The Medical Messiahs:
A Social History of Health Quackery
in Twentieth-Century America

Chapter 10: Two Gentlemen from Indiana

James Harvey Young, PhD


"And the striking thing about it is that all the time these defendants operated this institution they knew there was no cure for diabetes; they knew the only treatment for diabetes was insulin and a restricted diet, free from sugar. Yet, notwithstanding that knowledge, in their avarice and greed for wealth, they wrongfully advised these trustful patients, and, as a result, they suffered damage and injury, and some have gone to an early grave."

—United States v. Dr. Charles F. Kaadt (Kaadt Diabetic Institute and Kaadt
Diabetic Clinic), Dr. Peter S. Kaadt, and Robert S. Benson, 1948 [1]


In 1923 the Canadian physician Frederick G. Banting was awarded a Nobel prize for the discovery of insulin and for the first successful use of this hormone in treating patients afflicted with diabetes. Soon thereafter, an Indiana doctor marketed a starkly different treatment for the same disease. The achievement of Banting and his associates offered the hope of something approximating normal life for men, women, and children hitherto doomed to a hazardous existence and, quite frequently, to rapid death. The achievement of Charles Frederick Kaadt and his physician brother snatched that hope away from many diabetics who responded with pathetic eagerness to their delusive promises.

A decade after the enactment of the 1938 law, the Food and Drug Administration, bolstered by favorable court decisions, began action aimed at sending to prison these two gentlemen from Indiana. The Kaadt case illustrates the specious "clinic" as an evasionary maneuver to circumvent the new law. It shows too how the old in quackery persisted into the new day: the rapid progress of medical science had not eliminated the renegade physician, nor had a major breakthrough associated with that progress, like the discovery of insulin, stopped heartless efforts by charlatans to prescribe for diseases newly controllable by scientific treatment. The Kaadt case also reveals how various agencies—the FDA, the Post Office Department, an alert press, the American Medical Association, the Better Business Bureau, a state medical licensing board—could, when the need was great enough, combine their efforts into a united attack against the most egregious quackery.

Diabetes had long been a quack favorite. "In connection with no disease," wrote a physician in the year the first food and drug law went into effect, "is quackery in and out of the profession more rampant." In that era, life expectancy for those who became ill with the disease averaged about five years-for children about two. This was short enough to be deeply disturbing, yet long enough (as compared with death from an acute infection) to give the quack a chance to make his appeals heard. In its earlier stages, diabetes does not produce much pain or suffering, a situation useful to the quack, since pain tends to drive the ailing to regular practitioners. In its absence self-medication seems a plausible course of action. The orthodox treatment for diabetes also aided the quacks, for it required a complete and often irksome change in previous routines of life. An obscure and complex metabolic disorder, diabetes, before insulin, could be treated only with a regimen of hygiene and severely circumscribed diet, both as to quantity and kinds of food. Although semi-starving lengthened the life expectancy, patients often rebelled against its limitations and yielded to the quack's promise of an easier way [2].

Even after Banting's notable discovery, diabetes therapy often required rigorous dietary restrictions, and the insulin itself established a new routine against which the impatient might rebel. The only method of introducing insulin into the body was by hypodermic injection—in the early years by several injections a day. Quacks, in playing on fear of the needle, struck a responsive chord. Thus, even after Dr. Banting's achievement, there was plenty of room for Dr. Kaat's appeals.

Kaadt had secured his M.D. degree in 1902 from the Keokuk Medical College. Three years later he moved to Indiana, beginning a general practice in Fort Wayne. Soon he was supplementing his fees with a salary for serving as division surgeon for a railroad, a post he held for over 30 years. In the mid-1920's other doctors in the Midwest began to bear of Kaadt's "wonderful new treatment" for diabetes. It was, he asserted, an "absolute cure." The formula, Kaadt told his patients, was secret, "disclosed" to him "by an old European woman." Perhaps a new promise of a new cure, announced at this time, was more than ever alluring. Popular optimism engendered by Banting's discovery—as so often happens in quackery—helped Kaadt by conditioning would-be customers to a more hopeful prognosis. Kaades sales, at any rate, began to grow [3]. "It is not necessary to use insulin . . . ," he wrote an inquirer. "It is not necessary to diet. . . . The length of treatment varies from three to seven months depending on the severity of the case. I have patients who took the treatment several years ago and as yet show no return of the disease." Kaadt sold his treatment by mail, without seeing his patients, and a $5 bottle contained enough medicine to last for 20 days [4].

Dr. Kaadt was a member of his local medical society, and in1930 an official of the American Medical Association, prompted by letters of inquiry from physicians, wrote asking what the miraculous medicine contained. No answer came back. A year later, a second letter brought a reply but no formula. His results with his remedy, Kaadt said, had been "gratifying," but he would postpone an announcement until he could prove his claims, since his "experience with this disease, its cause and treatment" was "so widely different from the general opinion of the profession." When he had complete records of several hundred cases, be would submit a paper [5].

Kaadt!s cases accumulated but, of course, no paper came. His "Diabetic Laboratories" became the "Kaadt Diabetic Institute"; his personal replies to inquirers expanded into a pamphlet and advertising in such journals as Home Circle Magazine and the Pathfinder. In 1932 the Food and Drug Administration cited Kaadt, alleging that his "Diabetic Ferment Treatment" was misbranded. At a hearing in Chicago, Kaadt boasted that his formula cured 90 per cent of all cases. To avoid trouble, however, he would remove all claims for diabetes from his labels. This he did, and the FDA did not go on with the case. The label change did not hamper Kaadt's business in the least. Customers, whether they came in person or shopped for health by mail, had been persuaded to try Kaades formula before they ever saw his label [6].

