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Editor, 編者, 편자, Redakteur NISHIYAMA Katsuo, 西山勝夫 17/7/2014 多言語版(multilingual version, 다언어판, vielsprachige Version) WAR AND MEDICAL ETHICS 战争与医学伦理 Translator KOJIMA Somei 監翻譯員 金成民中文版, 패널집 전쟁과 의(医)의 윤리 Krieg und Medizin 감역자 任祥赫 Übersetzer: KUBO Schun ichi Publication, 出版, 출판, Veröffentlichung Inaugural Meeting of the Association for the Verification of Inhuman Conduct by Japanese Researchers and Health Care Professionals during the War 战争与医学伦理 检证推进会 "전쟁과 의사의 윤리 검증추진위원회 Forderungsverein fur die.krieg und medizinische Ethik

WAR AND MEDICAL ETHICS English version Translator KOJIMA Somei 1

WAR AND MEDICAL ETHICS Participation and Responsibility of the Japanese Medical Researchers and Physicians for the Fifteen Years War with Special Reference to Unit 731 Towards the Improvement of Medical Education and Ethics in Future Prospectus Because of recent remarkable progress in medical science and patient care, human beings face new ethical problems. Medical researchers and health care professionals are obliged to tackle those problems as their own. It is essential to the success of this enterprise to look back and reflect seriously on the recent past. In the particular case of Japan, it is essential for Japanese themselves to investigate and to try to learn important lessons from the participation of the Japanese Association of Medical Sciences (JAMS)/the Japan Medical Association (JMA) in the 15 Years War and Unit 731 including the inhuman conduct at the front during the war, such as human experimentation, vivisection, the practice of operating on living human bodies and the case of the vivisection of 8 POWs at Kyushu Imperial University School of Medicine etc. However, the whole picture of these problems is not yet clear and the verification of the facts is not easy because of the destruction and dispersal of contemporaneous documents and the secrecy and concealment of remaining ones. As for Unit 731, in order to acquire its research results, GHQ, which occupied Japan after the defeat of Japan, questioned many medical researchers and health professionals involved in the Unit on the understanding that GHQ would not to raise the issue of their war crimes. Under these circumstances, the truth of the Unit 731 issue has been treated among the circles of JMA/JAMS as obscure or the issue itself as resolved or taboo. In 1951, on its accession to the World Medical Association, the JMA, representing Japanese doctors, issued the statement that as the representative institution of Japanese doctors, JMA, on this occasion, reprimands the violence inflicted upon the people of the enemy countries, and condemns the alleged and in a few cases actually performed cruelties on patients, (The Journal of the Japan Medical Association, vol. 26, p. 71, 1951) and has since treated the issue as resolved. But this statement did not point towards a future for Japanese medical sciences and health care based on the eradication of racism and the protection of human rights, which could have resulted from a serious reflection on the past inhuman conduct by Japanese researchers and health care professionals. Thus, Japan entered the 21 st century without having made serious efforts to confront the inhuman, wartime conduct committed by the Japanese medical profession and to make the best use of the lessons that could have been learned. We must draw from the historical lesson that Those who close their eyes to the past become blind to the present. (Richard von Weizsäcker 1985). Consequently, it is essential for the establishment of medical ethics and the true progress of medical care and sciences in Japan to reveal and further verify the historical facts concerning the atrocities committed by the Japanese medical profession during the war. In this regard, it is vital for JMA/JAMS, which represent Japanese medical circles, and for involved academic associations and universities to tackle the issue as their own. The Executive Committee of the War and Medicine exhibition at the 27 th General Assembly of the Japan Medical Congress (2007) asked the Congress that a verification of the historical facts be undertaken as an official project of the General Assembly, but that request was not approved. Instead, the Congress only permitted a small exhibition booth for a standard fee. Consequently, the Executive Committee implemented a small exhibition on its own a War and Medicine panel exhibition at the assigned exhibition booth, and held an international symposium at another venue. Based on these achievements, we will make a great effort to carry on the activities necessary for the further verification of the historical facts with a view towards the 28 th General Assembly of the Japan Medical Congress (Spring of 2011, Tokyo) among other activities. After the 60 years since the end of the war, it is becoming more difficult to collect the testimony of the relevant survivors and documents from that era. We must, therefore, speed up our efforts for the verification. Furthermore, vital for an objective verification on the basis of historical facts is the cooperation of not just medical researchers and doctors but also co-medicals, such as nurses, and historians, bioethicists and lawyers as well as others. Although the verification of the deeds done during in the war needs to be carried out by all levels of civil society, it is important that medical circles, more than anyone else, carry out seriously their share of the verification and inform the nation of the results because the attitude of medical scientists and doctors can directly affect human lives. In addition, for the successful verification by all levels of the nation to occur, an educational campaign, including mass media, and aimed towards the nation, is also needed. We found this association in order to carry out the activities as explained above in the prospectus. We hope from the bottom of our hearts that the activities of this Association for the Verification of Inhuman Conduct by Japanese Researchers and Health Care Professionals during the War will contribute to: 1) the development of the medical sciences and health care based on human rights and dignity; 2) the improvement of medical ethics; and 3) the eventual realization of a warless and peaceful society in Japan. 2

September 27, 2009 Inaugural Meeting of the Association for the Verification of Inhuman Conduct by Japanese Researchers and Health Care Professionals during the War Introduction In the annual meeting of the House of Delegates of the Japan Medical Association (JMA) held on 30 th March 1949, it was unanimously approved that As the representative institution of Japanese doctors, the JMA, denounces atrocities inflicted upon the people of the enemy countries, and condemns the alleged and in a few cases actually performed cruelties on patients. In this statement, nothing was described specifically about the atrocities allegedly committed against so called patients. Without a more accurate compilation of historical facts, it would be impossible to criticize or to condemn such atrocities. The present exhibition aims to confirm what we know up to now, and to offer some serious reflections and apologies on behalf of the Japanese medical community. In addition, we would also like to provide further evidence in the hope that such crimes against medical ethics will never be repeated. The exhibition consists of five parts and joint displays set out on panels. Part 1: The history of the atrocities committed by Japanese medical researchers and physicians during the Fifteen Years War. Part 2: Japanese colonial medicine and practices: The impact on civilians. Part 3: Military recruitment of medical communities and their resistance. Part 4: The postwar medical establishment in Japan: How medical war crimes were concealed after the war. Part 5: How history helped the establishment of a new medical ethics. Joint Displays: Noborito Institute Museum for Peace Education, Meiji University. Panel 1-1 [Part 1] History of the Atrocities Committed by Japanese Medical Researchers and Physicians during the Fifteen Years War Part 1 shows how Japanese medical researchers and physicians killed thousands of people during the Fifteen Years War starting from 1931. These deaths were largely the result of experiments in surgery and other treatments on a range of POW`s and others. These treatments were carried out in institutes of military medicine, led by Unit 731 which was organized by ISHII Shiro, in army hospitals built in the occupied territories. Other experiments were also performed at prestigious academies such as Manchuria Medical College or Kyushu Imperial University. <Figure 1> Map of Manchukuo, indicating Harbin (where Unit 731 was situated, Arrow 1), and Mukuden (Hotien) (Shenyang) (where Manchuria Medical College existed, Arrow 2). Liutiahu was located at the north of Shenyang. Liutiahu was the site of Manchurian Incident which began the Fifteen Years War. Panel 1-2 ISHII Shiro ISHII Shiro graduated from Kyoto Imperial University School of Medicine in 1920. The prohibition of the use of poisonous gas and biological weapons in war by the Geneva Protocol in 1925 paradoxically encouraged him to realize the potential of biological weapons and to prompt the upper echelons of the army into the research and development of such weapons. In 1930, ISHII returned from studying in the West and began to serve as a teacher at the Japanese Army Medical School. He saw the development of biological weapons as a way not only to create a network of research institutions for military medicine that would surpass already existing imperial medical schools but also to improve the status of army surgeons. <Photo> ISHII Shiro, the last portrait in military uniform (1946). Panel 1-3 Epidemic Prevention Research Laboratory of the Japanese Army Medical School In 1931, the Kwantung Army used the Manchurian Incident as a pretest and conquered Northeast China. This provided ISHII with an opportunity to carry out his schemes. In August 1932, he founded the Epidemic Prevention Research Laboratory (EPRL) at the Japanese Army Medical School and in October of the next year, when a new laboratory building was constructed at the campus next to the Medical School, he became the principal of the Laboratory. He went to Manchuria together with his staff with the special mission to set up a secret service for epidemic prevention. Large numbers of research reports were published by many doctors and physicians who participated in Unit 731 and the Army Medical School, or joined as non-regular staff from various medical colleges. This work is recorded in the Reports of the Army School Epidemic Prevention Research Laboratory (Part II), which was 3

