A. Rascher did not discover anything.
Q. Well, how about air embolism; did you always consider the fact of air embolism in connection with all your experiments?
A. With what experiments?
Q. In the high altitude experiments.
A. You mean rescue from groat height?
Q. Yes?
A. In those experiments about high altitude rescuing we did not take air embolism into account.
Q. I see. Well, now Doctor, could you tell us just what air embolism is, very briefly so that myself and the Tribunal will understand it and try to put it in layman's language for us, will you please?
A. Under the expression air embolism one understands the occlusion of a larger or a smaller blood vessel through an air bubble or a gas bubble.
Q. Well, now, how can you as a physician ascertain such a state, such a condition; how is it possible to ascertain whether or not a person is suffering from air embolism?
A. You ascertain this one the basis of the symptoms that such air embolism causes. It depends entirely on what organ, what tissue or what part of the body has the air bubble. in it, and on that depends the symptoms because this air bubble prevents the blood from circulating in the blood vessel in which it is located.
Q. What I am getting at is, can you diagnose it; for instance is pain a proof of air embolism?
A. A general air embolism does not cause pain.
Q. I See, well suppose you are looking at one of the subjects; how can you determine whether or not they are suffering from air embolism; what would be your way to diagnose this condition?
A. First, I should have to suspect that some form of air embolism was present. I could only have this suspicision if there are some symptoms of deficiency, and on the basis of these symptoms of deficiency, I can under certain conditions form an impression of where the air embolism is blocking off.
Q. Then it is most difficult, is it not, to diagnose air embolism on living man?
A. To diagnose air embolism, if one diagnoses air embolism, that of course is only a diagnosis of probability and conjectures in most cases.
Q. Then, the only way you can actually ascertain that air embolism existed would be on a dead man by an autopsy or as Rascher did by keeping a dead man under water etc.; that is the only way you can determine if the state of air embolism exists?
A. It is usual in pathology that if you suspect that there is an air embolism for instance, in the heart or in the paracordis, you carry out the dissection of this organ under water.
Q. Let us look at Rascher's two reports, the first one being on page 60 of the English Document Book, Document No. 2, which is Document 1971-A PS. The first page of the Document is a covering letter, Dr. Ruff, What I am trying to got you to do, Dr. Ruff, is in the best manner you can describe to the Tribunal this situation of air embolism, inasmuch as it is referred to in Rascher's report. Rascher could probably answer the question better than you however, I want you to go over this with us. This is the first report, under No. II, if you will go down to the line, "The experiments conducted by myself and Dr. Romberg proved the following, " then skip one, two, three and the fourth paragraph under that statement; do you have that?
This will be under paragraph 2 in the report. ---What is the trouble? ---- It is under No. 2, you will sec the second paragraph starts out with the words, "The experiments conducted by myself and Dr. Romberg proved the following:" Then if you will jump down to the fourth paragraph under this section, which starts out: "The third experiment of this type took such an extraordinary course...." Do you have that Doctor?
A. Yes, I have.
Q. Now, I want to read this to you, Doctor, and see if you can help us with this problem.
"The third experiment of this type took such an extraordinary course that I called an SS physician of the camp as witness, since I had worked on these experiments all by myself. It was a continuous experiment without oxygen at the height of 12 km conducted on a 37 year old Jew in good general condition. Breathing continued up to 30 minutes. After 4 minutes the experimental subject began to perspire and to wiggle his head, after 5 minutes cramps occurred, between 6 and 10 minutes breathing increased in speed and the VP experimental subject became unconscious; from 11 to 30 minutes breathing slowed down to throe breaths per minute, finally stopping altogether.
"Severest cyanosis developed in between and foam appeared at the mouth.
"At five minute intervals electrocardiograms from 3 leads were written, After breathing had stopped, dissection was started."
