ETIOLOGY OF BERIBERI. 



325 





DAYS OF DIET 

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CASE NO. 11 (GROUP ll). 



Diet: White rice 97 days, together with the special diet common to all the 

 groups. 



Following is a summary of the notes of the case : Fairly well- 

 nourished man ; auscultation and percussion of the lungs shows 

 nothing abnormal ; examination of the heart shows no increase in 

 the area of cardiac dulness beyond the normal ; the point of maxi- 

 mum impulse is not visible; it is palpable 8 centimeters to the 

 left of the median line and 2 centimeters below the nipple line; 

 there is no epigastric pulsation ; the heart sounds are clear ; the 

 pulse is 80, and the systolic blood pressure 110 millimeters Hg 

 (Faught) ; the liver dulness extends from the lower border of the 

 fourth rib to the costal margin; the spleen is not palpable; the 

 knee jerks are very active. 



The patient lost but 1.3 kilograms (3 pounds) in weight up to 

 the fiftieth day of the diet. On the thirty-fifth day erosions 

 appeared on the corners of the lips. These were touched with a 

 solution of silver nitrate. The notes are otherwise unimportant 

 up to the forty-ninth day, when oedema of the right leg above the 

 ankle was noted. The knee jerks were normal or increased. By 

 the fiftieth day the oedema of the ankle had subsided. On the 

 fifty-third day he complained of soreness of the left eye and of 

 headache. On the sixty-fourth day at noon he vomited. He com- 

 plained of no pain, and there was no fever. His food was left 

 with him. On the sixty-fifth day he felt better and was eating 



