404 THE ETIOLOGY OF TROPICAL DISEASES 



of Shiga, Kruse, Flexner, and others point to acute dysentery being caused by the 

 specific bacillus B. dysenterioB, or some member of that group of organisms. Mott 

 holds that " asylum dysentery " is identical with tropical dysentery, and both 

 conditions are in all probability of bacillary origin.* 



Beri-b»ri.—The first medical writer to describe beri-beri, and by that name, was 

 Dr J. D. Malcolmson, F.R.S., of the Madras Medical Service, in a paper published 

 in 1835. Sir Joseph Fayrer, F.R.S., wrote on it, identifying one form of it with 

 the barbiers of the earlier European travellers, t The disease is endemic in Western 

 India, in the Indian Archipelago, and throughout the coasts of Further India and 

 Upper India, or China and Japan. It is practically confined to the labouring classes 

 where they are vegetarians. Dr Wallace Taylor traces it to a microscopic spore 

 infecting rice ; and other observers consider it a " place disease. " The salient fact 

 is that it almost exclusively attacks those who are engaged in hard labour on insuffi- 

 cient nourishment, and it may be defined as the scurvy of the tropics. It is marked 

 by extreme weakness and dropsical distension of the abdomen, Umbs, and face, both 

 symptoms developing so rapidly as to alarm alike the sufferer and those attending to 

 him. Hence its name beri, meaning " debility," and the reduplication of it, beri-beri 

 signifying " extreme," " alarming," " fatal," debility. 



The disease is in all probability a germ disease but possibly not communicable 

 from man to man. It may be that the germ resides in soil or rice, or houses, and 

 surroundings of beri-beri localities, and produces a toxin which on being absorbed 

 produces a disease having many similarities with alcoholic neuritis (Manson). This 

 may be the explanation of the view that beri-beri is a " place disease." Pekelharing 

 and Winkler hold that they have isolated a bacterium which is the cause of the 

 disease, but their views 'aave not been generally accepted. 



* See a\so Bacterioloffical and Clinical Studies oftheDiarrhoeal Diseases ofln/aney, 

 by Flexner and Emmett Holt (Rockefeller Inst. Rep.), 1904. 



t Practitioner (January), 1877 ; see also Report on Prison Administration in 

 Burma, 1878. 



