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Syphilis is one of the common sexually transmitted diseases spreading through sexual activity. The bacterial infection will not spread to others by sharing towels, bath tubs or swimming pools with infected person. The infection can also spread to the baby from his infected mother during the stage of pregnancy. Syphilis infection occurs in 3 different stages known as primary, secondary and tertiary stage.
In the secondary stage, (6 weeks to 6 months) rashes are formed on the hands and feet of the person.
Tertiary stage of syphilis is very critical stage and it can damage your vital organs like brain or heart or nervous system. If not treated within time, the infection will spread into the entire body causing severe damage.
Penicillin is the best antibiotic for killing the dormant bacteria in your body causing infection.
Initially the infected person will experience Jarisch Herxheimer symptoms after receiving first shot of injection. Unlike many other diseases which cure on its own, syphilis will not get resolved without taking proper treatment. In the 1940s, US doctors deliberately infected thousands of Guatemalans with venereal diseases.
Sexually transmitted diseases (STDs) were a prime concern for health officials in the 1940s, and many medical studies a€” including the US experiments in Guatemala a€” used methods that would be considered unethical today. A 12-month-old baby in California is deliberately infected with herpes as part of an experiment.
During the Second World War, the US military and Public Health Service combat STDs through an all-out campaign of research, treatment programmes and advertising.US Natl Lib. John Cutler, a physician with the US Public Health Service, works on a prison experiment in Terre Haute, Indiana, in which inmate volunteers are infected with STDs to test a prophylactic method.US Natl Lib.
Cutler starts experiments in Guatemala that eventually expose 1,308 prisoners, soldiers and patients at a psychiatric hospital to STDs. Cutler starts an experiment at Sing Sing prison in New York, in which he injects syphilis into inmate volunteers, some of whom had received an experimental vaccine.
Chester Southam of the Sloan-Kettering Institute for Cancer Research and his colleagues injected live cancer cells into patients at the Jewish Chronic Disease Hospital in New York without their consent. Yet that report and documents written by the researchers involved in the Guatemalan work paint a more complex picture. Letters between John Cutler and his supervisor show him trying to keep details of the experiments secret and also demonstrate how he justified the research. The commission says there is no evidence that Cutler sought or obtained consent from participants, although in some cases he did get permission from commanding officers, prison officials and doctors who oversaw the patients at the psychiatric hospital. Presidential Commission for the Study of Bioethical Issues Ethically impossible: STD Research in Guatemala from 1946 to 1948 (2011). ComisiA?n Presidencial para el Esclarecimiento de los Experimentos Practicados con Humanos en Guatemala, durante el periodo 1946 a 1948 Consentir el DaA±o (2011). For the best commenting experience, please login or register as a user and agree to our Community Guidelines. The current situation of human research in the US has become severely biased and in some cases, an impediment to the social advancement of mankind.
Tuskegee experiment in Alabama, in which hundreds of black men with syphilis were studied for decades without receiving treatment.-They gave them syphilis as well, along with another group in Mississippi. As cyberattacks grow ever more sophisticated, those who defend against them are embracing behavioural science and economics to understand both the perpetrators and their victims. One of the things they don’t tell you in library school is that your personal and professional readings will occasionally overlap—something I’ve found to be especially true as I’ve worked to complete a long gestating newspaper project at the Rubenstein. The Cherokee syllabary was created by Sequoyah, a silversmith and trader by profession, who felt that written language could be harnessed and used to the Cherokee’s advantage. Three years later, the Cherokee nation purchased its own press and began publishing the Cherokee Phoenix in New Echota Georgia, the capital of the Cherokee Nation.
The Cherokee Phoenix has been digitized and is available through The Georgia Historic Newspapers project.
The post Cherokee Phoenix rises to the top of cataloger’s consciousness appeared first on The Devil's Tale.
This 1900 ad for Columbia’s chainless bicycle makes the progressive argument that women are entitled to the same quality bike as a man. Columbia additionally had the marketing vision to realize that the bike and rider formed a single ensemble, where the lines of the frame “Contribute to the Graceful Appearance of the Rider…”  That came at a price, though.
