CAPTIVE SURGEON IN HONG KONG
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staff, both doctors and R.A.M.C. and R.A.D.C. soldiers who looked after these patients. They did not shrink from an onerous and disagreeable task which I can illustrate by a record I have that during the night duty hours of 23-24 September 1942 patients' bowels opened 232 times in the dysentery division. Two nursing orderlies were on duty in that division.
It was not easy to construct a diet suitable for patients in the acute stages of dysentery because of shortages and because of our improvised kitchen. Four diets were used, ranging from a fluids only diet built up from rice water, milk when available, tea, marmite, tomato juice, cocoa, soy sauce, tinned milk foods up to a bread (which we still baked at that time), rice vegetable and fish (when available) diet as a precursor to full diet. Some of these patients became ravenously hungry as they improved and devoured rice in such quantity as to cause renewed diarrhoea.
During the months from August to December 1942 inclusive 154 patients suffering from dysentery were admitted; some had diphtheria as well and a high proportion showed signs of deficiency disease. Of these, 14 died with dysentery as the primary cause of death.
When the patients from St. Teresa's Hospital in Kowloon were transferred to Bowen Road on 11 August 1942 on the closure of that hospital they brought stories of an outbreak of diphtheria in prisoners in Kowloon and the Japanese required me to isolate 10 of the 24 so transferred. None of these patients developed the disease. Of the patients we admitted from North Point Camp with throat infections most were critically ill; the outbreak was explosive, 18 being admitted in August and a further 59 in September, but the Canadians then moved to Kowloon and that was the last of our diphtheria admissions though it was not the last of the outbreak in the camps. Of the diphtheria cases, 19 died up to the end of December 1942, 12 of these deaths occurring in September. In a number of cases there was extensive skin ulceration mainly affecting the scrotum and the perineum while the nose and face were also sometimes affected.
The greatest anxiety in treating the diphtheria sufferers arose from the shortage of serum. In the hospital we had 31,000 units in our own stock at the beginning of August. In September we received from the Japanese 37,500 units and in October 50,000 units. In September Lt. Alec Mackenzie, a Hong Kong man who was a