discovered in the Library of Congress of the United States of America. In July, 1989, human bones of about one hundred bodies were discovered from the site of the EPRL. Analysis by experts of anatomy confirmed the fact that the bones were from foreigners of Asian origin and that they had been artificially treated. At present, further excavation is on-going to unearth more human remains from the site. Panel 1-4 Establishment of the Togo Unit From 1932 to 1933, soon after the foundation of the EPRL, ISHII established a clandestine prevention water supply unit, i.e. so called Togo Unit, in a poor village of Beiyinhe near Wuchang, about 70 km southeast of Harbin, thereby initiating some of the research into bacteriological warfare and human experimentation. Most of the victims were Chinese. KURIHARA Yoshio, who worked in the Togo Unit as a nonmilitary employee from 1935 to 1936, was forced to perform endurance experiments in which subjects were allowed to take nothing but water. After the war, he testified as follows: [I was ordered to do experiments under a civilian person, Mr. SUGAWARA Satoshi, to examine how many days men can live on only water alone. In that experiment, the person who was given plain water lived for 45 days, while another given distilled water lived for 33 days. The latter was forced to keep drinking distilled water and as death approached, asked Sir, please give me water with taste! The man who lived for 45 days was a medical doctor named ZUO Guangya. He was a real intellectual and not a bandit at all.] <Photo> KURIHARA Yoshio, drawing a picture of a punishment cage called Lo-Tsu in which two persons of Maruta (a derogatory term for captured Chinese people) were imprisoned. Panel 1-5 Construction of Facilities in Pingfang The facilities of the Togo Unit in Beiyinhe were insufficient to conduct lethal human experimentation extensively and in secret. In addition, 16 inmates succeeded in escaping from the facilities, which became no longer secret. Therefore ISHII and the Kwantung Army left the installation in Beiyinhe and decided to move to Pingfang about 15km southeast of Harbin. In 1935, inhabitants of four neighboring villages were expelled, and by around 1939, a large military base for studying and manufacturing biological weapons had been constructed, with a headquarters building of Unit 731, laboratories for various experiments, jails, and an airfield for exclusive use. In addition, residences for Unit members and their families (commonly known as Togo Village), dormitories for boy soldiers, and power centers for heating were also provided in the base. The number of Japanese members belonging to Unit 731 and their families reached a maximum of as many as 3,000 individuals in 1942. The area surrounding the facilities of Pingfang with a total of 80 km 2 was designated as a special military zone. The central part of 6 km 2 for the headquarters was isolated and surrounded by a mud wall, high voltage wires, and a moat. The main building, which functioned as the experimental research institution and biological weapons plant, was as large as 100 m 2 with three stories and was called the Number Ro Building after its shape of the phonetic Japanese syllabic letter, ロ (read as ro ). Human subjects were kept in two special jails, which were placed in the quadrangle of the building so that captives might be unable to escape. <Photo> Panoramic view of devil facilities of the Unit 731: The picture was taken by the air force and the photography squad, clearly showing the headquarters building with the special jails surrounding it (known as log (maruta) lodges). Panel 1-6 Branches of Unit 731 Unit 731 established in Pingfang, a suburb of Harbin, had its own field experiment sites in Anda, about 150km northwest of Harbin, and in Hailar. In addition, four branches were placed in Mudanjiang, Linkou, Sunwu, and Hailar, respectively, all of which were located along the border with the USSR, providing a war against the USSR. Thus, if a sub branch at Dalian was included, Unit 731 had set up five branches in total. Panel 1-7 Special Transfer Procedure of Maruta (Logs) In Unit 731, victims of human experimentation were called maruta or logs. They were captured as members of resistance against Manchukuo or Japan, and Chinese, Russians and Koreans were included. These people were sent to Pingfang under a system called special transfer procedure, which was specified by the Japanese Army to procure subjects for human experimentation. Surgeon Major KAWASHIMA Kiyoshi, Bacterial Production Director, admitted in response to interrogations at the Khabarovsk Trial (1949) that women and children were also held in the special jails. Thus, at least 3,000 people were sent to the Unit as subjects of the experimentation and none of them was able to return alive. 4

<Photo> Documents of the military police of the Japanese Imperial Army concerning the special transfer procedure discovered in China after the War: The term Socho described in the document means Soviet spy. Panel 1-8 Organization of Unit 731 ISHII Shiro worked as the captain of Unit 731 during most of the Fifteen Years War. KITANO Masaji was his successor from August 1942 to March 1945 but after that, until August 1945, ISHII again occupied the position. Unit 731 consisted of eight sections, but among them four sections from Section 1to Section 4 played important central roles. Sections 1 and 4 were set up in the inside of the main building of the Number Ro House. Section 1 was provided for the Department of Bacteriology (Director: KIKUCHI Hitoshi) which consisted of more than 10 laboratories according to bacterial species, while Section 4 was for the Department of Bacterial Production (Director: KAWASHIMA Kiyoshi). Section 4 had a capacity of producing a huge amount of bacteria, for example, 300 kg of pest bacillus, 800~900 kg of Salmonella typhi, and 1 t of Vibrio cholerae every month, respectively. Thus, bacteria like pest bacillus produced in the section were distributed through more than ten areas in China. Section 2 (Director: OHTA Kiyoshi) carried out operational studies, having departments for studying plant extermination (YAGISAWA Yukimasa), entomology (TANAKA Hideo), and an aviation team (MASUDA Yoshio), so that the section was able to breed fleas used for infection to pest bacillus. Section 3 (Director: EGUCHI Toyokiyo) manufactured the Ishii type water filter, which was set up next to the Army Hospital at Nangang, Harbin, in order to camouflage Unit 731 as if it was an institution specialized only for epidemic prevention and water supply. In fact, however, ceramic bombs (Uji type bombs) were produced as containers for pest bacillus in this Section. Besides the sections mentioned above, the Unit had sections for Education, General Affairs, Materials, and Clinics where human experimentations using maruta (logs) as well as medical examination and treatment of the Unit members were performed. Panel 1-9 Development of Methods for Raising Fleas Infected with Pest Bacilli in Unit 731 It was pest fleas that Unit 731 had developed as the most effective biological weapon. Instead of dispersing the bacteria directly, the Unit developed methods of infecting the vector fleas with pest bacilli, and ways of distributing them by dusting buffers or filling ceramic bombshells with such fleas. After the War, Norbert H. Fell who was dispatched as a US military investigator to interrogate members of the Unit, described in his report of 30 June 1947: A great deal of work was carried out on methods of breeding fleas and infecting them with pest bacilli through rats. It was found that pest fleas were able to survive for about 30 days under the most appropriate conditions and that they could maintain their infecting ability during all that time. When human subjects were allowed to move freely inside of a room where 20 fleas/m 2 had been released, six out of ten subjects became infected and four of them died. Most of the bacteria distributed in China were pest bacilli. <Drawing> A confessed testing method of pest flea-bombs. Panel 1-10 Toxicity Test of Pest Bacilli In his book published in 2004, SHINOZUKA Yoshio (former family name TAMURA), a boy soldier of Unit 731, described human experimentations carried out for vaccine development against pest bacilli as follows: In Karasawa squad, we performed human experimentations and vivisections under the name of the toxicity test in order to confirm the infectivity and toxicity of produced bacilli. We always earnestly worked on how to obtain bacteria strong enough to exert the toxicity and killing power to humans. We used to perform mass killing experiments with animals such as mice or rats, but as a quick and easy way we also performed human experimentations. I murdered five persons by these experiments. The place was used by a special squad. There were dissecting rooms inside the 7 th and 8 th ward of the two-story building in the Number Ro House. There were dissecting rooms also in a place outside connected with a corridor. The place we did vivisections was the room of the 8 th ward. Panel 1-11 Frostbite Experiments in Unit 731 YOSHIMURA Hisato conducted research on frostbite in Unit 731 from 1938 to the defeat in 1945. His experiments were cruel ones in which the limbs of human subjects were artificially frozen. In 1941 at a meeting of the Harbin branch of the Manchuria Medical Association, YOSHIMURA presented his research results in which he demonstrated a graph recording changes of skin temperature and finger volume during the congealing process of the fingers. (Since YOSHIMURA s original drawing was handwritten and illegible, the graph shown below was a copy restored by KARITA Keishiro). After the war, YOSHIMURA published a paper in English in which he described the results obtained from 5

