x, B, 2 Williams and Saleeby: Treatment of Human Beribert 117 
had practically disappeared, the heart enlargement had markedly 
diminished, especially on the right (Plate IJ), and the general 
condition was vastly improved, as indicated by the temper, ap- 
petite, and voice. Improvement continued for a few days, when 
the child’s condition appeared normal, except for the continued 
slight accentuation of the pulmonic second and absence of knee 
jerks. At the end of a month the heart had become entirely 
normal, and the knee reflexes were detectable, although still much 
diminished. 
In 5 of the 6 cases treated with vitamine, improvement was so 
prompt and radical as to leave no doubt of the specific curative 
properties of the substance. Even in the sixth (case 25), al- 
though the dose was relatively minute, amounting to about 0.25 
gram of dry substance for a man weighing about 50 kilograms, 
improvement although gradual was marked. 
We are unable to assign a definite cause for the rise of tem- 
perature after the administration of vitamine. No such tem- 
perature rise has been noted in fowls, nor is there any record 
of an observation to the contrary. Therefore this reaction may 
be due to the vitamine itself or to an impurity in our product. 
Funk® has noted that the pure substance is without marked 
physiological properties. If, therefore, the temperature reaction 
is due to the vitamine itself, it must constitute a specific reaction 
for beriberi. It will be noted that in the cases in which the 
temperature rise was slight or absent the amount of vitamine 
was either small or administered in small doses at intervals of 
a few hours. This was done to avoid the rise of temperature, 
which had caused considerable anxiety, especially in case 23. 
It should be noted also that case 4, after treatment for three 
weeks with hydrolyzed extract, also experienced a temporary 
rise of temperature very much like that noted in case 23. 
CONCLUSIONS 
Allantoin has a beneficial effect in certain cases of beriberi, 
although probably never amounting to a complete cure. Its 
value should be tested further. 
Hydrolyzed extract of rice polishings has benefited all the types 
of beriberi upon which it has been tried. It can be of practical 
service, but should be used only in cases under the direct super- 
vision of physicians and nurses. 
Unhydrolyzed extract of rice polishings is a safe and valuable 
remedy for infantile beriberi, but is of little use for older cases. 
* Journ. Phys. (1918), 46, 178. 
