Catholic Medical Quarterly Volume 75(2) May 2025
The German Concentration Camp
Republished from the October 1939 edition of the Catholic Medical Guardian
The German Concentration Camp
Preamble by the Dr GR Edwards, (Editor of Catholic Medical Guardian)
The author of this article is a well-known German medical man who underwent the experiences of which he writes. He uses a nom de plume as he has relatives in Germany. We are much indebted to Mrs. E. 0. Lorimer, author of 'What Hitler Wants', for her expert assistance in translation.
The editor himself, as a prisoner of war in 1917, saw British prisoners of war upon whom reprisals had been practised whose physical condition was exactly similar to that of the 'black' prisoners and for the same reasons-malnutrition, heavy work, and abominable living conditions.
The mental states described in the article had a close parallel in those observed personally by the editor in ordinary prisoner-of-war camps-making allowance, of course, for the better treatment of the prisoner of war.
The German Concentration Camp
by Dr I . M. Truth, M.D. (in collaboration with the Editor)
In attempting to form a picture of the physical and psychological conditions obtaining in German Concentration Camps, it must be remembered that these institutions appear to be an indispensable part of the Nazi State machine. How important a part the camps play in the life of the German people may roughly be estimated from the fact that even before the Czechoslovak Republic was added to the Reich approximately 100,000 men and women were incarcerated in them.
Anonymous denunciation, however baseless, is enough to secure admission to a camp; hence the prisoners include men from every social stratum and of every shade of opinion. None of them has been accorded trial, but some of them know the reasons for their 'protective arrest' - a word against the Party or its deeds, marriage with a non-Aryan, democratic or international sympathies, pacifism, are but a few.
The very words 'concentration camp' produce a cold sweat throughout Germany for it is only too well known that not merely the displeasure of the Party or the Gestapo, but also the vindictiveness of a neighbour can place a man or a woman behind electrically-charged barbed wire. Once within a camp, no prisoner knows how long he will remain there; such knowledge belongs to the Gestapo only.
The road to the Concentration Camp is a via dolorosa, as the following description shows : On a brilliant summer day hundreds of prisoners are herded into a train, beaten and battered with rifle-butts and kicked by the Prussian-booted S.S. Guards, twenty to each ten-seated compartment. The doors and windows are tightly closed; the atmosphere rapidly becomes intolerable. Throughout the fourteen-hour journey the prisoners are compelled first to gaze at the ceiling and then to stoop till their heads are between their feet.
These gymnastics had to be performed smartly, otherwise blows and bayonet prods were vigorously applied. The prisoners included men of all ages from 17 to 78, some of whom had already passed two days with neither food nor sleep ; all were treated alike save six in one compartment who had been shot as they stood.
The heat increases; tongues cleave to palates. Only the sheer will to live enables us to continue the gymnastics under the bludgeoning of the guards. At last the train stops at Dachau and its freight is transferred to special prison railway waggons without windows . The detraining and entraining operation is accompanied by the same stimuli as had been used fourteen hours earlier. The prisoners now spend half an hour in total darkness, helplessly jostling each other, more tightly packed than before, as the train jolts along the line to Dachau Concentration Camp station.
The road into the camp is thickly lined with S.S. youths carrying rifles at the ready with bayonets fixed. At a word of command the human herd professors, doctors, lawyers, students, merchants, officials, workmen is driven into the camp under a hail of blows.
Once within the camp, the new arrivals are kept standing at attention on the parade ground throughout a whole day, hatless under a burning sun, no opportunity to attend to nature’s needs, no food and no water. Tongues crack, the mucous membrane of the throat is so parched that speech is hardly possible. Some prisoners have had their ears permanently damaged and others have blood-suffused eyes from the clouts on the head they have been given.
Evening comes; prison clothes are issued and the victims of protective arrest get what sleep they can on straw pallets.
