For information on Nurses, see Nurses
Diseases for the men in the Philippines ran rampant, and the first to occur and haunt the men for the entire war was malnutrition.
Many men were suffering from multiple afflictions.
Jack Gordon, MD discusses his views on the diseases he witnessed and the mental depression that overcame the men.
About Cabanatuan and malnutrition in particular
Food was scant. It consisted of rice with much dirt in it, some crude greens called 'cancan' which gave everyone diarrhea (most refused to eat it, some coconut oil, occasionally salted fish and, rarely, a bit of meat in a stew. With this diet deficiency diseases began to appear. I saw several hundred cases of scurvy. Night blindness was common. Beriberi was frequent, causing swollen, then severely painful feet as the swelling receded. To survive, we had to be extremely careful. A raw vegetable could never be eaten unless it was dipped in boiling water. Mosquito nets were carefully affixed as sundown. We did everything possible to avoid getting diarrhea because of the debilitation which followed. Getting strong and regaining weight was very difficult under these circumstances. In spite of all our precautions, 1, 500 Americans and many Filipinos perished. Their deaths were ascribed to malaria and dysentery, but the real reason was malnutrition. One does not die from vivax malaria. I have often wondered what might have happened if we had just a little bit more protein. In a lush, tropical area surrounded by oceans, fish should have been easily available. Lack of food in these circumstances was inexcusable. Thousands of lives could have been saved with a minimum of these foods added to our diet. Curiously, the sick men in the hospital used to discuss food. They would take turns roster-fashions, "Joe talks about lunch today, Bill has dinner tonight, and Sam has breakfast tomorrow. The conversation would include the name of the restaurant, where it was, what the waitresses were like, how the place settings and the napkins looked, and then the food described in full detail.. I believe daydreaming is a defense mechanism...When people became ill and succumbed and you asked, "What happened to so-and-so?" the answer would invariably be, "He gave up." They never said, "He died." It was always, "He gave up." I felt that this was a special phenomenon, probably relating to a kind of terminal depression. Many of these men had been very ill but were not really sick enough to die. They could have gotten well, but they threw up their hands and gave up their will to live. Read his full story.
Malaria comes from the bite of infected mosquitoes containing parasites. The Plasmodium parasites cause malaria, with the Plasmodium falciparum being the most deadly. The mosquitoes breed in water, some favoring rice fields and puddles. Malaria causes high fever. The symptoms start about 10 to 15 days after the infected bite. It can cause anemia, respiratory distress and cerebral malaria. In an adult, it can cause problems in multiple organs. In 1942, roughly one third of the troops and Filipino defenders were suffering from malaria, causing problems for effective military duty. The supplies of quinine were limited and not supplied by the Japanese once the men were in the prison camps.
For the prisoners, malaria caused sweat drenching fevers and teeth-chattering chills. Joe Poster, Past PNC, said he contracted malaria in Cabanatuan, and suffered from a 105 fever in 115 degree heat with six blankets on, shivering all the while.
The malaria sufferer would cycle through these periods of fevers and chills. It was common to have malaria go dormant and then return. If it progressed to cerebral malaria the patient would die in three or four days.
Beri Beri ensues when there is a lack of vitamin B-1 or thiamine in the diet. Wet beriberi affects the cardiovascular system, while dry beriberi affects the nervous system. Dry beriberi can develop into wet beriberi which is more serious.
Dry Beriberi causes difficulty walking, loss of feeling (sensation) in hands and feet, loss of feeling (sensation) in hands and feet, loss of muscle function or paralysis of the lower legs, mental confusion/speech difficulties, pain, strange eye movements (nystagmus), tingling, and vomiting. POWs with beriberi would have a distinctive gait that was called the beriberi shuffle. Doctors would relieve the swelling of beriberi with hypodermic needles to drain the fluid.
Wet Beriberi affects the afflicted with awakening at night short of breath, increased heart rate, shortness of breath with activity, and swelling of the lower legs. Late stage beriberi make the person confused with memory loss and delusions. Untreated beriberi can prove deadly. Heart damage is reversible if treated in time, otherwise the prognosis isn't good. Nervous damage can also be reversed, but otherwise memory loss can remain.
Personal Accounts of Beriberi sufferers
Joseph McKusick talks about his beriberi and other ailments, "Beriberi was starting to get to me. This meant my body started to eat itself up to survive. Fluid would replace the cells that were destroyed by the beriberi plus the nerve ends. As this was taking place your legs would swell first, then the rest of you, even your head would swell. If you pushed your finger against any part of your body it would leave and indentation for quite a while after you quit pushing. Then too there was the dry beriberi. In this type, your legs and feet would feel like they were on fire and hurt. You would be unable to walk on them. The pain would almost drive you insane...With my body being swollen with beriberi, I was like a bowling pin. When I tried to run, first thing I did was to fall flat on my face about the same time this Jap soldier came running up and screamed at the top of his voice at me. He raised his rifle with a bayonet on it and took a jab at me, good thing that I just rolled over when he jabbed at me.
Note: Joseph McKusick was fortunate in actually getting treatment in Bilibid, but it seemed to be some experiments the Japanese were doing to try out success of various treatments. Read his full story.
