ETIOLOGY OF BERIBERI. 283 



To one party white z-ice (No. 2 Siam) was issued as the staple article 

 of diet, and to the other party parboiled rice. In about three months cases 

 of Beri-Beri bejran to occur amonj^: the members of the party on white rice. 

 When a certain number of cases had been noted white rice was discontinued 

 and thereafter no cases occurred. No sijifn of the disease appeared among 

 the control party on parboiled rice. 



The conditions were then reversed. The party hitherto on parboiled 

 rice were given white rice and after a somewhat longer interval than in 

 the first instance, Beri-Beri broke out in this group also. This outbreak 

 ceased on discontinuing the issue of white rice. Again no sign of the 

 disease appeared among the control party on parboiled rice. By the 

 transfer of individuals suffering from Beri-Beri and of whole groups in 

 which the disease was occurring it was found possible to test the influence 

 of place considered as a nidus of infection and also to test the possibility 

 that the disease was communicable from one individual to another. 



The average daily ration was as follows — 



Rice 



21.3 oz. 



603 



grammes. 



Dried salt fish 



4.25 " 



120 





Onions 



1.75 " 



50 





Potatoes 



1.75 " 



50 





Coconut oil 



0.85 " 



24 





Coconut 



1.50 " 



42 





Tea 



0.12 " 



3.4 





Salt 



0.1 " 



2.8 





The symptoms and subsequent histories of the cases which de- 

 veloped beriberi during the course of the investigation are not 

 given in Fraser and Stanton's publication and merely the dates 

 are stated on which the patients developed the disease, though 

 Fraser and Stanton write with regard to party No. 1-B : 



It is proper to mention here that in determining whether a given case 

 was to be admitted as a case of Beri-Beri the most rigid exclusion was 

 practised. Only such cases as presented unequivocal signs of the disease 

 were admitted. In every instance the diagnosis was based on the opinion 

 of at least two medical men, in most instances on that of four. Where 

 any doubt was cast upon the accuracy of the diagnosis such case was 

 rejected. The result therefore is that, apart from the cases here recorded, 

 there were many others which, in the opinion of the writers as well as 

 of those associated with them in this inquiry, were really mild or obscure 

 cases of the disease. The difficulties in this respect will be appreciated 

 by those who have had to deal with the disease clinically. No such doubtful 

 case was at any time observed among the people on parboiled rice and 

 the inclusion of cases of this type occurring in the white rice parties in 

 no way streng^thens the case for an infectious origin of the disease. 



The conclusions arrived at as a result of their inquiry were 

 stated as follows : 



Twenty cases of Beri-Beri occurred among 220 people on white rice. 

 No case occurred among 273 people on parboiled rice and under similar 

 conditions to those which obtained in the white rice parties at the time 

 Beri-Beri was prevalent among them. 



