' • 4 23 54 DRAFT MEMO - TO MOHSE SALISBURY SUBJECT CHRONOLOOY _Qr Ai '1ERJ CAN OFFERS OF I'- EDICAL A9 S IS'l'ANCE IN RE Jf PANESE FISHERMEN -·· -------- 1 Following newspaper reports of injury to Japanese fishermen Dr Bugher telephoned Dr John Morton Director Atomic Bomb Casualty Commission in Japan requesting that he proceed to Tokyo detennine such facts as he could and offer facilities and services of the staff of the ABCC Dr Bugher talked to Norton by long distance NON-CCRP phone on March 16 and March 19 CLASSIFICATION CANCELLED iL SlA BY AUTHORITY OF voeC#' BY Q _ __ TE svi t 2 ' - 7l iV Ilj g J TE 3- On March 17 Morton cabled Bugher - d Tsuzuki contacted 1 g-zz He invited our assistanc e STOP ABCC medical team will arrive Tokyo on Thursday March 18 American Embassy informed of these plansy ½orton t u r n to Tokyo from Hiroshima with this team DOE ARCHIV Next information was sent March 21 A cable from Morton in Tokyo giving average white c o n Toky f tients and patie at Yaizu Average white count on afil patients Tok-Jo 6133 7000 f s s r--------- s -zs n zs- oC 5 1 3' ' ' rs DGE ARCl P 'ES • _ As of March 14 Counts on March 17 Tokyo __ - _ M'qt r-y ' L' l 1 n snRf H APPL liL U • U t1- - 2 - patients 4400 mi J 1 i while Yaizu patients 7358 within nonnal Japanese limits Differential counts This teletype contains statement Tsuzuki judgment patients improving STOP Note obviously none of these counts were critical 4 Dispatch from A mbassador Allison dated March 17 contains the following I informed Okumura that in response to invitation from Tokyo University Hospital1 ABCC sending team of three American and three Japanese doctors to Tokyo to consult in treating injured fishermen 11 S March 18 - Ambassador Allison's message contains following statement Item S Cooperation to date has been complete regarding direct medical treatment reserved regarding scientific and technical withheld re custody or transfer of ship 6 Oispatch from Ambassador Allison March 19 contains following A- Ambassado tf call¢p on Vice Foreign ·1inister March 17 to offer medical assistance well received and has given weight to government's confident assertion that US can be expected to do the right thing DOE ARCHlVE' 3 - 3 - 7 March 19 report from Ambassador Allison states Ambassador's meeting with Okasaki treated favorably U s offers of medical aid and co- operation in decontamination and investigation appear well received 8 March 19 vernacular press featured news of investigations and arrival of Dr Morton and ABCC group from Hiroshima but stories appear on local news page rather than monopolizing front page Press demanded 9 Yomiuri speculates on rivalry between Japanese and American scientists Japanese scientists reported to fear A erican scientists will use them as mere gatherers of information meanwhile refusing to give essential bomb scientific facts o f type necessary for treatment of injured Uote by B M staff Details about bomb type not essential for treat• • - fl ' I r Lt'r r r ' q '- A ' t 't - I' '-1 ment of inJured ' r 1 · 0 ry-l ' p i _f 10 '-V - ' rh_ rc r I f C Z r Dispatch Harch 19 from Allison contains the following item ✓ orton vessel and Meek flying to Yaizu to inspect hospitalized sailors and Preliminary reports ABCC doctors indicate degree injury suffered may be less than Press has reported Should have better indication nature incident on their return Tokyo 1- arch 21 Also - 4- report states believe it highly important US-Japanese relations we appear as solicitous re Japanese as re South Sea islanders 11 Dispatch March 19 contains the text of the E -nbassy 1 s press re- lease put out 6 IM Friday March 19 I have been pleased to learn of the prompt action which is being taken by'both Japanese and A erican authorities to provide the most effective possible medical and technical assistance to those affected by the accident which befell the Fukuryu Maru This assistance is being offered out of humanitarian concern for the injured crew rrembers and concern for the public safety I wish to renew the assurance already given that US civilian and military personnel and facilities in Japan are available to give the greatest possible degree of assistance to the Japanese authorities who have already shown themselves alert and vigorous in dealing with the problem Our joint investigations of the incident az e already well under way and will I believe lead to findings which we can both accept In advance of those findings I am authorized to make clear that the US is prepared to take such steps as may be necessary to insure fair and just compensation if the facts so warrant n The foregoins was read to Vice Minister Om'llura who expressed gratification and belj_eved statement would have very helpful effect l OE ARCHiVE5- - 5- 12 Dispatch dated March 20 from Allison returned