BERIBERI 283 



be thought of as a symptom of vitamine hunger. A decrease of sexual 

 ability is frequently observed. 



Hepburn (I.e. 845) enumerates, in observations of 100 cases, the 

 following symptoms: The first symptoms, as a rule, consisted in 

 one of three manifestations, (1) edema of the feet and legs in 50 per 

 cent of all cases; (2) numbness, irritability and tingling of the legs 

 in 42 per cent, and (3) epigastric manifestations in 7 per cent. A soft 

 mitral systolic murmur was noted in 20 cases in the first investigation. 

 Cardiac arrhythmia was noted in 5 cases in the first stage. Kato 

 and Yamada (873) noted arrhythmia in the convalescent stage. The 

 body temperature was found subnormal by Doyle (874) . As regards 

 the blood picture, Chun (875) found an increase in the number x of 

 leucocytes amounting to 100 per cent. The blood pressure was 

 found to range up to 200 mm. by Yoshikawa, Yano and Nemoto 

 (876). Jida (877) investigated the cerebrospinal fluid. In a number 

 of cases he found a large pressure, particularly in the acute stage, 

 up to 280 mm. with a low blood pressure. This fluid, in cases with 

 high pressure, injected into the .ear of a rabbit showed a powerful 

 vaso-constrictor action (which indicates, perhaps, a high adrenaline 

 content). Sicard and Roger (878), on the contrary, failed to dis- 

 cover any peculiarities in the cerebrospinal fluid. 



The picture of beriberi shows many different forms, according to 

 Balz and Miura. 



1. The light, sensory-motor form. 



2. The dry, atrophic form. 



3. The wet, atrophic form. 



4. The pernicious, acute form. 



These forms may also merge into one another. As a rule, the 

 picture of the disease shows paralysis and muscle atrophy in chronic 

 cases; in acute cases, however, there are gastro-intestinal disturb- 

 ances, anasarca, hydropericardium and severe cardiac symptoms. 



1. The sensory-motor form 



This is the most common form of beriberi. After an exertion, 

 especially during the summer months, the patient feels unsteady and 

 weak in the legs; often there is numbness of the arches of the feet 

 and of the legs; the calf muscles are sensitive to pressure. In addi- 

 tion, there is palpitation of the heart after exertion, and edema of the 



