Beriberi is a deficiency disease (lack of vitamin B1), commonest among Orientals, who eat polished rice, and Western alcoholics, who eat next to nothing. The Japanese have described an acute form of the disease, which kills suddenly by causing the heart to collapse; they call it shoshin (from sho, acute damage, and shin, heart). Now West meets East as two Detroit doctors report in the New England Journal of Medicine that shoshin beriberi may kill U.S. alcoholics, too.
A woman of 37 was admitted to Detroit Receiving Hospital because she could hardly breathe. A bizarre symptom was the cyanosis of her hands and feet: it ended so abruptly at the wrists and ankles that she might have been wearing blue gloves and socks. This indicated heart damage. The doctors gave her all the heart stimulants they could think of, but within eleven hours she died. It turned out that she had been on the bottle (and off food) for three weeks. Postmortem examination showed a heart so damaged by beriberi as to induce shoshin.
The condition need not be fatal, Drs. Paul L. Wolf and Murray B. Levin suggest. A few months later they suspected beriberi in a man of 54, and added massive doses of B1 to the battery of drugs they gave him. His heart was saved. Shoshin beriberi, they conclude, deserves more attention in the U.S.
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