CO129-564-4 Cholera epidemic 23-8-1937 - 9-4-1938 — Page 42

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UNVERSITY OF HONG KONG

FACULTY OF MEDICINE

The Hon. D.M.S.

3ir

42

7th January, 1938.

You have asked me to give you a short report on the work done by members of the Department of Physiology and students of the Ledical Faculty during the recent cholera epidemic.

Two students Fung Ching Wen and Varga soff volunteered to help with the work in the G.C.H., and they continued right taroughout the epidemic. For a full report of their work, must refer you to Dr. Shaw.

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The first contract I had with the work was about the middle of August, when Dr. Shaw asked if we could help in certain difficulties being experienced in taking the specific gravity of the blood. This we were able to do and it was then that Dr. Shaw asked if I would be interested in the cases of oedema which were appearing amongst the convalescent pa tients.

This oedema question we soon found to be very complicated and in order to get at the real cause we had to initiate & complete investigation into the urine and blood chemistry of a large number of patients. Providing the aparatus is to hand, the most important things in such a pro, ect are (a) a free hand in the hospital and (b) a well organised team of willing labor- a tory workers. The former was readily given and I cannot thank the doctors and the sisters too much for their help, for when they had their hands so full with urgent work, it must have be en irksome to have outsiders trying all sorts of new stunts and blocking up the steady, necessary outflow of patients. The organised team of laboratory workers I was also fortunate enough to have. Drs. Ling and Cheng in order to carry out this heavy programme, in addition to keeping pace with the blood and urine samples, to devise methods of analysis so that all our investi gations could be made on one small sample of blood; two of their me thods namely blood urea and non-protein-n.trogen, using 0.6 ccs of blood were especially creditable and their new me thods art being published quite soon. Their work was all done in the Physiology laboratory and is in faut still being carried on; there was so much coming in from the hospital that they had to carry the tests to a point where they could be left without de terioration, and they are now being completed. The work of Dr. Lim and myself was done in the wards and in the laboratory.

Dr. Lim had just been up to the Henry Lester Institute in Shanghai learning the technique for estimating pyruvic acid in blood; he undertook this aspect of the work and found in most of the convalescent cases high pyruvic acid values indicating a vitamin B1 definciency. A number of the oedema cages showed the same deficiency clinically. I am not in a position yet to forma an opinion as to the cause of this; it may be that the tremend- cus dehydration plus transfusion treatmen, depletes the body of ali its 31; it may be that the se processes are at work in individuals who by the nature of their meagre diet were already lacking in B1 before the onset of the cholera; I feel both the se play a part; but what is definitely certain in my mind is that the diet in these cases, if not in all hospital cases in Hong Kong, should have its B2 content raised.

It often happens in investigations of this kind, one is side tracked by cases of a different and more urgent nature. This