pilation was one of the most spectacular and obvious findings. The
appearance of the epilated patient was typical. The crown was involved
more than the sides, and in many instances the resemblance to a monk's
tonsure was striking. In extreme cases the hair was totally lost. In
some cases, re-growth of hair had begun by the time patients were seen
50 days after the bombing. Curiously, epilation of hair other than
that of the scalp was extremely unusual.

Petechiae and other hemorrhagic manifestations were striking findings.
Bleeding began usually from the gums and in the more seriously affected
was soon evident from every possible source. Petechiae appeared on the
limbs and on pressure points. Large ecchymoses (hemorrhages under the
skin) developed about needle punctures, and wounds partially healed
broke down and bled freely. Retinal hemorrhages occurred in many of
the patients. The bleeding time and the coagulation time were
prolonged. The platelets (coagulation of the blood) were
characteristically reduced in numbers.

Nausea and vomiting appearing within a few hours after the explosion
was reported frequently by the Japanese. This usually had subsided by
the following morning, although occasionally it continued for two or
three days. Vomiting was not infrequently reported and observed during
the course of the later symptoms, although at these times it generally
appeared to be related to other manifestation of systemic reactions
associated with infection.

Diarrhea of varying degrees of severity was reported and observed. In
the more severe cases, it was frequently bloody. For reasons which are
not yet clear, the diarrhea in some cases was very persistent.

Lesions of the gums, and the oral mucous membrane, and the throat were
observed. The affected areas became deep red, then violacious in
color; and in many instances ulcerations and necrosis (breakdown of
tissue) followed. Blood counts done and recorded by the Japanese, as
well as counts done by the Manhattan Engineer District Group, on such
patients regularly showed leucopenia (low-white blood cell count). In
extreme cases the white blood cell count was below 1,000 (normal count
is around 7,000). In association with the leucopenia and the
oropharyngeal lesions, a variety of other infective processes were
seen. Wounds and burns which were healing adequately suppurated and
serious necrosis occurred. At the same time, similar ulcerations were
o