ETIOLOGY OF BERIBERI. 287 



Shibayama"" reports that : 



In 1908, 1,195 cases of beriberi developed in the Blinjoe, one of the 

 mining' districts. Mine No. 3 was especially unfortunate, for IGf! out of 

 410 workmen contracted the disease, and mine No. 4 developed 118 cases 

 among 390. No. 5 had 400 workmen, and 97 of these were ill with beriberi; 

 on the other hand, the remaining mines showed but few ca.scs. For two 

 years the workmen had received unpolished, fre.sh rice, not only in mines 

 Nos. 3, 4, and 5, but also in No. 11, in which latter 49 out of 300 workmen 

 contracted the disease; on the other hand, the laborers in the remainder 

 always had polished and old rice. It may further be stated, according to 

 Hulshoff-Pol, that the workmen in all the mines received 1.50 grams 

 kadjang id jo beans, together with dried fish and fresh vegetables, daily. 

 The result of our observations, therefore, was as follows: 



1. Even if the workmen in the mines receive 150 grams of kadjang idjo 

 regularly every day, nevertheless beriberi occurs among them. 



2. Even if the laborers are given a diet of fresh, unpolished rice, never- 

 theless they develop more cases of beriberi than those in the other mines, 

 where they receive polished and older Java rice. 



I therefore could not find the assumption to be confirmed that unpolished 

 rice, which has the same composition as parboiled rice, could prevent beri- 

 beri. * * * 



All my observations lead me to the conclusion that uniform, but little 

 changing, monotonous diet predisposes to the disease. The condition of 

 nourishment of the Chinese in two of the mines of Banka was fairly 

 good, the total quantity of the chief constituents of diet, namely, protein, 

 fat and carbohydrates, was sufficient, but the diet was always one-sided 

 and not varied throughout the year. This is also true of the general 

 epidemic of beriberi aboard the steamship referred to above, and in the 

 fishing villages the one-sided diet was the only point to be observed. 



However, the one-sided or monotonous diet is only the predisposing cause 

 of beriberi; the true cause must be sought in other directions. * * * 



Montel,*^^ at the meeting of the Far Eastern Association of 

 Tropical Medicine held during the present year, reports the 

 occurrence of an epidemic of beriberi near Saigon which could 

 not be entirely explained by the so-called rice origin of the 

 disease. He calls attention to an instance in a monastery and a 

 convent where the conditions were more or less the same and 

 yet in one beriberi frequently occurred while in the other out- 

 breaks of the disease were never known. The monastery and 

 convent were located in the same area of the town and were only 

 separated by a small stream. In the monastery rice was con- 

 sumed a few days after it was hulled and no case of beriberi 

 occurred. In the convent much the same rice was used, but large 

 quantities were hulled at a time and stored, and in this institu- 

 tion beriberi outbreaks were quite common. 



•* This Journal, Sec. B (1910), 5, 124. 

 "Med. Rec. (1912), 81, 630. 



