BERIBERI.
Until the true pathology of this interesting disease is worked out its treatment must remain unsatisfactory. Whether the real causal factor is of the nature of a ferment or a microbe, this much appears to be proven —that its prevention can be accomplished by using undermined or un polished rice instead of the polished grain, the latter being apparently devoid of some agent which prevents ,the growth of an organism or inhibits the formation of a deleterious ferment.
Moreover, the fact that the disease can be cured by the administration of a Hydrolysed Extract of Rice Polishing proves that it is caused by an absence of the vitamines in the polished grain. The mixing of beans, potatoes, and fresh fruit or yeast with the diet when the unpolished or unpalatable rice is not available is of considerable value. Benefit also follows the improvement of the patient's environment, as removal to a higher and drier locality.
The way, therefore, seems open to the future rational treatment of this preventable malady by the administration of the above-mentioned ex tract, provided the patient comes under observation before irreparable damage is done to the nerves.
The peripheral neuritis and anasarca afford clear indications for treat ment, though no known drug can be said to possess any specific action; minute doses of Antipyrine or Nitrate of Silver, and in the dry form of the disease the latter drug combined with Belladonna, have proved valuable. Absolute rest in bed for long periods is essential owing to the danger of the cardiac dilatation through implication of the vagus which is usually present. Strychnine hypodermically with inhalation of Nitrite of Amyl, and even venesection may be demanded.
Diuretics are indicated where the anasarca is abundant, and these should he combined with Digitalis and Quinine or with minute doses of Trinitrin. Massage and Electricity, with passive movements of the joints, should be practised twice daily, after the subsidence of pain and muscular tenderness, before the patient is permitted to leave his bed.