With constant access to moving images via your cell phone, laptop, or tablet, I expect it is difficult to imagine when even simple movement in a book was revolutionary. The Rubenstein’s History of Medicine Collection features many early movable books, which were usually intended for scholars. It wasn’t until the late 1700s that movable books intended for entertainment were produced, usually for children. My favorite page features a lion that transforms into a griffin, that transforms into an eagle. As part of the Lisa Unger Baskin Collection, we recently received one of these metamorphoses books, handmade by Elizabeth Winspear in 1799. The post Adding to our collection of Movable Books appeared first on The Devil's Tale. On April 26, 1963, Francois Duvalier ordered his forces – the army and the Tontons Macoutes – to wreak unprecedented violence throughout the city of Port-au-Prince.   It was the perhaps the single moment in which the encompassing brutality of Duvalierist repression was realized in full. On April 26, 1986, two and a half short months after the fall of Jean-Claude Duvalier, eight civilians were gunned down by the army at a commemoration of the violence that had taken place twenty-three years before.  It was one of the first of many events that proved that Duvalierism and Macoutism would outlive the Duvalier regime. On the one-year anniversary of the 1986 massacre, the mothers and sister of the slain young men demand justice on the airwaves of Radio Haiti.  Their grief is still fresh. April 26, 1987 poster commemorating the violence of the regime: photographs of Duvalier’s victims, arranged in the shape of Fort Dimanche. The post Rare sheet music finds in the Hartman Center appeared first on The Devil's Tale. How do you describe what you do to people you meet at a party?  To fellow librarians and library staff?
Jean Dominique, Michele Montas, and other members of the Radio Haiti team had numbered among my heroes since I first started learning about Haiti and learning Haitian Creole, back in 2004. I was a researcher and writer before I started working on this project, so I have to keep myself in check; I cannot follow my instincts and desires by letting myself act as a researcher and writer when my job, for the moment, is to be processing the archive.
Syphilis is an STD (sexually transmitted disease) caused by a bacterium called Treponema pallidum, which most common symptom is a painless ulcer on the genitals. In the era before antibiotics, syphilis was a chronic, prolonged, painful and, in advanced stages, assailed all systems of the body, being very greatly feared and stigmatized. As stated in the introduction of this text, syphilis is caused by a bacterium called Treponema pallidum.
In advanced stages of disease, syphilis can be transmitted by kissing and even by touch if there are lesions on the skin or mouth (the symptoms explained below).
The transmission of syphilis by blood transfusion is very rare as Treponema pallidum does not survive more than 48 hours in stored blood.
There is also congenital syphilis that is acquired by the fetus when the mother is infected by Treponema pallidum during pregnancy. The disease is divided into three stages, called primary syphilis, secondary syphilis and tertiary syphilis. The lesion of primary syphilis is a papule (a small, raised, solid pimple or swelling on the skin) on the genitals; in a few hours it turns into a painless ulcer. In some cases ulcer can arise in the mouth or pharynx, if the transmission has been given via the oral sex.
The ulcer of syphilis is called chancre, and after 3 to 6 weeks it disappears even without treatment, leading to a false impression of a spontaneous cure.
Secondary syphilis Some weeks or months after the disappearance of the chancre, syphilis returns, now spread throughout the body. The lesions on the soles of the feet, palms and oral mucosa are characteristic, but the skin eruptions can occur anywhere on the body. Another typical lesion of secondary syphilis is called condylomalata, a wet lesion, resembling a large wart, which usually appears near where there was injury to the chancre in primary syphilis.
There are cases, however, that secondary syphilis presents few symptoms, so that the patient does not give much importance to the frame.
Just as occurs in primary syphilis, the symptoms of secondary syphilis resolve spontaneously without treatment.
Treponema pallidum In primary syphilis, the chancre appears when as yet there was time for the body to produce antibodies to Treponema pallidum, so blood tests are usually negative at this stage.
