1692 



BERI-BERI AND EPIDEMIC DROPSY 



colour index is said by other observers to be about normal, and 

 the proportion of white to red cells to vary from i to 430 at the 

 invasion, to i to 384 in the course, to i to 615 at the end. 

 Leucocytes are apparently always increased in number, but only 

 slightly. The differential count is: — 



Per Cent. 



Polymorphonuclears . , . . . . 6o'2 



Lymphocytes .. .. .. 21*4 



Mononuclears .. .. .. .. ii'j 



Eosinophiles . . . . . . . . . . 6-7 



No animal 01 vegetal parasites have been discovered in blood 

 which is sterile. 



The condition of the urine is described as very variable, but there 

 is no albumen and no casts are to be found. 



Effusions into the peritoneal and pleural cavities may take place. 

 The ahmentary canal is early irritated, and vomiting and diarrhoea 

 are common occurrences. A rash appears early on the extremities 

 in the dropsical areas; it is usually erythematous or ' measly,' but 

 vesicles and haemorrhages may be seen. Anaemia, as remarked, is 

 progressive during the disease, and there may be cardiac dilatation 

 with haemic murmurs. In severe cases there may be cough and 

 dyspnoea, due to oedema into the lungs. , Recovery is the rule, but 

 death may occur from cardiac or pulmonary complications. 



SequelSB.- — The onb/ sequela so far observed is cardiac weakness. 



Diagnosis. — Epidemic dropsy shows the following characteristic 

 signs: dropsy, slight fever, diarrhoea, rash, anaemia, and no albu- 

 minuria. 



Its diagnosis from beri-beri is based upon the presence of fever, 

 the persistence in some cases of the knee-jerk, the lack of paralysis, 

 of painful muscles, and of anaesthesia. Some authorities maintain, 

 however, that in epidemic dropsy there is no fever and no rash, and 

 is indistinguishable from beri-beri. 



Prognosis. — The prognosis is favourable except in the aged, the 

 case mortality being only 2 to 8 per cent. 



Treatment. — Rest in bed and the administration of calcium 

 chloride, or iron and strophanthus, are the only remedies usually 

 required. High temperatures should be treated by diaphoretics, 

 quinine, and sponging. 



Prophylaxis, — Segregation and disinfection are recommended, but 

 no rational prophylaxis can be advised so long as the cause remains 

 unknown. 



POTTER'S DISEASE. 



In 1913 Potter in Jamaica described a disease which began with 

 numbness, tingling cramps, loss of power, loss of hearing, and defec- 

 tive vision, without skin or mental symptoms, oedema or cardiac 

 symptoms. Both sexes are attacked, generally after puberty and 

 in rural districts. Whole families may be attacked. 



