Hiroshima and Nagasaki: The Physical, Medical and Social Effects of the Atomic Bombings 
translated by Eisei Ishikawa and David Swain.
Hutchinson, 706 pp., £20, August 1981, 0 09 145640 1
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President Reagan’s attention span is known to be brief, and he is said to prefer his memoranda to be limited to a single page. It is therefore unlikely that he will read closely the 640-page report which describes experience of the bombings of Hiroshima and Nagasaki. Nevertheless, it would be useful if he – and Mr Brezhnev – were to look through the photographs, which, for the convenience of those who will get no further, have been wisely placed before the text. They reveal a pivotal fact about the use of nuclear weapons: that the most desirable outcome for those within their reach is not to survive. In these pictures the faces of the living, helpless and hopeless, are more disturbing than the bodies of the dead.

‘I would rather be tied to the soil as another man’s serf, even a poor man’s, who hadn’t much to live on himself, than be King of all these the dead and destroyed.’ Homer’s words might have been written for the 20th century, for they need little change to make them appropriate to the nuclear age.

There must be few lives, even in the poorest country, which would not be preferable to that of the first citizen in a post-nuclear metropolis.

In relation to their experience of civilian bombing, the world’s population can be divided into three classes: the large majority who have had no experience of it; those exposed to conventional weapons during or since World War Two; and the small number who were in Hiroshima and Nagasaki on 6 and 9 August 1945. The contrast between the experiences of the last two classes is instructive. Many of the bombs intended for British and German cities never reached their targets. Those that did caused extensive physical damage but had surprisingly limited effects on day-to-day existence. There was no breakdown of morale, and indeed, as Bertrand Russell noted, for many people the changes during wartime provided welcome relief from the routine of their ordinary lives. (The sombre figures in Henry Moore’s drawings do not reflect accurately the quality of life in air-raid shelters.) The economic consequences of the bombing in World War Two were less obvious and were often overestimated by those who might have been expected to be well-informed. I was involved in examination of the effects of raids on British cities, and I remember interviewing the manager of a major port who was under the impression that the results of the bombing were very serious indeed. His grounds for this conclusion were threefold: he could not get a hot meal, drive his car across town or communicate by telephone with the dockside. But in the port itself, ships were loaded and unloaded with remarkably little delay in spite of loss of contact with the directorate. Even after the heaviest raids the interruption to industry was a matter of days rather than weeks or months, a finding confirmed when the effects on German cities became known. The results of civilian bombing by conventional weapons might be compared to a series of major accidents. For those killed, wounded or homeless the consequences were tragic: but for many others not directly involved ‘life laughed and moved on unsubdued.’

The report now published by the Japanese authorities presents a very different picture. It can be considered from two points of view: as a historical record of everything related to the atomic bombs; and as a presentation of experience of the first bombs which, it is hoped, will ensure that they are also the last. The dust-cover provides an unusually accurate summary of what has been achieved under the first heading: ‘The book is the definitive account of the destruction of Hiroshima and Nagasaki. It brings together literally all that is known about the short-term and long-term effects of the most frightening event of the 20th century. More than four years in the making, this clearly-written and jargon-free account is both a summary and an analysis by Japan’s leading physicists, physicians and social scientists of the full findings about the immediate damage of the bombs – in killing and wounding people and in smashing down buildings – and their permanent medical, genetic, social and psychological effects.’

The contrast between the Japanese bombings and World War Two experience of conventional weapons is perhaps least striking in the physical damage. The damage was of course enormous: the central area of Hiroshima was completely destroyed and only 8 per cent of the buildings in the city could still be used; in Nagasaki, although the bomb was more powerful, the physical damage was somewhat less, chiefly because of differences in the terrain and distribution of buildings and because the hypocenter was located some distance from the city centre. But the human eye, like the imagination, is limited in scope, and, for an observer standing in the devastated areas of Berlin or Cologne in 1945, the scene was probably not very different from that at the centre of the Japanese cities. The far more significant differences were in the effects on people and organised life.

Because of uncertainty about the population in the towns when the bombs fell it has been difficult to make precise estimates of the numbers killed, but the best figures now available suggest that in the five years to 1950 more than half the population died as a result of the raids: 200,000 out of 350,000 persons in Hiroshima and 140,000 out of 270,000 in Nagasaki. Injuries were of three kinds: thermal injury, blast injury and radiation injury. Thermal injuries were primary, caused by the direct action of heat rays on the body, or secondary, from fires produced by atomic-bomb thermal rays. Blast injuries were also primary, due to the direct effect of blast, or secondary, from destruction of buildings by blast. Radiation injury was due to initial radiation from gamma rays and neutrons emitted immediately after the explosion, or to residual radiation caused by the action of radiation from various neutron-induced radioisotopes in the air and on earth or in fall-out composed of nuclear-fission products. Perhaps the text should be quoted to give some idea of the realities behind this scientific analysis:

