Product Description

In this comprehensive account of the history and treatment of beriberi, Kenneth Carpenter traces the decades of medical and chemical research that solved the puzzle posed by this mysterious disease. Caused by the lack of a minute quantity of the chemical thiamin, or vitamin B1 in the diet, beriberi is characterized by weakness and loss of feeling in the feet and legs, then swelling from fluid retention, and finally heart failure. Western doctors working in Asia after 1870 saw it as the major disease in native armed forces and prisons. It was at first attributed to miasms (poisonous vapors from damp soil) or to bacterial infections. In Java, chickens fed by chance on white rice lost the use of their legs. On brown rice, where the grain still contained its bran and germ, they remained healthy. Studies in Javanese prisons then showed beriberi also occurring where white (rather than brown) rice was the staple food. Birds were used to assay the potency of fractions extracted from rice bran and, after 20 years, highly active crystals were obtained. In another 10 years their structure was determined and "thiamin" was synthesized. Beriberi is a story of contested knowledge and erratic scientific pathways. It offers a fascinating chronicle of the development of scientific thought, a history that encompasses public health, science, diet, trade, expanding empires, war, and technology.

Product Details

• Amazon Sales Rank: #1206111 in Books
• Published on: 2000-03-25
• Original language: English
• Number of items: 1
• Binding: Hardcover
• 296 pages

From The New England Journal of Medicine
For much of the past century, beriberi played a bit part on the stage of medical history as the disease that initially prompted the identification of vitamins and the elucidation of their role in human well-being. The Dutch colonial scientist Christiaan Eijkman, who noted that his chickens came down with beriberi when fed an experimental diet of white rice, has entered nutritional folklore along with James Lind and his lime and Joseph Goldberger and his elucidation of pellagra. Perhaps because it was uncommon in the West, or perhaps because it paled as a scourge of the 20th-century tropics beside such persistent evils as malaria and malnutrition, beriberi has received little attention from historians. Yet it is a disease that maims and that can kill: probably more than a million people have suffered and died from it. Beriberi has been observed and experienced by Westerners in southeast Asia since the 16th century. Associated with the consumption of highly polished rice since the first decade of the 20th century, beriberi and related disorders have also been found to occur where white rice is not a staple item in the diet.

Beriberi is in fact a dietary-deficiency disease caused by a lack of thiamine, or vitamin B, in the diet. It first attracted the attention of Western scientists in the 1880s, when Dutch military personnel experienced an epidemic of the disease while operating in Sumatra, at a time when the "germ theory" was newly dominant as an interpretative framework for disease causation. These elements provide Kenneth Carpenter with the principal themes of his book: the relation between beriberi and diet; the elucidation of the role that thiamine plays in the chemistry of human health; and the tangled pathways by which modern scientific knowledge has been achieved. With his customary clarity and painstaking attention to detail, Carpenter begins by describing the Japanese experience with the disease (in the 19th century, beriberi was the "national disease" of Japan) and exploring the characteristics of rice as a staple food before embarking on a journey of scientific detection by way of competing contemporary theories of disease causation that were to lead, eventually, to the discovery of the cause of beriberi and the means for its prevention and cure.

No one who reads this book will remain in any doubt that the process of scientific discovery is far from simple or that behind the legends of modern medicine are morasses of uncertainty and painful webs of scientific competitiveness from which, only at length, do agreed-upon scientific "truths" emerge. It took some 50 years and lifetimes of dedication by dozens of scientists from many different fields and of various nationalities before the mysteries of beriberi were unraveled and successful synthesis of thiamine cleared the way for reliable prevention and cure.

As Carpenter makes clear, however, the ability to produce a synthetic vitamin on a commercial scale is by no means the end of the story. That ability itself raises new questions: How much thiamine does the average human being need? How should knowledge of the vitamin's role in disease processes be used? How far should a government intervene in people's food choices for their own good? Part of the charm of this deceptively simple account of medical discovery lies in its sweep of coverage from daily life in 19th-century Japan, through the laboratories of medical scientists in the decades of discovery, to the continuing ethical dilemmas posed by scientific knowledge in the present.

Anne Hardy, D.Phil.
Copyright © 2000 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Review
"Carpenter tells a straightforward tale." -- New Scientist

About the Author
Kenneth Carpenter is Professor Emeritus of Nutrition at the University of California, Berkeley. His books include Protein and Energy (1994) and The History of Scurvy and Vitamin C (1986).