74 



HIGHET. 



several of my colleagues who had already been many years in Siam, 

 I was told that beriberi was a rarity. However, on August 29, 1900, 

 our first case was admitted to the Police Hospital in the person of a 

 Siamese constable. Another case came in a month later, but after that 

 no further ones are noted in our Police Hospital register until April, 

 1901, since which time beriberi has become one of the ordinary diseases 

 seen in that hospital. During this year, 1901, a very severe epidemic 

 broke out amongst the soldiers in the central barracks, several cases were 

 reported from the navy, and cases began to be admitted in increasing 

 numbers to the general hospitals. 



Since then, beriberi has taken a prominent place as a cause of invalid- 

 ing in the public services. In the absence of reliable data for the ordinary 

 civilian population, the following return of cases of and deaths from 

 beriberi recorded in the hospitals, the army, the navy, and the police 

 during eight years may be of interest : 



Year (April to March). 



Cases. 



Deaths. 



1901-2 



1,128 

 1,007 

 2, 615 

 2,813 

 3,361 

 2,712 

 2, 427 

 4,607 



14 

 81 

 161 

 103 

 92 

 101 

 229 

 282 



1902-3... 



1903-4 _ __ 



1904-5. __ 



1905-0 



1906-7- _ 



1907-8. 



1908-9 



Totals ; 



22, 670 



1,063 



It must be noted, however, that these 1,063 deaths give no real con- 

 ception of the actual death rate, as it was the custom of us all to send 

 our beriberi sick away to their own homes in the country, finding that 

 after a month or two many returned cured. Why such cases should 

 recover much more satisfactorily if sent home is a most important point 

 which will be discussed later. At any rate, here we have a total of nearly 

 23,000 cases in the public services in eight years. Naturally, the figures 

 for the present year are not yet obtainable, but I have no doubt they will 

 be very high. Compulsory registration of deaths only came into force 

 in Bangkok in October last, but during the three months during which 

 the law has been in force 203 deaths from beriberi have been recorded. 

 So much for the history of beriberi in Bangkok up to a year ago. 



Now, as to the cause of beriberi. My experience in Bangkok leads 

 me to confirm absolutely the opinion first expressed by Braddon and 

 lately confirmed by Fraser and Stanton, of Kuala Lumpur, that beriberi 

 is closely associated with the consumption of white, steam-milled rice. 



Why this should be so, I am not yet prepared to say. Is it due to the 

 presence of a fungus on the white rice which has become stale, is it 



