BERIBERI, This is the strange name for a disease of which but few cases are seen in the United States, but in Ori ental countries and in the Philippines it is of common occurrence and still more so in Japan. It is also very common in Ceylon, Java, Borneo and the Malay countries else where. It is a member of the group diseases called tropical diseases which at the present time, when all the nations of the world are neighbors and mutually interested in each other, for purposes of trade if for nothing else, are being constantly investigated. The word originated in Ceylon and simply means great weakness, in Japan it is called Kakke, while the English equivalent is tropical endemic multiple neuritis. It is common not only among the common people in tropical countries, but is also often seen in camps, hospitals and on ship board.
Multiple neuritis is a disease whichis very well known in this country, it is very pain ful, disfiguring, protracted and fatal. If a large number of people were constantly affected with this disease at the same time and in the same region of territory it would be called endemic multiple neuritis, and if they were in a tropical country it would be called beriberi.
Multiple neuritis, in temperate climates, can come from a great many causes, from the free use of alcohol in any form, from poisoning by arsenic, lead, mercury or phosphorus, from syphilis, malaria and the infectious fevers, from cold and wet, poor food and poor home sur roundings, and some of these causes are often at work when the disease is called beriberi.
So many diseases are the result of germ life and action, it was thought for a long time there must be such a cause for this disease. As yet no such germ has been found, though when it is associated with other diseases like syphilis, malaria and the infectious fevers, the specific germs of those diseases will of course be present. It is chiefly observed in those countries in which rice forms the principal article of food for the majority of the people, and about 20 years ago it began to be suspected by those who were studying the disease in the islands of the East India archipelago that there must be a relation between a diet of rice and this disease, especially after it was observed that those who had multiple neuritis as a result of insufficient food and those who were fed on a diet of polished rice, that is, rice from which the husk has been removed, suffered with the same symptoms.
In experiments which were made on fowls the symptoms of multiple neuritis were pro duced when they were fed on polished rice but not when they were given the unhusked or red rice. Similar results were obtained on human beings in Java, in the Malay Peninsula, and in the Philippines, and hence it was concluded that the husk of rice like the husk of wheat contains important mineral constituents, probably phos phorus in particular, the lack of which resulted in the developmept of beriberi. When those
who suffered with this disease were fed with rice bran they at once began to improve and steadily got well. In this disease there is injury or destruction of the ends of the nerves which go to the skin, with consequent loss of sensa tion, and of those which go to the muscles, with loss of motion and gradual withering, the heart muscle becomes flabby and weak and the liver, kidneys, lungs and spleen become congested. There are two forms of the disease, the wet and the dry.
In the wet form there are dropsical swell ings of the tissues, especially of the legs and ankles, and the cavities of the body, the abdo men, the chest and the pericardium, which sur rounds the heart, become more or less filled with fluid. This of course produces great weak ness, difficulty in walking, standing and breath ing, weak heart action and frequently death within a few days. The disease often begins with a chill and besides the symptoms already mentioned there are fever, nausea, vomiting of blood, albumen in the urine, etc. Should the disease take a favorable turn the bad symptoms will gradually subside leaving more or less paralysis and withering of the muscles which after weeks or months may entirely disappear. In the dry form of beri-beri the disease pro gresses slowly and is less fatal than the wet form. It begins with neuralgic pain in the ex tremities and with changes in the nutrition of the skin. There are cramps, tenderness to the touch, deformity of the joints, paralysis of the muscles and unsteady gait. Then follow dis turbances of the stomach, blood poisoning and emaciation, and the disease may continue for weeks, months or years or until some other disease develops and the patient dies. The mortality from both forms of the disease is from 10 to 40 per cent. The most important thing in the treatment of the disease is to change the diet from polished rice to un polished, that is with the husk intact or ground up in bran with the rest of the kernel. Pre ventive measures are all important and mean proper diet, freedom from exposure to wet and cold, freedom from excesses and vice, and avoidance of infectious tropical diseases. Tonics like quinine and strychnia must be given, and such drugs as will relieve pain and assist in removing the dropsical fluids from the body. Massage, electricity and hot baths also play an important part in the treatment.