a 
of vessels causes an increase of pressure on 
the pulmonary artery”. 
“The pulmonary circulation having its 
tension increased, the pulmonary sound be- 
comes accentuated, the ventricte is dilated, 
and byreathing, on the increased it pressure 
becomes hypertrophied. The right ventricle 
being dilated, the fibres of the myocardium 
lose their tenacity; hence the galloping sound. 
The right ventricular cavity becomes dilated, 
so that the diastolic aspiration is lessened, 
-and the pulmonary valve, closing after the 
aortic, causes the doubling of the second 
sound”. This explanation is reasonable and 
logical. MAGALHAES is of opinion that 
tachycardia is provoked by the irritation of 
the sympathetic system and the degenera- 
tion of the vagus. 
We avoid dividing beriberi into different 
forms aS One cannot separate well-defined 
varities. Sometimes beriberi progresses slowly 
and becomes chronic; at other times it pro- 
gresses swiftly and becomes very acute, with 
the intervention of the serious phenomena 
above-described. Often however the evolution 
ot the disease takes place in a few hours or 
days; it is then known as galloping. Beriberi 
nearly always terminates in asystolia, either 
by direct attack or by the degeneration of the 
nerves innervating the heart. The degeyeration 
of the vagi and the lesions of the great sympa- 
thetic explain the evolution of the symptoms 
which have been noticed by many pathologists. 
VEDDER does not accept the classifica- 
tion of clinical forms, but establishes a list 
of three kinds of principal symptoms: Ist) 
symptoms of peripheric neuritis 2d) cardiac 
insufficiency 3d) general tendency to oedema. 
On comparing Brazilian studies with 
those of the Eastern authors I came to 
the conclusion that there is no difference betw- 
een brazilian beriberi and they Japanese, 
Malayan or Philippine kind. No description 
could fit the galloping forms of the Amazonas 
better than that of the mostacute forms seen in 
Japan by SCHEUBE. There is no difference 
between some of the chronic, torpid, attenua- 
ted forms observed by me in the Amazonas 
province, and the Segel-schiff beriberi of 
NOCHT. The experimental cases in men, 
recently described by STRONG and CRO- 
WELL, might be pictures of those described 
by SILVA LIMA and SODRE. 
We therefore conclude that the beriberi 
in Brazil is the same as Eastern beriberi as 
SILVA LIMA recognised. 
Experimental beriberi. 
In 1890 EIJKMAN noticed for the first 
time, that the birds fed with polished and 
cooked rice in his laboratory in Batavia (Java), 
showed ataxic symptoms, paralysis and 
convulsions after some time; in short, they 
revealed symptoms of an illness resembling 
human beriberi. His communication was re- 
ceived either with absolute indifference or, 
with complete unbelief. He did not however 
allow himself to be discouraged, but went on 
with his studies. At first he thought that 
polynevritis gallinarum, as the new disease 
was called, was a toxic polyneuritis caused 
by a substance that poisoned the nerves and 
resulted from fermentation or change in the 
rice when shelled, and which harmed birds 
when it remained in their crop. Since the birds 
showed no signs of illness when they were 
fed on unshelled rice, he thought that the 
pericarp protected the seed from the germs of 
fermentation. 
In another series of investigations ElJK- 
MAN renounced this hypothesis of intoxica- 
tion as he saw that the shell of the rice con- 
tained a matter essential to the nourishment 
of birds and that without it they had polyneu- 
ritis. This substance is found in the red pel- 
licule which encloses the seed. The 
pigeons nourished with unpolished rice with 
the pellicule, did not get polyneuritis even 
when the rice was cooked in the ordinary 
way. Consequently he realised that the illness 
was caused by a defficient nourishment. 
EJJKMAN therefore came to the conclusion 
that in the pellicule of rice there is a subs- 
tance of such nutrive and protective value to 
the nerves that when it is wanting they beca- 
me disintegrated because theyr structure is 
attacked.” 
