BERHAMPUR, a town of British India, in the presidency of Madras. Pop. (1931) 37,75o. It is the headquarters of Gan jam district, and is situated about 9m. from the sea. It is a station on the East Coast railway, which connects Calcutta with Madras. The military cantonment was transferred elsewhere in 1906. There is some weaving of silk cloth, rice mills and a tan nery, and export trade in sugar. The town contains Kallikota college, an industrial school and the Jubilee hospital. The col lege, originally founded by the Government, is now maintained by the rajah of Kallikota.
so called from the Sinhalese word meaning weakness, is a disease that for a long time was a heavy handicap to tropic and semi-tropic enterprise. It was endemic in India, Malaya, China, Japan, the Philippines, and South America. Iso lated cases occurred on the high seas and were known even in Dublin. Its symptoms are neuritic and polyneuritic : inanition, gastric irritation, emaciation, swelling of legs, chest, and face, burning pains, muscular wastage, paralysis, disturbance of the heart's action. It was at one time believed to be due to malarial poisoning or infection, but no bacillus could be discovered. In the year 1890, from careful observation of native habits and movements in Sarawak, Dr. Charles Hose became convinced that it had a connection with diet. Though every effort to locate some micro-organism f ailed, the more closely the problem was studied the more certain it appeared that this hypothesis was right. A new stage in the attempt to unravel the mystery was reached when it was found that men working many months in the forest or on plantations far away from home and eating imported polished rice went down with the disease, whilst their women folk and others at home, living on their own freshly-husked supplies, were immune. The idea that weevils or mould might be respon sible naturally suggested itself. That, however, was difficult to reconcile with the fact that outbreaks were usually worse at the very season when importations were freshest. But the association was established by the recovery of the sufferers when their diet was changed from the imported to the home-grown newly-husked rice. Experiments on monkeys and fowls with imported polished rice resulted in all the symptoms of beriberi and recovery when the native article was substituted. During the '9os, Capt. E. R. Rost of the Indian Medical Service, studying the problem in Burmah, suspected the existence of a germ which he said he found in rice and Jowari grain, and Mr. John Foreman, in his account of the Philippines then just taken over from Spain by the United States, noted that many deaths occurred from "acute indiges tion due to eating too plentifully of new rice" and that many who recovered from cholera "became victims of a disease known as beri-beri." In various directions, therefore, the trouble was more or less directly traced to diet. When home on furlough in 1899 Dr. Hose submitted a paper to Mr. Strangeways, demonstrator of pathology at Cambridge—an abstract of which appeared in the Medical Review, June 1901—and in 1905 again in the labora tories at Cambridge, with the encouragement of Dr. Duckworth and others, he pursued researches which still seemed to point to the weevil or fermentation as the cause. These researches were laid before the British Medical Association meeting at Leicester in the latter year. Controversy as to the etiology of the disease grew in interest. It occupied the attention of the London and Liverpool schools of tropical medicine. In 1909 and 1911, how ever, Drs. Henry Fraser and A. T. Stanton in Etiology of Beri beri (studies from the Institute of Medical Research, Federated Malay States) explained how investigations made by De Haan, Chamberlain, and Eijkmann had shown that a substance so minute that there are only ten grains in a ton of rice was absent from the milled and polished article. That particle Dr. Casimir Funk, of the Lister Institute, isolated and called vitamin. So the food theory prevailed, and the conclusion was recorded in Man son's Tropical Diseases: "We now know that beriberi is a sequel of a diet into which enters, as the principal element . . . rice from which the entire pericarp and germ have been removed, and that in this pericarp and germ there is a substance essential to the proper nutrition of the nervous system of man and of many other warm-blooded vertebrates." But the last word has not yet been said on the subject, as may be gathered from (I) the experience of the Americans in the Philippines (from which in 1911 President Taft said the disease had been almost eliminated by the substitution of unpolished for polished rice), for a recent American visitor (Katherine Mayo: The Isles of Fear; the Truth about the Philippines, 1925) re ports that it has again become a scourge as the result of the in efficient Filipino medical work, (2) the account of beriberi outbreaks in Singapore given by Dr. G. E. Brooke so late as 1919 (One Hundred Years of Singapore), when he said that "the re markable periodicity, with maxima about every four years, pointed more towards a bacterial origin than to a deficiency in vitamins," though he admitted that experience had proved that "ordinary polished rice has some connection (probably bacterial) with the disease," and (3) Dr. H. H. Woollard (Journal of Anatomy, April 1927, on The Nature of the Structural Changes in Nerve Endings in Starvation and Beriberi) says there are several points relating to the pathology of the disease that have not been adequately decided. "Most authors who have con sidered the relation of beriberi to inanition record their opinion that inanition alone does not produce beriberi. In this inability to reproduce the disease by starvation alone those who see a close parallel between beri-beri and the various forms Of toxic neuritis find their best ground for believing that beriberi is a similar dis ease." From an examination of the literature of the subject he says : "It is obvious that the findings in the beri-beri animal pre sent a close parallel with the changes that occur in an animal that is deprived of all food. . . . It is true that, save for Eijkmann, observers are accustomed to confirm the idea that the polyneuritis is peculiar to beriberi. The experimental cases are not compara ble to what occurs in the chronic cases in man, as presumably there the time allows of far-reaching degeneration of the nerves." This seems to show that, the origin of the disease having been settled, early treatment by restoration of the necessary vitamins to the food reduces the possibility of complication to a minimum. Is, then, the vitamin, if administered in time, an antitoxin or is it merely a stimulant?