Torments of China

Greatest medical center of the Orient, Peiping Union Medical College has been held in Japanese-occupied territory for more than four years, but its large staff of scientists still carries on remarkable research on Chinese diseases. Head of Peiping Union's Department of Medicine, which was founded by the Rockefeller Foundation, is Dr. Isadore Snapper, famed Dutch physician. Last week Dr. Snapper, now a prisoner in Peiping, published a tragic picture of health in occupied China (Chinese Lessons to Western Medicine; Interscience Press; $5.50). His chief points:

> Food is so inadequate that every disease is influenced by malnutrition. The average diet in North China rarely includes meat, consists of yellow corn and millet flour, sometimes mixed with soybean flour, and sesame or peanut oil. People who have a little money eat spinach, cabbage, string beans, kohlrabi or turnips. Their diet is deficient not only in energy content, but in calcium (necessary for bones and teeth), protein (essential for tissues), vitamins A, C and D. Hence many suffer from osteomalacia (softening of the bones), scurvy, anemia, severe rickets, infantile tetany (convulsions), horny skin, tuberculosis. Unlike the U.S., North China has little vitamin B deficiency, for the roughly milled flours are rich in vitamin B elements.

> Many maladies which occur as epidemics in the U.S. are endemic (permanent) in North China. Scarlet fever smolders constantly. Also common: typhoid, diphtheria, erysipelas, meningitis, mumps, encephalitis, amebiasis (infection of the intestines by amebae).

> Said Dr. Snapper: "The parasitic disease which places its mark all over internal medicine in North China is kala-azar....It has to be considered in nearly every patient." This hideous malady, caused by tiny protozoa (Leishmania), produces an enormous spleen, anemia, and ulcers around the mouth, robs the body of its white blood cells, kills 95% of its victims who are not treated. Antimony is a specific for the disease, but of course few of its victims ever see a doctor until the disease is far advanced. Kala-azar is primarily an affliction of dogs, is passed to human beings by sand flies.

> Although rheumatic heart disease is very common, the fever which accompanies this malady in the U.S. is rarely seen in North China. Another strange fact: the symptoms of high blood pressure very often occur in Chinese whose blood pressure is, by U.S. standards, very low.

> To judge by "scores of middle-aged patients dying from all sorts of diseases," arteriosclerosis (hardening of the arteries) is very rare. So is angina pectoris (heart attack) which is often caused by arteriosclerosis. The rarity of these diseases, said Dr. Snapper, "is the more striking because the increase of the frequency of this affection in America and Europe is appalling....It is difficult to give an explanation...one can fall back on the equanimity of the Chinese, but the differences in nutrition of Chinese and Westerners may give a better explanation." Arteriosclerosis begins by the seeping of fat into bloodvessel walls. The Chinese do not eat butter, fat, or other dairy products rich in fat, such as milk and cheese. In fact, said Dr. Snapper, the fatty acids present in their cooking oils may help to prevent arteriosclerosis.

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