The diagnosis of secondary syphilis, tertiary, or primary, as in later phases, is done by two serological tests: VDRL and FTA-ABS (or TPHA). As the VDRL may be positive in several diseases other than syphilis, such as lupus, liver disease, mononucleosis, leprosy, smallpox, rheumatoid arthritis, etc. Penicillin allergic patients can be treated with doxycycline (100mg 2x, daily for 14 days) or azithromycin (2 g, a single dose), but they are not as effective as penicillin. In some cases, such as contaminated with syphilis in pregnant women, may be given a treatment for allergy desensitization of the patient so that it can be treated with penicillin.
These photos are the main way I realized what I had, as I thought back to the presentations on the females back after the second time we had sex that night. These sores will either occur on the vagina or penis or sometimes on the mouth of the infected individual.
It can cause permanent blindness, deafness, paralysis and impotence, if the infection is not treated at this stage. Similarly men who have sex with men and women with multiple sex partners are also under the risk of developing syphilis. Antibodies are produced to fight against bacteria remains in your body indicating the presence of infection.
In case if the person is allergic to penicillin doctors would prescribe doxycycline or tetracycline.
It can cause chills, fever, muscle-ache and headache but all these signs will disappear within a day or two. The bacteria remain dormant in the body for several years and become active some time later.
One editor objects to publishing the work, but it appears in 1942 in the Journal of Pediatrics.R.
The US team also takes blood from 1,384 orphans and other children to assess STD diagnostic tests.
Outrage over the experiment helps to spark a debate about research ethics and prompts federal authorities to develop tighter controls on research.Special Collections and Archives, Univ. As a low-ranking soldier in the Guatemalan army in 1948, Federico Ramos was preparing for weekend leave one Friday when he was ordered to report to a clinic run by US doctors.Ramos walked to the medical station, where he was given an injection in his right arm and told to return for another after his leave. In a letter to his supervisor, John Mahoney, director of the VDRL, Cutler openly admits to deceiving patients at the psychiatric hospital, whom he was injecting with syphilis and later treating.
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The intention of that study was to watch the men with late latent syphilis (five years after infection).
When I serendipitously encounter primary sources in my readings, I’m forced to ask myself (and occasionally regret asking myself): Does the Rubenstein hold this?


Voluntary removals were increasingly involuntary, forcing the Cherokee farther and farther from their homes in the southeast United States. Harris on February 21, 1828, navigates this sliver of time in the history of the Cherokee Nation, a time in which it fought to maintain its lands, protect its people, and keep its ways of life. In his initial attempts, Sequoyah tried to create a “symbol for each word in the language,” but that soon proved insufficient, and he turned his attention to the sounds of the language, paying particular attention to the syllables (Sequoyah and the Cherokee Syllabary). The type was cast by Reverend Samuel Worcester, a missionary, postmaster, and now printer (Samuel Worcester). Apart from sudden showers and the onslaught of inchworms and allergens, spring is perhaps the finest season to ride.
The copy goes on to show how the bike’s frame accommodates the latest in women’s biking fashions, and how the chainless design facilitates mounting and dismounting while eliminating the possibility of one’s skirt getting caught in a chain—or soiled by it, a concern that persists among our current-day urbanites rolling along with the right pant-leg rolled-up out of harm’s way. But just image the impact of being able to manipulate part of a page in a book in the 18th century! These were generally the “turn-up” style, often used by students of anatomy, where separate leaves, each featuring a different section of the body, were hinged together and attached to a page. Hinged at the top and bottom of each fold, the picture was cut through horizontally across the center to make two flaps that could be opened up or down.
Most digitized versions, including one held by Duke, features a red cover with a photograph of pianist Joseph A. Transmission occurs in the vast majority of cases, by sexual contact and happens by the penetration of bacteria through microscopic wounds or abrasions in the mucosa of the vagina or penis. Syphilis in pregnant women can cause miscarriage, premature birth, fetal death and malformations.
In women, this injury may go unnoticed, since it is small (on average 1 cm in diameter), painless and usually stay hidden among the pubic hair or inside the vagina.