from Yaizu inspection today and ship Dr Morton Colonel Meek Examined hospitalized patients Preliminary report indicates some of Yaizu patients more seriously injured than two patients previously removed to Tokyo We may wish to recommend to Japanese transfer entire group Tokyo University Hospital FEC will cooperate in providing facilities Later information suggestsnthat this recornm ndatiP n which was indeed made c vl 11'6 If -- a Ii- --4 't J antagonized Yaizu doctors which may have played an important part in later deterioration of relations with Dr Morton's group This dispatch also contains the following estimat the minimum total body radiation dose acquired by boat person elWas approximately A 50 Roentgens 13 March 21 dispatch contains following request from Allison Recom nend that I be authorized to inform Foreign Hinister that without prejudice to question of responsibility for accident US Government will imr lediately assume full responsibility for medical expenses of injured a d will pay fishermen's wages while they remain hospitalized with perhaps solatium to their families in accordance with Japanese custom nor ARC- _i l r s _ - - - 6 - 14 March 22 dispatch from Allison quotes Okasaki as saying early indication from US Government that it would at least be responsible financially medical care of fishermen and relief to their families would have great favorable effect US action along these 15 March The Embassy again urges prompt lines 22 dispatch from Allison states Japanese Government has not yet authorized movement patients from Yaizu Accordingly only two patients in Tokyo available for examination Reviewed xtt blood studies on all cases today 16 March 23 Not surnmarized yet Message from Allison states Morton and ABCC physicians have only limited access to the Hospital two patients at Tokyo University Have not been permitted to make independent blood counts analyses etc or to take full case histories The 21 patients have not been moved from Yaizu go to Tokyo Tne excuse is that some are reluctant to al Japanese Foreign Office informs us privately re diffi- culty is with hospital officials patients DOE ARCHIVES Yaizu authorities want to retain Tokyo doctors and bureaucrats cannot agree whether Tokyo U - 7- or National Health Institute should have custody Press stories continue allegations US wishes to obtain ship to destroy the evidence and interest in patients only as guinea pigs at t _ t • Note 21 f patients left in provincial hospital at Yaizu and denied S aid while 1 0'1L- v-c r T r t r J pxtiem Japanese doctors argue over prescriptive right to Dr Tsuzuki of Tokyo University predicted to the Diet yesterday that two patients would die 17 Called Japan a victimized country Dispatch dated March 24 from Allison states Morton's effectiveness handicapped by poor cooperation of Japanese two fishermen may Statement by Tsuzuki that die inconsistent with facts available to Morton Tsuzuki's motivations not clear but further direct com 1U nication from AEC not advisable for time being 18 Dispatch dated March 24 includes suggestions made by Allison to Okasaki that there be full access to ill crewmen for US technicians among other things A central authority for review and control of reports to be published was another item l OE ARC --I VES - 8 - 19 Dispatch dated March 24 care and treatment of patients Refers to morning meeting - discussed Attended on Japanese side by 12 representatives ministries Foreign Affairs Welfare Education National Health Institute Scientific Institute Tokyo University On US side Embassy Eisenbud for AEC Horton for ABCC Colonels MacNinch and Marx for FEC Hanna for USIS Japanese requested fullest possible information re constituents explosion seemed fairly satisfied with Eisenbud 1 s general staterrents Probably will move Yaizu patients to Tokyo March 26 when their arrangements coordinated Pro nised ash sample from Fukuryu Maru and 24 hrs urine output all patients Japanese side favorably impressed Eisenbud 1 s competence and presentations tion Conu1tl ttee Japanese have formed Atomic Bomb Injury Investiga- hereafter will be referred to as ABIIC under Kobayashi of National Health Institute to coordinate investigations and liaison through Foreign office more relaxed and cordial Atmosphere afternoon meeting considerably Heeting opened by presentation by Kobayashi to Eisenbud of ash sample requested in mornir g Attribute much of cooperation at this level to excellent impression made by Eisenbud DDE ARCHIVE - 9 - 20 11 Dispatch same date to Bugher from Eisenbud includes request Japanese want benefit of American clinical experience with EDTA Please have prepared a concise StUllr lary of progress with this and other agents for mobilizing bone seekers and can do this if you wish Albert is up to date Today obtained Japanese