My Experience and Damages : Dr. Raisuke Shirabe
HOME>My Experience and Damages : Dr. Raisuke Shirabe

Dr. Raisuke Shirabe
I. Exposed to the Atomic Bomb Explosion at Nagasaki Medical College
  - Establishing temporary relief stations at Nameshi Shinto Shrine and Iwaya Club(I,II)
- The Death of Dr.Tsuno'o,dean of Nagasaki Medical College
- Searching for the ashes of my second son
- My battle with atomic bomb disease
II. IDamages Caused by the Atomic Bombing - An Outline
  1. Mortality Rates in the Atomic Bombing
2. Times of Death in Atomic Bomb Victims
3. Damages Caused by the Blast Wind
4. Injuries Caused by the Heat Rays
5. Radiation Disease Caused by the Atomic Bombing
6. Late Effects of the Atomic Bombing
Dr. Shirabe's Curriculum Vitae
  Pictures of Nagasaki Medical College after A-bombing
Dr. Raisuke Shirabe's Curriculum Vitae
調 来助


When my colleagues and students in the 1st department of surgery at Nagasaki University School of Medicine told me that they planned to celebrate my 87th birthday with an alumni meeting on May 17, 1986, I tried to think of some way to express my gratitude in a tangibIe form.

After considerable deliberation I decided to write a brief description of my experience of the Nagasaki atomic bombing and an outline of the damages caused by the explosion. This was of course the most notable event during my career; a disaster of such colossal proportions that it is surely difficult to imagine for members of the postwar generation.

Voluminous amounts of information are now avaiIable about the atomic bombings. But with the threat of nuclear of nuclear war growing stronger than ever, I felt that this small book might help to enhance awareness of the vital need for nuclear disarmament.

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I. Exposed to the Atomic Bomb Explosion at Nagasaki Medical College

August 9.1945
It was to be a day of carnage and horror that, one can only hope, will be remembered for all eternity. I had been on duty since the previous afternoon as supervisor of the air-raid guard at Nagasaki Medical College. In place of the guard leader Professor Takase, who was absent at the time, I instructed the medical students on duty to be vigilant.

Arising at six on the morning of the 9th, I joined professors Naito, Umeda, Kido and Sugiura - who had also been on duty - and went to the dining room above the hospital kitchen to have breakfast at 6:30.

An air-raid alarm sounded at seven,cutting our conversation short. I gathered the students on duty in front of the main building and carried out a simple roll call. Each person went to his designated post to watch for enemy aircraft. At nine o'clock, when no aircraft had appeared,the alarm was reduced to an "alert" and we were able to return to our daily routines.

Still wearing gaiters, I went to the 2nd lecture hall to conduct the usual lecture to a class of third-year students, On the way back to my office, I passed the entrance to the central lecture hall where Dr. Tsuno'o, dean of the medical college,was giving a lecture on clinical studies. It was past ten o'clock and the lecture shouId have been over, but Dr. Tsuno'o was involved in an intensive discussion with the students.

I was writing a dissertation in my office when the distant sound of airplane engines reached my ears. Assuming that it was the enemy, I jumped to my feet and changed from my laboratory coat into my suit jacket and quickly gathered my things together in order to flee to the air-raid shelter. But just as I reached the door of the office, a silvery purple light flashed in the window on the northern side of the room, followed immediately by a thunderous roar as the building shuddered and the ceilings and walls crashed down around me. Everything became dark, and the debris buried me as I huddled on the floor.

When I regained my senses I could hear a dull drumming noise like the sound of heavy rain. It was probably caused by the falling of soil that had been sucked up into the sky by the explosion. When the sound subsided I tried to stand up. Fortunately the debris on my back was light enough to allow me to struggle to my feet.

I opened my eyes but it was too dark to see anything. Again I crouched down on the floor and waited. I cannot properly describe in words my feelings at this time. It was as though I had been abandoned by humanity to a hell of utter darkness and solitude.

Standing up for the second time,I found the room illuminated by a faintlight. I was stunned by the scene that appeared before my eyes. The desk where I had been writing was lying on its side. the bookshelves had toppIed over,and the bed was askew. Nothing remained intact. The fallen ceiling lay over the distorted objects in the room like a strange blanket.

Moving to the front of the desk, I found the shredded remains of my diary, which I picked up and put in my pocket. I could not find my briefcase,and not a trace remained of the papers, books, clock and other objects that had been on the desk.

It suddenly occurred to me that another air raid might be coming. I rushed out of the room and managed to descend to the ground floor of the building despite the rubble strewn throughout the corridors and staircases.

Emerging from the east exit of the building, I saw a woman on whom I had operated only a few days earlier for appendicitis. She was crying out for help. Looking closer I saw that she had no external injuries.

" You're all right, don't worry," I yelled as I fled toward the air raid shelter behind the kitchen. "Get away from the building as quickly as possible." Escaping steam whistled inside a boiler shed that had been crushed by the blast,and several people were lying motionless on the concrete platform in front of it. I could see other people hanging dead from the hospital windows.

I met Professor Koyano on the way to the shelter. He had two small contusions on his face that had probably been caused by flying glass. Fortunately the wounds were not bleeding badly. After exchanging words of encouragement, I rushed into the air-raid shelter.

The shelter was jammed with people, among whom I noticed a nurse from my department named Ms. Araki. She had a gaping cut of about five by three centimeters on her left forearm and was bleeding profusely. I pulled out my hankerchief and bandaged the wound as best I could.

I left the shelter again and tried to enter the main building of the hospital, but there was a torrent of people pouring out and I could not squeeze through. I decided to climb the hill behind the hospital. For the first time I noticed that I had not suffered even as much as a scratch. I hurried off in search of acquaintances.

The first person I met was a graduate student named Satoh who was walking with a nurse. He was supporting himself with a stick but had no apparent injuries. The nurse's face was stained with blood and her work trousers were ripped open at the hip, where she had also suffered an injury. But she could walk. I told them to continue on toward the top of the mountain.

Deciding to return to my office, I crossed the hospital tennis court, where I met Professor Hasegawa. He had suffered a small wound on his right shoulder and was bleeding slightly. "Keep a press on the wound and sit there until the bleeding stops," I said as I hurried off again.

Map of Nagasaki Medical College Hospital
and the Route Dr. Shirabe took to Escape
Just as I started running, Dr. Ishizaki, an assistant professor in Dr. Koyano's department of surgery, came crawling toward me calling my name in a pain-stricken voice. He had suffered terrible burns all over his face, and scorched skin was hanging down in sheets from his hands and forearms.

" Where were you when it happened?" I asked. "In my office," he replied feebly. "There's nothing to worry about. Stay here and rest with Dr. Hasegawa."

I shouted this order as I started off toward the east wing of the hospital. Dr. Kido came up the hillside smiling and apparentIy uninjured except for a small wound on the head. As we were speaking to each other, Ms. Murayama, head nurse of the hospital, came running up the slope crying and screaming out my name. She had burns on her face and arms, although they were not as serious as those suffered by Dr. Ishizaki.

" It's so good to see you alive," I exclaimed. "Let's go up to the top of the hill together. "Having heard from Dr. Kido that the nurses in my department had escaped injury, I gave up the idea of returning to the building and started back up the hill supporting Ms. Murayama on my shoulder.

