week. This is im contrast to other mammals
where deaths frem the acute phees sre wecemmon after tie 30th day.
653 Prebabiiiey of Survival co Rela
Symupeoms
with little clinical evidence of jnjaries ot het
than stight fatigue. Ac the termination of
the latent period, the patient may develop
purpura, epilation, oral and cutaneous
lesions, infections of wounds or burns,
diarrhea, and melons. The mortality will
Hencn, individeale exposed in the lethal)
be significamt. With therapy the survived
time can be expected to be prelonged and
feut several weeks following exposure) can be
divided according te symptoms and signs, inte
groups having a diferent prognosis. Thes
they may be divided inte three groups in which
survival is, reapectively, improdebls, peesidie,
and predebic. It will be apparent that there is
row regeneration the survival rate will be
increased.
In groups 1 and 2 the bleod picture is not as
well documented as in group 3. There are goed
clinical reasons to believe that im the lethal
renge the granulocyte depressions will be
range (where some, but not all, will die in the
no sharp line of demarcation among the groups.
if sufheient time ie provided for bone mar-
marked and below 1,000 per man’ during the
ad week,
(jood observations in Japan (31,
Group 1.—Swrrivel impredeble :
If vomiting occurs promptly or within a
few hours and continues and is followed in
22) confirm this contention. However, in the
sublethal range it takes much longer for the
death will almost cefinitely occur in 100
percent of the individuals within the 1st
week. There is no known therapy for thease
Hiroshima, the data of Kikuchi and Wakisaka
rapid succession by prostration, diarrhea,
anorexia, fever, the prognosis is grave;
people; accordingly, in a catastrophe, at-
tention shoald be devoted principally to
others for whom there is some hope.
Group 2.—arvtral poamble:
Vomiting may occur early but will be of
relatively short duration followed by a
granulocyte count and platelet count of mea
to reach minimal values, as compared to other
mammals (see Chapter IV and reference 10).
Despite the chaotic conditions that existed in
(22) shows that there was a more rapid and
marked decrease in Groups | and 2 than in
(sroup 3.
Group 3.—Surviral prodeble :
This group consists of individuals who may
or may not have had fleeting nausea and
In this period of
vomiting on the day of exposure. In this
group there is no further evidence of ef-
in the hemopoietic tissues. [Lymphocytes
are profoundly depressed within hours and
tologic changes that can be detected by
and time of maximum depression depend-
The Ivmphocvtes reach low levels early,
within 4% hours, and may show little evi-
period of well-being.
well-being marked changes are taking place
remain so for months. The neutrophile
count is depressed to low levels, the degree
ing upon the dose. Signs of infection may
be seen when the total neutrophile count
hax reached virtually zero (7-9 days). The
platelet count may reach very low levels
after 2 weeks. External evidence of bleed-
Ing may occur within 2 of 4 weeks. This
group represents the lethal dose range in
the classical pharmacologic sense.
In the
higher exposure groups of this category
the latent period lasts from 1 to 3 weeks
te PR
fecta of the exposure except the hema-
serial studies of the blood with particular
reference to lymphocytes and platelets.
dence of recovery for many months after
exposure. The granulocytes may show
some depression during the second snd
third week.
However, considerable varia-
A iate fail in the
granulocytes during the 6th or (th week
may occur and should be watched for.
Platelet counts reach the lowest on approximately the %th day at the time when
tion is encountered,