BERIBERI 337 



coolies are imported. It has been reported in the Congo (Van den 

 Branden). 



It is the scourge of many mines and plantations in the Malay and 

 Eastern Archipelago. 



HISTORY. 



Beriberi probabl}- attacked the Roman army in Arabia (24 B.C.). 



In the Straits Settlements and Malaya (population 1,250,000) there 

 have occurred 150,000 cases with 30,000 deaths in the Government 

 Hospital during the last twenty years (Bradden). 



In the Japanese navy, prior to 1884, 23 P^r cent, of the sailors were 

 continuously disabled by it. 



In the Japanese army, during 1904 and 1905, 24 per cent, of the 

 total sick and wounded were its victims. 



The Government of Malaya pays ^10,000 per annum for direct 

 hospital cases. 



Labourers, sailors, soldiers and prisoners are most frequently 

 attacked. 



It is common in large cities, and overcrowding favours its spread. 



It is very common amongst Mohammedans, who do not take 

 alcohol. 



iETIOLOGY. 



It is a deficiency disease. It tends to be racial in young adults 

 between fifteen and thirty, but no age is exempt. 



Disturbances of the soil and high atmospheric pressure are pre- 

 disposing factors. The exciting cause is unknown, but theories are 

 legion. The chief are : — 



(1) Arsenical Poisoning (Ross, 1900). It is based largely upon 

 finding arsenic in the hair of recent beriberi patients. Herzog 

 failed to find it in ten patients. 



(2) Oxalate Poisoning (Treutlein). When oxalates were given in 

 the food of fowls beriberi symptoms set in. The acid was 

 supposed to remove the calcium salts and so predispose to 

 nerve degeneration. 



Excess of calcium salts was found in the urine of beriberi 

 patients. 



(3) Carbon Dioxide Poisoning (Ashmead). The result of excessive 

 inhalation of carbon dioxide. Overcrowding alone, however, 

 does not cause it. 



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