Chapter II: Part 2

Distance Total Killed per
from X, feet Killed Injured Missing Casualties square mile
0 - 1,640 7,505 960 1,127 9,592 24,700
1,640 - 3,300 3,688 1,478 1,799 6,965 4,040
3,300 - 4,900 8,678 17,137 3,597 29,412 5,710
4,900 - 6,550 221 11,958 28 12,207 125
6,550 - 9,850 112 9,460 17 9,589 20

No figure for total pre-raid population at these different distances were available. Such figures would be necessary in order to compute per cent mortality. A calculation made by the British Mission to Japan and based on a preliminary analysis of the study of the Joint Medical-Atomic Bomb Investigating Commission gives the following calculated values for per cent mortality at increasing distances from X:

TABLE C
Per-Cent Mortality at Various Distances

Distance from X, Per-cent Mortality
in feet
0 - 1000 93.0%
1000 - 2000 92.0
2000 - 3000 86.0
3000 - 4000 69.0
4000 - 5000 49.0
5000 - 6000 31.5
6000 - 7000 12.5
7000 - 8000 1.3
8000 - 9000 0.5
9000 - 10,000 0.0

It seems almost certain from the various reports that the greatest total number of deaths were those occurring immediately after the bombing. The causes of many of the deaths can only be surmised, and of course many persons near the center of explosion suffered fatal injuries from more than one of the bomb effects. The proper order of importance for possible causes of death is: burns, mechanical injury, and gamma radiation. Early estimates by the Japanese are shown in D below:

TABLE D
Cause of Immediate Deaths

City Cause of Death Per-cent of Total
Hiroshima Burns 60%
Falling debris 30
Other 10

Nagasaki Burns 95%
Falling debris 9
Flying glass 7
Other 7

THE NATURE OF AN ATOMIC EXPLOSION

The most striking difference between the explosion of an atomic bomb and that of an ordinary T.N.T. bomb is of course in magnitude; as the President announced after the Hiroshima attack, the explosive energy of each of the atomic bombs was equivalent to about 20,000 tons of T.N.T.

But in addition to its vastly greater power, an atomic explosion has several other very special characteristics. Ordinary explosion is a chemical reaction in which energy is released by the rearrangement of the atoms of the explosive material. In an atomic explosion the identity of the atoms, not simply their arrangement, is changed. A considerable fraction of the mass of the explosive charge, which may be uranium 235 or plutonium, is transformed into energy. Einstein's equation, E = mc^2, shows that matter that is transformed into energy may yield a total energy equivalent to the mass multiplied by the square of the velocity of light. The significance of the equation is easily seen when one recalls that the velocity of light is 186,000 miles per second. The energy released when a pound of T.N.T. explodes would, if converted entirely into heat, raise the temperature of 36 lbs. of water from freezing temperature (32 deg F) to boiling temperature (212 deg F). The nuclear fission of a pound of uranium would produce an equal temperature rise in over 200 million pounds of water.

The explosive effect of an ordinary material such as T.N.T. is derived from the rapid conversion of solid T.N.T. to gas, which occupies initially the same volume as the solid; it exerts intense pressures on the surrounding air and expands rapidly to a volume many times larger than the initial volume. A wave of high pressure thus rapidly moves outward from the center of the explosion and is the major cause of damage from ordinary high explosives. An atomic bomb also generates a wave of high pressure which is in fact of, much higher pressure than that from ordinary explosions; and this wave is again the major cause of damage to buildings and other structures. It differs from the pressure wave of a block buster in the size of the area over which high pressures are generated. It also differs in the duration of the pressure pulse at any given point: the pressure from a blockbuster lasts for a few milliseconds (a millisecond is one thousandth of a second) only, that from the atomic bomb for nearly a second, and was felt by observers both in Japan and in New Mexico as a very strong wind going by.

The next greatest difference between the atomic bomb and the T.N.T. explosion is the fact that the atomic bomb gives off greater amounts of radiation. Most of this radiation is "light" of some wave-length ranging from the so-called heat radiations of very long wave length to the so-called gamma rays which have wave-lengths even shorter than the X-rays used in medicine. All of these radiations travel at the same speed; this, the speed of light, is 186,000 miles per second. The radiations are intense enough to kill people within an appreciable distance from the explosion, and are in fact the major cause of deaths and injuries apart from mechanical injuries. The greatest number of radiation injuries was probably due to the ultra-violet rays which have a wave length slightly shorter than visible light and which caused flash burn comparable to severe sunburn. After these, the gamma rays of ultra short wave length are most important; these cause injuries similar to those from over-doses of X-rays.

The origin of the gamma rays is different from that of the bulk of the radiation: the latter is caused by the extremely high temperatures in the bomb, in the same way as light is emitted from the hot surface of the sun or from the wires in an incandescent lamp. The gamma rays on the other hand are emitted by the atomic nuclei themselves when they are transformed in the fission process. The gamma rays are therefore specific to the atomic bomb and are completely absent in T.N.T. explosions. The light of longer wave length (visible and ultra-violet) is also emitted by a T.N.T. explosion, but with much smaller intensity than by an atomic bomb, which makes it insignificant as far as damage is concerned.

