364 ETIOLOGY OF BERIBERI. 



epigastric pulsation but no cardiac throbbing ; the point of maxi- 

 mum impulse was not distinctly visible nor palpable ; there were 

 no murmurs; he complained of pain from his waist down; the 

 legs were distinctly oedematous; there was slight tenderness of 

 the calves; the knee jerks were active; the urine contained no 

 albumin nor casts. It became necessary to change to the regular 

 prison diet two days later. 



CASE NO. 22 (GROUP IV). 



Diet: White rice 92 days, together with the 1 Total period of experi- 



special diet common to all the groups. J ment, 92 days. 



Dried codfish and potatoes were added to the diet on the 81st day. 



Following is a summary of the notes of the case: Sparely 

 nourished man; percussion of the lungs shows no distinct area 

 of dulness; the respiratory sounds are somewhat enfeebled at 

 the apices ; there is no tubular modification and no rales are pres- 

 ent; the area of cardiac dulness is not increased beyond the 

 normal limits; the point of maximum impulse is not visible nor 

 palpable; the sounds are clear at the apex and base; there is no 

 epigastric pulsation ; the pulse is 72, and the systolic blood pres- 

 sure 120 millimeters Hg (Faught) ; the abdomen is prominent. 

 The liver and spleen are not enlarged; the knee jerks are active. 



The earlier notes of the case are otherwise not important. 

 The patient lost but 1.8 kilograms (4 pounds) in weight during 

 the first sixty-one days of the experiment. The knee jerks 

 remained active. On the sixty-eighth day the systolic blood 

 pressure was 110 millimeters Hg. On the seventy-second day 

 he complained of soreness of the throat. There was nothing 

 apparent to account for the complaint, though he continued to 

 complain of this symptom during the following days. On the 

 eighty-first day dried codfish and potatoes were added to the 

 diet. On the eighty-third day he complained of no pain except 

 in the throat after eating. The heart sounds were clear; the 

 cardiac dulness was apparently not changed ; there was no throb- 

 bing over the cardiac area, and but slight epigastric pulsation; 

 the pulse was 70; there was marked oedema of the legs, but no 

 tenderness; the knee jerks were very active. On the eighty- 

 eighth day the pulse was 72. There was no complaint of pain, 

 but the throat was still sore ; there was marked oedema of the legs, 

 but the knee jerks were active. On the ninetieth day the knee 

 jerks were still active. The marked oedema of the legs con- 

 tinued; there was no tenderness of the calves. On the ninety- 

 second day it became necessary to discontinue the diet. The 