The daily routine of the camp, Sundays included for all prisoners, save those who have earned privileged position, is one of severest manual labour whatever the age or physical condition of the prisoner and no matter what the weather may be. In Dachau the men are driven to work in the Gravel pits, as the stone quarries are called, at 5 a.m. They work without a break till 11 a.m. and again from 1p.m. to 5 p.m. ; their jobs include carrying blocks of stone weighing anything between 6o lb. and 120 lb. or more, hauling carts and trucks, etc. Both before and after work, there is a call-over on the parade ground - all this, of course, under the guard of S.S. men who omit no opportunity for administering kicks and clouts.
Prisoners whose bodily strength is not up to such exertions are reported as refusing to work and enrolled, with other delinquents, in the Punishment Squad. This group is given fatigue drill after work, has one day's fast per week, is located in a separate barrack, may neither write nor receive letters, works apart from other prisoners and may not speak to them.
All prisoners wear a classificatory coloured label, Work-shy black, Politicals red, Jews yellow, “Students of the Bible” an anti-Nazi Christian sect (Bibelforscher) Violet, professional criminals green, etc. The insane are left at large and made to work like the rest, but they wear armlets bearing the word MAD (blöd). At one time there were at least forty such men in Buchenwald. The writer can state that their armlet earned them no consideration from their guards and he is unaware that they were accorded asylum treatment. Hard labour, performed hatless and under painful urgings from the S.S. guards, was exhausting enough in scorching summer weather, but in wet weather misery was acute, for wet clothes were still soaking on the following day - sometimes clothes were wringing wet for a week or longer.
These conditions did not apply entirely to a certain privileged class of prisoner - the prisoner-overseers or 'Capos' as they were called. Such men earned immunity from hardship as well as various much prized privileges by officially aiding the guards in their work. Many of them in their conduct were indistinguishable from the S.S. guards themselves.
The diet in a concentration camp supplies on the average between 1,200 and 1,500 calories per day, as will be seen from the following: Each prisoner gets, on three mornings a week only, as a rule, a quarter of a litre (about two cupfuls) of black unsweetened acorn coffee, nourishment-value nil. On this he goes out to his labours carrying the bread he has saved from the previous day in some sort of a haversack. This serves two purposes - to prevent its being stolen by other hungry prisoners - and to provide his midday meal near his work. On return from work the evening meal is usually soup containing either about 300 grammes of potatoes (288 calories), or 300 grammes of cabbage (176 calories), or 300 grammes of beans (780 calories) ; 300 grammes of black bread (750 calories) are issued at the same time. Occasionally this issue was supplemented by 50 grammes of black pudding (126 calories) , or by jam, cheese or syrup supplying about 150 calories. If the fast days occasionally imposed are taken into account, it must be agreed that an estimate of 1,200 to 1,500 calories per day is on the high side.
Fat was almost completely absent from the rations; pulse of various kinds frequently occurred, presumably because it is the cheapest way of supplying albumen.
In Dachau, those who received money from home could supplement their prison fare very considerably from the canteen; in Buchenwald the canteen was seldom open and was woefully inadequate - incidentally, sugar was unobtainable in this camp and did not appear in the diet.
The canteens were surrounded by a web of corruption of all kinds. 'Black' prisoners were the worst off, for they were too poor to receive money from friends. Many of them specialised in culling vegetable refuse from pig troughs, etc., and obtained large sums from vitamin-starved prisoners for rotting tomatoes, windfall apples and other vegetable refuse - having first satisfied their own needs of such food. 'Green' prisoners (professional criminals) applied their nefarious knowledge to their own advantage by all kinds of underground methods: These men were able to obtain and market at fantastic prices not only higher class refuse from the S.S. kitchens and canteen, but also real food. They built up such a system of profiteering round the canteen that a prisoner was courageous enough to complain. The profiteering prisoners were enraged and, with the connivance of the guards, dragged the unfortunate man over piles of stones until he died.
