By Robert S.; Thimann, Kenneth V.; Marrian, G. F. Harris

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5%) Battle casualties. . . Dengue.. .... Typhus..... . . 2%) -- Total with recent a . . . . 7%) Total number of cases.. 7%). The following points can be made about the etiology: (a) the undernourished were more prone to the disease, (b) there was no difference in incidence between smokers and nonsmokers, although the clinical features were indistinguishable from tobacco amblyopia, (c) prolonged physical effort seemed to be a precipitating factor, and when improvement had occurred it could also bring about a relapse, as would an acute febrile illness such as malaria or dysentery, (d) symptoms appeared in some cases as long as 6-9 weeks after a marked improvement in the diet, suggesting a latent period before damage is apparent.

A variety of adjectives is used to describe it, such as aching, burning,Lor throbbing. (2) I n over half the cases, sharp or stabbing pains may be superadded. These last a few seconds, travelling parallel to the toes and soles of the feet to the heels and sometimes extending up the shins to the knees. I n a small proportion of cases, similar symptoms develop in the hands, but usually in cases where the pains in the feet are of long duration. As time goes by, the ache or burning sensation becomes persistent, getting worse a t nighttime, when the sharp stabs of pain appear, reaching their maximum particularly after the patients retire, thus preventing sleep.

Deafness of a central type of gradual onset was observed in a number of camps in the Far East. Such a symptom had already been recognized as part of a deficiency syndrome by Stannus (1936) and other medical officers in British Colonies. Grande and Jiminez (1942) and Peraita (1942) termed the condition ‘(cochlear neuritis” when it appeared in patients with retrobulbar neuropathy and signs of cord damage during the Spanish Civil War. In the patients in Changi Camp the deafness was rarely complete and in many appeared to be confined to sounds of certain pitch only, although the range would vary from patient to patient.

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