A large fraction of the gamma rays is emitted in the first few microseconds (millionths of a second) of the atomic explosion, together with neutrons which are also produced in the nuclear fission. The neutrons have much less damage effect than the gamma rays because they have a smaller intensity and also because they are strongly absorbed in air and therefore can penetrate only to relatively small distances from the explosion: at a thousand yards the neutron intensity is negligible. After the nuclear emission, strong gamma radiation continues to come from the exploded bomb. This generates from the fission products and continues for about one minute until all of the explosion products have risen to such a height that the intensity received on the ground is negligible. A large number of beta rays are also emitted during this time, but they are unimportant because their range is not very great, only a few feet. The range of alpha particles from the unused active material and fissionable material of the bomb is even smaller.

Apart from the gamma radiation ordinary light is emitted, some of which is visible and some of which is the ultra violet rays mainly responsible for flash burns. The emission of light starts a few milliseconds after the nuclear explosion when the energy from the explosion reaches the air surrounding the bomb. The observer sees then a ball of fire which rapidly grows in size. During most of the early time, the ball of fire extends as far as the wave of high pressure. As the ball of fire grows its temperature and brightness decrease. Several milliseconds after the initiation of the explosion, the brightness of the ball of fire goes through a minimum, then it gets somewhat brighter and remains at the order of a few times the brightness of the sun for a period of 10 to 15 seconds for an observer at six miles distance. Most of the radiation is given off after this point of maximum brightness. Also after this maximum, the pressure waves run ahead of the ball of fire.

The ball of fire rapidly expands from the size of the bomb to a radius of several hundred feet at one second after the explosion. After this the most striking feature is the rise of the ball of fire at the rate of about 30 yards per second. Meanwhile it also continues to expand by mixing with the cooler air surrounding it. At the end of the first minute the ball has expanded to a radius of several hundred yards and risen to a height of about one mile. The shock wave has by now reached a radius of 15 miles and its pressure dropped to less than 1/10 of a pound per square inch. The ball now loses its brilliance and appears as a great cloud of smoke: the pulverized material of the bomb. This cloud continues to rise vertically and finally mushrooms out at an altitude of about 25,000 feet depending upon meteorological conditions. The cloud reaches a maximum height of between 50,000 and 70,000 feet in a time of over 30 minutes.

It is of interest to note that Dr. Hans Bethe, then a member of the Manhattan Engineer District on loan from Cornell University, predicted the existence and characteristics of this ball of fire months before the first test was carried out.

To summarize, radiation comes in two bursts--an extremely intense one lasting only about 3 milliseconds and a less intense one of much longer duration lasting several seconds. The second burst contains by far the larger fraction of the total light energy, more than 90%. But the first flash is especially large in ultra-violet radiation which is biologically more effective. Moreover, because the heat in this flash comes in such a short time, there is no time for any cooling to take place, and the temperature of a person's skin can be raised 50 degrees centigrade by the flash of visible and ultra-violet rays in the first millisecond at a distance of 4,000 yards. People may be injured by flash burns at even larger distances. Gamma radiation danger does not extend nearly so far and neutron radiation danger is still more limited.

The high skin temperatures result from the first flash of high intensity radiation and are probably as significant for injuries as the total dosages which come mainly from the second more sustained burst of radiation. The combination of skin temperature increase plus large ultra-violet flux inside 4,000 yards is injurious in all cases to exposed personnel. Beyond this point there may be cases of injury, depending upon the individual sensitivity. The infra-red dosage is probably less important because of its smaller intensity.

CHARACTERISTICS OF THE DAMAGE CAUSED BY THE ATOMIC BOMBS

The damage to man-made structures caused by the bombs was due to two distinct causes: first the blast, or pressure wave, emanating from the center of the explosion, and, second, the fires which were caused either by the heat of the explosion itself or by the collapse of buildings containing stoves, electrical fixtures, or any other equipment which might produce what is known as a secondary fire, and subsequent spread of these fires.

The blast produced by the atomic bomb has already been stated to be approximately equivalent to that of 20,000 tons of T.N.T. Given this figure, one may calculate the expected peak pressures in the air, at various distances from the center of the explosion, which occurred following detonation of the bomb. The peak pressures which were calculated before the bombs were dropped agreed very closely with those which were actually experienced in the cities during the attack as computed by Allied experts in a number of ingenious ways after the occupation of Japan.

The blast of pressure from the atomic bombs differed from that of ordinary high explosive bombs in three main ways:

A. Downward thrust. Because the explosions were well up in the air, much of the damage resulted from a downward pressure. This pressure of course most largely effected flat roofs. Some telegraph and other poles immediately below the explosion remained upright while those at greater distances from the center of damage, being more largely exposed to a horizontal thrust from the blast pressure waves, were overturned or tilted. Trees underneath the explosion remained upright but had their branches broken downward.

B. Mass distortion of buildings. An ordinary bomb can damage only a part of a large building, which may then collapse further under the action of gravity. But the blast wave from an atomic bomb is so large that it can engulf whole buildings, no matter how great their size, pushing them over as though a giant hand had given them a shove.

