Autopsy Data tells Primary Symptoms of A-Bomb Radiation Damage "75 Years Hiroshima" Dr Soko's 50days talk (DAY40)

Pharyngitis and Colitis, Bone Marrow Dysfunction 

22 y.o Female, Sore throat, Vomiting, Diarrhea and Fever

Exposed Outdoors

At the moment of the explosion, she laid her body down and covered the face on the road. It was in front of the back gate of Mikawacho Police, 1.1 km from the hypocenter. Her clothes were black cotton trousers called Monpe, and a white blouse.

She returned to home in Funairi Kawaguchi, 2.2 km south of the hypocenter. She had a sore throat and vomited three times 30 minutes after returning home.
Day14 after the bombing, her hair began to fall out.
Day18, she had diarrhea 4 times in the night and 2 times in the morning. She had a stomachache and had a fever of 39 degrees.
Day19, Body temperature was within normal limit. The white blood cell count was 3300. However,  she had diarrhea mixed with mucus and blood for 23 times. The tonsils were red and swollen, and white tongue coating was seen. Bacteriological examination of the stool revealed no Shigella or S. typhi. At night, fever reached 40 degrees.

DAY 20, the white blood cell count was 850, a significant decrease.
Day 21, the white blood cell count was further reduced to 220. Urobilin and urobilinogen are found in urine.
Day 22-24, she had severe abdominal pain and a fever of 40 degrees. She was applied a compress to her sore throat.
Day 25, she had dyspnea.

Day 26, she died.

Pathological Findings

Severe necrotizing, pseudomembranous colitis
Necrosis of the tonsils is conspicuous and discoloration around
Head hair loss
Absence of coagulation (no tendency for blood to clot)
Tuberculosis lesions in the upper lobe of the right lung
Small tuberculous ulcer of the small intestine, cecum
Good nutrition

Findings show that the subcutaneous fat is 2 cm thick and the physique is good. Ascites containing 10 ml of blood was found in the abdominal cavity. Multiple ulcers were found in the small intestine, some of which were tuberculous ulcers and scars. One roundworm was found. Bleeding and multiple ulcers were observed in the large intestine. Of the large intestine, the wall of the descending colon was 20 cm thick, and the mucous membrane was black and necrotic. The rectum and colon that continue 20 cm above the anus are black and necrotic, the entire mucous membrane is thickened to 8 mm.

Explanation：

Records show that the 22-year-old young woman was exposed unobstructed outdoors. It was also recorded that the women were relatively well-nutrition. She had complained of sore throat immediately after the bombing, and  she had severe nausea and vomiting from the day of the bombing. Her symptoms infer that there were inflammation in the pharynx and tonsils of lymphatic tissue and severe inflammation of the large intestine from the very early days of the atomic bombing.

On the 14th day, hair loss, which is a characteristic of exposure, was observed, and then marked leukopenia was observed. 

 Initial dissection revealed that her large intestine had extensive ulceration and necrosis, with a black necrotic intestinal mucosa 20 cm from the anus. It is a very strong mucosal disorder by radiation damage.

Her cause of death is thought to be due to multiple organ failure including pulmonary edema by extreme dehydration and strong bleeding tendency in the body or sepsis due to immunosuppression. 

In any case, it is considered that the effects of radiation were too strong.

Summary of major initial symptoms and severity of acute radiation injury from atomic bomb records

Pharyngitis, colitis, and bone marrow dysfunction, which are characteristic pathologies of acute radiation injury, caused many A-bomb survivors to die.

"Soar throat" laryngopharyngitis, necrotizing tonsillitis

"Pain when swallowing" inflammation from the pharynx to the esophagus

"Vomiting, diarrhea, abdominal pain, melena" (necrotic, ulcerative) colitis

* Sore throat and diarrhea were seen from the day of the bombing.

* Symptoms such as gingival bleeding and internal bleeding appear after a few days to a few weeks. This is because it takes several days or longer before the bone marrow function stops and the platelet count decreases. Conversely, it can be said that the symptoms of gingival bleeding and subcutaneous bleeding, which show a bleeding tendency, are the symptoms of myelosuppression, which indicates high severity. It is a symptom that suggests  the patient is in a severe state.

*This data is based on the atomic bomb records. Radiation damage also depends on the amount of radiation.

*About shielding: The place where there is no shielding is more affected by radiation exposure. Even if exposed to the same radiation dose, the degree of damage changes depending on whether or not there is shielding. To compare to the outside, radiation  can be shielded by a wooden house to the extent. A concrete building can be a better shield than a wooden house.Even thick soil can be shielded more than just outdoors.