Great Disease Enemy, Kak'ke (Beriberi) and the Imperial Japanese Army, The

Military Medicine, Apr 2006 by Hawk, Alan

Conclusion

The high incidence of beriberi has often been cited as an example of the neglect of the soldiers by the Imperial Japanese Army. Western observers had long been puzzled by this failure, as was Louis Seaman, who, in 1906, observed, "All the more lamentable was the failure to prevent the ravages of beri-beri in the army in view of the fact that she sinned against her own light; and, speaking in all kindness, the sin may be characterized as almost willful."45 The high incidence during the second World War made even less sense.

There is a more nuanced story to beriberi. During the RussoJapanese War, the case that it was a nutritional disorder was far from closed, despite Takaki's research 20 years earlier. The army's reluctance to accept that diet was the sole cause of beriberi was shared by most western observers. Once they were successful in preventing beriberi, the army applied the lessons during World War II. Yet, they failed to promote the means of prevention to their own soldiers, who rejected what, to them, was either essentially a prison diet or unpleasant-tasting tablets. By failing to make thiarnin palatable, they condemned their solders to be ravaged by beriberi.

Acknowledgments

I express my gratitude to James T. H. Connor, PhD; COL Robert Joy, USA (Ret.); Ken Kobayashi, MD; and the peer reviewers in addition to Stanley Sandier and the Ç-War military history network (http://www. h-net.org/~war/) for suggesting the topic.

References

1. Beriberi is classically categorized as either wet beriberi; primarily with cardiovascular symptoms or dry beriberi; primarily with peripheral neuropathy. Most patients present with a combination of sets of symptoms. Braunwald E, et al: Harrison's Principles of Internal Medicine, Ed 15, p 461. New York, NY, McGraw-Hill Medical Publishing Division, 2001.

2. Jap Medical Problems in the South and Southwest Pacific, Know Your Enemy, pp 2-4. United States Government, Department of the Army, Third Amphibious Corps, 1944.

3. Havard V, Van R Hoff J: Reports of military observers attached to the armies in Manchuria during the Russo-Japanese War, Part II, ñ 85. Washington, DC, Government Printing Office, 1906.

4. William Willis practiced in Japan from 1861 to 1881. He assisted the fledgling Meji government during the War ofBakumatsu Restoration 11864-1865) and founded the Kagoshima Medical School Izumi Y, Isozumil K: Modem Japanese medical history and the European influence. Keio J Med 2001; 50: 96-7 and Founding Spirit-Patient-Centered Medical Care, Jikei University School of Medicine, available at http//:www.jikei.ac.jp/eng/found.html, accessed September 23, 2004.

5. Vedder E: Beriberi, p 152. New York, William Wood and Company, 1913.

6. Suzuki S: The Surgical and Medical History of the Naval War between Japan and China During 1894-1895, pp 452-3. Tokyo, Japan, Z. P. Maruya and Company, 1901.

7. Vedder E: Beriberi, pp 152-3. New York, William Wood and Company, 1913.

8. Seaman L: The Real Triumph of Japan, The Conquest of the Silent Foe, p 240. New York, Appleton and Company, 1906.