|
Statement of Mori (taken between 3 September and ___ September 1947) 37, was house surgeon at 1st surgical clinic from 1935 to 1939, went to So. Manchuria with the Army, returned to 1st surgery in 1942 as house surgeon and assistant doctor in August, but left in September as exchange student of the International Students’ Association at Bangkok, doing special research in gall-stone diseases and urinary calculus, returning to 1st surgery in October 1944, resigning in November to join Toho Coal Mining Company, working at their hospital 3 days a week, 3 days on gallstone research at 1st Surgery. One of the 3 days a week at the University Mori acted as a non-regular lecturer to student nurses, resigning as such lecturer about 26 May 1945., leaving the University at that time and arriving at Kagoshima 29 May to his new station. American Prisoners were operated upon at the University before Mori left on 26 May. About 1300 on 17 May Mori was in his room when Hirao came in, said that Ishiyama wanted him to assist on a lung operation on a Prisoner that PM in the Anatomy Section autopsy room. Mori asked why it was to be there, and Hirao stated that he believed it to be because the patient was a PW, that civilian doctors were not to operate on them, and because the Japanese patients might become angry if they knew they were treating PWs. It was common knowledge with other doctors that PWs should be treated only by military personnel only. Hirao further stated that the army had ordered Ishiyama to perform this operation. Ishiyama was a temporary civilian official in the army as a medical supervisor, and because the operation was a difficult one, he may have been asked to perform this operation, Hirao said it was to remove a bullet from the lung. Mori had never assisted Ishiyama in a lung operation. During Mori’s 2nd period at the clinic from 1942, he had done no surgery, but devoted his entire time to research in gallstone diseases, except 2-3 times when he assisted other surgeons. Since he had done no surgery for a long time he asked Ishiyama at the time he joined the Toho Coal Mining Company to allow him to assist in operations to get practice. Hirao said the entire staff of the Clinic would be at the operation. About 1400, Hirao came in again, said they must prepare for the operation. Mori met Suyama, and Manabe and one other nurse in the hall carrying gauze, which Mori and Hirao helped them carry over to the Anatomy Section autopsy room. On arrival, Mori found the light insufficient for operating, so a hand lamp had been brought along with a large bulb to give sufficient light. The floor seemed clean, the table to be used for the operation scrubbed, condition of the room sanitary enough for operating safely. 30 minutes later the Prisoner was brought in. In the meantime the doctors discussed why the operation was not being performed in a military hospital, and they arrived at the conclusion that this Prisoner must be an American Flyer who was probably shot in the lung. Mori had not been told prior that it was an American flyer. After setting up the operating table and preparing the room, Mori went out the rear entrance of the building and stood waiting for the Prisoners to arrive. MORI -2- Hirao, Kubo, several junior assistants and Mori waited together. An army truck pulled up, containing Komori, a staff officer, 4-5 guards, and 2 Pis, who were sitting in the back of the truck, blindfolded, handcuffed. The Prisoners were helped off the truck by. guards, guided by the arm from the rear of the truck, about 10' from the truls, then walking with assistants, 2 guards holding each Prisoner under his arm, until through the doorway, whereupon they were placed on stretchers and carried down the hall into a small dressing room, , Ishiyama arrived in the meantime, saluted the army officer, ordered Mori to inject 0.3 cc's of Narcopon Scopolamin into each Prisoner. Mori learned the staff officer was Sato. This was a normal amount of opiate, but not enough to cause unconsciousness or to put patient into condition so that he can be operated on. Normally 0.3 cc's is a first injection, with a 2nd injection of 0.3 or 0.4 cc’s given 1 hour later, which will cause the patient to lose consciousness so he can be operated on. Mori overheard Komori tell Ishiyama that he had given the Prisoners a narcotic before bringing them to the University. When Mori saw the Prisoners, they were in a relaxed condition. When Mori injected them, they were half conscious, one flat on his back, the other leaning