BERI-BERI IN THE JAPANESE ARMY DURING THE LATE 
WAR: THE KAKKE COCCUS OF OKATA-KOKUBO. 
(A PRELIMINARY REPORT.) 
By MAXIMILIAN HERzo«. 
(From the Biological Laboratory, Bureau of Neience.) 
The affection most commonly known in European and American litera- 
ture as beri-beri, and universally designated in Japan as kakke, is a 
disease generally confined to tropical and subtropical zones and partic- 
ularly prevalent in certain parts of Asia, namely, Japan, China, the 
Malay Peninsula, the Dutch colonies, and the Philippise Islands. Espe- 
cially in former years, beri-beri was exceedingly widespread in Japan, 
and it is from this country that most of our exact original knowledge 
concerning the disease has come. In this connection the work of Baelz. 
Scheube, M. Miura, K. Miura, and Yamagiwa, among others, should 
always be favorably remembered. During the late Russo-Japanese war 
much discussion was carried on, both in the medical and in the secular 
press, concerning the excellent management by the Japanese army 
medical corps of the sanitary affairs of the Japanese army ; indeed, as it 
appears at present, the latter to a great extent succeeded in fain any 
serious outbreak of typhoid, typhus, dysentery, or scorbutus, and in pre- 
venting entirely the appearance of cholera and plague in the rank and 
file of their fighting bodies. However, reports came to Manila during 
the second year of the war (1905) to the effect that a very large number 
of cases of beri-beri, occurring among soldiers returned incapacitated 
from the front because of this affection, were accumulating in the military 
reserve hospitals of Japan. As will appear from the official figures to 
be given below, this was indeed the case; and it was true to so great an 
extent that probably no outside observer, during the progress of the war, 
had any conception of it. It may here be stated that the total number 
of cases of beri-beri which developed in the Japanese army during this 
period is to be placed at a minimum of from 75,000 to 80,000. 
However, it would certainly be doing a great injustice to blame the 
Japanese army medical corps for this great epidemic. There are certain 
points which must be considered when one is dealing with an occurrence 
such as this. Beri-beri is a disease the etiology of which is ill understood 
at the present time. We neither know its specific cause nor by what 
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