CHAPTER I 

 BERIBERI 



The first stage of vitamine research, which we shall assign to the 

 period between 1910 and 1920, served as the instructive period. The 

 vitamine hypothesis, which can really no longer be regarded as such, 

 was promulgated during this period, and will survive in a more or 

 less modified form. The stage of enthusiasm, in which all possible 

 pathological conditions were regarded as deficiency diseases, has 

 passed and we shall endeavor now to treat the matter from the 

 objective point of view. In the study of the known and also the 

 suspected avitaminoses, we meet with the real difficulty that most 

 of the medical men are divided into two camps. One champions 

 the vitamines, while the other will have none of them. The resultant 

 feud is not very conducive to a speedy solution of the questions that 

 interest us here, for, if one has a preformed idea, then all facts are 

 viewed in a light best in accord with this idea. We find, in addition, 

 little cooperation between experimental investigators and clinicians. 

 This would be the more desirable, because most investigators have 

 very little clinical expeiience, while the clinician lacks the broad 

 scientific basis of the modes of nutrition. 



We frequently read in clinical papers, in connection with the 

 description of a possible avitaminosis, that dietary changes and 

 vitamine therapy have been resorted to without success. This 

 whole situation is usually disposed of in a few words and there is 

 frequently a failure to report important observations. In purely 

 scientific investigations, as in the field of physiological chemistry, 

 physiology or pharmacology, it remains for the author of the par- 

 ticular subject to prove his results. Very frequently, his facts inter- 

 est us far more than his conclusions. In the clinical work on avitam- 

 inoses, we often see the conclusions of the individual authors merely 

 as personal impressions, without giving all the particulars, upon 

 which basis, perhaps, a different conclusion might be possible. In the 

 interest of progress, it would be very desirable if in the clinical 

 investigations in this field, an exact description of the previous diets, 

 as well as of the vitamine therapy, were given. In this way, there 

 would be the opportunity, in every individual instance, of forming a 



275 



