NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
17
From this table it will be observed that from 3 to 4 months was the dura-
tion of the disease in 40.4 per cent. of the total number of cases examined
and 5 to 6 months in 24.9 per cent. It will be seen from these figures that
the duration of the disease is prolonged. In many cases certain symptoms,
e.g. , cardiac disturbance, slight œdema, may persist for long periods giving
rise to partial or complete incapacity for work.
2. Relapses in Epidemic Dropsy.
The following table shows the frequency of relapses in Epidemic
Dropsy :—
Total number of cases of
Epidemic Dropsy
investigated.
NUMBER OF THESE CASES WHICH HAD
1 relapse.
2 relapses.
3 relapses.
630
26
2
3
3. Fever in Epidemic Dropsy.
The following table shows the frequency of the occurrence of fever in
cases of Epidemic Dropsy examined :—
Total number of cases of Epidemic Dropsy
investigated.
Number of cases in which fever has been
recorded.
630
322
From this table it will be seen that fever is not a constant symptom in
Epidemic Dropsy.
4. Gastro-intestinal Symptoms in Epidemic Dropsy.
The following table shows the frequency of these symptoms :—
Total number of cases of
Epidemic Dropsy investigated.
Number of cases showing
gastro-intestinal symptoms.
NUMBER OF CASES IN WHICH GASTRO-
INTESTINAL SYMPTOMS WERE
Severe.
Moderate.
Slight.
630
382
35
294
53
Severe = profuse diarrhœa, vomiting, etc.
Moderate = diarrhœa moderate, occasional vomiting, want of appetite.
Slight = dyspepsia, liquid stools twice or thrice daily, want of appetite.
Profuse vomiting was noted in three cases only.
D
18
5. Œdema in Epidemic Dropsy.
The following table shows the position and frequency of occurrence of the
œdema occurred in Epidemic Dropsy :—
Total number of Epidemic
Dropsy cases investigated.
NUMBER OF CASES IN WHICH (ŒDEMA WAS PRESENT IN
Feet
alone.
Feet and
legs.
Lower
extremities.
Legs and
hands.
Face
alone.
Hand and
face.
Whole
body.
630
8
400
42
37
0
5
129
It will be seen from this table that in the great majority of cases the
œdema occurred in the feet and legs.
6. Cardiac Symptoms in Epidemic Dropsy.
The following table shows the frequency of cardiac symptoms in Epi
-demic Dropsy :—
Total number of cases
of Epidemic Dropsy
investigated.
NUMBER OF CASES IN WHICH THE FOLLOWING SYMPTOMS AND SIGNS
WERE NOTED.
Precordial pain
alone.
Palpitation
alone.
Pain and.
palpitation.
Dyspnœa.
630
0
102
4
364
7. Condition of the Knee Jerk in Epidemic Dropsy.
Total number of cases
of Epidemic Dropsy
investigated.
NUMBER OF CASES IN WHICH KNEE JERKS WERE
Number of cases in
which tenderness of
calf muscle was noted.
Normal.
Increased.
Diminished.
181
I153
12
6
54
As the majority of the cases were examined towards the end of the dis-
ease or when convalescence was advanced, it is probable that the number of
instances in which the knee jerk was found normal is higher than it would
have been if it had been possible to examine the cases at an earlier period in
the illness.
8. Eye Symptoms in Epidemic Dropsy.
Total number of cases of Epidemic Dropsy
investigated.
Number of cases of increased intraocular tension
with disturbance of vision.
630
,--.
