A CASE OF INFANTILE BERIBERI WITH AUTOPSY REPORT. 1 



By Josls Albert. 2 



The case under discussion is that of an infant three months of age, 

 which was brought to my clinic at St. Paul's Hospital on the afternoon 

 of December 3 last, and died during the next night. Upon examining 

 the child, she was seen to be of robust frame. In general the face was 

 pallid, but cyanosis was present around the mouth and nostrils. There 

 was no rise of temperature; oedema of the legs and anterior chestwall 

 was present ; the urine was scanty ; nausea was present, but not vomiting. 

 From the previous afternoon until the time she was examined, two 

 normal stools had been passed; the respirations numbered from 30 to 40, 

 and the pulse 120 to 130 beats per minute. Pronounced aphonia was 

 present, although the patient was constantly moaning. 



The history of the case as given by the mother is as follows : 



Two weeks previously the child lost her voice, as the result, so the mother 

 thinks, of a bath. She vomited a good deal at this time and had frequent stools 

 of a very dark color. It was these gastric and intestinal symptoms which caused 

 the mother to bring her to the hospital. 



Upon examining the mother, it was seen that she was suffering from a drop- 

 sical form of beriberi. There was cedema and swelling of the feet, the patellar 

 reflexes were absent; there was a sensation of weight in the epigastrium; tachy- 

 cardia was present. The mother said she had suffered from beriberi for a long 

 time; she had besides the present child four other children of whom the first 

 three, all of whom she had nursed, had died during the first months of infancy. 

 The fourth child, immediately preceding the one whose case I am reporting, was 

 not suckled, but had been brought up by the bottle, and is alive and in good 

 health. 



With the foregoing data there could be no doubt that the case was 

 one of beriberi. As has already been mentioned above, the child died 

 a little more than twenty-four hours later, and the autopsy and micros- 

 copical examination for the results of which I am indebted to Drs. 

 Marshall and Gilman showed that the most important lesions were : 



First, degeneration of both vagi and swelling of the cells of the right cervical 

 ganglion ; second, dilatation of the right side of the heart to a degree which threw 



1 Read at the Fifth Annual Meeting of the Philippine Islands Medical Associa- 

 tion, February 29, 1908. 



2 Professor of pediatrics in the Philippine Medical School. 



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