Of Rice and Men
Case developed by Douglas Allchin (firstname.lastname@example.org)
This case study focuses on Christiaan Eijkman and his search for the cause of beriberi in the Dutch East Indies in 1890s. It highlights chance and error on the path to a Nobel Prize.
In October, 1886, three doctors embarked from the Netherlands on a mission of medical research that would take them almost halfway around the globe. They passed through the Suez Canal--only opened a few years earlier--and arrived a few weeks later in the Dutch East Indies (now Indonesia). On Java and the surrounding islands, they could be fascinated by the exotic wildlife and towering forests, and by dense thickets of fibrous rattan vines, harvested by the Javanese and exported to Japan to make tatami mats. Elsewhere, trees had been cleared to grow crops brought from other tropical regions: sugar cane, coffee, cacao and indigo. These crops made the East Indies valuable as a colony to the Netherlands.
Life on Java would not be the same for the three doctors. Amenities commonplace in Europe were scarce. The tropical heat was everywhere. A typical Dutchman would also have to develop a taste for rice, a staple in this region of Asia.
One of the doctors, Christiaan Eijkman, age 28, had seen the sights of Java before. He had served as an officer for the Dutch Army in Batavia. After two years, he had contracted malaria and returned to the Netherlands. Malaria was one of many diseases common in the tropics. Cholera, influenza, dysentery and plague were also widespread. So, too, was beriberi.
Beriberi was, in fact, the reason why the medical commission had been sent to Java. It is a debilitating disease, indicated by the name itself. In Sinhalese, the word beri means weak, and doubling it intensifies its meaning. Beriberi involves weight loss, muscle weakness, loss of feeling and eventually paralysis in the limbs. Fatigue can give way to confusion, depression and irritability. In some cases fluid collects in the legs, taxing the circulatory system, enlarging the heart and causing heart failure. The disease can be fatal. Anywhere from one to eighty percent of beriberi patients died.
In the late 1800s epidemics of beriberi in Asia became more frequent. In Japan in 1880-81, one doctor was swamped with so many beriberi patients that the hospital could not accommmodate them all and they overflowed into nearby temples. The Dutch government was particularly concerned that large numbers of its fleet crews and native workforce were suffering. They wanted to find to cure for the disease or--better--prevent it. They sent the medical commission to find the cause of beriberi. Eijkman would eventually share a Noble Prize for his discoveries on Java.
Disease, Germ Theory and Eijkman
Eijkman and his colleagues were also not the first to try to identify the cause of beriberi. Beriberi had been known in southern and eastern Asia for centuries. A Chinese physician had described it four thousand years earlier. In the East Indies it had been reported as early as 1642. But no one knew a cure....
link to audio recording to be added after the face2face class