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A Brief Note on Beri-beri in Asylums
Published online by Cambridge University Press: 19 February 2018
Extract
Elsewhere I have dwelt on the occurrence of beri-beri in temperate climates and on the clinical features of that affection as I have seen it. At an early date I hope to be able to publish in detail the clinical records of a number of interesting cases. It is not my intention on the present occasion to dwell, save incidentally, on the symptomatology of the disease, nor to indulge in any speculations upon its origin or essential nature, for these latter points are, unfortunately, still in the region of speculation, and the light which I can throw upon them is scanty and indirect.
- Type
- Part I.—Original Articles
- Information
- Copyright
- Copyright © Royal College of Psychiatrists, 1899
References
(1) In a paper read at the Tropical Diseases Section of the British Medical Association at the Annual Meeting, 1898; see Brit. Med. Journ., Sept. 24th, 1898.Google Scholar
(2) In a paper read at the Medical Section of the Royal Academy of Medicine in Ireland, Jan. 27th, 1899.Google Scholar
(3) See Putnam's article in Journal of Nervous and Mental Diseases, Aug., 1890. Dr. Osier informs me, on the authority of Dr. Birge, that such cases continue to occur among these fishermen.Google Scholar
(4) New York Medical Journal, Nov. 2Oth and 27th, 1897.Google Scholar
(5) Annales de l'Institut Pasteur, t. xii, No. 9 (Sept. 25th, 1898).Google Scholar
(6) Archives générales de Médecine, 1858, vols, i and ii.Google Scholar
(7) See paper and discussion in Allgemeine Zeitschrift fär Psychiatrie, Bd. Iv, H. i.Google Scholar
(8) The disease is probably both variable and periodic. Dr. Sinclair, Residency Surgeon at Selangor, has noted in his annual report for 1890 the variability which occurs in the Straits Settlements. He says, “The disease, happily, though still very prevalent, seems to have altered its character. In former years the history was an acute one; fever, ansemia, rapidly advancing paralysis and cardiac weakness, dropsy and death, or protracted paralysis in cases of recovery. Now it seems to be more chronic, perhaps endemic. Little or no aniemia with slight cardiac weakness, and subacute or chronic paralysis; death due less frequently to beri-beri itself than to intercurrent disease.” Probably this change is analogous to that which distinguished the first from the later Dublin epidemics. As to periodicity some interesting observations made in the Dutch colonies in the Malayan Archi pelago have been recorded by Kohlbrugge of Tosari, Java, in the Therapeutische Monatshefte (Bd. xxx, H. I, January, 1899), from which it would appear that the prevalence of beri-beri amongst the European troops rose steadily from 1873 till 1884; and that there was then a sudden increase continuing till 1888, when the disease began to decline and decreased continuously till 1897. Treatment, pro phylactic and other, seemed of little service, and disinfection valueless. The disease declined as unaccountably as it rose. Meanwhile Asiatics were more severely affected than Europeans, and the Asiatic curve, as it were, over-rode the European, beginning some years earlier, rising to a much greater height, and declining much more tardily. A similar periodicity, however, is evident in both.Google Scholar
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