Camp sanitation in Dachau was relatively satisfactory but in Buchenwald it was abominable. There was no protection in bitter winter weather and in this latter camp, which takes its name from the forests among which it stands, prisoners very early recognised the virtue of beech bark on account of the tannic acid which it contains. Though dysentery, enteritis and kindred afflictions were common, the use of the latrines was restricted to certain hours of the day.
Punishments included flogging, hanging to trees, the punishment squad already spoken of and solitary confinement in total darkness. The cells in which the last punishment was earned out were called the 'Bunkers'. An imperfectly polished dish, a speck of dust on the shoes at shoe inspection (this occurred only in Dachau - in Buchenwald shoes were not cleaned at all), a bed not faultlessly made according to Prussian military regulations, talking or eating while at work, was enough to earn suspension from a tree for an hour and a half. In Buchenwald as many as thirty prisoners underwent this pumshment at a time. The method adopted was to tie the hands crossed behind the back, the fastening being above the wrists, by means of cords or chains; by these the unfortunate was then hoisted to a tree until his toes were roughly 18 inches from the ground.
At first the pain was agonizing owing to the strain upon the plexus brachialis and the cutting of the chains into the skin; the body gradually stretched owing to the elasticity of the intervertebral discs-the sensation was that of being torn asunder by the legs. The acutely painful phase was followed first by paraesthesia, then by a sensation of paralysis; the muscles then became lifeless and the backs of the hands oedematous. For days afterwards hands and feet were stiff and without feeling. The psychic shock cannot be estimated.
Flogging is standardized at twenty-five blows with a steel rod or ox penis on the gluteal region. The victim is laid with his trunk horizontally in a hollow carved in the flogging horse; his legs hang vertically downwards and his feet are secured in stocks. The S.S. official, specially chosen for this work by reason of his physique, then administers the twenty-five blows. The prisoner must next let his trousers down so that the official may inspect his handiwork. This proving satisfactory, the prisoner must stand at attention facing a wall and a few feet away from it, for twelve hours without eating or drinking. It is not long before huge haematomata develop in the gluteal region. Fever, whether of resorption or of suppuration, follows. These two punishments are scheduled in the minor category; the reader can therefore picture, in the light of the general information already given, what 'Punishment Squad' and 'Bunker' imply.
On the two occasions known to the author when the gallows were used on the parade ground in the presence of the assembled prisoners, the victim was a prisoner who had murdered an S.S. man.
Suicides are common; the simplest and most popular method is to make for the electrically-charged barbed wire. Shots are quite frequently heard in the camp, for the lives of those under protective arrest do not count.
It is not to be wondered at that the most ruthless egoism develops among the prisoners. Old prisoners advise the newcomer that the only possible policy is utter selfishness. Though it is easy to understand that a despairing attitude very frequently develops in prisoners in concentration camps, it must also be said that there are many inmates whose high courage cannot be too greatly praised. Such men are unknown and unconscious psychotherapists even though they do but spread rumours of speedy release, disbandment of the camp, institution of regular legal procedure, the replacement of the skull and crossbones guard and so forth. Hope, optimism, strong will and faith in God are the only possible antidotes to the neurosis endemic in the concentration camp. This anxiety neurosis is very analogous to the 'barbed wire disease' of prisoners of war analysed by Vischer in 1918, with this difference - that in the concentration camp everybody knows that any man who marches out to work in the morning may meet his death in the afternoon. The neurosis of the concentration camp spreads even among the general population in Germany and the power of the Nazi is strengthened accordingly.
In addition to the hardships inherent in the official organization of the camps there is scope for the malice of the individual camp commander or officer to make itself felt. For example, one day the camp loud speaker announced that Catholics who wished to attend Sunday Mass should report on the parade ground. They did so. Instead of receiving the consolation of the Holy Sacrifice they were made to do punitive drill. The exercises included hopping like frogs and rolling in the mire. They were continued until prisoners collapsed.
