And so one must always consider the possibility of landing in an unconscious condition with all the attendant dangers. Well, now, it is apparent that you have decided that a safe altitude is 13,000 meters, is that correct?
A. Yes, 13,000; yes, it is said here 13,000. The conditions as they are entitled in this sentence, nonoxygen and pressure drop sickness, which means a descent when the parachute was unfolded, and in that connection the limit was considered to be 13,000 meter. That is correct.
Q. Did you actually sent men up to an altitude higher than 13,000 meters?
A. Yes, that is true---
Q. And how do you justify doing that; 13,000 meters is determined to be the highest you can go and still be safe?
A. Firstly, the determination of this save limit was only possible after the conclusion of the experiment. I can only determine a limit if I notice when reaching that limit that I can go on no longer, and after having concluded some experiments subsequently which had gone beyond this limit. Say that for practical conditions I would have to consider that the limit lies at 13,000 meters, The conditions which prevailed when we lay down the limit of 13,000 meters were only derived after having experienced a 15,000 meter height. After these experiments I could say that in an altitude of 15,000 meters a flyer who has no oxygen at his disposal and whose parachute is unfolded at 15.000 meters cannot be saved without injuries, because when landing on the ground he is still unconscious and that when landing on the ground he could of necessity be injured or in case of dropping into the water he would drown.
Q. Well, then, you do agree, inasmuch as you were unable to determine before the experiments started, just how high a man could go up, but these were extremely dangerous; were they not, these experiments?
A. These are two different matters, the ignorance whether one can ascend to those limits or not and the danger which may be incurred through the experiments. They have nothing to do with one another. I should like to give you an example, I should like to assume if a human being can carry out one hundred knee bonds, unless I can experiment on him, I don't know. On the other hand, you cannot maintain that I could say whether this is dangerous or not, because I don't know before hand if it is possible for him to carry out one hundred knee bonds or or not.
Q. Would it not have been then the proper thing to experiment first in any of the things, which you speak of in the report, to experiment on animals to determine the effect there before having resorted to human beings?
A. Naturally, we also performed animal experiments, but these animal experiments can only roughly inform us. In this report you find a comparison made between animal experiments, which were carried out by Lutz at the Institute of Weltz and our experiments and the results of these two experiments do not only differentiate themselves from a quantitative point of view, but also from a qualitative point of view; that is the altitude which you can use by using an animal can never by the same, as you use when using a human being, it can be higher or lower. Here we not only have a quantitative difference in the experiments, but we found that we also had a qualitative difference. In other words, the reaction of the animal conducted experiments was entirely different from that of experiments on human beings.
Q. Just a moment, you said that Lutz and Wendt experimented on animals and you gained your knowledge from Lutz and Wendt is that right; and that is, why it was not necessary for you to experiment on animals; is that what you are trying to tell me?
A. No, perhaps I did not express myself clearly, All I said, was that a proof is to be found, that such experiments cannot be carried out on animals, in this very same Document, where the results of the animal experiments carried out by Lutz and Wendt are Doing compared with the experiments on human beings. The results of the animal experiments, carried cut by Lutz and Wendt were not known to us when we executed these experiments and this is something which is actually contained in the report. This only came to cur knowledge after the end of the experiments.
Q. Then, how do you justify experimenting on human beings before you experimented on animals; Lutz and Wendt used animals, you did not even go that far.
A. I was just saying that naturally we were carrying out experiments on animals before the experiments on human beings, in order to clarify the trend to which these experiments would have to be molded. Yesterday, I tried to explain that there are a number of questions which crop up in medicine, especially aviation medicine, which cannot be clarified. by the use of animals. The responsibility for not having carried out those experiments on animals instead of human beings, I can well assume as a scientist and as a physician.
Q. May I call it to the Tribunal's attention on page 96 of the English Document Book, Ruff's report states: "Unfort unately this work was not available to us during these experiments, so that we could not build upon the valuable results contained in it and derived from numerous animal experiments, or upon the experience of the authors," Well, Dr. Ruff, when did Romberg first report the death to you?
A. Naturally, I cannot state today exactly, but I should say it was in April.
Q. March maybe or April of 1942, is that it?
A. I did not say anything of March, I spoke here of April.
Q. You said downstairs in answer to Mr. Denny that you assumed it was in March of 1942; now do you assume that it was in April rather than March?