Dysentery is diarrhea with red blood visible, most often caused by Entamoeba histolytica (amoebic dysentery) or Shigella species bacillary dysentery. The men in the Philippines suffered mostly from the dysentery from amoeba that live predominantly in the tropics. The dysentery infestation enters the large intestine and the amoeba can dig through the intestinal wall and spread through the bloodstream to infect other organs in the body, such as the liver, lungs and brain. Complications occur when the amoebae break through the intestinal wall and cause peritonitis. The parasites can be found in contaminated food or drink and spread in unhygienic conditions. Amoebic dysentery can lie dormant and then cause problems later which can turn serious. The rundown condition of the men made recovering from dysentery more difficult.
One problem at the prison camps came from the placement of the latrines too close to the cooking areas. Dysentery affected the camps in terms of morale, because the odor from dysentery was offensive and nauseating. Killing the flies that caused dysentery offered a small sense of accomplishment for the prisoners.
Pellagra occurs when a person does not get enough vitamin B3 or niacin. Symptoms include delusions, diarrhea, inflamed mucus membranes, mental confusion and scaly skin sores. The person suffering may also have nausea, vomiting, lethargy and weakness.
Scurvy occurs from a severe lack of vitamin C (ascorbic acid ) in the diet. It causes general weakness, gum disease and skin hemorrhages.
William Montgomery describes his problem with scurvy in his biography while taking a ship to Mindanoa to work in the Davao Penal Colony.
He described scurvy as feeling sore in your mouth like it is being burned by hot coffee. The sensation would spread down his larynx and his gums bled and teeth were loose in their sockets. "The scurvy that kept my mouth aflame and the raw sores that covered parts of my body kept me awake much of each night. I tried to relax and sleep as often as the pain would permit. One friend found a batch of Ticki-Ticki which he gave me with the assurance it would cure my scurvy. Ticki-Ticki is the rice hull preparation containing a high Vitamin B content that is husked off the polished rice. In its refined form, it is often taken as an elixir by those who eat polished rice. As I got it though, the stuff was merely a branny sort of meal, with a yeasty flavor. I ate all I could get and I believe it helped."
Paul Reuter also talks about his bout of scurvy,
"Pellagra and scurvy were the
results of vitamin deficiency.
Scurvy by far was the most
painful of all these ailments.
Sensitive areas of the skin such
as mouth, underarm, neck areas
and scrotum- were affected.
On- entry to Bilibid
effects of scurvy were so bad
that blood oozed through the
scrotum so much I had to
stand with legs spread so the
scrotum would not touch the
legs. At times it was almost
comical to see grown men sitting
with legs spread- fanning the
scrotum wit a mess gear cover to
get some measure of relief. "
Dengue Fever comes from the bite of the mosquito and causes fever and muscle and joint aches with nausea, vomiting, and swollen lymph nodes. A rash can appear two to five days after the fevers. and then a second rash can occur later. The fevers are high in the beginning between 104 and 105 degrees.
There are four different viruses causing dengue fever, and if a person gets a second incident with a different virus from the first, then they can develop dengue hemorrhagic fever that is more lethal and can cause a state of shock and death.
Men and nurses referred to the fever as the "bone-break disease" because of the pain and feeling that their bones were breaking.
Pneumonia troubled some of the men, especially the ones moving from the tropical climates to the bitter cold in camps such as Mukden in Manchuria (now China). These men arrived in November and in the winter the temperatures dropped to 40 below. From his book Undaunted Valor, the Men of Mukden Sheldon Zimbler said the doctors worked with limited quantities of medicine and the men were told to heat water on their stoves and inhale the steam. The imprisoned Dr. Shabart was told to draw blood from a patient and inject it into the patient's buttocks. Several days later the patient passed away.
Tuberculosis, or TB, is a bacterial infection that can spread through the lymph nodes and bloodstream to organs in the body, but is most often found in the lungs. Most people exposed to TB do not develop symptoms, but people with compromised immune systems can have the TB activate. Active TB disease can cause death. Those with latent tuberculosis may still need treatment to get rid of the inactive bacteria.
The tiny parasite known as Sarcoptes scabiei, or human itch mite burrows into the skin and lays eggs. This causes intense itching. Scabies is contagious and is common in places where people living in close quarters.
Paul Reuter discusses the treatment of scabies in Old Bilibid Prison, Scabies like their American cousin, the chigger, caused intense itching, subsequent scratching and infection. The Bilibid method of attacking these pests consisted of complete coverage of the body with a thick sulphur paste. Although the problem was not life threatening, for me the treatment used-contributed to a dangerous situation I became exposed to weeks later because the skin retained a yellow tone similar to jaundice. The sulphur material remained on the body for three days, then a wash off and inspection followed. This treatment was repeated once then the level of scabies was considered acceptable.
Joseph Mann recounts the incident that mangled his leg and the subsequent amputation of that leg. Mann was caught in a mine blast while under forced labor as a POW. He was forced to experience the amputation of his leg and the removal of bone protrusions without the use of anesthesia. Mann was left to clean and tend to his wounds on his own. Upon his return to the States, Mann was compensated by the government for his time as a POW, dependent not on the loss of his leg or the treatment he received, but on the amount of food he was given.