INFANTILE BERIBERI. 85 



Hnd a moLlier siio\vinj>: symptoms oi' the disease and the child 

 apparently free, but with continued watching, sooner or later, 

 symptoms will appear in the infant. 



The history of the mother shows that invariably her diet con- 

 sists of white rice and fish or meat; rarely of a vegetable or 

 any fruit. When taken for a sufficient length of time such a 

 diet leads to beriberi according to the present ideas that obtain 

 as to the etiology of beriberi in the adult. 



The woman before pregnancy probably exhibited symptoms of 

 beriberi, as many of the natives do. When the necessity arises 

 for providing the material for a new being, as she is called upon 

 to do in pregnancy, the strain becomes too great. The latest 

 works on the etiology of adult beriberi consider this disease not 

 as an infection or toxsemia, but as the result of an improperly- 

 balanced diet. Further proof that this condition is not due to 

 an infection* or toxsemia is aflorded by the recent work of Cham- 

 berlain and Vedder in which they made an extract of tiqui tiqui 

 (rice polishings), and by feeding this extract to chickens pre- 

 vented the development of polyneuritis in them. They (16) also 

 treated infants suffering from taon or infantile beriberi witlj 

 this extract, and the improvement in the symptoms was prompt 

 and striking. In one suffering from this disease there is some- 

 thing lacking in the diet which is essential to the normal growth 

 and development of the nerves. When this substance is defi- 

 cient in the mother's diet it is highly probable that it will also 

 be deficient in her milk, and hence both the mother and child 

 will suffer. Probably with a deficiency in her diet the mother 

 draws on her own store-house for this substance for her child, 

 thus diminishing her own supply and producing the disease in 

 herself. This probably accounts for the variation in time in the 

 development of symptoms in the infant and its mother. 



In the records of the Bureau of Health the death certificates 

 show^ that infantile beriberi is more prevalent in the wet season. 

 I think this is due, not to the effect of the season per se on the 

 child, but to the relation it has to the growing crops. After the 

 rainy season, usually in November, vegetables and fruits begin 

 to come into the market in increasing quantity. These com- 

 modities decrease in price and they are available as food to a 

 larger number of people. These foods become scarcer with the 

 beginning of the rainy season ; prices go up with a consequent 

 shutting off of the supply to the poorer classes. 



It has been recognized for some time among Filipino physi- 

 cians that the ordnary medication in these cases of infantile 