Four years later, Dr. Kaadt established new and larger headquarters, moving his Institute westward from Fort Wayne to the village of South Whitley. There a capacious inn, built for the carriage trade, had fallen victim to the depression. The two-story building of brown brick, with its large lobby, its ample dining room, its well-appointed kitchen, and its numerous guest rooms, provided a perfect site for treating diabetic patients, if mail prescribing should prove hazardous [7].

The Post Office Department had, indeed, received a complaint from one of Kaadt's customers and had launched a test case. An inspector, using an assumed name, had answered an advertisement, returned a case history sheet with symptoms vaguely stated, and submitted a sample of sugarless synthetic urine concocted by a Food and Drug Administration chemist. Back came Kaadt's answer that the urine contained sugar and that he would accept the case for treatment. The inspector sent his money, and Kaadt mailed his medicine. Analyzing the yellow-brown cloudy fluid, the Food and Drug chemist gave his verdict: it was essentially saltpeter—potassium nitrate—dissolved in vinegar. These ingredients were not only useless in treating diabetes; saltpeter, especially in the quantity prescribed by Kaadt, would irritate the gastrointestinal tract and the kidneys, already overworked in diabetes, and lead to the most serious complications [8].

Saltpeter was no new ingredient in diabetes quackery. A central characteristic of the disease was the body's inability to utilize carbohydrates properly, leading to sugar excretion in the urine. Doctors had developed chemical color tests of the urine as an indication of the presence of diabetes and, when insulin was being used, as a clue to the effectiveness of the insulin dosage. The test was simple and impressive, and quacks turned it to their advantage. The trick was to fool the diabetic into believing that the nostrum was decreasing the sugar in his urine and thus promoting a cure. Diuretics increased the quantity of urine and also diluted it. This resulted in a lighter color when the test was made, even though the total amount of sugar excreted daily in the greater quantity of urine might be larger than before. The diabetic, believing from file evidence of his own eyes that he was better, might instead be worse. Ninety-five per cent of the quack remedies for diabetes, estimated the AMA's Dr. Arthur Cramp, were diuretics. Such was the action of saltpeter [9].

If this form of deception was his intent, Dr. Kaadt did not hint at it in his literature. Indeed, he rather frowned on testing the urine for sugar. "It would be better for you," he had written a patient some years before, "so long as you are feeling good not to have any tests made as it only puts you on the wrong track and will interfere with you getting well." Still and all, his medicine contained a great deal of saltpeter [10].

Dr. Kaadt did not subscribe to the orthodox explanation of diabetes, that the "islands of Langerhans" in the pancreas failed to produce enough insulin to regulate, in the liver and muscles, the use of carbohydrates derived from digested food. Instead he blamed the disease on digestive failure, the "faulty fermentation," mostly in the small intestines, of sugars and starches. This theory was fantastic, reported the FDA to the Post Office, so a citation was issued Dr. Kaadt's Institute to show cause why his venture should not be declared fraudulent and denied use of the mails. The Indiana doctor went to Washington [11].

With Dr. Charles to the Post Office hearing went his brother, Peter Kaadt. Also a physician, Peter had received his medical degree from the Rush Medical College in Chicago in 1895. After some years of practice in the Midwest, he had moved to Portland, Oregon, where he had added to his doctoring the teaching of anatomy in a dental college. In 1938 Dr. Peter had temporarily left his practice to help Dr. Charles, whose health was not robust, and so was on hand for the three days of testimony before Post Office officials. The upshot was a stipulation—signed during the same week in which the new Food, Drug, and Cosmetic Act became law—in which Charles Kaadt avowed the complete discontinuance of any use of the mails to promote his home treatment [12].

The doctor did not lock the door of his South Whitley Institute. He did, however, revamp his methods of doing business. He abandoned the mails as a method of communication and resorted to telephone and express. That is, he strove to do so. When money to pay for some of his turbid fluid reached him by letter, he mailed it back, advising the diabetic sender to place his order by phone and remit payment by express. This use of the mails to advise customers to use a differing route, postal authorities decided, was a violation of the stipulation. Dr. Charles was indicted and tried in a federal court in Fort Wayne [13].

The need to prove fraudulent intent proved to be the stumbling block in the Fort Wayne courtroom. The government presented experts on diabetes to describe the hazardous unorthodoxy of the Kaadt treatment. A boy of 12 testified that Dr. Charles had never examined him, but had diagnosed and prescribed only by mail. To the father's worried inquiry, Kaadt had replied, "Your son is taking too much insulin!" Four days after receipt of this letter, the boy had collapsed from lack of insulin in a diabetic coma. Another witness, who testified from a stretcher, died of diabetes—unknown to those in court—while the prosecutor was engaged in summing up. But Dr. Kaadt's parade of satisfied users to the witness stand was also impressive. When the jury returned from their deliberations, they found that Dr. Kaadt was guilty on only one of the six counts in the indictment. The judge, partly on technical grounds, partly from persuasion, voided the guilty verdict and granted a motion for a new trial. "It is hard to conceive," he said, "that the defendant devised a scheme to defraud and had the intent to defraud in the face of these witnesses who honestly believe in the efficacy of the treatment." [14]

