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

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The feet are rapidly withdrawn when lightly touched and hypersensitivity to pinprick is common, but the patient can usually tolerate without distress (although with some apprehension) firm gripping or handling of the feet. c. Nervous System. Sensory changes suggestive of coexisting peripheral neuritis have been described by some authors in as many as 30% of the cases (Smith, 1946; Harrison, 1946). Such findings, however, are probably due to coexisting beriberi, as edema was also common in these patients.

Harrison (1946), reporting on the 400 cases of the painful feet syndrome he observed in the military prisoner-ofwar camp in Hong Kong, found considerably raised systolic and diastolic blood pressure in 19% of the patients, and he is also of the opinion that vascular spasm is the primary disorder in this complaint. Page (1946) describes marked circulatory impairment as a late development of the syndrome in men taken to the colder climate of Japan. The feet became pale, cold and cyanotic when dependent.

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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