Of the victims receiving severe thermal burns in the central district, their clothes were completely burned, and they themselves were blown away by the blast. The exposed skin was burned, inflamed and desquamated; and in many people the skin became loosened and dropped down in flaps. Most of the victims received direct thermal injuries to the viscera and died instantly or soon after the explosion. Demarcation and falling-off of burned necrotic tissue took time in victims receiving moderate thermal injury at the hypocenter and up to about two kilometres away. Furthermore, since all had received varying degrees of ionising radiation, there were many complications with suppuration of the injured surface due to delayed healing owing to altered tissue reaction and also to lowered resistance to infection. The fact that normal recovery processes were delayed by suppuration led to debility and poor prognosis. Malnutrition – at a time when the food situation was poor, and drugs were in short supply – also influenced the recovery process. Many of these victims developed contractures of scars and keloid.

The greatest number of casualties, including about 90 per cent of the fatal cases, occurred immediately or before the end of the second week. Many moderate injuries caused by radioactivity appeared between the third and eighth weeks, and in this period most of the remaining fatal cases died. By the end of the fourth month many of the surviving patients had recovered to a certain degree: but delayed effects began to appear and have continued to the present day. The first case of atomic-bomb cataract was observed in 1948, and there have been many others since then. Leukaemia appeared in 1945, and although its incidence reached a peak between 1950 and 1953, the disease is still common. There was an increase in the frequency of various cancers – of thyroid, breast, lung and salivary glands. Microcephaly occurred in some infants exposed to the effects of the bomb during pregnancy. Fortunately, no harmful genetic effects have so far been observed in either the first or second generations, but the Japanese workers consider that the observations must continue for several generations.

The report describes the psychological stress to which those who retained or recovered consciousness were exposed. They find it very difficult to convey their experience of ‘utter chaos’ to those who have not shared it: ‘It was like hell.’ ‘It was beyond words.’ ‘All those wounds and burns.’ ‘Unless you are an A-bomb victim you can’t understand.’ Most victims, however, began soon to recover their mental equilibrium, especially if they were able to leave the city temporarily and to receive treatment for their wounds and burns. But in a short time other reasons for anxiety began to appear.

First, there was always the threat to their health from delayed radiation effects. Second, there was the fear that their children would be unhealthy or deformed. Third, economic instability threatened if delayed radiation effects decreased their ability to work and care for themselves and also required increased medical expenses. Fourth, death, sickness and decline or loss of ability to work and manage could further accelerate the disintegration of A-bomb victims’ families. Fifth, discrimination against them by non-victims added to life’s difficulties.

These multiple effects on health, life and livelihood imposed a great psychological burden, and made their efforts to rebuild their lives extremely vulnerable to external pressures.

A socio-psychological survey in 1954 left no doubt that the atom-bomb experience was brutalising. The instinctive reaction of the victims was to protect themselves and to get away from the bombed areas as quickly as possible. Perpetuation of the genes does not require children to be nice to their parents, but it is saddening to learn that the tendency was to abandon them and for husbands to leave their wives – although not for mothers to abandon their children.

The report on Hiroshima and Nagasaki states that the seriousness of atomic destruction cannot be understood unless it is recognised that, in addition to the injuries and stress suffered by individuals, there is profound damage to the whole social fabric. Where parents were injured or killed, the entire household suffered and was unable to function as a corporate body. Many stores, factories and offices were forced to close because of loss of personnel. Over half the schools, hospitals and other community organisations were destroyed. And as key members of the community were killed or wounded, the community itself disintegrated and traditional society collapsed. The devastation was worse in Hiroshima, which experienced total loss of its central functions. Nagasaki narrowly escaped with very heavy damage but not total loss of its key capabilities.

In addition to the more obvious effects, there were many circumstances related to the bombings which made the experience particularly bitter to those who survived. In the first place, they were completely unprepared, psychologically as well as physically, for an atom-bomb attack, and for some time the authorities tried to conceal the nature of the disaster. In Hiroshima, for example, on 7 August, the police offered the remarkable advice that ‘all burns should first be bathed in solution of half sea water and half fresh water; this way we can fully defend ourselves against this kind of attack.’ Another reason for bitterness was that the survivors were neglected as well as deceived. The Japanese government at the time was extremely bureaucratic and accepted no responsibility for assistance or compensation; even today it rejects the demand for an ‘A-bomb Victims Relief Law’ that would require it to extend aid to those who suffered bodily injury or loss of livelihood. Aid was provided by the cities of Hiroshima and Nagasaki, but it was quite inadequate and many ‘A-bomb victims have had to grow old and die in social isolation.’ Thus their initial suffering was exacerbated by political decisions.

