BERIBERI 295 



of fresh vegetables approaches the end. Characteristic symptoms 

 are numbness of the extremities, short breathing, and finally death 

 from heart failure. The patients recover very rapidly when they 

 receive fresh provisions, nervous symptoms being noted only seldom; 

 this is not the case in ordinary beriberi. If the crew is made up of 

 representatives of rice-eating people, who keep to their dietary 

 customs, then true rice-beriberi, and not ship-beriberi, develops. 

 Since long sea voyages are now of rare occurrence, ship-beriberi is 

 rarely met with. During the World War, the German raider 

 Kronprinz Wilhelm, with a great number of cases of ship-beriberi, 

 was interned in New York harbor. The crew lived on frozen meat, 

 while the officers received a daily portion of fresh vegetables and fruits 

 in addition, and therefore did not contract this disease. Since fruits 

 and vegetables contain both vitamines B and C, the above cases 

 can not give us any clue as to the true nature of the above condition. 

 Nocht (902) was of the opinion that the disease was not identical 

 with rice-beriberi, while Vedder (I.e. 838) believed that it was. Hoist 

 and Frolich (903), on the contrary, saw therein a greater resemblance 

 to scurvy, although Hoist (904) stated later that on Norwegian ships 

 the crews, which ate rye bread, were free of this disease. However, 

 if the rye was mixed with wheat, the disease developed. From this, 

 it might be concluded that we are dealing with beriberi, in which 

 view Hoist was strengthened by the results of his pigeon experiments. 

 Ship-beriberi is apparently a mixed syndrome, differentiated from 

 scurvy by numbness of the extremities, and from beriberi by scor- 

 butic gum changes. 



RELATIONSHIP BETWEEN BERIBERI AND SCURVY 



As we have already seen in the previous chapter, we believe that 

 under certain conditions mixed avitaminoses of beriberi and scurvy 

 may arise, though in practice, from a lack of both vitamines, one 

 condition develops in preference to the other. It is nevertheless 

 possible that scurvy should develop on an exclusive diet of rice. 

 During the siege of Paris in 1871, if the observations are correct, 

 such cases occurred and were reported by Delpech (905) and Bucquoy 

 (906). Garcia (907) described a mixed form of scurvy and beriberi. 

 Scherer (908) had the opportunity of observing an outbreak of scurvy 

 in German Southwest Africa, in which there was a death rate of 30 

 per cent. The disease developed because of an exclusive rice diet 