Fires had apparently broken out in the ruins of the hospital buildings and wooden houses nearby. The hill was enveloped in smoke. It was like trying to walk through a thick fog. The surface of the ground, which only yesterday had been covered in lush vegetation, was stripped bare. The building of the boy's reformatory on the hillside had been demolished and fires were starting to crackle amid the broken lumber. The area was in a state of pandemonium with wails of people crying out for help; it was like a portrait of the agonies of hell in Buddhist iconography. The wind blew from below,carrying clouds of black smoke upwards and pushing an endless procession of hideously injured people up toward the illusion of safety.

As we reached the level of the hillside where the boy's reformatory stood, I heard someone calling my name off to the right. I recognized it as the voice of Dr. Tsuno'o, dean of Nagasaki Medical College. He was lying injured somewhere on the hillside nearby. Instructing my companions to continue upward without me, I cut a path sideways over the rocks and hurried in the direction from which the voice had sounded. I finally found Dr. Tsuno'o lying on the ground surrounded by Drs. Osashima, Takahashi, and a nurse named Miss Maeda. His face was ashen and his shirt was stained red with bIood.

" Where is the injury," I inquired as I bent over him. "My left arm and leg," he replied in a weak voice. "It's nothing."

I offered words of encouragement and he told me not to worry. The cut on his left thigh had been caused by flying glass. It was bleeding slightly. I covered it with an improvised triangle bandage. His blood-drenched shirt looked horribly uncomfortable. so I stripped it off and gave him my shirt to wear. The fires below were raging more ferociously than ever and the wind was beginning to shower us with sparks. I couId hear the awesome roar of fire consuming destroyed houses in the Sakamoto neighborhood. We could no longer remain on that spot. I enlisted Takahashi. who seemed the strongest to carry Dr. Tsuno'o while I led the way up the hill. We made slow progress,however,because the dean complained of faintness and nausea and we had to pause several times.

The building of the boy's reformatory was in flames. All along the way we were accosted by countless numbers of injured people begging for help. They were in a pitiful state. Some were completely naked, and the others were covered by only the remnants of clothing. Some were hideously burned, while others were streaming with blood. Some lay on the ground as others trudged by like wretched convicts, compelling each other not to give up hope. Sights of unthinkable carnage and horror appeared at every turn; it can only be described as aliving hell on earth.

Related point map of this diary
We finally arrived at a point about half way up Mt. Konpira and laid Dr. Tsuno'o to rest on a ravaged sweet potato patch where the remains of leaves and stems lay scattered on the ground. We used a quilt that had turned up from somewhere to cover him. The wind was strong and he seemed cold.

Before long, a healthy and uninjured colleague named Dr. Okura arrived at the scene and built a flag stand out of potato stems to mark our new hospital "headquarters"

The wind shifted direction and began to blow downward toward the city. The smoke dissipated, allowing us a clear view of the scenery for the first time. The nurses' dormitory, outdoor corridors, medical school buildings and structures were all enveloped in a ragging conflagration. The sun was a sickening reddy-brown color and the faces of my companions were dark ashen red as though they were gazing at a sunset.

Someone brought a first-aid kit. The kit contained tincture of iodine, which I promptly used to treat Dr. Tsuno'o's wounds. He had suffered two lacerations on his head, four on his left thigh, and countless numbers of the small cuts from flying glass splinters. Asking him to endure the pain, I spread the iodine over the wounds and washed debris away from the large wound on his thigh with cleansing solution. His nausea gradually began to subside. Dr. Ichinose had already spread Mercurochrome over the cuts on his arms, so I left those as they were.

The wind changed again in the direction of the hilltop and a passing shower brought rain down upon us. The injured people on the hillside shivered in the rain and wind. Finding the opportunity, I cut across the valley to the opposite hill in search of my second son Koji, a first-year medical student at that time. On the way down the slope I noticed Dr. Ishizaki lying motionless with a bed quilt wrapped around his shoulders, but I could not carry him alone and had to leave him where he was. I also met patients who had been receiving treatment in my department. When I greeted them they replied with genuine delight.

I walked around the hill behind the department of psychiatry, shouting my son's name as loudly as I could. There was no response. He had apparently been trapped in the ruins of the lecture hall and had burned to death in the subsequent fires.
The roads and fields were scattered with hideously injured people. Most of them had not even enough energy left to speak. Among them I noticed a fourth-year student named Oku, who was unconscious and did not answer my calls. Rainwater was dripping on his face through the weeds but he made no effort to cover himself. He was dying. A third-year student named Ueno, although bandaged on the head and devoid of his usual vigor, was busy attending to his friends. Dr. Hidaka, a graduate student under my charge, helped me look for Koji, but the search was in vain after all.

I heard a voice calling me from the hill where Dr. Tsuno'o was lying. "We can't stop Dr. Nagai's bleeding," cried the voice. "Please come back!"

Running up the hillside, I found Dr. Nagai lying on a vegetable plot with a severe cut near his right ear. Two assistants from the department of radiology were attending to him but they had been unable to stop the bleeding. Several hemostats were hanging from the wound. I took over but also failed to stop the bleeding. I was struck with admiration for Dr. Nagai, who never so much as flinched during the anesthesia-less operation. I finally had to resort to pressing tampons into the wound and suturing the skin over them. This succeeded in bringing the bleeding to a halt.

After the procedure, Dr. Nagai descended the hillside with his assistants and nurses and began to build a shelter under a rocky overhang to spend the night. He was a fervent Catholic,and the procession down the slope reminded me of a pilgrimage of Jesus Christ with his followers.

I returned to the spot where Dr. Tsuno'o was resting. He said nothing but seemed to be in a stable condition. Someone brought a piece of ice,which we gave to the dean in a cup fashioned from half of a squash. He had obviously been thirsty because he ate the ice with great relish.

It was around four o'clock in the afternoon when a medical student named Koda trudged up the hillside carrying Professor Takaki on his back. The professor had no superficial injuries but he was deathly pale and utterly exhausted. He had been in his office when the bomb exploded. Although trapped in the fallen debris of the building,he had managed to break through the ceilng and escape outdoors. He had fled across the soccer field toward Urakami Church and then collapsed at the side of the river, where Koda discovered him. After placing him beside Dr. Tsuno'o, I examined him but could find neither superficial injuries, broken bones nor abnormalities in the chest and abdomen regions. But he seemed to be suffering terribly. From the fact that his pulse was fast and weak, I assumed that the symptoms were due to shock.

The next person to ascend the path toward the headquarters flag was Professor Kiyoki of the department of pharmacology. He was walking with the aid of a cane and wearing only a pair of undershorts. He had been digging an air-raid shelter and happened to be inside at the time of the bombing, thereby escaping direct exposure to the explosion. He had been hit on the lower back by falling debris but he was otherwise uninjured.

Dr. Egami of the ear, nose and throat department and Dr. Kawamoto of the pharmacy arrived in the evening dressed in relief uniforms. Both had been at home in Nameshi several kilometers north of the hypocenter and therefore had escaped injury. Fearing for the safety or their colleagues, however, they had made their way into the hypocenter area dodging the fires as they walked. They brought medical supplies and helped to treat several of the injured but eventually left the area.