A. When answering Mr. Donny's questions, I never said March.
Q. Well, now, when you received this report from Romberg about the death of an inmate, just what did Romberg tell you?
A. I have tried to explain it several times. Romberg came to Berlin and reported to me that Rascher, by order of Himmler, was carrying out other experiments than ours designed for the rescue of high altitude and during this other experiment a case of death had occurred. He further said that during the experiments, which Rascher was carrying out , he intended to study the heart in the case of pressure drop sickness.
Q. Now, was this the first time that you realized that there were actually two sots of experiments going on; the Rascher , Ruff and Romberg experiments and then the Rascher experiments which he did exclusively; when this report was reported, was this the first time you realized you were cooperating with Rascher only in the Luftwaffe experiments?
A. When Romberg at that time came to Berlin, I heard as far as I know for the first time that there existed at all, in addition to cur experiments for the protection from high, altitude other experiments, which were carried out by Rascher by order of Himmler.
Q. Well now, upon receiving the report from Romberg about this then what did you do?
A. I already stated what we considered about the matter. We came to the conclusion that it would be best to conclude the experiments as quickly as possible. I had reported this matter to Hippke and Romberg returned to Dachau in order to conclude the experiments, subsequently the chamber was taken from Dachau.
Q. While we are on the point of the chamber, you state that the chamber was taken from Dachau by rail ; that you loaded it on a railroad, in connection with the book which Dr. Sauter presented to you in direct examination and that it took some eight hours to load the chamber; I presume it took nearly eight Hours to unload the chamber. Would it not have been easier to load the chamber on a truck and drive to Berlin; was there a gasoline shortage?
I did not got any answer.
THE INTERPRETOR: I did not come through.
BY MR. HARDY:
Q. Will you start again please.
A. From the Document , which was submitted by Dr. Sauter yesterday from the book of my mechanic, I said there is no indication about the time, which was necessary for the loading of the low pressure chamber, with the exception that my mechanic had to work on a contain day for so many hours when unloading the chamber. From these hours of work, one cannot conclude the entire amount of hours, which were necessary for the loading or unloading of that chamber.
The transport back of this chamber by rail actually resulted on the basis of the lack of fuel. There we were not concerned with gasoline, but with diesel oil. As I already said during my direct examination, diesel oil was terribly scarce in Germany and was essentially reserved for the submarines. It was impossible to receive permission for a journey from Munich to Berlin and got the corresponding amount of diesel oil for that purpose. That is the reason why the chamber was transported by rail.
Q. Well, now after these deaths were reported to you, or after this first death, did you order any steps to be taken with reference to Rascher?
A. I stated that our experiments were to be concluded as quickly as possible and that we tried to get the chamber out of Dachau.
Q. I ask you again, did you take any steps against Rascher?
A. No, I did not take any steps against Rascher. I could not do that.
Q. Here is a person who had died and you have not done anything about it; is that right?
A. It is correct that a person died; it is not correct that I did nothing about it. I saw that this chamber was removed from Dachau, which meant that Rascher was deprived of the opportunity of carrying out future experiments.
Q. Now, did Romberg report any other deaths to you?
A. Yes, that is right.
Q When?
AAs I said already during my direct examination that during the time which elapsed between the return of Romberg and the final return of Romberg to Berlin, we were repeatedly in telephonic contact with one another. During one of these telephone conversations, and as far as I remember the last one, Dr. Romberg told me Rascher was carrying out further experiments and on that occasion he indicated something had happened again. After his return to Berlin he confirmed my assumption which I had during tho telephone conversation and actually told me another two persons had lost their lives during these Rascher experiments.
Q Did you do anything about that?
A There was nothing for me to do. The chamber at that time had already been removed from Dachau. Tho experiments had already been concluded and when I reported this matter to Hippke that the chamber had been returned, I at first told him verbally about the result of the experiments and at the same time informed him about these facts.
Q Was Rascher still in the Luftwaffe at that time?
A Rascher at that time still belonged to the Luftwaffe. I believe that at that time he was trying to be transferred to the SS. Rascher, therefore, from a military point of view belonged to the Luftwaffe, but as it has become evident from a number of documents, he has been made available to the SS or rather Himmler.
Q Well now would you tell us just what function the electrocardiogram served?
A The electrocardiogram served the purpose to master the electrical vibrations which occurred in the heart whenever it is active. Each muscle and every other tissue produces by it activity an electrical current. In the case of the heart this current is rather strong and one easily succeeds in registering this electrical current in the heart.
Q Well no do you use an electrocardiogram each time you are conducting one of these high altitude experiments?
A No, I cannot answer that question exactly, but I don't believe that in the case of all experiments electrocardiograph registers were made.
