The Holmesburg Prison Experiments

Join Kelli as she goes over yet another example of US doctors experimenting on their own people.

Starting in the 1950s, dermatology Dr. Albert Kligman came to the Holmesburg Prison in Philadelphia and experimented on its prisoners. What started as a simple cure for an athlete's foot outbreak turned into a decades-long series of experiments, ranging from testing lotions and cremes to hallucinogenic drugs to the toxic compounds found in Agent Orange.

Though the experiments eventually stopped in 1974, it was more or less swept under the rug, despite prisoner/victims filing lawsuits. But thanks to the work of men like Allen Hornblum, and the victims and their families who never gave up, the horrors at what happened at Holmesburg are coming to light.

Source referenced:
Acres of Skin: Human Experiments at Holmesburg Prison by Allen Hornblum

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Transcript

The Holmesburg Prison Experiments
Intro
Welcome to A Popular History of Unpopular Things, a mostly scripted podcast that makes history more fun and accessible. My kind of history is the unpopular stuff - disease, death, and destruction. I like learning about all things bloody, gross, mysterious, and weird. 

Between 1951 and 1974, Doctor Albert Kligman conducted experiments on prisoners at the Holmesburg Prison in Philadelphia. Kligman, a dermatologist who worked at and for the Hospital at UPenn, recklessly exposed prisoners to all kinds of things - from untested skin care, to psychoactive drugs, to the toxic agent that makes up Agent Orange. Though his victims were paid for their participation, what happened at Holmesburg is another textbook case of unethical experimentation on humans in postwar America, something we’ve covered on this channel before. 

But what stands out in this case is that unlike other high-profile cases, what happened at Holmesburg was more or less buried. But in the past quarter century or so, thanks to the tireless work of journalists, historians, and survivors, we’re learning more about the experiments Kligman performed on inmates at the Holmesburg Prison.

In his book Acres of Skin: Human Experiments at Holmesburg Prison, journalist, historian and author Allen Hornblum asks: 
Why did human experiments on vulnerable, institutionalized populations go on so long in the United States?

It’s a valid questions at the heart of this story and others like it, like the Tuskegee Syphilis Study or the Minnesota Starvation Experiment - both stories I’ve already covered in other episodes. So today, let’s dive into the history of the Holmesburg Prison Experiments to once again answer the basic question of why the US experimented on its own people, particularly its vulnerable minority populations. Like I said with Tuskegee, short answers like “racism” or “because of evil men” aren’t satisfying or nuanced enough for me. I want to know more.

So let’s get started!
Historical Context
As we normally do, let’s start with a brief historical context. What was going on in the US, and perhaps the world, that encouraged scientific experiments on humans? We can clearly see a pattern of this happening in postwar America. So… why?

Well first, we need to consider perhaps the most notorious example of human experimentation - what the Nazis did to their prisoners during WWII. At the Nuremberg Trials, which took place between 1945 and 1946, the Allies put some of Germany’s higher-ranking Nazi officials on trial for all sorts of things, including of course their horrific human experimentation. We know that Nazi doctors did all kinds of evil things to prisoners at concentration and death camps. Perhaps the most infamous was Dr. Josef Mengele, known as the Angel of Death. He’s the one who experimented on twins, if you remember any of that from history class. And there is a lot of oral history from some of the survivors.

Anyway, at the Nuremberg trial, Nazi doctors argued that there were no laws in place for experimenting on humans, and that other nations did the same thing - including the US. Was this true? Absolutely. Did perhaps the Nazis take human experimentation a bit further than other nations? Yes. BUT - the trials did expose the fact that there wasn’t a law on the books, so to speak, about experimenting on your fellow man. So part of the ensuing Nuremberg Code of 1947 addressed that with the concept of informed consent; the subject’s consent must be voluntary - not forced, not coerced… voluntary.