assurance that urine samples from all sailors will be made available tomor1 w They apparently have been unsuccessful in their o m radio-chemical analyses despite press releases to the contrary I promised Japanese a report o n composition of ash in one week Japanese will want benefit of our estimate of internal dose based on analyses Please obtain summary of stateside experience with skin deconta1nination and mdl to Embassy Morton unable to examine patients has had very limited access to data Formation of new Japanese co J littee offers prospects for a better relationship in next day or so 21 Dispatch dated - arch 25 Japanese governrrent not yet decided form and amounts financial assistcnce fishermen and families As of yesterday both patients Tokyo U hospital felt well White count on one had fallen from 6 000 earlier in week to 3600 Other stationary - 10 - at 4600 but complained of pain around head ulceration reports 21 patients at Yaizu were okay Tsuzuki Information refers acute radiation effects only B M stai'f assumes this means external whole US experts have no lmowledge regarding internal body irradiation emitters or absorption radioactive materials Eisenbud is acquainting Japanese scientists with unclassified fa cts regarding general nature air water atmospheric contamination 22 March 27 dispatch identifies air special delivery confidential package as being on way to NYOO presumably contains fallout material and or urine specimens 23 Dispatch Harch 27 Eisen bud Kobayashi Chairman of the ABIIC two Tokyo patients left this date 1- orton and I conferred i th hr 24-urine analyses from each of Instruct Harley undertake analyses irr JrEdiately for total fission product activity and principal individual fission products Tsuzuki leaves Japan next week for Geneva via India In private talk he told me he was avoiding US for fear visa difficulties Embassy officials indicate this unlikely visit US Urges Tsuzuki ce invited to Effibassy officials concur in this nr •- RCHIVES _ Gi - 11 - 24 March 27 Bugher from Morton Two Tokyo patients almost com- pletely worked up by American standards were both improving Note Last seen by us I-larch 25 and Morton does not use word examined Blood counts up no constitutional complaints or reactions Prognosis should be guarded until urine analytical tests completed by you patients seen March 26 Yaizu All day trip no exarninations but patients visited i e seen but not examined None appeared ill all ambulatcry One patient ·with no complaints shows enlarged tonsils and pharyngeal pustules Will try to watch able to us Patients supposedly being air transported arch 28 to Tokyo hospitals doctors Cooperation promised again today knt xi by top Japanese Hope it materializes circumstances Up to now cooperation difficult 25 r-- essage March 27 Eisenbud this week Very difficult to study under present Will do our best to finish examinations all patients this coming week improving No new hematological Yaizu data avail- Cooperation Japanese physicians Horton ·will probably have full access to all patients -12 - 26 March 28 Allison to State Department Interest Eisenbud Horton and Embassy now concentrated on problem of full access to crevnnen as their rr edical histories of major importance At Japanese request FEC is flying remaining 21 crewmen from Yaizu to Tokyo today We are cur- rently working both at scientific and government level to remove obstacles thorough which have thus far made it impossible to conduct examinations Okumura yesterday appeared not to have realized failure of scientists and lower officials cooperate as promised He agreed full access was both proper and reasonable and I would expect him to take this position in interdepartmental vice ministers committee Eisenbud and Morton now more optimistic that their contacts will make necessary examinations key possible early next week Until problem of access to patients is solved I do not wish to commit us further on compensation question as it may be neces a -ry to take position that amount and na ure of compensa- 1 tion cannot be authori P-d under American practice until erican experts had a chance to make their own findings 27 March 29 Allison to Bugher Tokyo morning 28 tfarch lb Patients arrived by army plane 1 Admitted Tokyo and tc national hospitals Waiting official permission Japanese authorities to complete examination DOE ARCHIV DPAFT • DUNHAM rme 4 23 54 - 13 28 March 30 tomorrow in Tokyo my Allison to Bugher - I have asked Eisenbud participate regular off-record briefing of U s press representatives They have strongly urged his appearance on grounds Japanese officials and scientists have been issuing continual series inflammatory and inaccurate statements regarding Fukurya Maru incident and they lack background for appraisal 29 March 30 Allison to Bugher - I