Pacholegg, Polygal and Puzzling friendships.
Recently my attention was drawn to an overall excellent article regarding Anton Pacholegg, a rather incredible witness from Dachau, and his testimony regarding human skin leather production at Dachau, which can be read here. Overall the biographical detail and the subsequent career of Anton Pacholegg makes Dr Joachim Neander’s article fascinating, although I would disagree with some points of interpretation.
Anton Pacholegg was also heavily involved with one of Dr Sigismund Rascher’s more infamous projects, the development of an anti-coagulant for the pre-surgical treatment of wounded soldiers, Polygal. The concept being that given this drug would greatly reduce bleeding and thereby improve survival prospects. Without doubt a worthwhile concept, a typical summary of this aspect of Rascher’s career might be as follows:
Another of Rascher’s major research efforts focused on the introduction of a pectin-based preparation, Polygal, to promte blood clotting. He predicted that the prophylactic use of Polygal tablets would reduce bleeding from wounds sustained in combat or during surgical procedures. The agent was also recommended for the control of spontaneous gastrointestinal and pulmonary hemorrhages. Combat woulds were simulated by the amputation of the viable extremities of camp prisoners without anesthesia or by shooting the prisoners through the neck and chest.
Rascher also claimed that oral premedication with Polygal minimized bleeding during major surgical procedures, rendering hemostatic clips or ligatures unnecessary and shortening operating times. He published an enthusiastic article about his clinical experiece with Polygal, withou specifying the nature of some of the trial in humans. The paper concluded. “The tests of this medicine “Polygal 10″ showed no failures under the most varied circumstances.” Rascher also formed a company to manufacture Polygal and used prisoners to work in the factory.Taken from the New England Journal of Medine article by Robert L. Berger: Nazi Science: The Dachau Hypothermia Experiments.
During World War II, the processses of coagulation were not as well known as they are today, that coagulation is a highly controlled cascade of factors (usually proteolytic factors) with the end result of the cross-linking of fibrin and the formation of a clot. In general, the main medical interventions in this case is with anti-coagulants because inappropriate formation of blood clots is a common cause of strokes and myocardial infarction. Typical drugs include warfarin, a low weight organic molecule originally isolated from a mould causing bleeding problems in cattle. Warfarin because of its small size, can be absorded through the gut easily and inhibits the synthesis of Factors II, VII, IX and X. Heparin, also an anticoagulant, is a more complex molecule, namely a glucosaminoglycan, a derivative of a basic sugar molecule. Because of its greater size and chemistry it can not be absorbed in the gut and has to delivered via injection. Heparin is in fact an endogenous substance, so its medical use is simply mimicing a mechanism the body uses. Pro-coagulants are not so common in medical practice, although people like hemophiliacs have a need for them. Generally a hemophiliac will be supplied, if required, with the actual coagulation factor they are lacking, such as Factor VIII or Factor IX.
Pectin, the basis of Polygal, is a complex polysaccharide, its main use is as the gelling agent of jam. Because it consists of long strings of polysaccharides, orally consumed pectin will not be absorded by the gut or only once it has been hydrolysed into individual sugars. It would be treated much like dietary fibre and simply pass through the bowels. It possibly might protect against constipation but have no effect at all in regards to coagulation. Pectin is often used as a topical application in hydrocolloid dressings where its gel like consistency can aid in wound healing, but it is not thought to do so by any direct interaction with the coagulation cascade, rather merely promoting the absorption of exudates into its gel like structure. It as if someone seeing benefits from applying a bandage to a wound, decided that the same benefits could be obtained by swallowing the bandage.
A pectin based orally ingested anti-coagulant would be without any benefits whatsoever, firstly because it would not even be absorded into the blood stream and even if it was injected in some form, it would have no action of the process of coagulation based on modern understanding of the process
The Public Experiments
Rascher published a paper on his researches into Polygal at Dachau in early 1944 in the Muencher Medizinische Wochenschrift. The main text of this paper can be read in English here. Some extracts:
A good hemostat has to have the following qualifications :
1.It must be harmless.
2.It must be administered easily (orally).
3.It must not have an unpleasant taste.
4.It must have a deep and long-lasting effect on bleeding and clotting time.
5.After the effect wears off it must be possible to administer another dose without any danger. […..]
1.It could be given prophylactically to the combat troops before an attack and to air crews before action. Too great a loss of blood could be avoided that way when tending to wounds is delayed; simi- larly it would prevent the wounded from becoming incapacitated by delaying the loss of blood.
2.Before operations in which greater areal bleeding is to be expected, it could be used to keep the operational region clear of interfering bleeding. [….]
