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Beriberi

2007 Schools Wikipedia Selection. Related subjects: Health and medicine

   Beriberi is a nervous system ailment caused by a deficiency of Vitamin
   B[1] (thiamine), the symptoms of which may include weight loss,
   emotional disturbances, impaired sensory perception ( Wernicke's
   encephalopathy), weakness and pain in the limbs, and periods of
   irregular heartbeat. Swelling of bodily tissues (edema) is common. In
   advanced cases, the disease may cause heart failure and death. The
   origin of the word is from the Sinhalese (Sri Lankan) language meaning
   "I cannot, I cannot".

Causes

   Beriberi is caused by a lack of thiamine. It is common in people whose
   diet consists mainly of polished white rice, which contains little or
   no thiamine, in chronic alcoholics with impaired liver function, and is
   a known (though rare) potential side-effect of gastric bypass surgery.
   If a baby is fed the milk of a mother who suffers from a deficiency in
   thiamine, the child may develop beriberi.

   The disease has been seen traditionally in people in Asian countries
   (especially in the 19th century and before), due to those countries'
   reliance on rice as a staple food.

Symptoms and effects

   There are two forms of the disease: wet beriberi and dry beriberi.

   Wet beriberi affects the heart; it is sometimes fatal, as it causes a
   combination of heart failure and weakening of the capillary walls,
   which causes the peripheral tissues to become waterlogged. Dry beriberi
   causes wasting and partial paralysis resulting from damaged peripheral
   nerves. It is also referred to as endemic neuritis.

Treatment

   Treatment is with thiamine hydrochloride, either in tablet form or
   injection. A rapid and dramatic recovery can be made when this is
   administered to patients with beriberi, and their health can be
   transformed within an hour of administration of the treatment. Thiamine
   occurs naturally in fresh foods and cereals, particularly fresh meat,
   legumes, green vegetables, fruit, and milk.

History

   The discovery of the cause of beriberi started in Japan, where the
   disease was a national epidemic. The poor often mixed rice with barley,
   while the upper class ate only white rice. Therefore, during the feudal
   period, beriberi was commonly found among the upper class of Japan.
   However, the introduction of mechanical polishing of rice, and
   increased standards of living, allowed the poor to eat the more highly
   regarded diet of white rice without barley. This shift made beriberi
   widespread in urban Japan.

   The problem of beriberi was particularly acute in the Japanese
   military, where conscripts' diet often consisted of white rice and
   little else. Kanehiro Takaki, a Japanese naval physician, who was
   originally a doctor in Chinese medicine and who was later educated as a
   doctor in Britain, came to believe that diet was the cause of beriberi,
   which conflicted with the prevailing idea among medical scientists that
   beriberi was an infectious disease. Takaki knew that beriberi was not
   common among Western navies. He also noticed that Japanese naval
   officers, whose diet consisted of various types of vegetables and meat,
   rarely suffered from beriberi. On the other hand, for ordinary crewmen
   rice was free, while other foods had to be purchased. Those from poor
   families, who had to send money back home, often tried to save money by
   eating nothing but rice.

   Takaki, while serving on a battleship, experimented by providing a
   western style diet to his crew. In 1882, Takaki made a petition to
   Emperor Meiji to fund an experiment. In 1884, two battleships were
   chosen, the crew of one being fed with a mix of meat, fish, barley,
   rice, and beans, the other being fed with only white rice, with both
   ships traveling the exact same course. The latter soon reported that
   half of the crew was suffering from beriberi, while the former reported
   no cases of beriberi. This experiment convinced the Japanese Navy that
   poor diet is the cause of beriberi. They soon started to experiment
   with different combinations of diet. They eventually discovered the
   traditional combination of barley and rice to be an effective remedy,
   and the disease was soon eliminated from the Navy.

   However the Army, which was dominated by doctors from the University of
   Tokyo, persisted in their belief that beriberi was an infectious
   disease, and for decades refused to implement the effective remedy. In
   the Russo-Japanese War (1904–1905), 211,600 soldiers suffered from
   beriberi — 27,000 fatally, compared to 47,000 deaths from combat. Mori
   Ogai, the chief army physician and a proponent of the infectious
   disease theory, was later described as the man who caused more deaths
   than any Russian general. The Japanese medical establishment at that
   time was dominated by doctors from Tokyo University, many of them
   educated in Germany, who tended to regard medicine as scientific
   research. They thought that the dietary theory lacked a scientific
   explanation and were sceptical of the idea that disease can be cured by
   a simple change in diet. Those who practiced traditional medicine and
   those educated in Britain, on the other hand supported the view that
   the cause was in diet. In 1905, Kanehiro Takaki was made a Baron for
   his contribution of eliminating beriberi from Japanese Navy. He was
   later affectionately nicknamed "Barley Baron".

   In 1910, Umetaro Suzuki discovered and later received patent rights to
   aberic acid, which later became known as Vitamin B[1]. His research was
   the beginning of modern vitamin categorization. However, his discovery
   was not well known outside of Japan.

   In 1912, Casimir Funk isolated the anti-beriberi factor from rice and
   called it vitamine — an amine essential for life. In the 1930s, the
   chemical formula of this Vitamin B[1] was published by Robert R.
   Williams, and it was named thiamine.

   In the 1890s, a Dutch doctor, Christiaan Eijkman, found that fowl fed
   only on polished rice developed similar symptoms to his patients who
   had beriberi, and that they could be cured if they were also fed some
   of the husks from the rice grains. Together with Frederick Gowland
   Hopkins, he was awarded the Nobel Prize in Physiology or Medicine in
   1929.

   Beriberi was widespread among Allied prisoners of war captured by the
   Japanese during World War II. They were fed a diet of rice only, which
   did not contain adequate quantities of most vitamins. Other common
   diseases included malaria, dysentery and rickets.
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