ETIOLOGY OF BERIBERI. 301 



complaint of pain. The knee jerks are active. The condition 

 of the patient continued about the same. On the one hundred 

 eighth day of diet when it became neces.sary to discontinue 

 the experiment, owing to the reasons ah'eady stated under the 

 previous case, the following note was made: Subject rather 

 sparely nourished; pulse, 104 and of fair volume; quite moderate 

 epigastric pulsation ; no visible throbbing over cardiac area ; apex 

 beat not distinctly visible and indistinctly palpable. Area of 

 cardiac dulness not increased. The heart sounds are clear. The 

 tongue is clean and the conjunctivae of good color. There is no 

 pain nor tenderness of the legs and no oedema of the legs. The 

 knee jerks are active. He says he feels weaker than at the begin- 

 ning of the experiment. The urine contained no albumin nor 

 casts. 



CASE NO. 3 (GROUP l). 



Diet: White rice + rice polishings for 13 days 



followed by white rice + extract of polish- 



ings for 95 days, together with the special 



diet common to all the groups. 

 Dried codfish and potatoes were added to the diet on the 97th day 



Total period of experi- 

 ment, 108 days. 



Following is a summary of the notes of the case: The subject 

 is fairly w^ell nourished; percussion and auscultation of the 

 lungs reveals nothing abnormal; on examination of the heart, 

 the area of cardiac dulness is not increased; the point of maxi- 

 mum impulse is invisible, but is palpable 7 centimeters to the 

 left of the median line and 1.5 centimeters below the nipple. 

 The pulse is 84, and the systolic blood pressure 110 millimeters 

 Hg (Faught). There was no epigastric pulsation. The liver 

 and spleen were not enlarged. The knee jerks were active. 



The patient lost steadily in weight, but the notes of his con- 

 dition during the earlier part of the experiment are otherwise 

 unimportant. By the eighty-first day he had lost 4.5 kilograms 

 (10 pounds). On this day he remained in bed, complained of 

 being sick, and refused to eat. His temperature was normal 

 (37° C), pulse 112, respiration 28. He complained of head- 

 ache and pain in his stomach and stated that he had vomited 

 twice during the night. There was slight visible epigastric 

 pulsation, but no throbbing visible over the cardiac area. On 

 the eighty-second day at noon the pulse was 78. He was eat- 

 ing but little. He complained of severe headache. At 4 

 o'clock in the afternoon he was still sick, pulse 109. He com- 

 plained of pain in his stomach and of pulsation in his abdomen. 

 On the eighty-third day at noon he seemed weak, his pulse was 



