MEDICAL CARE ON BATAAN - interior of hospital, below.

As time passed, uniforms became more ragged and threadbare, offering little protection against the cold nights and the cruel thorns so abundant on Bataan. Unit commanders were instructed to limit their clothing requisitions "to minimum replacement requirements" without regard to normal army standards. Most did not secure even this minimum. In one unit, comparatively well clad, the uniforms were considered 90 percent unserviceable. Less than 25 percent of the enlisted men in this unit had blankets, shelter halves, or raincoats. Fully one quarter of the command was without shoes; the rest went about in shoes so badly worn that under normal conditions they would have been considered unfit for use.⁴¹ For a time the most desperate needs were met by a salvage unit which "renovated, repaired, washed, and ironed" the clothing taken from patients in hospitals.⁴² Such a measure merely robbed Peter to pay Paul.

n the wake of starvation and want came dread disease. Malaria, dengue, and the evil consequences of avitaminosis (vitamin deficiency)-scurvy, beriberi, and amoebic dysentery-made their appearance soon after the troops reached Bataan. On 10 January General King's aide wrote prematurely in his diary that the effects of the enforced diet of half rations was already becoming evident in the condition of the men. Two weeks later he thought he saw signs of emaciation and nerve fatigue. The ration, he believed, had so reduced the stamina of the men that they were "being incapacitated by minor sickness they [formerly] had been able to throw off without medication."⁴⁸ Another layman described the symptoms of malnutrition he had noticed about the middle of February. In the morning, he observed, men's legs "feel watery and, at intervals, pump with pains that swell and go away again." Rapid movement brought an attack of vertigo and a thumping of the heart "like a tractor engine bogged in a swamp." For an hour after breakfast a feeling of normality was restored, followed by lassitude. The hour after noon, when men doubled up with intestinal pains, was the worst of the day.⁴⁹ Unknowingly, this officer was describing incipient beriberi resulting from the absence of fresh meat, vegetables, and dairy products- all rich in Vitamin B-from the diet.

Medical men began to warn commanders of the effects of the inadequate diet at the end of January. The caloric content of the ration then being issued, one medical officer reported, was "well under the requirements for the physical work demanded," and was resulting in serious loss of weight. In one unit, composed of Americans, the men had lost 15 to 25 pounds since the start of the campaign. The absence of fats and juices, as well as Vitamins A, B, and C, was evident, this medical officer declared, in "varying degrees of apathy, depression, lack of aggressiveness and irritability."⁵The alarm of medical and combat officers became so great during the next few weeks that Lt. Col. James O. Gillespie, the medical officer in the Bataan echelon of USAFFE, told his chief on Corregidor, Col. Wibb E. Cooper, that "it appears to be the consensus of surgeons attached to American front line troops that the diet provided is inadequate for the maintenance of health and combat efficiency." The lack of protein, fat, minerals, and certain vitamins, he pointed out, was resulting in common diarrhea and dysentery.

The number of men brought down by malnutrition and vitamin deficiency diseases increased in geometric proportion with the passage of time and the successive cuts in the ration. During January, the ration had provided, in terms of energy, approximately 2,000 calories a day. The next month the figure declined to 1,500 and during March it was only 1,000 calories daily. Defense of the line on Bataan, Lt. Col. Harold W. Glattly, the Luzon force surgeon estimated, required an expenditure of energy of at least 3,500 to 4,000 calories a day for each man. He found the results of this caloric deficit alarming in the extreme. Serious muscle waste and depletion of fat reserve were evident everywhere and beriberi in its incipient stages had become almost universal throughout the command. Moreover, malnutrition had so weakened the troops that they were particularly vulnerable to even the most minor ailment. The spread of any disease, he warned, would be of epidemic proportions. Men's physical reserves had disappeared by early March; at the end of the month the men were deteriorating rapidly.⁵⁴

Even more serious than malnutrition and avitaminosis was the spread of malaria. This disease had made its appearance shortly after the troops reached Bataan, but was kept under control by prophylactic doses of quinine. There was a small supply of atabrine but it was quickly exhausted. A malaria control program such as existed later in the war was not possible on Bataan. Most of the Filipino troops were never issued mosquito nets, and those who had them left them behind during the withdrawal for they were of a bulky and heavy type. The area occupied by the troops contained native villages where mosquitoes could breed freely, and there were always large numbers of Filipino civilians behind the lines. These civilians were "a reservoir for malaria," and nullified the effect of any limited control program adopted by the troops.

Malaria did not affect the efficiency of the troops until the beginning of March, but at the end of January most of the men were already infested with malarial parasites. Medical officers made gloomy predictions for the future, when the supply of quinine would give out. "If all troops take the prescribed 5 grams prophylactic dose," wrote a medical officer to General R. J. Marshall on 26 January, "the supply will be exhausted in a month." As early as the beginning of February there were signs that the disease would soon increase at an alarming rate. Only the regular dosage of quinine kept the disease in check that month, but the supply of this drug dwindled rapidly. During the first week of March, its use as a prophylactic in most units was discontinued. Thereafter the drug was administered only to those actually ill with the disease.

The consequences were frightful. The number of daily admissions to the hospitals for malaria alone jumped to 500 during the first week in March. After an inspection of fortifications on Bataan, General Casey reported that the incidence of malaria was as high as 35 percent among front-line units. Two weeks later Colonel Cooper declared that already there were 3,000 active cases of malaria among the troops on Bataan and that the disease was spreading with appalling rapidity. Colonel Glattly took an even more pessimistic view of the situation. The relapse rate, he noted, was high and since no quinine was available for any but active cases, the command could expect a frightful increase in the morbidity rate.⁶⁰ By the end of the month the number of daily admissions to the hospitals was approaching the fantastic figure of 1,000, and 75 to 80 percent of the men in front-line units had the disease.