against the wall. Mori believes that the Prisoner leaning against the wall said something to him, but he could not understand. A Japanese guard was also in this room, Mori first checked their pulse; it was a little weak, but had a regular rhythm, indicating the Prisoners might be slightly weak, but no in a bad condition. Mori then returned to the autopsy room, waited about half an hour. Ishiyama asked Mori to see if the injections had taken effect enough for the Prisoners to be operated on. Mori returned several times, after 20 minutes, insufficient effect, and Ishiyama ordered another injection of 0.3 cc's of Narcopon Scopolamin to the Prisoner with the blood stain on his uniform and to bring him in. Mori, Komori, 2-3 assistant doctors went back, Mori gave the Prisoner the injection, placed him on a stretcher and brought him in. The Prisoner was almost unconscious, was carried by 2 guards, his jacket removed by Komori or one of the soldiers. Hirao or Torisu, or both, swabbed the Prisoners chest and abdomen with tincture of iodine and then wiped it off with alcohol. The operation began about 40-60 minutes after the first injection. Mori checked the Prisoner, said he was ready. On orders of Ishiyama, Mori applied an ether mask to the Prisoner about 5 minutes before the operation began. Mori doesn’t recall examining the wound; it could not have been serious or Mori would have remembered it. Ishiyama stood on the Prisoner's right, Torisu on his left. Miki, on the Prisoner's right, handed instruments placed on a table perpendicular to the operating table. Komori and Hirao were across from Ishiyama, on the Prisoner's left. Mori stood at Hirao's left. Ishiyama made an incision, retracted the wound, was removing a section of, Mori believes, the 5th rib, the 3rd and 4th already removed, when Mori returned from scrubbing. The ribs were then retracted, exposing the right lung. Ishiyama lifted the right lung, made a ligature of the pulmonary veins and pulmonary artery, removed the right lung by cutting the bronchus and the pulmonary veins and pulmonary artery. The bronchus was then sutured. There were no wounds in the lung; it was not diseased in any way. MORI -3- Ishiyama handed the lung to Miki, who placed it on the instrument table. There was much internal‘.bleeding during the operation; Mori believes one of the ligatures must have slipped. Another ligature was made, but there had been much bleeding. After the lung was removed the bronchus was sutured and then the incision was roughly sutured. As soon as Mori saw the way they were handling the operation, he thought that it was not being done to try to save the life of the patient, because, while it was good surgery, it was done in a rough way. Too, Mori had been told he was to assist in an operation to remove a bullet from a Prisoner's lung, but there was no bleeding in the pleural cavity, the condition of the patient was not so serious, and yet they removed the entire right lung that was not infected in any way, It was an experimental operation. Ishiyama was interested in lung surgery, no doubt wanted to experiment in the total resection of a lung. A total resection had been reported at conferences by professors from other Universities, and, because it is done where a condition of cancer of the lung exists, these patients are rare and hard to find and this gave him an opportunity to experiment without waiting for the necessary patient. Mori believes the Prisoner was still alive when the incision was sutured, is not sure. Ishiyama said to Sato, "I have now learned how a total lung resection can be done." While the doctors were washing up after the first operation, Komori asked Mori to have one of the nurses wash the first Prisoner's clothing, said he would either come after the clothes or send someone. After the operations, Mori asked Suyama to wash them for Komori, but she said, "no", so Mori took the clothes of this aviator and put them.in a drawer in his room, where they remained until he returned from Kagoshima in July, at which time had had them sent to the hospital at Kagoshima where-they were destroyed during an air raid. Before Mori left the University, he told Komori that the clothes were in a drawer in his room, not washed, that he could get them. The first Prisoner died; the most important factor was bleeding. He was given an injection of 300-400 cc's of sea water by Senba. Not knowing how much narcotics had been given to the Prisoner prior to coming to the University, he may have been given an overdose of