C. Long duration of the positive pressure pulse and consequent small effect of the negative pressure, or suction, phase. In any explosion, the positive pressure exerted by the blast lasts for a definite period of time (usually a small fraction of a second) and is then followed by a somewhat longer period of negative pressure, or suction. The negative pressure is always much weaker than the positive, but in ordinary explosions the short duration of the positive pulse results in many structures not having time to fail in that phase, while they are able to fail under the more extended, though weaker, negative pressure. But the duration of the positive pulse is approximately proportional to the 1/3 power of the size of the explosive charge. Thus, if the relation held true throughout the range in question, a 10-ton T.N.T. explosion would have a positive pulse only about 1/14th as long as that of a 20,000-ton explosion. Consequently, the atomic explosions had positive pulses so much longer then those of ordinary explosives that nearly all failures probably occurred during this phase, and very little damage could be attributed to the suction which followed.

One other interesting feature was the combination of flash ignition and comparative slow pressure wave. Some objects, such as thin, dry wooden slats, were ignited by the radiated flash heat, and then their fires were blown out some time later (depending on their distance from X) by the pressure blast which followed the flash radiation.

CALCULATIONS OF THE PEAK PRESSURE OF THE BLAST WAVE

Several ingenious methods were used by the various investigators to determine, upon visiting the wrecked cities, what had actually been the peak pressures exerted by the atomic blasts. These pressures were computed for various distances from X, and curves were then plotted which were checked against the theoretical predictions of what the pressures would be. A further check was afforded from the readings obtained by the measuring instruments which were dropped by parachute at each atomic attack. The peak pressure figures gave a direct clue to the equivalent T.N.T. tonnage of the atomic bombs, since the pressures developed by any given amount of T.N.T. can be calculated easily.

One of the simplest methods of estimating the peak pressure is from crushing of oil drums, gasoline cans, or any other empty thin metal vessel with a small opening. The assumption made is that the blast wave pressure comes on instantaneously, the resulting pressure on the can is more than the case can withstand, and the walls collapse inward. The air inside is compressed adiabatically to such a point that the pressure inside is less by a certain amount than the pressure outside, this amount being the pressure difference outside and in that the walls can stand in their crumpled condition. The uncertainties involved are, first, that some air rushes in through any opening that the can may have, and thus helps to build up the pressure inside; and, second, that as the pressure outside falls, the air inside cannot escape sufficiently fast to avoid the walls of the can being blown out again to some extent. These uncertainties are such that estimates of pressure based on this method are on the low side, i.e., they are underestimated.

Another method of calculating the peak-pressure is through the bending of steel flagpoles, or lightning conductors, away from the explosion. It is possible to calculate the drag on a pole or rod in an airstream of a certain density and velocity; by connecting this drag with the strength of the pole in question, a determination of the pressure wave may be obtained.

Still another method of estimating the peak pressure is through the overturning of memorial stones, of which there are a great quantity in Japan. The dimensions of the stones can be used along with known data on the pressure exerted by wind against flat surfaces, to calculate the desired figure.

LONG RANGE BLAST DAMAGE

There was no consistency in the long range blast damage. Observers often thought that they had found the limit, and then 2,000 feet farther away would find further evidence of damage.

The most impressive long range damage was the collapse of some of the barracks sheds at Kamigo, 23,000 feet south of X in Nagasaki. It was remarkable to see some of the buildings intact to the last details, including the roof and even the windows, and yet next to them a similar building collapsed to ground level.

The limiting radius for severe displacement of roof tiles in Nagasaki was about 10,000 feet although isolated cases were found up to 16,000 feet. In Hiroshima the general limiting radius was about 8,000 feet; however, even at a distance of 26,000 feet from X in Hiroshima, some tiles were displaced.

At Mogi, 7 miles from X in Nagasaki, over steep hills over 600 feet high, about 10% of the glass came out. In nearer, sequestered localities only 4 miles from X, no damage of any kind was caused. An interesting effect was noted at Mogi; eyewitnesses said that they thought a raid was being made on the place; one big flash was seen, then a loud roar, followed at several second intervals by half a dozen other loud reports, from all directions. These successive reports were obviously reflections from the hills surrounding Mogi.

GROUND SHOCK

The ground shock in most cities was very light. Water pipes still carried water and where leaks were visible they were mainly above ground. Virtually all of the damage to underground utilities was caused by the collapse of buildings rather than by any direct exertion of the blast pressure. This fact of course resulted from the bombs' having been exploded high in the air.

SHIELDING, OR SCREENING FROM BLAST

In any explosion, a certain amount of protection from blast may be gained by having any large and substantial object between the protected object and the center of the explosion. This shielding effect was noticeable in the atomic explosions, just as in ordinary cases, although the magnitude of the explosions and the fact that they occurred at a considerable height in the air caused marked differences from the shielding which would have characterized ordinary bomb explosions.

The outstanding example of shielding was that afforded by the hills in the city of Nagasaki; it was the shielding of these hills which resulted in the smaller area of devastation in Nagasaki despite the fact that the bomb used there was not less powerful. The hills gave effective shielding only at such distances from the center of explosion that the blast pressure was becoming critical--that is, was only barely sufficient to cause collapse--for the structure. Houses built in ravines in Nagasaki pointing well away from the center of the explosion survived without damage, but others at similar distances in ravines pointing toward the center of explosion were greatly damaged. In the north of Nagasaki there was a small hamlet about 8,000 feet from the center of explosion; one could see a distinctive variation in the intensity of damage across the hamlet, corresponding with the shadows thrown by a sharp hill.

