When the court outcome was sterilization for the individual in question, the court ruling could be appealed to the Higher Hereditary Health Court (also known as Hereditary Health Supreme Court).[1] Dr. Karl Astel was in charge of the Hereditary Health Supreme Court from 1934 to 1937.[2] The Hereditary Health Courts were responsible for the sterilization of 400,000 persons in less than a decade of operation.[3]