BERIBERI IN SIAM. 1 



By H. Campbell Highet." 



Beriberi as a cause of invaliding and of death is now a common 

 enough disease in Bangkok, but it has not always been so; in fact, the 

 only reliable records which I can obtain date no further back than the 

 year 1890. In that year an epidemic broke out in the central jail and, 

 in the absence of definite figures, I can not do better than to quote a 

 portion of a letter to me with general reference to beriberi, by Dr. 

 Heyward Hays, of Bangkok. He writes : 



My first personal contact with the disease occurred in 1890 in the new jail. 

 Doctor Willis, who was then the physician to the British legation, invited me 

 to go to the jail with him to see a number of cases he supposed to be beriberi. 

 I confirmed his diagnosis. It was of the wet variety and very fatal. Doctor 

 Willis and myself made out a report which was handed to His Siamese Majesty 

 and the recommendations made in that report were immediately granted and 

 carried out. The result was that the disease disappeared and was not seen 

 in the jail up to the time I resigned in 1898, having succeeded Doctor Willis 

 as physician to the jail in "1892. My next experience with the disease was in the 

 year 1896 at Chantook and Muet Lek, during the construction of the Korat 

 Railway. 8 We had a great many cases, particularly of the wet variety, which 

 was very fatal. My next experience with the disease was in the year 1897 at 

 Java, during His Majesty's visit there. It broke out on all our ships simul- 

 taneously and we had some eighty or ninety cases. None proved fatal, owing to 

 the fact, I believe, that the disease was discovered in its early stages, as well 

 as to the caustic measures which were taken to stamp it out. 



Beyond these epidemics of the disease reported by Doctor Hays, beri- 

 beri was unknown to the general practitioner and even to the hospital 

 physician until 1900. Arriving in Bangkok in April, 1897, after nearly 

 five years' practice in Singapore, where I had seen much of the disease, 

 I was soon struck with the total absence of cases of beriberi amongst my 

 patients, whether in hospital or in private practice. On inquiry of 



1 Read at the first biennial meeting of the Far Eastern Association of Tropical 

 Medicine, March 11, 1910. 



= Fellow of the Royal Institute of Public Health; principal medical officer, local 

 government, Bangkok, Siam; delegate from His Imperial Siamese Majesty's 

 Government. 



3 These places are over 60 miles from Bangkok. 



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