The best example of shielding by a hill was southeast of the center of explosion in Nagasaki. The damage at 8,000 feet from X consisted of light plaster damage and destruction of about half the windows. These buildings were of European type and were on the reverse side of a steep hill. At the same distance to the south-southeast the damage was considerably greater, i.e., all windows and frames, doors, were damaged and heavy plaster damage and cracks in the brick work also appeared. The contrast may be illustrated also by the fact that at the Nagasaki Prefectural office at 10,800 feet the damage was bad enough for the building to be evacuated, while at the Nagasaki Normal School to which the Prefectural office had been moved, at the same distance, the damage was comparatively light.

Because of the height of the bursts no evidence was expected of the shielding of one building by another, at least up to a considerable radius. It was in fact difficult to find any evidence at any distance of such shielding. There appeared to have been a little shielding of the building behind the Administration Building of the Torpedo Works in Nagasaki, but the benefits were very slight. There was also some evidence that the group of buildings comprising the Medical School in Nagasaki did afford each other mutual protection. On the whole, however, shielding of one building by another was not noticeable.

There was one other peculiar type of shielding, best exhibited by the workers' houses to the north of the torpedo plant in Nagasaki. These were 6,000 to 7,000 feet north of X. The damage to these houses was not nearly as bad as those over a thousand feet farther away from the center of explosion. It seemed as though the great destruction caused in the torpedo plant had weakened the blast a little, and the full power was not restored for another 1,000 feet or more.

FLASH BURN

As already stated, a characteristic feature of the atomic bomb, which is quite foreign to ordinary explosives, is that a very appreciable fraction of the energy liberated goes into radiant heat and light. For a sufficiently large explosion, the flash burn produced by this radiated energy will become the dominant cause of damage, since the area of burn damage will increase in proportion to the energy released, whereas the area of blast damage increases only with the two-thirds power of the energy. Although such a reversal of the mechanism of damage was not achieved in the Hiroshima and Nagasaki bombs, the effects of the flash were, however, very evident, and many casualties resulted from flash burns. A discussion of the casualties caused by flash burns will be given later; in this section will be described the other flash effects which were observed in the two cities.

The duration of the heat radiation from the bomb is so short, just a few thousandths of a second, that there is no time for the energy falling on a surface to be dissipated by thermal defusion; the flash burn is typically a surface effect. In other words the surface of either a person or an object exposed to the flash is raised to a very high temperature while immediately beneath the surface very little rise in temperature occurs.

The flash burning of the surface of objects, particularly wooden objects, occurred in Hiroshima up to a radius of 9,500 feet from X; at Nagasaki burns were visible up to 11,000 feet from X. The charring and blackening of all telephone poles, trees and wooden posts in the areas not destroyed by the general fire occurred only on the side facing the center of explosion and did not go around the corners of buildings or hills. The exact position of the explosion was in fact accurately determined by taking a number of sights from various objects which had been flash burned on one side only.

To illustrate the effects of the flash burn, the following describes a number of examples found by an observer moving northward from the center of explosion in Nagasaki. First occurred a row of fence posts at the north edge of the prison hill, at 0.3 miles from X. The top and upper part of these posts were heavily charred. The charring on the front of the posts was sharply limited by the shadow of a wall. This wall had however been completely demolished by the blast, which of course arrived some time after the flash. At the north edge of the Torpedo works, 1.05 miles from X, telephone poles were charred to a depth of about 0.5 millimeters. A light piece of wood similar to the flat side of an orange crate, was found leaning against one of the telephone poles. Its front surface was charred the same way as the pole, but it was evident that it had actually been ignited. The wood was blackened through a couple of cracks and nail holes, and around the edges onto the back surface. It seemed likely that this piece of wood had flamed up under the flash for a few seconds before the flame was blown out by the wind of the blast. Farther out, between 1.05 and 1.5 miles from the explosion, were many trees and poles showing a blackening. Some of the poles had platforms near the top. The shadows cast by the platforms were clearly visible and showed that the bomb had detonated at a considerable height. The row of poles turned north and crossed the mountain ridge; the flash burn was plainly visible all the way to the top of the ridge, the farthest burn observed being at 2.0 miles from X.

Another striking effect of the flash burn was the autumnal appearance of the bowl formed by the hills on three sides of the explosion point. The ridges are about 1.5 miles from X. Throughout this bowl the foliage turned yellow, although on the far side of the ridges the countryside was quite green. This autumnal appearance of the trees extended to about 8,000 feet from X.

However, shrubs and small plants quite near the center of explosion in Hiroshima, although stripped of leaves, had obviously not been killed. Many were throwing out new buds when observers visited the city.

There are two other remarkable effects of the heat radiated from the bomb explosion. The first of these is the manner in which heat roughened the surface of polished granite, which retained its polish only where it was shielded from the radiated heat travelling in straight lines from the explosion. This roughening by radiated heat caused by the unequal expansion of the constituent crystals of the stone; for granite crystals the melting temperature is about 600 deg centigrade. Therefore the depth of roughening and ultimate flaking of the granite surface indicated the depth to which this temperature occurred and helped to determine the average ground temperatures in the instant following the explosion. This effect was noted for distances about 1 1/2 times as great in Nagasaki as in Hiroshima.

