1690 



BERI-BERI AND EPIDEMIC DROPSY 



minimum legal limit of 0-5 per cent. Pg^s ^^^^ should be 



imposed, or, failing this, the substitution of other foods, to make 

 up the deficient ingredient, and a strict control of cured rice^ — i.e., 

 white rice. Pregnant and nursing women especially should have a 

 liberal diet and harmless rice. 



A good nourishing diet is most important. 



Good hygienic surroundings — i.e., good ventilation, the avoid- 

 ance of overcrowding, plenty of sunshine, and exercise in the open 

 air — may be mentioned. 



It is as well to thoroughly disinfect with Clayton gas or sulphur 

 and formalin any room in which beri-beri patients have been 

 living, or any infected house or ship. 



SHIP BERI-BERI. 



Synonym. — Norwegian Beri-beri. Some authorities consider ship or 

 Norwegian beri-beri to be a separate entity from tropical beri-beri, and believe 

 it to be a deficiency disease taking an intermediate position between true 

 beri-beri and scurvy. Clinically, however, the condition is identical with 

 tropical beri-beri, and runs the same course, 



INFANTILE BERI-BERI. 



Synonyms.— Philippines : Taon, taol suba. 



Infants nursed by mothers suffering from beri-beri, and living on 

 a defective dietary in the Phihppine Islands, suffer from oedema, 

 dyspepsia, and cyanosis, and often die suddenly. Post-mortem 

 investigations show degenerations in the vagi, phrenics, intercostals, 

 and anterior tibial nerves, but not so extensive as in adults. 

 Chamberlain, V edder, Andrews, and others conclude that this is an 

 infantile beri-beri due to some deficiency in the mother's milk, and 

 hnd that it causes 56 per cent, of the infantile mortality in the 

 Phihppines. 



EPIDEMIC DROPSY. 

 Synonym. — Acute anaemic dropsy. 



Definition. — Epidemic dropsy is an acute infectious disease of 

 unknown cause, characterized by fever, dropsy, an erythematous 

 eruption, and sometimes cardiac symptoms, but without paralysis 

 or anaesthesia. 



History. — In 1876-77 there was a great famine in Southern 

 India, during which a dropsical disease, at the time called ' beri- 

 beri,' was noted. It is possible that this dropsical disease was con- 

 veyed in some way from Madras to Calcutta, for in 1877 there was 

 an outbreak of epidemic dropsy for the first recorded time in that 

 city. It appeared when the rains were over, and extended through 

 the cold season into 1878, disappearing when the warm weather 

 commenced in April. It recurred again, and followed the same 

 course in the cold season of 1878 and 1879, and it disappeared in the 

 warm weather of 1880, reappearing this time in the warm weather 

 of 1881. It only attacked natives of India, but it spread from 