The rain finally let up and the hill became enveloped in a soft evening mist. The wind also subsided. The fires below seemed to be raging more fiercely than ever. The red glow became brighter as night fell and the flames spread out like an ocean as far as the eye could see. The trail of people crossing the hill had tapered off and the injured were now settled in for the night. Drs. Tsuno'o and Takaki would spend the night on the hill above the boys' reformatory with other injured people from the hospital and surrounding neighborhoods.

Meanwhile, Dr. Nagai's group huddled in its makeshift shack and groups of nurses and students took shelter in the fields and gardens near Anakobo Temple. Everyone found a place to rest and,encouraging each other,greeted the arrival of a night steeped in cold, loneliness and fear.

Among them were many peopIe who had managed to reach the hill but had drawn their last breath. The agonized cry of an injured goat echoed from the ruins of the boy's reformatory and two other goats nosed around the hillside in search of something to eat.

As night deepened the wind let up completely and the stars twinkled brightly in the black sky. There was no moon and so the darkness made it impossible to see even one meter ahead. The burden of shock and strain had made me forget all sensation,but as I sat in the darkness my stomach began to growl with hunger. I had not eaten since my early breakfast. When I realized that nobody else had eaten either, a great rush of pity and chagrin welled up inside me.

Just around that time emergency relief teams brought up a case of dry bread, which I took the responsibility to distribute. Groping along the path by memory,I passed out a small package to each person I encountered, aching with sorrow at the sight of so many frightfuIIy injured people. I could not even find words of consolation. I related information about friends when asked and finally arrived at the house below Anakobo Temple.

A medical student named Ando had organized a relief group and was cookmg rice in a large pot. He had unearthed the pot and rice from a destroyed house after obtaining permission from the owner. Several young women in wartime work dress were assisting him. Upon inquiry I learned that they were students mobilized to work in the Mitsubishi factories. I was overcome with gratitude. Perhaps because of the soft glow of the fire below the pot, only this area exuded an atmosphere of warmth and life.

Listening to the reports of the students, I realized that Professor Sofue was lying nearby. l went out calling his name and brought him to the spot where the rice was being cooked. He had suffered only minor injuries but like Professor Takaki he was devoid of physical energy and seemed to be experiencing great discomfort. I laid him by the fire on a bed of weeds and left him to the care of the students.

The rice was soon ready. After making rice balls and placing them in the bread case, Ando and I headed back toward the spot where Dr. Tsuno'o was resting, distributing the food as we walked. The path was darker then ever and it took more than 30 mintutes to progress a distance of about one kilometer. Although silent, no one seemed to have fallen asleep. I gave a rice ball to Dr. Tsuno'o, who consumed it with obvious pleasure,assuring me that he was on the way to recovery.

By this time the fires in the city below had subsided considerably, but the remains of buildings were still glowing with anominous red light. I thought to myself how beautiful the neighborhoods and surroundings of Nagasaki had been before the war.

During the afternoon I had staved off hunger by chewing on raw sweet potatoes that I dug up as I crisscrossed the fields. After finishing four or five rice balls that evening though, I felt entirely satisfied. The efforts of Ando and the Mitsubishi student workers deserve special mention. I feel enormous gratitude toward them even today.

After the slmpIe meal,I went with several other uninjured persons to a vegetable patch below the ridge,where we warmed ourselves at a bonfire and discussed what needed to next day. The following points were decided:
  1. Two stretchers were to be found to carry Drs. Tsuno'o and Takaki back to their homes early in the morning.
  2. A list was to be made of all the hospital and college personnel present on the hillside.
  3. Ando was to take responsiblhty for preparation of a morning meal.
  4. An information officer was to be chosen to contact the relief headquarters at city hall.
  5. Professor Koyano was to be informed of all developments.

There were other matters to discuss. but we decided to disperse and return to our respective places. At Dr. Nagai's invitation, I lay down to rest on the bed of straw inside the rough shelter erected by members of his department.
Looking upwards I thought quietly about the events of the day. It all seemed like a twisted dream. That incredible flash of light had thrown the city into utter chaos,and countless numbers of people had been brutally killed or injured. A few of us had been fortunate enough to escape to the hillside,but the hospital and all the other familiar landmarks around it had been wiped out. What on earth were we going to do?!

The dean and a few of the professors and lecturers were safe on the hillside,but what,I wondered,had happened to all the others. My son Koji had been in the middle of a lecture. Had he managed to escape injury? My eldest son Seiichi had gone to work as usual in the Ohashi Arms Factory that morning. Was he all right? My head spun like a kaleidoscope with aching worries. Despite my fatigue I could not fall asleep.

Later I heard the roar of an enemy airplane and then bomb bursts in the directon of Michino'o. They seemed to be small bombs. There was another bomb burst overhead, but it passed without any apparent effect. The skies were silent after that and without knowing it I fell asleep. I had lost my watch but I imagine that it was already past midnight.

The above is a description of my experience of the atomic bombing and subsequent events. I kept a journal during the days after the bombing, of which the following are a few excerpts.

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Establishing temporary relief stations at Nameshi Shinto Shrine and Iwaya Club(I,II)

August 10.1945
It was another hot, clear day. Dr. Nagai and his group rose early and filed off toward the air-raid shelter at the department of pharmacology. I stayed beside Dr. Tsuno'o, whose condition had improved considerabIy. Professor Takaki, however, was still in a state of exhauston.

News arrived that Dr. Tsuno'o's residence and family in Nishiyama-machi were unharmed. I urged him to let us carry him home by stretcher, but he refused, saying that he would prefer to stay near the hospital for treatment. We decided to bring him to the college hospital. Arriving there, we found all the buildings gutted from the fires and so disarranged that it was difficult to find a place to step. Having no other choice, we carried Drs. Tsuno' o and Takaki on stretchers to the cave air-raid shelter near the hospital.Dr. Koyano, who fortunately happened to be there when we arrived, was asked by Dr. Tsuno'o to take over the duties of dean.

Finding the time, I set off on a tour around the ruins of the medical college. My own office was a complete shambles. The floors and ceilings had caved in, and not a trace remained of the documents and furniture that had been in the room.A few heavy medical text books were still smoldering. I had lost many vitally important objects, including a watch, a briefcase with my bank book and other personal items, records of medical theses and correspondence.

The wards and offices in a similar state of disarray. Dozens of corpses lay in the outter corridors. There were people walking like sleepwalkers through the smoking rubble, and others crawling along the ground begging for help.
The pre-medical course classrooms had been contained in wooden structures that were completely consumed by the conflagration. I noticed the corpse of one of the office directors in the ashes.Proceeding to the department of legal medicine, I found what I thought to be the body of Professor Kunifusa and stopped to say a prayer for the repose of his soul.

In the soccer field where members of the radiology department had been growing vegetables, the corpses of several nurses in soiled uniforms lay sprawled in a state of terrible carnage. Passing the department of psychiatry of the way back from the soccer field, I learned from a student that Professor Yamane was in the cave air-raid shelter. I found him lying with filthy bandages over his head and face.He was barely conscious. I administered simple treatment, including an injection of a cardiotonic drug, and then reported his condition to Dr. Koyano.

There were countless numbers of other injured people who could not possibly be treated in the remaining facilities. I talked with Dr. Koyano about establishing a temporary relief station in Nameshi-machi, where I had been livng with my family during the war.Receiving his consent, I left the college about one o'clock in the afternoon and visited the chairman of the Nameshi community council.The onIy suitable structure for such a relief station seemed to be the buildings of Nameshi Shinto Shrine. I decided to confer with the community council chairman of the adjacent neighborhood, and was fortunate enough to receive permission to use the facilities of the Iwaya Club.