The new trial did not take place. Because of the death of witnesses and the expense a retrial would involve, the case was dismissed. Dr. Kaadt did not tempt fate by resuming use of the mails. He seemed, indeed, to grow more cautious than ever. Inquirers received a printed letter in which he frankly confessed that a Post Office Department ruling prevented his mailing the detailed information they had requested. "It is compulsory that I examine my patients," he wrote, "so if you can conveniently do so, and care to, come to the Institute." [15]

Patients came in such increasing numbers that Kaadt's brown-brick building could not hold them all for the three prescribed days of initial treatment. They scattered out in dozens of South Whitley homes, where housewives went into the room-renting business. As many as a hundred new patients arrived daily from all parts of the country. Such a patient load, even though each hopeful diabetic took but a brief span of Dr Charles' time, was arduous, and the doctor was 70 and not in good health himself. In 1944 Dr. Peter closed down his Oregon practice and came to South Whitley to lend a hand [16].

Peter could not help Charles evade the reckoning that was soon to come. In May 1946 a Pittsburgh physician, president of the American Diabetes Association, wrote a letter of complaint to the AMA. The Kaadts' counsel to diabetics, he said was shocking and the results grim. He had records on 17 patients who had been treated at South Whitley, 12 of who had later been admitted to hospitals as emergency patients in diabetic coma. Five of the 17 had died. This concrete evidence strengthened the resolve of officials of the Indianapolis Better Business Bureau. Long active in the crusade against quackery, the Bureau had been assembling a file on the brothers Kaadt. In June 1946 the BBB sent an investigator in the guise of a patient to the establishment—now called a Clinic—where he was interviewed so hurriedly by Dr. Charles that he was not even asked his name. Diagnosed as diabetic and sold medicine for home treatment, the investigator went straight from South Whitley to a reputable clinic. Tests showed, of course, that he did not have the disease [17].

With such evidence in hand, the BBB petitioned the Indiana Board of Medical Registration and Examination for a revocation of Charles Kaadt's license to practice medicine. His methods of treating diabetics, the petition charged, amounted to "gross immorality" and violated the medical practice law [18].

Long before a hearing date set by the Board, Dr. Charles had left the Clinic, never to return as dispenser of diabetic drugs and diets. He sought help for his own pernicious anemia at the Johns Hopkins Hospital and then went to Tennessee for further treatment. Peter stayed on in South Whitley. He closed the Clinic but, in the same abode, pursued a private practice for diabetes sufferers. The nature of this practice was revealed by another undercover investigator, an observing reporter for the Indianapolis Star, who gave the citizens of Indiana a patient's eye view of what went on in the ex-Clinic [19].

Robert Johnson, absolved by a specialist of having diabetes, showed up at the Kaadt establishment as Robert Cook. He told a waitress, who between meals took his personal history, that he had lost ten pounds in six months and that his mouth was dry. A nurse showed him where to put his two-a-day specimens of urine, although he was not questioned for diluting one specimen with tap water, another with shaving lotion. When he inquired as to his condition, a nurse who neither knew nor asked his name quickly responded: "Oh, you're just fine." Nor was he chided for failing to take the prescribed medicine with two of his meals.

Johnson was sent to a rooming house to spend the night. "They only keep those with gangrene or the blind ones at the institute," his landlady told him. His meals were eaten at the main building, where menus contained such sweets—taboo on strict diabetic diets—as ice cream, chocolate cake, and vanilla pudding. The medication beside each plate consisted of black pills and brown pills and a glass of the traditional Kaadt standby, a reddish brown acidy liquid.

"You just see . . . [Dr. Kaadt] once," a nurse told Johnson, "the night before you leave."

Johnson joined other patients outside Kaadt's office.

"Wait your chance," the nurse counseled, "and then just crowd your way in."

"Dr. Pete"—as his staff called him—looked "benevolent" to the reporter. Conservatively dressed, tall and erect, Kaadt had white hair, shell rimmed glasses "nobly large nostrils and a large mouth." His eyes told Johnson nothing but that the doctor was tired—another patient told the reporter that Kaadt had dozed off during their consultation. Kaadt's voice was "hoarse and petulant." After studying the reporter's history sheet and listening to his protest that he did not have diabetes, the doctor said: "You probably have a mild case. You should snap out of it pretty soon if you watch your diet."

Then, despite the pretense of individual prescriptions for individual patients, Kaadt marked a diet sheet for Johnson to conform in every respect with all the others he had marked that day. And even though the reporter's take-home medication was stamped with individual numbers to show that it was only his, the prescription had been secured from the prescription room by a taxi driver in less than five minutes.

For his basic three-day treatment—board, room, medicine at meals, and a short conversation—Dr. Peter charged Johnson $30, plus another $30 for the 90-day supply of medicine taken home. Since patients were then coming and going at the rate of 50 a day, according to a nurse's estimate, Kaadt's daily gross was $3,000. A later calculation presented in court, based on the quantities of raw materials Dr. Peter ordered, placed the monthly gross at $60,000 [20].

