106 ARON AND HOCSON. 



Teruuchi and Saiki," 11 in opposition to Durham, as a result of an experiment 

 on metabolism, state that the destruction of protein is" increased during beriberi. 

 Finally, Miura, 1 - in a recent article on this disease which came to my notice only 

 after this paper had been read before the association, quotes a number of experi- 

 ments on metabolism which he has made on 4 people suffering from a more or 

 less acute attack of beriberi. It is characteristic that all of his patients were 

 undernourished during this time. The caloric intake per day often was not higher 

 than 250 to 300 calories, on an average not 1,000. The loss in body weight during 

 the short experimental periods was correspondingly high, namely, 55 to 49, 55 

 to 46, 46 to 42 kilos, etc. He concludes: "In acute, severe beriberi the nitrogen 

 and P:Os excretion is increased in the urine independently of the quantity of 

 urine passed, in subacute beriberi the nitrogen loss is much lower." His results 

 are very much obscured by the fact that his patients were at the same time highly 

 undernourished. 



It was our good fortune to encounter one case of typical beriberi in 

 Bilibid Prison which we could use for study of metabolism. The disease 

 is not at all common among the prisoners in this institution; if the diet 

 given to these people and upon which one of us reported i3 during the 

 past year is considered, it is scarcely to be understood how beriberi could 

 be present at all among its inmates. Indeed, every case occurring there 

 would argue against the theory that beriberi is caused by a diet low in 

 phosphorus, unless a reasonable explanation could be produced showing 

 that the man suffering from beriberi had not received the ample and 

 healthful diet of Bilibid Prison. The case which we encountered, prisoner 

 No. 7272, can easily be proved not to have had a full diet just before he 

 contracted the disease. 



The records show that this man has been in prison from April 30, 190S, up 

 to the present time, serving a life sentence. Up to September 25, 1909, his 

 conduct was sufficiently good so that he had suffered only light punishment, such as 

 "carrying stone." During this period his full diet was never restricted, but on 

 September 25, 1909, he received his first severe punishment, he being condemned 

 to ten days on bread and water. 



His second punishment began on October 22, 1909, and from this date up to 

 December 22, 1909, he was placed on bread and water for a total of forty-one 

 days, and on one day he received two meals, consisting only of bread and water. 



A summary of these dates and conditions is as follows : Prom Septem- 

 ber 25 to December 22 (a total of eighty-eight days), he was on a diet of 

 bread and water during fifty-one and two-thirds days; or, from October 22 

 to December 22 (a total of sixty-one days), he was on bread and ivater for 

 forty-one and two-thirds days. 



On December 22 this prisoner was taken to the hospital with typical 

 s}Tnptoms of beriberi. From this time on he was kept in the hospital 

 on a mixed diet and the Filipino assistant, Dr. Pineda, who treated him 

 attempted to induce him to take mongoj however, the prisoner had no 



n Mitt. med. Gesellsch. Tokyo (1905), 19, No. 6. 



a Beriberi oder Kakke. Ergeo. d. inn. Med. u. Einderheilk. (1910), 4, 280-318. 



"Aron, This Journal, Sec. B (1909), 4, 195. 



