x, B, 2 Williams and Saleeby: Treatment of Human Beribert 101 
ally beriberic. CMdema in the child was marked and general, 
with puffiness of the eyelids and marked pitting on the legs. 
The gait was rather unsteady, the patellar reflexes were absent, 
and the voice was husky. The face and mucous membranes 
were anemic, and the child was very restless and peevish. She 
suffered from excessive diarrhoea and prolapse of the rectum. 
The heart showed some enlargement. The first sound was short, — 
and the second was accentuated. 
The child was treated for the diarrhcea upon admission, and 
on the following day administration of 0.1 gram of allantoin, 
three times daily, was begun. General improvement was noted 
a day later. In the course of four or five days the cedema 
had practically disappeared, the gait became steady, the voice 
clearer, and the color better. The child was also brighter and 
better contented. The area of heart dullness decreased some- 
what, and the sounds improved, although they did not become. 
entirely normal. The patellar reflexes changed very little. 
CASE 2 
A girl, aged 9 years, was first seen about September 12. She 
had been sick a month with fever. The gums were spongy 
and bleeding. She was given a mouth wash, and when again 
seen on September 22, her gums were improved, but were still 
dark, swollen, and spongy. The general condition remained 
much the same as before and may be described as follows: 
The face was pale and puffy, especially around the eyelids. 
The patient appeared fleshy and heavy, but anemic. Cidema 
was general, but most marked in the legs. The patellar re- 
flexes were much diminished, the calves were slightly tender, 
and the gait was wobbly. The lower limbs were numb. The 
heart showed evidence of palpitation and slight enlargement. 
The first sound was rough and prolonged, and the second was ac- 
centuated. The temperature was 39°. The urine contained 
albumin and abundant blood cells. A blood examination showed. 
no filaria. 
The patient was admitted to the hospital on September 22 
and given a cathartic. The following day the fever had dis- 
appeared, and treatment with 0.1 gram allantoin four times 
daily was begun. An improvement in the general condition 
and gait and diminution of the cedema were noted the following 
day and continued for a week. The heart condition was also 
improved considerably after five days, and the patient could 
walk and run without stumbling, which she had been unable 
to do at first. The patellar reflexes remained practically un- 
