45 
are due to the disease, the prisoners only eat beans and dried 
goat’s meat imported from Rio Grande do Sul and Uruguay. Very 
little rice is used in the Santa Casa. The poorer class, in the suburbs 
and in the interior of the State, prefer farinha (mandioca meal) to rice. 
Beans, salt-cod, dried meat, plantains, farinha and fruit constitute the 
diet of many families, and yet beri-beri occurs. Much of the material 
used up-river is old and mouldy, but this does not apply to Manaos. 
Husked rice is used in Amazonas and is imported in sacks from 
Rio de Janeiro (arros national) and from Europe (arros carolino). It is 
well washed before being boiled, and is cooked for a long time. 
We have devoted considerable time to the investigation of this 
disease, but with few encouraging results. A large series of blood 
cultures; a series of cultures of the patient’s own colon bacilli, for 
agglutination with his blood serum, and cultures of organs at early 
post-mortem, and attempts to infect chimpanzees with rice or with 
food soiled with the faeces of beri-beri cases, constitute the p rincipa l 
6. Do they take rice? . . 
No. 
7. If no rice, what local farinaceous food? 
Principally farinha and yuca. 
8. Do they obtain salt meat or fish? Can salt be obtained locally? 
'Fish dried in the sun and preserved in tough, fibrous leaves tor 
varying periods of time is used extensively. Salt obtained from traders 
and possibly from Indians of the Kerary, though doubtful. 
9. Roughly'give diet of natives? . 
Consume very large quantities of paxiri. Sun-dried fish eaten raw, 
and fish broths seasoned to a fiery strength with ahi, into which are dipped 
pieces of baked cassava bread. Green boiled plantains and farm . 
uncooked or boiled to a viscous consistency known as mingai, and baked 
or stewed pupunhas. This varied from time to time with tapir, monkey, 
agouti, paca, peccary, and worms. 
10. Number of cases seen? - 
Three. Two men, 35 and 45 years old ; one woman, 20 years old. 
11. Native ideas of the disease? (Do the natives desert the sick and move to 
another village or hut?). 7,1 
Apparently unable to differentiate one disease from another e\en 
though different symptoms manifest themselves. Sick not deserte . 
12. Is there a possibility of beri-beri having been introduced from some infected 
district. 
No evidence of such. . • . . 
• 3 - 
14 - 
Forms of Beri-beri? 
Paralytic. Galloping. 
Treatment by natives? ' . , 
Removed to the darkest, least used or unoccupied portion ot the m “ 
to be cared for by the wife or nearest women relatives. Hammock siug 
very low to ground. Pages or medicine men practice their ritual o p « 
incantations, sucking and spitting to exorcise the tvil h >\ , 
eventually desist as the patient grows worse and the poor wretch is leu 
fare as best he can. 
