oi) te hee 
720 
Japanese soldiers transferred from Manchuria to Japan during the recent Russo- 
Japanese war. These investigators have isolated a coccus, which generally assumes 
the shape of a diplococcus but which may also at times present itself as a staphy- 
lococeus. They confidently maintain that this organism is the causative factor 
in beriberi, 
The author, working in the Hiroshima Kakke Hospital under the 
direction of Surgeon-Major Kokubo, has had an opportunity to isolate 
this identical organism from cases among soldiers suffering from beriberi 
in Hiroshima. A translation of Okata and Kokubo’s first description 
of the micro-organism, which they claim to be the etiologic factor in 
hakke, has already been published in a previous number of this Journal.** 
THE THEORY OF ARSENICAL POISONING AS THE CAUSATIVE 
FACTOR OF BERIBERI. 
Among the theories brought forward to explain the etiology of beriberi 
is that of arsenical poisoning. I shall consider it somewhat in detail. 
A number of observers who have made ,beriberi a subject of special 
inquiry have noticed the frequency of this affection among workers in 
tin mines. Occasionally, there has been a tendency to regard the disease 
as a direct manifestation of arsenical poisoning. 
Recently, Donald Ross“ has become an advocate of this theory. He calls 
attention to the fact that the clinical symptoms of certain cases of beriberi are 
extraordinarily similar to those shown by the victims of chronic arsenic poison- 
ing which oceurred in Chester and Manchester (England) in 1900 and which 
were characterized by a multiple, peripheral neuritis; in fact, they resembled 
what appeared to be cases of epidemic, peripheral neuritis. Following out 
this theory, Ross* later reported a case of beriberi which clinically presented 
features similar to those met with in the dry, paralytic form of the disease; it also 
resembled the cases of arsenic poisoning observed in England in 1900. Professor 
Dixon Mann examined a lock of hair from this patient and reported that he 
found a considerable amount of arsenic. No arsenic had been administered 
medicinally. 
Enlarging upon his researches in this direction, Ross * procured twenty samples 
of hair from beriberi patients, mostly Chinese, from the Penang General Hospital. 
These were also analyzed by Dixon Mann, who reported that 6 out of the 20 
samples contained arsenic; two yielded more than a trace; and two each a 
decided and a minute trace. The positive samples were nearly all from recent 
cases of beriberi, the negative ones as a rule from the older ones. Ross draws 
the following conclusion from the result. 
“The probability is very strong that the Penang beriberi is arsenical, especially 
when we know that the people there largely work in tin manufactories and are 
brought closely into contact with arsenic.” — 
4 Phil. Journ, Science (1906), 1, 169. 
2 Ross: Beriberi and Chronic Arsenical Poisoning. London Laneet (1900), 
2, 1677. : 
* Ross and Reynolds: A Case of Beriberi Probably due to Arsenic Poisoning. 
Brit. Med. Journ. (1901), 2, 979. 
* Ross: Arsenic in the Hair of Beriberi Patients from Penang. Brit. Med. 
Journ, (1902), 1, 329. 
an ae 
