And the evil lived on.

“First do no harm” is a term often associated with the Hippocratic Oath. Although the association is technically incorrect, the Hippocratic Oath is nonetheless an oath that Doctors adhere to.

The Hippocratic Oath is an oath of ethics historically taken by physicians. It is one of the most widely known of Greek medical texts. In its original form, it requires a new physician to swear, by a number of healing gods, to uphold specific ethical standards. The oath is the earliest expression of medical ethics in the Western world, establishing several principles of medical ethics which remain of paramount significance today. These include the principles of medical confidentiality and non-maleficence. As the seminal articulation of certain principles that continue to guide and inform medical practice, the ancient text is of more than historic and symbolic value. Swearing a modified form of the oath remains a rite of passage for medical graduates in many countries, and is a requirement enshrined in legal statutes of various jurisdictions, such that violations of the oath may carry criminal or other liability beyond the oath’s symbolic nature. The oath is attributed to the Greek doctor Hippocrates and.

The actual reference to no harm in the oath is really much stronger then ‘first do no harm’ It says the following

“I will use those dietary regimens which will benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Similarly I will not give to a woman a pessary to cause abortion. But I will keep pure and holy both my life and my art. I will not use the knife, not even, verily, on sufferers from stone, but I will give place to such as are craftsmen therein.

Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free. And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets.”

Although during the Nazi regime the physicians did not sign up to the oath, on a human level it makes only sense that you try to make a patient better rather then harm them. But several Nazi physicians, although they were ‘human beings’ they only acted inhumanely.

A few months ago I asked the question “Is it acceptable to use data from Nazi experiments?” I think that is a difficult question to answer. Initially I would say no, but what if some of that data was used to save the live of someone in my family. Or what if it was used to find a cure for Rheumatoid Arthritis , something I suffer from? Then the answer would probably be yes.

One thing that I don’t understand that the names of some of these evil men were still used as eponyms to describe some syndromes or disorders, long after the war and some are still being used, despite the fact that they were renamed. Below are just some examples where evil was allowed to live on.

Asperger syndrome- Replacement Term: Autism spectrum disorder.

Hans Asperger “managed to accommodate himself to the Nazi regime and was rewarded for his affirmations of loyalty with career opportunities. He joined several organizations affiliated with the NSDAP (although not the Nazi party itself), publicly legitimized race hygiene policies including forced sterilizations and, on several occasions, actively cooperated with the child ‘euthanasia’ program.

Beck–Ibrahim disease-Replacement Term: Congenital cutaneous candidiasis

Yusuf Ibrahim (May 27, 1877 in Cairo, Egypt – February 3, 1953 in Jena, Germany), also known as Yusuf Bey Murad Ibrahim, was a physician and pediatrician. He was responsible for the description of congenital cutaneous candidiasis, originally known as Beck-Ibrahim disease. The discovery of his association with the Nazi euthanasia program during the World War II resulted in an effort to rename this disease. The clinic for child and adolescent medicine at Friedrich Schiller University in Jena also chose to change its name from Kinderklinik Jussuf Ibrahim after his Nazi past was uncovered.

Cauchois–Eppinger–Frugoni syndrome-Replacement Term: Portal vein thrombosis

Hans Eppinger was born in Prague, the son of the physician Hans Eppinger. His grandmother was Jewish.Eppinger conducted cruel experiments on Romani prisoners in the Dachau concentration camp in order to test the potability of seawater. … Eppinger committed suicide with poison on 25 September 1946, one month before he was scheduled to testify in Nuremberg.

Clara cell-Replacement Term: Club Cell

Max Clara owed his career advancement in no small way to his membership in the Nazi party and active support of its programme. In his 1937 paper, Clara acknowledges that the sample he based his work on “was obtained from a prisoner executed by the Nazi ‘justice system

Hallervorden–Spatz disease-Replacement Term: Pantothenate kinase-associated neurodegeneration.

Julius Hallervorden readily admitted that 697 brains he investigated during the Nazi period were from victims of euthanasia. It is alleged that he was present at the killing of more than 60 children and adolescents in the Brandenburg Psychiatric Institution on 28 October 1940. He was reported to have removed brain material himself from euthanasia victims in a nearby extermination (euthanasia) center.

Hugo Spatz was a German neuropathologist. In 1937, he was appointed director of the Kaiser Wilhelm Institute for Brain Research. He was a member of the Nazi Party, and admitted to knowingly performing much of his controversial research on the brains of executed prisoners. Along with Julius Hallervorden.

