Beriberi, White Rice, and Vitamin B: A Disease, a Cause, and a Cure (review)

Beriberi, White Rice, and Vitamin B: A Disease, a Cause, and a Cure. By Kenneth J. Carpenter (Berkeley, University of California Press, 2000) 282 pp. $40.00

Heaviness in the legs, followed by a loss of feeling, and then partial to total paralysis has signaled the onset of "dry" or "neuritic" beriberi for a million or more individuals throughout the centuries. Beriberi can also assume what is called a "wet" or "cardiac" form if edema and cardiac symptoms develop. Some cases present with both wet and dry symptoms, and, in addition, there is generally fatal infantile beriberi that strikes the nursing infants of thiamin-deficient mothers.

Although beriberi is an ancient disease, pinpointing thiamin deficiency as its cause was the result of late nineteenth- and early twentieth-century research, which is the subject of this book. Appropriately, Carpenter calls it a "medical detective story" (xi). The clues were both myriad, and baffling. Because beriberi had a greater incidence during the rainy season it was frequently blamed on miasmas arising from marshy areas close to costal areas. Yet, it also erupted in arid areas and aboard ships in temperate zones. Rice, too, was a centuries-old suspect because the disease was most common in rice-eating cultures. But just as new steam-driven mills were managing to polish the thiamin out of rice with ever-increasing efficiency, and epidemic beriberi plagued many parts of the world, the advent of germ theory precipitated searches for a pathogenic, rather than a nutritional, cause.

The book begins with a look at beriberi as Japan's "national disease" during the latter part of the nineteenth century and the opinions of Western doctors about its cause. The following chapter, which examines "Rice as a Staple Food," shows that the manner in which rice was processed and cooked could either predispose consumers to beriberi or protect them from it, no matter how limited (or thiamin-deficient) the supplements to the rice core diet might be.

Beriberi research in the colonies of Western nations is the subject of the following four chapters. Christiaan Eijkman's work in Java in the Dutch East Indies during the 1880s and subsequently in Holland is showcased, as is that of Gerrit Grijns who took over the research project in 1896. But the story is not simply confined to the familiar. Carpenter follows this discussion with the less well-known story of British beriberi workers in Malaya who were advancing knowledge of the disease even as America acquired the Philippines and entered the beriberi research field to rid its new island possessions of this long-standing scourge.

The names of Edward Vedder, Casmir Funk, Elmer McCollum, and Richard R. Williams share the stage with Japanese, British, and Dutch counterparts during the period 1912--1938, which saw thiamin isolated along with the other B vitamins (designated B² [riboflavin] and B³ [niacin]) and the mystery of beriberi's cause resolved. Although no longer a detective story, the book continues with an analysis of the thiamin content of foods, a chapter on beriberi's occurrence in the absence of rice (manioc and sago are very low in thiamin), a retrospective look at beriberi research, and, finally, a technical discussion of thiamin biochemistry.

This is a well-written, well-documented, and well-appointed work with numerous illustrations, photographs, tables, and maps. Beriberi, White Rice and Vitamin B takes its place alongside the other masterful books by Carpenter--Pellagra (Stroudsburg, Pa., 1981), The History of Scurvy and Vitamin C (New York, 1986), and Protein and Energy (New York, 1994).

Kenneth F. Kiple
Bowling Green State University

...