Memo to M Salisbury, Subject: Chronology of American Offers of Medical Assistance in re Japanese Fisherman (Draft Memo)

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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, determine such facts as he could, and offer facilities and services of the staff of the ABCC. (Dr. Bugher talked to Morton by long distance phone on March 16 and March 19). N-tHwx~ 2. On March 17 Morton cabled team will arrive Tokyo on Thursday March 18 DOE ARCI-ELVE!j~Next information was sent March 21. A cable from Morton in Tokyo, giving average white tients Average white count on a5I patients q Tokyo As of March 14. Counts on March 17 Tokyo

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patients 4400 mink~~while Yaizu patients 7358. Differential counts within normal Japanese limits. This teletype contains statement of these counts were critical.) 4. Dispatch from Ambassador Allison dated Narch 17 contains the following: "1 informed Okumura that in response to invitation from Tokyo University Hospital,ABCC sending team of three American and three Japanese doctors to Tokyo to consult in treating injured fisher5. March 18 - Ambassador Allison's message contains following statement: Item 5. Cooperation to date has been complete regarding direct medical treatment, reserved regarding scientific and technical, withheld re custody or transfer of ship. 6. Dispatch from Ambassador Allison, Narch 19; contains following: Ambassado$fcall@ on Vice Foreign Kinister March 17 to offer medical assistance well received and has given weight to government's confident assertion that US can be expected 'Ita do the right thingn.

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7. Ma&h 19 report from Ambassador Allison states Ambassador(s meeting with Ckasaki treated favorably. U. S. offers of medical aid and cooperation in decontamination and investigation appear well received. 8. March 19: vernacular press featured news of investigations and arrival of Dr. Norton and ABCC group from Hiroshima but stories appear on local news page rather than monopolizing front page. Press demanded US divulge It&l_1information" needed to treat pa8'’ ’ c victims. /. Yomiuri speculates on rivalry between Japanese and American scientists. Japanese scientists reported to fear kzerican scientists will use them as mere gatherers of information, meanwhile refusing to give essential scientific facts of .+ type necessary for treatment of injured. (Note by E&M staff: Details about bomb type not essential for treatXorton and Meek flying from Allison contains the following item: to Yaizu to inspect hospitalized sailors and vessel. 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 Karch 21. Also

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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 Embassy's press release put out 6 FM FridayMarch 19. "1 have been pleased to learn of the prompt action which is being taken by'both Japanese and American authorities to provide the most effective possible medical and technical assistance to those affected by the accident which befell tineFukuryu MWll. This assistance is being offered out of humanitarian concern for the injured crew members 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 are 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." The foregoing was read to Vice Cnister Okxmura, who expressed gratification and believed statement would have very helpful effect.

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12. Dispatchdated March 20 from Allison: Dr. Morton, Colonel Meek returnedfrom Yaisu inspectiontoday. Examinedhospitalizedpatients and ship. Preliminaryreport indicatessome of Yaizu patientsmore seriouslyinjuredthan two patientspreviouslyremovedto Tokyo. We may wish to recommendto Japanesetransferentire group Tokyo University Hospital. FEC will cooperatein providingfacilities. (Later informationsugg hat this recommendatin which was indeedmade, antagonizedYaizu doctor;,which may have played an importantpart in later deteriorationof relationswith Dr. Morton'sgroup.) This dispatchalso containsthe followingestimateq the minimumtotal body radiationdose acquiredby boat personnelps approximately50 13. March 21 dispatchcontainsfollowingrequest from Allison: Recomend that I be authorizedto informForeign Ninisterthat, without prejudiceto questionof responsibilityfor accident,US Government will immediatelyassumefull responsibilityfor medical expensesof injured,and will pay fishermen'swages while they remain hospitalized with perhaps solatiumto their families(in accordancewith Japanese