saw Okazaki this morning immediately before Cabinet meeting and set forth serious effects continued failure of cooperation may have both for critically ill FM sailors and for medical and scientific knowledge useful to both countries Okazaki promised to do his best Okazaki telephoned this evening to say A Eisenbud and Morton will have full access to patients beginning tomorrow Arrangements should be made by them directly with directors of hospitals concerned He thought everything would be adjusted to their satisfaction but if there were any slip he Okazaki should be informed immediately B No tests have been made on patients yesterday because of their extreme nervousness After day rest tests will begin C At meeting April 2 findings of all participating doctors and technicians will be reviewed Dr Morton and Eisenbud are specifically invited attend No reports regarding patients available to us today One measure government's and our difficulty is fact that examination and treatment of the seven patients hospitalized at Tokyo University have been divided among four independent medical services Okazaki 1 s intervention with Minister Welfare -14 may have at last brought some order to medical and scientific confusion which has existed here since FM docked March 14 If he has succeeded he deserves full marks 30 March 30 Allison to Bugher - Arrangements made by Okazaki failed to provide facilities required for examination patients At Tol yo University Hospital no official could be found able authorize access At Dai Ichi Hospital Director National Institute of liealth was uninstructed and after telephone call to Ministry Welfare reported latter uninforned regarding Foreign Office arrangements This afternoon Dr Tszuki called in Dr Morton urged him not to insist on seeing patients ho were highly disturbed by confinement I• etrcpolitan Hospital and alarmed by examinations of any doctors except those hom they knew Even strange Japanese doctors were not learned and this applied to non-Caucasians on ABCC staff Dr Horton replied in circumstances he ould respect 1 li hes doctors and their patients and ould return to Hiroshima He and staff would come back to Tol yo whenever their services were desired I sent Okazaki letter at Diet today reciting these facts and concluding ttat unless Japanese authorities changed their rrd nds and unless invitations irsued tomorrow to Dr Morton and staff to conduct whatever eY arr nations their professional judgment considers necessary they would be returned to Hiroshima Furtter to correct misinterpretations some public explanation 1- ould probably be unavoidable Inforr ed advices regar_din9 _p jient § today Biology and l edicine staff uncertain where the inforrr ed dvice came f rom indicate blood counts three A - lS remain dangerously low yesterday's 800 one at 2100 one at 1700 and one at 1500 today from Tsuzuki reported last of these showed increased coagulation time and complained of not feeling well These three patients plus two original patients at Tokyo receive 100-JOO cc transfusions daily lowest blood count patient additionally given 600 000 units penicillin daily At this point full and free access to patients for ABCC staff seems to us on basis Eisencud and orton advice irreducible U S interest Data possibly derivable from these patients and available nowhere else may have highest importance U s scientific security and planning Request Department and AEC evaluation this point I would be prepared to go to Yoshida and put case for immediate cooperation on following lines A Continued decline of white blood counts as reported informally by Japanese physicians to Dr4 Morton indicates need for prorr t application of best available techniques and therapeutic procedures B Future well-being of FH sailors is being handicapped because Japanese physicians have not chosen to consult with Dr rt orton•s staff C Extent to hi ch government will accept liability for this unfortunate accident will depend on extent to which in our judgment best available medical techniques have been applied D Japanese goverrur ent has moral responsibility to assure patients every opportunity to regain health E A friendly attitude towards the U S requires our gover mnent be given every opportunity to minimize its potential liability by utilization of American-trained medical scientists on staff of ABCC F Potential findings of importance to national interests both countries - 16 31 March 31 Allison to Bugher - Please cable your advice as to type therapy t iae radiation injuries any new Cable urgent within six hours 32 April 1 Eisenbud to Bugher - Okazaki•s secretary telephoned late last night to say Foreign Minister seriously concerned by situation my letter reported and asking to persuade Dr Morton to stay on This morning I telephoned again report Foreign