fdttal
Jtfujs.
LONDON LETTER.
(Our Special Correspondent.) The outbreak of a disease so oriental in nature and name as Beri-Beri in an Irish lunatic asylum is a very remarkable circumstance, yet it appears to be a veritable fact. The disease seems
to have made its appearance early in September, and to have rapidly reached a climax in about There were 110 cases under treata month. ment in the first week of October. It has subsided with equal rapidity, and the latest accounts indicate that, with the advent of winter, iiew:
\
.
to. 1895.]
LONDON LETTER:
f
7
'
'r ?
45
and often violent variations of temperature, have ceased to appear, though some 150 moisture and wind. Provision is therefore a seizures with 23 deaths have taken place. The diagnosis seems to be beyond question, both the matter of no small difficulty, though of: great importance to health and comfort. It is notedropsical and paralytic symptoms which constiworthy that, with the better understanding of tute the principal feature of the malady being the law of weather and the more rapid and well marked. Medical Officers who had seen beri-beri in Japan and Singapore had no hesitasystematic exchange of information from place to place, it has become possible to prophesy tion in identifying it; though as might be expected, the phenomena were in some minor the probable weather of to-morrow with great points not quite identical. The Medical Super- accuracy. The progress of cyclonic disturbances can be watched and foretold with confidence, intendent of the Asylum, Dr. Norman, in his '? and information is of vital importance this latest report states that further clinical obserto the mariner and farmer ; but even without vation confirms me in the opinion that the disthe clear indications afforded by advancing ease is the so-called beri-beri and this view is supported by the discovery of certain organisms storms, the daily weather forecasts published in the newspapers are seldom far and never in the blood." There is no evidence of any similar disease prevailing in Dublin or any altogether wrong, and are often strikingly and other part of Ireland at the same time, and the literally correct. To the traveller, sportsman and golfer,; this is practically useful; but with did this how outbreak arises question strange occur in so isolated and peculiar a community ; increasing accuracy and confidence in these forewere the casts, great benefit must accrue to the community germs of it, whose existence is still at from without and did introduced doubtful, large, by way of rendering the prevention of they' find in the conditions of the locality and instisoaking and chill possible. Still, there are those who cannot live in health and comfort through tution a suitable nidus, or are we to look on the a British winter and spring, arid who must, if outbreak as autogenous?the product of a special' environment affecting special subjects? The reply, they can afford it like the birds migrate to a more to these questions is so far a matter of speculacongenial environment. Attention has recently begn drawn to the discomforts, as regards action. Three points :ippear to be quite certain? and food which are frequently commodation Richmond is that site of the the first, Asylum low; encountered in places otherwise very eligible and damp ; second, that the institution built to for winter and spring residence and which are accommodate about '1,000 inmates, contained at often highly landed and much advertised.- This the period of the outbreak some.1,500 ; and, third; is a very important,point, and I would, strongly that a low type of dysentery had been prevailing counsel old, or for the matter of that young, in the asylum for some time before these events occurred. Are over-crowding, damp and fcetor Indians, in search of a health resort to make very competent to produce beri-beri ? An intelligent special enquiries regarding the housing and feedwriter in the B7'itish Medical Journal compares ing available. The retirement of -Sir Joseph Fayrer from the the conditions which seem to have obtained in the Richmond Asylum at the time of the-outPresidency of the Medical Board at the India Office takes place in January next. It is very break to those which arise in the forecastle hard lines for Sir Joseph, whose capacity is ; of a trading vessel or the hold of a crowded emigrant ship, where epidemics of beri-beri unimpaired and experience unrivalled, to have to submit to an age-condition which was -/riot in have not ^infrequently been observed in the tropics. But admitting the analogy, Dublin existence when he accepted the appointment. I hope the authorities will take this into conis certainly not tropical and beyond the cases sideration and.bestow .on him such honorary .and of a few seamen landed in London with, the disease contracted in the East, the malady has substantial compensation as his distinguished career and the loss of his hitherto been unknown as a British disease. appointment entitle him to. This is not: the place nor perhaps the Hence the great interest, which this outbreak time to;attempt-any sketch of Sir Joseph Fayrer's has excited and the anxiety with which Dr. eventful and most useful life; He has filled Norman's full and final report of his observations and conclusions is awaited. The only many, high offices, and; always lived and worked redeeming feature in the matter is that a new to the full level of their requirements.. A high sense of honour, terror has been added to the evil of over-crowdgreat abilities, true love of his At time of this weather the profession, ing. year, unweaiying diligency have combined to enable him to turn becomes a subject of keen and constant interest. opportunities of distinction which fall to the lot of very few to high We do not enjoy (or suffer) the great meteorological uniformities which render weather pre- advantage. He has had, his?meed of praise, pf dictions almost a certainty in India. In these success, of titles and honours,; literary, scientific and social; but it seems to me that a. Life of suqh British isles we are in the centre of a circle of influences'from North, South, East and West, exceptional merit and value as his should not be from ocean and continent, which cause rapid permitted, to cjose v^ithout impressing. ou> itisome cases
,
-'
.
,
46
INDIAN MEDICAL GAZETTE
token of recognition?a peerage or even a barofor example?which would in some measure requite its desert and render it conspicuous for future imitation and emulation. Whatever may be" done in this direction by the powers that be will be gratefully received by the Indian Medical Service, effective and non-effective?as an honour bestowed upon an organization which has for so long and in so many ways deserved well of the British Empiie.
netcy
"
9th November 1894.
[Jan.