Though the author cannot give a complete analysis of the life in the camp he feels that enough has been said to indicate that sadism flourishes. The indiscriminate beatings of defenceless men allowed to the humblest member of the S.S. gratifies a lust for self-glorification which springs from a consciousness of inferiority. The deeper this consciousness the more passionately it seeks to make itself felt. The mere infliction of pain is not always enough to satisfy this lust; 'I must see blood' repeatedly shrieked one S.S. youth as he maltreated his prisoners. These young men vied with each other in devising ingenious tortures apart from the official punishments.
It is not surprising then that the death rate in the camps is high. Statistics are not available apparently, but the author is in a position to state that Buchenwald boasts a death rate unparalleled in any prison in the world, for the daily number of those who 'went out feet foremost to Weimar' (i.e. to the crematorium) was often as many as sixty in a population of 21,000. In Buchenwald all reporting sick was once forbidden for some six weeks by way of general punishment. During this time every inmate of the camp was forced out to work without exception and the death rate leapt sharply up.
The psychiatrist would find ample scope for his activities in a concentration camp, both among the prisoners and among their guards. Among prisoners the well-known textbook prison reactions are extremely rare, presumably because by far the greater majority of them are innocent of any crime. Their neuroses are of the unobtrusive type; the author observed no attacks of rage and abuse such as occur in other prisons, but it is understood that outbursts of this sort did occur in the 'Bunker.' Prisoners suffering from claustrophobia would in normal circumstances have been accorded medical attention, but in the concentration camp this was denied them; one of the punishments described above was the only therapy they received.
Apart from the lamentable consequences to prisoners of their incarceration, it is indeed a melancholy thought that 7,000 young S.S. men are posted to Buchenwald at a time, and that whatever tendencies towards sadism they may have in them are here given the fullest opportunity of development. Future monographs on this type of mental disorder will not be able to ignore the material provided by the German concentration camp. It is interesting to note, too, in this tragic connotation, that parties of Hitler youth are frequently taken through the camps. It is difficult to escape the conclusion that one of the functions of these institutions is to produce a systematic brutalization of the German youth of military age. Thousands of men among the nation which has enriched the culture of the world are now suffering this terrible spiritual metamorphosis.
The quality of the concentration camps varies, as those who have been inmates of several can testify. They have, however, one thing in common in regard to medical service. This is always exclusively in the hands of more or less brutalized fellow prisoners and the principal governing diagnostic would appear to be 'what the eye does not see the heart does not grieve over'.
Difficulties were put in the way of any man who wanted to report sick. This permission to report sick had to be obtained from the 'Capo' or the S.S. guard. If the prisoner overcame this initial difficulty he was passed on to other lay officials equally unendowed with medical knowledge, who made it an exception rather than a rule to allow access to the doctor. Occasionally the doctor was quite a good surgeon, but far more often he was a man who found his true level in the crude circumstances of the camp. It was, therefore, only as a very last resort that any prisoner reported sick, for the general feeling among them was that over the hospital doors should be written 'All hope abandon ye who enter here.' Occasionally such obvious things as a struma or hydrocele were treated and lighter work allowed for their possessors. On the other hand, duodenal ulcers, weak hearts, active tubercle or diabetes were disregarded. Temperatures of less than 102 degrees were not considered serious, taking the pulse was the sole means of diagnosing a heart condition; no auscultation was practised.
Once in camp hospital, the sick were left entirely to the mercy of orderlies or fellow-prisoners of the ‘Capo' type.
On the surgical side a certain amount was done. Palmar phlegmons, often exacerbated by the mistreatment given by the orderlies, were cut out and compound fractures of the hands and feet arising from accidents at work or from 'incidents' came to the doctor for amputation.
In Dachau some dental treatment was given by a civilian dentist, but in Buchenwald the prisoners were told that they must not expect it. In this latter camp not even extractions were performed, and periosteal abscesses were extremely common as a result, while dental caries assumed enormous proportions.
