x, B, 2 Williams and Saleeby: Treatment of Human Beriberi 107 
reflexes were found to be more active; the heart sounds them- 
selves were nearly normal in quality, but the arhythmia seemed 
somewhat increased. This symptom has persisted more or less 
throughout the treatment with hydrolyzed extract, although the 
general comfort of the patient has increased, the pain in the 
legs disappeared, and the sense of heaviness diminished. She 
nursed her sick child (case 18) throughout these treatments. 
CASE 11 
A boy of 17 years was admitted on October 16, complaining of 
numbness, heaviness, and pain in the legs. This condition began 
six days previously and was becoming worse. He reported 
having had a slight swelling and numbness of the feet about a 
year before. The patellar reflexes were diminished, the calves 
of the legs were tender to pressure, and formication was felt 
frequently. Ctdema was general, but not excessive. He could 
walk only with much pain and difficulty. The heart was moder- 
ately enlarged to the right, the first sound presenting a faint 
murmur, and the second being accentuated. There was no 
dyspnea, and the lungs appeared normal. The urine showed 
no albumin nor casts. 
Treatment was begun with 12 cubic centimeters of hydrolyzed 
extract three times daily. The dose was increased from time 
to time to 40 cubic centimeters. The cedema disappeared rather 
rapidly, and the patient felt much more comfortable. After 
a week he could walk with comparative ease, could run a little, 
and stoop and touch the floor with his hands. He stated that the 
pains in the legs had disappeared, the numbness remaining, 
however, over a less extended area. The reflexes were more 
active. After that time improvement was very slow, and when 
last seen the patient still complained that his knees ached on 
walking more than a few meters. 
CASE 12 
A woman, aged 30 years, was admitted to the hospital with 
a child (case 18) 2 months old that had partially recovered 
from an attack of infantile beriberi after treatment with tiqui- 
tique extract by Doctor Castaneda. The patient dated her ill- 
ness from the birth of the child, and although she had borne 
7 children previously, said she had had no similar illness. She 
complained of pain and oppression of the chest, numbness and 
heaviness of the legs, dizziness, and formication. She was pale 
and anemic. The knee reflexes were active, and oedema of the 
legs was slight. The heart was slightly enlarged, the first 