Thus, syphilis is a disease initially painless, it often tends to go unnoticed and seems to disappear spontaneously after some time.
About 20% of patients with secondary syphilis do not consider their symptoms bothersome enough to seek medical help. Laboratory confirmation can be made after collecting material from the ulcer for direct visualization of the bacteria under a microscope. Your window period is shorter, and may be positive already after a few days after the appearance of the chancre.
The values of the VDRL after curing fall progressively, becoming negative after some years.
The criterion of cure of syphilis is the disappearance of symptoms and a fall of 4 degrees in antibody levels. The FTA-ABS does not mean to control treatment, because, as already explained, it is not negative after cure. I was getting ready to mount her the third time but from behind rather than on top and saw the conda latum on her butt and the lesions on her back.
It begins as a small painless sore on the sex organs and spreads to the partner through skin contact. Syphilis infection is one of the major health concerns causing serious health problems in many countries.
On an average the bacteria will take minimum three weeks of showing the symptoms after it enters the body.
The signs of rash and warts will be there for few weeks and disappear on its own without taking treatment. This stage happens when the infected individual ignores all the symptoms above and simply restrains himself from taking treatment. It can cause neurological problems like paralysis, stroke, meningitis, loss of vision and dementia.
Make sure that you are making follow-up visits to your doctor for testing your blood regularly. Without giving proper treatment, it can cause severe damage to vital organs like brain or heart and can even cause death.
But they viewed the studies as ethically defensible because they believed that the results would have widespread benefits and help Guatemala to improve its public-health system. Unbiased information regarding the negative impacts on sexual function and psychological health are unlikely to be given.
In the case of The Cherokee Phoenix, a newspaper written by the Cherokee Nation, the answer turns out to be a resounding yes, and one that I’m glad I pursued. In the first issue, the editor, Elias Boudinot, juxtaposes the opening salvos of the recently written (1827!) Constitution of the Cherokee Nation with a letter written by Thomas L.
Eventually, he was able to isolate 85 syllables and devise associated symbols that could be combined to create a written component of the Cherokee language. Cherokee phoenix, advent of a newspaper: The print shop of the Cherokee Nation 1828-1834, with a chronology. Trees are filling out, flowers are a’bloom and the birds are a’tweet: in short the whole planet has its hormones on fine display.
Actually, this basic frame design is still with us, in unisex “Dutch” and townie bike styles like the Breezers that Zagster provides for rent. On the other hand, grace is priceless, and the freedom and autonomy provided by the bicycle was likely well worth the investment. One of the best examples, De humani corporis fabrica librorum epitome was printed by Andreas Vesalius in 1543. When raised, the pages disclosed another hidden picture underneath, each having a few lines of verse. The book features just four pages in full color with accompanying verse, each page with two flaps that reveal a new drawing underneath, in stages. The verses include instructions for how to move the flaps. Baden Collection of Print Advertisements, a collection of about 50 linear feet of print ads that cover primarily the first three quarters of the twentieth century.
The composer, Johann Schmid, was quite prolific composer of popular music, with nearly 300 known compositions ranging from minstrel tunes to rags and schottisches, but very little is known of him as a person. It is estimated that the risk of contagion in each unprotected sexual intercourse with an infected partner is approximately 30%. However, there are cases where this interval may be as short as three days or as long as three months.
No other symptoms associated with lesions of primary syphilis, the patient has a maximum increase in the groin lymph nodes (buboes). The problem is that the disappearance of the chancre does not mean healing , however, the bacterium is now multiplied and silently spreads body.
Also common are fever, malaise, loss of appetite, joint pain, hair loss, eye lesions and enlarged lymph nodes diffusely throughout the body. This test is not always necessary, since the genital ulcers of syphilis are well characterized. So if the test is done one or two days after the appearance of the lesion of syphilis, the VDRL test can give false negative.
