xn, B, 3 Proceedings of the Manila Medical Society 167 



three cases of infantile beriberi entirely distinct from the two 

 types described above. They were characterized by cerebro- 

 meningeal symptoms. I have applied the name "pseudomenin- 

 gitic form" to this type of the disease. As far as I know, this 

 form has never been described in this country. 



The three cases I referred to were treated unsuccessfully out- 

 side our clinic as cases of meningitis. Their age varies from 

 5 to 6 months, somewhat older than the ordinary cases. All 

 were entirely breast-fed, and the mothers had symptoms of 

 rudimentary or latent beriberi. Two of the cases had brothers 

 and sisters who died of infantile beriberi, while the third case 

 was the first child of the family. 



The most striking symptom in these patients was drooping of 

 the eyelids — ptosis — a paralytic manifestation of the neuromus- 

 cular form according to Professor Takasu, of Osaka. Because 

 of the paralysis of the eyelids, the child has a vacant, idiotic 

 expression. He is drowsy most of the time, the eyes looking 

 upward and the head bent slightly backward. Moderate fever 

 was present at the onset in two cases, while absent in the third. 

 One had marked choreic movements of the limbs, which lasted 

 for from three to four weeks, and on admission this patient 

 presented convulsions of the extremities, twitching of the facial 

 muscles, strabismus, the eyes rolling up, slight rigidity of the 

 neck, and fever of 38.5°C. for two days. Lumbar puncture was 

 performed on this patient with negative results. Two gave a 

 history of having hoarseness of voice at the age of two months, 

 which fact suggests that these cerebromeningeal symptoms are 

 manifestations of a second attack of infantile beriberi. 



In all these cases X-ray examinations demonstrated the en- 

 largement of the right heart, the characteristic lesion of the 

 disease. 



All were treated with extract of tiqui-tiqui with rapid and 

 marvelous effects, as observed in other forms of infantile beriberi. 



In view of these observations I feel justified in presenting 

 to your consideration this pseudomeningitic form of infantile 

 beriberi as a new type of the disease distinct from the aphonic 

 and pernicious types. This form of infantile beriberi simulates 

 meningitis in its clinical manifestation; it presents hypertrophy 

 and dilatation of the heart and is observed in infants older than 

 3 months, and extract of tiqui-tiqui is its specific remedy. 