an experiment on a 3-day newborn, although the above mentioned graph, which clearly indicates the freezing of the fingers of the subjects, was not included in the article. Panel 1-12 Anthrax Experiments in Unit 731 Norbert H. Fell, in his report in June 1947, mentioned bombing tests using Anthrax carried out in the field as follows: In most cases, human subjects were bound to a post, being protected with a helmet and a suit of armour. Then various types of bombs were dropped such as those fixed to explode on the ground or those attached with time triggering devices and detonated from airplanes. He also described field experiments using Uji-type bombs (ceramic bombs) that the bacillus was detected from the blood of 6 among 10 subjects; 4 of them were considered to be infected through respiratory organs and all of them were dead. The distance between these four subjects and 9 exploded bombs was in range of only 25 m. Human experimentations with Anthrax were also performed by various infection routes such as subcutaneous injections, oral or oral spray infections, and nasal infections. Panel 1-13 Experiments on Epidemic Hemorrhagic Fever In 1944, KASAHARA Shiro who had joined Unit 731 published an article co-authored with KITANO Masaji who was the captain of the Unit for a certain period of time, describing how they had detected the pathogen of epidemic hemorrhagic fever. This disease was epidemic in northeast China, for enough in Sunwu, near the border with the Soviet Union, where it was called Sunwu fever. After the war, KASAHARA admitted himself that he had performed infection experiments using human subjects. IKEDA Naeo, in his report entitled Experimental studies on pathogenesis of epidemic hemorrhagic fever, also described, I succeeded to cause the disease by putting toxic fleas on the lower abdomen of a healthy person named MARUYAMA. Panel 1-14 Expansion of Epidemic Prevention and Water Supply Departments Epidemic prevention and water supply departments like Unit 731 in Harbin were formed in various areas of China. By 1940, such departments were organized in Beijing ( Kou Unit 1855), Nanjing ( Sakae Unit 1644) and Canton ( Nami Unit 8604). As Unit 731 was authorized as a formal army unit under the control of the Commander in Chief of the Kwantung Army, these units were under the command of Commanders of the North China, the Central China, and the South China Expeditionary Armies, respectively. These units had several and sometimes more than ten branches and some had army hospitals or Dojin Association hospitals, and cross linkages with the Manchuria Medical College. (For details, refer to Section 2). Thus, a system for bacteriological warfare was built up throughout the whole of China with a strong network of Unit 731 in terms of human and material resources and therefore members of Unit 731 as well as ISHII Shiro made frequently official visits from Pingfang to other epidemic prevention institutions. The bacteria produced by Unit 731 were sprayed in various parts of China with co-operation with other units, especially Unit 1644 in Nanjing. Furthermore, immediately after the Japanese Army occupied Singapore in February 1942, the Southern Expeditionary Army Epidemic Prevention and Water Supply Department ( Oka Unit 9420) was built up there. NAITO Ryoichi and KIHOIN Akio were dispatched from Pingfang to teach and help to develop the department. Thus, the bacteriological warfare system had been established under the overall architecture of the Japanese Army, with human experimentations carried out in some of the epidemic prevention institutions or their branches. Panel 1-15 Human Experimentations in Unit 1644 in Nanjing In 1998, a box stuffed with many human cranial bones was discovered from 1.5 m below ground at a site of the bacteria producing factory of the Nanjing Sakae Unit 1644. Careful and thorough studies by specialists of forensic medicine revealed that the total number of cranial bones was 41, consisting of 27 males, one female and 13 of undetermined sex, between the ages of 17 to 38 years old. The cranial bones were black and found to be treated with sulfuric acid. Gene analysis disclosed the enterotoxin gene of Vibrio cholerae, leading to the conclusion that these bones were those of victims of human experimentations with V. cholera (KAO Shinzu and CHU Chengshan, 2000). The research report is kept in the Nanjing Massacre Museum and the excavated bones are displayed so as to reproduce the situation of the excavation. <Photos> Left: Display of human cranial bones (real ones) excavated from the site of bacterial weapons factory. Right: The building where vivisections were carried out. Panel 1-16 Kwantung Army Military Horse Epidemic Prevention Arsenal (Unit 100) In 1936, in the same year as the establishment of Unit 731, the Kwantung Army Military Horse Epidemic 6

Prevention Arsenal (Unit 100) was set up in Xinjing (present Changchun), where experiments were carried out not only on livestock but on humans. MITOMO Kazuo, a sergeant of Unit 100, disclosed in his statement at the Khabarovsk Trial that he assisted after poison administration trials on Russian and Chinese prisoners under the guidance of a research fellow. <Photo> A document of the statement of MITOMO Kazuo at the Khabarovsk Trial, presenting his assistance in poison administration trials. From Materials on the Trial of Former Servicemen of the Japanese Army Charged with Manufacturing and Employing Bacteriological Weapons (Moscow: Foreign Languages Publishing House, 1950, p.109) Panel 1-17 Attacks with Biological Weapons The Japanese Army attacked China with biological weapons, mainly with those of pest fleas, at least 7 or 8 times. Examples included at Nomonhan in July 1939, Nongan in June 1940, Zhejiang Province (Quzhou, Ningbo) in October 1940, Junhua of the same province in November 1940, Chande of Hunan Province in November 1941, on the occasion of the Sekkan (Chekiang-Kiangsi) Operation in May 1942 and Kanzhou in July of the same year. A then staff officer of the China Expeditionary Army, Lieutenant Colonel IMOTO Kumao, wrote in his business log on 7 October 1940 that he received a report by an officer of Unit 731 mentioning that the germ attacks to several places including Ningbo had been carried out 6 times in total until now. IMOTO also described the bombing of Chande with plague-infected fleas by Japanese Army planes on 4 November 1941 and spraying of bacteria on the ground performed as a part of the Sekkan Operation in 1942. Moreover, it was written that the use of these biological weapons was conducted by the cooperation between Unit 731 and the Nanjing Unit 1644 under the guidance of ISHII Shiro. Panel 1-18 Victims of Attacks with Biological Weapons Recent surveys carried out by civil organizations in Japan as well as by the Committees for Survey of Victims of Bacteriological Warfare, which were organized in various parts of China, have exposed the actual situations of victims caused by the spraying of microbes by the Japanese Army. It should be pointed out that the power of the spray of biological weapons depends on their ability to cause secondary or tertiary infections by moving of initially infected individuals. For example, pest bombs dropped down to Cheishen on 4 October 1940 resulted in more than 1,500 deaths while a railroad employee who had returned from a business trip to Cheishen caused more than 200 deaths in Yiwu 120 km from Cheishen. In addition, the plague infected villages near Yiwu and resulted in more than 400 deaths among about 1,200 villagers, i.e. one third of the total population, in Chungshantsun. Furthermore, by pest fleas dropped on Changde on 4 November 1940 infected surrounding villages causing more than 7,000 deaths. As the distribution of victims by bacterial infections might be considered to be a natural occurrence of plague, there was merit in the Japanese Army hiding the facts of pest bombing. The table on the next page shows the number of victims up to 10,000 or more which was confirmed later in the court of the bacterial warfare (the final judgment was made by the Japan Supreme Court in May 2007) by counting numbers reported by inhabitants but not including those whose entire family members were dead nor those who were unclear regarding the cause of death, which suggests the possible existence of further numbers of victims. Accordingly, the numbers listed here must be considered provisional. Further surveys are required to clarify the actual situation (Table). <Explanations of figures> (Upper) Areas dropped down with pollutants, in relation to the areas where plague-infected rats or patients were found. (Lower) Expansion of plague victims toward the surrounding areas of Changde. Panel 1-19 A Newly Disclosed Article on Attacks by Biological Weapons Recently, an inside report of Unit 731 covering attacks with biological weapons was discovered (the Asahi Shimbun, 15 October 2011). This article was entitled A simplified calculation method for evaluation of the PX effects which was submitted by KANEKO Jun-ichi, a member of Unit 731, to the University of Tokyo for application of the thesis for the degree of Doctor of Medical Science in 1948. The original form of this article had been enclosed in the Part 1 (undiscovered yet) of the Japanese Army Military Medical School Epidemic Prevention Research Report. The word PX means pest-infected fleas. The table cited from the article describes a summary of the weight of used fleas and the numbers of infected individuals in 6 operations in China from 1940 to 42, suggesting that the total of the infected had reached up to 25,964 individuals, if secondary infections were included. The presence of this newly discovered work undermines the basis of the Japanese Government s insistence that there was no evidence of the existence of bacterial warfare. 7

