INFANTILE BERIBERI. 87 



cent of the total death rate of Filipinos. Further, we showed that 

 this was more than two and one-half times higher than the death 

 rate of such infants in the United States or in European countries. 

 We stated that in Manila practically 75 per cent of the deaths of 

 infants occurred among the breast fed, while in Germany the 

 breast-fed infants numbered from 12 to 15 per cent of the total. 

 In this same paper ' we stated further : 



In the Philippines the mortality is greatest amont!; breast-fed children, 

 possibly because of the poor quality of the mother's milk. The latter is 

 probably deleterious by reason of what it lacks rather than because of 

 any harmful constituent. The averaj^e Filipino mother is in poor physical 

 condition, many of them are beriberic and subsist upon a diet favorable 

 to [the production of] beriberi. It seems probable that there is an intimate 

 relation between beriberi of infants and a mother's milk poor in quality 

 and lacking certain necessary elements which are not included in the 

 mother's dietary. * * * ^ possible solution of the problem lies in 

 improvinfif the quality of the mother's milk and encouraging- the continuance 

 of the custom of breast-feeding so general among the Filipino poor. The 

 improvement of the physical condition of the Filipino mother and of the 

 quality of her milk is an economic question. Her condition is the result 

 of poverty and therefore insufficient and unsuitable food, especially during 

 the periods of pregnancy and lactation. 



In this connection I want to emphasize again that "the im- 

 provement of the physical condition of the Filipino mother 

 and of the quality of her milk is an economic question" of 

 the highest importance to Manila. Fifty per cent of the total 

 number of deaths of Filipinos in Manila is of infants 1 year 

 of age and under. Over fifty per cent of these is due to infan- 

 tile beriberi. Since the recent advances in our knowledge 

 of the etiology of beriberi indicate that this appalling condition 

 may be stopped or at least checked by the substitution of under- 

 milled rice for white rice in the daily diet of this people, it cer- 

 tainly behooves us to become active in some measures of relief. 

 Just the modus operandi for bringing this about would have to 

 be determined. It might be possible, perhaps, to require all 

 dealers handling rice to keep a stock of the undermilled variety 

 on hand, and then, by the introduction of a campaign of educa- 

 tion among the people with especial reference to pregnant women, 

 it may be possible to do considerable to relieve the situation. 



The mothers are crying for relief. They realize that they 

 are begetting children only for them to be seized after one or two 

 months by the scourge tao7i or suba. Time after time we obtain 

 the history that the mother has had 3, 5, or 6 children all of 

 whom have died of this disease. 



' p. 159. 