Being a medical man the writer feels it not too much to say that had suitable medical attention been provided in the camps 80 per cent of the deaths would have been prevented.
As might be anticipated, innumerable dirt diseases - impetigo, furunculosis, erysipelas, eczema, infectious fungoid diseases, etc., were rife. The lack of natural healing power in wounds was particularly noticeable, probably owing to the shortage of vitamins in the diet as well as to the impossibility of securing rest for a wound. Sufferers from phlegmons or from recent fractures were put to work in the most makeshift of bandages. Sufferers from severe lymphangitis of the lower extremities were occasionally put on indoor work and in one or two cases ordered rest in bed, but even so, they, as well as the patients with high temperatures, were compelled to attend roll call twice a day. It was a commonplace to see sick prisoners carried by their fellows pick-a-back or on improvised stretchers to call-over on the parade ground. This function sometimes lasted for a very considerable time and it was by no means rare for a sick man to die during the parade.
Dachau lies at a height of over 2,000 feet above sea level and the site is not unfavourable climatically, especially since the surrounding moors and marshes have been drained by the prisoners; but it was no place for heavy labour in summer under the burning sun for men with shaven heads compelled to work hatless. This produced fantastic sunburn effects. Heads frequently swelled to twice their normal size; large oedemas formed on the face, especially on the eyelids, rendering sufferers practically blind for days. These men were led to work and to roll-call by their comrades. Oedema on the back of the hands and round the ankles was frequent, presumably owing to faulty central and peripheral circulation.
Considering the arduous work combined with miserably inadequate food, it must be remembered that a man engaged in hard manual work requires 4,000 to 5,000 calories per day, whereas the food supplied in the camp contained not more than 1,200 to 1,500 calories. The symptoms shown by men who suffered in this way were probably the same as those noted in 'hunger oedema' and 'war oedema' observed in 1914 1918.
It has been stated that this type of oedema is due to a diet deficient in calories and with an undue proportion of water and salt. Experience in a concentration camp would seem to show that it is produced even when water and salt are not supplied in undue quantities. In this case, however, other maladies even more dangerous to life manifest themselves - dysentery, pneumonia, tuberculosis, enteritis.
In Dachau, where the chief occupation of the prisoners was pick and shovel work, large numbers suffered from tendovaginitis. The rest which this condition demands was denied them. The effects of this affliction were still felt many months after their release by men who had been prisoners at Dachau.
The aetiology of a somewhat rare complaint, trigger finger (Schnellender Finger) is now clear to the author. Surgical textbooks have stated that it is probably caused by over-exertion, and operation shows that the tendon has suffered fibrous thickening in annular form in the vincula tendinum. Practically every man in Dachau suffered from this complaint. Its cause would, therefore, seem to be a chronic neglected tendovaginitis.
Functional neuroses, especially of the intestinal tract, were also noteworthy, but these conditions almost without exception improved in spite of extremely indigestible food; medical experience during the last war records the same phenomenon. It therefore seems safe to venture the generalization that the best cure for functional disorders is 'authoritative and imperative suggestion-therapy'.
In Buchenwald many hundreds of prisoners suffered from acute itching dermatitis of the edge of the pinna. This may have been due to a fungoid infection, or dermatitis artificialis caused by silica dust in the quarries, or it may have been allergic dermatitis induced by the blankets woven from stinging nettles. In the bitter cold of winter prisoners used to pull these blankets well over their heads in the hopes of sleeping better. At this time of year frostbite not infrequently complicated the dermatitis. It was, however, more frequent in summer. This ailment yielded to painting with a zinc solution.
