292 Proceedings of Royal Society of Edinburgh. [sess. 
Definition . — A disease characterised by anaemia, anasarca, de- 
generation of muscular tissue, effusion into the serous cavities, de- 
bility, numbness, pain and paralysis of the extremities, especially 
the lower; precordial anxiety, pain, and dyspnoea, and in some 
cases drowsiness or sleepiness. Beri-beri occurs in a chronic and 
an acute form. 
Geographical Distribution. — Beri-beri, like other similar diseases, 
has a wide distribution in many countries situated in the tropical 
and sub-tropical zones, but, although its area of distribution is so 
extensive, it is strictly limited in its endemicity. It is to be found 
both in the eastern and western hemispheres. Looking at the 
eastern hemisphere first, we find that one of its chief habitats is in 
Japan. There it was limited, until fifty years ago, to the coast 
towns, but since that time it has been met with practically all over 
the islands. In China it is not so frequently seen now as it used 
to be, but it is endemic in Burmah, in Singapore, and in the 
Calabash islands. In the Malay Archipelago, we find that most 
of the islands are endemically affected, especially Sumatra, Banka, 
Borneo, Labuan, Celebes, and some of the Molucca group of islands. 
We meet with it, too, on the west coast of Hew Guinea, and on 
the extreme east of Java, as well as in the prisons of Batavia in 
Passuruan and Samarang. With regard to India, Beri-beri infests 
a strip of country, 100 miles broad, on the coast from Gran dj am to 
Masulipatam, while it is more rare on the Coromandel and 
Malabar coasts, and in the plain of the Carnatic. It is also met 
with at various isolated spots in the provinces of Decca and Assam, 
and it is seen occasionally in Calcutta. It exists in Ceylon, 
especially at Trincomalee and Candy. As an epidemic, it is met 
with in Mauritius, Reunion, Nossi Be, Zanzibar, and probably on 
the Congo. Passing to the western hemisphere, we find that Beri- 
beri has been undoubtedly imported from the east. Thus, at various 
times it has been epidemic in Guadaloupe, Cuba, Cayenne, Para- 
guay, and San Francisco. Beri-beri may be said to be endemic 
over the greater part of Brazil, where it commenced in the Bahia 
Province, and it is also met with in Guiana. It must be mentioned, 
too, that Beri-beri often breaks out on board ship, especially in 
transports, coolie ships, and vessels tradiug in the Malay Archipelago, 
Bay of Bengal, and with Japan. 
