IW The Philippine Journal of Science 1915 
CASE 21 
A girl, aged 3 years, was admitted to the hospital on September 
22, together with her 5-year-old sister (case 1), who was simi- 
larly affected. The mother and grandmother living in the same 
house were also beriberic. The patient had been sick two weeks 
and was steadily growing worse. Ctdema was general and very 
pronounced in legs and vulva. The abdomen was distended, and 
the face was pale and puffy. The patellar reflex was absent in 
the right knee and diminished in the left. The heart was slightly 
enlarged, and the sounds were somewhat accentuated. The child 
also suffered from diarrhea, and was very peevish. 
She was treated for the diarrhcea and was given 3 cubic centi- 
meters of extract of rice polishings four times daily. Very slow 
but steady improvement was noted from day to day, especially 
in the brightness and temper of the child and in the diminution 
of the cdema. The dilatation of the heart decreased and the 
sounds improved, although the beats became rather rapid and 
equally spaced. The knee jerks changed noticeably and became 
normal on the left and slight on the right. Some cedema re- 
mained after three weeks of treatment, when the patient was 
discharged at the request of the parents. 
CASE 5 CONTINUED 
After having been treated one week with allantoin without 
benefit, the patient, who still showed the symptoms of chronic 
beriberi, was given 30 cubic centimeters of unhydrolyzed extract 
of rice polishings three times daily. This produced marked 
diarrhcea; so the dose was reduced to 15 cubic centimeters and 
continued for five days. The patient received no benefit, and 
the heart condition became markedly worse; we were forced to 
resort to symptomatic treatment with digitalis and strychnine. 
Of the use of neutral extract we have little to remark except 
the confirmation of the general experience that it is very bene- 
ficial in infantile, but not in adult cases, especially those of long 
standing. 
VITAMINE 
The vitamine found by Funk in rice polishings was isolated 
in a moderately pure condition, and this preparation was used 
in treating 6 cases of human beriberi. The method used for the 
isolation of the vitamine was that described by Funk,’ with 
minor modifications, which experience suggested. The chemical 
methods will be discussed fully in a later paper. 
* Journ. Physiol. (1911), 48, 395; (1912), 45, 75. 