Reiter’s syndrome-Replacement Term: Reactive Arthritis

Hans Conrad Julius Reiter was a member of the SS. He participated in medical experiments performed by the Nazis. After the Nazis were defeated, he was arrested by the Red Army in Soviet Union-occupied Germany and tried at Nuremberg. During his detention, he admitted to knowledge of involuntary sterilization, euthanasia, and the murder of mental hospital patients in his function as the gatherer of statistics and acting as “quality control” officer, and to helping design and implement an explicitly criminal undertaking at Buchenwald concentration camp, in which internees were inoculated with an experimental typhus vaccine, resulting in over 200 deaths. He gained an early release from his internment, possibly because he assisted the Allies with his knowledge of germ warfare.

After his release, Reiter went back to work in the field of medicine and research in rheumatology. He died at age 88, in 1969, at his country estate in Kassel-Wilhelmshöhe.

Seitelberger disease-Replacement Term: Infantile neuroaxonal dystrophy

“Franz Seitelberger, a Vienna neurologist and former member of the SS, although never involved in the planning or execution of NS-euthanasia, benefited from it scientifically during the post-war period. Examining the brains of 3 ‘euthanasia’ victims from the Landesanstalt Görden in Brandenburg, Seitelberger earned his PhD in 1954 under the supervision of Julius Hallervorden.

Spatz–Stiefler reaction-Replacement Term: Paralysis agitans reaction

Under Spatz’s control and direction, the brain research institute collaborated with the killing institute at Brandenburg-Gorden, obtaining hundreds of brains from the mentally ill of all ages.

Van Bogaert–Scherer–Epstein syndrome-Replacement Term: Cerebrotendineous xanthomatosis

“During the war, Scherer]worked at the Neurology Institute in Breslau, Silesia. Here Scherer was directly involved in neuropathological brain analyses of over 300 Polish and German children euthanized in the nearby Loben Psychiatric Clinic for Youth.

Wegener’s granulomatosis-Replacement Term: Granulomatosis with polyangiitis

The facts which were uncovered do not prove Dr Friedrich Wegener guilty of war crimes. However, the evidence suggests that Dr Wegener was, at least at some point of his career, a follower of the Nazi regime. Dr Wegener’s mentor, Martin Staemmler, was an ardent supporter of the racial hygiene. In addition, our data indicate that Dr Wegener was wanted by Polish authorities and that his files were forwarded to the United Nations War Crimes Commission. Finally, Dr Wegener worked in close proximity to the genocide machinery in Lodz.

Although many of the terms were replaced, some of the original terms are still commonly used. The most common is probably the Aspergers syndrome.

I know there is quite a lot of data in this blog. I do believe it is important to understand that by using these eponyms, we are still keeping the evil alive.

sources

https://www.ima.org.il/MedicineIMAJ/viewarticle.aspx?aid=1082

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1962844/

https://erj.ersjournals.com/content/36/4/706.full

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Eduard Krebsbach- Just doing a Job

TRIAL

Primum non nocere is the Latin phrase for “First do no harm” It is part of the Hippocratic Oath including the promise “to abstain from doing harm” .

The Hippocratic Oath is an oath historically taken by physicians. It is one of the most widely known of Greek medical texts. In its original form, it requires a new physician to swear, by a number of healing gods, to uphold specific ethical standards. The Oath is the earliest expression of medical ethics in the Western world, establishing several principles of medical ethics which remain of paramount significance today. These include the principles of medical confidentiality and non-maleficence. Although the ancient text is only of historic and symbolic value, swearing a modified form of the Oath remains a rite of passage for medical graduates in many countries.

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Eduard Krebsbach (b. 8 August 1894, d. 28 May 1947) received his doctorate in medicine from the University of Bonn. He worked for many years as a pediatrician, before applying for membership in the SS in 1937. The following year he was inducted into the SS as Untersturmführer (SS Captain). Between the fall of 1941 and the fall of 1943 Krebsbach served as SS Sturmbannführer (Major) and Standortarzt (Chief Physician) of the SS and the Police at the Linz, Steyr, Wels and Gusen satellite camps of the main Konzentrationslager (concentration camp) commonly referred to as KL Mauthausen-Gusen.

Mauthausen

In this period Krebsbach initiated the practice of mass execution of prisoners that he judged unworthy to live or unable to work. This was performed by lethal injections (Spritzen) of phenol directly into the heart, thus he killed or supervised the murder of at least 900 prisoners, for which he earned the nickname among inmates “Dr. Spritzbach”. Lethal heart injections continued to be administered at the Gusen camp twice a week even until April 1945.

Following the end of World War II he was arrested and given the death penalty during the Dachau trials conducted by the US military on 13 May 1946 and was executed by hanging on 28 May 1947 at Landsberg Prison in Landsberg am Lech.

