Treating Beri-beri in Ireland

Guinness factory Dublin 1910
Guinness factory Dublin 1910

Dr Norman thought that as the diet in the Richmond Asylum in Dublin was better than elsewhere, the beri-beri like disease could not have a nutritional basis. However,  evidence for a dietary connection, especially with polished white rice, had emerged, and a precedent for a deficiency disorder – scurvy – was known if not fully understood. It was not until Casimir Funk in 1912 published ‘The etiology of the deficiency diseases’ that this concept began to take hold, and was the start of ‘vitamin theory’.

The deficiency in beriberi is of Vitamin B1, also known as thiamine, which is found more in brown rice and bread than the ‘white’ versions. Beriberi is less common in complete starvation than when extra but refined carbohydrate such as sugar is introduced. White bread may have been used in the asylum, and thiamine’s absorption is impaired with dysentery, in alcoholism, and even by tea drinking. There were no cases among the medical staff.

Unbeknownst to Dr Norman, a remedy akin to Marmite was at hand along the River Liffey at the Guinness Factory. The Brewery’s Chief Chemist, Dr Millar, developed the popular and tasty savoury spread, Guinness Yeast Extract or GYE, from the surplus yeast generated in the fermentation process. It was launched in Ireland in 1936 and was discontinued in 1968.

Garlic is a good source of thiamine too.

 

 

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Dr Norman and Beri-beri

Conolly Norman pic

Dr Conolly Norman reviewed the issue of beri-beri in asylums in 1899. He pointed out that following the outbreak in the Richmond Asylum, others had occurred in Suffolk, England, Alabama and Arkansas in the USA, and at St. Gemmes-sur-Loire in France. Norman remained puzzled as to the possible causes: sometimes there seemed to be an association with nutrition but he thought that the Richmond diet was quite as good as in other asylums.

He wondered about a ‘miasmatic poison’ especially in conditions where the ground was damp and marshy, and subject to frequent excavation as was common with asylums. (He is probably thinking here of the frequent building works, probably on top of human waste and, indeed, buried corpses.)

He decided that ‘infective peripheral neuritis’ would be an appropriate term, and that at least asylum doctors needed to be aware of the problem even if the cause and treatment were unknown.

‘Dracula’ and Diet: Beri-beri in the Asylum

richmond-hospital.jpg

The British Medical Journal reported on a ‘supposed outbreak of beri-beri’ in the Richmond Asylum, Dublin in 1894. This was remarkable, because previously such a disease had mainly been seen in the East.

The first noticeable symptom was oedema of the legs, which tended to spread rapidly. This was followed by weakness of the heart and breathing difficulties. Mentally, the sufferers became dull and sleepy. Sometimes there were symptoms of hyperaesthesia or paralysis. At this point there had been 110 cases under treatment, and 13 deaths.

Dr Conolly Norman, the medical superintendent, called for outside help, and the eminent Dublin surgeon Dr Thornley Stoker (Bram Stoker’s brother) led an investigation and provided a report to the governors. The disease appeared to resemble the beri-beri known in tropical and sub-tropical regions but the cause was unknown, although it seemed as if the cause must lie within the boundaries of the asylum. They concluded:

Bad ventilation and bad blood appear to be promoters, but the bacillary origin does not appear to be yet established.

The BMJ noted later that ‘blood’ had been a misprint for ‘food’.

 

 

Rossetti and the Goitrous Necks: 5. Christina

Christina pics 2Christina was Dante Gabriel Rosetti’s sister, and along with their mother, the model for ‘The Girlhood of Mary Virgin’ (1849). The next image shows a sketch of her looking more like his usual models, but less sexy, more studious. She did actually have a visible ‘neck’/thyroid gland problem, which she later kept covered up.

This condition was recognised as ‘Graves’ Disease’ even in 1871, and was thought to be a disturbance of the heart because of the raised pulse rate, common in hyperthyroidism. Apart from enlargement at the neck (goitre), another classic sign is bulging of the eyes (exopthalmia), visible in the photograph. Although this illness is now considered auto-immune, Christina was treated with iodine amongst other things and surgery was considered.

In her famous poem ‘The Goblin Market’, the tempted sister is described thus:

Laura stretched her gleaming neck
Like a rush-imbedded swan,
Like a lily from the beck,
Like a moonlit poplar branch,
Like a vessel at the launch
When its last restraint is gone.

These are ‘stunning’ lines which well match Dante Gabriel Rossetti’s painted beauties, the so-called ‘stunners’.

 

 

Rossetti and the Goitrous Necks: 4. Jane

ProserpineJane Morris (nee Burden) came from humble family origins in Oxfordshire. She was admired by and then married to the artist, designer and writer William Morris. He shared both his wife and their famous arts-and-crafts house Kelmscott Manor with Dante Gabriel Rossetti. In myth, Proserpine comes to earth in summer, but must return to Pluto the God of the Underworld for the winter months, because she has eaten six seeds of the pomegranate fruit.

Once again, Rossetti is entranced by his muse’s neck.

Rossetti and the Goitrous Necks: 3. Alexa

2019 Alexa Pics 2

Alexa (born Alice) Wilding is less well-known these days than Dante Gabriel Rosetti’s other ‘stunning’ muses, perhaps because of a lesser romantic entanglement. However, in fact she was painted more often than the others. ‘Veronica Veronese’ is believed to represent ‘the artistic soul in the act of creation’.

The artfully posed, languorous and serpentine neck was obviously becoming a source of attraction to wealthy purchasers, whether connoting sickness or not. Modern ‘re-creations’ of these pictures often miss this essential point.

 

 

Rossetti and the Goitrous Necks: 2. Fanny

Fanny Pics

Fanny Cornforth was born Sarah Cox, the daughter of a blacksmith, and had been in domestic service. The story is that she met the artist Dante Gabriel Rossetti in Surrey Gardens, Walworth, where he tweaked loose her abundant golden hair. Soon she became his model and second muse, offering more vitality and sensuality than the fading Lizzie.

Nevertheless, the neck continued to be a central focus and attraction.