15
19
Maynard1 contributes an interesting note on increased intraocular ten-
sion met with in cases of Epidemic Dropsy in Calcutta. He states, " On
examining them one usually finds the cornea a little steamy; the anterior
chamber normal or deep, pupils small or moderately dilated and acting but
sluggishly to light; there is sometimes complaint of pain, but rarely is there
any injection of the vessels. The tension of the eyeball is usually distinctly
increased; sometimes it is normal, in one case it was diminished. Halos, gene-
rally rainbow-like, are spontaneously complained of by those not complain-
ing of dimness of vision; it will often be found that they have had halos at
some time or another during the attack of dropsy. These halos are some-
times seen early in the morning, but more often later in the day and lasting
only a few hours, sometimes recurring again in the evening. They are not
due to conjunctival secretion. Usually the failure of the vision follows the
dropsy, but in some cases it is noticed at the same time and in two cases it
preceded the dropsical signs by a short interval.
" Two-thirds of the cases showed pathological cupping of the disc from
2 to 6 D in depth, a few showed only physiological cupping, though usually
of considerable extent, and a few showed no cupping at all. The retinal veins
are usually engorged and both they and the arteries show marked pressure
pulsation in several cases. Priestly Smith's scotometer frequently gave nega-
tive results, Bijerrum's sign being absent. The fields were generally contracted,
especially on the nasal side. In none was the eyeball enlarged. None had
R. P. or signs of iritis, past or present. None of the patients had markedly
small corneæ. Two were myopes. Two-thirds were men and one-third
women. The ages of all except 2 were under 36. Eight were under 28, and.
there was no family history of Glaucoma forthcoming."
9. Skin Lesions in Epidemic Dropsy.
The following table shows the kind and frequency of occurrence of skin
lesions in Epidemic Dropsy :—
Total number of cases
of Epidemic Dropsy
investigated.
NUMBER OF CASES IN WHICH THE FOLLOWING LESIONS
WERE NOTED.
Mottling over the
œd e
matous parts and
petechiæ.
OTHER LESIONS.
Ulceration of cheek.
Bleeding nævi.
630
180
3
4
1
I n d i a n M e d i c a l G a z e t t e ,
O c t o b e r 1 9 0 9 .
D 2
20
The petechiæ were quite distinct from the mottling and their distribu-
tion was different, being found on the back, chest and other places, whilst the
mottling was confined to the œdematous parts. The petechiæ were appar-
ently small cutaneous hæmorrhages.
10. Emaciation in Epidemic Dropsy.
The following table shows the total number of cases of Epidemic Dropsy
investigated and the presence or absence of emaciation amongst them :—
NUMBER, OF CASES IN WHICH EMACIATION WAS
Total number of cases of
Epidemic Dropsy investigated.
PRESENT.
ABSENT.
Slight.
Well marked.
630
85
67
478
11. Complication in Epidemic Dropsy.
The following table shows the kind and frequency of occurrence of com-
plications in Epidemic Dropsy :—
Total number
of cases
of Epidemic
Dropsy in-
vestigated.
Scorbutus.*
Piles.
Hæmop-
tysis.
Septic
infections.†
Pneu-
monia.
Jaundice.
Ascites.
Dysentery.
630
52
43
3
1 2
1
3
10
4
* Includes stomatitis, bleeding from the gums, hæmorrhage from the bowel.
† I n c l u d e s b r a w n y i n d u r a t i o n , c a n c r u m o r i s , n e c r o s i s o f j a w .
12. Analysis of Urine and Blood in Beriberi and " Ship Beriberi."
In a recent paper Breaudat 1 contributes a note on the urine and blood
in Beriberi and a short account of his results is given.
He finds on examining the urine of Beriberi cases at an early stage the
following :—
(1) The constant absence of important pahological elements in salu-
tion (Nucleo-albumin, albumin, sugars, alkaptone blood or bile
pigments, urobiline, acetone, oxybutyric acid). Peptone is
hardly ever found and only in traces.
(2) Few anatomical elements in suspension, but the most frequent are
castes, hyaline castes with or without leucocytes.
(3) Extreme poverty of physiological elements, especially in organic
material.