Now, in this autopsy report it is apparent that Dr. Rascher found this condition of embolism, inasmuch as he states after his autopsy in the second paragraph and if you will turn to the second paragraph, under the "Autopsy Report," he states:
"One hour after breathing had stopped, the spinal morrow was completely severed and the brain removed. Thereupon the action of the auricle stopped for 40 seconds. It then renewed its action coming to a complete standstill 8 minutes later. A heavy subarchnoid edema was found in the brain. In the veins and arteries of the brain a considerable quantity of air was discovered, Furthermore, the blood vessels in the heart and liver were enormously obstructed by embolism."
Well, now was that the only way that Rascher could have determined that this subject was suffering from air embolism was to perform an autopsy; he definitely found that condition, you see, Doctor?
A. Yes, it is certainly true that he found this condition in this autopsy.
Q. Well, now, this picture which we have to put into evidence here; is it possible form this picture of the brain to diagnose air embolism; it night perhaps be the light, but you can see some bubbles in this picture, so I have had it enlarged for your benefit to look at. Do you perhaps see those light spots; would that perhaps be air embolism?
(The picture is shown to the witness.)
A. Yes, that is air embolism, but the discovery that air is in these vessels does not mean that the vessels are obstructed. These air bubbles in the blood vessel can be present without their leading to any disorders. We know from experimental medicine, for example, that an injection of air, let us say at 100 cubic cms.
can be made into a blood vessel without the experimental subject noticing anything at all. In other words, the effect of air in the blood stream depends entirely where that air gets to.
Q. Would you kindly pass back that photograph? I want to show it to the Tribunal, so that they can get a picture of just what this condition is.
THE PRESIDENT: Will the Secretary General procure a copy of Prosecution Document Book 2 for the Tribunal?
MR HARDY: This, Your Honor, is an enlarged version of what appears in Document Book 2 and you can quite clearly see what Dr. Ruff has pointed out.
Well, now, Dr. Ruff, on page 76 of this Document Book, which is Rascher's second report, the report of Rascher dated 11 May, to the 1st, 2nd, 3rd, 4th, 5th, 6th, the 6th paragraph under No. 7. It starts out. "To find out whether the severe psychical and physical effects." Do you have that Doctor?
THE WITNESS: I have paragraph 6 and 7, yes. Experiments as Peruitin and..........
Q. This is paragraph 6 under No. 7, and it starts out: "To find out whether the severe psychical and physical effects, as mentioned under No. 3, are due to the formation of embolism, the following was done." Do you have it now?
A. Yes, I have it.
Q. It states here: "To find out whether the severe psychical and physical effects as mentioned under No. 3, are due to the formation of embolism, the following was done." Now before we go into that it appears apparent that Dr. Rascher deemed it necessary to conduct an autopsy under water until.... in order to find out whether or not this embolism condition existed in this particular experimental person. Now his purpose in doing this, as it states, was to find out whether or not this condition of embolism was the cause for the severe psychical and physical effects. Well now from your experience since that time with the American authorities and your past experience, was Rascher correct in performing an autopsy in order to find out this condition, or could it have been ascertained without such an autopsy.
A. It is not altogether easy to answer that question. I think the situation is that whether or not there is a case of air embolism, one can say from the symptoms with pretty great certainty whether embolism is present, but for a more certain answer or an absolutely certain answer, you have to carry out an autopsy. For example, if after an operation, death occurs through embolism, then of course the autopsy is the first thing that absolutely determines for certain the cause of death.
Q. Well now let us read this: Rascher states:
"After relative recuperation from such a parachute descending test had taken place, however before regaining of consciousness, some experimental persons were kept under water until they died. When the skull and cavities of the breast and of the abdomen had been opened under water, an enormous amount of air embolism was found in the vessels of the brain, the coronary vessels,and the vessels of the liver and the intestines, etc.
"That proves that air embolism, so far considered as absolutely fatal, is not fatal at all, but that it is reversible, as shown by the return to normal conditions of all of the other experimental persons.
"It was also proved by experiments that air embolism occurs in practically all vessels even while pure oxygen is being inhaled, One experimental person was made to breathe pure oxygen for two and one-half hours before the experiment started. After six minutes at a height of 20 kilometers he died and at dissection also showed ample air embolism as was the case in all other experiments.
