BeriBeri: Yup a real health problem

 Most Americans are vaguely familiar with scurvy in sailors (the citrus used by the Brits to prevent this is why they are called Limeys).

And of course Pellegra from corn was a major health problem in the southern USA.

we saw this in our heavy drinkers in Africa, who ate local corn sazda but not much else.

But BeriBeri? Various epidemics here including in the Philippines where imported polished rice was given out to local during famine after the clueless Yanks took over.

But I am doing an investigation into ancient Japan, the Heian period, and medical articles suggest deaths from that.

So I asked Grok:

In Heian Japan (794–1185), the diet of the aristocracy, heavily reliant on polished white rice, led to beriberi, a disease caused by vitamin B1 (thiamine) deficiency. White rice, stripped of its nutrient-rich husk, was a status symbol, but its lack of thiamine caused symptoms like fatigue, nerve damage, heart failure, and death.

 

Commoners, who ate less processed grains like barley or millet, were less affected. Historical records, like court diaries, note unexplained illnesses and deaths, especially among elites, likely linked to beriberi. For example, the disease may have contributed to the high mortality rates in the imperial court, though exact figures are scarce due to limited medical understanding.

 

By the Edo period, beriberi was better documented, but in Heian times, its cause was unknown, and no effective treatments existed. Dietary diversification or unpolished rice could have mitigated it, but social preferences delayed such changes.

one article I read said 20 percent of the deaths back then    And at least one death Kashiwagi , in Gengi was probably partly due to beriberi, since his legs got weak.

...................,  

modern story of how a Japanese military doc found how to stop beriberi from killing their sailors in the Japanese Russia war in the early 1900s. 

  

I should note at this time that white rice has a longer shelf life than brown or partially polished rice. Our organic brown rice is healthier, but the germ etc. has oil and gets racid after six months.

So what about the Philippines? At least one book on the multiple epidemics of people and animals (Foot and mouth disease killed the waterbuffalo so people couldn't plow), mentioned deaths because the Yanks supplied imported polishe Rice.

So I asked Grok:.....

Beriberi, caused by vitamin B1 (thiamine) deficiency, was a significant health issue in the Philippines, particularly due to the widespread consumption of polished white rice, which lacks the thiamine-rich husk. 

 

Historically, the disease was prevalent in rice-dependent regions like the Philippines, where milling practices removed essential nutrients. Historical Context and Impact Early 20th Century: Beriberi was a major public health problem in the Philippines, especially among populations relying on polished rice. Research from the period, such as a 1911 study, highlighted its preventability through dietary changes.

Infantile Beriberi: A critical issue in the Philippines, infantile beriberi affected babies of thiamine-deficient mothers, leading to high mortality rates.

 

Studies from 1947 estimated 12,000–20,000 deaths annually in the 1920s–1930s, with symptoms like heart failure and cyanosis in infants aged 2–6 months. Colonial Period:

 

During the Spanish and American colonial eras, beriberi was noted among soldiers and prisoners. For instance, in 1898, Spanish soldiers in Baler suffered from beriberi due to poor diet during a siege, with 12 deaths reported. 

Japanese Occupation (1942): Malnutrition, including beriberi, surged due to food shortages, affecting both civilians and prisoners in camps like Santo Tomas. Symptoms and Types Dry Beriberi: Affects the nervous system, causing numbness, weakness, and potential paralysis.

 

Wet Beriberi: Impacts the cardiovascular system, leading to edema, heart failure, and high mortality if untreated. Infantile Beriberi: Seen in breastfed infants of deficient mothers, causing rapid heart failure and death if not addressed.

 

Causes and Risk Factors Dietary Cause: Polished white rice, stripped of thiamine, was the primary culprit.

 

The shift to milled rice in the late 19th century, driven by taste and economic factors, increased beriberi cases.

 

Other Factors: Alcoholism, bariatric surgery, and conditions like hyperemesis gravidarum increased risk. Breastfeeding mothers with low thiamine intake endangered infants. Interventions and Decline Early Interventions: By 1910, American researcher Robert R. Williams in Manila identified rice bran extract as a cure, leading to thiamine’s isolation in 1935.

 

Rice Enrichment: Post-World War II, enriched rice programs in the Philippines significantly reduced beriberi incidence. By the 1950s, death rates dropped in areas using enriched rice, with costs as low as 35 cents per person annually. Tikitiki Treatment: Filipino physician Proceso Gabriel developed a tikitiki extract (from rice bran) for beriberi treatment, a notable contribution to local medicine.

 

Modern Status Beriberi is now rare in the Philippines due to improved diets, food fortification, and awareness of thiamine-rich foods (e.g., whole grains, meat, beans). However, it persists in vulnerable groups, such as alcoholics or those with restrictive diets. Diagnosis involves blood/urine tests and neurological exams, with treatment using thiamine supplements (oral or intravenous). Early intervention reverses most symptoms, though severe cases may leave permanent damage. For further details on historical beriberi in the Philippines, see studies like Acta Medica Philippina (1947) on infantile beriberi. For current prevention, consult resources like the Philippine Department of Health or WHO guidelines on nutrition.