By this point, American doctors had already been experimenting on its own - of many examples, the one I think of first is Tuskeegee, which began in the 1930s. Black men with syphilis were studied by our government, but they weren’t told they had syphilis. Just that they had “bad blood.” They were also kept away from antibiotics or other potential cures so that doctors could study the effects of untreated syphilis on them. Part of the reason was to help prove a horribly racist theory about the way syphilis targeted black men vs. white men, trying to argue that the races were in fact different by the way syphilis killed them. Go watch my episode on Tuskegee for more on that one.

But the bigger point here is that the US, like Nazi doctors, were conducting experiments on humans before the Nuremberg Trials. Sure, it wasn’t at the scale of the Holocaust, and the main point wasn’t extermination, but it was happening. 

So did we change things after the Nuremberg Laws established informed consent?

No. No we did not.

As Hornblum writes in Acres of Skin, quote,
…the opposite occurred. Rather than embracing the Nuremberg Code, the American medical establishment considered it a “good code for barbarians, but an unnecessary code for ordinary physician-scientists” like themselves.

We harangued and executed Nazi doctors for experiments that forced human to drink seawater, to be placed in icewater, to be castrated, to be infected with spotted fever and other pathogens, and to undergo painful limb transplant experiments, 

but at the same time we found it justifiable to inject hospital patients with plutonium without their consent, to observe hundreds of poor, black sharecroppers as they withered away from syphilis while withholding effective treatment *that was the Tuskegee experiments I just mentioned*, … [and to give mentally handicapped] orphans breakfast cereal in milk laced with radioactive calcium at the Walter E. Fernald State School in Massachusetts.

End quote.

And so, American scientists continued human experiments after WWII, despite the horrors unveiled during the Holocaust that showed the world what happens when you treat human beings as things, as subjects, not as people. And what we notice is that scientists targeted vulnerable populations - the Tuskegee experiments focused on impoverished Black men in Macon County, Alabama, and with the Holmesburg Prison Experiments, it was prisoners. Why? Well, with informed consent, scientists needed their test subjects to agree. And at Holmesburg, a lot of prisoners were offered money in exchange for their participation in experiments. Money for use in the commissary or even bail. One of the men who was experimented on, William Robb, mentions that the money felt like, quote, “a king’s ransom for an inmate trying to raise bail money.” End quote. 

So this, to me, just makes the whole situation really morally grey - you’ve got scientists doing all kinds of tests on men for the promise of money. They weren’t told explicitly of the dangers, just offered cash for a pinch here and there, maybe a weird cream or two slathered on the back. But at what price? And can prisoners even consent? Does their status change the scope of consent, as they can be pressured into things with incentives like parole, extra perks, money for commissary, the potential to make bail?

So let’s focus in on Holmesburg, then. What kinds of experiments were happening at Holmesburg, and why?
Holmesburg Prison
Holmesburg was opened in 1896, and over the almost 100 years it operated, it earned a reputation for violence and bloodshed. In some of the earlier years, living conditions were rough, injuries were often left unattended, and prisoners were sometimes beaten by those in charge. 

Here’s one story for you to demonstrate what things were like in the early days at Holmesburg: in 1938, some inmates went on a hunger strike to protest conditions, particularly the poor food quality. So, in retaliation, guards put the men - about two dozen of them - into an isolation chamber known as the Klondike. No ice cream bars there, I’m afraid; the name was ironic. The Klondike had a bunch of brick cells with radiators generating a ton of heat. It was August, and it was sweltering, but the windows were shut tight with the radiators running at full blast. Four of the men were essentially cooked to death.

It made the news. Pennsylvania’s governor at the time called it a torture chamber, and the guards who used it, quote, “the cruelest sadists who ever lived.” Debateable, of course, but the man was clearly impacted by what he saw. 