Q Was it used in the high altitude experiments?
A. Yes.
Q Well now, if Romberg was using the electrocardiogram in these experiments, he was doing that for the benefit of the Rascher, Ruff and Romberg work, wasn't he?
A He used the E K G whenever it seemed advisable to him when carrying out experiments for tho purpose of rescue from high altitudes. Apart from using it during the high altitude experiments, he used the E K G in order to supervise and observe the experimental subjects. Before the beginning of the experiments he registered the heart of the experimental subjects.
Q That is right. Lot's look at Mr. Romberg's affidavit, which is document NO 476, on page 2 of Document Book 2. This is the paragraph No. 6 in the affidavit, No. 6: "I witnessed the death of three of Dr. Rascher's human experimental subjects during the experiments. The first death occurred in the latter part of April, and on this particular occasion I was studying: the electrocardiogram by using the experimental subjects."
Romberg was your subordinate, wasn't he?
A Yes, that is true.
MR. HARDY: No further questions, Your Honors.
THE PRESIDENT: Is there any re-direct examination by defense counsel?
RE-DIRECT EXAMINATION BY DR. SAUTER:
Q Dr. Ruff, I should like to clarify a number of points which have been raised during the course of your examination which require clarification.
Counsel for the Prosecution has repeated your testimony regarding the voluntary nature of the experimental subjects and he stated that according; to your testimony sixty experimental subjects were selected at Dachau, and I think ten or fifteen of these sixty were actually used for the experiments. In order not to allow any erroneous opinion appearing I shall ask you once more. Did the Camp Commandant or Dr. Rascher or any one else select a group of sixty experimental subjects who were then to be used for the experiments, or is it rather true as you already stated during your direct examination that this group of approximately sixty persons volunteered and then, Rascher, Neff or any one else selected from these sixty volunteers those persons who were to be used for these experiments on a certain date? How was the true situation?
AAlready yesterday I have tried to illustrate that point. According to my information sixty persons all together volunteered. Of these sixty people, approximately 12 were selected, who, because of their health and physical condition, complied with the conditions which we needed for our experiments. These ten or twelve experimental subjects were housed together in tho experimental station throughout the entire length of the experiment. These ten or twelve persons, are the experimental subjects were for the experiments as it is stated in our report.
Q This, I think, finally clear up that point. The second correction, Dr. Ruff, when describing these experimental subjects, you repeatedly used the expression "Sicherheitsverwahrung?", people in protective custody, and you said that these were profession criminals who had been placed into protective custody and for that reason were sent to Dachau. I heard in the meantime that this expression "sicherheitsverwahrung" was in the English translation expressed as protective custody. The difference is the following: The "sicherheitsverwahrung" of which Dr. Ruff was speaking, according to German law, could only be used in the case of professional criminals, and was ordered by the court. Protective custody on the other hand, which is a very similar expression, although containing a different content, has nothing whatsoever to do with justice or any court.
It was carried out mostly for political reasons, completely arbitrarily, and without any justice or sentence. Dr. Ruff, is it correct what just told you?
A Yes, it is true.
Q I would now like to rectify a further error. At the beginning of the trial a witness Lutz was heard who at one time had been employed at Professor Weltz office. Dr. Lutz at that time stated he was principally opposed to experimental subjects because he wasn't robust enough, he wasn't rough and strong enough. Then using this expression "robust" under quotation marks, he was asked what he really meant by it. As I see from the record of the 12th of December, he replied, and i quote:
"I should like - and, then a little pause, and the sentence wasn't completed. When the witness continues, and quote: "It is even difficult to take a dog for experiment who has a soulful look in his eyes," end of quote. So far the testimony of the witness Lutz, who, I think is still today in the Dachau concentration camp as an old Austrians SS nan, Dr. Ruff was told that Dr. Lutz's testimony road as follows, and I quote: That is what I understood from the German translation, it was said that Lutz wouldn't even carry out the experiments on a dog that Ruff had been carrying out or, human beings. I am sure that this repetition of Dr. Lutz testimony was erroneous, and I should like to rectify that in order to prevent the defendant Ruff from being incriminated by an erroneous statement in the record.
Q. Dr. Ruff, the question of whether animal experiments could have been used instead of your experiments was discussed; and you st ted that in the case of the high altitude experiments which you were to carry out the use of animal experiments was often impossible. I am now asking you, Dr. Ruff, is it correct that during your high altitude experiments--and I am in particular referring to the altitude sickness which plays a part--the essential points consist of the fact that the experimental subject, after awakening from unconsciousness, reaches out above his head and then pulls the lever of the parachute with all his strength, Naturally a guinea-pib cannot be trained sufficiently to cause it to pull the lever of the parachute after awakening. You will agree with me there, won't you.
