84 ANDREWS. 



and fell over easily. As time passed these symptoms became more marked. 

 There was never paralysis. 



Necropsy. — Apparently a fairly well-nourished puppy. Feet oedematous. 

 Subcutaneous tissues very oedematous and anaemic. Slight increase of fluid 

 in the peritoneal cavity. Heart firm, normal. Increase of fluid in the 

 pericardial sac. Lungs congested and oedematous. Spleen normal. Kidneys 

 apparently normal. Liver dark red, normal. Stomach normal. Intestines 

 show a very few hookworms. 



Puppy which died December 31, 1911. — The puppy lost weight the first 

 two weeks but was sick and nursed but little several days of this time. 

 During the third week it gained in weight and its feet began to swell. 

 As the fourth week came on the oedema of the feet increased in amount 

 and the legs became weak, the ankles of its front feet turning under 

 it when it stood up. It staggered first to one side and then to the 

 other, stumbled on its ■ face, and in other ways exhibited a weakness or 

 loss of control of its muscles. It lost its footing easily. This condition 

 continued through the fifth and sixth weeks until the puppy died December 

 31, having nursed six weeks. 



Necropsy. — Body of an apparently well-nourished puppy. Feet and 

 ankles oedematous. Subcutaneous tissues oedematous and anaemic. Increase 

 of fluid in the peritoneal cavity. Pericardial sac shows slight increase of 

 fluid. Heart apparently normal. The lungs are congested and oedematous. 

 Spleen normal. Kidneys apparently normal. Liver dark-red, normal. 

 Stomach normal. Intestines contain a few hookworms. 



In all these necropsies the vagi, sciatic and intercostal nerves were 

 preserved and stained for degeneration. In all those examined a few 

 fibers were found in which degeneration was present. 



To summarize, all of these puppies showed incoordination and 

 weakness of the extremities, particularly of the hind legs. In all 

 slight degeneration of the peripheral nerves by the Marchi method 

 was demonstrated. All showed oedema and anaemia of the sub- 

 cutaneous tissues. These findings agree entirely with those of 

 the infants dying of beriberi. However, only one of the puppies 

 showed the dilation and hypertrophy of the right heart which 

 I have regarded as a constant finding in infantile beriberi. In 

 my opinion these experiments furnish, therefore, additional 

 evidence that the condition described as infantile beriberi is due 

 simply and solely to the ingestion of the mother's milk. 



DISCUSSION. 



Without doubt in these infants we are dealing with cases of 

 infantile beriberi. The clinical picture and the anatomic findings 

 all point to this. In all cases the child is breast fed, and 

 with the manifestation of symptoms in the infant the mother 

 likewise shows some symptoms. Occasionally the symptoms in 

 the mother are not apparent on the first examination, but will 

 appear later if the child continues nursing. Infrequently we 



