In the first expose of unjust medical experimentation since David Rothman's Willowbrook's Wars, Allen M. Hornblum releases devastating stories from within the walls of Philadelphia's Holmesburg Prison. For more than two decades, from the mid-1950s through the mid-1970s, inmates were used, in exchange for a few dollars, as guinea pigs in a host of medical experiments. An array of doctors, in conjunction with the University of Pennsylvania and prison officials, established Holmesburg as a laboratory testing ground. Hundreds of prisoners were used to test products from facial creams to far more hazardous, even potentially lethal, substances such chemical warfare agents. Based on in-depth interviews with dozens of prisoners as well as the doctors and prison officials who performed or enforced these experimental tests, Hornblum paints a disturbing portrait of abuse, moral indifference, and greed. Central to this account are the millions of dollars many of America's leading drug and consumer goodscompanies made available for the all too eager doctors seeking fame and fortune through their medical experiments. Acres of Skin is rigorously researched and shocking in its depiction of men treated as laboratory animals.
Contrary to other reviews, this book is not repetitive. It is a thoroughly researched and presented academic text. It is far from dry or difficult to read.
Kligman is presented as an evil genius whose charismatic character allows him to get away with next to murder. The story reads like a dime store crime novel at times, giving a suspenseful historical review with engaging characters from all sides of the argument.
Hornblum focuses his study on Dr. Albert Kligman, a dermatologist from the 1950's to the present day. He is closely associated with the University of Pennsylvania. Kligman was the driving force behind the Holmesburg Prison medical, military, and cosmetic experimental program that used prisoners as test subjects. 'Acres of Skin' presents this specific case in the wider national context -giving the reader an over view of the prison/human experimentation that was common across the U.S. between the 1920' to 1970's.
'Acres' details how prisoners were exposed to radioactive material, mind altering drugs, carcinogens, and many other toxic and scarring procedures. One of the most disturbing revelations comes near the end of the book; it tells of how the experiments severely, and violently disrupted the social regulation of the internal prison economy. This book might seem like a 'special interest study' localized to prisoner justice and civil rights in medical research, but given that human experiments in prisons spanned 50 years, throughout the entire US, and involved such huge corporations as DOW and Johnson & Johnson, pretty much everyone who uses pharmaceutical drugs or cosmetics could be directly associated with the exploitation that occurred behind the prison walls.
I have definitely rethought my relationship with all corporate beauty products. Previous to reading this book, I was aware of, and sensitive to, animal testing, but had never heard of prison human experimentation. The corruption on all levels, from prison guards, to Kilgman himself, to University heads, state governments to the FDA and the American Medical Association is repulsive and disturbing.
This is a story that needs to be told about the horrific abuses of prisoners used in medical experiments led by dermatologist Albert Kligman (of Renova anti-wrinkle cream fame) in Philadelphia-area jails in the 1950's to early 1970's (when the governor outlawed the use of prisoners for testing). What amazed me most is how Dr. Kligman seemed to operate with little/no oversight-he was subject to several inquiries about his methods/lack of adequate record-keeping, his credentials in conducting some studies (he was a dermatologist by training, so what did he know about studies using radioactivity or mind-altering drugs like LSD?) and even lost his status as clinical investigator by FDA for a short period of time. But somehow he still chugged on doing research that today often sounds like either the information gained was useless to science, or unnecessarily harmful to test subject ("the means didn't justify the end").
While the book is well-researched, it is poorly written with many typos (including misspellings of the word "research", the amino acid "tryptophan", and pharmaceutical company name "Schering" Plough) with wordy, redundant text (e.g., "Pennsylvania governor, George Eagle, of Pennsylvania...") and the constant reminder in almost every paragraph that the inmates ONLY did it for the money (and not for any patriotic or altruistic reasons). I don't blame them for wanting to earn $5-$10 for doing a skin patch test so they could raise money for a lawyer/bail or candy, cigarettes,etc. in the prison commissary. For comparison, during the same time period, the prisons were only paying 10 cents per hour to the inmates working in the facilities. It was the "large" payments to the prisoners which was considered to be exploiting their need for money (so that they were not truly volunteering of their own free will), along with complaints and documentation of abuses that finally led to the practice of using prisoners being outlawed.
