Evening star. [volume] (Washington, D.C.) 1854-1972, 1902-11-12
ASIATIC DISEASE
HISTORY, CAUSE AND NATURE OF
DREADED BERI-BERI.
Was Epidemic in Insular and Com
tinental Europe-The Orient
Its Home.


The disease known as beri-ben CHAD sick
ness'). first described as early as 1929, is
especially met with in tropical and subtrop-
ical regions, but is by no means confined to
them. 1t has occurred in epidemic form in
England. Ireland and other parts of Eu-
rope, and as far north as the Russian penal
settlement at Saghalien.
The home of beri-beri Is Papan, the Malay
peninsula, the eastern archipelago and
Brazil; 1t occurs with less frequency in some
parts of India, Ceylon and Africa, in west
ern Australia ard elsewhere. 1t Is worthy
of note that whereas beri-beri was formerly
very common in China and rare in Japan,
the reverse is now the case. The disease is
especially prone to break out in certain dis
tricts, and not infrequently assumes an
epidemic form; low-lying damp localities are
favorable to Its spread. Newcomers to in
fected localities are very prone to attack,
but long residence does not confer immunity
In some cases the first symptoms of the dis
ease make their appearance within a few
weeks after exposure to infection, in others
not for many months.
Beri-beri especially selects crowded GEN.
tiers. such as gaols. asylums. schools and
ships, Such centers soon become infected:
and although the disease may lie dormant
for time, it is very liable to break out
afresh with the return of warm weather or
under other favpring conditions. It is ex-
tremely difficult no matter what stems are
taken, to eradicate the poison from build
Ing which has become infected Defective
sanitation plays only a subsidiary part In
the causation. Race, age, sex. poverty or
wealth neither court the occurrence of the
disease nor confer immunity from It. al
though 1t is true that adult males suffer
most probably from their greater exposure
to infection.
Cause of the MaIady.
The immediate cause of beri-beri is as
yet unknown, and excites considerable dis
cussion and difference of opinion The
facts connected with the disease present a
striking analogy to the effects produced by
the abuse Of alcohol. arsenic and certain
other poisons and by the toxins C'poisons'D
formed in the bodies of patients suffering
from malaria, typhoid fever and certain
other diseases.
ber1-beri is also produced by poison. But
what that poison is, whether 1t is manu-
featured in the body or outside it. and ir
the latter, how it gains entrance to the sys-
TEN, are matters as yet undetermined
Their solution will do much to help the
stamping out of beri-beri. So closely does
beri-beri resemble some cases of arsenicaI
poisoning that arsenic mas been cited as
the cause of the disease, theory seeming
ly finally disposed Of by the fact that ar
senic does beri-berics good.
The Beri-Beri Poison.
Organisms have been described as occur
ring in the blood of beri-berics but as yet
no organism has been definitely proved to
be the materies rnorb
1t is, however. practically certain that the
poison Is manufactured by an organism,
which produces it outside the body, but by
what means the poison then enters the sys-
tenn is unknown. The fact that a beri-berio
rapidly improves after his removal from the
affected area is strong evidence that the
poison Is formed outside his body: in point
of fact, he is In the position of a drunkard
whose supply of alcohol, which he cannot
form within him, has been cut off. Were
the organism in the patients blood 1t IS
highly improbable, though not impossible.
that mere removal from infected center
would be followed by such rapid improve
ment.
1t is asserted by some that the vehicle
containing the poison is rice-that is rice
of bad quality, in which, presumably. the
organism f1ourishes. While there is much
evidence to support this view, there is much
against it, and at present the question must
remain an open one. Water seems to be
beyond suspicion as means of conveyance
of the poison. 1t may yet be shown that
the toxin is air-borne but until the organ
ism is discovered and it's mode of life and
the poisons which it creates are definitely
known, the means by which the patients
become infected must remain matter for
speculation.
Symptoms of the Disease.
Whatever the beri-beric poison may be- it
eXertS its baneful influence upon the ends
of the nerves, inducing inflammation Cperi-
pheral neuritis) and degeneration, the
symptoms of the disease being thus trace
able to diminution or abolition of the nor
NAL nervous impulses.
The disease develops gradually as rule.
but sometimes very suddenly. The symp-
toms depend upon whether the nerves of
motion and sensation those regulating
the circulation are affected Thus the
symptoms may be chiefly connected with
the muscular and sensory system (dry oeri-
berD, or with the circulatory system twet
beri-berD, but in most cases the two condi-
lions combined, though one other
predominates.
At first there is weakness of the muscles
of the legs, which gradually increases Until
a stage of complete paralysis is reached.
the leg dropping from the knee in a helpless
condition; later on the same condition ap-
pears in the forearms and the wrists droop.
The muscular feebleness, ending in COM
plete paralysis and subsequent atrophy,
gradually spreads up the limbs to the mus
cles of the trunk, unless the patient be re-
moved from the infected area, and later
grave symptoms referable to weakness or
paralysis of the muscles concerned in res
piration make their appearance. If the
muscles of the larynx are affected the voice
becomes weak, and may be eventually lost
as the paralysis deepens. At the same time
there is numbness or perverted sensation
of the skin, but considerable pain. and
sometimes cramp in the weakened or par
alyzed muscles, which ultimately waste.