BERIBERI 291 



mouth and nose, dyspnea, tachycardia, aphonia, edema of the face 

 and the legs, oliguria, but no fever. In some of the cases, the mother 

 is still in the latent stage and shows only indicanuria, while more 

 marked symptoms develop later. These statements were confirmed 

 by Andrews (I.e. 744) in the Philippines. He found that a great 

 number of infants died there because of this reason. The milk of 

 such mothers was shown to be poor in fat (2 per cent instead of 4 per 

 cent), while the calcium and phosphorus content was increased. If 

 this milk was given to young dogs, they developed beriberi. The 

 question as to the mode of development and the nature of infantile 

 beriberi was also treated by Lagane (881), Weill and Mouriquand 

 (882) and Walshe (883). In addition, Ogata and Jizuki (884) 

 investigated the influence of beriberi in the mother on the fetus. 

 According to Roxas (885), the disease in the Philippines occurs less 

 frequently in artificially fed children. The great number of cases of 

 infantile beriberi, compared with infrequency of scurvy and pellagra 

 in naturally nourished infants, makes it evident that the formation 

 of vitamine B in the milk proceeds somewhat differently from that 

 of the other vitamines. 



PATHOLOGY OF BERIBERI 



General 



Diirck (886) has written a good monograph on the subject. For 

 the most part, sections were made of acute cases. The skin of the 

 beriberi corpse is quite edematous, cyanotic at the extremities, lips 

 and ears, often with subcutaneous hemorrhages; the musculature is 

 also edematous. One of the most common typical findings is hydro- 

 pericardium, which develops as a result of the degeneration of the 

 nerves of the pericardium. Hydrothorax, ascites fluid and pin- 

 point hemorrhages are frequently observed in the serous membranes. 

 In acute cases, ecchymoses are not infrequently noted in the stomach 

 and in the duodenum. The heart, especially the right ventricle and 

 auricle, is markedly dilated and hypertrophied. The heart muscle 

 itself shows yellowish spots and streaks (of a fatty nature). The 

 lungs are usually edematous. The kidneys are full of blood, but here, 

 as in other organs, there are small hemorrhages. Nephritis was not 

 observed. 