Among so large an assembly of people there was, of course, a very wide variety of disease not due to the camp conditions, but the lack of medical care was responsible for the very large number of acute cases which terminated fatally. Among such cases are included perforated appendix, ileus, and cancer, and innumerable chills which developed into pneumonia. The cause of death on the certificates provided by the medical authorities of the camp was almost without exception 'heart failure', whether such failure was caused by illness, bludgeon or bullet. This irony will be easily apprehended when the author states that when the first cases of typhoid were recognized by the hospital orderly in Buchenwald - they heralded a full-dress epidemic - and reported to the S.S.. Storm Leader doctor, this gentleman did not attempt to verify the diagnosis by seeing the patients but contented himself with the remark that it was better to let them die.
It is perhaps obvious to say that practically all the prisoners suffered from actual hunger pangs - at all events they grew rapidly thinner - in many cases to the point of the classical 'hunger marasmus' . This was particularly noticeable among the 'Black' prisoners, who became practically walking skeletons, yet they were able to work and did so until they died.
Both in Dachau and in Buchenwald even in the summer heat no drinking water was supplied to men losing enormous quantities in sweat at heavy labour. This lack of water may not have been accidental for any man found drinking from the basin sometimes supplied for washing was accorded the standard 25-stroke flogging. Owing to lack of water the natural healthy colour of the skin disappeared and the covering of the emaciated bodies became a dry, yellow, corpse-like 'mummy-skin' such as could only be seen in famine areas in India or in Russia after the 1918 revolution.
Scientifically speaking, it is a matter to be recorded that men whose diet was wholly insufficient in quantity, in calories and in vitamin content, could carry out the heavy labour demanded of them. Some years ago Dr. Bier, writing in the Munchener Medizinischer Wochenschrift on the maximum physical effort possible under compulsion of the will, was uncannily prophetic of the achievements of prisoners in concentration camps.
Even among the miseries undergone in the camps there are certain points on the less harrowing side to be recorded. There were prisoners who, by submission to iron discipline and by developing the habit of enduring privation, schooled and strengthened their characters. On the physical side it is noteworthy that hunger and work appeared to agree fairly well with some of the diabetics, particularly those who arrived in camp possessed of a generous supply of superfluous fat. It was noteworthy that diabetics receiving no insulin treatment showed no sign of coma. It is, of course, well known that a carefully calculated amount of work reduces the production of sugar in the body. It would seem that starvation, and in particular, lack of all fat, can be beneficial as a protection against diabetic coma. There were diabetics in the camp who had lost as much as 80 lb. in weight and yet felt reasonably well.
It has been held that a fat-free diet containing a sufficiency of calories exercises no effect on psoriasis, but that a reduction in weight is beneficial. This theory would appear to be completely corroborated by the fact that almost all sufferers from this disease were strikingly benefited in concentration camps.
Though there were many deaths from pneumonia, colds were relatively rare. This is probably due to the hardening process of body and mind that all prisoners underwent, combined with the dread of the camp hospital and its terrible mortality rate. The will not to be ill evidently strengthened even the weakened organisms of the prisoners. Experiments on the influence of hypnosis on the opsonic index would appear to bear this out.
The author has no first-hand information as to the concentration camps for women, such as at Oranienberg, but they are said to be little better than those provided for men.
In conclusion the author wishes to state clearly that his testimony in the foregoing article is that of personal experience. He is not in a position to give statistics; indeed no reliable statistics exist in regard to the numbers who have died while in camps, nor is there any trustworthy record of the number of cases in which relatives have received the ashes of prisoners who have met their death.
The number of men crippled for life, whether in body or in mind thanks to these camps is not known. It is clear that hundreds of thousands have been robbed of every human right and - worst of all - of faith in Humanity and belief in human dignity. This sin against the Spirit of God in Man is committed not only against the prisoners but also against the youth of Germany, for their finer feelings are being systematically brutalized and their ideals perverted by a cynically unchristian regime. When the war is over, Europe will be faced not only with the problem of setting up a new order but also with the need for a spiritual re-education of those who have suffered through the Nazi regime and of those who have been the instruments of that regime.
Agnus dei, qui tollis peccata mundi, miserere nobis.