Page:Tropical Diseases.djvu/449



Definition.— Beriberi is a form of multiple peripheral neuritis occurring endemically, or as an epidemic, in most tropical and sub-tropical climates, and also, under certain conditions, in more temperate latitudes. The mortality is considerable, death usually depending on heart paresis.

Historical.— The special nature of beriberi was recognized by the Dutch in the early years of their intercourse with the East. Later, it was studied by British physicians in India, particularly by Malcom sen, Carter, Waring, and Morehead. It was not until a more recent epidemic in Brazil that beriberi began to receive attention from the present generation of medical men ; and only when Anderson, Simmons, Scheube, and Baelz took up the subject in Japan was it studied by modern methods, accurately defined, and its true pathology apprehended. Scheube and Baelz were the first to show distinctly that beriberi is of the nature of a peripheral neuritis similar to that of diphtheria and alcohol a view which was subsequently confirmed and adopted by Pekelharing and Winkler, and by most subsequent observers. More recently, and mainly owing to the investigations of Eijkman, Braddon, Fraser, and Stanton, its principal it may not be the only etiological factor has been shown to be a dietary of which the staple ingredient is over-milled rice.

Geographical distribution.— The area of the endemic distribution of beriberi is coextensive,