ENDNOTES 
X 
428 It was not clear that his death was caused by penicillin; the subject “developed status epileptiaus during 
the course of therapy with aqueous penicillin for primary syphilis on the 6th day, and despite efforts to 
control the condition, died,” but, Dr. Cutler reported, the subject had a history of severe epileptic attacks 
prior to his exposure to penicillin during the experiment. John Cutler. (1955, February 24). Final Syphilis 
•Report. PCSBI HSPI Archives, CTLR 0000748. Dr. Cutler and his staff also made a number of clinical 
observations in the Final Syphilis Report. With regard to lesions, the researchers found that: “. . .it can be 
said that absence of lesion signifies with a high degree of certainly the absence of infection. This statement 
had subsequently been confirmed with respect to the group of patients initially treated for latent syphilis 
or late symptomatic syphilis in the Sing Sing study.” John Cutler. (1955, February 24). Final Syphilis 
Report. PCSBI HSPI Archives, CTLR 0000925. As Dr. Cutler points out in his Final Syphilis Report, he 
was also involved in the U.S. PHS-sponsored Sing Sing Correctional Facility study conducted from 1953 
to 1954. To develop a syphilis vaccine, researchers inoculated volunteers with a very high level of syphilis 
spirochetes. Investigators discussed “the study, the objectives, and the details of its day-to-day conduct” 
with the volunteers. Patients received follow-up for a year (monthly checkups) through the study and 
then were treated as part of the general “syphilitic” prison population. The details of this research were 
widely published in the medical and popular press. Syphilis vaccine gains: Sing Sing tests held raising 
hopes for finding preventive. (1954). New York Times, December, 9; Sing Sing study confirms rabbit tests. 
(1955, February). Public Health Reports (1896-1970), 70(2):214; Magnuson, H., et al. (1956, February). 
Inoculation syphilis in human volunteers. Medicine 35(l):33-82; Reverby, S. (2009). Examining Tuskegee: 
The Infamous Syphilis Study and its Legacy. Chapel Hill: University of North Carolina Press, p. 146. 
429 This date is taken from the day that two commercial sex workers were exposed to syphilis via intra- 
cervical injection on May 10, 1947 “to send to the penitentiary as part of the study to determine normal 
rate of infections.” Cutler Documents. (1947-1948). Guatemala Journal Studies with the Military (GC). 
Clinical notebook. PCSBI HSPI Archives, CTLR 0000620. While there are no contemporaneous clinical 
notes of Penitentiary subjects having sexual intercourse with sex workers on that date and it is not included 
in the summary section of the Final Syphilis Report, Dr. Cutler does discuss this “risk of infection” study 
in the “Immunity” section of his final report. John Cutler. (1955, February 24). Final Syphilis Report. 
PCSBI HSPI Archives, CTLR_0000885. 
430 PCSBI. (2011). Subject Database. Five prison guards were also included in the researchers’ intentional 
exposure experiments (see, e.g., Cutler Documents. Insane Asylum Asilo de Alienados and Prison Patient 
Records. (Various dates). Subject note cards. PCSBI HSPI Archives, CTLR 0003401); for the sake of 
brevity, they will be included with the data of the “prisoners.” 
431 PCSBI. (2011). Subject Database. 
432 John Cutler. (1955, February 24). Final Syphilis Report. PCSBI HSPI Archives, CTLR 0000662. 
433 Ibid. PCSBI HSPI Archives, CTLR 0000667. 
434 Unsigned [John Cutler] to Richard Arnold. (1946, August 21). Correspondence. PCSBI HSPI Archives, 
CTLR 0001215. 
435 Ibid. 
436 John Cutler to John Mahoney. (1947, January 7). Correspondence. PCSBI HSPI Archives, CTLR 0001039. 
When Dr. Cutler wrote that the papers were already complaining about prison conditions, he is probably 
referring to articles such as the one published later that year reporting that “the prison system in 
Guatemala, like the infamous Bastille to the French and the horrible Romada to the Venezuelans, has 
not fulfilled the purpose outlined by national law, but has been a pit for vengeance, for suffering and for 
crime that has served dictators in satisfying their basest instincts on defenseless enemies, who in reality 
have been the best friends of democratic institutions and the joyful march to civilization and culture” 
[translation]. Editorial. (1947, August, 9). La Reforma Penitenciaria. Diario de Centro America. 
437 PCSBI. (2011). Subject Database. There is one day on which the method of exposure is unclear. 
438 John Cutler. (1955, February 24). Final Syphilis Report. PCSBI HSPI Archives, CTLR 0000723. 
439 Ibid, PCSBI HSPI Archives, CTLR_0000724. 
440 Ibid, PCSBI HSPI Archives, CTLR_0000699. 
441 Ibid. 
187 