The following is from the court record of the Dachau trials (quoted in Hans Maršálek, “Die Geschichte des Konzentrationslagers Mauthausen”, p. 174):

“Krebsbach: When I started work I was ordered by the head of Office III D to kill or have killed all those who were unable to work, and the incurably sick.

Prosecutor: And how did you carry out this order?

Krebsbach: Incurably sick inmates who were absolutely incapable of work were generally gassed. Some were also killed by gasoline injection.

Prosecutor: To your knowledge, how many persons were killed in this way in your presence?

Krebsbach: (no answer)

Prosecutor: You were ordered to kill those unfit to live?

Krebsbach: Yes. I was ordered to have persons killed if I was of the opinion that they were a burden on the state.

Prosecutor: Did it never occur to you that these were human beings, people who had the misfortune to be inmates or who had been neglected?

Krebsbach: No. People are like animals. Animals that are born deformed or incapable of living are put down at birth. This should be done for humanitarian reasons with people as well. This would prevent a lot of misery and unhappiness.

Prosecutor: That is your opinion. The world does not agree with you. Did it never occur to you that killing a human being is a terrible crime?

Krebsbach: No. Every state is entitled to protect itself against asocial persons including those unfit to live.

Prosecutor: In other words, it never occurred to you that what you were doing was a crime?

Krebsbach: No. I carried out my work to the best of my knowledge and belief because I had to.”

KZ Mauthausen, Ewald Krebsbach

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Primum non Nocere-First do no harm.

HippocraticOath

First do no harm is  a misquoted line from the Hippocratic oath, but it has been adopted as part of it.The actual translation is “I will utterly reject harm and mischief” however the message is the same.

A great number of Physicians of the Nazi regime did not adhere to the oath. They took the opportunity to do a lot of harm in order to conduct their own experiments.

But some Nazi Doctors did stick to the oath with the aim to heal rather then to harm, and even defy the Nazi regime’s regulations.

US Army Pvt. Bob Levine arrived in England a few days before the Allied forces were to land on Normandy.

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He actively took part in the D-Day invasion and his 81-mm mortar crew was right behind the 90th Infantry when the actual invasion took place. The Allied forces met with fierce German opposition, and the intense fighting lasted weeks. In one such encounter, Levine was hit by a grenade that landed very close to him; his right leg was severely damaged in the explosion. He was captured by German forces, along with many other US soldiers. On his way to the POW camp, they were hit by a mortar shell fired by the US Army, which landed very close to POW killing scores of soldiers. Although Bob survived the explosion, his leg took more blows and he became even weaker and lost more blood.

Next thing Levine remembers was a Nazi doctor’s face, inspecting his wounds and reading his dog tag.

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Levine said that when this doctor read his dog tag and uttered the words ‘Was ist H?’ he knew then that he would definitely be executed. At that time, every American soldier had a religious designation marked on the dog tag, C for Catholic, P for Protestant and H for Hebrew. He was badly wounded, and was at the mercy of a Nazi doctor, in Nazi-controlled territory, and on top of all that, he was Jewish, Levine called this a recipe for disaster.

The Nazi doctor who treated Levine was Dr Edgar Woll.

saved9v-2-web

When Levine woke up after some time of unconsciousness, he found out that his leg had been amputated, and that the Nazi doctor was gone. His dog tag was missing and there was a note tucked into his pocket. The doctor had written a note on back of a Nazi propaganda card bearing quotes of the Fuehrer. Levine could not understand it, as it was written in German.

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The soldier couldn’t understand a word, but he clung to the card for months, hanging onto it while still a POW, after he was rescued by Allied troops and on the ship taking him back to the United States

Once translated, Levine found the note explained exactly why the doctor opted for amputation and detailed his post-surgical treatment:

“Crushed right foot. Fracture of lower leg. Foreign body in upper right leg’s tissue. Opening of the ankle joint. Amputation at place of fracture. Bandage with sulfa. Vaccinated against gas gangrene.”

After this, Levine was transferred to a POW camp, where he stayed until US soldiers liberated them and he was sent home.

The Nazi doctor had definitely saved his life, by performing an amputation, and most importantly removing his dog tag with its mention of ‘H’. The missing dog tags likely spared Levine from Berga, a notorious camp for Jewish POWs where 350 American soldiers were worked to the bone — or the grave.

berga

Levine went back to Normandy in 1981, where he wanted to meet the Nazi doctor but found out that he had died in 1954. A local historian tracked down Dr Woll’s family, who were happy to see Levine and his wife. They had an evening of drinks and toasts together. Levine mentioned to Edgar’s family how grateful he was for what he had done for Levine, to which one of Edgar’s family member said that if it hadn’t been for Levine, they would still be saying ‘Heil Hitler

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Karl Gebhardt Medical Experiments

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Karl Gebhardt was Gruppenführer in the SS and Generalleutnant (Lieutenant General) in the Waffen SS; personal physician to Reichsfuehrer-SS Himmler; Chief Surgeon of the Staff of the Reich Physician SS and Police (Oberster Kliniker, Reichsarzt SS und Polizei); and President of the German Red Cross.