At the ex-Clinic, Johnson had met patients from all over the country. Most of them, he felt, rather enjoyed being sick. But this did not excuse Kaadt, who had advised many true diabetics to cut down on their insulin. To patients seriously ill, Johnson wrote in the Star, South Whitley was a "profane Mecca." Diabetics were offering up "this gift of life, their insulin, to the easy glory of a medical entrepreneur."

Charles Kaadt was still in Tennessee when the Indiana Board of Medical Registration met to weigh the charges brought against him by the Indianapolis BBB. His lawyers first sought a postponement of the hearing, then permission for him to resign his license, but in vain. The BBB began to present its witnesses: Kaadt patients who had gone into coma after abandoning insulin for his $30 gallon jugs of vinegar-saltpeter mix—which cost him 90 cents. The evidence proved so incriminating that, before it was all given, Dr. Charles' attorneys threw in the towel. He would consent, they said, to a "cancellation" of his medical license "with prejudice," and would promise never again to practice in Indiana [21].

On the same day as these bearings, the Board began proceedings aimed at canceling the license of Peter Kaadt. Unlike his younger brother, Peter was still at work. Nor did he give in so easily. Peter fought the Board and, when he lost, appealed to a state circuit court and won. The evidence, the judge ruled, was insufficient to convict Peter of "gross immorality" in his medical practice. Thus Peter Kaadt was given a year's grace in which to continue prescribing saltpeter and vinegar, before the Indiana Supreme Court, early in 1948, reversed the circuit court, vindicated the Board, and forbade Peter to practice as physician within the state [22].

"We feel," the Indianapolis Better Business Bureau had charged, "that the case of the Kaadt Diabetic Institute . . . involves by far the largest and most reprehensible operation of its kind in the United States." The denial of the Kaadts' right to practice medicine was an important victory. But was it enough? Officials of the Food and Drug Administration thought not. Armed with court decisions expanding the definition of labeling to make it seem broad enough to cover the Kaadt methods, the FDA had been gathering evidence for many months before the Indiana Supreme Court handed down its decision. Two weeks later, the Kaadt brothers and their Clinic superintendent were indicted on seven counts of violating the 1938 law. The case was tried in Fort Wayne during April 1948 [23].

It was no problem to establish that Kaadt's medicines had crossed state lines. Customers testified to receiving jugs sent from South Whitley, and an FDA inspector introduced in evidence a stack of waybills, with Dr. Charles' name as sender, demonstrating that both medicines and pamphlets-the labeling-had been shipped to various states by railway express [24].

The main task of the United States attorney and his assistants was to persuade the jury that the Kaadt medicines were misbranded, that statements in the pamphlets were false and misleading in suggesting that the medicines possessed efficacy in treating diabetes. In one pamphlet Dr. Charles had offered "real hope" for the "possibility of recovery" through "a treatment, which is free from prolonged or continuous dieting, with internal medicine, taken by mouth, and without the necessity of absence from home, work, or business." The majority of patients, he wrote, resume "a normal diet within two or three weeks." Kaadt's dietary doctrines, according to another leaflet, included the view that "among the things most diabetics have been taught to avoid but which in many cases are beneficial are: ice cream, cakes and pies, milk and cream, all citrus fruits. Honey (clover or buckwheat only). In fact most anything that is made of sugar that has been thoroughly cooked." [25]

That the Kaadts had followed these theories in practice was the burden of many witnesses. The South Whitley waitresses—as the Star reporter had observed—served diabetic patients with sweet desserts. There was even uncooked sugar on the table. Dr. Charles, before his retirement, had reiterated and expanded his dietary notions in lectures to his patients. One diabetic boy of 13, Leonard Schulist, had taken rough notes. At the trial, two years later, Leonard was asked to read the notes to the judge and jury [26].

"Honey is best," he read. "You can use it . . . . You can . . . eat all you want. . . . Boiled sugar is safe . . . . You can drink whiskey. . . . It is good for diabetes . . . . Smoking does not affect diabetics in any way."

"Read it out louder," the boy was asked.

"No beer, positively. . . . Anger is bad for diabetics."

"Anger?" the judge asked.

"Yes," said Leonard, and continued puzzling out his notes. "Never be nervous . . . . All sugar that has been boiled can be eaten by diabetics . . . . Insulin is cause of bloating. . . . Not due to pancreas . . . . Not due to shock. . . . You should always have sugar in urine."

"Read that again," the district attorney said.

"You should always have sugar in urine Leonard complied. "If you don't eat enough, you do still feel hungry, eat more . . . . Don't ever get [a] blood sugar [test], it is dangerous . . . . The less insulin, the better . . . . No can go on diet, can~t be done. . . . It is dangerous . . . . If you have one, throw it away."

Leonard had gone home from the Clinic and thrown his diet away, his mother testified, biting her lips to hold back the tears. He had also, on the advice of one of Dr. Kaadt's nurses, cut down on his insulin. Not long afterward, at a birthday party, the boy had eaten ice cream and cake [27].

"In the morning," Mrs. Schulist said, "I went to call Leonard for school, and he appeared lazy and didn't care to get up."

"What did you do then?" the government attorney asked.

"I thought I would get him a glass of milk, and he began to throw up, and went back to lie down. So I thought I would let him miss school that day, which he never had done before; and in the afternoon he seemed to be more lazy and in a stupor, sort of. And my husband left for work, and he told me to call him if Leonard did not feel well. . . . I told him I would call him, but I didn't call. I saw Leonard was sleeping; I thought he would be all right. He was flushed. I knew something was wrong. I thought, well, I will wait until my husband comes home; he will know what to do."

