ETIOLOGY OF BERIBERI. 317 



one-half days might have been due tu old pulmonary trouble. 

 However, there were no rales present in the lungs, and the spu- 

 tum was negative for tubercle Ijacilli. On the fifty-seventh day 

 he returned from the prison hospital. However, he continued to 

 lose in weight. On the seventy-fourth day he was found lying in 

 bed, complaining of weakness and of soreness "all over the body," 

 and of a sense of tightness about the neck. He stated that when 

 he moved his hands and legs they seemed stiff. He ate nothing at 

 noon. The pulse was 130; the interval between the heart sounds 

 was evenly spaced (pendulum spacing) . There was no accentua- 

 tion or reduplication of the second sounds at the base, and no 

 murmurs were present. There was visible pulsation of the ves- 

 sels of the neck. The point of maximum impulse was not dis- 

 tinctly visible nor palpable. The respirations were increased 

 in number. At 4 p. m. he still would not eat. The pulse was 

 slower and occasionally missed a beat. On the seventy-fifth day 

 the following note was made: The pulse is 110; the heart sounds 

 have the same equal spacing. On the seventy-seventh day, the 

 patient feels much better, is up, and eating. Seventy-eighth 

 day: Continues to feel much better, no change in heart sounds. 

 Continues to lose in weight. Eighty-first day: He has recovered 

 from all subjective symptoms and states that he feels well. On 

 the eighty-fifth day the systolic blood pressure was 90 millimeters 

 Hg. On the eighty-eighth day the note was made as follows : 12 

 m. in bed again; pulse 104; respirations 40; complains of feeling 

 hot, and of tingling and pains in the fingers and toes, and of 

 headache; 4 p. m. pulse 96, respirations 24; complains of pain all 

 over the body, and will not eat. Eighty-ninth day, condition of 

 patient much the same. Ninetieth day, pulse 100. Complains of 

 headache, weakness, no appetite, and pains from the knees to the 

 toes and from the elbows to the fingers. No areas of distinct 

 anaesthesia found. During the whole time of the experiment the 

 knee jerks were absent. On the ninety-first day the note was 

 made that a severe catarrhal conjunctivitis had developed for 

 which treatment was given. Pulse 100, respirations 18. Mark- 

 ed pain in the fingers and toes. Ninety-fifth day, has been in bed 

 two days, complaining of pains throughout the body; pulse 120. 

 There is no distinct increase in the area of cardiac dulness. The 

 heart sounds are evenly spaced. Owing to the complaints of 

 this prisoner, it became necessary to change his diet, and on the 

 ninety-seventh day red rice was substituted for white rice, and 

 dried codfish and potatoes were added to the diet. On the 

 ninety-ninth day the note was made : There is no throbbing over 