10 prison officials, including the superintendent and deputy warden, were indicted on various charges. And according to Allen Hornblum, who is really the expert in all of this, a warden and a guard were found guilty of involuntary manslaughter and sentenced 1-3 years in prison. The survivors got nothing, and the whole thing was soon forgotten anyway after because of WWII.

There are more stories, but I think that gives you a good picture of what this prison was like.

Let’s fast forward a bit.

Dr. Albert Kligman started doing medical research at Holmesburg starting in the early 1950s. There was an outbreak of athlete’s foot - which can happen pretty easily in large, unsanitary places like a prison - and dermatologist Kligman was called in to help.

Kligman himself was… well I’ll say that he was a product of his education. The dermatology department at UPenn - in the 40s and 50s, anyway - had no moral problems with using the incarcerated as test subjects. They didn’t see this as a violation of the Nuremberg Laws; they saw the incarcerated as a vast untapped market of test subjects that were easy to coerce into medical testing. 

Hornblum notes in his book that the dermatology department would make all kinds of troubling comments during lectures. Apparently Kligman once said in a lecture that he would rub ringworm into the scalps of mentally disabled children. Kligman would follow up with the claim that they wanted the attention so badly, if you hit them over the head with a hammer, they would love you for it.

So he’s… a problematic man. To say the least. But this was apparently a systemic issue at the UPenn dermatology department.

So Kligman was brought over to help with the athlete’s foot fungal outbreak at Holmesburg, and he leveraged that into a research project with an almost $14,000 grant to examine, quote, “Pathologic Reactions of the Fingernails Including Fungus Infections.” Those affected weren’t just cured, they were used as test subjects. And I’m sorry to have to say that it wasn’t just prison inmates; mentally disabled children across the border in NJ were part of it as well. Apparently, Kligman favored those who didn’t have agency for his experiments.

So here’s what Kligman said of Holmesburg in 1966 during an interview. Quote:
All I saw before me were acres of skin. It was like a farmer seeing a fertile field for the first time.

End quote.

In fact, he liked the aspect of control over his subjects; he said so himself! Quote:
We know where they are, what they’re doing, what they’re eating; and if they’re given pills six times a day, we know they are taken.

And I think all of that information, including his own words, gives you a good idea of what kind of man Kligman was.

The Victims
As part of the incredible research that men like Allen Hornblum conducted, we have the oral histories of the men who were part of the trials. Historians love this kind of stuff - instead of having to guess at motivations or make assumptions, we can just hear it straight from the source!

One man who joined the experiments was Al Zabala, a Jersey native who found himself in Holmesburg Prison for burglary in 1963. He couldn’t get a prison job, as competition was high. And the pay wasn’t great, anyway - workers would get 15 cents a day making shoes or knitting socks. So, he agreed to experiments. Zabala notes that, quote,
I soon heard about the [University of Pennsylvania] studies and the good pay they offered. They had all kinds of tests - foot powder tests, eye drop tests, face creams, underarm deodorant, toothpaste, liquid diets, and more. It was easy money. You could make $10 to $300 a test depending on how long it lasted.

At first, he started with the deodorants, as that seemed innocuous enough. But the money was enticing. He heard about a special study for the Army, and they were going to pay anywhere between $1000-1500 dollars! And remember - prisoners with normal prison jobs were only making 15 cents a day. So there’s no wonder these men signed on for the experiments. So again - it’s consent, but can prisoners even give informed consent when there’s this much coercion? That’s a fun question for the philosophers out there. Let me know what you think in the comments.

The Army gig in question was some kind of chemical testing that induced a trip. Zabala, after taking the drug, essentially lost a week of his life. Beyond some details from tripping out, which took him back to fond memories of the past, he didn’t remember anything from the week he was under surveillance. Here’s what Zabala said of the whole thing. Quote:
I wasn’t right for a month after the test. I was real subdued and quiet. I had problems swallowing food and a constantly dry throat. They put me on a liquid diet until I could swallow whole food again.