"What happened then?"

"He began to breathe heavy, and just then, when my husband came, he said, 'Call his doctor.'

"I said no, no, because he is taking this treatment he is supposed to have some kind of reaction.

"He said, 'Take the urine test,' which I did. I got the solution which was given me [at the Kaadt Institute]. I said, 'It doesn't show anything. It is just like the urine would be if I didn't put anything in it.'"

"He said, 'Put more solution,' which I did; he said, 'Put more urine in.' I did that. It didn't show anything."

"He said, 'Take the regular test.' So I took the Benedict and Clini-Test. They both showed he had an awful lot of sugar in his urine."

"Was Leonard taken to the hospital?" the district attorney asked.

"Around one o'clock at night we called the ambulance, took him to the hospital immediately."

"Is Leonard taking the Kaadt treatment today?"

"No."

"Is he taking insulin today?"

"Yes, sir."

"How is be getting along today?"

"Wonderful. He is growing fast. He is brilliant in school."

Leonard's physician, Dr. William Lefevre, affirmed that it had been diabetic coma that had brought the boy unconscious to the hospital, that with the resumption of insulin and proper diet Leonard's diabetes was under good control. The doctor did not speculate on the damage that had been done during Leonard's lapse from the proper regimen [28].

Dr. Lefevre was but one of a number of medical specialists, testifying for the government, who stressed that the abandonment of proper treatment was the most hazardous feature of the Kaadt advice. Dr. Henry T. Ricketts, head of the diabetes clinic at the University of Chicago, described for the jury in layman's language the disastrous chain of events unloosed when injections of insulin were stopped or reduced below the needed amount. Without insulin, he said, the diabetic cannot derive nourishment from any food containing sugar or starch. The sugar in the blood rises higher and higher and finally "spills over into the urine, like water going over a dam." Since the body cannot use starches and sugars, it must rely for heat and energy on proteins and fats. This is the reason that rapid weight loss is a symptom of diabetes. Eventually the breakdown of fats exceeds the body's ability to handle it. Acid byproducts, especially diacetic acid and acetone, build up in the blood faster than they can be excreted through the urine. These acids, Dr. Ricketts testified, "are toxic; they poison the tissues of the body, and particularly the tissues of the brain; and the liver, and the kidneys." The diabetic patient "develops shortness of breath; he gets nauseated, be vomits; he becomes very dehydrated; he excretes large volumes of urine . . . ; and he goes into a stupor, and the stupor deepens into coma. Unless he is given insulin, he dies." [29]

Some diabetics, especially older people, Dr. Ricketts stated, can control their disease by careful dieting without insulin. But if they break the taboos, they confront great danger. The hazard of a coma is always present, and less dramatic long-range complications—infections, cataracts, hemorrhages in the retina of the eye, deterioration of the entire vascular system—are certain to develop [30].

The venerable Elliott Proctor Joslin of Boston, the nation's leading authority on diabetes, made the same point. A slight, balding man of great dignity, Dr. Joslin stood on the witness stand for two hours as he discussed the disease to which he had devoted half a century of research. Diet, exercise, and insulin, he said, were the proper treatment, and he added, "To say one word against following treatment straight through to the end, that is terrible; that is terrible." [31]

The Kaadts had gone further at South Whitley than to discredit the orthodox treatment for diabetes. For this treatment they had substituted Dr. Charles' medication. Government witnesses explained the irrelevance, the positive harmfulness, of the Kaadt approach.

What patients had taken home with them from the Clinic, Food and Drug chemists testified, were four things [32]. One was a ferric chloride solution for testing diacetic acid in urine. If the patient showed diacetic acid, Dr. Ricketts was asked, did that mean his diabetes was at a dangerous stage? [33]

"Yes, decidedly so," the physician answered. "It is the stage just before coma."

Could a patient—like Leonard Schulist—be a severe diabetic and not necessarily reveal diacetic acid at the time of using the Kaadt test solution?

"That is true. If people have disease of the kidneys it may be the urine will not contain diacetic acid, even though the blood contains large amounts."

The second item on the Kaadt prescription list was a vegetable laxative pill, the third an enzyme "Digestive Tablet." Neither would help the diabetic, government witnesses said, and overuse of laxatives was a hazard in itself [34].

Last and central in the Kaadt therapy was the liquid Dr. Charles had relied on for more than a score years, now slightly changed. A starch-digesting enzyme had been added, but to FDA chemists the $30 gallon jug consisted essentially of vinegar and saltpeter. Indeed, all digestive power of the enzyme was destroyed by the acid in the jug before it reached the stomach [35].

