Beriberi

Submitted by Aldi on Fri, 03/17/2023 - 02:21

Beriberi is one of the tropical illnesses prevalent in Hong Kong during the War.  The name is thought to come from Sinhalese, from beri meaning weak.  The disease is caused by a deficiency of thiamine (vitamin B1), which affects the nerves to the limbs and produces pain, paralysis and swelling.

Wet beriberi causes edema, appearing as a swelling of the ankles,  feet and legs, eventually impairing the functioning of the heart, and leading to poor circulation and shortness of breath.  For photo see here.

Dry beriberi causes severe pains in the hands and feet, with the sensation of numbness and pins and needles, abnormal temperature, weakness and slow deterioration of general condition. 

Causes of beriberi include a diet of mostly white rice, hence its prevalence in Asia.  Today it is seen in sub-Saharan Africa, where the diet is the cassava root, and outbreaks have been seen in refugee camps.  Displaced populations are susceptible to nutritional deficiency, including beriberi.  In the West people who drink a lot of alcohol or struggle with alcohol addiction are more likely to be deficient in thiamine. Excess alcohol can interfere with the body’s ability to absorb thiamine.

Beriberi is easily treated with thiamine supplements. A doctor may prescribe a thiamine shot or pill. For severe cases, intravenous thiamine is given.  Foods rich in thiamine are fortified breakfast cereals, pork, fish, beans, lentils, green peas, yogurt, and enriched breads, noodles and rice.  However cooking or processing these foods reduces their thiamine content.

If beriberi is diagnosed and treated early, the outlook is good. Nerve and heart damage from beriberi is usually reversible when it’s caught in the early stages. Recovery is often quick once treatment is begun.

If beriberi progresses the outlook is poor, with permanent brain damage possible.  Here symptoms may include confusion and changes to the eyes and vision.  Beriberi can be life threatening if it isn't treated.

Sources: Various

My paternal grandmother - Baba Manya (Maria Pio-Ulski/Pio-Ulskaya) - died from beri beri on June 10, just two months before Hong Kong was liberated  :'(

Although we were not interred during the War, we certainly suffered from malnutrition, along with most of the residents in Hong Kong. My father had beriberi and his legs swelled up. We were living in St Josephs College on Kennedy Road at the time. My father was asked by the Church to be a caretaker there. One day, when he was struck by beriberi, his heart stopped and my mother ran out onto Kennedy Road screaming in panic. Luckily, an old Russian lady, who had a reputation for being a "healer", was walking by. She rushed into the building, found an old upright piano, grabbed a few camphor balls from its back, then ripped open my father's shirt and started massaging his chest with the camphor balls. His heart started beating again. Phew! He eventually died of heart failure in Australia, many years later.

 

'In POW camps Marmite became a lifesaver, one spoonful was enough to take away beriberi.' Leopold Manning, POW Changi.

A German scientist - Iustus Von Liebig discovered the product that was to become Marmite when he found brewer's yeast could be concentrated, bottled and eaten.

After Von Liebig's death, the Marmite Food Extract Company was created in Burton upon Trent, Staffordshire, in 1902, to produce it. Marmite was given its name because it used to be made in an earthenware pot called a marmite, a French word. Hence the Marmite emblem on the bottle.

Marmite was later found to contain a mass of vitamins, especially B12, and in WW2 it became an important part of a Tommy's rations.

Similar vegetable extract products are Vegemite from Australia and Cenovit from Brazil.

Black Beauty - the story behind Marmite.  

In Stanley Camp, where the main diet was rice, wet beriberi appeared first, but not immediately, as the human body usually has enough B1 stored up to last about three months.  The first case appeared on 18 March 1942 and many cases followed until there was a sudden decrease from 84 in May to zero in August.  This sudden decrease was due to Dr Selwyn-Clarke sending in a supply of synthetic B1 thiamine, which from June was given in a daily dose of 3 milligrams in the internees’ soup, where it could not be tasted.

This Thiamine however, while being good for wet beriberi, was not as effective for dry beriberi, which was appearing at the rate of about 30 cases per month in 1943.  Natural sources of B1 were better for dry beriberi, such as bran or beans.  Bran is usually fed to horses, but it was given to patients in doses of up to 3 ounces per day, when it was available.  When the supply stopped, relapses occurred.

Source:  Hong Kong Internment 1942-45 – Geoffrey Emerson