Beriberi is a disease caused by a deficiency of vitamin B1, or thiamine, in the diet. Although some thiamine may be synthesized by bacteria living in the intestines, they cannot produce it in quantities large enough to meet the body's needs. Beriberi can be prevented only by eating foods containing the vitamin. These foods include whole grain products, such as whole wheat bread and unhusked rice, nuts, milk, pork, chicken, and legumes, such as peas. Sometimes a person whose diet includes raw fish may develop the disease even though he eats some thiamine-rich foods. This is because raw fish contains an enzyme, called thiaminase, that inactivates thiamine.
Prevalence of Beriberi
Beriberi is most common in the countries of the Far East, where husked, or polished, rice makes up a large part of the average diet. Uncooked fish is also widely eaten in many of these countries. In other parts of the world, beriberi occurs mostly in alcoholics, whose diets often do not include thiamine-containing foods. Sometimes beriberi occurs in pregnant women, whose supply of thiamine is depleted by the developing embryo.
Types of Beriberi
There are three major forms of beriberi: wet, dry, and infantile. Wet beriberi is an acute disease that causes heart failure, anemia, and edema (an accumulation of body fluids that results in swelling). Dry beriberi is a chronic disease generally characterized by neuritis (inflammation of the nerves), causing numbness and tingling in the hands and feet and sometimes producing a burning sensation in the soles of the feet. Eventually paralysis may occur, with a wasting away of the muscles of the arms and legs.
Infantile beriberi occurs in infants who are nursed by mothers afflicted with beriberi. This form of the disease occurs within the first year of life, usually between the first and fourth month, and is generally characterized by rapid heartbeat, vomiting, and convulsions. Unless the infant is treated immediately, he may die within a few days after the onset of symptoms. Treatment. All three forms of beriberi are treated by the administration of thiamine, either orally or through injections. In the wet and infantile forms, the patient may show signs of improvement within a few hours after receiving the vitamin. For dry beriberi, treatment takes longer, depending on how severely the nerves have been damaged.
History of Beriberi
The earliest written record of beriberi was found in an ancient Chinese medical book dated about 2700 B.C. It was not until the late 1800's, however, that the cause of the disease was suspected. In 1897, while working at a hospital for beriberi patients in Java, the Dutch physician Christiaan Eijkman noticed that laboratory chickens that were fed polished rice left over by patients soon developed a disease similar to beriberi. In studying this disease, Eijkman found that the chickens could be cured by feeding them rice that had not been husked. Unfortunately, however, Eijkman's findings were published only in Dutch and were not generally known for some years.
During the early 1900s, an outbreak of beriberi among plantation workers in Malaya posed a serious threat to the area's rubber production. Two British scientists, Henry Eraser and Ambrose Stanton, were sent to Malaya in 1909 to investigate the disease. Through their studies, which were similar to Eijkman's, they discovered that beriberi is caused by a deficiency of a certain substance in the diet. In later years, as more vitamins were isolated and studied, this substance was found to be the B vitamin thiamine.
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