As a treatment for diabetes, the government experts agreed, the Kaadt concoction was "of absolutely no value." Vinegar had no therapeutic purpose, testified an Indiana University biochemist, R.N. Harger, and saltpeter was the only active drug in an "incompatible" mixture. Even saltpeter, long used as a diuretic, had been dropped from that "druggists' and doctors' bible," the Pharmacopeia, as "practically valueless." There were positive hazards to its overuse, including "distress of the stomach and intestines .... irritation of the kidneys . . . , changes in the blood—, giddiness and nausea, and irregular heart action." Taking the Kaadt mixture as directed, Dr. Harger asserted, could well lead to a considerable overdose, In fact, the biochemist concluded, the whole Kaadt therapeutic system was "perfectly ridiculous." [36]

This same judgment was expressed by Dr. Barach of Pittsburgh, who had earlier raised the alarm in the JAMA. Nothing in the Kaadt treatment could help the diabetic state. "I would vouch for every member of our association," he added, " one thousand specialists in diabetes, that they would confirm what I have said." [37]

The government sought to establish that, despite the Kaadt avowal of individual prescriptions for each patient according to his need, each customer got the same kind of jug of vinegar and saltpeter mixed by guesswork in the same big barrel in the basement. Nor did Dr. Charles or Dr. Peter know many exact details about the ailments of their patients. A brief medical history, often taken by an unskilled employee, several urinalyses, a short conversation, did not add up to the "thorough examination" claimed in Kaadt promotion. Dr. Charles, indeed, had sometimes been curt [38].

"When I got in there to Dr. Charles," one woman testified, "I tried to talk to him about my condition. He didn't talk at all about diabetes, or anything. He talked about his trip to Florida in an airplane." [39]

Case history testimony the prosecution presented with telling effect. Besides the sad tale of Leonard Schulist, government witnesses described for the jury, in all their shocking details, five other encounters between diabetic patients and the Kaadts, One witness, Eleanor Swanson, had, at the age of eight, forsaken for three years her doctor to place reliance in the Kaadts. She gave up insulin, ate pie and cake, and made nine trips from Cedar, Michigan, to South Whitley. Disaster came in the form of diabetic cataracts. Six operations had been required to remove the lenses from Eleanor's eyes. At point in the testimony, she took off her thick glasses while district attorney held up a glasses case 12 feet away. Eleanor could not see it; she could see the lawyer himself only as a vague outline. Never without her glasses, Eleanor's doctor testified, would the 14-year-old girl be able to see again. Never, he added, had he seen cataracts develop in a juvenile diabetic who was faithful to proper treatment."

Two of the prosecution "witnesses" against the Kaats were not present in Fort Wayne to testify, for they were dead. Their widow and widower spoke for them [41].

Satisfied users who took the witness stand in defense of the Kaadts lacked the effectiveness of the prosecution's "injury" witnesses like Eleanor Swanson. They had no doctors to bolster their own assertions of remarkable recovery. And during cross-examination their evidence sometimes came close to backfiring. A retired furniture salesman credited the Kaaat treatment with improving his eyesight. "I always had used glasses," he said. "I can read and write without them now." But when a government attorney held objects 15, 10, and 5 feet from the salesman, he could not tell what they were. Another defense witness, a checking clerk in an automobile plant, credited $300 worth of Kaadt's medicine for his recovery from an aggravated diabetic state. "I haven't an ache or a pain," he said, "feel perfect." But a company doctor took the stand to show the jury a urine test given that very afternoon, revealing a four-plus urine sugar reading, dangerously high. The clerk's eye symptoms, moreover, were so suspicious, the doctor had already made an appointment with an eye specialist [42].

None of the three medical witnesses presented by the defense was a diabetes expert. Neither, of course, was Dr. Peter Kaadt, and his testimony in his own behalf was one of the high points of the case. Dr. Charles sat the trial through, a small scrawny man, showing little interest in what went on, now and then placidly dozing. He had been very sick, be told a reporter, and could remember hardly anything [43].

Dr. Peter spent hours in the witness chair. Tall, broadshouldered, and erect, he sat with his glasses perched on his forehead, and answered questions in a slow, low, patient voice, constantly stroking his chin with the index finger of his left hand [44].

When he took charge at South Whitley, Peter Kaadt said, he had eliminated some of his brother's practices with which he did not agree. He had ended the Clinic and engaged only in private practice. He had dispensed medicine only by individual prescriptions, and, unlike earlier procedure, had kept a file of prescriptions written. He had stopped prescribing by mail, accepting bed patients, and treating children. He had destroyed thousands of pamphlets, not because they were illegal, but because he "didn't like them from an ethical standpoint." He had played down the diacetic acid test, opposed alcoholic drinks, and treated insulin with more respect than had his brother.

Still and all, Dr. Peter believed in the efficacy of the therapeutic system which Dr. Charles had developed. He would not flatly call it a "cure" for diabetes. "I have had patients," he told the judge, "who were apparently cured for three years after I had treated them. Now, whether you call that a cure, or not, I don't know."

Had he ever told a patient he could cure diabetes?

"Absolutely never; no; that is not an ethical thing. No honest physician would do that."

Dr. Peter's theory of diabetes was that the disease was "of nervous origin, because the sympathetic nervous system controls all of the secreting glands of the body."

"It can follow shock," he elaborated, "it can follow injuries; sorrow; people that have financial difficulties, or family troubles.... It is not only the pancreas, it is all of the glands of the body. The pituitary is invariably a factor. . . . Then, as I say, the thyroid gland, the adrenal glands, the sex glands, they are all involved.

"Now, when you have anything that causes a depressed condition through the sympathetic nervous system, all of the secretions are retarded, not only the islands of Langerhans, all the secretions of the liver, or the stomach, or the intestines, and the pancreas."

What it all seemed to boil down to came out in the cross-examination.

