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5-BACTERIOLOGY.
Like most diseases of wide geographical distribution and even recurring in- cidence amongst the natives of many of our most important colonies, the Etiology of Beri-beri has been the subject of much careful investigation. Prior to the days of the microbic theory of disease, Beri-beri was attributed to causes such as cold, heat, rains, fatigue, etc., upon which the investigator placed great significance, and which are now recognised as mere general predisposing causes of the majority of diseases affecting man.
It would be out of place in such a Report as the present to attempt to unravel the chaos of theories which has accumulated within the past few years, and espe- cially since the advent of Bacteriology and Pathological Chemistry. It will be sufficient to note here that since this date, the theories regarding Beri-beri have, in the main, run along two lines, namely, the Diet Theory and the Gerin Theory.
Regarding the Diet Theory, Nitrogen Starvation, Deficiency of Fat, and In- fected Poisonous Foods all these have been adduced, with many plausible arguments, as excitants of the disease. On the other hand, the Bacteriological Theory includes the discovery in Beri-beri of the most varied species in biology from worms down to amoebae and bacteria. In the presence of such a chaotic mass of theories and literature regarding the etiology of Beri-beri, it is obvious that the subject still requires much investigation along absolutely unbiassed lines of research. It has seemed to us that so far as the bacteriological theories are concerned and the re- sults of bacteriological investigation, too much attention has been paid to the fashionable cause of disease at the present day, namely, bacteria. In such investi- gations of the unknown causes of certain diseases, one must always bear in mind, that although the tendency at the present day is to cause everything to be bacte- riological, there must be many discases affecting man the etiology of which has nothing to do with biology. The significance of this is at once apparent regarding the disease at present under consideration, as many recent investigations shew. Although some experts on Heri-beri who have dealt voluminously with the subject declare that the factors regarding the diet theories can be reduced ad absurdum, and that the only theories which may hold sway are bacteriological, we believe that still much remains to be done from the point of view of pathological chemis- try. Indeed we doubt if the disease has ever been dealt with thoroughly by an expert pathological chemist.
During the present research our investigations have been necessarily limited to the bacteriological side of the question and the negative results which have been obtained as regards the etiology of the disease have much to recommend further research, not along bacteriological principles, but along the lines pursued by the expert pathological chemist.
If it be granted that the disease is bacteriological in its etiology there is little to recommend the theory of gas-intoxication of MANSON. We cannot conceive a disease such as Beri-beri with its many manifestations being stirred up in such a manner. Noxious or non-noxious gaseous effluvia could scarcely cause Beri- beri. The results of PEKELHARING and WINKLER may be verified by anyone. posses-ing bacteriological knowledge. Cocci, pigment producing or otherwise, bacteria, etc., may be isolated from almost every case of Beri-beri and from almost every organ in such cadavers. Such micro-organisms, however, have no great pathogenic effect on animals and so far as one can judge they bear no causal relationship to the disease. The isolation of such micro-organisms as cocci, bacilli or bacteria, is not limited to Beri-beri cadavers, they may be isolated from almost any cadaver of a few hours old. With a knowledge of the rapid post- mortem wanderings of micro-organisms and the influence of the tropical climate on the degree of rapidity of decomposition, one cannot be surprised at the advent of such organisms in our culture tubes, particularly if the technique employed is in the slightest degree defective. Again, therefore, we wish to emphasize that, in our opinion, the micro-organisms isolated by PEKELHARING and WINKLER have no connection with Beri-beri, and their isolation by these workers was due to the circumstances uentioned in the foregoing.