When I finally got this book into my hot little hands, I couldn't WAIT to start it. I had seen it during a few trips to the Eastern State Penitentiary, and was quite interested. The price, however, was kind of steep ($32.00) and I hoped it would be worth it. The first few chapters were exactly what I was looking for: details on the experiments done to prisoners, their reactions, their side effects, their own words. Towards the middle of the book, it slowly moved from lurid details to the dry recounting of Dr Kligman's hubris, his battles with the FDA and the government, and scads of paragraphs rehashing the "I knew it was important research so I did it" opinion. Also looming large in the rather dull second half of the book is the "Maybe we shouldn't experiment on prisoners, who is going to do something about it?" and the constant refrain of money, cash money, being the reason for the quick compliance of the inmates.
Hornblum has written another book, "Sentenced To Science" which is the story of one particular inmate and his experience with these drug trials. I'm interested, but I may get it from the library. I was a little too disappointed with how "Acres of Skin" ended up to invest my money right now.
Unflinching look into experiments done on prisoners at Holmesburg prison, asking questions like what is informed consent in a vulnerable population stripped of civil rights and other question of medical ethics. Incredible to think that Philadelphia and UPenn have never formally addressed it.
This book is an important one to read, and I wish its contents were taught in school. They should be. However, the writing is a little dated, and I thought the organization of the book was a bit off. Some sections felt repetitive, and at some points, there was a shift in focus from the prison itself to the main doctor experimenting on the prisoners--which was important information to cover, but not handled as successfully as it could have been.
Again, that said, I do think everyone should read this and know what happened, especially now.
I never actually finished this book (a cardinal sin which I frequently commit), but it's not entirely the book's fault. I found it interesting and illuminating, but very dryly written. Ultimately I think it was this that made it hard for me to finish. Not altogether the author's fault, as he is an academic, but it just read too textbook-y to me. Could possibly have benefited from a co-author and/or better editing. Still, worth a look.
Interesting, but not as disturbing as I'd anticipated. While the author had a clear agenda, the book is somewhat disorganized and very repetitive, with nearly every other phrase being in quotations (you're a writer, find your own words!) to the point of distraction -- the weak composition detracts from his arguments. The main point appeared to be to discredit the main experimenter (Kligman) personally, which is unfortunate when there is a much grander scale this book could have attempted. While his methods do appear slipshod and completely unscientific as presented here, I'd be curious as to how they stood up in the context of the times.
This is a very well written and necessary book *however* if you're looking for something that pays special attention to the victims personal stories this is absolutely not the book for you. Of 245 pages only 15-ish were devoted to personal stories and the rest was an incredibly dense, bureaucratic look into the actual science and politics behind the atrocities at Holmesburg. Still a riveting story (and one that should be told, loudly, so as not to repeat it,) but it could have carried that much more weight if perhaps the victims had been interviewed more thoroughly or able to speak in their own voice unedited on the page.
I admire the author for doing all of his research, citing all of his sources, and generally doing a great job of informing me about this issue which took shape just miles from my current house while my parents were growing up.
It does get a little repetitive at times, and there are way too many "quotation marks," but that's a writer's quibble. The points made are valid and very well supported. Great job on your research, Mr. Hornblum!
Want to cringe? A very worthwhile read if you want peek into how some of your favorite sunblocks and other products used to be tested (on Human prisoners, the sickos used human prisoners and paid them next to nothing)
"An uninformed and desperate group of prisoners met an unrestrained and ambitious doctor, and Holmesburg Prison became one of postwar America's largest, nontherapeutic, human research factories".
The quote above is taken from the book and sums it all up in a nutshell.
I read about this book in another book, and I couldn’t believe it. It’s what people mean when they say no one wants to know how the sausage is made. What the prisoners have endured for the sake of consumerism and in the name of patriotism is enough to make me want to gag. Who knows how many products I use that resulted from taking advantage of prisoners and others who are institutionalized. While I’m relieved that these experiments are no longer going on, that we have stricter restrictions, I still now will always wonder how a product was tested when human trials might’ve been required to get it FDA approved. And whole race wasn’t the focus of this book, I can’t help but wonder if they would’ve been treated with such little regard of the prison population wasn’t predominantly Black/BIPoC (thanks in large part to Reagan era policies). The author had extensive footnotes all along. I’m really grateful to the author for the extent of research put in.
