761 
radiatus Bak.) as a part of their daily nourishment, and it is believed 
that this has both a favorable prophylactic and a curative tendency. In 
the Philippines, similar virtues are claimed for the mongo or mungo-bean 
(Phaseolus mungo L.). Rice should, in private practice at least, be 
entirely withdrawn from the daily diet of the patient. Alcohol in any 
form is considered inadmissible in the treatment of beriberi and _ it 
should be entirely withheld. A person sick with a severe type of beriberi, 
accompanied by grave circulatory disturbances, should not under ordinary 
conditions be removed to a distance. Even during the early stages of 
recovery, a long railroad journey may bring on a relapse with severe 
and dangerous heart symptoms. Cases which are mild from the onset 
and serious ones after complete recovery, may with advantage be removed 
from a beriberi-infected neighborhood to a high and dry locality free 
from this disease, and a change of climate and return to a more bracing 
atmosphere should be recommended to Europeans and Americans who 
have suffered an attack. : 
CONCLUSION. 
(1) Beriberi, kakke, or neuritis multiplex endemica is an acute, sub- 
acute, or chronic disease, generally only prevalent in certain well-defined 
territories. It is clinically characterized by disturbances of circulation, , 
of motion, and of sensation. 
(2) Its most pronounced anatomical lesions are, first, hypertrophy 
and degeneration of the myocardium and degeneration of the peripheral 
nerves and skeletal muscles, and second, localized or more or less general 
cedema, parenchymatous degeneration of the kidneys, liver, and inter- 
stitial hepatitis. 
(3) Beriberi is neither primarily a nutritional disturbance nor a 
simple intoxication like lead, alcohol, arsenic, or similar intoxications 
accompanied with multiple peripheral neuritis, but is an infectious 
(lisease. - 
(4) Our animal experiments and blood examinations appear to in- 
dicate very strongly that none of the claims brought forward for the 
discovery of a specific micro-organism for the disease can be looked upon 
as substantiated. 
(5) While, in the absence of any positive evidence or proof, it is 
perhaps dangerous to venture on an hypothesis, I would like to express 
the belief that beriberi is due to an organism which gains entrance into 
the human body, either directly or through food, and there produces a 
toxin which in character and effect is similar to the diphtheria or tetanus 
toxin and which by an accumulative action gives rise to the well- 
characterized anatomical and histological lesions of beriberi. 