A third source of unhappiness for those affected was the outcome of the war itself and the way they thought of their experience in relation to it. For a time they believed that their suffering was a necessary sacrifice for Japan’s achievement of hegemony in the East, and that the proper response to the bombs was to seek revenge against the enemy. Indeed, it was rumoured in Hiroshima that ‘this makes it possible for our planes to attack America with atomic bombs’ – an attempt to retain some psychological equilibrium despite the massive destruction. The Emperor’s unexpected declaration of Japan’s defeat within ten days of the bombings was far more shocking to the victims than to the general public, for it undermined their belief in the need for their sacrifice. In time, yet another source of comfort was removed. On the day after the attack on Hiroshima, President Truman said that ‘the A-bomb was dropped in order to end the Pacific War.’ ‘Once the American occupation got under way a new interpretation was propagated: Japan’s war effort was a great folly, the end of the war a great good; the public was released from allegiance to the state, and defeat became the gateway to peace.’ The belief that the Allied forces had ‘liberated’ the Japanese people gradually spread, and the idea that the A-bomb damages were ‘a sacrifice that Japan simply had to accept’ began to gain currency, not least with the victims. This view was shaken when it became known that ‘the A-bomb attacks were needed not so much against Japan – already on the brink of surrender and no longer capable of mounting an effective counter-offensive – as to establish America’s post-war international position and strategic supremacy in the anticipated cold war setting. One tragedy of Hiroshima and Nagasaki is that this historically unprecedented devastation of human society stemmed from essentially experimental and political aims.’ This interpretation, advanced by Blackett (in 1947) among others, is accepted by the authors of Hiroshima and Nagasaki, as well as by the survivors of the attacks.

There is one further circumstance which must have convinced the people in Nagasaki that fate was indeed against them: the fact that initially the bomb was not intended for their city. The primary target on 9 August 1945 was Kokura: but this town was covered by heavy clouds, and after circling the area for about ten minutes, the planes headed for Nagasaki, their second target. Here again there were clouds: but a gap revealed the Mitsubishi Heavy Industries Nagasaki Arsenal and the bomb was released.

The final part of Hiroshima and Nagasaki – ‘Toward the Abolition of Nuclear Weapons’ – was written to support the cause to which many people in the two cities have dedicated their lives. For although the events of 1945 are widely known, knowledge and understanding of them are far from adequate. ‘Indeed, with the change of generations and the persistent expansion of the nuclear arms race, these experiences fade into the background and are, in fact, in danger of being forgotten.’ (The report summarises the progressive development of nuclear weapons, from atom to hydrogen bomb – in the US, 1945, 1952; Russia, 1949, 1953; Britain, 1952, 1957; France, 1960, 1968.) The atomic bomb, like the war itself, is now history, no longer a living experience. Even in Hiroshima and Nagasaki ‘there now were more and more children who did not know who dropped the bomb, or when; who were not worried about political trends that left the peace constitution increasingly void of substance.’

Hiroshima and Nagasaki is an admirable history of the Japanese tragedy, and it is not a criticism of its immense achievement to say that the extent to which it will contribute to the abolition of nuclear weapons is an open question. It is a large book, quite expensive, and in spite of its excellent writing some imagination is needed to envisage the grim realities behind the tables and figures. Unfortunately, contrary to the views expressed in many self-congratulatory publications – Bronowski’s Ascent of Man is a recent example – man was a late starter and is slow in learning. It is only during the last few thousand years that his control of the environment has been sufficient to advance his health significantly beyond that of other living things; it is only in the last few hundred years that his control of reproduction has made it unnecessary to resort to infanticide and homicide; and he has not yet learned to preserve his health by behaving in ways which are in accord with the requirements of his genes. His recently-acquired technological skills are advancing far more rapidly than his moral or common sense. Who would have guessed that his best idea for preventing war would be to make its effects so widespread and so frightful that if it occurred no one would be safe? Or that the aggressive postures of two antagonists would be unaffected by the certain knowledge that if they fight both will lose? According to his mood, the Almighty may be greatly amused that his most ‘intelligent’ creation is at risk of using his brains to destroy himself; or He may react like Arkel in Pelléas et Mélisande: ‘Si j’étais Dieu, j’aurais pitié du coeur des hommes.’

If anything in the report might raise a wry smile, it is the description of the effect of the bombs on other living things. Even near the hypocenter, the earthworms were apparently unharmed, still able to regenerate joints when segments were experimentally removed; with the resilience characteristic of the arthropods, the flies and mosquitoes disappeared for a few days and then returned in greater numbers; the litters of rats and rabbits were only slightly below normal size; and after a winter’s repose the shattered tree trunks, unlike the corpses, developed buds and began to sprout. In Hiroshima two years after the bomb, ‘the people obtained a rich harvest of wheat, tomato, eggplant and soybean which surpassed that in nearby villages’; there was a particularly good crop of tomatoes, which ‘formerly were difficult to raise inside the city because of blight and insects’; and ‘fauna at the hypocenter had recovered to a degree that did not differ from that in other districts.’ There is cosmic justice in the conclusion that if man destroys himself, many of his humbler fellow creatures will resume their lives after no more than a temporary setback.

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