Acres of Skin tells of the history of using prisoners as human guinea pigs for 30 years, focusing mainly on Holmesburg Prison in Phila. This was a tough read, but very enlightening. Sadly it kind of feels like medicine still has a lot of "the good of the many outweighs the pains of the few" mentality......but at least it isn't quite as rampant. It's painful to read these historical facts, but if you don't know your history it is way too easy to repeat it.
This is an expose, as the title states, about medical experiments on prisoners at Holmesburg Prison. Its a well researched and written history that will definitely make you feel nauseous and pissed. its a great text to look to to understand how parts of the Medical Establishment are situated in the prison industrial complex.
Nazi Germany was alive and well within our prison systems for decades. A fascinating read, considering drug companies are now looking to third world countries for human testing. It makes you realize that products we use on a daily basis were once tested on another human being.
It was interesting to find out retin A would not exist except for the fact that prisoners tested it on their faces and such. And that people would be so desperate for money that they would submit to testing on themselves.
I was more interested in the actual experiments rather than how Dr. Klingman got around the FDA rules. This book is more about Dr. Klingman than it is about the prisoners who were tested on.
In 1961, the assistant dean of Harvard Medical School told an administrative board that the Nuremberg Code is not necessarily pertinent to or adequate for the conduct of medical research in the United States. p. 234. In fact, the view that American medicine deserved exception to the code was expressed during the trial before the close itself was drafted. Dr. Andrew C. Ivy, the "conscience of U.S. science" and the prosecution's key witness on medical ethics argued on the witness stand that prison research in America was "ideal" and "all subjects have been volunteers in the absence of coercion in any form." These pronouncements were endorsed later by the AMA and prominently printed in its respected journal for all physicians to digest. p. 234
Physicians reported that medical ethics were not taught in medical school and the Nuremberg Code never mentioned. Nazi medicine was a horrible but distant medical aberration that could never happen here... Prestigious medical journals published articles reporting and recommending the use of vulnerable, institutionalized children or prisoners as ideal test subjects. For physician researchers, there appeared to be few constraints. p. 235
Medical precedents, an insular AMA and a growing profit motive fueled by lucrative research contracts made reform impossible. p. 235
Kligman's research was acceptable to doctors in all fields. For those closest to him, the pursuit of career advancement, publications, lucrative contracts and fame, became the goals of their professional careers.. p. 237 No one in the prison questioned the studies, no one wanted to make waves.
Corrupting influence of money... p. 239 Many former test subjects and their families now regard the medical profession as torturers rather than healers. p. 242
All agencies looked the other way or encouraged the tests: FDA, EPA, the Army. No government agency knowing the inherent dangers to the prisoners in sloppy methods when drugs with unknowable effects are being tested, questioned that the prisoners could be exercising informed, uncoerced consent.
The doctors who entered Holmesburg Prison a few short years after Nuremberg were conditioned to see the mass of idle humanity before them as a fertile field of investigatory opportunity. p. 235
In time, no protocol was too risky, no relationship too troubling, no code immune to violating. p. 235
Of course there is little doubt that the Holmesburg human guinea pigs acquiesced in their own exploitation. Uneducated and isolated, desperately short of money, the inmates were an easy target for medical mercenaries looking for test subjects. A drowning person does ask penetrating questions about a life raft. Some may have decided to believe that the . . . tests were harmless, but many understood that they were gambling with their health and safety without knowing the risks and without giving genuine, uncoerced, informed consent. p. 241
There we are. No longer prisoners in institutions, but isolated due to Covid, the world is a prison. This explains it.
