design.” 
322 In addition, some studies were designed in a way that subjects in the active arm of the experiment, (testing 
the prophylaxis), were given a less effective form of inoculation than the control arm, thus making the 
prophylaxis appear more effective (see, e.g., experiment 31 in which the researchers used superficial 
inoculation for the active arm, but deep inoculation for the control group — a method they knew to be more 
likely to transfer gonorrhea). Cutler Documents. (1947-1948). Guatemala Journal Studies with the Military 
(GC). Clinical notebook. PCSBI HSPI Archives, CTLR_0000602. 
323 PCSBI. (2011). Subject Database. 
324 Ibid. This number excludes several subjects for whom the records reflect confusion as to whether the 
subject died or not. See, e.g. Cutler Documents, (n.d.). Penitentiary, Alphabetical Lists of Patients by 
Number. PCSBI HSPI Archives, CTLR 0001500. Seventy-six of the 83 subjects that the researchers 
recorded as having passed away were involved in the STD exposure experiments. 
325 These deaths occurred “either during the inoculation stage, during the active phase of the disease, 
or post treatment.” John Cutler. (1955, February 24). Final Syphilis Report. PCSBI HSPI Archives, 
CTLR 0000672. 
326 Ibid. The researchers offered staff at the Psychiatric Hospital “a few extra dollars” to notify them of subject 
deaths so that autopsies could be performed. John Cutler. (1955, February 24). Final Syphilis Report. 
PCSBI HSPI Archives, CTLR 0000674. This practice is consistent with the PHS/Venereal Disease 
Division activities in the Tuskegee Syphilis Study, where Dr. R.A. Vonderlehr coordinated with a wide 
variety of agencies and individuals, including Dr. Eugene Dibble, a physician at the Tuskegee Institute to 
whom he offered a PHS appointment, to ensure that researchers were notified of subject deaths to facilitate 
autopsies. Jones, J.H. (1993). Bad Blood: The Tuskegee Syphilis Experiment. New York: The Free Press, 
pp. 132-150. No autopsy reports were found in the Cutler Documents, but there are records of tissue 
samples from seven subjects being sent to Dr. James D. Thayer at the Venereal Disease Experimental 
Laboratory in Chapel Hill, North Carolina in April 1957. The Venereal Disease Experimental Laboratory 
was part of the PHS Venereal Disease Branch and was also associated with the University of North 
Carolina, Chapel Hill. John Cutler to L.L. Ashbum. (1957, January 7). Correspondence. PCSBI HSPI 
Archives, CTLR 0001531; L.L. Ashbum to James Thayer. (1957, April 3). PCSBI HSPI Archives, CTLR 
000152. 
327 PCSBI. (2011). Subject Database. 
328 John Cutler. (1952, October 29). Experimental Studies in Gonorrhea. Report. PCSBI HSPI Archives, 
CTLR 0001299. 
329 Ibid, PCSBI HSPI Archives, CTLR_0001285. 
330 John Cutler to R.C. Arnold. (1947, September 16). Correspondence. PCSBI HSPI Archives, 
CTLR 0001230. 
181 