narcotics. Usually when a patient is on the operating table as long as this one, it is necessary to continue to administer either a local anesthesia, such as novocain or some other form. Here unnecessary. The first Prisoner was on the table about 1 hour. The normal duration of 0.5 ccs of Narcopon Scopolamin is 1-2 hours, but not sufficient for him to undergo surgery for 1-2 hours. Even with the ether, it was insufficient for the period, but the patient was in a heavy sleep. The Prisoner did not move on the table. After the first operation was finished, Ishiyama ordered Mori to check the 2nd patient for the effects of the anaesthetic and to give another injection of 0.3 cc's of Narcopon Scopolamin. He was sleeping, and Mori administered this 2nd injection; he was completely relaxed, seemed unconscious, was placed on a stretcher carried into the autopsy room by 2 guards, placed on a 2nd table set up the same as the first. His chest was painted with iodine, swabbed with alcohol, his body was covered with a sterilized cloth. No wounds, were visible. MORI -4- Mori knew this to be an experimental operation before it started after seeing the 1st operation, had a funny feeling, knew these operations were not intended to save the lives of the Prisoners. When Mori went in to give the last injection to the 2nd Prisoner, he asked the guard if these Prisoners had been brought up there to died, and the guard said, "It seems so." Hirao told Ishiyama the 2nd Prisoner was ready. Mori thought ether was necessary, but it was not administered, 20 minutes elapsed from the 2nd injection. Ishiyama, Komori, Torisu, Hirao, Senba and Mori participated in this operation. Miki handled the instruments, Tsutsui supervised the nurses, and Suyama observed. Mori was not told what this operation would be, but assisted, probably with the retractor and wiping blood, since that was the job assigned to him at his position at the operating table. The doctors were arranged as before. Hirao was in a position to use retractors and to swab the blood, Komori in position to retract, swab, do ligatures and use the Kocher; Torisu to do ligatures, retract, swab, and use the Kocher; Ishiyama to do the surgery. Mori recalls a lot of bleeding from the lung, cannot remember whether a total or partial lung resection. Kochers were used to stop the bleeding. A sea water transfusion was given. The Prisoner died from (l) loss of blood; (2) effects of removal of the lung; (3) the pressure on the heart caused by the opening of the pleural cavity. The ordinary pressure of the pleural cavity is negative, and when opened the outside pressure forces the heart and the healthy lung off to one side, which causes difficulty in respiration. The object of the operation was to learn procedure for future operations; Mori doesn't believe it was done carelessly. Mori doesn't recall whether the incision was sutured at the end of the operation. On the day of the 2nd series of operations, Hirao came to Mori's room, told him that Ishiyama had ordered that they,again, assist in operations on Prisoners that day, that he would like to go to him and ask him not to go ahead with the operations; Mori agreed. Hirao said this was the way Torisu felt. Hirao got Torisu, and Mori saw them go in Ishiyama's office, come out a few minutes later, where upon Hirao told Mori that Ishiyama told them that they should not worry, that "I am doing the operation. You just follow my orders." They all agreed that the Prisoners were brought there just to be killed by experimental operations and while they didn’t like it, felt there was nothing to be done, but to obey Ishiyama. They were trained to obey orders of the superior professor, Mori thought about appealing to Dean Ohno of the medical college, but he was head in name only, of no higher position than Ishiyama. Too, since the operations had been ordered by the army, he had no control. Mori thought that Hyakutake, the President, could do nothing about it, since an order of the military. Mori doesn't believe that Ishiyama could have approved this arrangement himself; it would be formal custom to talk to the proper authorities of the University, (Hyakutake). In September 1945, when Mori came back to attend a medical conference, Ishiyama told him for the first time to keep the operations secret. On 22 May, 1400, Mori went to the autopsy room to make preparations for the MORI -5- operations, then went out in back to wait for the Prisoner, but went back to the autopsy room before the Prisoners arrived, and shortly