Beriberi
2007 Schools Wikipedia Selection. Related subjects: Health and medicine
Beriberi is a nervous system ailment caused by a deficiency of Vitamin B1 (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 B1. 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 B1 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.