A. This is no doubt correct.
Q. Dr. Ruff, upon a question by the prosecutor, you said--or at least you said when he asked you--that you didn't know who exactly told you that these persons at Dachau were volunteers. That is, at any rate, how your answer sounded, even though you may protest against it at the moment. You were asked: "Was Dr. Romberg present? Does he know it from his own knowledge? Was he there when these people were asked? You said, "No." Then you were asked: "Was Hippke there?" and you said "No", and so forth, until at the end it was that, "In that case, you don't know who exactly told you that these people were volunteers." Then you answered, and I quote: "That is correct."
I believe that you really wanted to say something else because in addition to Dr. Romberg and Dr. Hippke outher people confirmed it to you that these persons were volunteers.
Who were these other persons?
A. Prof. Weltz, Rascher, and the camp Commandant.
Q. Weltz, Rascher, and the camp Commandant. Rascher and in particular the camp Commandant were in fact the people who had personally spoken to the prisoners?
A. Yes.
Q. I have just heard that in the question of this dog there was another error; that the sound of the translation was to the effect that the Austrian SS nan who is now in Dachau, was to have Stated that he wouldn't even kill a dog. There is no word of killing. We are only concerned with an experiment on a little dog who looks at one with a mournful expression in its eyes, that's all.
MR HARDY: Your Honor, would you please advise defense counsel to ask his question rather than just talk to the witness? He hasn't asked a question yet in that last remark.
DR. SAUTER: The last thing I said naturally was no question. In that case Mr. Hardy is completely correct. It was merely a correction of an error in translation. Naturally I cannot put that in the form of a question; I can only make a statement.
MR HARDY: Your Honor, may I suggest that these corrections of translations could take place after he finishes his redirect examination?
THE PRESIDENT: It might well be convenient if those corrections were written out, typewritten, and handed to the Tribunal and to opposing counsel at one time.
BY DR. SAUTER:
Q. Dr. Ruff, I should like to draw your attention, to another document and should like to ask you to tell us how exactly you interpret that document; in other words, what conclusions you derive from it.
This document can be found in Document Volume Number II on Page 79. This is a letter by Dr. Rascher to the Reichsfuehrer SS. It is dated the 11th of May 1942. If you will look at the second paragraph, you will find that it starts with the words, "tonight..." and there you will find the sentence and I quote: "He(and that means a certain Dr. Fahrenkamp) intends to report to you about his own opinion regarding my heart experiments."
THE PRESIDENT: Can you give as the page in the English Document Book of this document?
THE INTERPRETER: This is found on Page 74 of the Document Book Number II,
DR. SAUTER: Page 74 of the English Document Book, second paragraph, middle of the second paragraph. ".... He intends to report to you about his own opinion regarding my heart experiments Dr. Fahrenkamp gave to you himself. From our conversation (Dr. Rascher's conversation) I have the impression that a great field of work will open up to me yet."
BY DR. SAUTER:
Q. Dr. Ruff, if you now compare this quotation to the intermediate secret report which Rascher submitted to the Reichsfuehrer Himmler before your official reports, behind your back, won't you find a clear confirmation that these experiments of which you are now speaking to us were special experiments of Rascher's and were always actually claimed by him as being his own experiments, having nothing at all to do with your experiments?
A. This letter, Document No. 220, which you just submitted to me, is the accompanying letter to the intermediate report dated the 11th of May. This is the secret intermediate report dated the 11th of May and addressed to Himmler.
In my opinion it becomes clearly evident from the paragraph that in the case of these heart experiments they are concerned with Rascher's experiments; and it furthermore becomes evident from that paragraph that Rascher intended to carry out yet a large number of experiments in order to clarify these questions. Of this opportunity, however, he was deprived by the transport of the chamber back to Berlin.
Q. Now, a last question, Doctor. In all the letters which reached me and in all affidavits which I have submitted to the Tribunal, you wore described to us as a particularly conscientious and careful researcher and a man filled with a love for truth. Doctor, within five or six months, during which you have been in solitary confinement, you had sufficient opportunity to search your conscience and to ask yourself whether, during those Dachau experiments in which you wore mixed up in such an unfortunate manner, you acted justifiably or whether you committed a mistake.
