Dysentery among Prisoners of War: Singapore 1942-45

Hutchin, Kenneth C (1948) Dysentery among Prisoners of War: Singapore 1942-45. MD thesis, University of Glasgow.

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The history of dysentery and of its treatment from the earliest times to the end of 1941 has been reviewed. The conditions of life of Allied Prisoners of War in the hands of the Japanese in Singapore from February 1942 to September 1945 have been described. The incidence of dysentery in this community has been estimated. Acute Bacillary Dysentery. (1) The survey covers some 15,000 cases of acute bacillary dysentery. 202 fatal cases have been reviewed. (2) In most cases of severe acute bacillary dysentery (75%) the onset was sudden with acute abdominal pain immediately followed by diarrhoea. In 25% there was a prodromal period varying from 12 hours to 6 days. (3) The ileum was involved in 50% of fatal cases. (4) The symptoms and signs have been discussed. (5) In severe cases persistent hiccoughs and persistent vomiting were of grave prognostic significance. (6) 39% of fatal cases died between the 10th and 15th days. (7) The complications which were encountered have been described. (8) Fatal haemorrhage occurred during the 2nd and 3rd weeks in 17 cases out of a series of 117. (9) Two forms of peritonitis occurred (a) by direct spread of the infection through the bowel wall and (b) secondary to perforation. Sudden cessation of diarrhoea always accompanied the onset of peritonitis. (10) The appearance of the stools of acute cases and the microscopic picture of the bacillary exudate have been described in detail. (11) The paramount importance of copious fluids and adequate rest has been stressed In the treatment of acute bacillary dysentery. (12) Treatment by saline cathartics and by sulphonamides has been compared. (13) Sulphapyridine was used in a total dosage of 5 grammes for cases of moderate severity and 10 grammes for very severe toxic cases. (14) Sulphaguanidine was used at first in a dosage of 0. 1 gramme per kilo of body weight followed by 0. 05 grammes per kilo every four hours. It was later used in a total dosage of 15 grammes in cases of moderate severity. Chronic Bacillary Dysentery. (1) Some hundreds of cases of chronic bacillary dysentery were seen. (2) The appearance of the patient and the symptoms and signs have been described and complications enumerated. (3) All cases were sigmoidoscoped as a diagnostic procedure and as a check on treatment. The sigmoidoscopic appearances have been described. (4) The condition of post-dysenteric colitis was not uncommon. (5) The difficulties of dieting dysentery cases in a Prisoner of War Camp and some methods of supplying an increased vitamin intake have been described. ( 6) Methods of treatment have been described. The disappoint- ing results obtained with most methods of treatment in severe cases have been mentioned. (7) Sulphonamides were used in 50 intractable cases with a 90% recovery rate. Sulphapyridine was chiefly used, in a dosage of 1 gramme thrice daily for one week. Amoebiasis. (1) Approximately 600 cases of amoebiasis occurred. (2) The symptoms were extremely variable. Pour typical varieties of cases have been described. The principal symptoms in 150 cases have been tabulated and analysed. (3) The daily number of stools in 100 cases have been tabulated. (4) The macroscopic and microscopic appearances of amoebic stools have been described in detail. (5) The methods of examining for vegetative and cystic forms of E. histolytica which were used have been described. It was found to be quite inadequate in many cases to examine two or three stools. The average number of careful microscopic examinations required was found to be 6. 5. 39 exhaustive but fruitless searches were carried out in one fatal case which was found to have amoebic ulcers at post mortem. (6) The value of the sigmoidoscope as a diagnostic aid has been discussed, and the sigmoidoscopic appearances in 100 active cases tabulated. A second similar table includes 530 cases of amoebiasis. (7) The reaction of the stools in cases of amoebiasis, bacillary dysentery and in normal persons was investigated. All acid stools were from cases of amoebiasis or cases which were later found to be suffering from amoebiasis. (8) The complications of amoebiasis which occurred have been discussed. The cause of death in 29 fatal cases has been indicated. (9) The position of amoebic ulceration in 24 fatal cases has been tabulated. The ileum was involved in 2 cases.

Item Type: Thesis (MD)
Qualification Level: Doctoral
Keywords: Medicine, Epidemiology
Date of Award: 1948
Depositing User: Enlighten Team
Unique ID: glathesis:1948-79671
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 04 Mar 2020 15:41
Last Modified: 04 Mar 2020 15:41
URI: https://theses.gla.ac.uk/id/eprint/79671

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