ETHICALLY IMPOSSIBLE” STD Research in Guatemala from 1946-1948 
whom the sex workers had contact, indeed “precise observations were not made” of the women’s sexual 
contacts [translation]. Arnold, R.C., Mahoney, J.F. (1948). Local prophylaxis in experimental syphilis of 
the rabbit. Journal of Venereal Disease Information 29:138-41; Funes, J. Aguilar, C.L. (1952 agosto). La 
solucion de mafarside-orvus en la profilaxis de la blenorragia de la mujer. Boletln de la Oficina Sanitaria 
Panamericana 33(2):121-125. Dr. Cutler discussed this study in a later article on STD prophlaxis; however, 
he added “[sjtudies involving the exposure of non-infected volunteers to infected contacts in order to 
observe relative rates of protection have become increasingly difficult, due to the rigid medical research 
ethics now operative.” Cutler, J.C., et al., (1973). Op cit., p. 89. 
413 PCSBI. (2011). Subject Database. 
414 Ibid. 
415 The idea to infect in subjects’ eyes possibly came from Dr. Arnold’s letter in which he had written to Dr. 
Cutler about another experiment “that could be done” involving “the actual infection or [an] attempt to 
infect the eye with [gonococcal] pus...” He was curious whether the eye became infected easily as “Lj]ust 
a thought for the future.” Richard Arnold to John Cutler. (1947, April 19). Correspondence. PCSBI HSPI 
Archives, CTLR_0001220. 
416 Cutler Documents. Insane Asylum Asilo de Alienados and Prison Patient Records. (Various dates) Subject 
note cards. PCSBI HSPI Archives, CTLR 00041 55-57; Cutler Documents. (1947-1948) Guatemala 
Journal Studies with the Military (GC). Clinical notebook. PCSBI HSPI Archives, CTLR 0000617; Cutler 
Documents. (1948, February 8). Asylum Asilo de Alienados and Prison Patient Records. (Various dates) 
Subject note cards. PCSBI HSPI Archives, CTLR 0004158. 
417 PCSBI. (2011). Subject Database. 
418 Arnold, R.C., Mahoney, J.F. (1948, May). Op cit., pp. 138-141; John Cutler. (1955, February 24). Final 
Syphilis Report. PCSBI HSPI Archives, CTLR_0000759. 
419 John Cutler. (1955, February 24). Final Syphilis Report. PCSBI HSPI Archives, CTLR 0000782. 
420 These strains include the Nichols strain, the Frew Strain, and a “street strain” of Dr. Cutler’s own making. 
John Cutler. (1955, February 24). Final Syphilis Report. PCSBI HSPI Archives, CTLR 0000684-86. 
421 Treponema pallidum cannot be maintained adequately in culture and can only be maintained in the testes 
of rabbits. To produce Treponema pallidum for research purposes, rabbits are inoculated intra-testicularly 
with the organism and, after a month, are killed. Emulsions are then prepared from the testes. The 
researchers had “access to large quantities of the organism more or less at will” because “an animal colony 
was maintained at the VDRL Staten Island to use in experimental work.” See John Cutler. (1955, February 
24). Final Syphilis Report. PCSBI HSPI Archives, CTLR_0000688. 
422 John Cutler. (1955, February 24). Final Syphilis Report. PCSBI HSPI Archives, CTLR_0000711. 
423 Ibid, PCSBI HSPI Archives, CTLR_0000675. 
424 Ibid, PCSBI HSPI Archives, CTLR_0000687. 
425 Ibid, PCSBI HSPI Archives, CTLR 0000686. 
426 As of 1946, as evidenced by a statement by Dr. Moore at a Penicillin Conference held under the Auspices 
of the U.S. PHS, FDA, and NRC, the U.S. Armed Forces were treating patients with syphilis with 
2.4 million units of penicillin, but data indicated that amount was insufficient. As a result, penicillin 
researchers were testing other amounts, as high as 9.6 million units, but there were insufficient data 
to determine which amount was most effective. Penicillin Conference Under the Auspices of the U.S. 
Public Health Service, Food and Drug Administration, and National Research Council. March 27, 1946, 
at 158-159. The researchers defined “adequate” treatment as > 3,400,000 units of penicillin administered 
over seven to eight days, with aqueous preparations every two hours and 12 to 24 hours for the POB and 
Duracillin, which fit within the standard of care guidelines at the time. Crawford, G.M. (1947). Syphilis. 
New England Journal of Medicine 236(8):283. 
427 PCSBI. (2011). Subject Database. Several patients in the Psychiatric Hospital without serological or clinical 
evidence of syphilis were also treated with penicillin “for political reasons only (emphasis in original).” 
See, e.g, Cutler Documents. Insane Asylum Asilo de Alienados and Prison Patient Records. (Various 
dates). Subject note cards. PCSBI HSPI Archives, CTLR 00006321. 
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