In alcoholic neuritis we have, besides a history of drinking, gastric catarrh and mental disturbances. (Edema is infre quent in uncomplicated cases. It is pos sible, however, for malaria, beriberi, and alcoholic neuritis to be present in the same patient.
In lathyrism, due to the poison of the Lath-yrus satin's, there is no ()edema, an sthesia, or cardiac disturbance.
In trichinosis the pain is principally in the muscles of the trunk, head, and neck. Violent gastrointestinal paroxysms pre cede the muscular pain. Cardiac trouble and paresis are absent. 0. D. Norton (Indian Lancet, June 16, 'OS).
Polymyesitis, polyneuritis, and Lan dry's paralysis have so many symptoms in common with beriberi that they are probably to be considered as sporadic cases of that disease. Ebbe]] (Norsk Meg. f. Laegevidensk., p. 629, '99). F. LEVISON, Corr. Ed.
In the blood of beriberi patients bacilli and micrococci are to be found.
Pure cultures of these microcoeci give a ne•ve-degeneration of like nature to that found in beriberi when injected into rabbits and dogs. The inhalation of air impregnated with such culture can originate a nerve-degeneration in rabbits. Beriberi must, in all probability, be re garded as a contagious disease induced by the action of a micro-organism. The infecting micrococcus can also exist apart from contact with the human being.
Direct transmission from one person to another rarely occurs; infection through wearing-apparel is more com mon. The. infecting material finds its way into the body principally through the respiratory organs. The spread of the malady can be interrupted by dis infection, or, in a person attacked, by removal; when the symptoms are once well developed nothing but Nature can effect a cure. Pekelharing and Winkler (An Investigation into the Nature and Origin of Beriberi, and the Means to be Adopted for Counteracting the Disease, 'SS).
Examination of 20 specimens of hair from beriberi patients. Nineteen speci mens were obtained from Penang, and 1 from India. Out of these 20 specimens. 6 contained arsenic. The whieh contained arsenic were obtained from recent cases, while nearly all the negative specimens come from older eases. This result augments the evi dence in favor of beriberi being due arsenic, since it suggests that the ar senic was present only at a certain stage of the disease. R. floss (Brit. Med
Jour., Feb. 8, 1902).
While the discovery of the specific micro-organism is yet to be verified, clin ical evidence has shown that overcrowd ing, as in the case in ships, associated with defective and noxious ventilation and moisture and oftentimes insufficient or improper diet, tend to cause the development of the disease. By thus de bilitating the system and rendering the latter amenable to the pathogenic effects of the germ, such untoward conditions of life might act as an indirect factor.
Etiology.— Until recently a great diversity of opinion has existed regard ing the cause of this affection. The researches of Pekelharing and have increased the probability that beri beri is caused by the presence, in food and infected habitations or ships, of a specific micro-organism.
Living in a confined atmosphere and in districts favorable to cryptogamic vegetation has considerable influence in the production of beriberi. Agapito de Veiga (Int. Med. Jour., Aug., '93).
Three cases in colored men who had worked in phosphate-beds. Probably caused by microbe of telluric origin, dis tinct from that of malaria. Dercum (Jour. of Nerv. and Mental Dis., Feb., '94).
Whole crew affected in ship loaded with fermenting Manila hemp; also in another vessel loaded with fermenting cocoa-nut fibre. Ashmead (N. Y. Med. Rec., Nov. 24, '94; Univ. Med. Meg., Aug., '95; N. Y. Med. Rec.. Oct. 5, '95).
Regarding the epidemic at the Rich mond Asylum, Dublin: 'Not only is the whole institution overcrowded far be yond its normal accommodation, but even the new wooden building for males is not fit to contain more than half the number at present occupying it. Its two dormitories are at present occupied by 100 patients, although not suited to give sanitary accommodation to more than 50. The women's permanent hospital contains as many as 03 patients, who have an average of 451.96S cubic feet of space each." This space ought properly to suffice for the accommodation of 25 patients. Sir Thornley Stoker (Boston Med. and Surg. Jour., Aug. 12, '97).