FOOD SALTS IX RELATION TO BEEIBEKI. 129 



The rice used in the Philippines, as regards preparation, is of three 

 kinds: That grown at home and pounded out by hand in large wooden 

 mortars ; that grown at home and submitted to milling of varying degrees 

 of thoroughness ; and the imported rice, all of which has been milled and 

 polished abroad. 



The first variety, home grown and hand produced, is used in the rural 

 districts and by about one-half of the natives in the coast towns. The second 

 and third varieties, polished native and imported rice, are used principally in 

 the coast towns and their immediate vicinity. There are regions where little 

 or no rice is consumed, as in the Batan Islands, just north of Luzon. Meat and 

 vegetables constitute the diet of the inhabitants of these islands; the} 7 have no 

 beriberi. In the town of Aparri, 120 miles south of the Batan group, imported 

 polished rice is found for sale in. the tiendas and beriberi exists among the natives. 

 On the contrary, in the coast towns of Casiguran and Baler, which are around the 

 northeastern corner of Luzon from Aparri, no imported rice was observed in 

 the tiendas and no beriberi among the people. 



In general, beriberi is found in the coast towns and along the lines of com- 

 munication, and in the same places polished rice is extensively eaten. At Taytay, 

 in Rizal Province, a small town of 6,000 inhabitants about 15 miles from Manila, 

 beriberi is remarkably infrequent, although the town is on the railroad. As 

 a matter of fact, however, . polished rice seems to be used there little, if any. 

 Samples of rice gathered at random in the tiendas of Taytay were all of the 

 home-grown varieties and incompletely milled. 



Our observations seem to prove that beriberi in the Philippines is 

 found only where polished rice, either imported or home grown, is used, 

 principally along the coasts or rivers. ~So doubt the new railway system 

 will open up increased areas where polished rice will be consumed and 

 the distribution of beriberi in the Philippine Islands may be changed 

 in the next few years. 



This etiologic relation of polished rice to beriberi agrees with the 

 findings of other workers. If polished rice is a factor in the causation 

 of beriberi, and this seems to us to be proved, it must be because it either 

 conveys into the body some extraneous poisonous substance, or else is 

 deficient in, or, at least, fails to give to the body enough of -some needed 

 element or elements. The work done in the Philippines by Major 

 Dutcher and others, and our own observations, have failed to give any 

 support to the first idea, consequently our researches have been directed 

 to an investigation of the privation theory! 



It is not sufficient to make deductions from analyses of the various 

 rices, polished and parboiled, or to draw conclusions from experiments 

 in which such rices are fed to lower animals, although such experiments 

 may be suggestive and point out a profitable line of research in the 

 human. The ingestion by the human of other articles of diet, rich in 

 a certain element, may entirely compensate for the lack of such element 

 in the rice eaten, so unless the entire diet of a body of men for a period 

 equal, at least, to the so-called "period of incubation"' is known, no 



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