With that important task achieved, I proceeded to the house inhabited temporally by my family. Seeing me approach, my wife Sumiko,son Seiichi(18), and daughters Choko(14), Reiko(12) and Junko(8) ran out of the house to greet me.Seiichi was bandaged from head to toe. My wife informed me that our second son Koji(16) had not returncd from the college.

Although the house was located about four kilometers from the hypocenter, the ceiling had fallen in and all the windows and paper screens had been broken.I was relieved to see that my 80 year-old mother had escaped injury.
My wife and children had spent a fretful night, worried sick over my safety, and so they shed tears of joy when I appeared at the door. I remained home for the night, talking with them about the events of the past two days and forgetting briefly all the misery and fatigue.

August 11.1945
After asking residents of the neighborhood to prepare the Iwaya Club for treatment of the injured.I set off toward the medical college. A makeshift reception counter had been established in front of the outpatients clinic to collect information and answer questions about survivors, deaths and missing people.

After visiting Drs. Tsuno'o and Takaki, I began an investigation into the whereabouts of the still-missing medical college staff. Among other things, I discovered to my relief that Professor Kunifusa had in fact survived the explosion. He was lying in the ruins of the dermatology ward.His wife was with him trying to bring down his temperature with water drawn in a small can. I touched his skin and found that he was burning with fever.Fetching a bucket full of cold water for Mrs. Kunifusa, I instructed her to make every effort to reduce the fever because the professor would die if it continued.

While talking later with Dr.Koyano, a fourth year medical student informed us that he had found a body which he thought to be that of Professor Naito. Looking in the clothing for identification,he found a pocketbook which proved that it was in fact Dr.Naito.Running to the department of gynecology, I found the body buckled up like a prawn on the corridor floor beside fallen lumber. There was a reddy black handprint on the wall nearby which had obviously been made with blood from a gaping wound on Dr. Naito's head.

It was exceedingly difficult to decide which injured people were to be taken to the relief station in Nameshi. As I had expected, Dr.Tsuno'o said that he would prefer to go to the relief station than to go home. According to one of the other professors,Dr.Takaki was in too severe a state to allow him to be carricd home. We decided to use the stretcher to carry Dr. Kunifusa home and later to bring Drs. Tsuno'o and Yamane to the emergency relief station.Dr. Kido was asked to select medical students for these tasks.

Along with eight surviving nurses from my department, I managed to retrieve several cases of medical supplies that had been stored under the floors of the surgery ward. I engaged a resident of Nameshi to carry the supplies to the relief station by pull cart and then took the nurses back to my own house.The structure was too small for so many people but we managed to squeeze everybody in. I asked a member of the college pharmacy to go to the relief headquarters in Itonokuchi to collect rations of rice. After an austere evening meal,the nurses lay down like sardines in a small room of the house and were deep asleep almost immediately.

August 12.1945
The nurses rose early and departed for the relief station to clean out the rooms. Around noon, I unpacked the medical supplies and prepared for the treatment of patients but it was not until the middle of the night that the injured were finally carried to the relief station. Apparently it had been very difficult to arrange transportation.The nurses and I had given up waiting and were sleeping at my house, and so we did not learn of the arrival of the injured until the following morning.

August 13.1945
The news came just after dawn.Hurrying to the relief station, I found Drs. Tsuno'o and Yamane lying in one of the rooms still on stretchers.The injured students had been laid on a large boarded floor. I rushed back to my house to fetch two bed quilts, which I brought to the Shinto shrine,and then arranged for Drs. Tsuno'o and Yamane to be carried to the outer oratory of the shrine. The head nurse in Dr.Tsuno'o's department came to care for the two injured professors and I instructed one of my nurses to assist her.

A medical school assistant professor named Dr. Kido took charge of the survivors. He requested the help of several third year medical students.who immediately accepted and began selfless efforts along with the nurses to help the many injured.Their duties included everything from treatment of wounds and burns to assistance with meals and urination and defecation. The relief stations were like battlefields.

No sterilizers like those in the hospital were available. We had to boil water in wash basins over charcoal fires. A disinfectant was dissolved in the hot water and the solution was used to sterilize gauze strips. Also, because of the lack of any pots or pans, rice and vegetables had to be cooked in used steel buckets.

Dr. Tsuno'o's wounds began to infect on this day. He came down with a fever of 38.8 degrees C., although otherwise his condition seemed to be stable. Dr. Yamane, on the other hand, had no fever but began to suffer from mild muscle spasms in the afternoon, raising suspicions of tetanus.

At home, my son Seiichi was lying groaning with pain and my wife Sumiko was busy in the kitchen preparing meals for almost 20 people.

August 14.1945
The relief station at Iwaya Club was occupied completely by critical patients, many of whom were suffering from severe fever and diarrhea. Observing that some even had bloody stools, we jumped to the conclusion that dysentery had broken out and went to all the trouble to isolate these patients in a corner of the room. However, our efforts were in vain. The patients died one after another and soon a large part or the medical students' time was devoted to gathering wooden debris for cremations. The students were also required to visit homes in the vicinity with one of the nurses and to apply dressings to wounds or to give injections of cardiotonic drugs.

Dr.Tsuno'o continued to run a high temperature, compounded by bouts of diarrhea that caused him great discomfort. However, it was Dr.Yamane's "tetanus" that became the most markedly aggravated.Injections of serum taken from Dr.Tsuno'o had no effect whatever. He suffered terrible seizures every time someone rang the bell at the front of the shrine oratory, and he could ingest neither food nor medicine. It was a wretched sight. I felt particularly disheartened to see that he could not even drink a small cup of sake, something which he normally enjoyed so much.

My son Seiichi's condition showed no improvement; he continued to groan and cry without interruption.There was no news at alI about his younger brother Koji. The hectic activity in and around the relief station gave me no time to think about my second son. But in the evening, when we partook of a silent meal by the eerie light of an oil lamp, the image of his face came into my mind.

August 15.1945
Dr.Yamane's condition took a very bad turn. By afternoon his consciousness had dimmed and around seven o'clock he drew his last breath. I wonder how this tragic event affected Dr.Tsuno'o, who lay beside him struggling to stay alive.

While walking along the road outdoors that afternoon,I had heard from a neighbor that the war had been declared over. With no access to a radio, we had failed to hear the Emperor's official announcement or Japan's surrrender. When I passed along the news to the nurses at supper time, they continued to eat without saying a word. but they could not hide their dejection.

That night, Seiichi's consciousness was still clear despite his rapidly deteriorating condition.He told me how much he detested the war.

August 16.1945
The dissipation of Seiichi's energy reached a climax. His cries to his mother turned to a whisper and, finally, he drew his last breath around noon. I obtained the assistance of several neighbors in carrying his body to a nearby hillside for cremation.During the war I had often heard my sons saying pessimistically "Our lifespan is 20 years" But Seiichi had finished his sojourn in this world after only 18 years.

After the cremation I went immediately to the relief station to check on Dr. Tsuno'o and the medical students and then went out to treat the injured in houses around the neighborhood. The situation did not allow me to get lost in private grief or to hole up in a quiet corner of my house.