Y inister had personally persuaded l' inister elfare to authorize access to patients for r s doctors Officials Foreign Office and Welfare would escort doctors to hospital Dr - orton and staff spent afternoon in antechamber Dai I chi Hospital while officials discussed question and Japanese doctors insisted patients too nervous to undergo examinations Morton repeatedly offered to withdraw Final resolutioh late in afternoon was that patients should vote whether they wished to be examined tomorrow '1- j_ th This will be preceded by discussion among themselves balloting scheduled ttprobably tomorrow night Dr Morton will be proThptly informed of results Patients at Tokyo Hospital generally same Patient with hite blood count 800 two days ago now 1000 ones at 1700 and 2100 statimary 1hen temperatures rise they begin experience few subjective complaints Staff dbctor believes one may be bleeding into central nervous system but has no objective evidence plans tap tonight Less than five of sixteen patients at Dai Ichi Hospital reported with white blood count under 4 ooo No other information available l1 - 17 - 33 April 2 Allison to Bugher - No developments of substance during day from Japanese side and no change in their failure authorize access to patients Okazaki sent Prime Minister who is still recuperating at Oiso urgent personal letter recapitulating background of unsatisfactory situation I have also discussed letter and iJr lications this evening with his daughter who is perhaps her father's closest and most influential adviser 34 April over weekend Allison to Bugher - No developments re access to patients Japanese doctors inform us patients still discussing whether they wish examination by foreign doctors Have not yet voted but have sent for home town cooperative leaders to advise them Today for first time in three days ABCC staff able reach Dr Miyoshi chief hematologist on case at Tokyo Hospital He stated three patients with loi est white blood counts are now at 1000 and 1500 and have normal temperatures He felt guardedly optimistic 35 April No in formation re 16 patients Dai Iti Hospital 7 Allison to Bu gher - FM situation essentially unchanged Yesterday afternoon Foreign Office asked Dr Morton and staff to attend urgent meeting with Japanese doctors to discuss access to patients One subordinate Japanese doctor at Dai Iti Hospital and one bureau chief Ministry Welfare were preEent Foreign Office representative read prepared statement detailing disturbed psychology of the t enty-three patients and proposing examinations of only two patients by u s physicians on fcur conditions A u s side - 18 would designate two desired for examination Japanese doctors would consider and work out selections by mutual agreement B Examinations would be permitted for twenty minutes for each patient C hxaminations 'Ould be limited to history and external physical D Examinations would not begin until after April 7 The Japanese stated 'Willingness supply copies all laboratory data they have charted and transmitted charts white blood counts taken all patients since arrival Tokyo March 27 have better than even chance survive Opinion expressed all patients now u s side indicated impossibility make examination in twenty minutes bud did not categorically reject offer at this meeting This morning Okazaki requested me to call received presentation yesterday• s meeting said tl- enty minutes limit obviously insufficient for examination but this was conceived more to break psychological ice and after patients acquired more confidence perhaps longer sessions with more patients would be possible He bespoke need for additional patience and gradual approach to allay hervous fears or childishly ignorant fishermen u s I said doctors had been demonstrating full measure patients since Harch 18 estion was not whether they were suTficiently patient but hether Japanese govern ent wished accept u s offers assistance replied official regrets had already been extended On request for apology I He thought apology might be deleted if he could say in Diet American Ambassador had conveyed regrets After reviewing entire situation with Eisenbud and Morton I sent Okazaki letter tonight briefly reviewing backgrcund saying Eisenbud and Morton would be leaving are willing visit two patients tomorrow as pro r1osed e 9 - 19 but only to say goodbye Letter adds that if Japanese doctors wish ABOC physician left as liaison arrangements will be made If situation changes and Dr Morton and staff invited return I was sure request would be sympathetically considered This action was based on Department's 2190 and 2199 altering emphasis of 2167 36 April 8 Allison to Bugher - Dr Morton and assistants visited seven patients at Tokyo this afternoon on invitation transmitted through Foreign Office If 'I Visit not