At the end, Doctor, I want to ask you about this-and don't think now about the end of the trial but just give me your answer as a man who loves the truth. Please answer the question, if today from the point of view of your conscience you are now judging your acts at that time, if you yourself take your conscience into account do you feel today that you acted correctly, or is it your feeling today that you committed crimes; that you committed an error? Mill you please answer this and tell the Tribunal honestly and openly in the conclusion of your examination?
A. I can assure you that even after serious deliberation I have a free conscience. If I have made a mistake, it was only perhaps that I gave my approval to working with a man like Rascher; but that Rascher was a criminal I found out only after the war and chiefly during this trial.
In the year 1942 when these experiments took place, I knew nothing of all that. Rascher to me meant the serious officer who never gave any occasion for criticism; and if his superior considered him to be a seriously-thinking officer, I certainly could not think of judging him as a criminal.
The conditions under which the experiments were carried out in Dachau on voluntary people, on professional criminals, in my opinion were not objectionable; and that is even my opinion today. The manner in which the experiments were carried out was unobjectionable. They were carried out scientifically, prepared scientifically; and they were necessary. After all these considerations I can even today say that my conscience as a human being and as a researcher is free.
DR. SAUTER: Mr. President, I have no further questions on the reexamination of the defendant Ruff.
MR. HARDY: Your Honor, I have some other questions to put to this witness before he is dismissed from the stand.
THE PRESIDENT: The Tribunal will now be in recess until 1:30 o'clock.
(A recess was taken until 1330 hours.)
AFTERNOON SESSION The Tribunal reconvened at 1330 hours, 30 April 1947.)
THE MARSHAL: The Tribunal is again in session.
DR. SIEGFRIED RUFF - Resumed RECROSS EXAMINATION BY MR. HARDY:
Q Dr. Ruff, in clarification of this translation, the word "aero embolism", you have implied that aero-embolism is not a constant feature of the condition known as pressure drop sickness, also known as decompression caisson disease, or the bends. Now, in fact it is not only a constant feature of it, but in English it is actually used as a synonym. Now I would like to show you and the Tribunal a standard medical dictionary, namely, Dolans American Illustrated Medical Dictionary published by. W. B. Sanders in 1944, and on page 214 you find that bends is a name for caisson disease, also for aero-embolism. This makes the translation as set forth in the English here perfectly correct. In addition, caisson disease is defined on page 448 as, and it states, "it is due to the release of bubbles of atmospheric gases in the body." Now, this caisson disease is also synonomous with your pressure drop disease, both of which are caused by decompression. Then you find decompression defined on page 410 of this same dictionary, which states, "the removal of pressure or compression force, particularly the slow removal of pressure from deep sea divers and caisson workers to prevent the onset of bends."
Now, Dr. Ruff, we have here a German dictionary -
A Lot me say one thing about the definition you just read to me. If the translation of that definition was heard correctly, then the definition in that dictionary is altogether wrong, because both the caisson disease and the bonds do not arise if the pressure is gradually raised or rather, lowered. On the other hand, these diseases occur if the change of pressure is relatively rapid. For this reason there are legal regulations of how caissons are to be used, for instance, at what rate the pressure in the caisson is to be reduced, namely, a change of 1-2 atmospheres cannot be made in less than half an hour.
In other words, if the translation of the definition you read was correct, then that definition in the dictionary is wrong.
Q Well, now, here you find a German dictionary wherein we have marked this. I would like to have you read this as marked. This is a standard German dictionary, Meyer's. Where it is marked there -- I have it marked for you, doctor. Would you read that definition, please. Would you road that aloud, please.
A (Dictionary handed to witness) "Caisson disease occurs in persons who are subject to a high air pressure, workers under air pressure, and such people. (The laws for the protection of workers should be referred to, page 771.) The sudden appearance of gases absorbed by the blood at higher than normal pressure when the pressure is suddenly reduced, leads to obstructions and stoppages which cut off parts of the body from blood circulation. This is fatal in the brain, causes hommorhages in nose, stomach and so forth. Compare also mountain disease, and see also professional diseases in the same dictionary." This is Meyer's Konversations Lexikon of the year 1925. At this time very little was known about pressure fall disease if anything at all. Here again the same mistake is made that has occasionally been made here in the trial. Here the caisson disease, for example, is brought into relation with mountain sickness. Now mountain sickness is an altitude sickness which rests on a lack of oxygen, whereas the caisson disease, rather the symptoms that result from caisson disease, result from the change of pressure. Now, the confusion of these two terms in this dictionary shows that the editor of this particular definition was not an expert in this field.
