Q4 - The Philippine Journal of Science 1916 
The administration of the extract must be continued as long 
as the aphonia persists. So long as the voice has not recovered 
its normal pitch, the infant is constantly threatened by an acute 
attack which may terminate in death in a few hours. In cases 
of infantile beriberi without aphonia, it is wise to prolong the 
treatment at least three weeks after apparent cure, to avoid 
relapses which frequently occur. It is necessary to impress 
upon the mother the importance of prolonging the treatment, as 
it is the tendency, in private practice, to discontinue treatment 
as soon as the acute symptoms disappear. 
The failure of the extract to effect a cure may be due to many 
causes: 
1. Extreme severity of the case—a very advanced neuritis. 
Vedder and Clark, in their work on polyneuritis gallinarum, 
have shown that symptoms appear only when the anatomic 
lesions in the nerves are well advanced. It is the same with 
infantile beriberi. It is not infrequent that mothers bring their — 
children when the disease is far advanced. Therefore it is 
necessary to give the extract early in the disease in order that 
the treatment be successful. 
2. The extract proves ineffective also in cases associated with 
other infections, commonly pneumococcic in the form of bron- 
chopneumonia, which is a frequent complication of infantile 
beriberi. 
3. Another cause of failure of the extract is its poor quality. 
It has either an insufficient quantity of the active principle or 
an excess of alcohol which makes its ingestion disagreeable and 
injurious. Analyses made by the Bureau of Science of the ex- 
tracts prepared by the local drug stores revealed the fact that 
all the samples with the exception of one from one drug store 
were very deficient in the active principle. This was why treat- 
ment with extracts of tiqui-tiqui obtained from this drug store 
were the most successful. 
The interpretation of the curative action of the extract of 
tiqui-tiqui is not a hard task. Hirota’s theory of intoxication 
can be discarded. It does not explain why the beriberic child 
treated with tiqui-tiqui extract improves and gets well even 
without discontinuing the maternal nursing. The extract has 
no antitoxic properties and, therefore, it cannot be said that it 
neutralizes the toxic action of the breast milk. 
Knowing the prophylactic and curative actions of the extract 
in*polyneuritis gallinarum, which is caused by a deficiency in 
the diet, we must admit that this extract supplies the beriberic 