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He served as Medical Superintendent of the Hohenlychen Sanatorium. As a physician he would have sworn to the Hippocratic Oath ‘First do no harm’

sanatorium_area_hohenlychen_by_skanatiker

He was a Consulting Surgeon of the Waffen-SS, Chief Surgeon in the Staff of the Reich Physician SS and Police, and personal physician to Heinrich Himmler.

Karl Gebhardt

Gebhardt was the main coordinator of a series of surgical experiments performed on inmates of the concentration camps at Ravensbrück and Auschwitz.

During the war, Gebhardt conducted medical and surgical experiments on prisoners in the concentration camps at Ravensbrück (which was close to Hohenlychen Sanatorium) and Auschwitz. At Ravensbruck he had initially faced opposition from camp commandant Fritz Suhren, who feared future legal problems given the status of most camp inmates as political prisoners, but the SS leadership backed Gebhardt and Suhren was forced to cooperate.

05-2 Suhren

In order to absolve Gebhardt for his failure to prescribe sulfonamide for Heydrich, Himmler suggested to Gebhardt that he should conduct experiments proving that sulfonamide was useless in the treatment of gangrene and sepsis. In order to vindicate his decision to not administer sulfa drugs in treating Heydrich’s wounds, he carried out a series of experiments on Ravensbrück concentration camp prisoners, breaking their legs and infecting them with various organisms in order to prove the worthlessness of the drugs in treating gas gangrene.

43-031He also attempted to transplant the limbs from camp victims to German soldiers wounded on the Russian front. The Ravensbrück experiments were slanted in Gebhardt’s favor; women in the sulfonamide-treated experimental group received little or no nursing care, while those in the untreated control group received better care. Not surprisingly, those in the control group were more likely to survive the experiments.

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During the Subsequent Nuremberg Trials, Gebhardt stood trial in the Doctors’ Trial (9 December 1946–20 August 1947), along with 22 other doctors.

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He was found guilty of war crimes and crimes against humanity and sentenced to death on 20 August 1947. He was hanged on 2 June 1948, in Landsberg Prison in Bavaria.

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Fritz Klein’s interpretation of the Hippocratic oath.

Nuremberg Trial Suspect Fritz Klein, Belsen Camp Doctor

Fritz Klein (24 November 1888 – 13 December 1945) was a German Nazi physician hanged for his role in atrocities at Bergen-Belsen concentration camp during the Holocaust.

Klein was born in Feketehalom, Austria-Hungary (now Codlea in central Romania).Klein was considered a Volksdeutscher, or ethnic German. He studied medicine at the University of Budapest and completed his military service in Romania, finishing his studies in Budapest after World War I. He lived as a doctor in Siebenbürgen(Transylvania). In 1939 as a Romanian citizen he was drafted into the Romanian army, where after the outbreak of the war with the Soviet Union in 1941 he served as paramedic on the eastern front. In May 1943 Romanian dictator Marshal Antonescu, on a demand from Hitler to release ethnic Germans in the Romanian Army, drafted them into the German army.

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Hence Klein became a soldier in the Waffen-SS, was listed in the SS-Personalhauptamt, and was posted to Yugoslavia.

On 15 December 1943, he arrived in Auschwitz concentration camp, where at first he served as a camp doctor in the women’s camp in Birkenau. Subsequently, he worked as a camp doctor in the Gypsy camp. He also participated in numerous selections (“Selektionen”) on the ramp. In December 1944 he was transferred to Neuengamme concentration camp, from where he was sent to Bergen-Belsen concentration camp in January 1945.

BELSEN EXTERMINATION CAMP

He remained at the camp with commandant Josef Kramer and assisted in handing it over to British troops. Klein was imprisoned and required to help bury all unburied corpses in mass graves.

Dr. Fritz Klein

The British Fifth Army Film & Photographic Unit photographed Klein standing in a mass grave in a well-known 1945 photo.

When asked how he reconciled his actions with his ethical obligations as a physician, Klein famously stated:

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“My Hippocratic oath tells me to cut a gangrenous appendix out of the human body. The Jews are the gangrenous appendix of mankind. That’s why I cut them out.”

Klein and 44 other camp staff were tried in the Belsen Trial by a British military court at Lüneburg. The trial lasted several weeks from September to November 1945. During the trial Anita Lasker testified that he took part in selections for the gas chamber. He was sentenced to death and hanged at Hamelin jail by Albert Pierrepoint on 13 December 1945

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