116 The Philippine Journal of Science 1915 
patient was noticeable before the administration of the second 
dose, the dyspncea having become less severe. The child had also 
eaten with improved appetite. The following day the child 
breathed easily and freely, and the heart was vastly improved. 
The appetite was good, and sleep was sound and unbroken. All 
the symptoms of infantile beriberi disappeared in three days. 
The gain in weight during a week after treatment amounted to 
7 ounces. A month later the child was well and had gained 
greatly in general robustness. 
CASE 27 
A boy, aged 9 years, was admitted to the Philippine General 
Hospital under the care of Dr. José Albert, who kindly invited 
us to treat the patient and observed the results with us. Earlier 
than one week previous to admission the family and personal 
history appeared negative. At this time cedema began to appear 
in the face and three days later in all extremities. About the 
same time there was numbness and heaviness of the legs and 
difficulty in walking. Marked dyspncea and pains in the chest 
began the day previous to admission. All of these symptoms 
were increased in severity, so that when the patient was first seen 
he was unable to stand or walk. The heart showed general 
and marked enlargement. The first sound lacked clearness, but 
was without definite murmur, and the pulmonic second was ac- 
centuated. The apex beat was diffused, and pulsation of the 
neck veins was visible. 'The muscles of the calves were sensitive 
to pressure, and the knee jerks were entirely absent. The 
urine proved negative for albumin and casts. 
He was observed for thirty-six hours, being treated with nitro- 
glycerin several times. On the second day after admission, 
December 8, there was no substantial change in the condition of 
the patient. Cidema was more marked, and the pulse and res- 
pirations were very slightly improved. The heart was still much 
enlarged, as determined by percussion and verified by a skiagram 
(Plate I). 
He was given at this time the semicrystallized vitamine ob- 
tained from 25 kilograms of rice polishings. This was given by 
mouth during the course of the following twelve hours, being 
divided into 4 equal doses. A scarcely appreciable rise of tem- 
perature occurred. Twenty-four hours after administration of 
the first dose marked improvement of the dyspnea and heart 
condition was apparent. The cedema was also much diminished. 
At the end of forty-eight hours after the first dose the edema 
