What Is Blackfoot Disease

Black Foot Disease (BFD),was also colloquially named as “black and dry snakes”,which is scientifically known as “spontaneous gangrene” (the name was given by two scholars, Pro. Gao Cong Ming and Pro. Gao Shang Rong, and their papers were published on Formosan Medical Association’s periodical in 1954.) Black Foot Disease was first seen around 1920 in the times of Japanese Colonial government, yet it was not widespread until after 1956 along the southwestern coast of Taiwan where the water supply was contaminated with arsenic. The disease had affected mostly adults at that time, yet children were not excluded.

The Areas where BFD was found:

Beimen and Xiejia in Tainan County, and Budai and Yizhu in Chiayi County were the areas in which BFD was first found. These places were known as the “original prevalent areas”. In around 1976, some other towns along the southern-west coast also had BFD cases and were known as the “new prevalent areas”. 

The Geographical Environment:

Some main aspects of the local areas where BFD was found could be categorized into the following conditions:

1. Since the water from shallower wells was not sufficient for the local residents, they had to dig deeper wells and pump out water which was contaminated with arsenic.

2. The water that springs from the south-western plains in Taiwan naturally contained many chemical substances.

3. The underground water was overly developed and used, causing the water source to be salted by sea water and was no longer able to drink. The water quality was worsened and contaminated.

The symptoms of BFD may be either quite sudden or happen progressively. It usually begins with prickliness, coldness, numbness or a burning feeling in one or more extremities, typically the feet. Eventually, the feelings turn into severe pain, then progress to gangrene. As the condition grows worse, the extremities including toes and even fingers would undergo apoptosis and necrosis so that amputations were eventually required. Apart from the black wound caused by lack of blood on the tips of limbs, the constant effusion of ropy fluid and the blackish blood layer formed on the putrefied wound would appear again even if it is removed. If the wounds were not treated carefully, they would have an awful odor and maggots would even grow inside the wound. Patients were unable to eat or sleep normally for months due to the continuous suffering; therefore many patients would be in a weak overall state of health condition, as well as mental condition, and be more contagious to other diseases as well. The gangrene symptom could be temporary relieved after amputation surgery, yet it may emerge again without warning.

Since there was no tap-water available back then, the residents had to dig their own well and use underground water. Yet the water contained high portions of arsenic, which amounted to 0.4~0.6 ppm.(the safe standard being 0.05 ppm) Drinking the polluted water caused not only BFD, but also enhanced the risk of heart diseases and cancer.　

The Symptoms of Blackfoot Disease:

烏腳病在病理學上是一種末梢血管疾病：

1. Extremities would lack blood circulation and appear pale when lifted, swollen or red when laid down. Blood pulse may also be very weak.

2. Other symptoms include those caused by lack of blood circulation and nutrition, including

1. coldness in arms or legs

2.  different intensity of pain

3.  If the blood vessels are congested, the patient may have difficulty walking due to tenseness of the muscles, or severe pain.

4. The infected area may feel rapid pain as if suffering from a sudden gun shot or electric shock. Such throbbing pains often troubles the patients extremely and cause them to be restless and mentally exhausted.

5. The wound may undergo apoptosis and necrosis, or gangrene.