1895.
Jtfujs.
LONDON LETTER.
(Our Special Correspondent.) The outbreak of a disease so oriental in nature and name as Beri-Beri in an Irish lunatic asylum is a very remarkable circumstance, yet it appears to be a veritable fact. The disease seems
to have made its appearance early in September, and to have rapidly reached a climax in about There were 110 cases under treata month. ment in the first week of October. It has subsided with equal rapidity, and the latest accounts indicate that, with the advent of winter, iiew:
\
.
to. 1895.]
LONDON LETTER:
f
7
'
'r ?
45
and often violent variations of temperature, have ceased to appear, though some 150 moisture and wind. Provision is therefore a seizures with 23 deaths have taken place. The diagnosis seems to be beyond question, both the matter of no small difficulty, though of: great importance to health and comfort. It is notedropsical and paralytic symptoms which constiworthy that, with the better understanding of tute the principal feature of the malady being the law of weather and the more rapid and well marked. Medical Officers who had seen beri-beri in Japan and Singapore had no hesitasystematic exchange of information from place to place, it has become possible to prophesy tion in identifying it; though as might be expected, the phenomena were in some minor the probable weather of to-morrow with great points not quite identical. The Medical Super- accuracy. The progress of cyclonic disturbances can be watched and foretold with confidence, intendent of the Asylum, Dr. Norman, in his '? and information is of vital importance this latest report states that further clinical obserto the mariner and farmer ; but even without vation confirms me in the opinion that the disthe clear indications afforded by advancing ease is the so-called beri-beri and this view is supported by the discovery of certain organisms storms, the daily weather forecasts published in the newspapers are seldom far and never in the blood." There is no evidence of any similar disease prevailing in Dublin or any altogether wrong, and are often strikingly and other part of Ireland at the same time, and the literally correct. To the traveller, sportsman and golfer,; this is practically useful; but with did this how outbreak arises question strange occur in so isolated and peculiar a community ; increasing accuracy and confidence in these forewere the casts, great benefit must accrue to the community germs of it, whose existence is still at from without and did introduced doubtful, large, by way of rendering the prevention of they' find in the conditions of the locality and instisoaking and chill possible. Still, there are those who cannot live in health and comfort through tution a suitable nidus, or are we to look on the a British winter and spring, arid who must, if outbreak as autogenous?the product of a special' environment affecting special subjects? The reply, they can afford it like the birds migrate to a more to these questions is so far a matter of speculacongenial environment. Attention has recently begn drawn to the discomforts, as regards action. Three points :ippear to be quite certain? and food which are frequently commodation Richmond is that site of the the first, Asylum low; encountered in places otherwise very eligible and damp ; second, that the institution built to for winter and spring residence and which are accommodate about '1,000 inmates, contained at often highly landed and much advertised.- This the period of the outbreak some.1,500 ; and, third; is a very important,point, and I would, strongly that a low type of dysentery had been prevailing counsel old, or for the matter of that young, in the asylum for some time before these events occurred. Are over-crowding, damp and fcetor Indians, in search of a health resort to make very competent to produce beri-beri ? An intelligent special enquiries regarding the housing and feedwriter in the B7'itish Medical Journal compares ing available. The retirement of -Sir Joseph Fayrer from the the conditions which seem to have obtained in the Richmond Asylum at the time of the-outPresidency of the Medical Board at the India Office takes place in January next. It is very break to those which arise in the forecastle hard lines for Sir Joseph, whose capacity is ; of a trading vessel or the hold of a crowded emigrant ship, where epidemics of beri-beri unimpaired and experience unrivalled, to have to submit to an age-condition which was -/riot in have not ^infrequently been observed in the tropics. But admitting the analogy, Dublin existence when he accepted the appointment. I hope the authorities will take this into conis certainly not tropical and beyond the cases sideration and.bestow .on him such honorary .and of a few seamen landed in London with, the disease contracted in the East, the malady has substantial compensation as his distinguished career and the loss of his hitherto been unknown as a British disease. appointment entitle him to. This is not: the place nor perhaps the Hence the great interest, which this outbreak time to;attempt-any sketch of Sir Joseph Fayrer's has excited and the anxiety with which Dr. eventful and most useful life; He has filled Norman's full and final report of his observations and conclusions is awaited. The only many, high offices, and; always lived and worked redeeming feature in the matter is that a new to the full level of their requirements.. A high sense of honour, terror has been added to the evil of over-crowdgreat abilities, true love of his At time of this weather the profession, ing. year, unweaiying diligency have combined to enable him to turn becomes a subject of keen and constant interest. opportunities of distinction which fall to the lot of very few to high We do not enjoy (or suffer) the great meteorological uniformities which render weather pre- advantage. He has had, his?meed of praise, pf dictions almost a certainty in India. In these success, of titles and honours,; literary, scientific and social; but it seems to me that a. Life of suqh British isles we are in the centre of a circle of influences'from North, South, East and West, exceptional merit and value as his should not be from ocean and continent, which cause rapid permitted, to cjose v^ithout impressing. ou> itisome cases
,
-'
.
,
46
INDIAN MEDICAL GAZETTE
token of recognition?a peerage or even a barofor example?which would in some measure requite its desert and render it conspicuous for future imitation and emulation. Whatever may be" done in this direction by the powers that be will be gratefully received by the Indian Medical Service, effective and non-effective?as an honour bestowed upon an organization which has for so long and in so many ways deserved well of the British Empiie.
netcy
"
9th November 1894.
[Jan.
1895.