<Photo> The cover page of KANEKO Jun-ichi s article appeared in Number 60, Part 1 of the Japanese Army Military Medical School Epidemic Prevention Research Report. Panel 1-20 Field Trials of Chemical Weapons In addition to biological weapons, Unit 731 carried out experimental studies on the development of chemical weapons in collaboration with Unit 516. In September 1940, a human experimentation was performed to examine the effects of yperite gas (mustard gas, erosive gas) in the north of Mudanjiang in the presence of the commander of the Kwantung Army Artillery and general supervisor of maneuvers. This was done under the inspection of UMEDU Yoshijiro, the commander of the Kwantung Army, and the leaders. The Unit 731 recorded details of the observation of the effects of shooting with about 10,000 yperite bullets on the bodies of 16 subjects who had been placed in 3 areas with different conditions (see the report shown below). The observation records on the 16 subjects correspond to the note described as mustard gas: examples of humans, appropriate 16 samples in Hill s Report (December 1947) which was completed through surveys done by the USA after the War. <Photo and Figure> A part of the text of the report prepared by the Unit Kamo (1940) and the attached map showing places of subjects set up in the field of the experiment. Panel 1-21 Vivisections Performed in Kyushu Imperial University Faculty of Medicine From May to June of 1945, Prof. ISHIYAMA Fukujiro and his students of the First Department of Surgery at the Faculty of Medicine, Kyushu Imperial University, performed experimental surgery and murdered8 POWs, the crew of a US Military B-29 that had been shot down. May 17: Removal of whole lobes of one side of the lungs from each of 2 POWs. May 22: Total removal of the stomach of 1 POW, arrest of bleeding by compressing the aorta, thus causing cardiac arrest, then open the chest, cardiac massage and cardiac surgery. Incision in the upper abdomen of another POW, cholecystectomy, and excision of a lobe of the liver. May 25: Brain surgery on 1 POW (trigeminal nerve block). June 2: Drawing about 500ml of blood from the right femoral artery of 1 POW, and injecting him with about 300ml of a blood substitute. Mediastinal surgery on another POW. Removal of the gallbladder of the last POW, injecting 200ml of a blood substitute, removal of the liver, open chest, cardiac massage, myocardial incision, suture, and hemostasis by pressing the aorta. Panel 1-22 Research on Hygiene in the Winter Season Surgeon Major TANIMURA Kazuharu at the Datong Army Hospital organized a Winter Hygiene Research Team and conducted a field exercise in Inner Mongolia from 31 January to 11 February 1941. The purpose was to investigate on frostbite, and also surgery, hemostasis and blood transfusion inside a tent. Members of the North China Expeditionary Army Epidemic Prevention and Water Supply Department also participated in this team. They carried 8 Chinese as living bodies, i.e. experimental materials. These 8 Chinese people were the subjects of the experiments or surgeries as mentioned above, before eventually being executed by vivisection or shooting. <Table> List of experimental materials carried by the research team; on the left are listed the names, ages, and numbers of 8 Chinese referred to as living bodies. <Photo> Victims under watch during setting up of a tent. Panel 1-23 Experiments to Develop Battlefield Surgery Techniques Experiments performed by TANIMURA s team included; 1. Enterectomy, followed by edge to edge anastomosis. 2. Amputation of the left thigh. 3. Treatments after making a penetrating gunshot wound through the soft part of the left brachium and a similar wound through the left lumbo-abdominal area. 4. Transfusion with three kinds of blood, i.e. preserved blood, frozen blood and sheep blood. 5. Causing and treatment of frostbite. 6. Panel 1-24 TANIMURA Team s Frostbite Experiments and Funeral Address for Victims 8

In the early morning of 6 February 1941, TANIMURA and his subordinates conducted frostbite experiments on subjects under different conditions such as forcing them to wear wet socks and gloves, to be intoxicated, hungry, or injected with atropine. After the experiments, TANIMURA killed 8 subjects and read the funeral address for victims at a memorial service which was held on 8 February 1941. Panel 1-25 Surgery Exercises in Military Hospitals Apart from Unit 731, anesthetized Chinese captives were often vivisected to death under the guise of surgery exercises in Japanese army hospitals located in various places in China. These surgical exercises were purportedly intended to provide training for novice surgeons in treatment of soldiers injured in the frontlines. It was the Winter Hygiene Research Team headed by TANIMURA that performed such surgical exercises. Besides TANIMURA s team, Army Surgeon YUASA Ken (one of the organizers of the Association for the Verification of Inhuman Conduct by Japanese Researchers and Health Care Professionals during the War, died in 2010), was dispatched to a military hospital in Luan, Shanxi Province, confessed his own surgical exercise which had resulted in the death of a Chinese captive. Panel 2-1 [Part 2] Japanese Colonial Medicine and Practices: Infliction on Civilians Until defeat in 1945, Japan governed colonies which included the Korean Peninsula and Taiwan, founded Manchukuo, and went so far as to occupy China and Southeast Asia. In the second part, information on colonial medicine and practices Japan offered to these colonies and occupied territories is exhibited. The colonial government introduced Western medicine into Taiwan, Japan s first colony. The Governor-General of Taiwan made provisions for a health system and constructed medical institutions and facilities. The leader of the driving force was GOTO Shinpei, who himself was a physician and Minister of Public Welfare of the Governor-General of Taiwan. He believed in the legitimacy of Japan s colonial rule over Taiwan because of the improved medical services made available. <Photo>GOTO Shinpei (The Who s Who of Today Illustrated, vol. 1. Today Illustrated, 1934) Distribution Society of the Who s Who of Panel 2-2 Taiwan Malaria is a vector-borne disease which is caused by infection of plasmodial parasites transmitted by anopheline mosquitoes, being easily affected by environmental changes such as agricultural developments. Therefore malaria may be regarded as a so called development-generating disease. The Governor-General of Taiwan concentrated his effort in health matters to control malaria. Mortality due to malaria gradually decreased in Taiwan but in some parts of the South, it became endemic again. This might have been due to the development of large scale irrigation systems for the increase of rice production, thus providing the generation of environmental conditions suitable for mosquitoes. If that development led to the disturbance of the environment of Taiwan, malaria control by the Governor-General could be thought of a matter of extinguishing the fire with water after starting it yourself. Panel 2-3 Korea After making Korea a protectorate, Japan established the Korean Medical College in 1907. The Japanese Army Surgeon General Susumu Sato became the first President of the college. Japanese Army Surgeons occupied all the chief positions at the public Jikei Hospital and provincial hospitals. This personnel management was to keep in mind the idea that in time of future emergency hospitals and clinics should be diverted to military purposes. The close relationship between Korean medical society and the Japanese Army appears to be apparent from a souvenir picture at the occasion of a general meeting of the Korean Medical Association, showing many army surgeons with uniforms among participants. <Photo> The Korean Medical College. After the annexation of Korea, the college was called as the Governor-General of Korea Medical College and then, since 1928, it was transferred to the Keijo Imperial University Faculty of Medicine. ( The Final Edition of the History of Showa, Annex I, the Mainichi Press, p.116) Panel 2-4 Micronesia In 1922, New Guinea north of the equator, a former territory of Germany, became a mandated territory of Japan as the result of the Versailles treaty. Japan founded the South Sea Agency and the Nanyo Kohatsu Kabushiki Kaisha (the South Sea Development Company), thereby operating cultivation and development of industries. Japan opened hospitals in each of 7 islands, i.e., Saipan, Palau, Yap, Truk, Ponape (presently, Pohnpei), Jaluit, and Angaur. Leprosaria were also built in Palau, Yap, Saipan, and Jaluit, where local patients were isolated and accommodated. 9

<Photos> Sanatorium for Lepers in Yap Island. Panel 2-5 Manchukuo The South Manchuria Medical School, which was founded by the South Manchuria Railway Co. Ltd., in 1911, developed into the Manchuria Medical College. The College was a core of medical investigation and education in Northeast China, and studies related to the local area were performed as listed in the table. Department Physiology Pathology Microbiology Hygiene Nutrition Topics of Research Significance of psycho-thermoregulatory responses resisting cold climate kala-azar, Kaschin-Bek disease, endemic dermatitis, endemic goiter the plague, relapsing fever spirophete, Pseudomonas mallei, typhus fever, tubercle bacillus house sanitation problems of Japanese agricultural settlers in Manchuria nutritional problems of Japanese agricultural settlers Panel 2-6 Vivisections Performed at the Manchuria Medical College Among researches performed at the Manchuria Medical College were found articles obtained by means of vivisections of Chinese people. One of such articles describes as follows; I often succeeded in obtaining very fresh and healthy brains of Northern Chinese adults without any clinical history of specific psychiatric diseases. Mr. ZHANG Piqing, a former laboratory assistant at the college, had already exposed the fact of these extremely cruel vivisections, saying that after vivisections carried out from autumn of 1942 to spring of 1943, he was engaged in the task of cleaning anatomized remains, carrying corpses to a boiler room to incinerate, and burying them. <Photo> Preparations of sliced brain sections. (Preserved in the archives of the China Medical University). Photographed by the 3rd Visiting Investigation Group to China from the Research Society for the 15 Years War and the Japanese Medical Science and Service. Panel 2-7 Mobile Clinic of the Manchuria Medical College The Manchuria Medical College, officially to confer the benefit of Japanese medicine on locals, started dispatching mobile clinic teams organizing faculty members and medical students to various areas. However, the real purpose of this project was to make a necessary good impression by promoting welfare of local residents along the railroad for an advantageous business development of companies affiliated with the Southern Manchuria Railway Co Ltd.. In addition, medical students were also engaged in the prevention of epidemics such as malaria, cholera, and the plague. When the plague happened to become epidemic in Xinjing (Hsinking) and Nongan in 1940, Unit 731 went into action as an epidemic prevention troop and students of the Manchuria Medical College joined the prevention activities. <Photo> The plague prevention student team dispatched to Nongan. (Preserved in the Jinlin Province Archives). Panel 2-8 Dispatch of Mobile Clinic Teams to Manchukuo under Sponsorship of Newspaper Publishers. The Osaka Mainichi Shimbun and the Tokyo Nichi Nichi Shimbun jointly dispatched mobile free clinic teams to the Empire of Manchuria. Actual medical examinations and treatments were performed by staff of the Manchuria Medical College. In 1931, the sixth mobile clinic team made its rounds in the west part of Manchukuo for 50 days and performed free medical services to 8,691 individuals in total. <Photo> The West of Manchukuo: visiting sites of mobile free clinic teams. Panel 2-9 The Shanghai Institute of Natural Science The Shanghai Institute of Natural Science was founded in the Shanghai French Concession in 1931 by the Ministry of Foreign Affairs of Japan based on reparations for the Boxer Rebellion (Yihetuan Movement). The purpose of the foundation was to study the pure theory of natural science. After the Japanese Army occupied Shanghai, however, researchers of the institute collaborated closely with the Government, in investigating infectious diseases as well as conducting preventive measures in response to requests from the Army or the Navy. For example, staff members like KOMIYA Yoshitaka and Tao Jhingsun joined prevention activities as personnel necessary for vaccination to prevent cholera at Nanyangmen of the Shanghai fortress. Thus, the initial purpose of the foundation of the institute, i.e., studying the pure theory of 10

