Beriberi.

  • Vedder, Edward B. (Edward Bright), 1878-
Date:
1913
Catalogue details

Licence: In copyright

Credit: Beriberi. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    tism, etc. Thirst, diminution of urine, palpitation, dyspnoea, pains in the limbs are emphasized, while paralyses and anaesthesia are barely mentioned. The most important Japanese work in the history of beriberi is the Koyoigen (prescriptions from a physician's leisure hours). This was written by Kagawa Shuan in 1720, but was edited and many additions made in later years by his son and his pupils. Kagawa the elder says Kakke or kiakuki (a pain in the legs) as it is now observed is always chronic and death does not occur. He says pain in the legs is the chief symptom. His son adds the following: According to the authors from the dynasty Kan (Han 202-265) and To (Tang 618-907), the chief symptoms of kakke are weakness of the legs, severe oedema, dyspnoea, palpitation and anaesthesia. This disease was not present among us in earlier times but the pains in the legs and knees were only caused by dis- turbances in the circulation. True kakke only appeared since the year Horeki (1750) when the original author was already dead, and the symptoms of this disease agree Avith those of the authors of the dynasties Kan and To referred to. It is commonest in summer and autumn, rare in spring and winter. It usually affects young men, rarely women and children. The disease is very severe and fatal cases are common. Noro Genjio, a contemporary and court physician to the Shogun, agrees with this statement. Kaempfer, a physician prac- tising in Nagasaki in 1690-1692, and a keen observer, did not describe kakke. Scheube concludes from this evidence that beri- beri only appeared in Japan since 1750. This of course is quite possible, but it also seems equally possible that it may have occurred in earlier times and disappeared again before 1720 when Kagawa wrote his book. Beriberi appears in waves or epidemics under certain circumstances and then almost disappears again. This was the case in Manila in 1882, as will be explained later. It is also well known that beriberi attacks certain localities, leaving the rest of a country almost untouched. Scheube himself wrote in 1883 that kakke was almost entirely confined to the larger cities such as Tokio and Kioto, and practically unknown in the country districts. Under such circumstances it seems unsafe to conclude that beriberi was not present in Japan earlier than 1750 simply because one or two observers failed to see it or to differentiate it from other diseases. Bearing in mind the fact that diet in Japan as in China altered little in the course of centuries, it seems quite