See

discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/320904565

75 years after Erich Wagner's doctoral

dissertation: “A Contribution to the Issue of
Tattooing” - scientific...

Article in Journal der Deutschen Dermatologischen Gesellschaft · November 2017

DOI: 10.1111/ddg.13360

CITATIONS READS

0 828

1 author:

Peter Elsner
Universitätsklinikum Jena
1,175 PUBLICATIONS 13,362 CITATIONS

SEE PROFILE

Some of the authors of this publication are also working on these related projects:

UV-induced occupational skin cancer: Rare variants View project

SODG Meeting, Erfurt 2017: Dermatology and the Reformation View project

All content following this page was uploaded by Peter Elsner on 08 November 2017.

The user has requested enhancement of the downloaded file.

 Correspondence Clinical Letter

Clinical Letter of individuals without a criminal record or those who had

only been convicted due to their political views.” The au-
thor – of course – merely refers to the “criminality” of the
75 years after Erich Wagner’s doctoral
tattooed individuals, without analyzing the nature and se-
dissertation: “A Contribution to the Issue of verity of the offenses (violent acts, property crimes) and the
Tattooing” – scientific misconduct in Nazi socioeconomic background. Thus, the dissertation lacks the
Germany adequate scientific depth in terms of methodology and data
interpretation.
However, the context in which the thesis was created is
greater interest than its scientific value. There are only hidden
DOI: 10.1111/ddg.13360
clues in the text, for example, on page 44: “Tattooed Jews are
Dear Editors, not frequently encountered. Three percent of Jews detained in
the camp had ‘skin pictures’, with only 20 % of all individuals
Given the large number of cases of plagiarism, the quality showing more than three tattoos”. Another reference relates to
of medical dissertations is increasingly being questioned in the author’s CV; he states to have been a member of the Waf-
Germany [1]. It has been pointed out that the supervision fen-SS since September 6, 1939. The author worked as a phy-
by university faculty members needs to be improved [2]. In sician in the Buchenwald concentration camp near Weimar,
this context, professors are not only co-responsible for the which was liberated by the U.S. Army in 1945. In his appli-
scientific content but also for the ethical and legal quality of cation for admission to the dissertation program, he reported
a dissertation. that – during the university years in Graz and Innsbruck – he
An example of this kind of indivisible overall responsi- had not had time to write a thesis as he was busy working
bility of faculty members in doctoral programs can be de- for “the illegal N.S.D.A.P. and the Austrian SS.” The dean of
monstrated by the thesis (on a dermatological subject) titled the Medical Faculty and Chairman of the Dermatology De-
“A Contribution to the Issue of Tattooing”. The dissertation partment, Prof. Josef Hämel, declared that he admitted the
was submitted by Erich Wagner in 1940 and accepted by the
Medical Faculty of the Friedrich Schiller University of Jena
in 1941 (2016 marked the 75th anniversary of its acceptance)
(Figure 1) [3].
Supervised by Prof. Dr. Friedrich Timm (Chairman of
the Department of Forensic Medicine and Scientific Crimi-
nology) and comprising 51 pages (including two graphs and
30 figures), the thesis analyzes the tattoos of 800 individuals
according to “race and nationality”, general and professio-
nal education, “criminal past”, type and number of pictures,
inscriptions, site, color, technique used, how the tattoo was
acquired, motivation for getting the tattoo, “regrets with re-
gard to disfiguration”, desire for removal, and “impression of
the interviewee”.
The dissertation includes chapters on “the history of
tattooing”, “tattooists and those tattooed”, “tattooing and
crime”, “theatrical and freak tattoos”, “topographic distri-
bution of ‘skin pictures’”, “images depicted”, “why was the
tattoo acquired?”, “some groups of tattooed individuals”,
and “the removal of tattoos”. Below each chapter, there are
tables containing the results of the descriptive analysis of a
questionnaire-based survey.
A serious and critical scientific analysis of the data pre-
sented is missing. There is, however, a tendency to associate
the presence of a tattoo with “criminality”. “The figures I
have found are quite clear and read as follows: About one-
third of all detainees with a prior criminal record is tat- Figure 1 Dissertation by Erich Wagner: A Contribution to the
tooed, whereas that figure is only one-thirtieth in the case Issue of Tattooing (1940).

