This is the ninth instalment of a series on the history of medicine in Singapore.
Dr LS da Silva's description (Alumni Association Newsletter 1969/1970) of an incident which occurred in August 1945 gives a glimpse of life when peace had been declared. "Dr Clarence Smith who was one of the medical officers at [Tan Tock Seng Hospital] (TTSH) developed a chill. This was very serious for him as it was superimposed on a non-specific lung lesion at the time. He was put to bed under the care of Dr Benjamin Chew, but grew steadily worse as little in the way of medicines or antibiotics was available. Some sulphonamide ampoules were obtained in some way or other from German submarine sources, but still no improvement was seen and he was rapidly going downhill. ... Dr B Chew told me that Clarence was in a bad way and that he could not do anything more for him with what was available. At that time, it was rumoured that the Americans had air dropped food parcels, and possibly medicine, into the Sime Road POW Civil Camp. I suggested that we go to the camp and see what was available, but it was said that nothing could be done as the camp was out of bounds. However, with the permission of Dr WA Balhatchet [Author's note: Chief Medical Officer of Miyako Byoin or TTSH], I obtained the use of the hospital ambulance, which bore the insignia of the Red Cross. I had to drive the ambulance myself to Sime Road and into the back entrance of the camp, the gates of which were closed. I was stopped by an Indian guard (of the Indian national army) named Serjit Singh whom I had known when in Penang, having played hockey with him ... He went in and spoke to the Japanese officer-in-charge, who granted me permission to go into the camp. The first person I saw was Dr Baeza (of the Health Department) who accompanied me to Dr GC Allen and then to Dr RB MacGregor [Author's note: then Director of Medical Services]. There at the camp I also met other doctors whom I knew - Drs JAP Cameron, R Calderwood, RB Wallace, HM Lewis, J Winchester, and others ... Dr Calderwood found several bottles of penicillin. We knew nothing about penicillin and its uses, but after discussion and reading the attached literature, they agreed that it would be useful, and gave me an adequate supply ... Dr Chew started the administration of the penicillin. Clarence recovered rapidly and Dr Wallace, when he came to see him a few days later, was pleased to see the recovery ... Clarence embarked for India and later to the UK, where he was operated on very successfully. Dr Clarence Smith .passed away on 13 September 1969. He was a splendid doctor and good friend – it was my privilege to know him and to have been his room-mate during the Japanese Occupation." Dr Da Silva's account might be the first case report of the use of penicillin in Singapore.
Prof ES Monteiro also described two interesting incidents that occurred in Loyang towards the end of the Japanese Occupation.1 The first incident took place just before the Japanese surrendered. Prof Monteiro was asked by the Japanese High Command to investigate whether an outbreak of diarrhoea and vomiting among the villagers in Loyang was due to cholera. The outbreak had killed many of the villagers and the few survivors had fled. Prof Monteiro and Dr T Balasingam went to the village only to find it deserted. They noticed wicker bamboo baskets everywhere near the houses but did not put any importance to them. They were then ordered to examine the corpse of an elderly Malay man who had just been buried. With the help of four Japanese soldiers, they uncovered the grave and took specimens from the gall bladder and intestines. Cultures at the Middleton Hospital grew Vibrio cholerae El Tor biotype, the first time this biotype had been isolated in Singapore. [Author's note: At that time, the pathogenicity of the El Tor biotype was in doubt.] Prof Monteiro happened to meet a Japanese naval doctor who was visiting the laboratory, who told Prof Monteiro in confidence what he (the Japanese doctor) thought had happened: A Japanese vessel used by the navy was on its way from Korea to the Singapore naval base, carrying vegetables. Diarrhoea had broken out among the crew members who ate the vegetables (later cultured by the Japanese doctor and found to be the El Tor biotype). The Japanese, fearing that the cargo of vegetables was infectious, jettisoned the vegetables in their wicker baskets into the sea near Pulau Ubin. The villagers in Loyang had probably seen the floating baskets of vegetables and swam across the straits to salvage the vegetables.
In the second incident, which occurred a few months after the Japanese surrendered, Prof Monteiro was again called to go to Loyang to investigate another outbreak of what was thought to be cholera (he had gained the reputation of being a cholera expert). The villagers, who had returned to their now peaceful village, had become ill with vomiting and abdominal pain. Prof Monteiro found that all those who were ill had eaten bread baked at the village bakery. The baker was also ill, and two children and 20 villagers had died. Prof Monteiro found that the bread was much heavier than usual. He brought the bread back to the General Hospital, X-rayed it, and found that they had dense opaque shadows inside. The bread was sent to the Department of Chemistry and found to be contaminated by barium. The villagers were treated with magnesium sulphate. [Author's note: Which converts soluble barium carbonate into insoluble barium sulphate.] What had happened was that soon after the Japanese surrender, the British Military Administration had distributed, among other things, sacks of wheat flour. The villagers in Loyang took their flour to the village bakery, where the baker made bread for a fee. The barium carbonate, used as a rat poison by the British Military, was thrown on the floor of army food stores where the sacks of flour had probably been stored. Headlines in the newspapers followed and for some time after the incident, people were afraid of eating bread.