Dr. Tsuno'o's diarrhea become severe this day. The nurses were at a loss, and so I asked an assistant professor from the department of internal medicine to do what he could.

August 17.1945
Dr. Tsuno'o's younger brother, a professor of pharmacology at Showa Medical College in Tokyo, arrived at the relief station and took up a vigil at his brother's side. He immediately took Dr. Tsuno'o's temperature.When I asked him how much it was, he replied, "39 degrees" but showed me the thermometer at the same time.It read 41 degrees C. He was trying to keep his brother from worrying unnecessarily.

" If l could only perspire,the temperature would go down." lamented the gravely ill Dr.Tsuno'o. I did not realize at the time how significant this statement was.

Rumors began to go around that the American forces would soon land in Japan. Hearing this, the residents of the Nameshi neighborhood gathered up mosquito nets, rations and other supplies and fled to nearby Mt. Iwaya. After finishing dinner around seven o'clock, I was asked by a neighbor to examine an injured member of his family. I made the short trip to his house.

I found that the injured person was an elderly man who had suffered a 10-centimeter gash on the left side of the face. The tatami mats in the room were stained with blood. I gathered together pieces of cloth to serve as a press for the wound then sent one of the patient relatives to the relief station for suturing equipment.This involved a considerable delay because the station was more than two kilometers away. While I was waiting, one of the neighbors rushed into the house and said, "Dr. Shirabe, it's too dangerous to stay here. The Americans could arrive at any minute. Please leave that patient and flee. Even the police have gone to the mountains."

As a physician, I obviously could not bc so irresponsible as to abandon a patient under my care. I stayed where I was and waited for the equipment to arrive and then sutured the elderly gentleman's wound.

When I returned home, I found my daughters in a state of great anxiety. I told then to relax and stop worrying. I proceeded to the relief station, where again I had to persuade the nurses to remain calm and carry out their allotted duties.

August 18.1945
The following morning the nurses were more concerned than ever about the impending American occupation. They begged me to let them go home. Having a vague knowledge of the terrible crimes committed by the Japanese armies in China, they probably feared that the Americans would run wild in the same way. I discussed the situation with Dr. Kido and decided that the only thing to do was to close down the relief station.

I made arrangements to send the remaining injured patients to the large hospitals in outlying cities such as Omura and Isahaya,and allowed the nurses to pack up their things and leave for home. Our relief activities had lasted for only six days, but the station had been as frantically busy as a battlefield under fire.We were exhausted both physically and mentally. I asked my wife to make preparations for a small farewell party in our house.

Dr. Kido and several other colleagues joined us.For the repast, we slaughtered two chickens that had been kept by my sons,and I obtained a bottle of sake from a nearby brewery as a special favor. HeId in the midst of a now silent and uninhabited neighborhood,our little party had the atmosphere of a wake. I thought of my sons and prayed for the repose of their souls.

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The Death of Dr.Tsuno'o,dean of Nagasaki Medical College

August 22.1945(The Death of Dr.Tsuno'o)
After the closure of the relief station, the pressures of responsibilty were considerably lightened. My only duties were to attend to Dr. Tsuno'o in the nearby Shinto shrine and to respond to the occasional request for treatment of an injured person still at home.

By this time, the dean's cuts from flying glass had healed for the most part and his symptoms were now confined to diarrhea and fever. With his brother by his side, he had apparently taken over the reins of his own treatment, but he continued to suffer from fever and a lack of appetite. On the 19th, he had developed inflammation of the oral mucosa and purple blotches from subcutaneous bleeding. His condition deteriorated rapidly during the subsequent 48 hours, and on the afternoon ofthe 21st his consciousness began to grow dim. At 10:00 a.m. on August 22, he finally succumbed to the strange disease ravaging his body.

Gathered at his bedside were his wife and younger brother; Drs.Koyano and several other members of Dr.Tsuno'o's department; Dr.Kido, and my wife and I. All we could do was to sit and gaze with silent grief at the lifeless body. That day I wrote the following words in my journal: "My first thought was that a bright star had fallen.He was not only a highly gifted and devoted scientist but also a competent administrator. He was a man of outstanding ability who contributed enormously to Nagasaki Medlcal College and to education in Japan as a whole and who will be sorely missed by all who knew him."

We carried the remains back to the college for a solemn vigil in the entrance hall of the former outpatients clinic.The following morning we conducted a simple funeral and then cremated the body on the site of the tennis court on the hillside behind the college.

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Searching for the ashes of my second son

August 28.1945(Searching for My Second Son)
This was the day that we miraculously discovered the remains of our second son Koji.
I had begun to feel greatly fatigued, probably, I thought, because of the great strain endured during the days and weeks since the atomic bombing. Now when requests came for treatment, it was extremely tiresome to make the trip to the injured person's house.Recalling my misson as a physician, however, I dragged my heavy legs along and continued to treat the many atomic bomb victims wavering on the brink of death.

Finally finding time to spare on August 28, I set off toward the ruins of Nagasaki Medical College with my wife and daughters, hoping to find some clue about the fate of our son in the atomic bombing.

Hall ruis
I had heard that the first year medical students had been in the middle of an anatomy lecture. We went to the site of the lecture hall and found it entirely destroyed. The wooden building had burned to ashes, leaving only the foundation stones intact. In the sky above the ruins, hundreds of crows soared back and forth searching for the decomposed flesh that had been so plentiful after the bombing. Like screeches from the world of the dead.their raspy cries added to the ghastly atmosphere enveloping the hypocenter area.

The foundation stones were arranged in two rows as shown in the diagram, and interspersed among them were three or four piles of human bones. As we picked among the bones, my youngest daughter Junko suddenly cried, "Look at this!"

Lying in the middle of the former lecture hall was a rectangular slab of metal that had undoubtedly been the door to the room, and stuck to the middle of it was a fragment of cloth. Looking more closely, we realized that it was the front part of the waist of a pair of blue serge trousers with the white lining facing upward.The india ink letters for "Yamamoto" were visible on the edge of the lining. Seeing this, my wife screamed out "These are Koji's trousers!"

Yamamoto was the name of my nephew, who after graduating from Kyushu University School of Medicine had become an army doctor stationed overseas. Koji had received his old school uniforms.

While all his classmates wore the standard khaki-colored uniforms. Koji had navy blue serge, and so there was no doubt that it was our son who had died on the slab of metal. He had burned to ashes in the fire and only this fragment of cloth bearing the name "Yamamoto" remained.

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My battle with atomic bomb disease

September 3(My Battle with Atomic Bomb Disease)
I felt robbed of all vitality after the confirmation of Koji's death.Passing days of mutual consolation with my wife and daughters, I only left the house when asked by someone to treat an injured or ailing relative. But I was like a man in a daze walking without reason or purpose.

On September 2, a request for treatment came from a village called Yokomichi located two kilometers away. I was so bereft of energy that I considered refusing this request, but thoughts of atomic bomb survivors lying in pain compelled me to go.

My pace was so slow and lethargic that it took more than an hour to arrive at my destination. I found the patient on the verge of death but administered an injection and did everything else I could.Later,I received news that the patient had died soon after I left.

On the 3rd, I received word from the temporary medical college headquarters that an emergency meeting was to be heId to discuss the restoration of the college. It was an important meeting that I felt obliged to attend, but I did not feel strong enough to go alone. I asked my 14 year-old daughter Choko to accompany and we left the house together.