after the Prisoners arrived were helped directly into the autopsy room, placed on tables, were not totally unconscious. Ether masks were applied to their faces. Ishiyama ordered Hirao and Mori to scrub, told Mori to prepare for an abdominal operation. Komori was administering ether to the first patient. Hirao and Mori painted the abdomen with iodine, washed it with alcohol, checked the patient for the effects of the anesthetic and told Ishiyama the patient was ready. Ishiyama ordered Mori to start the operation with Hirao and to do a total gastric resection. Either Suyama, Miki or Manabe was passing the instruments. Mori took his surgical knife, a 10" incision from just below the sternum to about 3" below the navel. Mori knew when he began this was an experimental operation. Hirao used artery forceps to stop the bleeding. Mori used a self retractor, retracted the incision, exposing the stomach. Mori then applied artery forceps to stop the bleeding. Hirao made ligatures on the arteries where the forceps had been applied. Mori then lifted the stomach and the greater omentum up into the operation field and used forceps on the arteries and veins in preparation to partially separate the greater omentum from the stomach, then partially separated the stomach from the greater omentum so the forceps could be applied to the pylorus and made ligatures on the veins and arteries. Komori then came over, prepared to continue the operation. The pylorus was clamped with 2 forceps, about 3/4" apart by Komori, who then cut down the pylorus between the 2 forceps. The lower end next to the duodenum was sutured and the stomach turned over,the small omentum was separated. The cardia was clamped with 2 forcesp about 3 3/4" apart and Komori cut between the forceps. The stomach was then removed; nothing was wrong with it. Before cutting between the forceps at the cardia and the pylorus, ligatures had been applied to the arteries and veins. After the stomach was removed, Komori took hold of the jejunum about 20 " below the end of the duodenojejunal flexture and lifted it up to the cardia. An incision was made in the wall of the jejunum, and the jejunum was sutured to the cardia. Komori then examined the suture to see if it were OK. One of the doctors then came alongside Mori and Mori asked if the other operation was over. He said "Not yet." At that time Ishiyama came over, said he would massage the heart, which is done with the hand to stimulate the heart action when the patient becomes weak. The heart massage is practically never used and is only as a last resort to restore action to the heart. Mori did not believe this action was applied to save the life of the Patient since he knew he was going to die anyway. Ishiyama made a semi-circular incision 9" long in the left breast, Mori retracted the ribs from his side and Hirao from his. The heart sac was exposed, and Ishiyama made an incision in the heart sac, exposing the heart, then readhed in with his hand and massaged the heart for 1-2 minutes. He then made an incision in the heart about Before this he took the heart in his left hand and showed Mori how to do an aortenklemme, which is done by pressing the heart so that the aorta is pressed shut, temporarily stopping the flow of blood into the heart so as to cause minimum bleeding when the incision is made. MORI -6- The incision was immediately sutured. Ishiyama then said, "See, it is not very difficult to suture an incision of the heart." He then turned to Hirao and Mori and said, "Now you try it, and check on the width of the sutured," then left to go to the other operation. The prisoner was still alive. Mori took the heart, used the aortehklemme method, made an incision alongside Ishiyama's, sutured it, using a small stitich, since he understood Ishiyama meant to compare the effects of muscular contraction on the wide and the small sutures while the patient was alive and then after death. The Prisoner died before Mori finished suturing the incision on the heart. Mori knew the patient would die because of this experiment. Mori completed the heart sutures, then sutured the chest and abdomen incision. Hirao made the ligatures while Mori made the sutures in separate stitches. Mori then told Ishiyama he was finished, watched the other operation. The 2nd operation was a liver operation, with Ishiyama, Komori, and Torisu doing the operation. Ishiyama was about to remove the liver; there was much bleeding, including the liver. It seemed that Ishiyama was removing the right lobe of the liver, and ligatures had been made on the arteries and veins to check the bleeding. The liver was almost removed when the patient died. Mori left and went to his office. 