natural science, was never fulfilled. <Photo> The former Shanghai Institute of Natural Science. (Photo by SUENAGA Keiko, 2008) Panel 2-10 Dojin Association Clinics in China Japanese political, business, and medical circles played a central role in setting up a foundation called the Dojin Association in1902. The purpose of the foundation was to spread medicine, pharmacy, and their relevant technologies throughout China and other Asian countries. The Association used to operate 4 clinics in China but after the Lugouqiao (Marco Polo Bridge) Incident in 1937, the Association fell under the control of the Japanese Military and began to support the war strongly through medical means. <Photos> 1) Hankou Clinic, picture postcard. 2) Qingdao Clinic, picture postcard. Panel 2-11 Expansion of the Dojin Association After the Lugouqiao Incident, the Dojin Association dramatically expanded its scale of management including clinical teams and epidemic prevention teams as well as affiliated research institutes, with 44 branches in total (3in Menggu-Xinjiang area, 19 in the Huabei area, 17 in Huazhong area, and 5 in Hainandao).. Doctors, pharmacists, nurses and clerks being assigned to the Association were dispatched to China. The number of staff members of the Association reached 1,455 individuals by the end of June 1942. Panel 2-12 Southeast Asia Indonesia Upon occupation of Burma, Malaysia, Indonesia then territory of Holland, and Philippines in 1941, Japan took over research and education institutions of these countries. Japanese scientists became the director of the institution as an army governor general. The Jakarta Medical College was one example. Panel 2-13 Medical Services for the Pacification Pacifications were operated to win the hearts of the people in occupied areas. Especially, a free medical service was expected to be effective in winning the hearts of the people. The telegram below was sent from the military governor general of the Southern Army to the army administrative vice-minister requesting the dispatch of an epidemic prevention team. Panel 2-14 Countermeasures against Hansen s Disease in Colonies The Governor-Generals of Taiwan and of Korea established sanatoria for Hansen s in the colonies. Prison facilities had been provided to confine patients in Sorokdo Rehabilitation Centre in Korea prior to building up such facilities in the Japanese mainland. Patients in the Centre, including Christians, were compelled to worship at a Shinto shrine. Male inmates who refused to worship there or attempted to escape were punished with surgical sterilization. In Losheng Sanatorium in Taiwan, patients were forced to undergo sterilization or abortion. The charnel house there still contains many unwanted urns left to go begging. <Photo> The Chosen-Asahi published on 14 April 1927, reporting SHIGA Kiyoshi, Director of the Korean Governor s Hospital, intends to promote sterilization upon requests of patients in Korea in order to eradicate Hansen s disease. Panel 2-15 Surgeons and Military Comfort Women Since the onset of the war between Japan and China in 1937, military comfort stations built by the Japanese Army rapidly increased in number by the end of the year. Surgeons were commissioned to examine military comfort women for venereal diseases, thus playing a role to prevent transmission among soldiers. A large percentage of the comfort women were girls from the Korean Peninsula. <Photos> 1) Comfort women. (From TAKASAKI Ryuji, Battlefield Reports and Opinions of Medical Officers. Fujishuppan, 1990) 2) Staff performing medical checks on comfort women. (ibid.) Panel 3-1 [Part 3] Recruitment of Medical Communities to the War and Their Resistance. What kinds of roles were expected to be played by individuals or groups engaged in medical science or services under the all-out war regime? And how did the war regime mobilize them to participate? Moreover, in medical communities, how did they handle the matters connected to the war regime? Furthermore, what happened to the actual circumstances of medical services and public health, to which physicians and medical researchers had been 11

involved? In Part 3, after describing how medical researchers and physicians were mobilized for war, the actual circumstances of the medical services for ordinary people at that time will be explored. This part will present the fact that the mobilization of medical research towards the war ranged over the General Assemblies of the Japan Medical Congress, medical associations, and funding of grant-in-aids for medical research. How physicians and nurses were mobilized toward the war will be also described in this part. It should be also noted that despite the nation being under the regime of rule by one political party, there were medical researchers, physicians, and medical students, who had resisted inhuman research as well as the war of aggression. Regarding the actual circumstances of medical and health services, it will be described that focused on the people who were mobilized toward the war, how pressures were given to the people with respect to their health and decisions on reproductive life. In addition, damage given to the people who had been excluded from the war time mobilization regime will be described in this part. Panel 3-2 The Mobilization of Medical Research by the War Regime: The General Assemblies of the Japan Medical Congress during the Period of the Fifteen Years War The Japanese Association of Medical Sciences originated from the first Assembly of Medical Societies held in April 1902. The present name of the Association was adopted at the third Assembly, and since then the general meeting has been held every four years until now. At the occasion of the 12 th General Assembly, the Association s permanent establishment was resolved and in 1948 the Association united with the Japan Medical Association. In the history of the Japanese Association of Medical Sciences, the General Assemblies of the Japan Medical Congress were held three times from the 9 th to 11 th during the period of the Fifteen Years War. <Photo>A group photo taken in front of the Yasuda Hall, the University of Tokyo, at the occasion of the meeting of the 9 th member society (Microbiology) held at the 11 th General Assembly of the Japan Medical Congress (Photo on 29 March 1942). Panel 3-3 The 9 th General Assembly of the Japan Medical Congress (1934) Presentations were made based on medical observations obtained by clinical and hygiene activities during the Manchurian Incident, including those reported by GODA Hitoshi, Army Surgeon General, and ISHII Shiro, Army Surgeon-Major. Military medicine increased its influence. The 12 th member society, the Society of Eugenics (the Japanese Society of Health and Human Ecology), insisted on the enactment of a Sterilization Law. Panel 3-4 The 10 th General Assembly of the Japan Medical Congress (1938) The War Ministry Medical Affairs Bureau asked for the significance of the Japanese Association of Medical Sciences under the wartime regime. In response to this requirement, the Board meeting of the Association decided that the 10 th General Assembly should not be of a purely scientific nature. KOIZUMI Chikahiko, Director of the War Ministry Medical Affairs Bureau, who was one of the special lecturers at the Assembly, worked as the Minister of Health from 1941 to the time of defeat in war. Panel 3-5 Medical Lectures under the Wartime Regime: Special Features in the 10 th General Assembly of the Japan Medical Congress (1938) At the 10 th General Assembly of the Japan Medical Congress, a special series of Medical Lectures under the Wartime Regime were held. Themes of the lectures were lined up with those related to the war and policies on colony management, such as the battle field surgery and issues of aeromedicine and poison gas, matters of pulmonary tuberculosis and pleurisy, issues of physical strength, issues of epidemic prevention, issues of myopia, and issues concerning endemic diseases in Manchuria and Northern China. In this series, Surgeon Lieutenant General Otto Muntsch of the Nazi Army gave a lecture on poison gas and its sequelae. TSUZUKI Masao, who was a former Navy Surgeon and professor at Tokyo Imperial University Faculty of Medicine, gave a lecture on war wounds in the China Incident. After the War, he made site investigations in Hiroshima City as a core member in charge of the Medical Section, the Special Committee for the Investigation of the Effects of the Atomic Bomb, the National Research Council in Japan. However, all of the enormous amounts of data obtained from patients were transferred to the US Army and never used directly for treatment of atomic bomb victims. (Note: General Report Atomic Bomb Casualty Commission January 1947 is available at http://www7.nationalacademies.org/ archives/ ABCCGeneralReport1947.html>). Panel 3-6 The 11 th General Assembly of the Japan Medical Congress (1942) In the opening address the Vice-chairman of the General Assembly, MIYAKAWA Yoneji, placed emphasis on the establishment of military medicine, the proposal for the foundation of the Greater East Asia Medical 12

