408 The Philippine Journal of Science ™™ 



of the Philippine General Hospital operating with the United 

 States Army Medical Department Research Board. The pa- 

 tients examined were those in whom the diagnosis of beriberi 

 had been made by this committee as a whole. The work done 

 consisted in the determination of the basal metabolic rate, the 

 urinary nitrogen, the respiratory quotient both for total com- 

 bustion and for nonprotein combustion, and the fraction of the 

 total heat derived from protein, fat, and carbohydrate, respec- 

 tively. For these determinations the technic of Boothby and 

 Sandiford(4) was followed, with estimation of nitrogen by the 

 Folin micro-Kjeldahl method. In addition, determinations of 

 blood sugar, nonprotein nitrogen, urea nitrogen, and creatinine 

 were made by the system of Folin and Wu,(7) and of uric acid 

 by the new method of Benedict. (3) 



The data obtained are negative as pertaining to a definite 

 pathological process in beriberi. However, the negative evi- 

 dence is of interest as showing a metabolism essentially normal 

 in a disease in which dietary factors loom so large. These fac- 

 tors are chiefly two : the lack of an essential element, the vita- 

 mine ; and a very high carbohydrate content of the diet. With- 

 out discussing the question of how far vitamine deficiency can 

 be considered an active factor in beriberi or taking up the 

 question of infection as a causative agent, either direct or 

 indirect in connection with the vitamine, two points may be 

 noted. The first is that, unlike the experimental animals 

 studied by Jansen and Mangkoewinoto, by Anderson and Kulp, 

 and by Mattill, which were kept under a known vitamine defi- 

 ciency, the patients studied in the present work, while in hospi- 

 tal, were kept on a diet rich in sources of vitamine B. The 

 clinical symptoms of a polyneuritis may have been the residual 

 result of a previous vitamine deficiency, this residuum being 

 slow of regeneration, while the patients were, at the time 

 studied, restored to a normal metabolism by the diet used in 

 treatment. This possibility is realized. Against it the results 

 of the work on animals by the investigators named must be 

 cited. 



Aub(2) and others have shown that the secretion of the 

 suprarenal glands has a marked influence on the metabolic 

 rate, raising this rate independently of action of the thyroid. 

 This action, while appearing more quickly than that of the 

 thyroid, is not so lasting. Since McCarrison(ll) found hyper- 

 trophy of the suprarenals a prominent feature of beriberi, 

 some expectation of an increased basal metabolic rate in these 