26 May, at 1300 Hirao told Mori there would be another operation in the autopsy room that day, that Ishiyama had requested that he assist. Mori went there about 1400, went out back to await the arrival of the Prisoner. A staff car drove up with Sato, Komori one Prisoner, and 2 guards. The Prisoner was partially supported under each arm;by the guards, placed on a table. Miki handled the instruments and Tsutsui supervised at this operation. The patient lay on his stomach. About 3/4 of his head was shaved clean, iodine and alcohol used, with an operating cloth placed over his shoulders and head. He had been given ether before -turned on his stomach, and novocain was injected at the base of the skull by Ishiyama. Ishiyama was the first surgeon, Komori first assistant, Torisu 2nd assistant, Hirao 3rd assistant, Mori 4th assistant. Ishiyama made a semi-circular incision about 3" long near the base of the skull and forceps were applied to the blood vessels to stop the bleeding. Hirao, Torisu, and Mori retracted the incision. The periost was then cut and scraped off with a laspatorium, Komori drilled 4 holes in the skull, 1 1/2" apart, and Ishiyama sawed through the skull with a gigli thread, lifted out a skull section about 1 1/2" square, exposing the meningea (membrane over the brain.) Ishiyama made a cross incision in the meningea, exposing the brain, and, using a spatel, separated the brain from the meningea. While Ishiyama was manipulating with the spatel, the blood suddenly gushed out of the opening in the skull. They tried to stop the bleeding by applying gauze to the opening. The Prisoner’s condition was critical; the blood color became black; he died a few minutes later. Ishiyama tried to stop the flow of blood with gauze, was unsuccessful, said that if he had a Bovie unit, an electro coagulator made in American, he could stop the bleeding. Hirako had been watching the operation from soon after it started, and either MORI -7- just before or after the blood started flowing, Ishiyama asked him how to reach the substantial nigra which is located at the base of the brain. Hirako replied it was difficult to reach it in such a manner, went out and got a brain specimen, showed him the location and the difficulty. Ishiyama merely said, "Is that so," continued to try and stop the blood flow. Ishiyama put the piece of skull back in and sutured the incision of the dead Prisoner. It appeared that Ishiyama was trying to find the best method of reaching the substantia nigra, was interested in epilepsy and interest to get to the nigra so as to treat his epilepsy patients. This was an experimental operation; the patient was normal; Mori knew before he assisted,it was to be experimental. Mori returned to the clinic after this operation. After the 3rd day of operations, while Mori was still in the autopsy room, Ishiyama told him "There will be a party tonight at the Ippotei, the military restaurant, after we are finished here." Mori cleaned up, went to the restaurant with Hirao and Torisu about 1730. Sato and Komori were there; Ishiyama came about an hour later. Mori asked Komori why these Prisoners had been used for such kind of operations, he replied, "These fliers have bombed the cities indiscriminately and, according to international law, they were court martialled and sentenced to death— so they would die anyway. Leave this matter to the army and don’t worry about it." This is the first time Mori knew they were to die. Each was introduced by Ishiyama to Sato, who said, "Thank you for your trouble." Mori left at 2000. Mori thought Sato was representing the military, thanking them for fulfilling their request. It ?*ould need the permission of the CG (Yokoyama) to have the Prisoners die, by using them for experimental operations. The next AM, 27 May, Mori went to Ishiyama to pay his respects before leaving for Kagoshima, leaving 28 May, returning to the University about 3 weeks later, after the Fukuoka bombing to buy surgical instruments. SUMMARY 1st series - 17 May 194$ - 1st Prisoner (blood stain on uniform)- Removal of right Lung. 2nd Prisoner - Total or partial lung resection 2nd series - 22 May 1945 - 1st Prisoner a. Total resection of stomach by Mori, Hirao-:and Komori b. Incision in heart by Ishiyama and Mori 2nd Prisoner Resection of liver (right lobe?) 3rd series - 26 May 1945 - 1 Prisoner - Brain operation. |