1 B u l l . S o c . P a t h . E x o t i q u e , T o me I I I , N o . 9 , S e a n c e , N o v . 9 , 1 9 1 0 .
21
In severe cases with generalised œdema he observed that the urine had a
specific gravity of 1,003, and giving in the 24 hours 24.74 grammes of soluble
material, 1.73 gram. of ash, 0.82 gram. phosphoric acid, and 9.50 gram. Urea.
In cases of moderate severity these numbers are somewhat increased.
The following table gives the results of the analysis in 15 cases of Beri-
beri, typical and comparable. For comparison, the results of the analysis
of the urine of natives (Annamite) and Europeans are given :—
Urine of 24 hours.
Annamites Beriberi. Annamites healthy.
European.
Volume .
. . . . . .
1,100 c. c.
1,097 c. c.
14 to 1,500
Reaction.
.
.
.
Slightly acid
Slightly acid.
Acid
Specific gravity.
. . .
1,008.6
1,011.8
1,018 to 1,022
Water
.
.
. . . . .
1,082.1
1,080.4
1,350 to 1,450
Elements dissolved .
.
.
. .
27.4%
20.4%
48 to 52
Organic matter
.
.
.
.
18.9
18.6
36 to 38
Urea
.
.
.
.
.
.
11.5
9.6
25 to 38
Sodium chloride
.
.
.
.
5.2
8.7
10 to 12
Phosphoric acid. P205 .
.
.
0.9
0.8
2.50
Total nitrogen
. . . .
...
5.8
...
Breaudat has made an analysis also of the blood of 6 cases of Beriberi.
4 to 6 c. c. of blood were taken from a vein at the bend of the elbow. These
cases were amongst the 15 recorded above in which an analysis of the urine
was made.
The following table shows the results of the examination per 100 gram.
of blood :—
Elements determined.
Beriberi cases
6 examined.
Annamites 2
examined.
Blood of
Europeans.
Water
.
. . . . . .
81.12
79.90
78.80
Dry extract
.
.
.
.
.
.
19.17
20.09
21.15
Organic matter
.
18.04
19.17
20.23
Ash
.
.
.
.
.
.
.
1.10
0.92
0.96
Breaudat concludes that the blood of a Beriberi patient is markedly poor
in organic matter, 1.13 per cent. less than a healthy native and 2.19 per cent.
less than a European. As the quantity of mineral matter varies little, it
22
follows that the blood of a Beriberi case is much richer in water than a
healthy person.
Schaumann1 gives the results of his analyses of the urine and fæces of
cases of " Ship Beriberi " at Hamburg.
The following table from his monograph shows the results of his analy-
sis of urine and fæces before treatment and after treatment :—
TABLE IV.—SCHAUMANN.
Urine and fœces examination.
3 Patients from sailing ship " P. R"
1. Patient T. admitted to Seaman's Hospital on 22nd December 1909.
Diet. —Mixed.
Treatment. —First day after admission 15 drops of digitalis twice daily.
Sweated once. In addition 4 times daily 1 gram. Testikulin.
2. Patient L. admitted to Seaman's Hospital on 23rd December 1909.
Diet. —Mixed.
Treatment. —For three days twice daily 15 drops of digitalis. In addi-
tion 4 times daily 1 gram. Testikulin.
3. Patient S. admitted to Seaman's Hospital on 23rd December 1909.
Diet.—Mixed.
Treatment.—For two days twice daily 15 drops of digitalis. In addition
4 times daily 1 gram. Testikulin.
OUTPUT IN 24 HOURS.
Patient.
Date
1909.
URINE.
FÆCES.
URINE
AND
FÆCES.
Quantity
of urine.
Reaction. Specific gra-v i t y a t 1 5 C .
P 2 O 5
g r a m .
P 2 O 5
gram.
P2O5
gram.
c. c.
T. .
.
22nd—23rd December
760
Acid.
1.027
1.0032
0.7395
1.7427
29th—30th
„
1,100
, ,
1.0200
1.9470
2.0254
3.9724
L. .
.
