~5the ancunt of radiation received. In other words, the syaptoms of the individual or groups of individuals becomes in a sense a personal indicator of ones’ own fate, Ex perience with huzan radiation injury in Eiroshima and Wegasaki (4,5,10,11) with reactor accidents (3,6,9) and the fallout accident (1,18) to be described later strongly suggest that the best incex of the seriousness of exposure of the individ~ val is the syaptomatology, in addition to the physical estimate of dose. Radiation injury is complex and subtle, and the manifestations of the injury vary considerably, In a general sense, individuals exposed in the lethal range, (rere some, but not all, will die in the first several weeks following exposure) can be divided accoriing to symptoms and signs, into groups having a different prognosis. Thue they may be divided into three groups in which survival is, res= pectively, jmprobable, possible, and probable. It will te appsrent that there is no sharp line of dezarecation arong the groups, The distinguishing features are severity and persistence of vomiting and diarrhea, Group I Survivel Incrobeble: If vomiting occurs proxnptly or within a few :.ours and continues and is followed in rapid succession by prostration, diarrhea, anorexia and fever the prognosis is grave: death will elmost definitely occur in 100% of the individuals Within the first week. There is no known therepy for these people; accordingly in & catastrophe attention should be devoted principally to others for whom there ide some Lope or in wiom therapy is clearly indicated. Group II Survival Possible: Yomiting may oceur early but will be of relatively short duration followed by a period of well being. In this period of well being marked cl.anges are taking plece in the henopoietic tissues, tours and rezain so for nonths, lLynphocytes are profcundly depressed within The neutrophil count is depressed to low levels, the degree and time of maximum depression depending upon the dose, Signs of in- fection nay be seen when the total neutrophil ccunt has reached virtually zero OE ARCHIVES 2!

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