We walked for a distance of about two kilometers to Michino'o Station, caught a train into central Nagasaki and then walked another one kilometer to the college headquarters established in the Chamber or Commerce Building in Sakura-machi. In Ogawa-machi, I caught a glimpse of Dr. Osajima walking about 10 meters ahead of us. Assuming that he too was going to the meeting. I tried to catch up with him and to call his name, but I could neither muster up a loud voice nor shorten the distance between us. When I arrived at the Chamber of Commerce Building I found that Dr. Osajima was in the same state of fatigue as I.

The meeting lasted about two hours and I returned home with Choko the same way we had come. But wben we arrived home I was so exhausted that l could no longer remain standing.
The following morning I found a large number of purple blotches on my upper arms and thighs. The color was identical to those I had seen on so many patients during the previous weeks - people who had an eventually died. Now, it seemed, my turn had come.

Professor Kitamura happened to drop by while I was lying in bed. He sat on the edge of the open garden corridor and I got up to greet him. When I showed him the purplce blotches he said, "I have them too," and rolled up his shirt sleeve to show me.Sure enough, although darker in color than mine,he had the same sort of subcutaneous bleeding spots. But he was in such good health!.

Next my wife joined the conversation. "They're just insect bites. I have some too," she said pointing to her own spots and trying to dispel my apprehensions. As an experiment, I showed Choko, who had only recently turned 14, how to give an injection and then had her give me a dose of vitamin C and also 20cc. of calcium for my sore throat. Choko performed the injections skillfully but the points of penetration turned into blotches that refused to disappear. This became another source of concern.

After the appearance of the purple blotches, I spent several miserable days worrying about what my family would do after my death and wondering whether or not I should write a last will and testament. I had no appetite and so little energy that I found it an ordeal even to roll over in bed.
With the passage of about a week, however, the needle marks on my arm began to change color from purple to blue and then to yellow.It was around September 12 or 13 that I began to think that perhaps I was going to survive after all. A feeling of joy welled up inside me.

On September 16, Dr. Fujii from my department came to visit me and took a blood sample to calculate my red and white blood cell count. The result was RBC 350 and WBC 2,400, but the levels had probably been even lower when the subcutaneous bleeding was at its worst. Hearing later that almost all the patients whose white blood cell count dropped below 1,000 had died after the bombing, I could not stop my body from trembling. Dr. Fujii brought a beer bottle filled with beef stock, which I drank with great pleasure.

A third-year medical student named Koda arrived at our door a few days later asking to be put up for the night. Having lost our own sons,we were more than happy to have him stay. He was so taIkative, though, that it did not take long to grow weary of his presence, especially when I was in such a weakened condition.

I was about to tell him to go to bed and stop bothering me when he found a bottle of alcohol on the earthen floor in the kitchen and asked me if he could drink it.
" If you want to die, go ahead," I said jokingly,but he assured me that it was ethyl not methyl alcohol and therefore safe to drink.He poured a small amount of the liquid into a wine glass and then diluted it with sugar water.

He offered to prepare a glass of it for me as well, but I turned it down saying that my liver was in no condition for alcohol.He was so insistent, though, that I took a few sips. It was unexpectedly pleasant on the tongue, and before I knew it I had polished off the whole glass. Amazingly,this primitive cocktail gave me a sensation of warmth and well-being and I found that talking with Koda no longer tired me out.

After he had left, I continued to drink the concoction every morning and evening as a kind of medicine and I felt my strength return. My wife commented that the color had come back to my face. What an excellent turn of events. I could treat my illness by drinking - a pastime that I thoroughly enjoyed!

The bottle of ethyl alcohol that had been sitting unnoticed in our kitchen suddenly became a commodity of great value. It seemed to me that it had saved my life. I felt vigor come back into my body and, with it, a certainty that I was going to survive.

What would become of the Shirabe family without sons to carry the name to future generatons? What was to become of Nagasaki Medical College, which had suffered tremendous, irrevocabIe damage? Would the college be restored and would I return to my position in it? These thoughts and others continued to cloud my mind as I waited at home with neither the strength nor the courage to visit the ruins. But it was not long before the calendar read September 24 - the day that the Allied forces landed at Nagasaki Harbor.

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II. Damages Caused by the Atomic Bombing - An Outline

Nagasaki Medical College had been reduced to a confusion of rubble, ash and scorched concrete. When the initial chaos finally subsided, the surviving staff and students established temporary facilities within the Naval Hospital in Omura City, and I was appointed to replace the deceased Professor Naito as director of the college hospital.

Several hundred atomic bomb survivors were receiving treatment in the hospital at the time.While continuing our care for these patients, my colleagues and I began research into the injuries suffered by approximately 8,000 people exposed to the Nagasakl atomic bombing.

Made from an isotope of plutonium, the Nagasaki bomb had been even more powerful than the uranium bomb used on Hiroshima. Generated with the explosion were heat rays of several thousand degrees Centigrade and a ferocious blast wind, as well as radioactive gamma rays and neutrons that, striking the human body, destroyed vital tissues and often resulted in death.

The damages caused by the atomic bomb, therefor, can be divided into three major categories:
1)fires and burns due to heat rays;
2) destruction and injuries due to blast;
3)internal damage due to radiation exposure.
Combined, these three factors inflicted severe damage on buildings, plants, animals, and of course the human body.

My associates in this research on the atomic bomb survivors included Assistant Professor Kido, ten other colleagues and about 50 medical students.We prepared survey charts on approximately 8,000 survivors during the period from October to December 1945. Then, I personally analysed the data and reported the results in a dissertation which took more than a year to complete.

The dissertation was divided into four chapters as follows:
1) Mortality Rates in the Atomic Bombing
2) Times of Death in Atomic Bomb Victims
3) External Injuries Caused by the Atomic Bombing
4) Radiation Disease Caused by the Atomic Bombing

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1. Mortality Rates in the Atomic Bombing

Studies on mortality rates were carried out from various aspects and revealed the following information.

a. In order to evaluate the mortality rates by distance from the hypocenter, a total of 1,052 deaths at 23 locations were studied. The 23 locations and the results of the study are shown in the following two figures. The results revealed a mortality rate of almost 100% within a one-kilometer radius of the hypocenter, although the Medical College Hospital(location#3)showed a markedly low rate because it contained the only concrete buildings in the area. Aburagi-machi(#8) and Mezame-machi(#10) showed low rates because they were shielded by hills, while Takao-machi (#9) and Yano-machi(#11) showed high rate because of their location on hillsides directly facing the hypocenter.

b. With regard to the male/female difference in mortality rate, the rate for men was generally higher than that for women. The reason for this is probably not a difference in power of resistance but rather the fact that more men than women were working outdoors a the time of the bombing.

c. With regard to the difference in mortality rate for indoor and outdoor exposure, the rate in persons exposed outdoors(70%) was naturally much higher than that in persons indoors(47%)at the time of the explosion. In the case of wooden houses within one kilometer of the hypocenter, however, there was very little difference(outdoors - 100%; indoors - 97%).

d. With regard to the age difference in mortality rate, persons 10 years of age or less(56%), and 60 years of age or more(57%), showed considerably higher rates than persons between 30 and 50 years of age(36%). This difference was probably due to the lower power of resistance in small children and elderly people.

e. The following are the results concerning the difference in mortality rate by type of injury. Looking at all the deaths, the mortality rates were 60% for burns. 44% for external injuries, and 18% for people without injuries.For deaths within one kilometer of the hypocenter, however, the rates were 96.7% for burns, 96.9% for external injuries, and 94.1% for people without injuries. Thus, there was very little difference between the three types among people killed within one kilometer of the hypocenter.