23rd—24th December
790
Acid
1.0218
2.0145
0.6670
2.6815
29th—30th
„
1,850
,,
1.0190
2.9970
3.1095
6.1065
S. .
.
23rd—24th December
1,310
Acid
1.0208
2.0798
1.5234
3.6032
29th—30th
„
2,290
,,
1.0155
3.8243
2.8078
6.6321
1 Archiv. f. Schiffs and Tropenhygiene, Beiheft, No. 8, Bd. XIV, Dec. 1910.
23
INCREASE OF P2O5 IN 6—7 DAYS
Patient.
IN URINE.
IN FÆCES.
IN URINE AND FÆCES.
Absolute
increase.
Relative
increase.
Absolute
increase.
Relative
increase.
Absolute
increase.
Relative
increase.
Gram.
Per cent.
Gram.
Per cent.
Gram.
Per cent.
T.
.
.
0.9438
94.08
1.2859
305.5
2.2297
127.9
L.
.
.
0.9825
48.77
2.4425
91.1
3.4250
127.7
S.
.
. .
1.7445
83.88
1.2844
84.3
3.0289
119.0
Average
.
1.2236
75.57
1.6709
160.3
2.8945
124.9
Durham1 carefully studied the composition of the urine in a number of
cases of tropical Beriberi in the Federated Malay States.
The following table shows the average output in 24 hours of his 14 cases
as regards the quantity of urine, Urea, P 2O5, SO 3 and the relation of the
output to normal :—
—
OUTPUT IN 24 HOURS.
Urine.
Urea.
P2O5.
SO3
Average of Durham's cases
.
c.c.
1.716
Gram.
11.261
Gram.
1.036
Gram.
0.6579
Relation to normal .
. .
Per cent.
98.06
Per cent.
37.54
Per cent.
29.60
Per cent.
29.29
Durham states, " That the metabolism in Beriberi is seriously diminished.
The amounts of Urea, Phosphoric, and Sulphuric acids may be greatly
reduced."
Schaumann2 gives the results of the analysis of the urine in 24 cases of
tropical Beriberi.
OUTPUT IN 24 HOURS.
—
Urine.
Reaction.
Speci fi c
gravity.
Urea.
SO3.
P2O5.
Average
.
.
. .
c. c.
1.113
Acid
1.021
Gram.
17.40
Gram.
1.4065
Gram.
1.7399
Relation to normal
. .
Per cent.
63.60
...
Per cent.
100.0
Per cent.
58.00
Per cent.
62.51
Per cent.
49.71
1B
r i t . M e d . J o u r n . , F e b . 2 7 , 1 9 0 4 .
2 Archiv. f. Schiffs and Tropenhygiene, Beiheft, No. 8, Bd. XIV, Dec. 1910.
24
Schaumann 1 a l s o g i v e s t h e f o l l o w i n g t a b l e : —
Combined estimation of Phosphoric Acid in Urine and Fæces in Beriberi.
Patient (Beriberi).
URINE OF 24 HOURS.
FÆCES OF 24 HOURS.
P 2 O 5 C O N T E N T I N
FÆCES OF 24 HOURS.
Quantity.
P2 O 5.
Quantity.
P2 O 5.
Absolute
amount.
Relation
to normal.
c. c.
Gram.
Gram.
Gram.
Gram.
Per cent.
22
231
0.9558
82
0.2839
1.2397
2 2 . 5 4
23
800
0.4560
88
0.6020
1.0580
19.24
24a
*
2,110
1.8146
83
0.3321
2.1467
39.03
24b
860
1 . 9 4 3 6
305
0.7210
2.6646
48.45
Average
.
750
1 . 2 9 2 5
139
0.4847
1.7772
32.31
* Urine and fæces of same patient estimated on different days.
Urine Analysis (Schaumann) .
Beriberi.
Food.—Hospital diet.
No treatment with Phosphorus.
Without Phosphorus
treatment.
