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
Schaumann considers the curative principle to be of the nature of
an activator. An increase in the ingestion of carbohydrates and
necessarily in the vitamine as well seems to produce neuritis more
rapidly than where a smaller amount is given, this indicating the
importance of these vitamines in carbohydrate metabolism.
There are those who deny this carbohydrate metabolism function of
vitamines and it is a fact that polyneuritis of fowls will develop on
a diet from which carbohydrates are excluded.
In epidemics of beriberi it has been observed that those who eat
most rice are more often attacked, thus men more frequently than
women. A temperature of 120°C. destroys the vitamine. Owing to the
absence of rice as a constituent of other than slightest importance
in the dietary of Brazilian cases of beriberi, as well as from
numerous reports of the occurrence of the disease in nonrice-eating
persons, the view that is now entertained is that not only polished
rice, but any predominating carbohydrate article of diet, which
is deficient in the neuritis-preventing substance, can produce
beriberi. Wellman and Bass have shown that such articles of diet as
sago, boiled white potatoes, corn grits and macaroni practically
parallel polished rice in the production of polyneuritis in fowls.
=Predisposing Causes.=—There does not seem to be any racial
predisposition other than that associated with the more varied
and the more neuritis-preventing diet of the white race. For the
same reason beriberi is more prevalent among the poor than among
the prosperous classes of countries where the disease exists
extensively.
It is customary to consider as predisposing causes bad hygienic
surroundings, such as occur in jails, camps, etc., as well as
the influence of warmth and dampness of the atmosphere. Beriberi
is more common among men than women and affects most commonly
individuals between 15 and 30 years of age. Physical exhaustion,
excessive grief, digestive derangements, abuse of alcohol and
tobacco are considered to have a bearing in the production of
the beriberi symptoms. Surgical operations may be followed by
manifestations of the disease.
=Epidemiology.=—Inasmuch as the experiments of Strong force us to
the conclusion that the disease is not infectious, the study of the
prevention of the disease would appear to rest almost exclusively in
the question of a neuritis-preventing dietary.
In this connection Heiser, in the Philippines, has reported that
with a diet in which polished rice was contained the monthly death
rate at the leper colony at Culion was approximately 100, the
majority of these deaths being from beriberi. As a result of the
substitution of unpolished rice, about 1909, the monthly death rate
fell to less than 20 and of these none were from beriberi.
Public-domain text, read in full here on John Shaqi.
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