BENZONAPHTHOL. See NAPH THALIN.
BERIBERI.—Jap.„ kakke. It has been suggested that the term is from bher bheri, a Ilindoo word meaning a sore or swelling; or from b7iere, a sheep. from the fancied resemblance between the gait of sufferers from this disease and the jerky movements of sheep; or from the Cingalese word beri-beri, meaning "great weakness." The latter etymology is almost surely the correct one.
Definition. — A probably specific en doepidemic disease characterized by mul tiple peripheral neuritis, in which there is numbness and stiffness of the limbs, paralysis of the extremities, pain and tenderness on pressure, parsthes* and abolition of the tendon reflexes, together with frequent anasarca, cardiac irregu larity, and gastro-intestinal disorder, often terminating in death.
Symptoms. — Two forms of beriberi are met with: the cedematous, some times termed the "wet" form, and the paralytic, or "dry" variety. The cedem atous form is characterized by general anasarca, with the appearance of great amcmia. It usually begins with fever, which may be slight and intermittent. (Edema of the extremities then sets in, beginning usually over the dorsum of the foot and extending upward. As the serous effusion into the subcutaneous cellular tissue takes place, puffiness and numbness follow. A peculiar localized thickening of the tissues, or "solid (edema," is sometimes observed over the shin and in the thighs and chest. With the beginning oedema, cardiac symptoms are usually observed, this fact having -caused some authors to attribute the effusions to the venous stasis resulting from dilatation of the right ventricle. The heart's action is irregular, rapid, palpitating, and frequent, the systole being somewhat increased in force and louder at the apex. Loud blowing mur murs, resembling the bruit de liable of exophthalmic goitre, with violent pulsa tion of the blood-vessels in the neck are present, as a rule.
In a great number of cases of beriberi the first heart-sound is observed to be so prolonged as to be considered by some authors as a sanguineous murmur. Be
sides this systolic murmur there is often violent palpitation, due to myocarditis, which may cause death, as does paralysis of the heart, from alterations of pnemno gastric, recurrent, and vasomotor nerves, found in the disease. Albert Ashinead (Inter. Med. Jour., '93).
Study of the modification of electrical reactions, showing relationship between the acceleration of the pulse and the diminution of galvanic excitability, though not in all cases. Glogner (Vir chow's Archiv, B. 132, p. 50).
The respiration is embarrassed, and prmcordial pains are frequent.
As regards the digestive system, the , tongue is usually pale and flabby. The appetite, normal at first, gradually be comes impaired; disorders of digestion ' are frequent and are occasionally accom panied by liTmatemesis. Constipation is almost the rule. The urine is usually high-colored and scanty, and contains no albumin, unless a concomitant affection be present.
The pale, blanched, and anremic-look ing cutaneous surface does not indicate true anemia, since examination of the blood shows percentage of haemoglobin slightly, if at all, lower than normal. E. D. Bondurant (N. V. Med. Jour., Nov. 20, '97).
In the so-called "dry" form the nerv ous symptoms, which are also present in the cedematous cases, are most promi nent. Pain, of a stinging, burning, and most distressing character, is frequent. Anesthesia to touch and pawesthesia, the latter being represented by pricking, ' formication, and tingling (the pi-ni-piri of the Japanese), are prominent symp toms, paresis of the extremities accom panying. Cramps are sometimes com plained of. The knee-jerk is absent in almost every case, while paralysis of the diaphragm is not infrequent, this com plication giving rise to dyspncea.
Paralysis of the diaphragm is not un common in severe cases. Coughing is thus rendered very difficult, and dysp ncea is not uncommon; anesthesia and parresthesia are frequent, beginning, as a rule, in the region of the peroneal nerve. Miura (Virchow's Archiv, B. 123, H. 2).