We believe we have such a remedy in “Polygal 10,” a preparation composed and tested in our institute, which does fulfill the above requirements. “Polygal 10” is a drug composed on a “pectin” base; its new method, differentiating it from other hemostats on a pectin base is to be found in the activation of pectin before composing it into the hemostat.
The basis of the experimental procedure, which while pointless was essentially harmless, is described as follows:
Before we tried the clinical use of the drug and had it probed, it was tested on human beings by thorough experiments as to its influence on the period of clotting and bleeding. The period of clot-ting was occasionally established in short intervals by 10 parallel definitions of free flowing venous blood according to the method of Buercker. The period of bleeding was measured by a stop watch after a wound at the ear had been inflicted by a “Frankeschen Schnepper.” On the enclosed graphic chart the curves of two experimental subjects are displayed (experimental subjects Nos. 200 and 207). The depth of decline and the duration of effect correspond to the average. It is to be mentioned with reference to the curves that various persons were always used for the experiments in order to avoid a possible accumulation of effect by the drug.
This short paper included 2 graphs, allegedly demonstrating the beneficial effects of Polygal
The same experiment was supposedly repeated on another subject to show the lack of an effect of meal time and hard labor on Polygal’s performance
The three curves tell the same story. On the y axis is time in minutes from 4 to 0, which records the Blutungszeit (Bleeding time) and Blutgerringungszeit (coagulation time – presumably in a test tube). The x axis represents time after oral ingestion of Polygal from 0 to 7 hours. The three curves show that both bleeding and coagulation takes between 3 to 4 minutes at zero time point and, within around 15 minutes after oral ingestion, coagulation and bleeding time rapidly drops to 1 minute and stays around that level for the entire 7 hour time-course. The effect is independent of recent food intake or heavy labor.
Not to mince words but these results are impossible when your pharmaceutical orally ingestive active ingredient is nothing more or less than the gelling agent of jam. While one should neveer underestimate the capacity of scientists to engage in self-deception, it is hard to see how such results could be produced without dishonesty.
The paper then went on to give 5 or 6 short clinical case studies of results of achieved in actual general practice (always highly favorable)
It turns out Dr Rascher had a history of publishing entirely unreproducible results beginning from his time as a doctoral student under Ehrenfried Pfeiffer and Lili Kolisko – as detailed by Siegfried Baer (open pen name of Labor Journal editor, Hubert Rehm) in Der Untergang des Hauses Rascher:
To solve the dilemma and to determine the claimed “ethereal” and “cosmic” forces, in the 1920’s two anthroposophists, the above-mentioned Ehrenfried Pfeiffer and Lili Kolisko developed a test. A CuCl2 solution is mixed with plant extract and dried on a glass plate. From the form of the resulting crystals an anthroposophically schooled person should be able to distinguish between biodynamically raised plants and conventionally raised plants. In particular, the test was claimed to show that biodynamically raised plants possess “vital power” (whatever this means). And it did! [….]
The CuCl2 test by Pfeiffer and Kolisko is also used in anthroposophical medicine. According to Pfeiffer, with its help and a drop of blood one can distinguish the healthy from the sick, cancer from tuberculosis and pregnant women from non-pregnant. Seeking recognition from science, Pfeiffer convinced one of his assistants and a student of medicine, Sigmund Rascher, to prove the CuCl2 diagnosis at the University of Munich. Indeed Rascher made the test the topic of his doctoral thesis and a following post-doc, paid for by the German Research Foundation (DFG). In three articles in the Münchner Medizinische Wochenschrift Rascher published astonishing confirmatory results. But the acting DFG referee grew suspicious and asked for an independent examination. Such an examination never took place as by this time Rascher had won Himmler’s favouritism and Himmler, leader of the SS, Chief of Police and Minister of the Interior, suppressed the examination.
The Lethal Experiments
The coagulation tests described above involved no serious breach of medical ethics. At the Medical Trial in Nuremberg, a number of sadistic experiments were also alleged to have taken place.
