ETIOLOGY OF BERIBERI. 297 



maximum impulse was invisible; it was palpable 5.5 centimeters 

 to the left of the median line and 3 centimeters below the 

 nipple line; the heart sounds were clear at the apex and base; 

 there was no visible epigastric pulsation ; the pulse was 82, and 

 the systolic blood pressure 124 millimeters of mercury '" 

 (Faught) ; the area of liver dulness was not increased ; the spleen 

 was not palpable ; the knee jerks were active. 



The subject soon objected to the taste and odor of the 

 rice mixed with the polishings and lost in weight. As soon as 

 a sufficient amount of fresh extract of polishings was prepared, 

 this was substituted for the polishings themselves. However, 

 while after a time he ate more, he continued to lose in weight. 

 (See accompanying chart.) Reference to the table placed after 

 the last case of the group on p. 308 will show the amount and 

 kind of food consumed each day. The earlier notes in regard 

 to the case are otherwise unimportant. On the eighty-first day 

 of diet, the knee jerks were found to be very active. He com- 

 plained slightly of cloudiness of vision. On the eighty-fifth 

 day of diet he remained in bed and complained of pain in the 

 abdomen and neck. The knee jerks were still very active. The 

 voice was husky. The pulse, when standing, was 160, and epi- 

 gastric pulsation was present. The point of maximum impulse 

 was still invisible. The heart sounds were clear. There was 

 very slight oedema of the legs and slight pain in the calves of the 

 legs. Pain was elicited on pressure. The skin was moist and 

 cool, but he stated that he felt hot. No distinct areas of anaes- 

 thesia of the skin were discovered. There was no fever. On 

 the eighty-seventh day the patient was still in bed. The voice 

 was very weak and husky, at times whispering, and he com- 

 plained of numbness of the fingers and tenderness of the calves 

 of the legs. The knee jerks were active. On the ninetieth day 

 of diet he seemed better. On the ninety-fifth day the knee jerks 

 were active, the voice was still very weak and harsh. There 

 was no cough, no sore throat, nor other evidences of a laryngitis, 

 and no pfein in the throat. Owing to the many complaints re- 

 ceived from this prisoner undergoing the experiment regarding 

 his diet, and to his loss in weight, and that of a number of the 

 other prisoners comprising this group, the prison authorities 

 felt that it was necessary to give them additional articles of 

 food. Therefore, dried codfish and potatoes were added to the 

 diet. On the ninety-eighth day the voice seemed a little stronger. 



'* Hereafter in the paper, the symbol Hg will be used for mercury. 



