It cannot be said, however, that the specific organism of beriberi has been found. All that can now be admitted is that it infects asylums, barracks, prisons, the holds of ships, and other abodes where the hygienic surroundings are de ficient.
The researches of Baclz and Scheube, in Japan, and those of Pekelharing and Winkler, in Java, have done much to elucidate the pathology of beriberi. The former ascribed to a multiple neuritis the symptoms of the disease, while the latter observers advanced and upheld with powerful evidence the view that the staphylococcus was the primary factor in its production. The disease is mainly one of the peripheral nervous system, which shows, in various regions remote from the cord and brain, more or less prop onn ced degeneration.
Results of fourteen autopsies. In the brain and spinal cord nothing abnormal found except the presence of vacuoles in the ganglion-cells of the spinal cord: a fact of little significance. In almost all of the cases there were cardiac hyper trophy and dilatation. The muscular tissue of the heart usually appeared normal, fatty degeneration was rare, but in two cases there were many granular cells in the interstitial tissue of the heart-muscle. There were no character istic changes in the lungs. In a number of cases the kidneys showed alterations in structure, usually in the form of glomerulonephritis. The liver was usu ally of the nutmeg variety, and the spleen normal. The muscles very com monly showed the "waxy degeneration" described by Zenker and also a multi plication of the nuclei of the sarcolemma and an increase in the connective tissue. Miura (Virchow's Archly, Feb., 'SS).
North Brazil as the father-land of the disease, from which it has been spread by commercial intercourse with other nations. Two forms: the oedematous and the paralytic. Four forms of bacteria. W. Leopold (Berliner klin. Woch., No. 4, '92).
Four micro-organisms were isolated, as follows: (1) staphylococcus pyogenes albus; (2) micrococci in chains; (3) a small streptococcus, colorless, of un known character and difficult cultiva tion; and (4) a micrococcus which, by inoculation in guinea-pigs and dogs, causes a degenerative neuritis, and is de scribed as the micrococcus of beriberi.
Musso and Morelli (Berliner klin. Woch., Jan. 25, '93).
Beriberi due to a bacillus cultivated from rice; the same found in the blood of rats that had died after eating the rice. De Lacerda (Bentley: "Beriberi"; Seheube: "Die Beriberi-Krankheit").
Organism sought in the blood of patients while alive. Numerous micro organisms—cocci and rods—found.
Inoculative experience leading to the conclusion that a white micrococcus cul tivated from the blood is the cause of beriberi. These white cocci impregnate the air of the infected houses, ships, and districts, get into the human circulation through the air-passages, and when they are absorbed in sufficient amount—some weeks' exposure to the infection being necessary—produce in the blood toxins in such quantity and of such a nature as to bring about a parenchymatous degeneration of the peripheral nerves. Pekelharing and Winkler ("Beriberi," Edinburgh, '93).
Pekelharing and Winkler did not pro duce beriberi in the animals injected; the cocci found by them are not the cause and not even one of the causes of the disease. Beriberi cannot probably be produced by several organisms, as sug gested. The cause of beriberi has not yet been ascertained. Scheube ("Die Beriberi-Krankbeit," '94).
Bacillus, found in the spinal cord of a patient who had died from beriberi, re sembling the anthrax bacillus. Cultures injected in mice and dogs caused the de velopment of the symptoms of beriberi. This bacillus being found in the intes tines of patients, conclusion reached that it was the toxins of these bacilli being absorbed into the circulation that caused the paralytic symptoms. Ogata (Bent ley: "Beriberi"; Scheube: "Die Beni beri-Krankheit," '95).
A rnierococcus cultivated from the blood and ascitic fluid of two cases of beriberi, which, when injected into rab bits, produced symptoms of beriberi. Musso and Morelli (Sternberg's "Bac teriology," '96).
Cocci cultivated from the blood of beriberi patients; by inoculating rabbits with the growth the symptoms of that disease produced. De Lacerda (Stern berg's "Bacteriology," p. 473, '96).