OUTPUT IN THE URINE OF 24 HOURS
ON THE FIRST DAY AFTER ADMISSION. AFTER 12 DAYS IN HOSPITAL.
Patient 2. Patient 3. Patient 4. Patient 2. Patient 3. Patient 4.
1. Quantity of urine .
.
680
c. c.
1,360
1,400
425
1,160
750
2. Reaction
.
.
. Slightly acid Slightly acid
Acid
Acid
Acid
Acid
3. Specific gravity
.
.
1.023
1.017
1.022
1.031
1.011
1.024
4. Calcium oxide (CaO)
0.1849
gram.
0.2258
0.4102
0.2074
0.1508
0.1325
5. Sodium chloride (NaCl) .
5.1320
gram.
8.5130
15.8060
3.9780
8.4146
6.9322
6. Total sulphuric acid (SO 3 ) 1.2603
gram.
2.2624
2.3464
1.3213 1.1380
1.7962
7. Phosphoric acid (P2O5) . 1.7476
gram.
2.6792
2.7720
2.0612
1.7516
2.1875
8. Urea .
.
.
.
15.96
29.67
31.36
8.81
24.77
17.61
1 Ibid.
25
Without Phosphorus
treatment.
AVERAGE OUTPUT IN 24 HOURS.
Quantity.
Specific
gravity.
Calcium
oxide.
Sodium
chloride.
Sulphuric acid.
Phosphoric
acid.
Urea.
c. c.
Gram.
Gram.
Gram.
Gram.
On first day .
.
.
1,147
1.021
0.2736
9.8170
1.9563
2.3996
25.66
After 12 days .
.
.
778
1.022
0.1636
6.4416
1.4185
2.3334
17.06
Difference
.
—369 —0.001 —0.1100 —3.3754 —0.5378 —0.0662
—8.60
Per cent. Per cent. Per cent. Per cent. Per cent. Per cent. Per cent.
Relative increase or diminu-
tion
.
.
.
. —32.17 —0.001
—40.20 —34.38 —27.49
—2.76
33.52
Urine Analysis (Schaumann).
Food.— Hospital diet—160 gram. Phaseolus daily.
Phaseolus radiatus (Mung dal) treatment.
.
OUTPUT IN THE URINE IN 24 HOURS
Hospital diet—160 gr.
Mung dal.
Patient 5 after 12 days.
ON 1ST DAY AFTER ADMIS-
SION.
AFTER 3 AND 12 DAYS' FEEDING ON
HOSPITAL DIET—MUNG DAL.
Patient 9 after 3 days.
Patient 5. Patient 9. Average. Patient 5. Patient 9. Average.
Average
increase.
1. Quantity of urine
.
1,805
410
1,107
1,850
1,460
1,655
Per cent.
49.50
c. c.
2. Reaction .
. . Neutral
Acid
Acid
Acid
...
. . .
3 Specific gravity .
.
1.010
1.026
1.018
1.018
1.020
. . . . . .
4. Sulphuric acid (SO 3) . 1.4223
1.1480 1.2851
2.7195
2.8180
2.7687
115. 4
gram.
5. Phosphoric acid (P2O5) . 1.1191
1.1480 1.1335
4.3105
4.0730
1.1917
270.6
gram.
6. Urea .
.
.
.
13.014
12.660
12.837
37.09
44.97
41.03
219.5
gram.
These tables show clearly the effect of the addition of Mung dal to the
ordinary hospital diet on the output of P 2 O 5 in the urine.
E
26
Schaumann tested the effect of the addition of various other phosphorus
containing substances to the diet on the output of phosphorus in the urine. He
found that the greatest increase in the output was given with Mung dal and
the least with yeast.
The beneficial action of Mung dal in the preventive and curative treat-
ment of Epidemic Dropsy is fully discussed in this report, page 49.
(iv) Diet in Epidemic Dropsy.