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2. Times of Death in Atomic Bomb Victims

We conducted a survey on the times of death in 797 atomic bomb victims who died in homes in Nagasaki City, or at Omura Naval Hospital, Kawatana Kyosaikai Hospital, Togitsu Primary School, Togitsu Mangyoji Temple and other locations.

As a result, we noticed a difference between the times of death in victims carried long distances(Omura, Kawatana, etc.) and those in victims carried only short distances(homes in Nagasaki city, etc.).

Among people carried short distances, the mortality rate shows a small increase on August 10 and peaks at August 16. Among people carried long distances, however, the rate peaks around August 10 and 11 and then decreases after a small increase on August 16. This finding indicates that rest after exposure to the bombing played an extremely important role in the survival of the victims.

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3. Damages Caused by the Blast Wind

The blast wind generated by the atomic bomb explosion defies description. It was so powerful that it caused tremors like an earthquake, tore houses apart, and snapped trees off at the trunk.The huge chimney at the Medical College Hospital was left bent out of shape and the one meter thick stone gate post at the front entrance leaned at a 30 degrees angle away from the hypocenter. (The latter remains to this day.)

In the city the towers that had been supporting petroleum tanks and the iron skeletons of factories lay squashed against the ground, their iron pillars and beams twisted like strands of taffy. At the hillside Anakobo Temple, not a single gravestone or monument was left standing. The lush sweet-potato leaves had been stripped off the vegetable patch, leaving young potatoes protruding from the ground like broken teeth. Glass windows had been blown out of buildings and houses more than ten kilometers from the hypocenter. Nagasaki's famous "one-legged torii" (the stone gate to Sanno Shinto Shrine that lost one of its two legs and upper beams but remained miraculously upright) stands today as evidence of the ferocity of the atomic bomb explosion.

The external injuries caused to the human body by the blast wind were all secondary injuries due to flying debris, especially glass splinters(60%). Some people suffered hundreds of cuts from small splinters,while others lost the mobility of limbs when larger splinters severed major nerves.In some cases, grass splinters even penetrated the skull and lodged in the brain.The next most frequent external injuries were bruises(20%) and contusions(12%). Although fractures were rare(2%), some victims suffered paralysis due to spinal injuries.

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4. Injuries Caused by the Heat Rays

This of course means burns, but the burns caused by exposure to the atomic bombing differed greatly from ordinary burns in that they involved large portions of the body. At least half of the people exposed to the explosion suffered deep burns over more than 50% of the body. In many cases, the outer layers of the skin peeled off in sheets and hung down from the limbs like the remnants of clothing.

Another feature of atomic bomb burns is the fact that the victims had no sensation whatever of heat at the moment of exposure. This is due to the extremely high temperature and the short duration ofthe flash of heat, which is said to have lasted for only a fraction of a second.

Still another feature is the keloid scar tissue which formed over almost all of the burns inflicted by the atomic bomb. Absent in ordinary burns, these keloid scars caused quite a stir in the academic community because surgeons had never encountered them before. Fortunately, they showed a tendency to shrink with the passage of time.This made me think that the scars had been caused not only by the intense heat but also by the added action of radiation, which induced temporary disorders of the endocrine system and changes in the constitution of the survivors. I still consider this to be true, because there are virtually no keloid scars remaining in the atomic bomb survivors today.

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5. Radiation Disease Caused by the Atomic Bombing

It was known for many years before the atomic bombings that substances emitting radiation have a destructive effect on the tissues and cells of the human body. It was for this reason that X- rays and radium were used in the treatment of disese. The radioactive rays generated by the atomic bomb, however, were far more powerful than these forms of radiation. Needless to say, they caused severe injuries to exposed persons.

Tissues most vulnerable to radiation include blood cells, bone marrow, germ cells, sex glands, endocrine glands and the mucosa. Decreases in white blood cell count, anemia and bloody stools are also thought to be due to radiation exposure.

The primary symptoms of atomic bomb disease include nausea, diarrhea, fever, internal hemorrhage, epilation and inflammation of the oral mucosa.Although other symptoms such as headache, dizziness, consciousness disorders and abdominal pain were observed, the primary symptoms were the most frequent in persons who eventually died.

The following graph shows the incidence of each symptom among 5,520 survivors and 333 people who later died.

Symptom Survivers Mortality Cases
Nausea 15.0% 51.6%
Diarrhea 33.3% 67.6%
Fever 21.5% 80.0%
Hemorrhage 14.7% 48.6%
Inflammation of the oral mucosa 17.8% 43.6%
Epilation 11.8% 29.1%
Headache 20.4% 39.0%
Dizziness 10.5% 21.3%
Consciousness disorder 6.6% 21.0%
Abdominal pain 10.8% 26.1%

Nausea tended to occur immediately after exposure to the atomic bombing or, at the latest, by the following day. It is obvious now that radiation exerted a considerable influence on the occurrence of this symptom.

Diarrhea was observed in most of the victims from the day of the bombing to less than one week later. The earlier the appearance of diarrhea, the worse was the prognosis. In severe cases, discharge resembled the watery stools seen in dysentery and was sometimes stained with blood(25%).

Fever tended to occur simultaneously with diarrhea during a one-week period after the bombing. Body temperatures usually soared to over 40 degrees C. As pointed out by Dr. Tsuno'o while he lay on his deathbed, the fever remained high because of damage to the sweat glands and loss of the ability to perspire.This high fever was observed frequently even among uninjured people(71.6%), which proves that it was induced not by external injuries, burns or diarrhea, but as an effect of exposure to radiation.

Hemorrhage was another specific symptom of atomic bomb disease.The most frequent form was subcutaneous bleeding resulting in purple spots(45.1%), followed by bloody stools (33.3%) , bleeding from the gums(27.8%), nose bleeds(20.4%), and hematemesis(18.5%). Hematuria(9.3%), hemoptysis(8.6%)and hemorrhage of the conjunctiva(4.3%)were also observed.The prognosis was poor when severe hemorrhage occurred soon after the bombing.

Inflammation of the oral mucosa included inflammation of the gums, tonsils and pharynx, and was accompanied by swallowing difficulty and pain when food touched the affected areas. In severe cases, the inflammation caused disintegration of the tissues of the cheek. This symptom was observed frequently among the mortality cases.

Epilation was another important symptom. The hair of exposed persons fell out as it would in a patient exposed to high X-ray doses. Some victims suffered complete loss of hair.Epilation was particularly pitiable in young women, but fortunately there was no direct correlation with death, and most of the women survived and today have full heads of hair. Epilation was relatively infrequent in mortality cases because it tended to occur two to three weeks after the bombing when the most severely injured people had already died.

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6. Late Effects of the Atomic Bombing

The symptoms of the atomic bomb survivors seemed to subside three or four months after the bombing or around the end of 1945. Subsequently, however, a variety of late effects began to appear. The following three disorders were the most conspicuous.