[A few] guys came back to population and didn’t remember their names. Guys would fade in and out of consciousness… Some guys beat themselves up and punched themselves in the head. Some of the guys told me they had ugly, violent trips - dogs as big as horses, worms like alligators - horrible trips, being eaten by giant spiders, living in the 13th century. One guy said he was hung and killed.

End quote

And though he left jail $1500 richer, Al Zabala suffered weird side effects from the experiment for years.

Another inmate, William Robb, describes a common experiment known as the Patch test:
The first patch test was one [that] tested lotions, creams, skin moisturizers, and suntan products. The procedure for these tests [was a grid] fixed to the upper portion of an inmate’s back shoulders. The grid consists of about 20 squares. In each one of these squares a dab of lotion was applied and the inmate’s back was exposed to different temperatures from a sunlamp…

After about five days of the sunlamp, there [were] sections of the… skin that were burnt a deep brown and the skin started to peel, itch, and blister. If a certain square became too damaged it was covered over with a permanent piece of tape and the tests continued.

One man who endured the patch test notes that he “looked like a checkerboard with patches and skin discoloration on my arms, back, and chest.”

Another test was the gauze test, where inmates would have pieces of gauze shoved into 1-inch incisions on the lower back - no anesthetic used, by the way - and then it was stitched up with the gauze inside. After ten days, they’d open the incisions back up and remove the gauze.

Needless to say, these men’s bodies were scarred from the experiments. 

And there were more. Inmates were exposed to herpes, staphylococcus, chemicals that blistered the skin, radioactive isotopes, and psychoactive drugs. Some men were injected with asbestos. Others were infected with various types of influenza virus, poison ivy, and poison oak. Some had acid poured on their skin, some even on their testicles, which caused painful blistering. Hornblum even notes that bits of the dead organs of corpses were stitched onto the backs of some inmates to see if they could regrow while attached to living tissue. Can you imagine? Having bits of DEAD BODY sewn onto you. 

The money for all this, if you were wondering, came from companies like Johnson & Johnson and Dow Chemicals, and sometimes even government institutions like the Army! 

Hornblum estimates that likely 80% of the prisoners were experimented on - perhaps closer to 90%.

But among all these horrible things, the one I want to focus on in more detail is dioxin.
Dioxins, Agent Orange, and Cancer
Before we understand why testing dioxin on the inmates was so bad, let’s do a bit of scientific context so we know what dioxin is.

Dioxin, simply put, is a toxic chemical compound. It’s created as a byproduct; you might produce dioxins by burning household or industrial waste, bleaching pulp to make paper, in manufacturing other chemicals, from car exhausts, or even from forest fires.

Dioxins, as the name might suggest, are incredibly toxic. They can cause harm to your reproductive system, they can cause developmental problems in babies and small children, they damage the immune system, they interfere with hormones, and like with most things nowadays, they can cause various cancers.

They are horrible environmental pollutants, can travel long distances through the air or water, and when they settle in the soil, they stay around for a really long time and continue to pollute various ecosystems.

Historically, dioxins were present in Agent Orange, the herbicide used in the Vietnam War between 1961 and 1971 to destroy agricultural lands in Vietnam, Cambodia, Laos, and Thailand. Specifically, TCDD - ok here we go… tetrachlorop-dibenzodioxin - the most toxic of the dioxins. Though it’s planned use was to destroy plant life, it was detrimental to human life as well; millions in Southeast Asia were exposed to Agent Orange’s toxins and it caused long-term health problems, a whole bunch of cancers, and birth defects. Not to mention an estimated 400,00 deaths attributed to its use.

So in short… dioxins are the worst. And they were directly applied to test subjects at Holmesburg prison. And that weird chemical that sent Al Zabala on a week long trip? He believes it was dioxin. Specifically, TCDD. The most dangerous type. What one Harvard professor called “the most powerful carcinogen known to man.” 

Ok, so naturally I want to know - why was this harmful chemical being tested on inmates at Holmesburg?