"At sudden decreases in pressure and subsequent immediate falls to heights where breathing is possible no deep reaching damages due to air embolism could be noted. The formation of air embolism always needs a certain amount of time."
Well now were you familiar enough with air embolism to have been able to determine this that Rascher found, or do you agree with what Rascher states here?
A. No, I do not agree in every point at all with what Rascher says here. Rascher says here that:
"That proves that air embolism, so far considered as absolutely fatal, is not fatal at all, but that it is reversible as shown by the return to normal conditions of all other experimental subjects."
Now this is a finding which Rascher made on the basis of his ignorance, and the case really is not air embolism. I said before what the effects of air embolism are depends on where the embolism is in the body. If the embolism is in the brain and in the vital part of the brain it can be fatal. If that embolism is located in the heart and in the neighborhood of the heart, it can also be fatal, because it interrupts the entier circulation of the blood. If it is located in the fatty tissue of the abdomen that cuts off a certain part of that tissue from blood irrigation, and then necrosis develops which is quite harmless.
In other words, it also depends on, first, how large the embolism is, and secondly, where it is located. A few minutes ago I said that long before Rascher made this discovery, experiments were carried out in which air was injected into the blood stream, and it was then observed that even large amounts of air, such as 100 cubic centimeters could be absorbed by the experimental subject with no danger or damage to himself at all. However, this experiment did not prove that 100 cubic centimeters of air in the blood stream are always harmless, because if that air reaches the right places it will cause an embolism so that air can be fatal.
Q. Now you will notice in the paragraph just above, six, that is paragraph 5, but in the some section cf the report Rascher said:
"For the following experiments Jewish professional criminals who had committed race pollution were used. The question of the formation of embolism was investigated in 10 cases. Some of the experimental subjects died during a continued high altitude experiment; for instance, after one-half hour at a height of 12 kilometers. After the skull had been open ed under water, an ample amount of air embolism was found in the brain vessels, and, in part, free air in the brain ventricles."
Well now it seems to me that Rascher did a great amount of experimentation to determine the cause of death or the causes for these conditions of drop pressure, drop sickness or high altitude sickness.
Were you as interested as Rascher was in whether or not air embolism was the cause of these things, or was that purely a side line of Rascher's part?
A. Of the experiments which were here described I know only what is in this report here and no more, and I saw this report for the first time when it was out in evidence in this trial. What Rascher's ideas were about the experiments I don't know. For us these results that he here sets forth would not have been entirely uninteresting, of course, but for all practical purposes those results played no role in what we were doing, because as I said in the thousands of experiments that we carried out in German medicine at such altitudes on soldiers or others, we never had a fatality, so that we had no reason to inquire into the reasons for fatality.
Q. Well then any question about - concerning air embolism, did not appear in the experiments that you and Romberg had any authority over, did it? What I am getting at here, it appears to me that the criminal aspect of Rascher's work was his strange desire to find out just what air embolism did and whether or not he could determine how a person was suffering from it, and consequently he killed these people, or left them up in the air long enough so that they died, and then he autopsied them, and that appears to me to be a crime in itself, and it appears from your testimony you were not involved in these matters. Now were you interested in finding out whether or not air embolism was one of the causes for the pressure fall sickness?
A. That pressure fall sickness has something to do with the freezing of the nitrogen from the blood or tissue was known very well at that time. Rascher's experiments were all together unnecessary to ascertain that, because it was already known.
Q. Well now it seems to me that in the ??urs of these experiments there would be two things to consider, one would be the altitude sickness as considered by lack of oxygen, and the other would be your so-called pressure drop sickness, which would be where the function of air embolism would come into play.
Now did it appear in the course of your experimentation that this pressure drop sickness was caused by something else rather than the lack of oxygen?
A Pressure fall sickness has nothing to do with the lack of oxygen. I have already described during my direct examination that there is a certain zone, namely, the zone between 12 and 14 kilometers, or let's say, 12 and 131/2 thousand kilometers; and in this altitude there is no sickness among the passengers nor pilot of a plane. That is to say, if they are adequately supplied with oxygen. But drop pressure fall diseases can occur. In other words, this proves that pressure falls have nothing to do with the supply of oxygen. That is an entire different matter, pressure fall sickness occurs as a result of the general reduction of the air pressure in which the person finds himself.
