t68o 



BERI-BERI AND EPIDEMIC DROPSY 



{b) Coccus and Bacillus. 



Pleomorphic organism obtained by Pekelharing and Winckler 



from the blood. 

 Bacilli and cocci by Lacerda. 



(c) Bacilli. 



1. Bacillus by Taylor. 



2. Bacillus by Rost. 



3. Bacillus by Ogata. 



4. Three kinds of bacilli by Nepveu. 



5. Bacillus by Eccke , 



Toxins from a bacillus in the alimentary canal (Hamilton Wright). 

 {d) Fungi higher than Bacteria. 

 Mouldy rice (Hose). 



Protozoa. — Glogner's parasites were similar to malarial parasites, but were 

 distinguished therefrom by being found only in splenic blood, by being 

 always extracorpuscular, and by increasing by gemmation. They were more 

 pigmented than malarial parasites. Scheube thinks that Glogner's cases 

 were comphcations of beri-beri with malaria, 



Hewlett and Korte centrifugalized the urine of beri-beri cases, and found 

 small refractile spherical bodies, 2 to 3 in diameter, with a thick capsule 

 and hyaline contents; others 20 jj, in diameter, with a cytoplasm studded 

 with refractile granules, and containing a single nucleus; and others 30 jj,, 

 with a thick capsule, an oval nucleus, and a rounded nucleolus. They further 

 described the congestion of the glomerular vessels and haemorrhages into the 

 tubules of the kidney. Further, they saw a somewhat similar disease in 

 monkeys, the urine of which contained highly refracted cells. They conclude 

 that the above are either peculiar degenerate cells or protozoa, and suggest 

 that the disease is a protozoan infection, and that the causal agent is ehmi- 

 nated by the urine. Fijordo and Voorthuis separately describe haematozoa, 

 partly free and partly in the red cells, which are similar to, but not identical 

 with, the malarial parasites. Their organisms do not agree with one another, 

 nor do they correspond to Glogner's. 



N emathelminthes . — Gelpke suggested that the disease might be due to a 

 Trichinella in fish, but he has withdrawn this. Trichiuris and Ancylostoma 

 need not seriously be considered, as this idea arose from a misunderstanding. 



Fungi. — Pekelharing and Winckler's bacillus has also been found by Hunter, 

 and experimental inoculations by both sets of observers produced degenera- 

 tions of the nerves. But it must be admitted with regard to bacteria that 

 competent observers have found the blood sterile time after time. 



Hamilton Wright's bacillus, which occurs in the alimentary canal, has been 

 found by Dudgeon to be non-pathogenic for monkeys, and not to be aggluti- 

 nated by the blood of beri-beri patients. Stanley's experiments on animals 

 with mouldy rice have been negative. Finally, attention may be drawn to 

 the researches of Hoist, Nocht, and the Norwegian Ship Beri-Beri Committee, 

 which indicate that the so-called ship beri-beri is not beri-beri, as the symp- 

 toms are shortness of breath and weak heart, with weakness and dropsy of 

 the lower limbs, but not paralysis of the limbs — i.e., the degeneration of 

 the nerves is not an essential phenomenon. 



Chalmers and Archibald separately have found fungi in the organs 

 of cases of beri-beri occurring at different times in British troops in 

 Khartoum. We feel that more than one disease is included under 

 the term beri-beri. One of these diseases is a deficiency disease, 

 but the others await discovery. 



Predisposing Causes. — The disease can occur in all races, and at 

 all ages, and in both sexes, but it is apt to cling particularly to one 

 race in a country — e.g., the Chinese in Malaya, the Filipinos in the 