The first piece of evidence involved an affidavit of an uncle of Sigismund Rascher which among other things (including saying his nephew was guilty of child abduction) alleged that he, the Uncle, had visited Dr Rascher at Dachau and sneaked a look at some autopsies on his desk:
5. In August 1943 I was with my nephew twice in the Dachau concentration camp. The first time I went only to his private quarters and did not see the laboratory. The second time he showed me his laboratory and introduced me to his colleagues. I still re- member the following names : Dr. Punzengruber and Dr. Feix. I in-spected the chemical exploitation of blood coagulation. At that time he also told me of freezing experiments. He said that he had carried these out on himself at first and then he introduced to me one of his colleagues who had volunteered three times for these experiments. If I remember rightly, Himmler is supposed to have been present at one of these experiments and to have pardoned the man who was condemned to death. During the absence of my nephew, I acciden-tally found the following document in his desk:
It refers to a report about the shooting (execution) of four people for the purpose of experimenting with the hemostatic preparation “Polygal10”. As far as I remember they were a Russian Commissar and a cretin, I do not remember who the other two were. The Russian was shot in the right shoulder from above by an SS man who stood on a chair. The bullet emerged near the spleen. It was described how the Russian twitched convulsively, then sat down on a chair and died after about 20 minutes. In the dissection protocol the rupture of the pulmonary vessels and the aorta was described. It was further described that the ruptures were tamponed by hard blood clots. That could have been the only explanation for the comparatively long span of life after the shot. After reading this first protocol I was so shocked that I did not read the others. At the time I took a sample of the hemostatic preparation from the desk which I submit herewith to the files.
6. On the way to Munich after this visit to Dachau, which was my last, I called my nephew to account. He raved when he learned that Iknew of this matter. After appealing to his conscience, from the scientific as well as from the humane point of view, he broke down and cried: “I dare not think, I dare not think.” In Munich my nephew and I continued this conversation during the whole night. Dr. Sigmund Rascher admitted at the time that he was on the wrong path but that he didn’t see any possibility of resigning from it.
The rest of the evidence of lethal experiments comes from Nuremburg Document NO-438, which consists of photostats of a folder entitled “Herstellung von Polygal”, the contents of this folder are only three documents, reproduced below (one can’t help thinking there must have been a far more extensive record at one time). The first is a confirmation that the SS did indead have a project on Polygal running.
The second is record of two standard operations (although I believe testimony was offered to assert that these operations had no medical justification)
Concentration Camp Dachau
The Camp Physician
Dachau 16 December 1943
To : SS Hauptsturmfuehrer Dr. Rascher
“Polygal 10” was used for 2 herniotomies. The patients were men of 35 and 42 years of ag:, respectively. In both cases the tablets were administered to the patlents 40 mfnutes before the operation, Blood pressure before the operation was 135/80 in the case of the 35-year-old patient and 145/80 in the case of the 42-year-old patient. Both patients tolerated “polygal10” without complaint, nor were there any unpleasant accompanying symptoms in the stomach.
It is to be said of the operation itself that the loss of blood was conspicuously slight in both cases. As in the case of all preceding operations where “polygal 10” had been administered, it was only necessary in this case, to cut off the bleeding from the vessels. In the first case, that of the 35-year-old patient, stronger bleeding from the subcutaneous tissues occurred after the skin had been cut, which, however, was stopped by mere wiping, so that in this case the applica- tion of clips to the, subcutaneous tissues was unnecessary. Only after cutting the cremaster was it necessary to apply some ligatures, because then some smaller vessels were pierced. During the further course . of the operation, i. e., the separation of the hernial sac from the funic- ulus spermaticus (it was an indirect inguinal hernia), several spots bled in the beginning, but bleeding came to a standstill at once and the use of ligatures was superfluous.
The same observations were made in the second case, the case of the 42-year-old patient. Hemostasis by application of ligatures was
necessary in only a few spots, and this was always i11 those places where vessels had been injured during the operation. The favorable effect of “polygal 10” in surgical operations consists not only in its causing slight bleeding and preventing great loss of blood, but also in that it makes possible considerably faster operations, because the applications of clips and later ligatures always takes up a certain time, which can be saved by the use of “polygal10.”
[Signed] DR. KAHR SS Obersturmfuehrer
The final document describes the miraculous effects of Polygal on the total amputation of a leg.
Concentration Camp Dachau The Camp Physician Dachau, 10 December 1943
Subject: Administering “polygal” after amputation of the thigh of a 40-year-old male patient.
To : Stabsarzt Dr. Rascher Dachau
On 10 December 1943 the effectiveness of “polygal” in the case of the amputation of the thigh was tested. The drug was administered per os 45 minutes before the operation and was placed in the patient’s niouth to be dissolved. A blood transfusion of 500 cc. had been made the previous day in preparation for the operation. Blood pressure on the day of the operation was 180/80.
As regards the effectiveness of “polygal” one can say that it was absolutely evident how little the tissues bled. After the first rush of blood from the vessels which had been cut, when completely emptied
of blood no more bleeding occurred after this first flow of accumulated blood, so that it was not necessary to apply any ligatures to the surface of the muscles and the fatty tissues, or the subcutaneous tissues, as had always been the case with other amputations. The effectiveness of “polygal” must in this case be described as complete.