The second remarkable effect was the bubbling of roof tile. The size of the bubbles and their extent was proportional to their nearness to the center of explosion and also depended on how squarely the tile itself was faced toward the explosion. The distance ratio of this effect between Nagasaki and Hiroshima was about the same as for the flaking of polished granite.

Various other effects of the radiated heat were noted, including the lightening of asphalt road surfaces in spots which had not been protected from the radiated heat by any object such as that of a person walking along the road. Various other surfaces were discolored in different ways by the radiated heat.

As has already been mentioned the fact that radiant heat traveled only in straight lines from the center of explosion enabled observers to determine the direction toward the center of explosion from a number of different points, by observing the "shadows" which were cast by intervening objects where they shielded the otherwise exposed surface of some object. Thus the center of explosion was located with considerable accuracy. In a number of cases these "shadows" also gave an indication of the height of burst of the bomb and occasionally a distinct penumbra was found which enabled observers to calculate the diameter of the ball of fire at the instant it was exerting the maximum charring or burning effect.

One more interesting feature connected with heat radiation was the charring of fabric to different degrees depending upon the color of the fabric. A number of instances were recorded in which persons wearing clothing of various colors received burns greatly varying in degree, the degree of burn depending upon the color of the fabric over the skin in question. For example a shirt of alternate light and dark gray stripes, each about 1/8 of an inch wide, had the dark stripes completely burned out but the light stripes were undamaged; and a piece of Japanese paper exposed nearly 1 1/2 miles from X had the characters which were written in black ink neatly burned out.

CHARACTERISTICS OF THE INJURIES TO PERSONS

Injuries to persons resulting from the atomic explosions were of the following types:

A. Burns, from
1. Flash radiation of heat
2. Fires started by the explosions.
B. Mechanical injuries from collapse of buildings, flying debris, etc.
C. Direct effects of the high blast pressure, i.e., straight
compression.
D. Radiation injuries, from the instantaneous emission of gamma rays and
neutrons.

It is impossible to assign exact percentages of casualties to each of the types of injury, because so many victims were injured by more than one effect of the explosions. However, it is certain that the greater part of the casualties resulted from burns and mechanical injures. Col. Warren, one of America's foremost radioligists, stated it is probable that 7 per cent or less of the deaths resulted primarily from radiation disease.

The greatest single factor influencing the occurrence of casualties was the distance of the person concerned from the center of explosion.

Estimates based on the study of a selected group of 900 patients indicated that total casualties occurred as far out as 14,000 feet at Nagasaki and 12,000 feet at Hiroshima.

Burns were suffered at a considerable greater distance from X than any other type of injury, and mechanical injuries farther out than radiation effects.

Medical findings show that no person was injured by radioactivity who was not exposed to the actual explosion of the bombs. No injuries resulted from persistent radioactivity of any sort.

BURNS

Two types of burns were observed. These are generally differentiated as flame or fire burn and so-called flash burn.

The early appearance of the flame burn as reported by the Japanese, and the later appearance as observed, was not unusual.

The flash burn presented several distinctive features. Marked redness of the affected skin areas appeared almost immediately, according to the Japanese, with progressive changes in the skin taking place over a period of a few hours. When seen after 50 days, the most distinctive feature of these burns was their sharp limitation to exposed skin areas facing the center of the explosion. For instance, a patient who had been walking in a direction at right angles to a line drawn between him and the explosion, and whose arms were swinging, might have burns only on the outside of the arm nearest the center and on the inside of the other arm.

Generally, any type of shielding protected the skin against flash burns, although burns through one, and very occasionally more, layers of clothing did occur in patients near the center. In such cases, it was not unusual to find burns through black but not through white clothing, on the same patient. Flash burns also tended to involve areas where the clothes were tightly drawn over the skin, such as at the elbows and shoulders.

The Japanese report the incidence of burns in patients surviving more than a few hours after the explosion, and seeking medical attention, as high as 95%. The total mortalities due to burns alone cannot be estimated with any degree of accuracy. As mentioned already, it is believed that the majority of all the deaths occurred immediately. Of these, the Japanese estimate that 75%, and most of the reports estimate that over 50%, of the deaths were due to burns.

In general, the incidence of burns was in direct proportion to the distance from X. However, certain irregularities in this relationship result in the medical studies because of variations in the amount of shielding from flash burn, and because of the lack of complete data on persons killed outright close to X.

The maximum distance from X at which flash burns were observed is of paramount interest. It has been estimated that patients with burns at Hiroshima were all less than 7,500 feet from the center of the explosion at the time of the bombing. At Nagasaki, patients with burns were observed out to the remarkable distance of 13,800 feet.

MECHANICAL INJURIES

The mechanical injuries included fractures, lacerations, contusions, abrasions, and other effects to be expected from falling roofs, crumbling walls, flying debris and glass, and other indirect blast effects. The appearance of these various types of mechanical injuries was not remarkable to the medical authorities who studied them.

It was estimated that patients with lacerations at Hiroshima were less than 10,600 feet from X, whereas at Nagasaki they extended as far as 12,200 feet.

The tremendous drag of wind, even as far as 1 mile from X, must have resulted in many injuries and deaths. Some large pieces of a prison wall, for example, were flung 80 feet, and many have gone 30 feet high before falling. The same fate must have befallen many persons, and the chances of a human being surviving such treatment are probably small.

