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
Toward the close of 1911 there was a great shortage of the rice
crop and the Philippine government bought quantities of rice in
order to protect the people from extortionate dealers. Much of
this rice was polished rice. The use of this polished rice was
commenced at Culion in November, 1911. In January, 1912, there
were 35 deaths, of which 2 were from beriberi. In February 86
deaths with 36 from beriberi and in March 82 deaths with 60 from
beriberi. In February the use of polished rice was discontinued
and unpolished rice substituted. In April the deaths had fallen to
25 with 3 from beriberi and, subsequent to that month, deaths from
beriberi cases developing at Culion ceased to be reported.
As regards the length of time necessary for the production of
the symptom-complex, Strong’s experiments show that beriberi was
produced in from sixty-one to seventy-five days. In Fraser and
Stanton’s work no case developed under eighty-seven days and many
of the cases did not develop for 120 to 160 days. Hamilton Wright
considered that the incubation period for his toxin-producing
bacillus was ten to thirty days.
PATHOLOGY AND MORBID ANATOMY
In polyneuritis gallinarum, Vedder and Clark are of the opinion
that there may be two vitamines involved, the absence of one from
the dietary causing the neuritis, while that of the other leads to
general prostration and cardiac degeneration, so that there may be
other factors in the production of beriberi than the degeneration of
the peripheral nerves and involvement of the vasomotors.
Furthermore, extract of rice polishings rapidly cures the cardiac
condition as well as the dropsy, but not the paresis; while Funk’s
vitamine base, which will cure the paralysis, will not affect the
cardiac disorder.
The blood of beriberics in the acute stage, has been shown to
contain a substance capable of profoundly influencing the vasomotor
functions, causing venous engorgement and a fall of blood pressure.
In deaths from wet beriberi the tissues are very moist so that
incisions tend to fill with fluid. There are generally present
pleural and in particular pericardial effusions. Serous fluid
in the abdominal cavity may also be present. The lower end of
the stomach and the upper portion of the small intestines, in
particular the duodenum, show marked congestion with more or less
abundant haemorrhagic extravasations. Some authorities do not admit
the existence of this duodenal congestion so insisted upon by
Wright.
The oesophagus is usually congested as may be also the pharynx and
the larynx.
Public-domain text, read in full here on John Shaqi.
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