"Will you state," Dr. Peter was asked, "whether or not it is your belief diabetes is due to poor digestion and if you treat the patient for digestion you can restore him to health?"

"That has been my experience," he answered. "It is not only a deficiency of insulin; it is a deficiency of all the digestive secretions."

Both the acetic acid in the vinegar and the saltpeter, Peter Kaadt asserted, reinvigorated the digestive process by stimulating glandular secretions, although he admitted it was "rather difficult to explain how. Most diabetics, he insisted, lacked hydrochloric acid in their stomachs, and the acetic acid could serve the same function of sparking "those alkaline glands that empty into the duodenum." The saltpeter, containing potassium, also replaced a deficiency in the body's potassium suffered by diabetic patients taking insulin. It performed this therapeutic function, Dr. Peter insisted, without harm. I have never seen potassium nitrate have any poisonous effect," he said.

The standard treatment for diabetes was wrong, Peter Kaadt charged, the weighing of diets, the daily testing of urine. "And what does that do to the patient? It keeps them depressed. That is what we don't want to do. I tell my patients, 'Don't weigh your diet.' I don't even want them to examine their urine every day, by golly. I tell them I would rather they didn't do it at all, but if they want to do it every couple of weeks or so, that is sufficient."

Such were the incredible medical views of Dr. Peter Kaadt, who considered himself an expert on diabetes but thought it "questionable" that Elliott Proctor Joslin was. The prosecution's cross-examination was merciless. Peter was forced to admit that he was a member of no medical society, that, indeed, his license to practice had been revoked. He had written no paper on diabetes, performed no animal or clinical research. Ideas presented in his direct examination, he had to agree, conflicted with ideas expressed at the Post Office hearing and in his testimony before the state medical board. Claiming expertness in diabetes, he could not define some of the elementary terms. He did not know how many calories there were in a gram of carbohydrate, or in a gram of protein, or in a gram of fat. "Oh, we don't pay much attention to calories," he testified. "I don't think that is of any consequence." He admitted he did not know how to make a blood sugar test, or a glucose tolerance test, or a test for basal metabolism.

It was a devastating performance, and Peter Kaadt left the witness stand, wrote a reporter, "apparently near breakdown." [45]

In the summing up, a defense attorney called the Kaadt brothers "modern-day Christopher Columbuses," and compared them with history's misunderstood scientists—Lister expelled from the London medical society, Pasteur stoned in the streets of Paris. A more apt comparison, replied a district attorney, was with the witch doctor. The monuments erected to the Kaadts, he said, were "all in the form of tomb stones." "Christopher Columbus," another government lawyer observed, "didn't lose his sailing license for gross immorality in sailing a ship." And bitter reference was made to $30 a jug and 30 pieces of silver [46].

The jury found the three defendants guilty on all counts, recommending leniency for the Clinic superintendent. A mistrial had been narrowly averted only because the foreman, suffering an attack of angina, bravely remained at duty until the jury agreed. When the verdict was read, the Kaadt brothers "sat as if dazed, unbelieving." Peter "half rose from his chair, then slumped back again." [47]

The sentencing came three weeks later. Charles Kaadt walked into the courtroom, but Peter, who had suffered several heart attacks since the trial, was wheeled in on a hospital cot, where he lay motionless under a pink spread. "These men . . . " their lawyer pleaded, "have reached the winter of life, if not the closing days of life. They have no previous conviction and if ever defendants deserved the utmost consideration, I submit, Your Honor, it is these men." [48]

Judge Patrick T. Stone—who had also presided over the Marmola trial—was not completely unmoved, but he remembered other unfortunates who had appeared in the courtroom during the trial.

"It has taken years of effort on the part of the United States Attorney and the Food and Drug Department," he said, "to bring you defendants to the bar of justice, to answer for your crimes. The proof submitted to the jury as to your guilt was overwhelming. I am satisfied that for many years you have engaged on a wide scale in a sordid, an evil and a vicious enterprise, without the slightest regard or consideration for the patients that consulted you, seeking relief from diabetes. These patients were innocent and hopeful, but so gullible. They poured out to you their savings, hoping and believing that you would cure them of their ailment [49].

"And the striking thing about it is that all the time these defendants operated this institution they knew there was no cure for diabetes; they knew the only treatment for diabetes was insulin and a restricted diet, free from sugar. Yet, notwithstanding that knowledge, in their avarice and greed for wealth, they wrongfully advised these trustful patients, and, as a result, they suffered permanent damage and injury, and some have gone to an early grave.

"You have brought disrepute to your profession, disgrace and dishonor to you and your family. . .

"If these men were younger men, I would not hesitate to impose the maximum sentences possible in this case. I shall give to them something they withheld from their patients, that is, just a little human consideration for their condition of health."

So, instead of the seven-year sentences they might have received, Charles and Peter Kaadt were each fined $7,000 and sent to prison for four years. It was indeed the winter of Dr. Peter's life. Released because of illness before his prison term was over, he died in 1951. Dr. Charles served out his term and died in 1957. An effort by Peter's wife to continue a surreptitious distribution of the medicine was cut short by her accidental asphyxiation in a motel. Even to the end Kaadt disciples had been pitifully faithful to the infamous vinegar-saltpeter mix [50].

