716 
Views other than the above in regard to the etiology of beriberi are that’ it 
is an anemia of a pernicious type, that it is a modified and secondarily changed 
form of scorbutus, that it is due to carbon monoxide poisoning, or that it is 
caused by Uncinaria duodenale or by Trichocephalus dispar. 
The following list gives the names of a number of investigators who have laid 
claim to the discovery of the specific micro-organism of beriberi: DeLacerda 
(a bacillus), Taylor (a bacillus), Rost (a bacillus), Ogata (a bacillus), Van 
Jecke (a coccus), Pekelharing and Winkler (a bacillus and a coccus), Wright 
(a coceus), Dangerfield (a coeccus), Glogner (an ameeba), Fajardo (a hiema- 
tozoén), and Okata and Kokubo (a coccus). 
Wright, in his studies on beriberi in the Malay Peninsula, noticed that 
although the disease is almost unknown among Europeans, a few authenticated 
cases had been reported during the last ten years. In the Malay Peninsula the 
disease occurs mainly among the Malays, Tamils, and particularly the Chinese. 
and the greatest number of cases is found in the prisons. This author’s theory 
in regard to the etiology of beriberi is that it is due to a specific organism which 
gains entrance to the body by the mouth, develops chiefly in the pyloric end of 
the stomach and the duodenum, and produces a toxin, and that the latter being 
absorbed, causes atrophy of the peripheral terminations of the afferent and 
efferents neurons. He further believes that the specific organism is passed in 
the feces and then lodges in the floors and walls of confined places through 
accident or through the careless personal habits of those affected by the disorder ; 
whereupon, provided congenial meteorologic, climatic, and artificial conditions 
exist or there is close association from overcrowding, the organism becomes 
virulent and, gaining entrance to the healthy body by means of food, gives rise 
to an attack of the disease. Wright explains the fact that the germ remains 
so closely focal by its being at once destroyed by the action of direct sunlight; 
he also assumes that the presence of carbon dioxide or some other gas is necessary 
for its development in a virulent state. It seemed to him that the duration of 
the active stage of the organism in the body is between three and four weeks. 
He examined blood taken from 12 acute pernicious beriberi cases, from 36 
simple acute ones, and from 27 in which a residual paralysis was existent, in 
order to detect the specific organism of the disease, if possible. The blood was 
first collected from the skin of the finger and lobe of the ear, and if a growth 
occurred in the culture media a second specimen was taken from the median 
cephalie vein at the elbow. The blood of 18 Chinese not infected with beriberi 
was examined by identical methods for control experiments. Wright concluded 
that the few organisms which developed in the cultures in these two series of 
investigations were contaminations derived from the skin and that they have no 
relation whatever to beriberi. Some of these organisms, Wright states, had 
previously been described by Pekelharing and Winkler and by Von Eecke, who 
had erroneously believed that they were associated with beriberi. It is interesting 
to quote freely from Pekelharing and Winkler, who have claimed to have dis- 
covered the specific cause of beriberi. They say: “In 15 cases we obtained a 
growth of bacteria; from 12 patients a growth of micrococei; from 3, one of 
rod-like bodies. The rods differed from each other in every instance. * * * 
“In the 12 other cases the tubes inoculated with blood showed micrococei. These 
developed best on the solid substances, where they formed a white bed with a 
shining surface. This phenomenon was noticed in 10 cases but in 2 of the cultures 
a yellow color developed. * * * Sometimes different bacteria were cultivated 
from the same blood but this did not happen when agar-agar and blood serum 
were used as the media. * * * The different colonies which developed on 
the bed of gelatine did not at all resemble each other. On one occasion we found 
seven colonies of micrococci, of which two consisted of a white and five of a yellow 
