og he sil Mile 
EL ed EN ion in hae ee RD 
711 
HISTORY AND GEOGRAPHICAL DISTRIBUTION. 
The first undoubted mention of beriberi is made in a Chinese work 
of the second century of the Christian era, and a good description of the 
disease is to be found in a Chinese text-book on medicine of the sixth 
century. It is also possible that the disease may very early have ap- 
peared in the Western Hemisphere, because two quotations from Strabo 
and Dio Cassius, giving a description of a Roman invasion of Arabia in 
the year 24 B. C., perhaps refer to an epidemic of beriberi among the 
soldiers of the Roman army. 
The disease is now generally prevalent in tropical and subtropical regions in 
which as a rule the humidity is considerable. It is found in Asia, Japan (inelud- 
ing Formosa), China, the Malay Archipelago and Peninsula, the Dutch Posses- 
sions, and in Eastern India. It oceurs on the eastern coast of South America, 
particularly in Brazil, and a number of reports of its presence in Africa during 
the last two decades have appeared.’ Some isolated epidemics have also taken 
place in England and Ireland, and sporadie, imported cases have been encountered 
in Continental Europe, the United States, and Canada. It is also prevalent among 
the native population throughout the Philippine Islands. During the early days 
of the American occupation of Manila a few cases occurred among the white 
troops, but for several years beriberi has certainly been of very rare occurrence 
among the Americans, the author having only seen two cases during two years. 
One was in a teacher who had returned to Manila from Mindanao, the other in a 
physician who for several years had been in charge of the Mindoro prison, which 
formerly was one of the most notorious foci of beriberi in the Islands, but which 
was abandoned some time ago. 
THE FIRST EPIDEMIC OF BERIBERI IN THE PHILIPPINE ISLANDS. 
It is somewhat strange that the records concerning beriberi in these 
Islands date back only a few decades. Koniger* in 1884 reported 
what he considers the first invasion of the Philippines by beriberi, the 
epidemic occurring during the year 1882-1883. In view of the fact 
that the disease has for many centuries been so widespread in Japan, it 
is hardly credible that the Philippines should have been exempt from 
it until 1882. Moreover, it is an historical fact that during the constant 
feudal strife and the civil wars preceding the establishment of the 
Fogugawa Shogunate many impoverished Japanese frequently were forci- 
bly exported to the Philippine Islands by Portuguese slave traders and 
sold as slaves. Besides, northern Luzon was once invaded by a Japanese 
army.” It is generally claimed in the Philippine Islands that leprosy 
* According to A. Plehn it has been observed in the latter country in the 
following places: Reunion, Mauritius, Nossi-be, Zanzibar, Cope Colony, Senegal, 
Angola, Congo State, German West Africa (Kamerun). 
* Kéniger: Ueber epidemisches Auftreten von Beriberi in Manila, 1882-1883. 
Deutsch. Archiv. fiir Klin. Medizin (1884), 35, 419. 
‘Griffis: The Mikado’s Empire, 9th edition, New York (1900), 246 and 254. 
