x, B, 2 Williams and Saleeby: Treatment of Human Beribert 103 
cedema in the feet, and the patellar reflexes were exceedingly 
sluggish. The area of heart dullness was slightly increased; the 
beat was intermittent and arythmic, the first sound being short 
and the second rather valvular and accentuated. There was 
some resonance in the upper lobe of the right lung, but respira- 
tions were deep and full. : 
The patient was given 0.4 gram of allantoin three times daily 
for three days. There was no apparent improvement other than 
amore restful appearance. On the fourth day the heart beat be- 
came more intermittent and arythmic. Therefore the allantoin 
was stopped, and strychnine and digitalin were administered. 
The heart became temporarily regular, and the patient was more 
comfortable. 
CASE 5 
A woman, aged 50 years, was admitted to the hospital on 
August 21 with typical symptoms of mild chronic beriberi, in- 
cluding numbness and heaviness of the legs, tenderness of 
muscles, sense of heat, and formication, with reflexes diminished 
in the left knee and exaggerated in the right. Dyspncoa was 
marked, and the patient tired out very quickly. The second 
heart sound was valvular and accentuated. The lungs and urine 
were negative. 
The patient was given 0.1 gram of allantoin six times daily 
for one week without receiving any benefit; on the contrary, 
if there was any change, the heart condition was slightly worse, 
and the patient seemed rather better after the allantoin was 
stopped. 
These cases treated and observed by us jointly do not afford 
definite evidence of any beneficial result of the treatment with 
allantoin. In those which were distinctly chronic it may be said. 
with certainty that the treatment did not produce any improve- 
ment. Rather, there is indication that in large doses allantoin 
produces a depressing effect upon the heart. In the acute cases 
there was marked improvement during the period of observation. 
However, such improvements are not uncommon as a result of 
a good diet, rest, and care alone. 
We are able to present the clinical records of 5 other cases 
treated with allantoin and observed by other physicians. These 
cases were treated in their homes without enforcing any change 
of diet or habits. They indicate that allantoin may frequently 
relieve the severity of the symptoms in acute cases much as it 
does in fowls. Further investigation will be necessary to decide 
