228 VITAMINS 



motility of the stomach and intestinal tract with resultant constipation 

 are also caused by this deficiency. 



Perhaps because of its intimate relation to carbohydrate metabolism, 

 thiamine plays an important role in the life of plants and microorganisms, 

 as well as higher animals. Many microorganisms cannot be grown with- 

 out it, and others, although able to synthesize it, make a much faster 

 growth if it is contained in the nutrient medium. The need for thiamine 

 seems to be universal, and it probably plays a part in the activities of 

 all living cells. Plants, however, seem able to synthesize adequate 

 amounts of thiamine to supply their own needs. Claims regarding the 

 beneficial effect of thiamine and other B vitamins when applied to grow- 

 ing plants as yet are unsubstantiated, and the evidence is conflicting. 

 It seems quite certain that these claims have been grossly exaggerated. 



Prevalence of thiamine deficiency 



Historically, beriberi has been associated with the Orient, where polished 

 rice constitutes such a large part of the diet. In spite of the knowledge 

 for many years that it is a deficiency disease, beriberi is still prevalent 

 in India, China, Japan, the Philippine Islands, and other Oriental coun- 

 tries. According to Salcedo and co-workers, beriberi is second only to 

 tuberculosis as a cause of death in the Philippines. Mortality figures for 

 1947 were 132 per 100,000 population, and 13 per cent of the population 

 showed evidence of thiamine deficiency. 



Although the disease in its worst form has been considered rare in the 

 United States, recent studies of various forms of neuritis have revealed 

 that a number of these exhibit a clinical picture comparable to that of 

 classical beriberi. Diets in the United States are seldom restricted to 

 foods so low in thiamine as is polished rice, yet it now seems fairly cer- 

 tain that the food ordinarily consumed by many people in this country 

 fails to furnish an "optimal" amount of this vitamin and that a slight 

 degree of thiamine deficiency is much more widespread than was formerly 

 supposed. Furthermore, a number of conditions which either increase 

 the thiamine requirement or in some way interfere with the utilization 

 of the normal supply probably contribute to the appearance of this de- 

 ficiency. Excessive consumption of alcohol is an important factor in 

 this regard, for the caloric value of the alcohol leads to a diminished 

 food intake, and, in addition, gastrointestinal disorders incident to exces- 

 sive use of alcohol may reduce the absorption of the vitamin. In one 

 of our large hospitals 61.6 per cent of 1000 consecutive male patients 

 admitted to the alcoholic ward in 1935 were suffering from polyneuritis. 

 Whereas during pregnancy the requirements of the body for thiamine 

 are materially increased, the nausea and vomiting frequently associated 

 with this condition may actually curtail the food intake and, with it, the 



