The diagnostics and treatment of tropical diseasesStitt, E. R. (Edward Rhodes)
Science
The diagnostics and treatment of tropical diseases
Stitt, E. R. (Edward Rhodes)
Tropical medicine
_Vitamine Deficiency._—Grijns was the first to insist that beriberi
was due to the absence in the diet of some substance essential to
proper metabolism of the peripheral nerves. His views were along the
line of our present _vitamine deficiency ones_. There are undoubtedly
many different vitamines, varying as to nature of protective
power, temperature at which destroyed, solubility, etc. McCollum
emphasizes the importance of a fat soluble A and a water and alcohol
soluble substance B for proper metabolism. This latter, usually
designated “Water soluble B,” is generally considered the same as the
anti-neuritis vitamine but there is recent evidence that this may not
be the case. The antiscorbutic vitamine is water soluble C.
_Food Poisoning as Cause._—There are other theories as to
intestinal parasites causing the disease and in particular views as
to relation of fish eating to the disease, which are (1) that it is
caused by the ingestion of raw fish, or again (2) from the eating
of certain poisonous fish.
Miura, who is the great advocate of a fish intoxication, believes
that this comes about from eating fish belonging to the Scomberidae
family. As proving this, he cites the absence of beriberi in
prisons in Japan, where no fish is allowed. He does not recognize
that it is the diet of barley 6 to rice 4 parts which is the
prophylactic factor. Barley is rich in vitamines.
RICE AND BERIBERI
There are a few points in connection with rice which should be
understood. The larger part of the rice grain is starch and
covering this central starch core we have the rather thin aleurone
layer containing the proteid and fat constituents of the grain.
Externally there is an adherent layer, the pericarp, which varies
in color from red to white according to the kind of rice. The
pericarp contains the salts. The grain is covered by the husk which
is always removed to render the rice suitable for food. Unhusked
rice is called _padi_ in India and _palay_ in the Philippines. In
the process of removing the husk (milling) the pericarp and more or
less of the aleurone layer may be rubbed off the grain. When the
milling process is carried to the extent that but little remains
except the starch the rice is termed _polished_, _highly milled_,
or _white_ rice. A process of parboiling causes the husk to be more
easily detached and the pericarp to adhere more firmly to the grain
and when milled there is less loss of the anti-neuritis principle,
which is contained in the outer layers. Such rice is called
_cured_ rice. The embryo also contains the anti-neuritis vitamine
as well as the fat soluble A one. It is also lost in milling. The
scale-like dust is termed _rice polishings_ and has curative value
for those who have developed beriberi under a diet of polished
rice. When the milling process is less complete the rice so treated
is called _undermilled_ rice or _red_ rice. Polished, highly milled
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