BLAST INJURIES

No estimate of the number of deaths or early symptoms due to blast pressure can be made. The pressures developed on the ground under the explosions were not sufficient to kill more than those people very near the center of damage (within a few hundred feet at most). Very few cases of ruptured ear drums were noted, and it is the general feeling of the medical authorities that the direct blast effects were not great. Many of the Japanese reports, which are believed to be false, describe immediate effects such as ruptured abdomens with protruding intestines and protruding eyes, but no such results were actually traced to the effect of air pressure alone.

RADIATION INJURIES

As pointed out in another section of this report the radiations from the nuclear explosions which caused injuries to persons were primarily those experienced within the first second after the explosion; a few may have occurred later, but all occurred in the first minute. The other two general types of radiation, viz., radiation from scattered fission products and induced radioactivity from objects near the center of explosion, were definitely proved not to have caused any casualties.

The proper designation of radiation injuries is somewhat difficult. Probably the two most direct designations are radiation injury and gamma ray injury. The former term is not entirely suitable in that it does not define the type of radiation as ionizing and allows possible confusion with other types of radiation (e.g., infra-red). The objection to the latter term is that it limits the ionizing radiation to gamma rays, which were undoubtedly the most important; but the possible contribution of neutron and even beta rays to the biological effects cannot be entirely ignored. Radiation injury has the advantage of custom, since it is generally understood in medicine to refer to X-ray effect as distinguished from the effects of actinic radiation. Accordingly, radiation injury is used in this report to mean injury due only to ionizing radiation.

According to Japanese observations, the early symptons in patients suffering from radiation injury closely resembled the symptons observed in patients receiving intensive roentgen therapy, as well as those observed in experimental animals receiving large doses of X-rays. The important symptoms reported by the Japanese and observed by American authorities were epilation (lose of hair), petechiae (bleeding into the skin), and other hemorrhagic manifestations, oropharyngeal lesions (inflammation of the mouth and throat), vomiting, diarrhea, and fever.

Epilation was one of the most spectacular and obvious findings. The appearance of the epilated patient was typical. The crown was involved more than the sides, and in many instances the resemblance to a monk's tonsure was striking. In extreme cases the hair was totally lost. In some cases, re-growth of hair had begun by the time patients were seen 50 days after the bombing. Curiously, epilation of hair other than that of the scalp was extremely unusual.

Petechiae and other hemorrhagic manifestations were striking findings. Bleeding began usually from the gums and in the more seriously affected was soon evident from every possible source. Petechiae appeared on the limbs and on pressure points. Large ecchymoses (hemorrhages under the skin) developed about needle punctures, and wounds partially healed broke down and bled freely. Retinal hemorrhages occurred in many of the patients. The bleeding time and the coagulation time were prolonged. The platelets (coagulation of the blood) were characteristically reduced in numbers.

Nausea and vomiting appearing within a few hours after the explosion was reported frequently by the Japanese. This usually had subsided by the following morning, although occasionally it continued for two or three days. Vomiting was not infrequently reported and observed during the course of the later symptoms, although at these times it generally appeared to be related to other manifestation of systemic reactions associated with infection.

Diarrhea of varying degrees of severity was reported and observed. In the more severe cases, it was frequently bloody. For reasons which are not yet clear, the diarrhea in some cases was very persistent.

Lesions of the gums, and the oral mucous membrane, and the throat were observed. The affected areas became deep red, then violacious in color; and in many instances ulcerations and necrosis (breakdown of tissue) followed. Blood counts done and recorded by the Japanese, as well as counts done by the Manhattan Engineer District Group, on such patients regularly showed leucopenia (low-white blood cell count). In extreme cases the white blood cell count was below 1,000 (normal count is around 7,000). In association with the leucopenia and the oropharyngeal lesions, a variety of other infective processes were seen. Wounds and burns which were healing adequately suppurated and serious necrosis occurred. At the same time, similar ulcerations were observed in the larynx, bowels, and in females, the gentalia. Fever usually accompanied these lesions.

Eye injuries produced by the atomic bombings in both cities were the subject of special investigations. The usual types of mechanical injuries were seen. In addition, lesions consisting of retinal hemorrhage and exudation were observed and 75% of the patients showing them had other signs of radiation injury.

The progress of radiation disease of various degrees of severity is shown in the following table:

Summary of Radiation Injury
Clinical Symptoms and Findings

Day
after
Explo-
sion Most Severe Moderately Severe Mild
1. 1. Nausea and vomiting 1. Nausea and vomiting
2. after 1-2 hours. after 1-2 hours.
3. NO DEFINITE SYMPTOMS
4.
5. 2. Diarrhea
6. 3. Vomiting NO DEFINITE SYMPTOMS
7. 4. Inflammation of the
mouth and throat
8. 5. Fever
9. 6. Rapid emaciation
10. Death NO DEFINITE SYMPTOMS
11. (Mortality probably 2. Beginning epilation.
12. 100%)
13.
14.
15.
16.
17.
18. 3. Loss of appetite
19. and general malaise. 1. Epilation
20. 4. Fever. 2. Loss of appetite
21. 5. Severe inflammation and malaise.
22. of the mouth and throat 3. Sore throat.
23. 4. Pallor.
24. 5. Petechiae
25. 6. Diarrhea
26. 7. Moderate emacia-
27. 6. Pallor. tion.
28. 7. Petechiae, diarrhea
29. and nose bleeds (Recovery unless com-
30. plicated by previous
31. 8. Rapid emaciation poor health or
Death super-imposed in-
(Mortality probably 50%) juries or infec-
tion).

