Licence: Public Domain Mark
Credit: Beriberi. Source: Wellcome Collection.
Provider: This material has been provided by the Gerstein Science Information Centre at the University of Toronto, through the Medical Heritage Library. The original may be consulted at the Gerstein Science Information Centre, University of Toronto.
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![any other disease. We naturally refrain from prescribing articles of diet that are notoriously difficult of digestion, and the amount of rice that they are accustomed to eat must be much curtailed, particu- larly if the polished variety is used. Otherwise there is little about the digestion that deserves comment. In some cases, however, vomit- ing occurs and is a serious symptom, since it usually indicates the onset of the disease in acute form, and in these cases the stomach must be most considerately treated. Diarrhoea and constipation l)oth occur, but the latter is l3y far the commoner and most characteristic. The Respiratory System. We have already referred to oedema of the lungs. Another important symptom that occurs more or less frequently is aphonia. This is usually only seen in advanced cases, and is pro]]al)ly due to paralysis of the muscles of the larynx which are supplied by the pneumogastric nerve. It is a very serious symp- tom and usual)}- means impending death, either because it ha])])ens to be one of the last symj^toms to develop as the disease ])rogresses. or because such extensive involvement of the pneumogastric must neces- sarily incapacitate the heart, wdiich it also innervates. Urinary System. The autopsy frequently shows a more or less intense congestion of the kidneys, almost merging into inflammation. As a result we find that the quantity of urine is generally diminished, and in acute cases the urine may be completely suppressed for several days before death. Schcube reports that the specific gravity is dimin- ished and that the secretion of urea, uric acid and phosphoric acid is also decreased. It has been noted that patients affected with the wet form may on occasions pass large quantities of urine, a process asso- ciated with the resor])tion of the dropsical effusions. The cause of this phenomenon is as oljscure as the cause of the oedema and ])r(3])- ably connected with it. Sugar is not found in the urine and albumen occur> on!}' rarely and in small quantities, probably corres])onding to those cases in which the congestion of the kidneys has changed to active inflammation. Sexual organs ])resent nothing of interest except that it has been reported that beribcric women cease to menstruate, and that this func- tion returns after convalescence. Differential Diagnosis. AAdiile beriberi is generally easily recog- nized, individual cases sometimes present great difficulties, especially when there is no oedema and the heart is little aff'ected. Such cases resemble the common peripheral neuritides. The following distinc- tions may ])e of help in making the diagnosis:](https://iiif.wellcomecollection.org/image/b20995611_0082.jp2/full/800%2C/0/default.jpg)