References

  1. Judge Patrick T. Stone while sentencing in the district court, Transcript of Record in the United States Circuit Court of Appeals for the Seventh Circuit, No. 9617, The United States of America, Plaintiff-Appellee, vs. Dr. Charles F. Kaadt, Defendant-Appellant, No. 9618, The United States of America, Plaintiff-Appellee, vs. Dr. Peter S. Kaadt, Defendant-Appellant; Appeals from the District Court of the United States for the Northern District of Indiana, Fort Wayne Division (Indianapolis [1948], 725-26.
  2. Thomas B. Futcher, "Diabetes Mellitus," in William Osler, ed., Modern Medicine: Its Theory and Practice (Phila., 1907), 789-96, quotation at 794; Howard F. Root, "Prognosis in idiopathic Diabetes Mellitus," in Robert H. Williams, ed., Diabetes (N.Y., 1960), 645-46; N&Q, I 459.
  3. Indianapolis Better Business Bureau Bulletin, 19 (Mar. 1947) and 20 (Feb. 1948), in Kaadt file, AMA Dept. of Investigation; Transcript qf Record, 628; JAMA, 97 (1931), 479.
  4. Cited in ibid.
  5. Ibid.
  6. Ibid.; information furnished by the Post Office Dept.; FDA file, Interstate Office Seizure No. 19-331H, FDA Records, RG 88, Federal Record Center, Alexandria. An ad appeared in the Pathfinder, Oct. 3, 1936.
  7. Indianapolis BBB Bull., Mar. 1947.
  8. Information furnished by Post Office Dept.
  9. N&Q, 11, 183-84; in, 42, 44; Cramp, "Some Diabetes 'Cures' and 'Treatments,"' Hygeia, 13 (1935), 916-20.
  10. JAMA, 97 (1931), 479.
  11. Kaadt pamphlet, Of Great Interest to Diabetics, in FDA file, Interstate Office Seizure No. 19-331H; information furnished by the Post Office Dept.
  12. Ibid.; the stipulation date was June 20, 1938. Biographical data on Peter Kaadt, Transcript of Record, 593-96, 635, 667.
  13. Information furnished by the Post Office Dept.
  14. Ibid.
  15. Ibid.; Indianapolis BBB Bull., Mar. 1947.
  16. Ibid.; Transcript of Record, 595.
  17. JAMA, 131 (1946), 251; Indianapolis BBB Bull., Mar. 1947.
  18. Ibid.
  19. Transcript of Record, 597-98, The Star series of seven articles appeared Sep. 10-16, 1946.
  20. The $60,000 estimate was made by the district attorney in his summing up at the trial. Indianapolis Star, Apr. 15, 1948.
  21. Indianapolis BBB Bull., Mar. 1947.
  22. Ibid., Mar. 1947 and Feb. 1948; Indianapolis Star, Mar. 28, 1947.
  23. Indianapolis BBB Bull., Mar. 1947; FDA file, Interstate Office Seizure No. 19-33111; Transcript of Record, 1-28 (the indictment). The dates of the trial were April 5-14.
  24. Transcript of Record, 45, 94-95, 105, 132-33.
  25. Of Great Interest to Diabetics; Transcript of Record, 5-12.
  26. Ibid., 103, 134, and (for Leonard's testimony) 397-98.
  27. Indianapolis Star, Apr. 9, 1948; Transcript of Testimony, 391-92.
  28. Ibid., 377.
  29. Ibid., 325-26, 331-32.
  30. Ibid., 330-34.
  31. Ibid., 421-51; Ft. Wayne Journal-Gazette, Apr. 9, 1948.
  32. Testimony on FDA chemical tests, Transcript of Record, 171-230.
  33. Ibid., 328.
  34. Ibid., 176, 221, 242-43,
  35. Ibid., 174, 180-81, 218.
  36. Ibid,, 232-34, 238, 241, 26-2.
  37. Ibid., 404,
  38. Ibid., 57, 93, 109, 147, 151.
  39. Ibid., 119.
  40. Ibid., 293-94, 297; Indianapolis Star, Apr. 8, 1948.
  41. Transcript of Record, 353-55, 312-17, 321-25.
  42. Ibid., 459, 467, 479-92, 701-705; Ft. Wayne Journal-Gazette, Apr. 9, 1948.
  43. Transcript of Record, 530-58, 575-89; Ft. Wayne News Sentinel, Apr. 13, 1948.
  44. Ibid.; Indianapolis Star, Apr. 13, 1948; Peter Kaadt's testimony in Transcript of Record, 593-679.
  45. Indianapolis Star, Apr. 14, 1948.
  46. Ibid., Apr. 15, 1948.
  47. Transcript of Record, 720-21; Indianapolis Star, Apr. 15, 1948.
  48. Ft. Wayne News Sentinel, May 4, 1948; Transcript of Record, 725.
  49. Ibid., 725-26.
  50. Ibid., 726-27; DDNJ 2578; Indianapolis Star, Feb. 8, 10, 24, 1949; FDA file, Interstate Office Seizure No. 19-331H; Ft. Wayne Journal-Gazette, Dec. 27, 1948; Oliver Field, AMA, to author, Jan. 5, 1961. The Kaadts had appealed the district court verdict and lost in the circuit court. U.S. v. Dr. Charles F. Kaadt and Dr. Peter S. Kaadt, 171 Fed. (2d) 600, in Kleinfeld and Dunn, Judicial and Administrative Record, 1938-1949, 388-93.
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