INFANTILE BERIBERI. 69 



In 1904, M. S. Guerrero, (9) in an article on The Etiolopry, Symp- 

 tomatolog-y, Clinical Forms, Diagnosis, and Pathogenesis of 

 Beriberi in Children, based his observations on 103 clinical cases 

 of tao7i. He came to the conclusion that faon was similar to a 

 disease described by Hirota as occurring in Japan in children 

 nursed by mothers suffering from beriberi and called by Hirota 

 "infantile beriberi." This paper was read before the Colegio 

 Medico-Farmaceutico de Filipinas and, although it was received 

 with considerable skepticism, nevertheless, it produced a com- 

 plete revolution of ideas concerning ianii. Guerrero performed 

 no necropsies and his conclusions were based solely on his clinical 

 observations. In the following year, 1905, the native doctors, 

 without attempting to confirm Guerrero's conclusions by nec- 

 ropsy, began attributing death to "infantile beriberi," and the 

 number of such death certificates has gradually increased to the 

 present time. 



Four years later, in 1908, Jose Albert (lO) described the clin- 

 ical and pathological findings in a case of infantile beriberi. 

 So far as I have been able to ascertain this was the first attempt 

 in the Philippine Islands to confirm the clinical diagnosis in these 

 cases by necropsy. In this case the pathological findings amply 

 confirmed the clinical observations, degeneration of the nerves 

 even being demonstrated. 



In the latter part of 1909, the Bureau of Health attempted to 

 confirm, by necropsy, the clinical diagnoses appearing upon the 

 death certificates of infants in Manila. In examining the death 

 certificates of infants of 1 year of age and under, it was found 

 that in a large majority of them death was attributed to "con- 

 vulsions," "congenital debility," "beriberi," "acute bronchitis," 

 "acute meningitis," or "enteritis." At first, necropsies were per- 

 formed in all cases in which death had been attributed to "acute 

 meningitis;" later with regard to congenital debility, convulsions, 

 beriberi, acute bronchitis, and enteritis. The results were start- 

 ling and appeared in a paper by McLaughlin and the writer fiD 

 which was presented at the first biennial meeting of the Far East- 

 ern Association of Tropical Medicine held in Manila in March, 

 1910, and was published in July, 1910. In this paper, we pre- 

 sented the pathologic findings observed at necropsy of 219 infants 

 under 1 year of age. Of this number, we found 124, or 56.6 per 

 cent, to have died of a condition which we called infantile beriberi. 

 Neither of us had been able to see the cases clinically and the 

 history obtained by the medical inspector was quite meager. 



Three months later M. S. Guerrero and Joaquin Quintosn2) 



