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Sometimes tingling and formication were present, and muscular tenderness was invariably present. Rapid wasting of the leg and thigh muscles occurred, together with loss of subcutaneous fat leading to a loss of rotundity and symmetry of the limb, and to a flabby "hanging" condition of the muscles. Appreciation of heat. and cold was always present. In two cases the nerve symptoms were ushered in by a slight elevation of temperature which lasted a few days, and which was never of high degree. These were the only cases in which any elevation of temperature was present: in all the other cases the temperature remained steadily at the normal or perhaps may have varied about half a degree (Fahren- heit) above and below the normal. The digestive system in this series of cases was seldom deranged-the tongue was generally clean, the action of the bowels normal, the function of digestion performed normally. and there was no vomiting. As regards the circulatory system there was nearly always some cardiac debility, and in a few instances this was associated with a slight amount of dilatation of the cavities of the heart. There were no murmurs, however, except occasionally a pulmonary systolic blowing murmur propagated up the neck. The action of the heart was not "wobbly", and did not suggest that the vagus had given it a loose rein. There was sometimes slight palpitation-never to any un- comfortable or extreme extent. The pulse was regular, of normal tension, beating between 80 and 100 beats, per minute. There was no suggestion in it of undue weakness. The respiratory system shewed no marked change--the lungs were not affected but in some instances the respiratory act was somewhat accelerated and shallow. There was no irregularity. The urinary system was not affected-urine was passed freely, of normal quantity, and free from albumin: there was no excess of urates and the chlorides were not increased in quantity. The menstrual func- tion was in about half the cases interfered with in the direction of suppression : in other cases it was normal and regular, and there was no dysinenorrhoea at any time. The nevous system, apart from what has been noted above, was not affected. The pupils shewed no irregularity. They were always equal and reacted normally to light and accommodation. As regards the cutaneous system, in some cases there was a condition of dryness of the skin to such a degree as to be almost patbo- logical. The sweat glands seemed arrested in their action. Apart froin the nervous symptoms in the lower extremity, the most prominent sign to be noticed was a condition of anæmia. This generally became more performed in proportion to the severity of the Beri-beri symptoms. Together with the diminution in the percentage of hæmoglobin, in some cases to 40, 30 or less, there was diminution in the number of red blood corpuscles to less than three millions, and an increase in the number of leucocytes to twelve or fourteen thousand. Of these there was a steady increase in the number of mononuclears and polymorphonuclears the eosi- nophiles rose to about double the normal, and normoblasts were to be occasionally seen. This condition of anæmia was indicated plainly, not only by the pallor of the palpebral conjunctiva and the shallow, and in some instances, hurried respi- rations, but also by the pulmonary murmur which was undoubtedly hæmic in origin.

The Diagnosis.

The symptoms which have been detailed above are practically all that were present and from a consideration of them it will be seen that all the cases were of a mild nature. The question arises then of the diagnosis of the disease. Înto that it is not proposed to enter at length in this section. But it may be stated that the diagnosis was guided by the rapid and sudden onset of sensory derangements confined principally to the lower extremities, accompanied by hyperesthesia of the musculature and followed by wasting all this leading to difficulty in locomotion amounting in some extreme cases to complete paraplegia, necessitating guidance and assistance with the hands, or with sticks or crutches. Together with this, cedema of greater or less amount and extent principally confined to the area over the tibia was present. These symptoms occurring in a building ill-ventilated and remote from the sun's rays, generally damp, dark and sometimes overcrowded, and rapidly attack- ing one after another of a population stagnating in it for months without outdoor exercise and without an opportunity of breathing the fresh outer air-a population that is free of the vice of alcohol and of the taint of syphilis-such symptoms occurring in this Colony can only point to Beri-beri--very mild it is true, but still it is Beri-beri.