1152 © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd. | JDDG | 1610-0379/2017/1511
Correspondence Clinical Letter
candidate “especially based on the commitment to the NSDAP
and the SS in Austria during the fighting years” [4].
The thesis was rated as “very good” by the reviewers
(first reviewer: Prof. Timm, second reviewer: Prof. Hämel).
In his assessment, Prof. Hämel states: “The dissertation is ba-
sed on extensive studies. The findings provide an interesting
insight into origin and race of tattooed individuals as well as
method and correlation with criminality. The present thesis
undoubtedly enriches our current knowledge […].” [4].
It is uncertain whether the reviewers knew about the
circumstances under which the thesis had come about. This
relates to both ethical and legal as well as scientific aspects.
Reports on the human rights violations associated with
the preparation of the thesis have come from detainees li-
berated from the Buchenwald concentration camp. The Bu-
chenwald prisoner Gustav Wegerer, chemical engineer from
Vienna, reported after his release: “The SS physician Dr.
Wagner worked on a dissertation on tattoos; remarkably, all
prisoners he had ordered to come to him for examination
died, and their tattoos were removed. It is safe to assume that
they were liquidated by him in the hospital building.” [5].
According to the statement by the German-Jewish political
prisoner Ludwig Scheinbrum, prisoner identification number
2765, the SS Untersturmführer Dr. Wagner, camp physician
in 1939, “often sent Jewish prisoners from Revierbaracke 2
who required too much time to heal to the main quarters
where they were hosed down.” [5].
However, the scientific authorship of the thesis is also
questionable. Based on a statement by the Buchenwald priso-
ner and medical writer Paul Grünwald in 1957 [6 ], the disser-
tation was not written by Erich Wagner himself but by Paul
Grünwald: “The questionnaire, as printed in the thesis, was
designed by me, and I conducted the survey among the 800
prisoners. I also carried out the compilation of data. The re-
ferences listed in the index were perused by me. In between,
Wagner naturally took an interest in the progress of the the-
sis, had also looked through the completed questionnaires,
and – among other things – made sure that particularly be-
autiful tattoos were photographed in the photo department.”
“Following these conversations, the thesis was also written
by me, with W. informing himself from time to time and sho-
wing interest. Shortly prior to my release, the manuscript had
been finished. I have now seen and read the printed thesis for
the first time. For sure, the dissertation – in the form of the
manuscript I left behind at the time – was redacted and, in
some parts, marginally altered after my release.” [6 ].
The legal implications of the atrocities of the “Third
Reich” were addressed by the Allies in the Nuremberg trials.
Following the “Trial of the Major War Criminals”, the next
trial – the “Trial of the Physicians” against 23 defendants –
took place from December 9, 1946 to August 20, 1947. In
its verdict, the American Military Court published the “Nu-
© 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd. | JDDG | 1610-0379/2017/1511
remberg Code”, which formed the basis of the “Declaration
of Helsinki” (subsequently issued) as a fundamental ethical
document with respect to research on humans. Consequently,
voluntary consent of trial subjects (informed consent) is a key
prerequisite for any scientific research on human beings; the
individual concerned must thus be able to provide legal con-
sent: “…that the individual must be able to make use of his or
her judgment, unaffected by violence, deception, guile, pres-
sure, pretense, or any other form of persuasion or force…”
[7]. Provisions of the Reich Ministry of the Interior to protect
the participants of medical trials had already existed in the
Weimar Republic, a fact that was also pointed out in the legal
proceedings before the American Military Court [8].
The fact that the dissertation presented herein violated
these principles seems obvious, given that ‘informed consent’
cannot be assumed under the circumstances of detention in
a concentration camp. The reviewers (university professors)
were complicit in human rights violations committed in the
context of this thesis insofar as they did not recognize the
aforementioned violation or did not want to recognize it. Er-
ich Wagner – the author of the dissertation and SS physician
– was charged with murder by the Offenburg District Court
in 1959. He escaped the verdict by committing suicide on
March 22, 1959 [9].
From the history of medical studies on humans, the
following lessons are to be learned:
1. Ethical and legal standards for studies on humans must
be rigorously adhered to, which – for a long time – was
not the case, even after the adoption of the Nuremberg
guidelines.
2. A university faculty member supervising a doctoral dis-
sertation should be so deeply involved that he/she is able
to assess the circumstances of the dissertation’s develop-
ment and to largely rule out plagiarism or third-party
authorship.
3. Scientific standards as regards methodology and analysis
have to be adhered to.
4. The above-mentioned standards are only adhered to if
they are part of everyday life and if all those involved
in clinical research are continually made aware thereof.
As laid down in the German laws for civil servants, uni-
versity professors have the obligation to not only ensure the
scientific quality of dissertations carried out under their su-
pervision but to also actively commit to the constitution, and
thus to the protection of human and fundamental rights in
medical research. This is a consequence of the conclusions
the fathers of the constitution and the legislature drew from
the human rights violations – also committed by physicians
– during the reign of national socialism in order to prevent
them from ever happening again.
1153
 Correspondence Clinical Letter

Conflict of interest 2 Arbeitsgemeinschaft Hochschulmedizin. Resolution Zukunft

None. der Medizinischen Promotion 2016. Available on https://www.
hochschulverband.de/969.html#_ [Last accessed December
30, 2016].
Peter Elsner
3 Wagner E. Ein Beitrag zur Tätowierungsfrage. Dissertation,
Friedrich-Schiller-Universität Jena, 1940.
Department of Dermatology, Jena University Hospital, Jena,
4 Bode C. Zur Geschichte der Gerichtlichen Medizin an der
Germany Universität Jena im Zeitraum von 1901 bis 1945. Dissertation,
Friedrich-Schiller-Universität Jena, 2007.
Correspondence to 5 Kautsky B. Teufel und Verdammte. Zürich: Büchergilde Guten-
berg, 1946: 308 – 9.
Prof. Dr. med. Peter Elsner 6 Hirte R , Stein H. Die Beziehungen der Universität Jena zum
Department of Dermatology Konzentrationslager Buchenwald. In: Hoßfeld U, John J, Le-
Jena University Hospital muth O, Stutz R (Hrsg.): Kämpferische Wissenschaft. Studien
zur Universität Jena im Nationalsozialismus. Köln, Weimar,
Erfurter Straße 35 Wien: Böhlau Verlag, 2003: 378 – 9, zitiert nach [4].
07743 Jena, Germany 7 Mitscherlich A , Mielke F. Medizin ohne Menschlichkeit. Doku-
mente des Nürnberger Ärzteprozesses. Fischer Verlag, Frank-
E-mail: elsner@derma-jena.de furt a. M. 1960: 272.
8 Müller F. Die Zulässigkeit ärztlicher Versuche an gesunden und
References kranken Menschen. Münchner Medizinische Wochenschrift
1 http://de.vroniplag.wikia.com [Last accessed December 30, 1931; 78: 104 –7.
2016]. 9 Herber F. Gerichtsmedizin unterm Hakenkreuz. Militzke Ver-
lag, Leipzig, 2002: 265, zitiert nach [4].

1154 © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd. | JDDG | 1610-0379/2017/1511

View publication stats