It is similar to the symptoms that occur when a deep sea diver rises from a considerable depth and does not do so slowly enough; in other words, the pressure on him is reduced. It is similar to the socalled caisson sickness. This is the same sort of disease that you notice with persons who have to work in caissons when they come from the caisson, which is a chamber under pressure. If they come from it too rapidly then they have similar symptoms as one finds in pressure fall symptoms. But what I am saying now is not something that was learned from these experiments of Rascher's; it is something that has been known for a long, long time.
Q I see.
THE PRESIDENT: Counsel, the Tribunal will now be in recess.
(A recess was taken.)
THE MARSHAL: The Tribunal is again in session.
BY MR. HARDY:
Q. Now, Doctor, we have about completed our discussion of this business of air embolism end I have gathered from what you have told me that in your experiments on rescue from high altitudes you were not particularly interested in collecting data on pressure drop sickness or air embolism, were you?
A. That is correct.
Q. Hell, now did the problem of pressure drop sickness or air embolism enter at all into your research on rescues from high altitude at that time or later on after the Dachau work or during the course of your time at the Aero Medical Center? Did this problem of pressure drop sickness or air embolism ever enter into any of your research on rescues from high altitude?
A. Regarding the complex of questions concerning itself with protection from high altitude this did not bother me. After the Dachau experiments I personally concerned myself with pressure fall diseases. This was from the year 1945 to 1946 at the Aero Medical Center at Heidelberg.
Q. Well, was there anything found in your experiments on rescue from high altitude that could have contributed to the problem of whether or not pressure drop sickness with air embolism was present in addition to the oxygen lack? You understand the question?
A. I don't understand you.
Q. I ask again. Was there anything found in your experiments on rescue from high altitude that could have contributed to the problem of whether or not pressure drop sickness with air embolism was present?
A. No, not really. These experiments had had nothing to do with the reason for the origination of this pressure fall disease.
Q. I see. Well now, Doctor, in this Document 402, which is on page 82 of the English copy, Document Book II, which is Exhibit No. 66. For your convenience, Doctor, I have the original here that I will pass up to you so that you can follow it better.
Would you kindly keep it in the order which it is now in. Now, on the first page there appears there your signature. Is that correct? Is that your signature?
A. Yes, that is my signature?
Q. Also the signature of Romberg?
A. Yes, that is correct.
Q. The first page is a cover letter to the report itself, is it not?
A. Yes.
Q. Well now, how many copies of this report did you make in the first instance?
A. I cannot tell you that exactly as to the number. I estimate that approximately a dozen of those reports were sent, which would mean a dozen of those copies, but that is only a approximation.
Q. What did you do with the first, the original copy? Did you keep that yourself, the original report, and just send out the copies?
A. I am sure that one of these reports was kept by us.
Q. I see. Well, now I notice here that this report is addressed to the Reichsfuehrer-SS, Berlin, and it states, "Inclosed we submit copies No. 2, 3, and 4 of the report on the experiments on rescue from high altitude for your files." And your signature appears. Well now, you were not connected with the Reichsfuehrer-SS. Your experiments were separate and apart from the Reichsfuehrer-SS. How do you account far addressing these reports to him?
A. The Reichsfuehrer-SS has demanded that all reports about these experiments would have to go through him. He was the man in whose sphere the experiments were carried out and he wanted these reports to be sent to him at first.
Q. I see. Well now, Doctor, this report here doesn't contain any of the information that is set forth in some of the Rascher reports. For instance, the deaths, etc. How does that happen?
A. Because the fatalities which occurred during the experiments of Rascher had nothing to do with our experiments - experiments for the rescue from high altitude - and didn't occur there.
As a result there was no reason to incorporate these deaths in that report.
