278 THE VITAMINES 



viewpoint of the modern conception of beriberi. Beriberi is a disease 

 which, according to Findlay (841), has been known for hundreds, if 

 not for thousands, of years. Its occurrence was described in the 

 Roman army which invaded Arabia in 24 B.C. Chinese writers in 

 the second century referred to this point. N etching, the oldest 

 medical book (2697 B.C.), speaks definitely of this disease. 



East Asia, including the group of Polynesian Islands, is the main 

 beriberi zone. The second greatest area is in Brazil and the neigh- 

 boring countries. Furthermore, the African coast shows numerous 

 foci. It was commonly held that a moist warm climate was especially 

 conducive for the development of the disease This report is incorrect 

 as, for example, in the Russo-Japanese War, a severe outbreak of 

 beriberi was noted in the Japanese army in spite of the severe winter; 

 beriberi is endemic also in northern Japan. The above mentioned 

 statement is based largely upon the fact that rice grows well only in 

 moist heat. Japan is the most afflicted country. Balz and Miura 

 (842) estimated the number of beriberi patients at about 50,000 

 yearly. China is very much less afflicted, though in Korea we find 

 numerous foci. Furthermore, we find the disease quite well spread 

 over the Malay Peninsula. The number of cases there was estimated 

 by Fraser (843) in 1911 to be 5540, among which 695 deaths occurred. 

 This is true also of the islands of the Malay Archipelago, Java, 

 Borneo, Celebes, the Molucca Islands, New Guinea, and especially 

 Sumatra. Simpson (844) reported cases in Singapore, where the 

 disease was often noted among Chinese coolies. In Hawaii, New 

 Caledonia and North Australia, the disease is mostly seen in Japanese 

 and Chinese immigrants. More beriberi zones are found in Cochin- 

 China, Siam (according to Hepburn, 845) and Burma, at the mouth 

 of the Ganges (according to Mulvany, 846), on the east coast of the 

 East Indies, Ceylon, Malabar, and less so on the Koromandel Coast. 



In Africa, numerous foci exist on the east and west coasts. Thus, 

 Chevalier (847) reported on an outbreak in Serenli (East Africa) with 

 112 cases in six months, with 44 deaths. In the Congo, the rice 

 eaters are often attacked by the disease, while other natives, to whom 

 rice feeding is unknown, remain free from the disease. Dubois and 

 Corin (848) describe a number of cases in Bokala (Belgian Congo) 

 which were caused by the consumption of "maniok." Similarly, 

 beriberi is known in Madagascar, and in the Mauritius and Reunion 

 Islands. 