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14. March 22: dispatchfrom Allisonquotes Okasaki as saying early indicationfrom US Governmentthat it would at least be responsible financiallymedical care of fishermenand reliefto their families would have great favorableeffect. The Embassyagain urges prompt US -actionalong these lines. 15. Earth 22: dispatchfrom Allisonstates JapaneseGovernmenthas not yet authorizedmovementpatientsfrom Yaizu. Accordinglyonly two patientsin Tokyo availablefor examination. Reviewed~33 blood studieson all cases today. Not summarizedyet. 16. March 23. Message from AllisonstatesMorton and ABCC physicians have only limitedaccessto the two patientsat Tokyo University Hospital. Have not been permittedto make independentblood counts, analyses,etc., or to take full case histories. The 21 patientshave not been moved from Yaizu. Tne excuse is that some are reluctantto go to Tokyo. JapaneseForeign Office informsus privatelyre/difficulty is with hospitalofficials. Yaizu authoritieswant to retain patients; Tokyo doctorsand bureaucratscannotagree whether To'eo U

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or NationalHealth Instituteshouldhave custody. Press stories evidence"and interestin patientsonly as guinea patientsleft in provincialhospitalat Yaisu and Dr. Tsuzukiof Tokyo Universitypredictedto the Diet yesterdaythat two patientswould die. CalledJapan a victimizedcountry. 17. DispatchdatedMarch 24 from Allison statesMorton's effectiveness handicappedby poor cooperationof Japanese. Statementby Tsuaukithat two fishermenmay die inconsistentwith facts availableto Morton. Tsuzuki'smotivationsnot clear but furtherdirect comxunicationfrom AEC not advisablefor time being. 18. DispatchdatedMarch 24 includessuggestionsmade by Allisonto Okasakithat there be full accessto ill crewmenfor US technicians song other things. A centralauthorityfor review and controlof reportsto be publishedwas anotheritem.

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19. Dispatch dated March 2b: Refers to morning meeting - discussed care and treatment of patients. Attended on Japanese side by 12 representatives ministries, Foreign Affairs, Welfare, Education, National Health Institute, Scientific Institute, Tokyo University. Cn US side Embassy, Eisenbud for AX, Morton for ABCC, Colonels MacNinch and Marx for FEC, Hanna for USIS. Japanese requested fullest possible information re constituents explosion, seemed fairly satisfied with Eisenbud's general statements. Probably will move Yaizu patients to Tokyo March 26 when their arrangements coordinated. Promised ash sample from Fukuryu Maru and 24 hrs urine output all patients. Japanese side favorably impressed Eisenbud's competence and presentations. Japanese have formed Atomic Bomb Injury Investigation Committee, hereafter will be referred to as ABIIC, under Kobayashi of National Health Institute, to coordinate investigations and liaison through Foreign office. Atmosphere afternoon meeting considerably more relaxed and cordial. Meeting opened by presentation by Kobayashi to Eisenbud of ash sample requested in morning. Attribute much of cooperation at this level to excellent impression made by Eisenbud.

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20. Dispatch same date to Bugher from Eisenbud includes request "Japanese want benefit of American clinical experience with EDTA. Please have prepared 2 concise summary of progress with this and other agents for mobilizing bone seekers. Albert is up to date and can do this if you tish. Today obtained Japanese assurance that urine samples from all sailors will be made available tomorrow. They apparently have been unsuccessful in their olrnradio-chemical analyses despite press releases to the contrary. I promised Japanese 2 report on v 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 decontamination and mail to Embassy. Morton unable to examine patients,has had very limited access to data. Formation of new Japanese committee offers prospects for a better relationship in next day or so. 21. Dispatch dated Karch 25: Japanese governrent not yet decided form and amounts financial assistance 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

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at 4600 but complained of pain around head ulceration. TSlXXlki reports 21 patients at Yaizu were "okay". Information refers acute radiation effects only. (BGM staff assumes this means external whole body irradiation.) US experts have no knoxledge regarding internal emitters or absorption radioactive materials. Eisenbud is acquainting Japanese scientists with unclassified facts regarding general nature air, water, atmospheric contamination. 22. March 27: dispatch identifies air special delive,ryconfidential Fackage as being on way to )X00 (presumably contains fallout material 23. Dispatch I,Tarch27: Eisenbud: Korton and I conferred with Kobayashi, Chairman of the ABIIC. 24-urine analyses from each of two Tokyo patients left this date. Instruct Harley undertake analyses immediately for total fission product activity and principal individual fissicn 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. Urges Tsuxuki lze invited to visit US. Embassy officials concur in this.