Q. Well, now. Rascher had these deaths that were connected with his research for air embolism and likewise that had nothing to do with your particular phase of the experiments, did it?
A. The experiments which were carried out by Rascher for reason of research in air embolism have nothing to do with the experiments carried out for the purpose of rescue from high altitude.
Q. Is that why you had no mention of air embolism in your report? That's why you didn't bring that factor up, isn't it, because it had nothing to do with you and you hadn't heard about it?
A I said, daring my direct examination, what I heard about Rascher's experiments from Romberg when a death occurred. He told me that Rascher wanted to take notes of the register of the electrocardiogram in the case of this pressure fall sickness. What I knew when this report was compiled was, first, of all, that Rascher, in addition to our experiments for the purpose of rescue from high altitude, was carrying out other experiments and that, in the course of these experiments which were carried out by order of Himmler, deaths occurred. As to the manner of the experiments Rascher was carrying through, I only knew that he was using the electrocardiogram in the case of these pressure drop sickness. This is all I knew about these other experiments when compiling my report. In other words, I knew exactly that deaths which occurred during Rascher's experiments had nothing to do with the experiments for the purpose of rescue from high altitudes. For that reason, there was no occasion to incorporate these death cases in that report for two reasons: one, that they did not occur during our experiments; and, secondly, the other experiments were only known to me in very broad outlines and I only knew about a part of these experiments. You can see from Rascher's intermediate reports that he had carried out a number of various experiments. For that reason, I could not embark on the idea to incorporate any thoughts that Rascher may have had, during the course of his experiments, in my report.
Q Well then, all this material that Rascher had collected concerning air embolism, since you didn't discuss it with him, since you didn't know about it, had no knowledge about it at all at that time, until such time as you were served with these documents in this case -is that the reason why this report contained or made no mention of the data concerning the facts that Rascher found in connection with this air embolism business?
A No, this report, as it is stated here, is a report for the purpose of rescuing people from high altitudes. The additional experiments of Rascher had nothing to do with these experiments. Even today, after these intermediate reports are available to me, I can still say that these experiments had nothing to do with the experiments for the purpose of rescue from high altitudes, and that was the reason.
Q Well, Doctor, we won't linger on this any longer. We will go to page 91 of your own report. Obviously, you slipped up when you wrote this. Page 91 of the English which is page 16 of the original document, Doctor, and it will be the last paragraph on page 16 of the original document. Do you have that?
A Yes.
Q Now, it starts off: "In spite of the relatively large number of experiments, the actual cause of the severe mental disturbances and body functions (paralysis, blindness, etc.) attendant upon posthypoxemic twilight still......"
A Just a moment. Page 16 of that report starts with a different text.
Q This is on the last paragraph of the page - of 16 of the report.
A Yes, thank you.
Q And I will start again:
"In spite of the relatively large number of experiments, the actual cause of the severe mental disturbance and body failures (paralysis, blindness, etc.) attendant upon post--hypoxemic twilight still remains something of a riddle. It appeared often as though the phenomena of pressure drop sickness (aeroembolism) had combined with the results of severe oxygen lack."
Now, how did you know that it "happened often as though the phenomena of pressure drop sickness had combined with the results of severe oxygen lack" had it not been for the fact that Mr. Rascher, Mr. Romberg, and Mr. Ruff had their heads together in each and every one of these experiments?
A I didn't understand the question.
Q Well, first of all, tho first sentence says that "a large number of the experiments found the cause of the severe mental disturbances and body failures" and then you state in the last four - five words "the twilight still remains something of a riddle."
Now, didn't Mr. Rascher supply the answers to that riddle when you go on to state "It appears often as though the phenomena of pressure drop sickness air embolism, had combined with the results of severe oxygen lack?" Now, I ask you, how did you know air embolism without Rascher's work?
