09-21-1994 12:13 5162825311 the amount of radiation received. BNL-MED. DEPT. P.Q07 In other words, the symptoms of the individual or groups of individuals becomes in a sense a personal indicator of oneb' own fate. Ex perience with human radiation injury in Hiroshima and Nagasaki (4,5,80,21) with reactor accidents (3,6,9) and the fallout accident (1,18) to be deschibed later strongly suggest that the best incex of the seriousness of exposure $f the individ- wal is the symptomatology, in addition to the physical estimate of dése. Raddation injury is complex and subtle, ami the manifestations vary considerably. §f the injury Ina general sense, individuals exposed in the l§@thal range, (here some, cut not all, ~i1l die in the first several veeks followisz exposure) can be divided according *o symptoms and signs, into groups having afdifferent vrognosls, Thus they may be divide] inte three groups in which survgval is, res- pectively, improbable, possible, and protable. no sharp line of Jesareation anong the groups. It will te apparent pet there is The distinguishing fqstures are severity and porsistence of vomiting and diarrhea, Group I Survival Improbable: If vomiting occurs premptly or within a few tours and continues Bri is followed in rapid succession by prostration, diarrhea, anorexia and er the prognosis is grave: individuals death will olmont definitely oceur in 100% of the within the first week, There is no known therapy for these people; akcordingly in a catastrophe attention should be dovotod principally to others fof whom there is some hope or in whom therapy is clearly indicated. oup IT Suryival Possible Vomiting may occur early but will be of relatively short duratiog by a period of well being. followed In this period of well being marked chang§s ere taking — place in the hemopoietic tissues. hours and remain so for wonths, Lymphocytes are profoundly depress within The neutrophil count 1s depressed tollow levels, the degree and tine of maximum depression depending upon the dose. Signs of in fection may ba seen when the total neutrophil count has reached virtuglly zero

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