QS ANDREWS. 



Clark of Hongkong, (l) in 1900, wrote of an epidemic of beri- 

 beri in the Berlin Foundling Home of that place. There was 

 nothing of particular interest in the outbreak except the early 

 age of the patients affected which varied from 4 to 7 years. 



The fact that the disease may attack still younger patients 

 apparently escaped the notice of the older writers on the subject. 

 Hirota first described the condition in infants. Although it has 

 been a number of years since his first contribution on the sub- 

 ject was published, still in only two countries (Japan and the 

 Philippine Islands) has infantile beriberi, as an entity, been 

 recognized and studied. In 1888 Hirota observed a peculiar 

 condition in some infants that were brought to his clinic. From 

 1888 to 1891 he reported 30 of these cases at a meeting of the 

 General Association of the Medical Society of Tokyo. (2) At this 

 time he noted the close similarity between the clinical findings of 

 beriberi in adults and the symptoms observed in these infants 

 and made a tentative diagnosis of "beriberi." Between 1891 

 and the latter part of 1897 he observed 38 more infants suffering 

 from the same condition. (3) He again noted the similarity of 

 clinical findings in beriberi in adults and the condition he had 

 described in infants and unconditionally called the disease from 

 which the infants were suffering "infantile beriberi." 



In 1900(4) he reported additional cases and again affirmed 

 the diagnosis of "infantile beriberi." Later, other workers (5) 

 performed necropsis upon similar cases and observed changes in 

 accord with Hirota's clinical findings. However, they did not 

 make sections of the nerves. But still other Japanese workers (6) 

 have amply confirmed Hirota's diagnosis by clinical and necropsy 

 findings, including the sectioning of nerves. 



Because of the high death rate among infants in the Philip- 

 pines, the subject of infant mortality has always been one of 

 great interest here. It has claimed the attention of many mem- 

 bers of the medical profession as well as of laymen from time 

 to time. As early as 1886 a medical symposium (7) was held in 

 Manila on the subject of infant mortality. Seven papers were 

 presented at this meeting, and the one which won the prize con- 

 sidered taon or suba as a synonym of infantile convulsions and 

 eclampsia. It may be mentioned that the sickness which carries 

 off so many infants here is called taon, taol, or suba by the native 

 laity. 



Some years later, Manuel Gomez Martinez (8) attributed this 

 sickness of infants to a nervous breakdown due to gastralgia 

 and intestinal colic produced by digestive disturbances. 



