178 "^he Philippine Jouryial of Science 



With the knowledge that this study was made from a routine 

 autopsy service in Manila and that the subjects were all Filipinos, 

 the following factors must be taken into consideration in at- 

 tempting to explain the occurrence of degeneration in 88 out 

 of 104 cases studied. 



1. In Manila beriberi is endemic, and therefore there is the 

 possibility of many unrecognized cases of mild beriberi dying 

 of other diseases. 



2. There may be many cases who recovered from beriberi 

 and died of other diseases. 



3. The nutrition of the working class of Filipinos in general 

 is below par, due to insufficient food, excessive nonnutritious 

 food, or a one-sided diet. 



It is necessary that the clinical history must aid the morbid 

 anatomist in the diagnosis of beriberi. The morbid anatomy of 

 this disease consists of subcutaneous oedema, moistness, conges- 

 tion, and petechiae of the serous surfaces, marked dilation of 

 the right ventricle with or without hypertrophy, congestion and 

 oedema of the lungs, congestion of the viscera, acute duodenitis, 

 and degeneration of the myeline sheath of the peripheral nerves. 



REFERENCES 



(1) Andrews. Phil. Journ. Scl, Sec. B (1912), 7, 67. 



(2) AscHOFF. Pathologische Anatomic. Gustav Fischer, Jena. 3d ed. 



(1911), 383. 



(3) Castellani and Chalmers. Manual of Tropical Medicine. Balliere, 



Tindall and Cox, London. 1st ed. (1910), 998. 



(4) OSLER. The Principles and Practice of Modern Medicine. D. Appleton 



& Company. New York and London. 8th ed. (1912), 1021. 



(5) Strong and Crowell. Phil. Journ. Scl, Sec. B (1912), 7, 271. 



(6) Vedder and Clark. Ibid. (1912), 7, 423. 



