276 STRONG AND CROWELL. 



VIEWS OF SOME PREVIOUS INVESTIGATORS.^^ 



The idea that beriberi is a disease which may have a dietetic 

 causation is a very old one. Van Leent, as early as 1867,^^ 

 writes : 



The principal cause of beriberi is recognized as being a diet too uniform, 

 insufficient, and of bad quality. The body, deprived of indispensable ele- 

 ments for the maintenance of the normal composition of the blood and con- 

 sequently of its nutrition, becomes impoverished little by little. 



Later, in 1880,^® van Leent regards the cause of beriberi as due 

 to too small a proportion of albuminous substances or of fat in 

 the diet. 



The Anglo-Indian physicians at an early period pointed to an 

 insufficient diet or a diet not corresponding to the needs of the 

 body, such as the exclusive or preponderant use of rice and of 

 dried fish as a cause of the malady, and many observers in the 

 Dutch East Indies and Japan assigned such a cause the first 

 place in the etiology.^^ 



A similar view was held by Maget and Wernich*" who studied 

 the disease in Japan. The latter wrote: 



Rice, as the exclusive food of the people, is answerable for beriberi in 

 a quite special way. Not, however, as some have thought, because it is used 

 in a decomposed state, but because it is used in such quantities that the 

 power of assimilation is gradually lost for other kinds of food; and even 

 the large quantity of rice is unable to render the nutrition and blood-making 

 adequate; although the Japanese diet contains albuminous elements in the 

 form of fish and bean-cheese, these are not sufficient. 



Takaki" believed that beriberi is caused by the disproportion 

 of nitrogenous and nonnitrogenous elements (nitrogen and 

 carbon in food) ; that is, the amount of the nitrogenous was in- 

 sufficient and that of the nonnitrogenous excessive. Up to 

 1883 the cases in the navy in Japan averaged over one-fourth of 

 its strength and in that year there were 1,236 cases of beriberi 

 '^tamong 5,349 men. In 1884 the diet was changed, a larger pro- 

 portion of nitrogenous food being given, and in 1885 there were 



" In this consideration of the previous investigations of other authors only 

 those relating to the occurrence of beriberi in the Tropics have been 

 reviewed and not those, with one exception, relating to ship beriberi. 



''Arch. d. Med. Nav. (1867), 241. 



''Genees. Tijd. v. Ned. Ind. (1880), 9, 295. 



^^ Hirsch's Handbuch der historisch-geographischen Pathologic (1883), 

 2, 414. 



*" Geographisch-medizinische Studien. Berlin (1878), 193. 



"" Lancet (1906), ^, 1371, 1451, 1520. 