professional but well wishing Arrangements not extended I to sixteen Dai Iti patients On departure tl ey were met laboratory group photographers and reporters who did not learn of visit U white blood counts these seven patients iisako 1500 Takaji 1000 s side Current Suzuki 1700 attori 3 000 Ando 3 500 Masuda 3 300 Yamamato 2100 slight lymphocytopenia and marked granulocytopenia all cases 37 April 9 JTF-7 at 1860 Allison to Bugher - Eisenbud and Morton departed Tokyo for Japanese Foreign Cffice given advanced opportunity propose changes in public statement replied they have no comr ents Both Eisenbud and Morton have indicated willingness return if situation regarding their respective interests so r arrants DOE ARC JlV - 20 - 38 April 12 Allison to Bugher - In final meeting April 6 at Foreign Office between two teams Embassy telegram 2442 Japanese while contirruing refusal authorize examinations by U S doctors expressed willingness supply copies all laboratory data they were co piling Dr Morton asked for whatever was available and particularly for complete blood-counts and clinical progress reports March 27-April 6 Japanese gave them white blood-count readings Since that time no further data supplied In April 7 letter to Foreign Minister Ambassador stated U S willingness to leave ABCC liaison physician in Tokyo if Japanese doctors desire to receive reports and provide direct channel to Dr Morton Or if situation changes so that attending physicians and patients tlsh ABCC consultative services arrangements would be so made public statement April 9 and U in its aide memoire April 10 s Both offers reiterated in Embassy desire for effective cooperation restated Okazaki acknowledged receipt April 7 letter but no affirmative responses re substance forthcoming In fact this uncooperative attitude and departure Eisenbud and Morton our tactic for il'nrnediate present seems to leave next move to Japanese Our working level contacts have been correct matter of fact and transactional First product this official coolness ay have coree today when Dr Kakehi Tokyo Hospital telephoned ABCC saying two week samples urine all 23 patients now ready for delivery to U s side whenever governnent so authorized University would also be prepared Jpply regular weekly samples in future every 'fuesday On basis all present indications most that Japanese will be prepared to do will be to transmit copies laboratory data and excretory samples DOE ARCHIVES - In - 21 view their level medical and laboratory techniques this will be far less satisfactory than products orton and staff could derive from direct access Even this will recuire continued persuasion from us both here and in Washington It would be most useful if•Iguchi were called in as suggested Embassy's 2476 and given emphatic sense of concern expressed reference telegram We doubt however as situation now stands and after successive representations to Foreign Minister and Prime Minister that our further preachments for cooperation will produce more than limited sharing of Japanese medical investiations If accurate knowledge true condition patients is sufficiently important to our national health interests to make denial of direct u S access matter of grave concern we shall probably have to move to some form or other of coercion and sanctions 39 April 15 Allison to Bugher - Dr Morton reports on basis his visit to test area that medical and scientific information being developed within area more complete than would Fukuryu Maru patients 1iuW in any case be possible derive from 2J In his view importance of Tokyo patients to U s national health interest now rrdnimal If Department and AEC concur it would seem neither possession of vessel Department's 2107 no direct access to patients is no of significant concern to us to be A Our interests in situation from this point on would then appear To eliminate it as focus of international agitation and B To minimize its strain on U S -Japanese relations attention would be con ensation question Immediate object for our - - 22 40 April 20 Allison to Bugher - Shipping two urines on each of the twenty-three patients Will ship another twenty-three specimens tomorrow Total of urines shipped in these two days will be sixty-nine Received no answer on cable discussing urines Embassy telegram 2543 Are twenty-three specimens needed each week he sults not received on last five specimens sent over two weeks ago 41 April 22 Allison to Bugher - Medical Subcommittee April 21 published long quasi-scientific statement re patients conditions which Dr Lewis of ABCC thought uninformative Only passages of interest reported A skin lesions of most patients healed B several unnamed patients still have white blood counts around 1000 C some bone marrows have shown no evidence of regeneration ' _ 'DOE ARCHIVES J '