CLIMA TOLOGY—MTIOLOGY 



1673 



In 1913 Cooper, and in 1917 Chick and Hume, studied the subject 

 of vitamines, the two latter especially dealing with beri-beri 

 vit amine. 



Climatology. — The endemic centre of beri-beri appears to be 

 Eastern Asia, Japan, China, the Philippine Islands, Indo-China, 

 Java, and Malaya. It is also said to occur in Brazil and, according 

 to Plehn, in Reunion, Mauritius, Nossi-be, Zanzibar, Cape Colony, 

 Senegal, Angola, the Congo Free State, and the Cameroons. We 

 have met with the disease on the Gold Coast in Chinese miners, but 

 have not noted it in the native population, though it may possibly 

 exist. Isolated epidemics, sporadic or imported cases, occur in 

 England, Ireland, and other parts of Europe, the United States, 

 Canada, and in Ceylon. In the last-named place it is now almost 

 entirely absent, and, indeed, it is possible that many of the cases 

 reported years ago may have been ankylostomiasis or some other 

 disease. Imported cases from India and China are frequently met 

 with in Colombo, owing to its possessing a large harbour where 

 numerous vessels, with Chinese and Indian crews, call. 



It is believed that the Bihimbo disease of the Chaka district of 

 Uganda is beri-beri. The disease known in that country as mun- 

 hiyo, and believed at one time to be beri-beri, has been demon- 

 strated to be Malta fever. In the tropics it is said to occur more 

 often in the cool wet months. 



etiology. — The- causation of beri-beri is at the present time 

 believed to be due to the deficiency of some essential substance in 

 the food, but as may be imagined in such a widespread and fatal 

 disorder, the investigators have been many, and hence the theories 

 are legion. In order to comprehend the present state of the ques- 

 tion, it is necessary very briefly to review a few of these theories, 

 which will be best done by following a method of classification. 



A. Physical Cause. — The older writers, like Davy, considered that it was 

 brought about by some unusual state of the atmosphere, but they said, 

 honestly, that this was merely a cloak for their ignorance of the true cause. 



B. Chemical Causes. — The chemical causes which have been advanced are: — 



1 . Arsenical poisoning (Ross) . 



2 . Oxalate poisoning (Treu tlein) , 



3. Carbon dioxide poisoning (Ashmead). 



4. Food poisoning: — 



(a) Ichthyotoxismus (Grimm and Miura) . 



(&) Sitotoxismus (Eijkman, Vorderman, Yamagiwa, Van 

 ;v1 Dieren) ; rice (Gelpke, Braddon) ; lathyrism (Le Roy de 

 Mericourt) . 



5. Some deficiency in the food : — 



{a) Deficient nitrogenous complex (vitamine) (Eijkman. 



Fraser, and Stanton). 

 (&) Deficient nitrogen (Takaki). 



c) Deficient fat (Bremaud and Laurent) . 



d) Deficient vegetables, together with an infection (Fales). 

 [e] Deficient phosphorus. 

 If) Deficient cholesterin (Chrisostem) . 



6. An intoxication from a germ living outside the body (Manson). 



7. An intoxication or an auto-intoxication (Duerck). 