I would place this book up there with The Immortal Life of Henrietta Lacks as among the most important modern explorations of science and research ethics written in English. This book concerns itself with incarcerated people of color exploited for profit not merely because of their race but also due to their diminished status as incarcerated people. Long before the beauty and cosmetics industry started experimenting on non-human animals, they first tried their hand on actual human subjects who were compensated (albeit poorly) for placing their lives at risk, there being few other opportunities for money making among the incarcerated. A demented and decidedly unethical dermatologist came up with this money making scheme and declared that within prisons were literally acres of skin with which to experiment on, hence the title. It wasn't just the cosmetics industry that utilized this skin, it was also the US War Department that wanted to understand the limits of human exposure to radiation. Apparently these kinds of scientific and experimental abuses were not limited to Nazis of a bygone era, but were present in the US until relatively recently.
The book reveals that the kind of racism we are discussing here is not of the drunk uncle kind. This is not an interpersonal problem concerning one individual who is not sufficiently woke to the humanity of others. This is a problem that is deeply systemic and affects not individuals but entire professional institutions that we all imagine operate better than this. But alas, systemic racism is something we are no longer allowed to teach about anymore in the US.
But I also can’t help believing that talking about ethics is somehow kind of moot. How can we as a nation talk about ethics when our leaders promote the slaughter of the Palestinian people in the most well documented genocide in human history? To talk about ethics in this context feels a lot like washing your clothing in a cesspool, then putting the clothes back on while they are still wet. It is neither pretty nor does it smell nice.
A thought provoking and shocking account of various medical experimentation that took place on the population at Philadelphia’s Holmesburg prison from the 1950s-70s. The author compares these to the experiments conducted by the Nazis during WW2 but I personally do not see them in the same light, seeing as one group was being persecuted for their beliefs while another group was in prison (and while I understand some are innocent and the system has failed, many — including the ones our author interviews — did in fact break the laws, steal, and take lives). It was interesting to read about various trials the prisoners partook in, the rewards they received, and how ethics have changed since this time. Many of the trials center around Dr. Kligman, a dermatologist, who is depicted as an evil scientist of sorts with free reign and a captive population on which to conduct experimentation. There are definitely shady ethical concerns by todays standards, but this was the 50s/70s and frankly the author turned me off a bit by his comparison to the Holocaust. The prisoners were paid meager amounts (I am not sure what the equivalents would be in todays monetary value) and could use this money towards commissary, bail, attorney fees, or send it home. Some experiments such as those involving chemicals for digestion seemed shadier than others such as deodorant trials but to the author they were all written about in the same regard.
My reason for reading this book was to support research regarding the social context for a shift towards deinstitutionalization of mental health care (co-occurring around the events of this book). Although this is not the book's focus, it proved to be a helpful resource for illustrating how changes in public consciousness contributed to shifts in institutional policy around this time. This book leaves no stone unturned when it comes to exploring the question of why medical experimentation in a carceral setting is problematic, as well as how this fact was able to be ignored even after the advent of the Nuremberg Code.
The author's writing makes his points feel easily accessible. Some bits were repetitive. I felt that it did not need to be repeated so often, across so many chapters, that money and social disadvantage was the ultimate reason for prisoner participation in the experiments, given that this was the primary focus of the first chapter.
Overall, I found it to be an enjoyable read that provided a well researched overview of both the events investigated within, as well as the social and political contexts behind these events.
This entire review has been hidden because of spoilers.
I used to pass by Holmesburg Prison each time I went to visit family in the far Northeast of Philadelphia and the joke was "oh look, a prison" and even after they closed the original location and moved up the road, it was still a fun moment in time.
It was not until I read Stiff: The Curious Lives of Human Cadavers that I heard of the terrible experiments that went on at the prisons around the US. All of the things we tried the Nazi party for at Nuremberg, we did to our people, whether they be prisoners or "volunteers"
A quick and compelling read and recommended for those who favor the true horrors of the world.
"An uninformed and desperate group of prisoners met an unrestrained and ambitious doctor, and Holmesburg Prison became one of postwar America’s largest, nontherapeutic, human research factories. Many American prisons housed medical research labs during the Cold War. Few, if any, involved as many test subjects in as wide a variety of experimental protocols for as many years as Holmesburg did. Even more remarkable is how such a large and intricate operation in a public facility went so long unnoticed and unchallenged."
This sums up the horrors in this book, using Black men as guinea pigs, and an extension of a a racist ideology that still permeates the core of American society.