There is every chance of receiving the infection when you involve in prolonged kissing or have intimate body contact with the individual. Many people will not give importance to these sores since they are painless and lies hidden in private parts. But the infection symptoms will continue to appear after few weeks again and it will continue for several years. About 20-30% of infected people (with syphilis) will develop these complications if not treated. You should abstain yourself from any type of sexual activity until the infection is completely cured. The best way to prevent syphilis is to be monogamous (having sex with single partner only).
The same thing happened several times during the early months of Ramos's two years of military service. Those rationalizations serve as a warning about the potential for medical abuses today, as Western clinical trials increasingly move to developing countries to take advantage of lower costs and large populations of people with untreated disease. In one case, detailed by the bioethics commission, the US doctors infected a woman named Berta, a patient at the psychiatric hospital, with syphilis, but did not treat her for three months. Nor would a full disclosure and discussion be given citing flaws in research and other studies showing no link between circumcision and reduced incidences of HIV. And in 1830, Andrew Jackson signed the Indian Removal Act into law, thereby granting the federal government power to forcibly migrate Native Americans into lands beyond Mississippi (Primary documents in American history). The first to learn how to read and write using this syllabary was Sequoyah’s daughter, A-Yo-Ka.
And now, almost 200 years later, the Cherokee Phoenix name is still in use: The Cherokee Nation publishes both online and print editions of the newspaper, with a subscription base of 40,000 readers (Cherokee Phoenix celebrates 184 years). What’s a girl not to like—especially on a bicycle built for her, equal in every way to a man’s? Not only that, but the “bevel gear” drive system was the precursor to today’s eclectic shaft-driven bicycles (still trumpeted as “innovative.” Hah!).
In fact, the bicycle has occasionally been praised as an instrument of liberation, and early feminists such as Susan B. However, it is clear that Winspear also intended some instruction or moral training to occur by reading this book, for all does not end well, despite a character’s obtaining gold and silver. It is notable and was initially attractive to the Hartman Center for its early ads for automobiles, perfume and watches, but it also includes a wide range of corporate ads as well as some travel and tourism literature. The version found in the Baden collection features a blue cover with a photograph of the African American Vaudeville duo Brandow and Wiley. Your doctor will usually start treatment based only on clinical data, waiting a week or two to confirm the laboratory diagnosis. It is better to prevent this infection by avoiding having sex with unknown persons or multiple partners.
Latent syphilis is one in which the infection causing bacteria remains dormant in your body without producing any symptoms. In rare cases, babies born to infected mothers will develop congenital syphilis showing rash on the feet and palms.
He believes that the doctors were deliberately infecting him with venereal disease.Now 87 years old, Ramos says that he has suffered for most of his life from the effects of those injections.
Bioethicists worry that laxer regulations and looser ethical standards in some countries allow researchers to conduct trials that would not be allowed at home.
Her health worsened, and within another three months Cutler reported that she seemed close to death. The IRB is composed mostly of scientists from the institution and is charged with protecting human subjects from harm due to research at that institution. The Cherokee were subsequently “rounded up and crowded into stockades” in October 1838 and made to march (Zinn, 2015, p.148).
A public notice underlining the difficulties in creating the paper and a column critical of the Federal government can also be found. Incredibly, in eleven years, Sequoyah’s efforts proved successful: he developed an entirely new means of communication for his Nation. All in all, the Columbia was a triumph of engineering in its day, especially with the available option of a coaster brake, which is also still in use in kids’ bikes and beach cruisers. Anthony were also advocates for cycling, as much for gender-political as for its health benefits.
Brandow and Wiley were quite prominent in their day, one of the few black song-and-dance acts to star in the mainly white Keith-Orpheum circuit of theaters. It also does not appear in online databases of known compositions by Schmid, although it does appear in the register of U.S.


Patients transmitting syphilis are those with the illness during primary or secondary stages, especially if there are active lesions in the sexual organs. Syphilis infection has been constantly rising in number in the USA and many other countries. If a pregnant woman has this infection penicillin is the ideal antibiotic to prevent further infection. After leaving the army, he returned to his family's remote village, on a steep mountain slope northeast of Guatemala City. He re-infected Berta with syphilis, and inserted pus from someone with gonorrhoea into her eyes, urethra and rectum. However, because of its ill-conceived structure, the IRB's primary objective is, in fact, to protect its institution from harm.
