In spite of the arduous researches of Pekelharing, Winkler, and others the organism which is the cause of beriberi has not been satisfactorily or certainly determined. Spencer (Lancet, Jan. 2, '97).
Four varieties of organisms cultivated from the blood of beriberi patients, as follows: (1) micrococcus albus: a mi crococcus which was immobile, aerobic and which liquefied gelatin; (2) micro coccus tetragonum flavus: cocci arranged in tetrad forms; (3) micrococcus flavus: also aerobic and liquefying gelatin; and (4) bacillus flavus: short rods in pairs and chains, in active motion, aerobic, and with spore-formation. On injecting animals with these growths, three of them—the first, third, and fourth—each produced paralysis. No result was ob tained with micrococcus tetragonum flavus. Van Eecke (Scheube: "Die Beni beri-Krankheit," '97). The above nine abstracts quoted from an article by W. K. Hunter (Lancet, July 31, '97).
Study of two cases, including inocula tion experiments, tending strongly to show that the staphylococcus of Pekel baring and Winkler is the specific micro organism of beriberi.
Although Fiebig has argued that it has the same characters as staphylococ cus pyogenes albus, and that it is the same organism, the pathogenic charac ters of the two are very different. The staphylococcus pyogenes albus injected into the abdominal cavity of a rabbit would produce septic results. In not one of six rabbits did an abscess form at the seat of inoculation, and in not one was any inflammatory condition of the peri toneum to be made out. W. K. Hunter (Lancet, July 31, '97).
Two cases of beriberi, in both of which specimens of freshly-drawn blood showed micro-organisms in rapid motion in the spaces between the groups of corpuscles. Of 30 tubes of culture-media (agar-agar and bouillon-tubes) that were inoculated with the blood 3 growths were obtained from one case and 1 from the other. These presented all characters of staphy lococcus of beriberi. Three of the cases were pure and one a mixed infection. Pathogenic properties of the staphylo cocci found were determined by injecting rabbits.
There were no macroscopical post mortem lesions. The nerves, however,
showed microscopically unmistakable parenchymatous degeneration. IV. K. Hunter (Lancet, June 25, '93).
Experiments showing that the blood of a patient suffering from beriberi con tained a substance that caused a fall of arterial pressure when injected in the veins of animals. The same result is caused by the choline found in the cere bra-spinal fluid from cases of general paralysis of the insane. The presence of choline in the former case could not be proved chemically. Mott and Hallibur ton (Brit. Med. Jour., July 29, '99).
When the disease has advanced, the various organs are infiltrated with serous fluid, and the tissues, especially the muscular, undergo degeneration. The heart is enlarged, and the kidneys also present marked evidence of degenera tion.
Histological examination; conclusion that the disease is an infectious lesion rapidly destroying the epithelium of the kidneys, liver, and muscles, particularly the cardiac fibres, by granulo-fatty de generation; it causes the production of masses of new cells in the connective tissue of the liver, spleen, kidneys, spinal marrow, and brain and certain nerves, the vagus in particular. Nepveu (Mar seille-m6dical, June 15, '94).
Series of seventy-one cases which, dur ing 1395-96, occurred among the patients in the State Insane Hospital at Tusca loosa, Ala. Of the 21 fatal cases, 1 pa tient died of pulmonary tuberculosis, 1 of pneumonia, 2 in the status epilep liens, 14 directly from heart-failure, and the remaining 3 from a combination of causes. The complications hastened or insured a fatal termination in 6 or 7 cases. E. D. Bondurant (N. Y. Med. Jou•., Nov. 20, '97).
In general, it may be said that, the nearer the equator, the more numerous the hydropic forms and the greater the mortality. The mortality is always high when the patients continue to live under the same conditions and in the same place as that in which the disease was contracted. The lethal complications are respiratory and cardiac failure and bron chitis. O. D. Norton (Indian Lancet, June 16, '9S).