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By Robert S.; Thimann, Kenneth V.; Marrian, G. F. Harris

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It is apparent, therefore, that in dietary deficiency, disturbance of both the cochlear and vestibular functions of the eighth nerve may occur but cannot as yet be attributed to deficiency of a specific food factor. A further condition involving the cranial nerves, termed (‘myasthenic DIETARY NEUROPATHIES 39 bulbar paralysis” is reviewed by Denny-Brown (1947). It is a rare occurrence and its main features are tiring of the eyes, ptosis of the lids, diplopia, weakness of the muscles of the face and neck, and sometimes dysarthria and dysphagia, all occurring towards the end of the day.

Harrison (1946), reporting on the 400 cases of the painful feet syndrome he observed in the military prisoner-ofwar camp in Hong Kong, found considerably raised systolic and diastolic blood pressure in 19% of the patients, and he is also of the opinion that vascular spasm is the primary disorder in this complaint. Page (1946) describes marked circulatory impairment as a late development of the syndrome in men taken to the colder climate of Japan. The feet became pale, cold and cyanotic when dependent.

He suggested that the disease was due to thiamine deficiency and was later able to show that the deficiency resulted from the inactivation of thiamine in the diet by a substance present in uncooked fish. The appearance of the disease could be prevented by large doses of thiamine. The histological findings in the brain of these animals were small, symmetrical, punctate hemorrhages in the floor of the fourth ventricle, in the corpora quadrigemina, in certain nuclei ventral and lateral to the aqueduct of Sylvius, in the thalamus, and in certain parts of the cerebral cortex; and, therefore, very similar t o the changes in the rats observed by Prickett (1934) and Church (1935).

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