16 REVIEW — TEOPIOAL MEDICINE, ETC. 



Beri-beri— Hamilton Wright's' bacillus found in the gastro-duodenal lesions described by him, and 

 rnnthined various other bacilli and cocci which have been claimed as etiological factors, together 

 with Glogner's amoeba and the haamatozoon put forward by Fajardo. Herzog expresses 

 his belief that " the disease is due to an organism which gains entrance into the human 

 body either directly or through food, and there produces a toxin which in character and 

 effect is similar to the diphtheria or tetanus toxin, and which, by an accumulative action, 

 gives rise to the well-characterised anatomical and histological lesions of beri-beri." 



This is more or less in accord with Daniels'- conclusions, who regards beri-beri as an 

 infectious disease, and points out that there is no evidence that an intermediate host is 

 required, but that if such is required it must be a bed-bug or a flea. Indeed, he tends to 

 think that a protozoon may yet be found. 



In this connection mention must be made of the recent observations by Hewlett and 

 de Kort^' on a disease in monkeys closely resembling beri-beri. In the urine of these 

 monkeys, and also in that of beri-berics, they found peculiar highly refractile bodies which 

 they think may be protozoa. They also describe certain inflammatory changes common to 

 the monkey's kidneys and the kidneys of a number of cases of acute beri-beri sent them from 

 Singapore. In reply to a paper by Wright, they point out^ that it is the intra-tubular 

 haemorrhages to which they specially refer. A recent review of the whole subject is that by 

 Nocht,'^* while experimental work has been performed by Hunter and Koch" in Hong Kong, 

 who employed monkeys, and believe it is impossible to transmit beri-beri from man to 

 animals, and that, in the strictest sense of the term, beri-beri is not an infectious disease. 

 Other recent work is that of Tsuzuki,'* who has found what he calls the " kakke coccus " in 

 the urine, stools and intestines of beri-berics, an organism which is agglutinated by the 

 blood-serum of beri-berics and produces in animals a disease which closely resembles human 

 beri-beri. As regards prophylaxis and therapeusis, there is little new to note. Herzog 

 mentions that women sick with beri-beri should not nurse children, describes a method 

 of treatment in vogue in Japan, and states that " rice should, in private practice at least, be 

 entirely withdrawn from the daily diet of the patient." 



Beverages. Under this heading attention may be drawn to the review of 

 Dr. Hamer's^ report on aerated waters. This shows how often waters, in themselves 

 good, become contaminated in process of conversion to aerated waters by the use of unclean 

 charcoal filters, by faulty storage, by faulty bottle cleaning, and especially by neglect in 

 purifying stoppers. It also points out that the evidence regarding the ability of carbonic 

 acid gas to destroy pathogenetic organisms, such as the Bacillns typhosus, is inconclusive 

 and quite insufficient to warrant neglect of precautions. 



This subject, which is one of much importance in the Sudan, will be further discussed 

 under " Sanitary Notes" (Third Eeport). It is said the Spirillum choleras speedily perishes 

 in well-aerated waters, and in India" it is recommended that such waters be drunk when 

 cholera is prevalent, provided no bicarbonate of soda has been added. 



Attention having been drawn to the presence of antimony in bottled beverages, the 

 poison having been derived from the rubber rings used to make the stoppers fit tightly, 

 Thresh^** investigated the subject. He concluded that the solubility of the antimony sulphide 

 contained in the rubber is so slight that the only danger to be apprehended is from detached 

 particles, and especially if old rings are used. At the same time, he notes that antimony 



• Wright, Hamilton (May, 1902), "On the Classification of Beri-beri." ShuHes from Institute for Medical 

 Research, Federated Malay States, Vol. II. 



'' Daniels, C. W. (1906), " Observations in the Federated Malay States on Beri-beri," Vol. IV. 



= Hewlett, B. T., and de Kort^, W. E. (July 27th, 1907), " On the Etiology and Pathological Histology of 

 Beri-beri." British Medical Jmirnal, p. 201. 



• Hewlett, E. T., and de Korte, W. E. (November 2nd, 1907), " The Pathological Histology of Beri-beri." 

 British Medical Journal, p. 1281. 



"> Nocht, B., " Eeal Encycl. d. gesamt. Heilkunde." 4th Edition. Berlin and Vienna. 



" Hunter, W.,and Koch, W. V. M. (November 1st, 1907), "Experimental Beri-beri in Monkeys." Journal of 

 Tropical Medicine and Hygiene, p. 346. Vol. X. 



' Tsuzuki. Archiv/iir Schiffs-and Trap. Hyg., Bd. X., Heft 13. 



« Hamer, W. H. (July 4th, 1903), "The Purity of Aerated Water." Lancet, p. 40. 



• Duke, I., Calcutta, 1904, " The Prevention of Cholera, and its Treatment." 



JO Thresh, J. C. (November, 190.5), "The Presence of Antimony in Bottled Beverages." Public Health, p. 95, 

 Vol. XVIII. 



• Article not consulted in the original. 



