82 ARON. 



been thoroughly confirmed b} r a number of authors. 3 All observers 

 further agree on this point, that the same kind of rice which causes 

 beriberi, if the diet of the people is based almost entirely on this foodstuff, 

 is eaten without any ill effects if a sufficient amount of other things such 

 as fresh meat, fresh vegetables, and especially certain kinds of beans are 

 taken with it. An ample supply of fresh meat or of the beans, accom- 

 panied by a restriction of the quantity of rice consumed, or with a total 

 change of diet, has always proved the best cure for beriberi. 4 The most 

 striking fact in all these observations is the great influence which the 

 preparation of the rice has in its relation to the etiology of beriberi. I 

 will, in order to give a clearer understanding of this phase of the question, 

 give a short description of the preparation of rice for consumption. 



At first the rice husk must be removed from the grain (in Spanish and native 

 dialect, palay) . This husk {ipa) is never eaten. The grain (pinaoa) as it now 

 appears when the husk is broken and thrown away is surrounded by a second, 

 thinner skin .of a more or less red or brownish color, which does not render the 

 appearance of the rice very appetizing. This second skin can also be cleaned off 

 by a process of milling between rotating stones which removes it, together with 

 the outside layer of the rice grain; and after this process of milling or polishing, 

 the grain is white and clean and now has the form which the European usually 

 knows as rice. The first rice, which still contains the second skin (the Silber- 

 hdutclien of the German writers) is that which usually does not cause beriberi; 

 while the grain which is deprived of this skin by the process of polishing must 

 be regarded as quite liable to produce the disease. There are different degrees 

 of polishing, for we find on the market rice which is only slightly polished and 

 grain which has been very highly treated. There are, in addition, certain pro- 

 cesses, usually practiced in India and elsewhere ("parboiling") which seem to 

 prevent the thorough removal of the outer parts of the rice, but I am unable 

 to judge of them, since they are not in use in these Islands. The native rice 

 prepared by hand is pounded in a large mortar (Tagalog, lusong) , and even if 

 milled by a hand mill is never deprived of its outer layers to as great an extent 

 as that milled by large machinery. 



Before the exact origin and method of preparing rice capable of causing 

 beriberi was known, it was termed "uncured," while that which did not 

 produce the disease was called "cured" rice. However, while these names 

 are very extensively used, I scarcely think that they convey the right idea. 



'Arch. f. Hyg. (1906), 58, 150-170; Fletcher, William. The Lancet, London 

 (1907). 1, 1776; Idem. Journ. Trop. Med. & Byg. (1909), 12, 127-135; Braddon, 

 W. L. The Cause and Prevention of Beriberi. London. 1907. Idem. Bombay 

 Med. Congr. (1909). Fraser, Ii., and Stanton, A. T. Bombay Med. Congr. 

 (1909) ; An Inquiry Concerning the Etiology of Beriberi. Studies from the Inst, 

 for Med. Research. Kulua Lampur (1909). 



1 Waller, F. H. Geneesh. Tyds. v. Ned. hid. (1908), 48. Hulshoff-Pol, F. 

 Geneesh. Tyds. r. Ned. Ind. (1909), 49. [Arch. 1. Schiffs-u. Trop.-Hyg. (1900), 

 13, 775) ; Kiewit de Jonge, ibid. 



