PHILADELPHIA -- It was 1951 when the father of Retin-A first came to Holmesburg Prison.
The 1,200 inmates of Philadelphia's gloomiest jail were plagued by an outbreak of athlete's foot, and the prison pharamacist had asked Dr. Albert M. Kligman, a University of Pennsylvania dermatologist, to take a look.
Imagine the researcher's thrill as he stepped into the aging prison, hundreds of men milling around.
"All I saw before me were acres of skin," Kligman told a newspaper reporter in 1966. "It was like a farmer seeing a field for the first time."
He had stumbled on a bonanza.
Twenty years later, Allen M. Hornblum entered the Philadelphia Detention Center to teach an adult literacy course.
Fresh out of a master's program at Villanova University, Hornblum, then 23, was getting his first view of a tough and alien society in a noisy, claustrophobic, foul-smelling city jail.
One sight struck him as particularly strange: Scores of men, bare-chested in the heat, their backs, shoulders and arms striped with gauze pads and adhesive tape.
"The sight of that, quite frankly, never left my mind," said Hornblum, now 50 and at the end of a long "crusade" - his word - to piece together the full story of what those bandages implied. The result is his first book, "Acres of Skin: Human Experiments at Holmesburg Prison; A True Story of Abuse and Exploitation in the Name of Medical Science" (Routledge).
The bandaged inmates were not, as Hornblum first thought, victims of some awful riot. As guards and inmates told him, the prisoners were taking part in "perfume experiments" conducted by doctors from the University of Pennsylvania. They were renting their bodies for cash.
And nobody seemed to think it unusual.
20 years of experiments
The experiments in Philadelphia's prisons had been going on for 20 years, under Kligman's tutelage: tests involving toothpaste, deodorant, shampoo, skin creams, detergents, liquid diets, eye drops, foot powders and hair dye, "seemingly benign," Hornblum writes, "but accompanied by constant biopsies and frequently painful procedures."
And there were other tests, Hornblum would later learn, involving mind-altering drugs, radioactive isotopes and dioxin.
Kligman, who is 82 and living in Philadelphia, became a wealthy man and a famous name in dermatology, the inventor of Retin-A, the acne cream and wrinkle-remover widely hailed as youth in a tube.
"The early human trials," Hornblum writes of Retin-A, "were performed on the backs and faces of the Holmesburg inmates."
Kligman has denied doing anything wrong. "My use of paid prisoners as research subjects in the 1950s and 1960s was in keeping with this nation's standard protocol for conducting scientific investigations at that time," he said in a recent )R two-sentence statement, one of the few he has made on the subject.
"To the best of my knowledge," Kligman added, "the result of those experiments advanced our knowledge of the pathogenesis skin disease, and no long-term harm was done to any person who voluntarily participated in the research program."
The experiments ended in 1974 as a wave of national publicity and congressional hearings put an end to most human experimentation involving populations such as prisoners and mental patients.
But Hornblum - who spent 10 years as a literacy instructor in the detention center, served on the prison system's board of trustees and sat on the board of the Philadelphia Prison Society - remained haunted by what he'd seen at Holmesburg, the Detention Center and the House of Correction.
"It was chilling," he said in a recent interview, "to be in a totalitarian atmosphere, which a prison is, and to see minorities - the prison was about 85 percent black and there were very few high school graduates - to see all these people involved in some medical experiment about which they had a minimal amount of information.
"It just rubbed me raw."
The idea that an injustice had gone unaddressed nagged at Hornblum ever after. Four years ago, the sometime college teacher and political adviser quit his job as chief of staff to Philadelphia Sheriff John Green. Without a book contract or a salary to fall back on, he plunged headlong into a welter of interviews, libraries and obscure documents, hoping to illuminate era that had received very little light over the years.
Hornblum is not the first critic to raise questions about the Philadelphia prison experiments. In 1979 the Philadelphia Inquirer disclosed that Holmesburg inmates had been used as guinea pigs to test whether mind-altering drugs were useful as Army weapons. In 1981 the paper reported that inmates had been dosed with dioxin to test the herbicide's effects on human
health.
But Hornblum's account is the most extensive and detailed to date. He writes that inmates were told very little about the tests performed on them - in violation, Hornblum argues, of the Nuremberg Code adopted after World War II in reaction to Nazi medical atrocities. The code's first statement: "The voluntary consent of the human subject is absolutely essential."
Eager for pay
Prisoners, Hornblum writes, were more than eager to gamble their health for pay. At Holmesburg, the going rate was $10 to $300, depending on the experiment - a fortune compared with the jail's normal wages of 15 cents or 25 cents a day.
Hornblum describes Kligman as a brilliant and entrepreneurial scientist, a pioneer in his field, a man of brimming self-confidence who told students that rules don't apply to genius.
To Kligman, a prison population was ideal for research. "An anthropoid colony," he called it, "mainly healthy, under perfect control conditions."
"I began to go to the prison regularly, although I had no authorization," Kligman said in a 1986 history of Penn's dermatology department. "It was years before the authorities knew that I was conducting various studies on prisoner volunteers. Things were simpler then. Informed consent was unheard of. No one asked me what I was doing. It was a wonderful time."
Before long, "Holmesburg Prison became one of America's largest, nontherapeutic, human research factories," Hornblum writes.
A common test was what inmates called a "patch test." Strips of hospital tape were stuck to an inmate's upper back, forming a grid with about 20 squares. On each square went a dab of lotion (skin cream, moisturizer, suntan lotion - a variety of products). Then came heat from a sunlamp. Doctors checked the skin for peeling, burning and blistering at different temperatures.
Withers Pond, a 79-year-old lifer, told Hornblum he once volunteered for a "gauze test." Without anesthetic, he lay on a table while two doctors cut two 1-inch incisions on each side of his lower back, inserted gauze pads into the wounds and then stitched him up, he said. Ten days later, doctors reopened one wound, removed the gauze pad and restitched him. They removed the other gauze pad 10 days later.
Pond never learned the purpose of the exercise, but he got $20. "Now I got these scars all over my back," he said.
"Both inmates and guards say you can recognize a Holmesburg prisoner decades later," Hornblum writes, "by the distinctive scars from skin burns and patch tests."
One guard told him: "Guys looked like zebras when the patches came off."
A former inmate named Johnnie Williams told Hornblum that the mind-altering drugs he took as a Holmesburg research subject changed his personality; he went from small-time hood to violent criminal.
Hit by a car recently, Williams refused to go to a hospital. "I'm paranoid about doctors," he told Hornblum. "I'm scared of 'em."
For all that, there are few documented cases of long-term injury to the estimated thousands of inmates who took part in the experiments. The main reason, according to Hornblum: Kligman destroyed the records when the program was killed in 1974.
Pub Date: 7/21/98