A There is no mention of this air embolism. I note the sentence "It appeared often as though the phenomena of pressure drop sickness had combined with the results of severe oxygen lack". This is entirely different and has nothing to do with what you have just said. You cannot say, as I already stated before, that pressure drop sickness and gas embolism is the same. I tried before to explain that, in the case of the pressure drop disease, gas embolism can appear. That, of course, is not absolutely necessary and does not follow. Therefrom our knowledge came which enabled us to discuss this question as to whether air pressure sickness would play a part in these serious symptoms can be seen on the next page. On the next page we have the two experiments by Romberg and Rascher......
Q. Just a moment, Doctor.
DR. SAUTER: Mr. President, the copy which is available to the Prosecutor must in some way be different to the original, which is before me and which was also available to the defendant Ruff. The Counsel for the Prosecution has repeatedly road "pressure drop sickness, Air embolism, etc." He wrote that twice. In our original however, there is no work mentioned of "air" or "embolism." I should like to point that out to you at thim time so as to avoid the Prosecutor reading a text to the defendant, which is probably just an error on the part of the Prosecution. I want to state expressly that in the German copy and the original there is no mention of embolism.
MR. HARDY: That is correct, Your Honor. The English contains the word in parenthesis "air embolism" and the German original text docs not. We will go on, Doctor.
Q. Now, on page---
DR. SAUTER: Mr. President, if what the Prosecutor has just said is correct I ask that the Document Book be rectified accordingly. Secondly, it may be expedient to explain at this moment how it is possible that an expression is introduced into a document which is not contained in the original, and it must of necessity mislead any person reading that document. I don't think that this is a tenable situation where such an erroneous expression gets into a document which is available to the Tribunal and upon which the Tribunal has to base its judgment.
THE PRESIDENT: Several times during the course of this trial similar errors have occurred and have been discovered. These matters are rather serious and when matters like this are found, the document book, the the original and the copies in the possession of the Tribunal should be corrected so they speak the truth and show correct translations of the original documents.
These errors are serious and cause a great deal of delay in the trial and a great deal of trouble for counsel and for the Tribunal. Some of the errors are apparently interpolations which have been inserted in the document, by whom or under what circumstances, of course, the Tribunal is not advised, but any such errors as this which are found should be immediately corrected by preparing the sheets, the mimeographed sheets calling attention to the volume and page where the error is found, and also the correct translation.
Q. Well, now, Dr. Ruff, is pressure drop sickness in an average or standard German dictionary defined as air embolism or vice-versa?
A. No.
Q. Is it common to say---
A. One has to distinguish there between two matters, firstly, pressure drop diseases are used in the English usage as bense and chokes, and then there is another designation "air embolism." Air embolism, however, does not at all mean gas embolie. These are two entirely different expressions. Air embolism in the English usage means that the complaints arise through the release of nitrogen within a person's body. It isn't a very exact designation. Gas embolie in medicine and air embolism are two entirely different matters.
Q. Well, now, will you explain to us how you found that it appeared often as though the phenonoma of pressure drop sickness had combined the pressures of severe oxygen lack?
A. I said that after these sentences it is explained how this conclusion could be drawn. It was drawn as a result of the self-experiments by Rascher and Romberg, then that experiment pressure drop sickness--
Q. Just a moment. It appears from the Rascher-Romberg experiment that they had performed on themselves, is that what you mean?
A. Yes, it says that in this regard observations are important carried out upon the person. I will read in this connection "the subjective accounts made by the authors in two experiments each were interesting." This is the following sentence.
Q. It says hero it appears often now, in what other experiments did it appear?
A. In the case of these drop experiments from a 15 kilometer altitude during which these more severe symptoms of altitude sickness appeared, and which are explained in detail in this report. It seemed as if during this sickness the lack of oxygen and the pressure drop sickness combined.
Q. Well, now, I wash you would turn to page 95, which would be page 22 of the original, and this is section 3, that is Roman numeral III entitled "Discussion of the Results."
A. Discussion of the Results,
Q. Do you have that?
A. Yes.
Q. Well, now, it says here "The descending experiments without oxygen show that the limit for a safe escape with an open parachute lies approximately at a jumping altitude of 13 Kilometers." That is 42,700 feet. "Since in a jump from 13 kilometers recovery of consciousness occurred only 1.6 kilometers."