Today we recognize this as the start of the Trail of Tears, a cataclysmic event resulting in the deaths of some 4,000 Cherokees (Primary documents in American history). The Cherokee Phoenix thus proves to be a remarkable historical document, made all the more remarkable by the fact it’s written in both English and Cherokee—a language that did not have a written component until 1821 (Brannon, 2005, p. By 1825, there were Cherokee translations of hymns and the Bible, and thousands of Cherokee were literate (Sequoyah’s syllabary) (Sequoyah and the Cherokee Syllabary). Although not 100% effective, the condom is still the best method for preventing sexual transmission of syphilis.
In 1943, Joseph Moore, then chairman of the US National Research Council's Subcommittee on Venereal Diseases, estimated that the military would face 350,000 new infections of gonorrhoea annually, a€?the equivalent of putting out of action for a full year the entire strength of two full armored divisions or of ten aircraft carriersa€?. Over several days, pus developed in Berta's eyes, she started bleeding from her urethra and then she died.Yet Cutler did do some good in Guatemala. The IRB is unique in the US in having no due process, no appeal process, and no oversight of its actions. The history of African American vaudeville, minstrel shows and other performing arts in the early 20th century is still an emerging research field, so it is exciting to find a picture of this pair of performers. The Loyola University Music Club did perform minstrels in the early 1900s but it is unclear whether this was among them.
It wasn't until he was 40, nearly two decades after the injections, that Ramos saw a doctor and was diagnosed with syphilis and gonorrhoea. The government launched vigorous campaigns of research, treatment and advertising to combat the problem. He took steps to improve public health, initiating a venereal-disease treatment programme at the military hospital and developing a prophylactic plan for the army. No researcher, and certainly no administrator, has the power to override the IRB's execution of its duties. He couldn't pay for medication.a€?For a lack of resources, I was here, trying to cure myself,a€? says Ramos.
He treated orphans for malaria, lobbied his supervisors to supply the army with penicillin a€” he was turned down a€” and trained local doctors and technicians.
The surgeon general who would approve the proposal for the Guatemalan experiments, Thomas Parran, had previously run the Public Health Service's Venereal Disease Research Lab (VDRL) in New York, and had written two books on the topic.
And he provided treatment for 142 people who may have had venereal disease but had not been exposed to it as part of the research.At the prison, he reported that a€?we have found a very ready acceptance of our group, both on the part of the prison officials and the part of the inmates, which we think stems from the fact that we now have given them a program of care for venereal disease, which they have lacked in the past.
Ramos and his children blame the United States for their decades of suffering from venereal disease. Thus we feel that our treatment program is worthwhile and fully justified.a€?In the end, Cutler could claim no real success in his experiments, in part because he was never able to infect people reliably without resorting to extreme methods.
Even after researchers demonstrated in 1943 that penicillin was an effective treatment for syphilis and gonorrhoea, they had many questions about preventing and treating those diseases and others. He secured an extension to continue the experiments from June to December 1948, and he left Guatemala at the end of that year.
US government researchers and their Guatemalan colleagues experimented without consent on more than 5,000 Guatemalan soldiers, prisoners, people with psychiatric disorders, orphans and prostitutes.
Other researchers published some of the blood-test results, but Cutler did not publish his work on prophylactic methods.
The investigators exposed 1,308 adults to syphilis, gonorrhoea or chancroid, in some cases using prostitutes to infect prisoners and soldiers. Certainly, the venereal-disease division in the 1940s didn't think the problem was licked.a€?The military, in particular, wanted to develop prophylactic techniques better than the 'pro kit' that had been in use for decades. The experiments were not only unconscionable violations of ethics, the bioethics commission charges, they were also poorly conceived and executed.A distinguished careerDespite the failures, the work burnished Cutler's credentials.
