Beriberi Symptoms

Beriberi is a disease which at one time was particularly common among oriental people, though by no means unknown outside of Asia. Its final stage takes the form of a general paralysis, which is usually very quickly followed by death; but it has a number of earlier symptoms that physicians have discovered. The first diagnosis may point to nothing more than a catarrh, but this is followed by pains in the limbs, by swelling of parts, by extreme weakness and possible paralysis of legs. If the disease makes further headway, the swellings will extend in size and increase in number; so will the paralysis; and with all this there develops a marked difficulty in breathing. In time the patient can neither walk nor move his arms, and his heart may become seriously affected.

Until quite recently the cause of this disease was a mystery. The popular belief was that it was due to an infection. Some physicians, however, insisted that its origin must be traced to a faulty diet.

Beriberi Among The Japanese

The "diet" theory was very strongly advocated by Takaki, at one time medical inspector-general of the Japanese navy. He had made very extensive studies of European systems of hygiene, and found that in this respect Japanese sailors suffered little by comparison with European sailors. The latter had few or no beriberi cases, whereas the Japanese were simply infested with them. Clearly beriberi was due to something other than infection.

While in Europe Takaki had noted the proportions of fat, carbohydrate and protein that were distributed among the men. By comparison with the Japanese, the Europeans were getting far more protein. Much of the Japanese diet consisted of rice, which contains a high percentage of carbohydrate. Takaki therefore recommended that other foods richer in protein be substituted for part of this rice. Like all innovations, this one met with much opposition.

Then in the early eighties of the last century came the opportunity for a crucial test. A Japanese training ship, the Ruijo, with 276 men on board, set out for a cruise of nine months. During this time 169 cases of beriberi developed, and of these, 25 died. Soon after, another training ship, the Tsukuba, with a similar crew, was sent out over the same route; but this time, as the result of Takaki's earnest plea, the crew's diet was radically changed. The most marked departure in the diet was to reduce the quantity of rice and include a fairly liberal supply of milk and meat, the latter two yielding the increased amount of protein. The change was nothing short of miraculous. During ten months only 14 cases of beriberi developed, and every one of these men had refused to adopt the modified diet!

Takaki became the hero. Rice, which the Japanese had eaten almost exclusively, was now reduced in quantity; meat, fish, vegetables and milk were substituted, and everywhere the beneficial results of the modified diet were in evidence.

You will remember that Takaki regarded beriberi as being due to protein deficiency, and the results apparently confirmed his view. We must now record some observations which will prove that the disease is not due to protein, but to vitamine deficiency; that rice of the type used by the Japanese is woefully deficient in vitamine of the water-soluble B type; and that the addition of meat and vegetables and milk supplied the necessary vitamine.

Polyneurites In Fowls

We must turn our attention to another eastern colony, Java, a Dutch settlement. The year is 1897. For fifteen years - ever since 1882 - no further progress on the cause of beriberi had been made. Many had adopted Takaki's view of protein deficiency. Some still adhered to the infection theory. An accident led Eijkman, a Dutch physician stationed at Java, to re-investigate the whole subject. He had some fowls that were to be used for a number of experiments in which he was interested. One fine day all the fowls fell sick. The symptoms they developed were characteristic of the symptoms the natives developed in beriberi, only to distinguish it from the form common to human beings, Eijkman called the disease in fowls polyneuritis. But how did the fowls get the disease?

Upon questioning the attendant, the important information was brought out that some days preceding the outbreak the fowls were fed with some cooked rice left over in the hospital kitchen. Eijkman thereupon replaced the diet of cooked rice with another also consisting of rice, but in the raw, unhusked condition. The fowls very quickly got well again.