As it became early evident in the course of the enquiry that there was a
relationship between the causation of Epidemic Dropsy and the kind of food
consumed, detailed notes of the diet in each case of Epidemic Dropsy investi-
gated were made, and these records were analysed with the following re-
sults :—
1. Rice.
The following shows the total number of cases investigated with special
reference to diet, and the number of those cases whose staple food was rice :—
Number of cases of Epidemic Dropsy investigated.
Number of those cases whose staple food was rice.
594
594.
The following table shows the number of cases of Epidemic Dropsy in-
vestigated, and the quantity of rice they consumed daily :—
1 CHITTAK.*
2 CHITTAKS.
3 CHITTAKS.
4 CHITTAKS.
ADULT.
CHILD.
ADULT.
CHILD.
ADULT.
CHILD.
ADULT.
CHILD.
M. F. M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
3
1
8
3
36
24
17
20
106
170
...
...
37
38
...
...
5 CHITTAKS.
6 CHITTAKS.
7 CHITTAKS.
8 CHITTAKS.
ADULT.
CHILD.
ADULT.
CHILD.
ADULT.
CHILD.
ADULT.
CHILD.
M. F. M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
8
6
...
...
55
46
...
...
...
...
...
...
12
2
...
...
* 1 C h i t t a k = 2 2 / 3 5 o z . A v o i r .
27
2. Dal.
The following table shows the total number of cases investigated with
special reference to diet, and the number of those consuming dal :—
Total number of cases investigated.
Number consuming dal.
594
594
The following table shows the number of cases of Epidemic Dropsy in-
vestigated, and the quantity of dal they consume daily :—
½ CHITTAK AND UNDER.
½ TO 1 CHITTAK.
1 TO 1½ CHITTAKS.
ADULTS.
CHILDREN.
ADULTS.
CHILDREN.
ADULTS.
CHILDREN.
Males. Females. Males. Females. Males. Females. Males. Females. Males. Females. Males. Females.
40
32
25
23
175
221
...
...
4 2
36
. . .
. . .
3.
Ata.
The following table shows the number of cases of Epidemic Dropsy in-
vestigated with special reference to diet, and the number of cases consuming
fine and coarse ata
Total number of cases of Epidemic Dropsy
investigated.
NUMBER OF CASES CONSUMING
Fine ata.
C o a r s e a t a .
594
505
3
4.
Fish.
The following table shows the total number of cases investigated with
special reference to diet, and the number of cases consuming fish :—
TOTAL NUMBER OF CASES OF
EPIDEMIC DROPSY.
NUMBER TAKING FISH.
ADULTS.
CHILDREN.
ADULTS.
CHILDREN.
Males. Females.* Widows. Males. Females. Males. Females.* Widows. Males. Females.
Hindus .
.
222
161
84
22
18
209
160
13
22
18
Others
.
.
35
39
5
3
5
33
38
3
3
5
* Excluding widows.
It will be seen from this table that the quantity of fish consumed was
not large.
E 2
28
5. Meat.
The following table shows the total number of cases of Epidemic Dropsy
investigated with special reference to diet, and the number of cases consuming
meat:—
TOTAL NUMBER OF CASES OF
EPIDEMIC DROPSY.
NUMBER OF MEAT-EATERS.
ADULTS.
CHILDREN.
ADULTS.
CHILDREN.
Males
Fe
males.*
Widows. Males. Females. Males.
Females.* Widows. Males. Females.
Hindus .
.
222
161
84
22
18
184
82.8%
18
13%
0
14
63.6%
11
61%
Others
.
.
35
39
5
3 5
35
39
5
3
5
* Excluding widows.
6. Milk.
The following table shows the total number of cases investigated in refer-
ence to diet, and the number of cases consuming milk:—
TOTAL NUMBER OF CASES OF
EPIDEMIC DROPSY
INVESTIGATED.
NUMBER TAKING MILK.
ADULTS.
CHILDREN.
ADULTS.