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24. March 27: Bugher from Morton: Two Tokyo patients almost completely worked up by American standards. Last seen by us Karch 25 and were both improving. (Eiote: Norton does not use word "examined".) Blood counts up, no constitutional complaints or reactions. Prognosis should be guarded until urine analytical tests completed by you. Yaizu patients seen Grch 26. All day trip no examinations 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. No new hematological Yaizu data available to us. Patients supposedly being air transported Karch 28 to Tokyo hospitals. Cooperation promised again today 3n&& by top Japanese doctors. Hope it materializes. Very difficult to study under present circumstances. Will do our best to finish examinations all patients this coming week. Up to now cooperation difficult. 25. Eessage Karch 27 Eisenbud: Cooperation Japanese physicians improving. Morton ~I.11 probably have full access to all patients

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26. March 28, Allison to State Department: Interest Eisenbud, Morton, and Embassy now concentrated on problem of full access to crewmen as their medical histories of major importance. At Japanese request FEC is flying remaining 21 crewmen from Yaizu to Tokyo today. We are currently working both at scientific and goverrment level to remove obstacles 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 possible early next week. Until w problem of access to patients is solved I do not wish to commit us further on compensation question as it may be necessary to take pesition t&hatamount and na tion cannot be authorized under American practice had a chance to make their own findings. 27. Narch 29: Allison to Bugher: Patients arrived Tokyo morning 28 r<arch. Admitted Tokyo and tc national hospitals. Waiting official permission Japanese authorities to complete examination.

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28. March 30. Allison to Bugher - I have asked Eisenbudparticipate Tokyo. They have stronglyurged his appearanceon groundsJapaneseofficials and scientistshave been issuingcontinualseriesinflammatoryand inaccurate statementsregardingFukuryaMaru incidentand they lack backgroundfor appraisal. 29. March 30. Allison to Bugher - I saw Okasakithis morning immediately before Cabinetmeetingand set forth seriouseffectscontinuedfailure of cooperationmay have both for criticallyill FM sailorsand for medical and scientificknowledgeuseful to both countries. Okazakipromisedto do his best. Okdzakitelephonedthis evening to say (A) Eisenbudand Morton will have full access to patientsbeginningtomorrow. Arrangementsshould be made by them directlywith directorsof hospitalsconcerned. He thoughteverything would be adjustedto their satisfaction,but if there were aw slip, he (Okazaki)shouldbe informedimmediately.(B) No tests have been made on patientsyesterdaybecauseof their extremenervousness.After day rest tests will begin. (C) At meetingApril 2 findingsof all participatingdoctorsand No reports regardingpatientsavailableto us today. One measure government'sand our difficultyis fact that examinationand treatmentof the sevenpatientshospitalizedat Tokyo Universityhave been dividedamong four independentmedical services. Okazakifsinterventionwith MinisterWelfare

