ETIOLOGY OF BERIBERI. 369 



centimeters to the left of the median line; the area of dulness 

 is not distinctly increased either to the right or to the left; the 

 first sound at the apex is prolonged, the second aortic markedly 

 accentuated; there is no reduplication of the sounds; the pulse 

 is 90; there is no oedema of the legs and no pain in the calves; 

 the knee jerks are active. On the eighty-ninth day the note 

 shows that there was no apparent change in his condition. The 

 knee jerks were active. There was no oedema and no pain in 

 the legs. The pulse was slow. He had gained 0.G8 kilogram 

 (1.5 pounds) in weight. His condition remained about the same 

 until it became necessary to discontinue the diet on the ninety- 

 second day of the experiment. On this day the following note 

 was made : Nutrition good ; abdomen prominent ; pulse 80 ; very 

 slight epigastric pulsation ; no visible pulsation over the cardiac 

 area ; point of maximum impulse not visible ; palpable 7.5 centi- 

 meters to the left of the median line; there is no tenderness of 

 the calves and no oedema of the legs; the knee jerks are active; 

 he states that he feels a little weaker than when he began the 

 diet; the urine was normal. Thirteen days after resuming the 

 regular prison ration he had gained 2.7 kilograms (6 pounds) 

 and stood at the same weight as at the time the experiment was 

 commenced. 



CASE NO. 25 (GROUP IV). 



Diet: White rice for 81 davs followed by 1 rr . , • j j- 



, . ^ ^^ , . ' ,. . ■ Total period of experi- 



red nee for 20 days, in addition to the \ 4. mi j 



. , ,. ,, , ment, 101 davs. 



special diet common to all the groups, j 



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



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

 ished man; examination of the lungs reveals nothing abnormal; 

 the examination of the heart shows no increase in the area of 

 cardiac dulness beyond the normal; the point of maximum im- 

 pulse is invisible ; it is palpable 7.5 centimeters to the left of the 

 median line and 1.5 centimeters below the nipple line; the heart 

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

 pulsation ; the pulse is 76, and the systolic blood pressure 100 

 millimeters Hg (Faught) ; the spleen is not palpable; the liver 

 flatness extends from the lower border of the fourth rib; the 

 liver is not palpable below the costal margin; the knee jerks are 

 active. 



The earlier notes concerning the case contained nothing of 

 importance, except that the patient lost in weight and by the 

 sixty-first day weighed 3.6 kilograms (8 pounds) less than when 



