BERIBERI AND UNPOLISHED RICE. 231 



Army. An investigation of these has shown that it was the invariable 

 practice to use polished rice as the staple article of diet in all of the 

 places mentioned. In May, 1910, an Executive Order was issued by 

 the Governor- General of the Philippine Islands prohibiting the use of 

 polished rice in all public civil institutions. Since AugTist, 1910, only 

 two cases of beriberi in the above places have come to the attention of 

 the writer. One of these was among the crew of the steamer Rizal. 

 An inspection of the ship's stores showed that the rice was of the white 

 polished variety. Further inquiry elicited the fact that it was custom- 

 ary for the crew of this vessel to use a varied diet which may account 

 for the fact that there were not more eases. The other case occurred 

 in a prisoner in the jail at Tacloban. The physician in charge reported 

 that it had not been possible to purchase unpolished rice at Tacloban 

 and for that reason polished rice was being used. He added that every 

 effort was, however, being made to comply with the spirit of the Exec- 

 utive Order by using more meat, mongos, potatoes, green vegetables, and 

 fish. 



At the Hospicio de San Jose, which is an insane and orphan asylum 

 of over 700 inmates, beriberi has almost constantly been present, at 

 least during the past ten years. Since June, 1910, unpolished rice has 

 been used, and a few weeks after its use was begun beriberi disappeared, 

 and since that time no further cases have been reported. 



Extensive inquiry made throughout the Philippine Islands has almost 

 invariably shown that in districts in which hand-pounded, or, in other 

 words, unpolished rice, is commonly used, there is little if any beriberi, 

 whereas in districts in which machined, or, in other words, polished 

 rice, is served as the staple article of diet, beriberi is quite common. 

 However, an apparent exception to this general nile is found among the 

 residents of the Batanes Islands. It may perhaps be mentioned that 

 these are isolated islands north of Luzon and south of Formosa, which 

 have communication with the oiiter world only a few times each year, 

 and, owing to their inaccessibility, they generally escape visitations of 

 cholera and other dangerous communicable diseases. 



The Batanes are poorly adapted to rice culture, and for this reason a 

 considerable amount of polished rice is imported each year, and it would 

 seem reasonable to infer that if the present theories with regard to the 

 etiology of beriberi are correct, cases of this disease should be encoun- 

 tered in these islands. However, an investigation of the dietary of the 

 inhabitants of the Batanes Islands shows that meat and potatoes are 

 more commonly used than in other parts of the Philippines. In brief, 

 food of various kinds, other than rice, is so plentiful that rice is not 

 the staple article of diet to the same extent as elsewhere in the Archi- 

 pelago. 



Considerable difficulty has been encountered and much opposition has 