1) Keloid scars
This disease is a kind of tumor characterized by the swelling of scar tissue on burns and other external injuries. The keloid scars were dark red in color, hard like rubber and accompanied by itching or pain.Because they also occur in wounds other than those inflicted by the atomic bombing, the scars are thought to be induced by an upset in the physical constitution. Keloid scars formed in more than 70% of atomic bomb survivors who suffered burns and 20% of survivors with other external injuries.Thus, they were referred to as "atomic bomb keloid" and became a subject of great concern during the immediate postwar period.
A feature of ordinary keloid scars is that they do not disappear spontaneously and surgical excision results in the recurrence of even larger scars. In the case of atomic bomb keloid, the scars showed a similar tendency at first but gradually shrank with the passage of time and eventually disappeared.
I believe that the reason for this difference is as follows. As mentioned earlier, keloid scars form as a result of an upset in the physical constitution.The endocrine system plays an important role in the human constitution. Atomic bomb keloid scars formed as a result of temporary damage to the endocrine glands - particularly the parathyroid glands - caused by exposure to radiation. The gradual alleviation of this damage was therefore accompanied by the shrinkage and finally disappearance of the keloid scars.Several years after the atomic bombing, keloid scars could be surgically removed without fear of recurrence, and those left untreated disappeared spontaneously.

2) Cataract
Cataract is an ocular disease charactrized by a deterioration of vision due to clouding of the crystalline lens or its capsule. Cataract is sometimes seen in the elderly(senile cataract), but it occurred in a large number of atomic bomb survivors and so was referred to at one time as "atomic bomb cataract." Fortunately though, its progress was slow in the survivors and there has been no report of an atomic bomb cataract leading to blindness.Today the topic seems to have fallen from importance.

3) Leukemia
Leukemia is a virtually incurable malignant disease characterized by an abnormal increase in white blood cells.A high incidence of the disease was observed in the atomic bomb survivors, especially among those exposed to the explosion at close range.
At Nagasaki University, the Late Professor Masanobu Tomonaga began studies concerning Ieukemia soon after the war. He was succeeded by Professor Michito Ichimaru, who continues to this day (*1) to lead research into the hematological diseases of the atomic bomb survivors. Presently, there are very few cases of leukemia. This is a comfort to the survivors, but it is still too early to rule out any further occurrence of the disease.
(*1): This was written in 1986. Since 1991, Prof. Masao Tomonaga has succeeded the works.

4) Others
Other diseases occurring in the atomic bomb survivors include blood diseases such as aplastic anemia, liver diseases, lung cancer, diseases of the endocrine system, bone marrow disease and malignant tumors of the bone marrow. Like leukemia, these diseases are treated through national medical funding for the atomic bomb survivors.

The increasing incidence of lung cancer in Japan is attracting considerable attention. Smoking has been cited as the primary cause, but Dr. Ichimaru tells me that according to a survey carried out by the Radiation Effects Research Foundation (1950 to l972), the incidence of lung cancer among survivors is twice as high as that among persons who were not exposed to the atomic bombing.

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I was born on May 5, 1899 to a poor family living in a rural area of Fukuoka Prefecture, Kyushu Island. With the help of an uncle and the owner of a local mine, I was able to graduate from the medical course at Tokyo Imperial University and to become a surgeon under the instruction of Professors Kondo and Aoyama. After serving as assistant professor in the second department of surgery at Seoul Imperial University, I became professor of the first department of surgery at Nagasaki Medical College - a post that I held for 23 years.

Now, thanks to the support of numerous students and coIleagues, I am fortunate enough to be able to greet my 87th birthday.

In the course of this life, however, it was my destiny to experience Japan's defeat in World War II and the tragedy of the atomic bombing of Nagasaki. My chance survival of the bombing imposed upon me a mission to conduct research into the effects of the atomic bomb explosion on other survivors.

I have had numerous opportunities in the past to serve as a member on committees concerned with the atomic bombing, and to write about my personal experiences.

On the spur of the moment, I decided to write an abbreviated version of my experiences and an outline of the damages caused by the atomic bombing as a reference for young people who have not had contact with this information. For a more detailed account, I invite the reader to refer to my book Ishi-no-shogen Nagasaki-genbaku-taiken (a Physician's Testimony - The Experience of the Nagasaki Atomic Bombing).

This year(1986) has been designated as International Peace Year by the United Nations. Genuine worLd peace cannot be achieved without the abolition of nuclear weapons. As a survivor of the Nagasaki atomic bombing, I want to shout this appeal out to the world in the loudest voice I can muster.

May 5, 1986
Raisuke Shirabe

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Dr. Shirabe's Curriculum Vitae

1899 Apr.
Born in Asakura-gun, Fukuoka Prefecture
1912 Entered Asakura Middle School
1971 Entered Fifth Higher School
1920 Sep. Entered the medical course at Tokyo Imperial University
1924 Apr. Appointed assistant in the first department of surgery at Tokyo Imperial University (2 and 1/2 yrs.)
1926 Sep. Appointed chief of the surgery department at Do jinkai Beijing Hospital (2 yrs.)
1929 Apr. Appointed assistant professor of the second department of surgery at Seoul Imperial University (8 yrs.)
1934 Mar. Obtained Ph. D. degree
1937 May Appointed director of Gwangju Hospital in Gwangju, Korea (5 yrs.)
1942 Apr. Appointed professor of the first department of surgery at Nagasaki Medical College (23 yrs.)
1945 Aug. Appointed director'of Nagasaki Medical College Hospital (3 and 1/2 yrs.)
1955 Feb. Traveled to Europe and North America for study (4 months)
1957 Apr. Appointed member of the A-Bomb Survivors Medical Treatment Council (18 yrs.)
1958 Oct.
Appointed acting dean of the Nagasaki University School of Medicine (1 and 1/2 months)
1962 Jan. Received the Nagasaki Shimbun Culture Award
1963 Nov. Appointed acting dean of the Nagasaki University School of Medicine (1 month)
1965 Mar. Retired from the post of professor at Nagasaki University School of Medicine
1965 Aug. Appointed consultant at Isahaya General Hospital (17 and 1/2 yrs.)
1965 Sep. Appointed consultant at Sasebo Central Hospital (16 and 1/2 yrs.)
1971 Apr. Awarded the Second Class Order of the Sacred Treasure by the Japanese government
1975 Jun. Appointed visiting director of the Radiation Effects Research Foundation (8 yrs.)
1981 Nov. Appointed expert advisor to the A-Bomb Survivors Medical Treatment Council (2 yrs.)
1983 Jul. Appointed honorary consultant of the Radiation Effects Research Foundation
1989 Apr. Passed away (Age 89)

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  The Medical Effects of Atomic Bombing  
  Atomic Bomb Rescue and Relief Report:Dr.Takashi Nagai  
  Pathological Effects : Dr. Issei Nishimori  
  My Experience and Damages : Dr. Raisuke Shirabe  
  Dr. Raisuke Shirabe's Survey Sheets  
  Final Report of Manhattan Investigation  
  Archives related to damage from Atomic bombing  
  The damage at Medical College and Hospital  
  A-bomb experiences of medical staffs  
  Reminiscences at the time (Japanese)  
  Foget-me-not (Wasunenagusa)  
  Exhibition Room  
  Atomic Bombing Q&A for Kids  
  Atomic Bomb Survivor Database  
  Division of Scientific Data Registry
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