86 ANDREWS. 



beriberi does little good. However, with a change of diet to 

 artificial feeding, the child rapidly improves unless the disease is 

 too far advanced. The dyspnoea disappears, the heart becomes 

 quiet, restlessness ceases, and peaceful slumbers follow. If 

 aphonia has been present, it remains usually for several weeks 

 but eventually subsides. Because of poverty a wet nurse is 

 impossible, and it is usually hard in the Philippines to find one 

 who does not show some symptoms of beriberi. Even with 

 artificial feeding the child is not safe; although it has escaped 

 death from beriberi it is likely to contract an acute gastro- 

 enteritis. Because of poverty and ignorance, artificial feeding 

 is practically impossible at the present time by these people. 

 Furthermore, unless the condition is too far advanced, a change 

 in the mother's diet with the child still nursing will bring about 

 a cure in both mother and child. One such case came into the 

 wards of the University Hospital on December 20. The mother, 

 a primipara, was 20 years old and her infant 6 weeks old. The 

 mother was suffering from such pain and numbness in the legs 

 that she could hardly stand and it was with considerable dif- 

 ficulty that she could walk. Areas of anaesthesia and numbness 

 with formication were present in both legs. Knee reflexes were 

 lost. The child was cyanotic in the face and very restless, and 

 while dyspnoea was constantly present there were periodic attacks 

 in which it was more marked. The second pulmonic sound was 

 accentuated. The child had no fever. The temperature was 

 taken every three hours for six days and the maximum regis- 

 tered was 37°. 2 C, the minimum 35°. 8 C. On entrance of the 

 child into the hospital, the pulse, was 140 per minute; the res- 

 piration, 50 per minute. The mother was placed in the ward 

 and given the usual hospital diet, except that undermilled rice 

 was substituted for the white rice and mongos were given in 

 addition. Both mother and child made an uninterrupted 

 recovery and were discharged from the hospital cured, January 

 9, 1912. 



As there seems to be a relation between the disease and the 

 mother's milk and as the artificial feeding of the infant is 

 attended with so much danger, the Filipino doctors have recog- 

 nized the importance of changing the mother's diet and making 

 it as nearly a balanced ration as the poverty of the people will 

 permit. As the undermilled rice is not available in the open 

 market, thej'' advise the use of mongos, a leguminous vegetable 

 very similar to the cow peas of the United States. 



In our paper written two years ago we showed that the death 

 rate of infants of 1 year of age and under was practically 50 per 



