x, B, 2 Williams and Saleeby: Treatment of Human Beribert 105 
an accentuation of the second sound. The knee reflexes were somewhat 
diminished, and the patient could stand and walk only with considerable 
pain and difficulty. 
Allantoin was administered in doses of 0.1 gram six times daily. The 
next day toward evening a fever came on, the temperature reaching 40°. 
All the symptoms were considerably intensified, and the patient was 
unable to rise from her bed. The allantoin was continued. The fever dis- 
appeared during the night, and the following day the patient’s condition 
seemed much better than when first seen. After four days she no longer 
complained of pains or numbness and was able to walk without difficulty. 
She continued to nurse her child throughout the treatment. 
Ten days later her child fell sick with the usual symptoms of infantile 
beriberi and was successfully treated with tiqui-tiqui extract. The symp- 
toms, with the exception of cedema, later reappeared in the mother, although 
much less severely than on the previous occasion. — 
Case 9 was treated and observed by Doctor Castaneda. 
CASE 9 
An infant, 2 months of age, had a sudden convulsion on July 16. Slight 
cyanosis was apparent about the mouth; the pulse was 130; the temperature 
was normal. The child was uneasy and vomited frequently and was treated 
with caffein citrate. Four days later the child was paler and more cyanotic, 
had no appetite, vomited frequently, and the urine was scanty. Attacks 
of dypsnoea were frequent, and the child cried often. The second heart 
sound was weak. 
The mother was pale and complained of numbness in the legs and pain 
in the chest. The heart palpitated occasionally; the pulse was 95. There 
was no cedema nor loss of reflexes. The child was given 0.05 gram of 
allantoin three times daily, and the mother received 0.1 gram six times 
daily. 
There was a marked improvement in the condition of the child after 
two days. After eight days the cyanosis and dypsnoea had disappeared, 
the urine became normal in quantity, and the child’s general condition as 
indicated by the color, activity, and contentment was greatly improved. Im- 
provement in the mother was slight. She continued to nurse the child 
throughout the treatment. 
The record of the following case was furnished by Doctor 
Elizalde: 
CASE 10 
Japanese, male, 31 years old, married, a laborer by occupation, residing 
in Calamba, was admitted to the Philippine General Hospital on July 9, 1914, 
complaining of numbness in lower limbs and difficulty in walking. Family 
and past history not reliable, as patient was unable to talk or understand 
English or Spanish. The present illness began twenty days before ad- 
mission with vomiting after meals accompanied by numbness and weakness 
in the lower extremity. 
On physical examination the patient was found to be well developed 
and well nourished; able to walk a few steps with support, but with difficulty. 
He could not flex the legs nor the feet; heart beats were rapid; cardiac 
dullness not increased. A soft systolic murmur was heard best in the 
