174 
(In the description of the anatomical and histological changes in the animals 
which died from an injection of cultures of the Kakke coccus, the authors do not 
make any statement as to the condition of the peripheral nerves. ) 
After having seen, and studied, more or less, all of the cases of beri-beri 
in the hospital in charge of Surgeon-Major Kokubo, and after having 
obtained a number of cultures of the coccus, which, according to Okata 
and Kokubo, is the cause of this disease, the author left Hiroshima about 
the middle of September, 1905, and proceeded to Tokyo, where, during 
the war, five large military hospitals had been in operation. In two of 
these, namely, the Shibuya and ‘Toyama hospitals, there were still present 
between 700 and 800 beri-beri patients. While visiting the Shibuya 
Hospital the author had the advantage of having the material demon- 
strated by Prof. M. Miura, senior professor of pathology in the Imperial 
University and one of the greatest Japanese authorities on beri-beri. 
Professor Miura had just returned from Manchuria, where he had been 
ordered during the latter part of the war by the Japanese Government, and 
was at this time attached to the Shibuya Hospital as chief consultant for 
beri-beri cases. Professor Miura is still an adherent of the theory that 
beri-beri is a disease introduced into the human organism by food. He 
attributed the greater prevalence of beri-beri among the Japanese soldiers 
in the field during the first year, as compared with the second one of the 
campaign, to the following facts: 
During the first year almost all of the food for the Japanese army was 
imported into Manchuria from Japan; during the second one, on the 
contrary, the commissary department (transportation department) had 
developed a system of purchasing and transportation in Manchuria and 
the surrounding parts of the continent of Asia, which enabled it to obtain 
its food supplies from these places without depending upon importation 
from Japan. Professor Miura believes that the cases of beri-beri in the 
field were not due to infection from those which had come from Japan 
to Manchuria, but to the food supply exported from Japan to the army 
in the field. 
The author afterwards visited Toyama Hospital, where he saw a large 
number of beri-beri cases. This is not only the largest hospital in Tokyo 
but in Japan, and perhaps in the world, as it accommodates 7,000 patients. 
‘The institution is situated on a very large tract of ground on the outskirts 
of Tokyo, this area having formerly been occupied by the Imperial 
Military School for Noncommissioned Officers. It now contains from 
50 to 55 different hospital and administration buildings. While in 
Tokyo, the laboratory of Surgeon-General Okata in the Military Medical 
School was also visited, and Professor Okata very kindly furnished a 
number of stems of his Kakke coccus. he following statistics as to the 
occurrence of kakke in the Japanese army during the first year of the late 