By order : [Signed] DR. KAHR
The First Camp Physician, Concentration Camp Dachau
When you cut off the thigh of someone who has swallowed some pectin 45 minutes previously and then do not put any bandages on the stump, it will behave like any other person who has a limb cut off – presumably bleeding to death unless some effort is made to staunch the flow. Not only is it an insane experiment, the described outcomes are also insane. The original document is below:
It is one thing to say these observations are impossible, however, given we know that all the positive reports of Polygal are false and fabrications and. in the case of the paper appearing in Muenchner Medizinischer Wochenscrift in 1944, fabrications carried out by Dr Rascher – can we be sure these incidents did not take place in some form? These two reports are typed memorandum from Dr Karl Kahr to Dr Rascher. They have no letterheads, stamps or distinguishing marks and are designated “Abschrift”, that is typed copies of originals that have never been found. They could have been typed in 1943 alternatively they could just as easily have been typed in 1946.
Given the typed signature on these documents is Dr Karl Kahr, it is worth finding a little bit about him. He appeared at Nuremberg where he gave an affidavit NO-1948 and gave testimony in court in the RuSHA case. He stated he had served as a doctor on the Russian front, he was wounded before Leningrad and after a period in hospital he was sent to Dachau until January 1944 when he was transferred to Dora and later Nordhausen. His testimony at Nuremberg can be described as favorable to the prosecution and sympathy for the inmates – to the extent that defence attorneys had to extract from him that the bread ration at Dora of 330 grams a day had been standard across Germany since 1942 and was not extraordinary low compared with civilian rates.
Bruno Arich-Gerz in his book Mittelbau-Dora: American and German representations of a Nazi concentration camp (pages 93-4)
Kahr was one of the major witnesses of the “Dora”-trial that took place in Dachau in 1947, and was later summoned again as a witness to the Essen trial against three Gestapo and SS men. The U.S biographers may have come across his name in the documents and files of the case against the “Dora” perpetrators. Their descriptionof Kahr’s personality puts him in a very favorable light, as various instances in the twelfth chapter of The Search for Johnny Nicholas demonstrate. The characterization of the SS doctor is moreover backed up by statements of other prisoner-survivors. According to (a) Josef Ackermann, Kahr, “wrote repeatedly to the administration requesting that better clothing be issued to the prisoners”. Julius Bouda from Czechoslovakia calls Kahr “the best of all the SS people, a man with feeling and a human heart.” Andre Sellier, in his monograph, characterizes Kahr as “a distinguished distant man who […] was competent and supported improvements in his ward.” Jean Michel, too, draws a sketch of Kahr’s character: “Though his deep-seated sense of superiority makes him antipathetic, he never strikes the deportees.”
It is no sin to get mostly highly positive reviews from inmates, but such a picture of humanitarian concern and extensive cooperation with trials of other SS officers after the war is difficult to square with his role in Polygal experiments as detailed by the two memos above. It is almost certain that these two documents were presented to Dr Kahr and he would have verified their authencity (that, at least, was standard practice), yet Dr Kahr remained a protected prosecution witness and never faced any legal consequences for the horrific acts these two memos describe. Given the biological impossibility of what these memos contain, Dr Kahr’s own apparent anti-Nazi leanings and his subsequent legal immunity, the most obvious conclusion is these alleged extraordinarly sadistic experiments did not take place. So this is not a false reporting of the outcomes of a real event, just a false report.
The escape of Anton Pacholegg
In a letter to Wolfram Sievers in September 1943 Rascher had already suggested Bregenz as the likely location for a Polygal factory. NO-611 [“As already discussed in Munich, the manufacturing of this medicine “Polygal 10″ would be quite possible in an establishment near Bregenz….In order to make it a prosperous enterprise, it would of course be necessary that the patentee, Herr Feix, personally see to the manufacturing possibilities in Bregenz etc. Condito sine qua non to this would be the release of Feix”]. The strong recommendation that Feix should be released as a parallel with another collaborator Walter Neff, who also arrived at Dachau as a political prisoner and was also released at Rascher’s request. The wide privileges granted Anton Pacholegg showed be viewed in this context.
On August 9, 1946, Major Jones, member of the British Prosecution Counsel, examined the witness Sievers and touched on the matter of Pacholegg’s escape:
“MAJOR JONES: I want you now to go back to your diary . . . You will see an entry for 14 April , ‘Political department about escape of Pacholegg.’ This prisoner Pacholegg escaped, didn’t he?
SIEVERS: Yes, at any rate he had disappeared.
MAJOR JONES: Why did you go to the political department about it?