Association, and the regulation of medical research in accordance with national policy. In member society meetings, many presentations were related to military medicine such as heat and cold resistance, epidemics on the continent, ethnic views of mental disorders, otolaryngology related to aeromedicine, pathology associated with low pressure or acceleration, instruments for bone injuries, all of which reflected changes in the expansion of theaters of operation and occupied territories as well as changes in the usage of sophisticated weapons including fighter aircraft. Panel 3-7 The Japanese Society of Pathology under the Wartime Regime (1) In 1938, at the 28 th General Meeting of the Japanese Society of Pathology, KIYONO Kenji, Professor of the Kyoto Imperial University Faculty of Medicine and a teacher of ISHII Shiro, delivered his opening address as follows: I believe that research materials for the Japanese Society of Pathology should be accumulated in the continent of China from today on. In 1941, at the 31 st General Meeting of the Society, Army Surgeon Lieutenant Colonel HIRAI Masatami of the Department of Pathology of the Army Military Medical School gave a special lecture entitled On the Military Pathology, in which he said: Since the outbreak of the Incident on 11 th July 1937 up to 10 th July 1940, the number of autopsies performed in the whole army forces reported as to be 1886 bodies, and therefore the total number had to reach to about 2000 or more if the number of 218 bodies done by the special research team was added. The materials of 200 bodies corresponding to one tenth of the total were sent to the Army Military Medical School. In addition, about 200 bodies were examined by autopsy to use for research reports although they were not yet published. This presentation by HIRAI is considered to be related to the issue that human bones corresponding to more than 100 bodies were found from the site of the Army Military Medical School at Shinjuku, Tokyo, in 1989.However, the actual picture of the special research team which performed autopsies on 218 bodies has not been clarified yet. Panel 3-8 The Japanese Society of Pathology under the Wartime Regime (2) Among the members of the Japanese Society of Pathology, 19 were involved in Unit 731. The number increases to 32 in total if one counts researchers who had belonged to the Dalian Institute of Hygiene, or to those Army Forces related to Unit 731 such as the Sakae Unit 1644 at Nanjing, as well as those persons believed to be intimately related - such as army surgeons, researchers, or army commissioned employees. After the war the Society ignored Unit 731, and those who had participated in bacteriological warfare got good jobs such as professors in universities or directors of research institutes. Panel 3-9 The Japanese Society of Health and Human Ecology The Japanese Society of Health and Human Ecology was founded in November 1930 (renamed as the Japanese Foundation of Racial Hygiene in 1935), where NAGAI Hisomu, Professor of the Tokyo Imperial University Faculty of Medicine, was a key figure. The purpose of the Society was stated as to purify the basis of the life--- and to bring prosperity to the nation---. Immediately after its establishment, the Society made set up the Subcommittee of Enactment of Sterilization and then adopted a Proposal for Promotion of Racial Hygiene. The Society disseminated its eugenic ideas through giving lectures and exhibitions on marriage hygiene, thereby acting as a society for the promotion of human and racial discrimination. <Photo> A newspaper article entitled Racial flower garden protected by stopping the fountains of dirty blood, reporting the submission of the Enactment of Sterilization to the Diet based on 3 years research by NAGAI Hisomu (Yomiuri Shimbun, 1936). Panel 3-10 The Japanese Society of Leprosy (Present Name: Japanese Leprosy Association) The Japanese Society of Leprosy was founded in 1927 and actively expressed its opinions or requests to the Government as shown below: Year Opinions or requests made by the Japanese Society of Leprosy during the 15 Years War 1932 Views about relief facilities for leprosy patients 1936 Statement requesting construction of facilities capable of accommodating of 10,000 patients with leprosy by Year 2600 of the National Foundation (Ki-Gen) 1939 Requests for the promotion of leprosy eradication 1941 Expansion of facilities for accommodation of 5,000 patients with leprosy 1942 Petition for the dispatch of leprosy specialists to the Southern territories 1943 Views on the eradication of leprosy in Greater East Asia 13

These requests contained accounts of the need for the absolute isolation of patients with Hansen s disease and the Society s cooperation in the construction of the Greater East Asia. The common sense of that time insisted that patients with Hansen s disease should be treated by relative isolation or home care but not by absolute isolation. In 1942, the effectiveness of sulfa was confirmed already. Panel 3-11 The Japan Society for the Promotion of Science and Medical Research (1) The Japan Society for the Promotion of Science was established in 1932. The Society urged the Army, Navy and the Ministry of Commerce and Industry to submit urgent issues on current affairs, to help research closely related to national policies. Research grants were provided based on reviews which were performed by 12 Standing Committees of experts (e.g., the 8 th Standing Committee for medicine and hygiene). In addition, Special Committees were organized for reviews of research related to more than one working area. Tables below on Panels 3-11 and 3-12 describe research subject titles granted by the Special Committees and the Subcommittees of the 8 th Standing Committee, respectively. Research supported by the Special Committee of the Japan Society for the Promotion of Science (Panel 3-11) No. of the Special Committee Research Title (Chairman) No.2 (Previous No.) Studies on economic issues in Manchuria and Mongolia (TODA Shozo) (Issues on the emigration of farmers in Manchuria and Mongolia) No.4 (OGUMA Kan & FURUHATA Tanemoto) Basic research on heredity No.5 (NISHIKAWA Masaharu) Studies on indirect roentgenography No.11 (Previous No.) (HAYASHI Haruo) Studies on the new population policies of Japan No.21 (Previous No.) (HASHIDA Kunihiko) Studies on hearing ability No.14 (Previous No.) (KAMISHITA Masao) Studies on the establishment of industry (TAMITA Teko) and national land planning No.26 (Chairman unlisted) Studies on living standards and strategy implementation No.29 (Chairman unlisted) Studies on the rational utilization of the national land No.30 (Chairman unlisted) Studies on production and utilization of new animal and plant resources (Ref. Kagakugijutushi Taikei (Compendium of Japanese History on Science and Technology Vol.25, The History of Science Society of Japan, Daiichi Houki Shuppan, 1965, p.210-211). Panel 3-12 The Japan Society for the Promotion of Science and Medical Research (2) Research agreed by the Subcommittee of the Japan Society for the Promotion of Science No. of the Subcommittee Research Title (Chairman) No.3 (Previous No.) (INADA Ryukichi) Epidemic encephalitis No.4 (Previous No.) (TAKADA Yasuma) Social policy on current affairs (FURUYA Yoshio) and protection of laborers No.7 (Previous No.) (ISHIHARA Shinobu) Trachoma (NAGAYO Mataro) No.8 (Previous No.)(NAGAI Hisomu) Medical and ethnobiological research on the Ainu No.8 (KUMAGAI Taizou) Prevention of tuberculosis (BCG vaccination) No.12(KURODA Taizou)(HORITA Kazuo) Organic synthesis and chemical components of sweat and other excreta from the skin No.16(Previous No.)(KAKIUCHI Saburo) Research on national nutritional standards No.20(Previous No.)(KOIZUMI Chikahiko) Research on the improvement of food, clothing and shelter of the Tohoku (northeast) district No.22(Previous No.)(KOIZUMI Chikahiko) Research on the national physical strength No.22 (MIYAKAWA Yoneji) Research on endemics No.26(Previous No.)(MIYAKE Koichi) Eugenic issues No.27(Previous No.)(TODA Shozo) Research on clothing and shelter No.28(Previous No.)(KOIZUMI Chikahiko) Medical and hygienic studies of Manchuria and Mongolia in North China No.37 (SEGAWA Soshoji)(SASAKAWA Kyugo) Studies on electronmicroscopy No.38(Previous No.)(TANAKA Higotaro) Research on aeromedicine No.40(Previous No.)(ISHIHARA Shinobu) Research on myopia No.43(Previous No.)(NISHIO Chujiro) Prevention of cerebral hemorrhage 14

