ETIOLOGY OF BERIBERI. 303 



oedema of the legs; the pulse was 88; the knee jerks were active; 

 the conjunctivitis was treated. On the one hundred fifth day 

 the condition of the eyes was improving. For the reasons al- 

 ready stated under case No. 1, it became necessary to discon- 

 tinue the experiment. On the one hundred eighth day the note 

 made was as follows: The nutrition is fair; pulse 94 and of 

 good volume; moderate epigastric pulsation; point of maximum 

 impulse not distinctly visible nor palpable; no increase in the 

 area of cardiac dulness; first heart sound somewhat prolonged 

 at apex; no distinct murmur; the pain and tenderness in the 

 legs has disappeared; there is no oedema of the legs; the knee 

 jerks are active; the voice is still somewhat harsh, and the con- 

 junctivitis marked; he says he feels weaker than before the ex- 

 periment; he has lost 4.5 kilograms (10 pounds) during the 

 experiment; the urine is normal. Twelve days after being 

 placed upon the regular prison ration he had gained 1.8 kilo- 

 grams (4 pounds) ; his voice gradually resumed its normal tone. 

 Possibly this prisoner also had already symptoms of beriberi. 



CASE NO. 4 (GROUP l). 



Total period of experi- 

 ment, 97 days." 



Diet: White rice + rice polishings for 13 days 

 followed by white rice + extract of polish- 

 ings for 84 days, together with the special 

 diet common to all the groups. 



Following is a summary of the notes of the case : Well-nour- 

 ished man; expansion of chest good; auscultation and percus- 

 sion of lungs normal; examination of heart shows no increase 

 in area of dulness beyond the normal; point of maximum im- 

 pulse invisible and just recognizable on palpation, 8 centi- 

 meters to left of median line and exactly in the nipple line; the 

 heart sounds are clear at both apex and base ; there is no special 

 accentuation of either second sound at the base, though the 

 second aortic seems sharper in the second interspace; there is 

 no epigastric pulsation; the pulse is 80, and the systolic blood 

 pressure 140 millimeters. 



The prisoner lost a few pounds in weight during the first two 

 weeks of the experiment, as did the other members of the group. 

 The earlier notes are unimportant regarding his condition. 

 The knee jerks remained active. He gained 2.2 kilograms (5 



" This prisoner refused to continue the diet after ninety-seven days and 

 was returned to the regular prison ration at the request of the prison 

 authorities. 



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