Friday, May 21, 2010

Disease Week: Beriberi

Here at Simon & Ivan we take our blog very seriously and approach all posts with dignified scientific detachment and profound gravity. As evidence please take this conversation in which we finally hit upon a suitable Disease of the Year:

SIMON: oh man
pellagra: the disease of the three D's
dermatitis, diarrhea, and dementia
holy crap, no pun intended
and it gives you amnesia!
IVAN: how about jumping frenchman disorder
ooo pellagra
sounds exotic
SIMON: jumping frenchman disorder?
what is that?!
oh my god: beriberi: it makes people walk in "a sheep-like fashion"
yes-- that one
the sheep one

Yep, we picked "the sheep one." It is not the most gruesome thing ever, but it has a great name and it involves walking like a sheep, and that's all we require of our favorite things, including diseases.

Beriberi has been around for at least 4,000 years. It comes in two varieties, wet and dry, like cat food. The dry kind affects the central nervous system and causes paralysis, and the wet kind affects your heart and makes you swell and gives you a fever.  So, there's no good kind, and even if you get better you might end up with Korsakoff's psychosis. Symptoms of Korsakoff's psychosis include apathy, amnesia, ataxia, lack of insight (I do not understand how this is a symptom), and confabulation. According to our friend Wikipedia, confabulation "is the spontaneous narrative report of events that never happened." In short: the sheep disease can make you crazy.

The sheep disease has nothing to do with sheep, actually. Plague, Pox, and Pestilence speculates that "beriberi" may come from the Malay word for "sheep" because the paralysis makes people walk strangely. I'm not honestly sure how a human being could walk in a sheep-like fashion even if he or she wanted to, but I will leave the experimentations up to our loyal readers. Please report back, preferably with video.

Beriberi is caused by thiamine deficiency, which is why it tends to afflict populations who subsist mainly on rice. Thiamine is found in the hulls of rice grains, but if the hulls are too efficiently removed, all the thiamine goes with it. It is particularly bad when the process is mechanized and the grains are rinsed or "polished." This in combination of a diet that includes a lot of raw fish, which counteracts thiamine, is not good. As you may expect, Asia was a marvelous place to develop a thiamine deficiency right up to the 1970s. Others at risk are those who are extremely active and alcoholics, the first because they use so much energy, and the second because they can't absorb thiamine very well. The book also observes that "an alcoholic may fail to consume a wide variety of foods," but even cereal is fortified these days so I don't think that's a good excuse. If you live on a ship, in an asylum, or are in the military you should also watch out (only applicable to readers living in the nineteenth century).

In the 1930s, an American chemist named Robert R. Williams figured out how to synthesize thiamine, and after that we were well on our way toward vitamin-fortified food. In the United States, flour is now enriched with thiamine so that we don't all die. Alternatively this may be a communist plot, like water flouridation. If given the choice between communism and walking like a toothless sheep, I will take communism.

What have we learned from this? Eat lots of different stuff. The number of diseases in this book that come from dietary deficiencies is really alarming. Then again, quite a few also come from crop fungi, so you could also take away the message that you're damned if you eat and damned if you don't. An early runner-up in the contest for Disease of the Year was ergotism (that's ergotism, not egotism, a condition also manifesting in lack of insight), which comes from a fungus on cereal crops. It makes your skin blister and your blood vessels constrict -- so that's one vote against eating. Meanwhile, the jumping Frenchmen disorder mentioned by Ivan above, seems only to occur in lumber camps -- one vote against lumber camps, which I didn't even know were a threat.

As for pellagra, I think we know all we want to know about that.

Go ye forth, fair readers, and diagnose! Or just accuse! As long as you get to say "beriberi" at least once a day, it's all the same to us.


Anonymous said...

The first word I typed was "wonderful", then though - Hmmm, people might think that I think that Beriberi is wonderful - that won't do. So let me be more precise. This was a wonderfully entertaining description about a terrible disease. Thank goodness for science and vitamins.

As for the sheep.... There is evidence on video (and we all know that video evidence is 100% reliable), from a couple of months ago, of demonic sheep people mingling with real sheep.

That compelling video was made available courtesy of a alert and public spirited politician whose video production staff just happened to stumble onto this horrifying situation. Wisely, they made no effort to capture the demon. No one knows what tragedy might have resulted, but the demon sheep is, apparently, still on the loose.

Perhaps if they had thought to carry a large supply of thiamine with them they could have rescued the poor soul from his woolen state.

So - I think S&I need to cross reference their research into beriberi with additional research into diseases that make people into demons with glowing red eyes. Finding a cause - perhaps a heretofore unknown variant of BB - that not only makes you walk like a sheep but makes your eyes glow red, would be a scientific breakthrough of the first order. That it would provide material for additional blog discussions is completely beside the point, of course.

The demonizing effect of hanging out with politicians cannot be neglected, of course. Too close an association may be the cause of "going demonic", even if one does not eat just polished rice. More research is definitely needed.

This is going to be a titanically interesting summer.

Simon said...

I love the idea that the demon sheep just had a bad case of beriberi. I wonder if I should add "eyes may glow red" to the symptoms on the Wikipedia page.

There must be a subset of diseases experienced mainly by politicians that involve evil demon-eyes or behaving in a generally sheep-like manner. I shall look into it.