CHILDREN.
Males. Females. Widows. Males. Females. Males. Females. Widows. Males. Females.
Hindus
.
.
222
161
84
22
18
141
177
60
17
15
Others
. .
35
39
5
3
5
21
13
2
1
3
7. Mustard Oil.
The following table shows the total number of cases investigated in refer-
ence to diet, and the number of cases consuming mill oil, and the number of
cases taking oil from other sources:—
TOTAL NUMBER OF
CASES OF EPIDEMIC
DROPSY INVESTI-
GATED.
NUMBER TAKING MILL OIL.
NUMBER TAKING
OIL FROM
OTHER SOURCES.
ADULTS.
CHILDREN.
A D U L T S .
CHILDREN.
ADULTS. CHILDREN.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
M.
F.
Calcutta
Mill.
Cawnpore
Mill.
Calcutta
Mill.
Cawnpore
Mill.
Calcutta
Mill.
Cawnpore
Mill.
Calcutta
Mill.
Cawnpore
Mill.
257
289
25
23
154
49
185
37
17
3
15
3
54
67
5
5
29
Several interesting facts emerge from a study of the above tables
giving details of the diet of cases of Epidemic Dropsy in Calcutta.
In the first place it will be seen that every one of the persons attacked
consumed rice, and this was their staple food. Further, it will be observed
that the amount of rice consumed daily varied from 1 Chittak to 8 Chittaks (1
Chittak equals 2 2/35 oz. Avoir.). In my first report 1 I dealt very fully with
the question of rice as an etiologic factor in Epidemic Dropsy, and in the pre-
sent report, in the chapter dealing with experimental investigations, further
particulars are given. It may be recalled, however, that the rice consumed
by persons attacked by Epidemic Dropsy had undergone a process of polishing
which deprived it of certain constituents essential for the physiological re-
quirements of the body.
Since the last report was written an interesting paper on " The bran of
paddy in the prevention and cure of Beriberi," by Breaudat and Dernier, 2 has
been published. They studied an epidemic of Beriberi in 1909-10 at Cape
St. Jacques. The disease was of moderate severity with a marked predomin-
ance of cardiac troubles. Preventive treatment was attempted in the 5th
Regiment of Artillery from 1st July 1909 to 1st March 1910; among the Rifles
from the 23rd June to the end of January 1910. 290 men were given rice bran,
and 471 were kept as controls. Different doses of bran were administered.
From the 23rd June to the 9th August the men took 20 gram. bran. They
furnished 17 cases per thousand, the controls 34. From 9th August to the
15th September the men took 30 gram. bran. They supplied 5 cases per
thousand, the controls 45 per thousand. From the 15th September to 1st
February 1910 the batch of men treated was reduced to 165, and the controls
to 189. The men took 40 gram. bran. There was not a single case of Beri-
beri amongst the treated, but there were 174 cases among the controls. The
experiments on the curative treatment lasted at the Hospital at St. Jacques
from 15th September 1909 to 5th April 1910. There were 119 cases during
this period. In the first month all the patients without exception were sup-
plied with bran. From the 15th October every alternate case was treated,
there was thus a batch of treated and a batch of controls. The doses of bran
varied from 40 to 350 gram. The patients of this series had the ordinary diet
without medicine. The control batch was treated on the usual therapeutic
lines; absolute milk diet, cardiac medication (Caffeine and Digitalis), purga-
tives, Brandy, Cod liver oil, Potassium Iodide, Cocodylate of Soda, Fowler's
solution, Quinine. From the milk dietary they passed on to ordinary food
through soups, meat juice, bread and grilled meat. A meat ration entered
1 First Report on Epidemie Dropsy in Calcutta by Major E. D. W. Greig, M.D., D.Sc., I.M.S., Scientific
Memoir No. 45.
2 Bull. de la Soc. Path. Exot. Seance. Nov. 9, 1910, Tome III, No. 9.