286 STRONG AND CROWELL. 



nection between the rice eaten by the prisoners and the beri-beri from 

 which they suffered. 



Some years having elapsed since the date of the above experiment, I 

 thought it advisable to, if possible, confirm the results then arrived at by 

 a somewhat more extensive observation carried out under conditions which 

 would exclude all possibility of error. The institutions selected for ob- 

 servation were the Pudoh Gaol, the Tai Wah Institution and the Leper 

 Asylum. 



The Tai Wah Institution is set apart for the care of persons suffering 

 from incurable disease, or who are unable to support themselves. On 

 October 31st, 1902, there were fifty-one patients in the wards, all of 

 Chinese nationality. These Chinamen were, almost without exception, for- 

 merly employed as coolies, and were drawn from the same class as the 

 inhabitants of the Pudoh Gaol. Of the fifty-one patients, forty-three, or 

 84.5 per cent, had been continuously in the hospital for over seven months. 



The Leper Asylum is, as its name implies, exclusively set apart for the 

 treatment of lepers. On October 21st, 1902, there were 131 patients in 

 the wards, of which 129 were Chinese and two Tamils. One hundred and 

 eighteen, or 90 per cent, of the inmates had been continuously in the 

 Asylum for more than seven months. 



The two hospitals referred to and the Pudoh Gaol are supplied with 

 Rangoon rice by the same Chinese contractor; it is purchased from a 

 merchant in Penang, it is taken delivery of at the Kuala Lumpur Railway 

 Station and is removed to a store in the town. This store is light, clean 

 and well ventilated. The rice is kept on a platform raised from the 

 ground, and is distributed to the various hospitals as required. At no time 

 is more than three weeks' supply kept in the store, and the bags of rice 

 are taken out and sent to the various institutions without selection of any 

 kind. 



In the Pudoh Gaol, the Tai Wah Institution and the Leper Asylum we 

 have three institutions, the inhabitants of which are of the same nationality, 

 and the Rangoon rice consumed by them is supplied from the same source, 

 by the same contractor. It would be reasonable to suppose that if the 

 disastrous outbreaks of beri-beri in one of them — the Pudoh Gaol — were 

 caused by a toxin conveyed by Rangoon rice, the patients in the other two — 

 the Tai Wah Institution and the Leper Asylum — should suffer from 

 beri-beri in the same way as the inmates of the prison. This, however, 

 is not the case, and no outbreak of beri-beri has at any time occurred in 

 either the Tai Wah Institution or the Leper Asylum. 



From January 1st to October 31st, 1902, 291 fresh cases of beri-beri 

 occurred among the prisoners in the Pudoh Gaol, whereas not a single case 

 of beri-beri occurred among the patients at the Tai Wah Institution or 

 Leper Asylum. This, I think, disposes of the theory of the connection of 

 beri-beri with the consumption of rice.^" * * * 



The Pudoh Gaol has now, after having been scourged by beri-beri for 

 nearly seven years, been free from the disease for seven months. Although 

 there is still some doubt as to the actual cause of the outbreak, it is hoped 

 that our experience of the disease among the prisoners may not have been 

 entirely valueless, and that some hitherto obscure points may have been 

 elucidated by the various observations carried out. 



" Italics are mine. R. P. S. 