No.48 (KOIZUMI Chikahiko) No.50 (KEISHO Katsuzaemon) No.53(Previous No.)(Chairman unlisted) No.60 (Chairman unlisted) No.65 (Chairman unlisted) No.68(Previous No.) (Chairman unlisted) No.73 (Chairman unlisted) No.78(Previous No.) (Chairman unlisted) (Ref. ibid) Psychiatric study of personality Supplement any measures of imported drugs Research on dysentery, diarrhea, enteritis, and food poisoning Research on postwar crimes and their measures Research on visibility Research on influenza Physiology of microorganisms and its application Promotion of laboring efficiency <Photo> Newspaper articles reporting medical research in the Southern Asia under occupation of the Japanese Military Forces and supported by grant-in-aids from the Japan Society for the Promotion of Science. (The Yomiuri Shimbun, 10 June 1942). Panel 3-13 Grant-in-aids and Medical Research Besides the Japan Society for the Promotion of Science, the following three policies were enforced for the promotion of science. 1. Increase of grant-in-aids of the Ministry of Education: The Minister of Education, ARAKI Sadao, took the lead by drastically increasing the total amount of grant-in-aids from 60,000-70,000 yen to 3 million yen. In the field of medical science, funds were provided for research subjects such as tuberculosis, infant care, myopia, climatological medicine, aeromedicine, etc. 2. Establishment of the committee for mobilizing science in wartime: For mobilization was to be efficient, the Mobilization Committee for Science and Research was formed under the Science Council of Japan. 3. Establishment of institutes affiliated with universities: <Table omitted> Panel 3-14 Measures to Remedy the Lack of Physicians due to Mobilization Issues on the transfer of physicians from rural to urban areas manifested after the economic panic in the Showa era remained unresolved. The problems of doctorless villages became more severe due to the call up of physicians as battalion surgeons under the long-term war. The number of villages without doctors increased to 3,600 in 1939, compared to 2,909 in 1927. The following measures were introduced to solve the lack of physicians. 1. Establishment of medical colleges temporarily affiliated with universities: The military estimated that based on the assumption of war against the Soviet Union, about 2,700 army surgeons and 5,100 others would be necessary by 1942 and by 1944, respectively. In 1939, medical colleges temporarily affiliated with 7 imperial universities and 6 government medical schools were established after pressure from the military. 2. Foundation of new municipal or prefectural medical colleges: During the war, public medical colleges were opened in 11 municipalities. 3. Foundation of new women s medical colleges: In war time, women were introduced in fields previously considered limited to men. Thus, women s medical colleges were established in 7 municipalities for training of woman doctors who could work in doctorless villages. Panel 3-15 Wartime Mobilization of Medical Students Since 1939 military training became a required course for college students at all universities. In medical schools, it was assigned for students by officers on active service and lectures on military courses were also given. Lectures concerning military medicine such as hygiene, prevention of epidemics, and battle field wounds were also provided. From the same year, student hygiene corps were organized by students of medical schools all over the country and they were dispatched to the North East of China to make a survey on hygiene during their summer vacation. <Photos> 1) Medical students attending military training, around 1939. (Cited from The Graduation Commemorative Album of the Tohoku Imperial University Faculty of Medicine in the Japanese Era 2600 ). 2) A military lecture in the Faculty of Medicine, around 1939. (Ref. ibid.) Panel 3-16 Going to the Battlefield as an Army Surgeon The Japanese Army and Navy had a scholarship system for medical students who were training to be army surgeons. There was also a course in which doctors, who had either graduated from a medical school or a medical college, were able to become army surgeons after this training. In case of the Osaka High Medical College affiliated with the Osaka Medical University, for examples, more than half of the 2,410 graduates from 15

the first year of its establishment in 1932 to the 15 th year of 1944 had a career as an army surgeon. of those who died in the war was 335 (13.9%) in total among the graduates. The number Panel 3-17 Wartime Regime Intensification and Health Care Reform The emphasis of the policy for healthy people was on tuberculosis and measures for maternal and child health, both promoted by the Ministry of Health. The health care reform was implemented alongside this policy. 1. Along with the national policy of Healthy Soldiers, Healthy People, the establishment of the national health insurance association and the expansion of the health insurance coverage were both enforced. 2. The enactment of the National Medical Care Law was a clear indication that physicians were executors of the national mission. The governmental regulation covered a wide range of health issues, including restrictions on opening practices, designation of working locations, and the conscription system of doctors. 3. The Japan Medical Treatment Corporation facilitated the consolidation of hospitals, thereby making a more systematic arrangement of nation-wide medical services. The Japan Medical Association (JMA) was also reorganized and the aim of its foundation was renewed so as to cooperate with the national policy. Panel 3-18 Cooperation of the Japan Medical Association in Wartime The Japan Medical Association (JMA) had always been supportive of the war. For example, as shown in the article (upper photo), the Kumamoto Prefectural Medical Association offered to the Army the Ishii type filtration apparatus, gas protectors, and oxygen inhalators. When maneuvers against air-raids were performed, the Association compelled all the members to join. In 1942, the enactment of the National Medical Care Law led to the reorganization of the JMA along the national policy lines. The JMA was transformed from a profitable association of medical practitioners to having the aim to cooperate with the national policy related to the improvement of the physical strength of the nation. Panel 3-19 Foundation of the Japan Medical Treatment Corporation The war brought about a situation in which medical services should be provided for all the people in order to ensure fitness for the all-out war. The Japan Medical Treatment Corporation was established to increase medical facilities with the aim of the broadest distribution of medical services to be promoted in response to the national policy for the improvement of the physical strength of the people. Its concrete objectives were to construct medical facilities from a central general hospital to local clinics and to arrange 100,000 beds for tuberculosis patients. In fact, however, the project was never completed. Panel 3-20 Mobilization of Nurses Nurses who worked in battlefields used to be called war nurses. They consisted of rescue nurses who were dispatched from the Japanese Red Cross Society in response to call-up duties, and of nurses who had been working in the military hospitals of the Army and Navy. The call-up duties insisted that they could be sent to battlefields even if they had a suckling baby. Panel 3-21 War Nurses in Battlefields Among those nurses sent out to the war between Japan and China and in the Pacific, over 30,000 rescue nurses are said to have been dispatched by the Japanese Red Cross Society. Some of these nurses who worked together with male soldiers in dangerous combat support hospitals were ordered to inject powerful medicine into severely wounded soldiers in the late stage of the war. Some were also forced to attend the vivisection of Chinese captives, while others were driven to commit mass suicide. The figure shown below indicates that the death toll among war nurses increased year by year, reaching half of all fatalities in 1945. It should be noted that the lives of hundreds of war nurses were lost during the chaos around the defeat in 1945. Panel 3-22 Medical Drugs in Wartime Medical institutions had suffered from the lack of medical supplies since the end of the 1930s. Those drugs under control of the government became unavailable to private medical practitioners without purchase tickets issued by a governor. There was also a change in the pharmaceutical industry. In the Tanabe Pharmaceutical Corporation, all the manufacture shifted so as to correspond to the national policy giving priority to military affairs, and the ratio of munitions of war increased year by year. On the other hand, upon request from the Army, the Sankyo Pharmaceutical Corporation manufactured Melanophoren Hormone (melanophore-stimulating hormone) which if injected, was expected to enable soldiers throwing a smoke screen in battlefields or pilots of fighters to gain visual acuity even on a dark night. The war also led to an increased drug induced sufferings or addictions. For example, the drug induced suffering of subacute myelo-optico-neuropathy (SMON) might be attributable to the amendment of the 16

Pharmacopoeia of Japan in 1939 which allowed broader indications of quinoform. In 1941, the Dainippon Pharmaceutical Corporation put philopon on the market as a new product of a fatigue removal stimulant which was used by students or all-night labourers and resulted in a massive number of patients with addiction. The reality of the anti-drug policy of Japan in China was rather to accelerate increase of the addictives. The Kwantung Army allowed cultivation of poppies in Inner Mongolia and other places and sold opium and morphine, as well as cocaine, illegally in Chinese territories to raise military funds, so that the crackdown on opium was only nominal. Panel 3-23 A Medical Researcher Who Resisted the War Regime YOKOYAMA Shomatsu, a physiologist, was called up to the Beijing Ko 1855 Unit as an army surgeon. He was ordered to perform an experiment using a Chinese captive, to whom a penetrating shot wound should be made in the abdomen, in order to develop a drug effective for treatment of a bullet wound. However, he refused to comply as such an experiment would be an outrage against humanity. As a result, he was sent to the front line where bullets were flying about. (YOKOYAMA Shomatsu, When I Was Young, the Mainichi Shimbun, 11 September 1986, morning edition). Panel 3-24 A Physician and Medical Students Who Resisted against the War Regime Even as the freedom of speech was suppressed, some physicians or medical students continued to support the ideals of the medical services. TAKAHASHI Minoru (Research Associate, Tohoku Imperial University Faculty of Medicine, 1942) was arrested twice during the war on a charge of crimes against the Public Peace Preservation Act and he spent over four years in jail. The judgment that found him guilty concluded that his book entitled Medical analysis of a pure farming village of the north-east Japan: A socio-hygienic survey in Shiwa Village of Iwate Prefecture analysed issues on the rural health and hygiene from the view point of communism. IMAMURA Yuichi, TSUDA Yasushi, and TOJIMA Hirotoshi, who were students belonging to the tuberculosis research club of the Kyoto Imperial University Faculty of Medicine, conducted mass examination of tuberculosis and living surveys in Katsuyama district of Fukui Prefecture in 1941 and published a report in Shirankai Zasshi. This report caught the eyes of the Special Higher Police (Tokko) and these students were punished in different ways including imprisonments for violations of the Public Peace Preservation Act. Panel 3-25 Real Situations of the Medical Care and Health: Mobilization of People s Life One of the emphases in the promotion of national health was placed on tuberculosis control. In order to build up bodies protective against tuberculosis infection, the National Physical Strength Law was enacted in 1940, with the first provision saying that the Government supervises the physical strength of the people to promote their health. This law obliged mainly underage males to take physical examinations and to record the results on the national health passbook until their examination for conscription. Panel 3-26 Examinations for Conscription The examinations included checks on the physique and strength required for soldiers. The Army emphasized endurance because of its peculiar system of local procurement of food supplies. It downplayed food supplies so that strength was necessary for soldiers in order to bear marching with heavy baggage while endurance was required to combat the food shortage. Such real situations of soldiers in the war between Japan and China led to a special view of physical strength. Tuberculosis was an important examination item and a chest X-ray examination was introduced for new recruits in 1942. <Photo> A chest X-ray examination was introduced for conscription. ( The Final Edition of Showa History, vol.10, the Mainichi Newspapers Co., Ltd., p.115) Panel 3-27 The End of Mobilization FUJIWARA Akira has confirmed the fact that more than half of the war dead of the Japanese Military starved to death: Lack of food supply resulted in malnutrition, which caused a decrease of physical strength, thereby leading to death by malaria, dysentery, beriberi and so on; this was the reason why death by starvation, in a broad of sense, occurred on a large scale. ( Hero Spirits Starved to Death, FUJIWARA Akira, Aoki Shoten, 2001). According to FUJIWARA, lack of food was partly the result of those in charge of military operations, who ignored logistics, supplies for survival, and hygiene, but gave the highest priority to imperative operations. He also pointed out that the loss of soldiers lives due to illness or starvation produced no sense of guilt in the Military leaders who ignored soldiers lives and human rights. <Photo>The wounded evacuated by boat. ( Unapproved Photos Kept in Secret, No.1, the Mainichi Newspapers Co., Ltd., p.117) 17

