ON THE ETIOLOGY OF BERIBERI. 1 



By J. de Haan. 2 



Beriberi has for many years been a subject of study by the govern- 

 ment medical laboratory at Weltevreden, and the object of this paper is 

 to communicate the results of all these investigations and to give the 

 point of view which is maintained by us with reference to the etiology, 

 especially for the Tropics, of this interesting disease. 



No one hitherto has succeeded in proving beriberi to be caused by a 

 specific microbe, or shown that it should be classed among the infectious 

 diseases. Neither its epidemic nor endemic dissemination, nor the few 

 cases mentioned in literature indicating the possibility of infection from 

 one person to another, should be considered as a proof of its microbic 

 origin, since the clinical symptoms of beriberi — polyneuritis with all its 

 sequels — may be caused by many other factors. My own very numerous 

 attempts to find the causa morbi in the blood, the organs, or the excreta 

 of persons suffering from beriberi also have never suceeded, and 

 although I should not wish to consider this as a decisive argument for 

 a nonmicrobic infection, it must be granted that it increases its 

 probability. 



By degrees we have gathered a series of facts that may possibly throw 

 some light on this obscure subject. 



Doctor Bykman, in the year 1888, observed 'the appearance among 

 the laboratory fowls of an epidemic of polyneuritis that in many respects 

 resembled beriberi. The clinical symptoms were : Staggering, often 

 followed by total paralysis, paresis of the wings, dyspnoea and cyanosis ; 

 followed by death. The post-mortem examination revealed emaciation 

 of the subcutaneous fatty tissue as well as of the muscles, much fluid in 

 the pericardium, degeneration of nerve fibers, but no macroscopic nor 

 microscopic alterations of the brain or of the spinal cord. It was evident 

 that this disease was not caused by an infection with microbes, but that 



"■Read at the first biennial meeting of the Far Eastern Association of Tropical 

 Medicine, at Manila, March 11, 1910. 



2 Director of the Government Medical Laboratory at Weltevreden, Java, Dutch 

 East Indies; delegate from Her Majesty's Government of the Netherlands East 

 Indies. 



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