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9. With the advent of the outbreak of Beri-beri in the Po Leung Kuk our - studies commenced, and the research was started from every point of view. The inmates of this Institution were removed and segregated, and their clinical con- dition noted daily. The treatment of these cases, as well as the prophylaxis against its further prevalence, is given in the preliminary part of our Report.
10. Subsequently the Institution was placed at our disposal, and with a little assistance the Po Leung Kuk was soon converted into an excellent experimental, compound with the virus of the disease presumably working in the immediate vicinity.
11. Furthermore, the inmates of the Tung Wah Hospital suffering from Beri-beri were also at our disposal, and had it not been for the generous supply of cases the material used for our bacteriological and experimental escarches would have suffered much depreciation.
12. We feel that we are deeply indebted to the Directors of the Tung Wah Hospital and the Po Leung Kuk respectively for the assistance they gave us in our work and the free access to, and utilisation of, the cases they afforded us.
13. The first part of this Report deals with the outbreak of Beri-beri in the Po Leung Kuk: the next part treats of certain points in the disease as regards its incidence with reference to (1), Age, (2) Sex, (3) Occupation-its diagnosis, prognosis, and treatment, etc.
14. The pathological section of the Report deals fully with the gross anatomy of Beri-beri cadavers. The œdematous and atrophic forms are dealt with under separate headings, and are presumably clear enough to afford one a picture of the morbid anatomy. The microscopic anatomy has not been investigated to any great extent. The literature on this question alone is voluminous, and so far investigation along these lines have led to no advance regarding the causation of the disease. The descriptions given recently by HAMILTON WRIGHT, Morr and others are sufficiently extensive and minute to gratify even the most curious of pathologists.
15. The most interesting feature of this part of the Report is the question as to the presence of a primary lesion in Beri-beri. Medical papers at the present time are full of Beri-beri, and one of the most widely discussed questions in this connection is whether there exists in Beri-beri a primary gastro-duodenitis, the premonitory syndrome of Hamilton Wright. According to our results such a lesion does not exist. Gastric and duodenal changes, and indeed occasionally changes of variable pathological degree of the entire small gut are often found in Beri-beri cadavers. These however do not appear to be primary and the seat of primary election of the so-called virus of Beri-beri. Congestions, hemorrhages, cedematous infiltrations and even patches of necrosis have often been found in the gastro-duo- denal mucosa, but that these are due to the actual Beri-beri virus we bave reason to doubt. Microscopically the changes found are difficult to class with active inflammation as found in diphtheria. They resemble more closely the changes consequent upon passive hyperemia and congestion set up by precedent nerve degeneration. Arguing, a posteriori, little weight is to be given to the changes found in the alimentary canal, and our observations in this respect are more or less in accord with the recent investigations of DURHAM who lately studied Beri- beri in Christmas Island and the Federated Malay States.
16. The bacteriological investigations which have been made during the re- search were many, and of a varied character. Almost every tissue and fluid of the bodies of cases of Beri-beri have been submitted to a searching examination by almost all the methods available for the isolation of specific micro-organisms. On referring to this part of the Report in detail, it will be seen that we found it im- yossible to find any micro-organism which could be brought into causal relation- shy with the disease. Again and again cocci, bacteria, etc., could be obtained from Beri-beri patients or fresh cadavers. These were of the same nature as the micro- organisms isolated by other workers. Detailed bacteriological work and experi- ments proted, however, that such micro-organisms have nothing to do with the