Panel 3-28 Eugenic Policy Japan enacted the National Eugenic Act in 1940. Article 1 describes that the aims of the Act are to eradicate the increase of the number of individuals who have a predisposition to vicious genetic disorders as well as to promote the increase of those who have healthy traits, thereby accomplishing the enhancement of the capabilities of the people. To accomplish these aims, people suffering from schizophrenia, manic depression, congenital deaf-mutism, and other conditions that might lead to inferiority in the Japanese gene pool became targets of compulsory sterilization. The consent of the individual or family was required for the sterilization. However, the Act had a byroad through which sterilization could be performed without consent, if a director of a mental hospital permitted it. <Table> The number of people who were subjected to compulsory sterilization under the National Eugenic Act (1941-1947) Male: 217 Female: 321 ( The Centennial History of the Medical Care System, the Ministry of Health and Welfare, the Medical Bureau, 1976, p.335) <Photo> Campaign for eugenic marriage and patriotism. ( The Final Edition of Showa History, vol.10, the Mainichi Newspapers Co., Ltd., p.230) Panel 3-29 Population Policy under the War Regime Under the all-out war, the nation intervened in what had been private matters of the family. In 1941, the cabinet meeting approved the Outline for the Establishment of a Population Policy which declared the aim of an urgent but everlasting developmental growing of our nation. The Outline intended to increase the birth rate and set up a numeral target. Marriage ages to be brought 3 years forward within 10 years from now on compared to the current situation as well as one married couple to bear 5 children on average. The Ministry of Health formulated the outline for honouring superior families bearing many children, thereby encouraging a growing tendency of parturition and patriotism. <Photo> Triplet babies: Superior families bearing many children were commended. Families bearing more than 10 children exceeded 12,000 households in the whole country in 1941. ( The Final Edition of Showa History, vol.10, the Mainichi Newspapers Co., Ltd., p.150) Panel 3-30 Enforcement of the Isolation of Patients with Hansen s Disease The war compelled patients with Hansen s disease to suffer enforced isolation, which worsened their living environment. In 1938, special sickrooms, i.e. strictly observing cells, were installed in the Kuryu Rakusenen Leprosarium, the purpose of which was to forcibly manage discontents among isolated patients. In the last stage of the war, facilities of the Miyako Nanseien Leprosarium in Okinawa Prefecture were seriously ruined by American air raids. All of the staff members including the director walked out. Isolated patients went to shelters of the nearby sea side but the number of the dead reached 110 due to exhaustion, malnutrition, aggravation of the disease, and air attacks day after day. <Photo> The concrete block wall of the Miyako Nanseien Leprosarium, showing bullet marks of machine gunning from US fighters. (by SUENAGA Keiko, 2009) Panel 3-31 Mental Patients Starved to Death The figure on the right shows the annual number of registered mental patients as well as that of the dead among them in the Tokyo Metropolitan Matsuzawa Hospital from 1936 to 1956. The mortality in the hospital increased rapidly in 1938 and reached 21.9% with the number of the dead being as many as 352 persons in 1940. The death toll also rapidly increased from 1944 and 478 among 1,169 registered patients (nearly 41%) died in 1945. TAKETSU Seijun analyzed these changes of mortality and mentioned that the main causes of the patients death were malnutrition and chronic enteritis, the rates of which were dominant and increased year by year. A control system of the staple food for patients started in 1939 as well as the rice control system launched in the next year. These resulted in a continuous decrease of the amount of rice, and the daily intake per person in the hospital became 297 g (1,034 calories) in July 1945. Thus, it was impossible for patients to maintain their lives in such conditions. Panel 4-1 [Part 4] Postwar Medical Establishment in Japan 18

--- Covering up of medical war crimes after the war by the Japanese authorities In the previous parts, we have demonstrated Historical Facts of Infliction Committed by Japanese Medical Researchers and Physicians during the Fifteen Years War, Japanese Colonial Medicine and Practices: Infliction on Civilians, and Recruitment of Medical Communities to the War and Their Resistance, all of which could be represented by the Unit 731 issue. Medical science and medical care systems were mobilized by the Japanese Military and the medical communities had been participating in their organizations. This was the result of the close relationship between the medical communities and the war, in which many physicians and medical researchers were involved either intentionally or unwillingly. There were some doctors who tried to resist to war crimes, but they were very limited in number. The historical facts demonstrated on the panels from Part 1 to Part 3 contain only those having been confirmed by testimonies after the war or evidence disclosed by scientific verifications. However, these facts are only fragments of historical incidents while the whole picture has not yet been clarified even 67 years after the war ended. Details of the postwar situation of the medical establishment seem to raise more important issues of verification of the war and medical ethics in addition to the historical crimes against human dignity and rights performed by Japanese doctors during wartime. From these viewpoints, we would like to present in the following panels what happened to the medical establishment in postwar Japan, including those people who should be considered responsible for medical crimes carried out in Unit 731. Panel 4-2 Immunity to Medical Crimes in the Fifteen Years War Japanese medical researchers and physicians, such as those who belonged to the Unit 731 and committed atrocities against Asian people, should have been convicted as war criminals as was done against the Nazis. However, all members of the Unit, including Commander ISHII Shiro, were granted immunity from prosecution for war crimes. To be granted immunity, the following ways were cooked up at the end of the war: First, a complete cover-up of the Unit was perpetrated in order to Preserve the National Polity. This was done to dismiss the responsibility of the Emperor who was the supreme commander, and to help the Emperor system survive after the war. Second, at the time of escape, members and their families were ordered to keep silent, definitely forever. Commander ISHII Shiro told them, Carry the secret of the Unit to your grave! If you ever leak anything about it, I will leave no stone unturned until I find you wherever you are and by means of whatever I can. He also ordered them neither to make contact with each other nor to take public office. Third, to prepare for the Cold War with the Soviet Union, the General Headquarters (GHQ) made a deal to conceal the facts. Because of this deal, the offences of Unit 731 were not prosecuted as war crimes in the Tokyo Trial. Meanwhile, the US military was provided with the research data from the Unit. Later, when the testimony of the members of Unit 731 at the Khabarovsk Trial in the Soviet Union and the Special Military Tribunal in China clarified the facts about the Unit, they had already been offered immunity by GHQ at the Tokyo Trial. Panel 4-3 Destruction of the Evidence of Unit 731 With the participation of the Soviet Union in the war on 9 August 1945, the central facilities of Unit 731 were blown up, and all of the imprisoned human subjects called maruta (404 individuals according to Blaze of Pingfang by MIZOBUCHI Toshimi, 1991) were all killed with gas in order to cover up the secrets of the Unit. Most of the documents and research materials were also disposed of by burning and at the same time all the members of the Unit and their families were ordered to leave China. ASAEDA Shigeharu (General Staff Operations` Section Chief) issued Directions of the Commander of the Kwantung Army to ISHII Shiro, the Commander of Unit 731, mentioning the orders as described above (ref. Figure below). Among the orders listed in the figure, there is a description regarding captives: Maruta in the building must be disposed of by the electric motors and burned in the boilers, all ashes of which should be washed away in the Songhua River. (3 in the figure). Panel 4-4 Immunity Granted by the USA At the Tokyo Trial, where Class-A war criminals during the aggressive war against China and the Pacific War were judged, Unit 731 issue should also have been prosecuted. Around October 1946, the realities of the Unit 731 had already been clarified by the questioning of military personnel committed to bacteriological warfare and taken as POWs into the Soviet Union. The Soviet Union demanded of the United States through the prosecuting counsel of the Tokyo Trial that three officers of the Unit, including ISHI Shiro, be questioned. However, Japan, in exchange for the presentation of research data to the USA, had already been promised by GHQ immunity from prosecution for bacterial warfare personnel. With the coming of the Cold War, the monopoly of such data suited the global strategy of the United States and its national interests. On 1 August 19