The Connection of Rice and Beriberi - Article Example

?11 Study Guide Questions for Quiz Beriberi: a disease of the peripheral nerves caused by a thiamine deficiency. It frequently results from a diet limited to polished white rice. Rare cases today in the US are associated with hypothyroidism, infections, pregnancy, and chronic alcoholism. Symptoms are fatigue, diarrhea, disturbed nerve function, edema and heart failure. Administration of thiamine prevents and cures most cases. --Source: Mosby’s Dictionary of Medicine, 8th ed. 2009. Rice and Beri-beri: Preliminary Report on an Experiment Conducted at the Kuala Lumpur Lunatic Asylum. 1. What is beriberi? (Hint: see paragraph above and your notes from the PowerPoint slides). Beri-beri is a disease caused by a thiamine (vitamin B1) deficiency. Symptoms include weight loss, weakness, fatigue, muscle pain, nervous disorders, diarrhea, and irregular heart rate. 2. What was the health problem and when and where did it occur? During the year 1905 in the lunatic asylum of Kuala Lumpur, Malaysia, a beri-beri epidemic broke out. 3. Describe the experiment in your own words. What year did the experiment start, how long did it last, who were the study subjects, what steps were taken during the experiment (methodology)? The experiment began on Dec. 5, 1905, and ended a little over a year later—Dec. 31, 1906. Patients at the lunatic asylum in Kuala Lumpur were randomly divided into two groups. After counting off, the odd numbered patients became the control group, and the even numbered patients became the experimental group. Both groups had identical housing, but they were separated from one another. Both groups also were given the same diets except for the type of rice. The control group continued to receive white (uncured) rice as the entire population of the asylum had been given in the past. The experimental group, however, received brown (cured rice). Both groups were tested for edema and their knee-jerk response at the outset of the experiment. 4. What were some attempts to remove bias from the experiment? (things being as equal as possible between groups) The groups were initially established by counting off, which was completely random. The housing was exactly the same but in different quadrants of the asylum. After some of the patients developed beri-beri in one location, the groups switched places to make sure that their housing wasn’t the cause of the disease. 5. The article states that the government gave its consent for this study. Does the article indicate that the study participants gave consent to be in this experiment? The study participants were institutionalized and provided for by the government—in this context, do they have the moral right not to be harmed in a scientific experiment? It does not appear that the patients had any say in the matter. In today’s world, the International Review Board has the authority to permit or deny any application for research involving human subjects based on possible harm which may come to them. Obviously in 1906 in Kuala Lumpur, such regulations did not exist. It is probable that patients in the asylum were considered to be second-class citizens or worse, and Mr. Fletcher was not held morally responsible. 6. What is “uncured rice” vs. “cured rice” in contemporary language? In contemporary language, uncured rice is the same as milled rice, or white rice. During milling, the husk, bran, and germ are removed in order to preserve the kernels longer. Cured rice is basically brown rice. Although the husk has been removed, the bran and germ have not, providing more nutritional value than white rice. 7. Definitions to know: lunatic, asylum, edema, dysentery. (You’ll need to look them up if you don’t know) Lunatic – anyone deemed to be psychologically and/or emotionally unstable; the clinical definition is not black and white; it varies from country to country and from decade to decade. Asylum – an institution designed to house and treat people with certain physical or mental diseases. Edema – a swelling of the tissues in the body caused by trapped fluids Dysentery – diarrhea caused by an abnormality or imbalance in the intestine 8. How did the researcher test the theory that beri-beri is a “place disease” (disease being a result of being in a particular place)? When patients in the east quadrangle of the asylum came down with beri-beri, everyone in that group switched places with the patients in the west quadrangle (none of whom had acquired the disease). The result proved that beri-beri is not a ‘place disease’. 9. What were some things the researcher did to test the theory that beri-beri is infectious (spread by parasites, excreta [fecal matter], bugs, or other people)? Patients suffering from beri-beri were sent to live among patients who did not have the disease to see if it was communicable, but it was not. Lice and bugs were collected from the patients and from the asylum and put on non-human animals, but none of them contracted the disease. 10. What were the results of the study? (Study the table under #12 on page 1778 and the last sentence of the article on page 1779.) You don’t have to memorize the exact numbers. For example, how did the death rate from beri-beri from those who ate brown rice compare with the death rate of those who ate white rice? How did the overall death rate compare between the two groups? How did the incidence of beri-beri (not just deaths from beri-beri) among the two groups compare? Eighteen patients on the white rice diet died of beri-beri; none on the brown rice diet died of the disease. Due to other causes, 17 patients who were on the white rice diet died, and 21 on the brown rice diet died. Overall, among the 120 patients on the white rice diet, there were 43 cases of beri-beri; among the 123 patients on the brown rice diet, none contracted the disease during the experimental period, but two had it when they arrived at the asylum. Ten patients who had the disease when they were admitted to the asylum and were put on the brown rice diet all recovered. 11. The author states that before he did this experiment, he did not believe in the “rice theory” and was surprised by the results. What was his theory/conclusion about the cause of beri-beri after the experiment? (see #15 on page 1778). The author came to three possible conclusions: 1) uncured (white) rice was poisonous 2) white rice lacked protein and caused the diseased body to be nitrogen-deficient 3) white rice lacked a certain nutrient (unidentified in this experiment) which caused the body to be susceptible to the disease Read More