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may have at last brought some order to medicaland scientificconfusionwhich has existedhere since F'XdockedMarch 14. If he has succeededhe deserves 30. March 30.. Allisonto Bugher - Arrangementsmade by Okazakifailedto providefacilitiesrequiredfor examinationpatients. At Tokyo University Hospitalno officialcouldbe found able authorizeaccess. At Dai Ichi him not to insist on seeingpatientswho were highly disturbedby confinement PZetropolitanHospitaland alarmedby examinationsof any doctorsexceptthose whom they knew. Even strangeJapanesedoctorswere not kzlcomed,and this applied to non-Caucasianson ABCC staff. Dr. Piortonreplied in circumstances he would respect Gahes doctorsand their patientsand would returnto Hiroshima. He and staffwould come back to Tokyo whenevertheir serviceswere I sent Okazakiletter at Diet today recitingthese facts and concluding that unless Japaneseauthoritieschangedtheir minds and unless invitations issued tomorrowto Dr. Eortonand staff to conductwhatevererninations their professionaljudgmentconsidersnecessarythey would be returnedto Xroshima. Further to correctmisinterpretationssome public explanation sould probablybe unavoidable. Informedadvicesregardin and Medicinestaff uncertainwhere the informed counts three

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remain dangerouslylow: one at 2100; one at1700; and one at1500 today from yesterday‘s800. Tsuzukireportedlast of these showedincreasedcoagulation time, and complainedof not feelingwell. These three patientsplus two originalpatientsat Tokyo receivelOO-300 cc transfusionsdaily; lowest blood count patientadditionallygiven 600,000units penicillindaily. At this point full and free access to patientsfor ABCC staff seems to us, on basis Eisenbudand Norton advice,irreducibleU. C,.interest. Data possiblyderivablefrom these patientsand availablenowhereelse may have and AEC evaluationthis point. I would be preparedto go to Yoshida and put case for immediate cooperationon followinglines. (A) Continueddeclineof white blood counts as reportedinformallyby Japanesephysiciansto Dr..Morton, indicatesneed for prom& applicationof best availabletechniquesand therapeuticprocedures. to which governmentwill acceptliabilityfor this unfortunateaccidentwill depend on extent to which, in our judgment,best availablemedical techniques have been applied; (D) Japanesegovernmenthas moral responsibilityto assure patientsevery opportunityto regain health; (E) A friendlyattitudetowards the G. S. requiresour governmentbe given every opportunityto minimizeits potentialliabilityby utilizationof American-trainedmedical scientistson staff of ABCC: (F) Potentialfind-in&sof importanceto nationalinterests

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31, Karch 31. Allisonto Bugher - Please cable your advice as to any new type therapyW radiationinjuries. Cable urgent within six hours. 32. April 1. Eisenbudto Dugher - Okazakitssecretarytelephonedlate last night to say ForeignKinisterseriouslyconcernedby situationmy letter reportedand asking to persuadeDr. Xorton to stay on. This morningI Office and Welfarewould escortdoctors to hospital. Dr. Xorton and staff spent afternoonin antechamberDai Ichi Hospital while officialsdiscussedquestionand Japanesedoctors insistedpatients Final resolutiohlate in afternoonKS that patientsshouldvote whetherthey wished to be examined. This will be promptlyinformedof results. Patients at Tokyo Hospital be precededby discussionamong themselves generallysame. Fatientwith white blood count 800 two days ago now 1000; ones at1700 and 2100 statiolary.V&en temperaturesrise they begin experiencefew subjectivecomplaints. Staff doctor believesone may be bleedinginto centralnervous system,but has no objectiveevidence,plans tap tonight. Less than five of sixteenpatients at Dai Ichi Hospitalreportedwith white blood count under 4,000. MO other

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33. April 2. Allison to Bugher - No developmentsof substanceduring day from Japaneseside and no change in their failureauthorizeaccess to patients. Okazakisent Prime Mnister, who is still recuperatingat Oiso urgent personal letterrecapitulatingbackgroundof unsatisfactorysituation. I have also discussedletter and implicationsthis eveningwith his daughter,who is perhapsher father'sclosestand most influentialadviser. 34. April 5. Allison to Dugher - No developments over weekend. Japanesedoctors informus patients re access to patients they wish examinationby foreigndoctors. Have not yet voted but have sent for home town cooperativeleaders to advise them. Today for first time in three days ABCC staff able reach Dr. IJIiyoshi, chief hematologiston case at Tokyo Hospital. He statedthree …