Q Well, now, these three dictionaries, the two I called to your attention so far, do show that the pressure drop disease, decompression disease, the bends, caisson disease and aero-embolism, are used interchangeably with each other, don't they, the dictionaries do? However, you maintain that these dictionaries are incorrect, is that right?
A The dictionary that I have here before me is certainly not correct, and I've already told you what things can be compared, namely, pressure fall disease, caisson disease and the bonds can be compared with one another. They are altogether similar. They arise roughly in the same manner only with the difference that the differences in pressure in aviation are less than one atmosphere, because the pressure of zero atmospheres is reached only at the height of 400 kilometers, namely, where you reach the total vacuum of outer space. In caisson disease, on the other hand, work is done under some circumstances under a pressure of two, three or four atmospheres. In other words, the difference in pressure in caisson disease, or in caisson work, is much greater than a difference in pressure that is possible in aviation. That is the reason why the symptoms of caisson disease are more severe than the symptoms of pressure fall disease in aviation. But in principle you can equate these three diseases, namely, pressure fall disease, bends and caisson disease. But there is a quantitative difference though the causes of them are by and large the same.
A. (Continued) Now what you cannot equate with these three diseases is air embolism because, as I said this morning, there is air embolism not infrequently in the case of operations. And, this air embolism in the case of operations can have nothing to do with any change of air pressure. In other words,this is something quite different. On the other hand it is correct that in the disturbances after reduction of pressure air embolism can occur. They do not necessarily have to but they may. In other words you cannot equate caisson disease or pressure fall disorders with air embolism.
Q. Well, now was Dr. Rascher, when he used air embolism, was he using it correctly in his sense.
A. When he said - I don't know just where he said it if he said it - that an air embolism had been discovered; then he actually had found in the heart or in a blood vessel greater or smaller amounts of air, and that is air embolism.
Q. Well, let us go on and get your opinion of this other definition in another dictionary. This is Taber's Encyclopaedia Medical dictionary, and under bends, on page B 20, records: "Bends (caisson disease)" and then it states as follows:
"Pain and weakness caused by increased atmospheric pressure. This brings about the absorption of atmospheric gases other than oxygen, particularly nitrogen. Release of pressure releases this nitrogen from solution in the blood and causes formation of gas bubbles in the tissues. Treatment: Decompression or increased pressure reapplied until nitrogen is redissolved in the blood when gradual sustation of the pressure is induced."
THE PRESIDENT: Counsel, there seems to be some trouble with the translation.
MR. BROWN: You are goint much too fast.
MR. HARDY: We will repeat. "Pain and weakness caused by increased atmospheric pressure. This brings about the absorption of atmospheric gases other than oxygen, particularly nitrogen. Release of pressure releases this nitrogen from solution in the blood and causes formation of gas bubbles in the tissues."
Then they have here "Treatment: Decompression or increased pressure reapplied until nitrogen is redissolved in the blood when gradual sustation of the pressure is induced."
Now, doesn't that convey the same thought that pressure drop sickness, decompression disease, the bends, caisson disease, and air embolism are used interchangeably?
A. Now, first of all, if the translation was correct I heard the statement that raising of pressure causes molestation. That is not so; it is the reduction of pressure that can cause suffering, because when I rise up in the air I do not raise the pressure but I lower it, and in caisson disease difficulties do not arise when pressure is increased, namely when people go into the caisson but symptoms occur when the workers leave the caisson. In other words, when the pressure on them is reduced.
Q. Well, now let's go to the next. The Encyclopaedia Americana has a very elucidating paragraph "written by no less a man than Smith Ely Jelfy. Now this here - I will read slowly for the benefit of the translator - shows unmistakably that air embolism is a constant feature of decompression disease. This is on page 150. Caisson disease is a disorder popularly known as the bends, occurring among workers in compressed air who are submitted to a pressure of two or three atmospheres, as are tunnel workers. The symptoms of the disease do not appear while the workman is under compression but come on after decompression when some minutes or even hours have elapsed. Symptoms were at first thought to be due to mechanical pressure, which by producing changes in the distribution of the blood, caused congestion of the blood when pressure was removed. This, however, is contrary to the adaptability of body fluids to pressure and does not agree with experimental evidence. The gas emboli theory is now generally accepted. According to this theory, blood in compressed air absorbs an increased amount of oxygen and nitrogen, which under compression is distributed to the fluids of the various parts of the body.