After the experiments were uncovered in 2010, Ramos and others sued the US government, and US President Barack Obama issued a formal apology. After sex, servicemen were supposed to inject a solution containing silver into their penises to prevent gonorrhoea, and rub a calomel ointment over their genitals to prevent syphilis.
A few months after he arrived home, the World Health Organization sent Cutler to India to lead a team demonstrating how to diagnose and treat venereal diseases. Obama also asked a panel of bioethics advisers to investigate, and to determine whether current standards adequately protect participants in clinical research supported by the US government.When details of the Guatemalan experiments came to light, US health officials condemned them as 'repugnant' and 'abhorrent'.
The methods were painful, messy and not very effective.To test treatments and prophylaxis, the Public Health Service had argued in late 1942 that it was crucial to give the disease to people under controlled conditions. In the 1960s, he became a lead researcher in the infamous Tuskegee experiment in Alabama, in which hundreds of black men with syphilis were studied for decades without receiving treatment. Last September, the Presidential Commission for the Study of Bioethical Issues went further, concluding in its report1, that a€?the Guatemala experiments involved unconscionable violations of ethics, even as judged against the researchers' own understanding of the practices and requirements of medical ethics of the daya€? (see 'Evolving ethics').
Officials debated the legality and ethics of this, and even solicited the input of the US attorney general. He flourished in the Public Health Service and later became a professor of international health at the University of Pittsburgh in Pennsylvania. They decided to do the work at a federal prison in Terre Haute, Indiana, using volunteer inmates.Cutler was one of the doctors charged with carrying out the work. He died in 2003, well before details of the Guatemala experiments were exposed.Michael Utidjian was an epidemiologist at Pittsburgh in the late 1960s and co-authored two papers with Cutler. When the prison study began in September 1943, Cutler was 28, and had finished medical school only two years before. He describes his former colleague as devoted to venereal-disease studies and enthusiastic about international research.
The researchers tried to infect prisoners by depositing bacteria a€” sometimes gathered from prostitutes arrested by the Terre Haute police a€” directly on the end of the penis. The experiment established several practices that Cutler would go on to use in Guatemala, including working with local law-enforcement agencies and prostitutes. But the researchers could not develop a means to effectively infect people a€” a necessary step towards testing prophylactic techniques.
However, the poor implementation of the experiment led to a€?pretty worthlessa€? results, says Utidjian.The participants in Cutler's Guatemalan study fared far worse than the doctor himself. Within ten months, the experiments were abandoned.Captive populationAfter Terre Haute, researchers began to plan a more ambitious study. Shuffling among the tin-roofed homes in Las Escaleras, Ramos is bone thin and speaks in a mumble, made worse by his lack of teeth.
They wanted to try causing infections through what they called normal exposure, in which people would have sex with infected prostitutes.In 1945, a Guatemalan health official who was working for a year at the VDRL offered to host studies in his country. He says that he put off treatment until about ten years ago, when it became too painful to urinate. As director of the Guatemalan Venereal Disease Control Department, Juan Funes was uniquely positioned to help. His son rushed him to a hospital, where doctors inserted a catheter and later performed an operation.Gonzalo Ramirez Tista lives in the same village as Ramos and says that his father, Celso Ramirez Reyes, also participated in the experiments during his three years in the army.
