ETIOLOGY OF BERIBERI. 



359 



pulsation visible in the second left interspace; the apex beat is 

 diffuse but not visible outside the nipple; the area of dulness is 

 not distinctly increased; both heart sounds are forcible and 

 clear; the second pulmonic sound is accentuated; the pulse is 

 100; he complains of pain in the legs and in the arms; slight 

 oedema of the legs has developed; the knee jerks are very weak. 

 On the eighty-ninth day the following note was made: Slight 

 oedema of the legs continues; there is no complaint of pain; the 

 pulse is slow. On the ninetieth day the note reads: Knee jerks 

 very weak ; slight oedema of the legs and no tenderness. On the 

 ninety-second day it became necessary to discontinue the diet. 

 The note made on this date reads as follows : Fairly well nour- 

 ished; pulse 88 before and 104 after slight exercise, of good 

 volume, tension somewhat increased ; epigastric pulsation visible ; 

 the point of maximum impulse is visible and palpable 7.5 centi- 





DAYS OF DIET 



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