It was concluded that persons exposed to the bombs at the time of detonation did show effects from ionizing radiation and that some of these patients, otherwise uninjured, died. Deaths from radiation began about a week after exposure and reached a peak in 3 to 4 weeks. They practically ceased to occur after 7 to 8 weeks.

Treatment of the burns and other physical injuries was carried out by the Japanese by orthodox methods. Treatment of radiation effects by them included general supportative measures such as rest and high vitamin and caloric diets. Liver and calcium preparations were administered by injection and blood transfusions were used to combat hemorrhage. Special vitamin preparations and other special drugs used in the treatment of similar medical conditions were used by American Army Medical Corps officers after their arrival. Although the general measures instituted were of some benefit no definite effect of any of the specific measures on the course of the disease could be demonstrated. The use of sulfonamide drugs by the Japanese and particularly of penicillin by the American physicians after their arrival undoubtedly helped control the infections and they appear to be the single important type of treatment which may have effectively altered the earlier course of these patients.

One of the most important tasks assigned to the mission which investigated the effects of the bombing was that of determining if the radiation effects were all due to the instantaneous discharges at the time of the explosion, or if people were being harmed in addition from persistent radioactivity. This question was investigated from two points of view. Direct measurements of persistent radioactivity were made at the time of the investigation. From these measurements, calculations were made of the graded radiation dosages, i.e., the total amount of radiation which could have been absorbed by any person. These calculations showed that the highest dosage which would have been received from persistent radioactivity at Hiroshima was between 6 and 25 roentgens of gamma radiation; the highest in the Nagasaki Area was between 30 and 110 roentgens of gamma radiation. The latter figure does not refer to the city itself, but to a localized area in the Nishiyama District. In interpreting these findings it must be understood that to get these dosages, one would have had to remain at the point of highest radioactivity for 6 weeks continuously, from the first hour after the bombing. It is apparent therefore that insofar as could be determined at Hiroshima and Nagasaki, the residual radiation alone could not have been detrimental to the health of persons entering and living in the bombed areas after the explosion.

The second approach to this question was to determine if any persons not in the city at the time of the explosion, but coming in immediately afterwards exhibited any symptoms or findings which might have been due to persistence induced radioactivity. By the time of the arrival of the Manhattan Engineer District group, several Japanese studies had been done on such persons. None of the persons examined in any of these studies showed any symptoms which could be attributed to radiation, and their actual blood cell counts were consistently within the normal range. Throughout the period of the Manhattan Engineer District investigation, Japanese doctors and patients were repeatedly requested to bring to them any patients who they thought might be examples of persons harmed from persistent radioactivity. No such subjects were found.

It was concluded therefore as a result of these findings and lack of findings, that although a measurable quantity of induced radioactivity was found, it had not been sufficient to cause any harm to persons living in the two cities after the bombings.

SHIELDING FROM RADIATION

Exact figures on the thicknesses of various substances to provide complete or partial protection from the effects of radiation in relation to the distance from the center of explosion, cannot be released at this time. Studies of collected data are still under way. It can be stated, however, that at a reasonable distance, say about 1/2 mile from the center of explosion, protection to persons from radiation injury can be afforded by a layer of concrete or other material whose thickness does not preclude reasonable construction.

Radiation ultimately caused the death of the few persons not killed by other effects and who were fully exposed to the bombs up to a distance of about 1/2 mile from X. The British Mission has estimated that people in the open had a 50% chance of surviving the effects of radiation at 3/4 of a mile from X.

EFFECTS OF THE ATOMIC BOMBINGS ON THE INHABITANTS OF THE BOMBED CITIES

In both Hiroshima and Nagasaki the tremendous scale of the disaster largely destroyed the cities as entities. Even the worst of all other previous bombing attacks on Germany and Japan, such as the incendiary raids on Hamburg in 1943 and on Tokyo in 1945, were not comparable to the paralyzing effect of the atomic bombs. In addition to the huge number of persons who were killed or injuried so that their services in rehabilitation were not available, a panic flight of the population took place from both cities immediately following the atomic explosions. No significant reconstruction or repair work was accomplished because of the slow return of the population; at the end of November 1945 each of the cities had only about 140,000 people. Although the ending of the war almost immediately after the atomic bombings removed much of the incentive of the Japanese people toward immediate reconstruction of their losses, their paralysis was still remarkable. Even the clearance of wreckage and the burning of the many bodies trapped in it were not well organized some weeks after the bombings. As the British Mission has stated, "the impression which both cities make is of having sunk, in an instant and without a struggle, to the most primitive level."

Aside from physical injury and damage, the most significant effect of the atomic bombs was the sheer terror which it struck into the peoples of the bombed cities. This terror, resulting in immediate hysterical activity and flight from the cities, had one especially pronounced effect: persons who had become accustomed to mass air raids had grown to pay little heed to single planes or small groups of planes, but after the atomic bombings the appearance of a single plane caused more terror and disruption of normal life than the appearance of many hundreds of planes had ever been able to cause before. The effect of this terrible fear of the potential danger from even a single enemy plane on the lives of the peoples of the world in the event of any future war can easily be conjectured.

