Bodies Need Food

China's hunger pangs were described with sharp medical clarity recently by a British surgeon. The average Chinese diet was always so low in protein (nitrogen compounds in meat, fish, some vegetables) that the slightest disruption in supply might produce famine. The disruption brought about by the war has"'been enormous. In south Kwangtung last year, H. T. Laycock, a Fellow of the Royal College of Surgeons, doctored hundreds of Chinese who had been getting no protein at all. Wrote he to the British Medical Journal:

"More than 90% . . . had come from occupied into 'free' China. The remainder were nearly all Chinese soldiers, many recently recruited from among the refugees.

"[Some] refugees were what the Japanese call 'repatriates'. . . . Without warning, some hundreds of harmless pedestrians, hawkers and beggars are rounded up in the streets of an occupied city . . . then systematically starved in one of the worst sort of concentration camps. The daily ration consists of rice gruel cooked with bicarbonate of soda (to economize on firewood) which is served without salt, flavoring, or other addition. . . .

"From the camp, victims considered sufficiently weakened are transported in overcrowded junks to the coast of free China, where those that have not died on the way are left, totally destitute, to their own resources--to the intense annoyance of the local residents. The ones who are too weak to walk remain where they are landed until they starve. Many of them try to prolong their sufferings by consuming inedible or semi-edible substances-hard woody roots . . . a dark green powder, prepared by drying and pounding certain leaves . . . heaps of banana skins and mango stones scavenged in the streets. . . ."

Too Weak to Stand. "Why more of these unfortunate people do not give up [and commit] suicide, I do not know. . . . Instead, they struggle inland with a frantic desperation of which one is forcibly reminded by seeing the deep ulcers on the buttocks of people too weak to walk who have struggled across the country in a sitting posture.

"Clinically the most conspicuous feature was the widespread edema which first appeared on the [tops] of the feet. These became more and more swollen until the skin was tightly stretched and assumed a peculiar bluish transparency. . . . Fissures appeared [which] were readily infected. . . . Farther up the leg, the edema distends the skin; and over the lower leg especially, this has often a high glaze. The whole limb up to the groin was often [swollen]. The external genitalia were early affected by the edema.

"The face was often grossly edematous with the eyes completely closed. There was a strong tendency for the edema to shift with gravity. . . . Unnatural creases appeared [and the expression became] toneless and gloomy . . . quite repulsive. . .. . The loss of the normal silky luster of Chinese hair in someone who was seen before and after several months of slow starvation was quite striking."

Too Weak to Live. "Scurvy was conspicuous by its absence. . . . The abdominal distention was often associated with a small umbilical hernia . . . watery diarrhea and a tendency to pass food unaltered. It was difficult to persuade many of these cases to eat. . . . Many complained of cough and produced a white frothy sputum which I took to be due to edema of the lungs. . . . The heart was sometimes moderately enlarged and the heart sounds diminished in volume. . . . A more or less severe secondary anemia was invariably present. . . . Amenorrhea and sterility were extremely common.

"The mental state was one of depression which varied with the degree of edema. This was particularly noticeable in children. . . . The adult patient . . . would repeat the same request over and over . . . with tears dripping from the cheeks. Cerebration was slow and the extraction of a history very tedious.

"Treatment consisted in giving a diet with a high protein content: liver, meat, fish and soya-bean derivates. We gave rice polishings in the form of a cake made with flour and a little baking powder and fried in peanut oil. These were very popular, especially with the children. Vitamins were given. [Some made] a rapid, uncomplicated recovery; in [others] progress was slow . . . with disappointing relapses and a tendency to die suddenly and unexpectedly."

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