Prostitution was legal in his country at the time, and sex workers were required to visit a clinic twice a week for examinations and treatment. Funes oversaw one of the main clinics, so he could recommend infected prostitutes for experiments. But the country was experiencing political upheaval in the mid-1940s and the bureaucracy did not object to the US plan. The study presented a chance to tap into US funding to upgrade Guatemala's inadequate public-health infrastructure, and to import scientific expertise.Cutler arrived in the country in August 1946 and began setting up experiments. But Pablo Werner, a doctor with Guatemala's Human Rights Ombudsman's office, has reviewed the cases and found that Ramos's and Reyes's stories are supported by the timing of their military service and details in the medical histories that they gave. He planned to assess diagnostic blood tests, and to determine the effectiveness of penicillin and an agent called orvus-mapharsen in preventing STDs. Reyes is also named in a database of research participants that was compiled by Guatemala's National Police Historical Archive from Cutler's papers.Never againThe US Department of Justice requested last month that the compensation case be dismissed, arguing that the courts are not the a€?proper foruma€? for it. At first, Cutler tried using infected prostitutes to spread gonorrhoea to soldiers: he and his team used various bacterial strains to inoculate sex workers, who then had intercourse with many men. The team also carried out similar experiments using sex workers at a prison.But it was hard to induce infections by the 'natural' method. The bioethics commission argues that Cutler and his superiors knew that they were violating the medical ethics of their day, because they had sought the consent of participants in Terre Haute. So researchers turned to inoculation, swabbing the urethra with an infected solution, or using a toothpick to insert the swab deep into the urethra. At the National Psychiatric Hospital of Guatemala, scientists scratched male patients' penises before artificial exposure to improve infection rates, and injected syphilis into the spinal fluid of seven female patients.According to the US bioethics commission's report, Cutler's team exposed 558 soldiers, 486 patients at the psychiatric hospital, 219 prisoners, 6 prostitutes and 39 other people to gonorrhoea, syphilis or chancroid.
One colleague told Cutler that the US surgeon general a€?is very much interested in the project and a merry twinkle came into his eye when he said, 'You know, we couldn't do such an experiment in this country'.a€?But the ethical landscape was evolving rapidly at the time. But the commission was unable to determine how many people actually developed infections or how many of the participants were treated.
The standards of the 1940s were a€?a lot murkiera€? than those of today, says Susan Lederer, a bioethicist at the University of Wisconsina€“Madison. Researchers also measured the accuracy of diagnostic tests in experiments that involved orphans and people with leprosy, as well as people from the psychiatric hospital, prison and the army.
From that trial emerged the Nuremberg Code, a set of principles that mandated that experimenters obtain voluntary consent from participants, that participants be capable of giving such consent and that experiments avoid unnecessary physical and mental harm.Although such tight standards were not entirely foreign to researchers before the Nuremberg trials, few followed them. In 1935, for example, the Supreme Court of Michigan stated that researchers could get consent from caregivers of participants, which Cutler did in a sense when he consulted commanding officers and other officials. Many of Cutler's participants were poor, uneducated people from indigenous populations, whom the scientists viewed as incapable of understanding the experiments.At the time, some of the United States's top researchers worked without obtaining consent from individuals.
Jonas Salk, who later earned fame for developing the polio vaccine, and Thomas Francis Jr, a leading influenza researcher, intentionally infected patients at a psychiatric hospital in Ypsilanti, Michigan, with influenza in 1943 (ref. There is evidence that the patients did not all consent to the experiments.Cutler and his superiors apparently thought it was acceptable in Guatemala to cross ethical lines that they would not have breached at home a€” an issue that raises concern today, with Western companies increasingly running clinical trials in foreign countries, particularly in developing nations. In 2010, the US Department of Health and Human Services investigated all requests by companies to market their drugs in the United States, and found that in 2008, nearly 80% of approved applications used data from clinical trials in other countries.Developing nations often have lower medical standards than developed countries, and can't enforce rules as effectively. In India, for example, human-rights activists and members of parliament say that foreign drug companies often test experimental drugs on poor, illiterate people without obtaining their consent or properly explaining the risks.And in 2009, the pharmaceutical giant Pfizer agreed to pay up to $75 million to settle lawsuits over the deaths of Nigerian children who had participated in tests of an experimental antibiotic. Nigerian officials and activists had claimed that the company had acted improperly by, for example, not obtaining proper authorization or consent. But Pfizer denies the allegations and did not admit any wrongdoing in the settlement.Ethicists also warn about practices viewed as acceptable today, such as testing medications on patients who are extremely ill, and who see new treatments as their only hope, no matter how dangerous they are. In any era, many if not most researchers might agree that a certain practice or rule is justified and necessary.



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