230 HEISER. 



locally polished rice, almost invariably contained less than 0.4 per cent 

 of phosphorus pentoxide, unpolished or slightly polished rice was found 

 to contain from 0.5 per cent to 0.75 per cent of phosphorus pentoxide.® 

 Since the opening of the Culion leper colony in 1906, rice has been 

 the staple article of diet in the place, and it was customary to use either 

 Saigon rice number 2, or local polished rice. Beriberi was more or less 

 continuously present in the colony until February, 1910. By substitut- 

 ing meat and mongos for rice it was always possible to reduce the num- 

 ber of cases of beriberi, but the disease was never completely eradicated. 

 It was found later that this failure was probably due to the fact that 

 many of the lepers preferred to deny themselves food rather than to eat 

 mongos, so that we had starvation as well as imj^roper diet to deal with. 



The total number of deaths at Culion by months from February, 1909, to 

 February, 1910, among an average population of 1,-537 was as follows: February, 

 39; March, 54; April, 52; May, 47; June, 48; July, 57; August, 61; September, 

 65; October, 43; November, 80; December, 188; January, 164; a total of 898. 

 Of this number 309 were due to beriberi. 



In February, 1910, the use of unpolished rice was made compulsory 

 for all inmates of the Culion leper colony. 



The total number of deaths for the months from February, 1910, to February, 

 1911, among an average population of 1,952, or a population greater by 27 per 

 cent, was as follows: February, 06; March, 36; April, 29; May, 22; June, 27; 

 July, 15; August, 24; September, 12; October, 13; November, 15; December, 58; 

 January, 52; or a total of 369. 



The increased death rate in December and January was due to an 

 acute outbreak of bacillary dysentery. Of the number cited, there were 

 no deaths from beriberi after February, 1910. 



At the end of January, 1910, there were approximately 50 cases of 

 beriberi undergoing treatment in the Culion hospital. Upon the sug- 

 gestion of Doctor Aron, 30 grams of rice polishings mixed with milk and 

 sugar were given to these patients twice daily. With the exception of 

 two very advanced cases that died within a few days after this treat- 

 ment was begun, all of them were able to leave the hospital, and within 

 four weeks every case of beriberi was reported as cured by the attending 

 physician of the hospital. So much for Culion. 



Prior to May, 1910, beriberi was very common throughout the Phil- 

 ippines, in Jails, light-house stations, charitable institutions, on Govern- 

 ment vessels, and among the Philippine troops of the United States 



" I wish to make clear that the amount of phosphorus in rice is only given 

 because it is a ready method for determining the degree of polishing that a given 

 rice has undergone; in other words, the estimation of the amount of phosphorus 

 is a laboratory method of ascertaining whether much or little of the pericarp has 

 been removed and at this time it can not be said that the lack of phosphorus 

 causes beriberi. 



