n; : PaOc nE U NG icie UI mag espero wae am Darol Froman Mey 20, 1954 purpose in doing this vas to obtain a series of 24-hour urine specimens. We felt that this should give us confirmation of our feeling that in such situations the external exposure rather than the internal exposure is the limiting factor. the present time. A second series of such specimens is being studied at We believe that we proved our point. We also estab- lished the fact that the Rongelap mtives had taken into their systens greater amounts of mixed fission products than is customarily regarded as permissible. We feel that Eisenbud vas overly optimistic ani probably mistaken in his letter of 6 April to Dr. Kobayashi. It is our belief that the assay carried out at NYO failed to measure total activity (they did not have adequate instruments to do this), and also presence of volatile fission products, principally I--+. ed to detest the Assuming an individual has already received a fairly large dose of external exposure, it is difficult to estimate to what extent this affects a concurrent internal exposure. We frankly don't know whether the two things operate independently or whether they aid and abet each other. Dr. George LeRoy of Argonne, who studied the Hiroshima and Nagasaki cases, told me this week that it was his opinion that a couple of these Japanese fisher=men might die and that, in his opinion, their deaths would result from their internal exposure to mixed fission products. We in H-Division do not agree with him but I mention it to point out the fact that differences of opinion on this general subject still exist even among the well~inforned. A well done urine analysis of the Japansse fishermen such as ve could have done here might have indicated the presence of large amounts of certain fission products whose excretion could have been speeded up immensely by edequate treatment. Determining whether such treatment should have been started and knowing how long and how vigorously it should be pursued would have depended on repeated urine assays, something which the Japanese were incapable of doing. This, again, would have been a specific benefit to patient and physician alike, Much of our indecision about what constitutes adequate treatment in such cases results from the lack of adequate factual data on humans. I believe that the Rongelap natives have provided about as much scientific informtion as we can squeeze out of thems I am happy to report from firsthand observation that all except the babies were unbelievably cheerful ani cooperative. The Japanese presumbly received significantly larger doses, both external and internal. They almost certainly represent the precise dose range in which ve are most keanly interested. We know that with smaller doses the people will get well anyway, and with larger doses they will die before ve can do anything about it ani in spite of what we can do. The Japanese received about the doses where they might die without treatment but might be saved under proper management. I only wish that we had had a number of these urine specimens to study here. I apologize for the length of this epistle; I intended it to be terse and succinct. See what happened! ree _ . clA — Froman = c2A ~ H-Div. Files =~ ee ~- am T. L. SHIPMAN, M. D., “ler. ~ HealthDivision Leader —