W.A.BURNETT, INVESTIGATIONS in EPIDEMIC DROPSY by B.Sc., M.B

INVESTIGATIONS

EPIDEMIC DROPSY

W.A.BURNETT, B.Sc., M.B., Ch.B., D T.M.and H. ProQuest Number: 13905457

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W.A.BURNETT, B.Sc., M.B., Ch.B., D.T.M.and H.

A pathological condition diagnosed as the Oedematous type of Beriberi has been present for many years in Sierra Leone, culminating at intervals in outbreaks of epidemic severity with a high rate of mortality. This research is a resume of some investigations made into the disease as it affected Freetown, with special reference to Wilberforce Barracks, Freetown Prison and Kissy Asylum, combined with an enquiry, working along biochemical lines, into the relationship of this disease with the nutritional aspects of rice. The work is subdivided to a number of headings, which are dealt with seriatim and finally summarised. A certain amount of statistical data is incorpor ated, and, in addition, there is an addendum dealing with the conditions at the Wilberforce Barracks Compound.

The problem of Beriberi is one which has been noted in Freetown Prison for at least the last forty-eight years. At this institution it had been reported under several diagnoses, to wit; Oedema, Dropsy, Beriberi, Dysentery with Dropsy.

Various spasmodic references have been put on record until recently when an investigation was made by Professor Blacklock

(1) in 1922, and later in 1929, when Drs.Leitch and Watson (2) 2

undertook an intensive and exhaustive survey of the condition at the Freetown Prison. The outcome of their work was that drastic alterations in management were suggested, together with the allowance of a diet very rich in vitamin B and of high calorie value, as much as thirty-five hundred calories daily being allowed to adult male prisoners on sedentary occupation.

"There is no excuse for its existence, as it can be guarded against by easily arranged and inexpensive measures; given an adequate diet, all that remains is to see that the vitamin B content of the diet remains up to standard”, quote the joint authors of ”Beriberi in the Freetown Prison”, yet, despite the most strict adherence by the Superintendent of Prisons to this dietary advice, coupled with the daily inspection of the inmates1 food rations by the prison doctor, the Medical Officer in charge of Freetown Prison continued to find this "Oedema” cropping up among the prisoners and culminating in a severe outbreak in 1931. A diet rich in yeast, cod liver oil, fresh vegetables and fruits, despite the reputedly high content of vitamin B had failed to prevent a serious recurrence of the condition. At that time large quantities of Marmite and Bemax were being given without the success one would have expected from these "vitamin” foods, if the condition had been one purely of avitaminosis. It was only after an alteration of the diet to consist of new rice, a step suggested by Mr.Biddle, the

Superintendent of Prisons, from his lifelong experience of the 3

condition, that a mass improvement set in and no new cases were reported.

Notes on the circumstances which pertained in 1931 and virtually led up to the investigation of the problem, have been kindly supplied by the Honourable Director of Medical and

Sanitary Service. He states that at the end of 1930, the

Superintendent of Prison