The atomic bomb did not alone win the war against Japan, but it most certainly ended it, saving the thousands of Allied lives that would have been lost in any combat invasion of Japan.

EYEWITNESS ACCOUNT
Hiroshima--August 6th, 1945

by Father John A. Siemes, professor of modern philosphy at Tokyo's Catholic University

Up to August 6th, occasional bombs, which did no great damage, had fallen on Hiroshima. Many cities roundabout, one after the other, were destroyed, but Hiroshima itself remained protected. There were almost daily observation planes over the city but none of them dropped a bomb. The citizens wondered why they alone had remained undisturbed for so long a time. There were fantastic rumors that the enemy had something special in mind for this city, but no one dreamed that the end would come in such a fashion as on the morning of August 6th.

August 6th began in a bright, clear, summer morning. About seven o'clock, there was an air raid alarm which we had heard almost every day and a few planes appeared over the city. No one paid any attention and at about eight o'clock, the all-clear was sounded. I am sitting in my room at the Novitiate of the Society of Jesus in Nagatsuke; during the past half year, the philosophical and theological section of our Mission had been evacuated to this place from Tokyo. The Novitiate is situated approximately two kilometers from Hiroshima, half-way up the sides of a broad valley which stretches from the town at sea level into this mountainous hinterland, and through which courses a river. From my window, I have a wonderful view down the valley to the edge of the city.

Suddenly--the time is approximately 8:14--the whole valley is filled by a garish light which resembles the magnesium light used in photography, and I am conscious of a wave of heat. I jump to the window to find out the cause of this remarkable phenomenon, but I see nothing more than that brilliant yellow light. As I make for the door, it doesn't occur to me that the light might have something to do with enemy planes. On the way from the window, I hear a moderately loud explosion which seems to come from a distance and, at the same time, the windows are broken in with a loud crash. There has been an interval of perhaps ten seconds since the flash of light. I am sprayed by fragments of glass. The entire window frame has been forced into the room. I realize now that a bomb has burst and I am under the impression that it exploded directly over our house or in the immediate vicinity.

I am bleeding from cuts about the hands and head. I attempt to get out of the door. It has been forced outwards by the air pressure and has become jammed. I force an opening in the door by means of repeated blows with my hands and feet and come to a broad hallway from which open the various rooms. Everything is in a state of confusion. All windows are broken and all the doors are forced inwards. The bookshelves in the hallway have tumbled down. I do not note a second explosion and the fliers seem to have gone on. Most of my colleagues have been injured by fragments of glass. A few are bleeding but none has been seriously injured. All of us have been fortunate since it is now apparent that the wall of my room opposite the window has been lacerated by long fragments of glass.

We proceed to the front of the house to see where the bomb has landed. There is no evidence, however, of a bomb crater; but the southeast section of the house is very severely damaged. Not a door nor a window remains. The blast of air had penetrated the entire house from the southeast, but the house still stands. It is constructed in a Japanese style with a wooden framework, but has been greatly strengthened by the labor of our Brother Gropper as is frequently done in Japanese homes. Only along the front of the chapel which adjoins the house, three supports have given way (it has been made in the manner of Japanese temple, entirely out of wood.)

Down in the valley, perhaps one kilometer toward the city from us, several peasant homes are on fire and the woods on the opposite side of the valley are aflame. A few of us go over to help control the flames. While we are attempting to put things in order, a storm comes up and it begins to rain. Over the city, clouds of smoke are rising and I hear a few slight explosions. I come to the conclusion that an incendiary bomb with an especially strong explosive action has gone off down in the valley. A few of us saw three planes at great altitude over the city at the time of the explosion. I, myself, saw no aircraft whatsoever.

Perhaps a half-hour after the explosion, a procession of people begins to stream up the valley from the city. The crowd thickens continuously. A few come up the road to our house. We give them first aid and bring them into the chapel, which we have in the meantime cleaned and cleared of wreckage, and put them to rest on the straw mats which constitute the floor of Japanese houses. A few display horrible wounds of the extremities and back. The small quantity of fat which we possessed during this time of war was soon used up in the care of the burns. Father Rektor who, before taking holy orders, had studied medicine, ministers to the injured, but our bandages and drugs are soon gone. We must be content with cleansing the wounds.

More and more of the injured come to us. The least injured drag the more seriously wounded. There are wounded soldiers, and mothers carrying burned children in their arms. From the houses of the farmers in the valley comes word: "Our houses are full of wounded and dying. Can you help, at least by taking the worst cases?" The wounded come from the sections at the edge of the city. They saw the bright light, their houses collapsed and buried the inmates in their rooms. Those that were in the open suffered instantaneous burns, particularly on the lightly clothed or unclothed parts of the body. Numerous fires sprang up which soon consumed the entire district. We now conclude that the epicenter of the explosion was at the edge of the city near the Jokogawa Station, three kilometers away from us. We are concerned about Father Kopp who that same morning, went to hold Mass at the Sisters of the Poor, who have a home for children at the edge of the city. He had not returned as yet.