Most dioxins were being produced by Dow Chemicals. But there were tests linking these dioxins to cancers - and this is all before the worst of Agent Orange’s impact came to light. So the EPA, the environmental protection agency, banned Dow Chemicals from making them. Fair enough, makes sense to a rational human being.

To try and prove the EPA wrong, Dow Chemicals contacted Kligman and used his band of “volunteer” inmates to show that dioxins were not harmful to humans. So for around three years, Kligman tested dioxin on the inmates. But when Dow Chemicals found out that he was exposing the men to over 7,500 micrograms of dioxin, more than 468 times the recommended dose, Dow Chemicals ended the experiment because they didn’t want to be associated with it anymore. Which is pretty telling.

Dow asserted it had no ill effects, because the prisoners were seemingly fine. The EPA disagreed.

But why was Dow so insistent on this obviously cancer-causing chemical being safe? Well… it’s so cliche, but it’s because it made them a lot of money… think back to Agent Orange and its military use - Dow was one of the companies who produced it. Alongside Monsanto, for those of you curious. 

So we’ve got a company using prison inmates to test a cancerous substance to try and prove it isn’t cancerous, even though it is. And in the end, it was the inmates who suffered.

And I’m going to throw it out there - the majority of test subjects for the dioxin testing were non-white populations. Mostly black. But unfortunately, that line of questioning never went anywhere. And written records of the tests were destroyed, because of course they were.

Some of the men sued - they sued Dr. Kligman, UPenn, the state of Pennsylvania, and the Dow Chemical Company - most lawsuits were settled out of court. And in the end, the whole story just kind of… died. Part of it was intentionally buried, but it also didn’t help that Kligman ended up developing Retin-A during his time testing on inmates at Holmesburg. 

Retin-A is primarily used to treat acne, but is also used for wrinkles, and is still very much used everywhere. So because some good came out of Kligman’s experiments at Holmesburg, the rest was sort of… swept under the rug.

Medical testing at Holmesburg ended in 1974, decided by the Philadelphia prison system’s Board of Trustees. The argument was that the medical tests were demeaning and dehumanizing, and rightly so. I can imagine that the end of the Tuskegee experiments 2 years earlier, and the absolute storm that that created, had something to do with Philly’s decision to stop testing on its inmates.

It was ended immediately with no phasing out - just completely stopped. This of course royally ticked off the men running the program, as it was a huge money maker, and in their eyes, a way to advance science. 27 years after the Nuremberg Code tried to stop or limit experimentation on humans, it was finally over for the men of Holmesburg Prison.

But only recently, thanks to the work of men like Allen Hornblum, do we even know about what went down at Holmesburg. Hornblum notes that, quote,
Because I witnessed it and saw it in the flesh—literally—it always impacted me as something that was unethical, immoral, and never should have been broached. What I found out and documented in Acres of Skin is that even though there were other states that allowed this to happen, and many prisons that did experiments, there was nothing like what occurred in the Philadelphia prison system.

University of Pennsylvania should have never gotten involved with this and should have never allowed their dermatology department and one of their most important dermatologists, to do this.  But they all did it—especially Penn—because they were making so much money from it and it benefited them greatly. In fact, it still is. They’re still making money from Retin-A, and Johnson & Johnson is still making money.

End quote.

It was only in 2021 that UPenn released a statement apologizing for their role in what happened. In 2022, the city of Philadelphia did the same - almost 50 years after the experiments ended.
Outro
Thanks for joining me for this episode of A Popular History of Unpopular Things. My name is Kelli Beard, and I hope you’ve enjoyed the story of the Holmesburg Prison Experiments. Thank you for supporting my podcast, and if you haven’t already checked out my other episodes, go have a listen!

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Be sure to follow my podcast, available wherever you listen, so you know when new episodes are dropped. And stay tuned to get a popular history of unpopular things.