SIEVERS: Because I had been in Vorarlberg together with Rascher and Pacholegg, and I was accused of aiding Pacholegg to escape. All the circumstances of the arrest at the time when the Rascher affair was suddenly uncovered were at issue.
MAJOR JONES: You must have been extremely anxious when Pacholegg escaped; he knew a lot of the facts about your work, didn’t he? You must have been anxious to secure his recapture.
SIEVERS: I was mainly anxious about myself, for it is not hard to imagine what would have happened to me, since Pacholegg knew much—if it had been proved that I had favored his escape, as was being maintained
Dr Neander quotes from Sievers diary on April 6: “1:30 p.m. Detective Superintendent Kieck, Dachau, reports (by telephone) that prisoner Pacholegg is missing.” However, Sievers diary was a work diary, an official record of his work for Ahenerble; his testimony at Nuremberg raises the suggestion that the escape took place at Vorarlberg (and Pacholegg apparently was recaptured at Feldkirch near Lake Constance) and that Sievers was suspected of participation. As such he is hardly likely to confide his early knowledge or involvement in this document. In fact already of the 31 March (see below) he records “the further involvement of Pacholegg (in Polygal) is to be dispensed with”, suggesting that Pacholegg is as already missing.
Sievers at Nuremberg suggests that Pacholegg and Rascher had been with him at Vorarlberg (the portion of Austria bordering Switzerland), and although his testimony can take multiple interpretations, one construction would be that this is where Pacholegg escaped. Sievers was at Bolzen in the 28 of March (which is really South Tirol) discussing Polygal business.
But the more likely reference for this visit to Vorarlberg is the 23 March. Here he records “Comprehensive conference with Dr Rascher, Police Sergeant Neff, Bromm and Feix” from 11.00 to 13.00 at Bregenz, where the site of the new Polygal factory at Schlachters is decided upon. Presumably Pacholegg was at that meeting also and either escape then or more likely was left to help set up the factory and escaped over the next few days. Dr Neander shows that he was recaptured and returned to Dachau on the 3 May 1944. The fact that his diary does not explicitly say Pacholegg was there, while mentioning Neff, Feix etc, and given that Sievers states at Nuremberg that Pacholegg was present, it raises the possibility that Sievers was already beginning to withhold things from his diary or perhaps rewrote his diary when Pacholegg became a dangerous issue. Either way not too much store should be set on the first formal recognition of Pacholegg’s disappearance on April 6, by March 31 at the latest he is no longer available.
This brings us to the fall of Dr Sigismund Rascher, usually it is claimed that this is because he and his wife had been abducting babies to adopt. On the night of March 28 Police visited his home and took him in for questioning. However at Nuremberg Wolfram Sievers, who was in a position to know, did not mention child abduction at all but seemed to imply that Pacholegg was closely tied up with Rascher’s problems. Child abduction was after all a criminal offence and a matter for the criminal courts, yet Rascher ended up under protective arrest in Dachau, a fate reserved for political prisoners. He was supposedly murdered on the eve of liberation. We can be fairly sure that Pacholegg went missing sometime between 23 and 31 March, and this alone may have been enough to bring the police to his door.
Persistant rumours crop up that Dr Rascher was also brought down because of false research (although these rumours never seem based on firm evidence), usually in relation to the Luftwaffe. His Polygal research was certainly fraudulent and potentially highly dangerous for the wounded soldiers who would be the recipient of this wonder drug (although quite probably surgeons would not have altered their surgical decision making because of the availablity of this pseudo-anticoagulant). Wolfram Sievers claimed to be part of a resistance organisation, although it did not save him from being hung, so did Anton Pacholegg and neither Feix, who was half Jewish, or Neff seemed particularly pro-Nazi. It is tempting to speculate that Polygal could even have been developed with sabotage in mind, but this impossible to be certain as Dr Rascher had shown himself quite capable of signing off on bogus work before the war.
At Nuremberg no shadow of suspicion was cast on the efficacy of Polygal, this was in everybody’s interests. It was in the interest of the surviving defendents who could point to the legitimate published work with the positive medical benefits of this new drug and say they had no knowledge or involvement in Rascher’s lethal experiments. It was in the interest of the Prosecution to pretend to the efficacy of Polygal, else their lovingly described horror-experiments would be called into question. But it is not in the interest of the historical record. Finally it should be noted that while Polygal was most definitely a real project with a lot of real people working on it, the amount of documentation that seems to have survived is very small and of that small number, much can not be trusted. Given the official publication regarding Polygal, while a scientific abnomination, is ethically of little concern, the suspicion must fall on Allied War Crimes investigators for the destruction of the bulk of the documentation.