THE ETIOLOGY OF BERIBERI. 61 



for valuable assistance in the chemical part of this investigation, and to 

 Dr. E. D. Keith for suggestions as to methods for the examination of 

 the nerves. 



SUMMARY. 



1. Beriberi is a disorder of metabolism and, as it occurs in this coun- 

 try, is associated with a diet in which white rice is the principal 

 constituent. 



2. White rice as produced in the mills here commonly makes default 

 in resjJect of some substance or substances essential for the maintenance 

 of the normal metabolism of nerve tissues. These substances exist in 

 adequate amount in the original grain and in superabundant amount in 

 the polishings from white rice. 



3. The estimation in terms of phosphorus pentoxide of the total 

 phosphorus present in a given rice may be used as an indicator of the 

 beriberi-producing power of such rice when forming the staple of a diet 

 in man. 



The prevention of beriberi in this country will be achieved by sub- 

 stituting for the ordinary white rice a rice in which the polishing process 

 has been omitted, or carried out to a minimal extent, or by the addition 

 to a white-rice diet of articles rich in those substances in which such 

 white rice now makes default. One such article which is cheap and 

 readily obtained is the polishings from white rice. 



The use of parboiled rice as suggested by Doctor Braddon will achieve 

 a like result, provided that the polishing process is not carried beyond 

 the limited extent now customary. 



REFERENCES. 



( 1 ) Braddon, W. L. The Etiology of Beriberi. Federated Malay States Medical 

 Archives (1901). The Cause and Prevention of Beriberi (1907). 



(2) Eraser, H., and Stanton, A. T. An Inquiry Concerning the Etiology of 

 Beriberi. Lancet (1909) 1, 451. An Inquiry Concerning the Etiology of 

 Beriberi. Studies from the Institute for Medical Research (1909) No. 10. 



(3) Fletcher, W. Rice and Beriberi. Lancet (1907) 1, 1776. Rice and Beri- 

 beri. Joum. Trop. Med. & Eyg. (1909) 12, 127. 



(4) Lucy, S. H. R. Address, British Medical Association, Penang (1905). 



(5) Dubrtjel. Le Beriberi (1905). 



(6) Ems, W. G. Uncured Rice as a Cause of Beriberi. Brit. Med. Joum. 

 (1909) 2, 935. 



(7) Etkman, C. Polyneuritis bij Hoenders. Jaarverslag van Lai. v. Path 

 Anat. en. Bald., Batavia (1896). 



