SOME OBSERVATIONS CONCERNING BERIBERI. 125 



of sailing ship,?, believed the disease to be genuine beriberi, whereas 

 other authors, for example, Nocht in Hamburg, maintain that the condi- 

 tion is dependent on defect in nourishment. In my case, at least, the 

 disease was genuine beriberi. 



Furthermore, in the past summer, I observed an epidemic of beriberi 

 in certain fishing villages of Japan. 



All nry observations lead me to the conclusion that uniform, but 

 little changing, monotonous diet predisposes to the disease. The con- 

 dition of nourishment of the Chinese in two of the mines of Banka 

 was fairly good, the total quantity of the chief constituents of diet, 

 namely, protein, fat and carbohydrates, was sufficient, but the diet was 

 always one-sided and not varied throughout the year. This is also 

 true of the general epidemic of beriberi aboard the steamship referred 

 to above, and in the fishing villages the one-sided diet was the only point 

 to be observed. 



However, the one-sided or monotonous diet is only the predisposing 

 cause of beriberi; the true cause must be sought in other directions. 

 This can be illustrated by an example. Abdominal typhoid is treated 

 in Europe and America, as well as in Java, or for that matter in the 

 entire Orient, by means of a liquid diet, especially milk. In the Orient, 

 beriberi very frequently occurs as a complication among the convalescent 

 patients; whereas this has never been observed in Europe or America. 

 It is also true in the Orient that during sieges of cities and under other 

 circumstances where there is insufficiency of diet, beriberi is very fre- 

 quently observed, whereas this is not the case in the Occident. It is 

 therefore not unreasonable to assume that the microorganisms of beriberi 

 are only present in the Orient and, given a. predisposing cause, are 

 capable of causing the disease, whereas in the West beriberi does not 

 appear, owing to the absence of the infecting organisms, although the 

 same favorable predisposing cause may be present. 



