1989/11/01 by Kenneth F. Kiple
Arts and Humanities · Biochemistry, Genetics and Molecular Biology · #History of Medicine and Tropical Health #Porphyrin Metabolism and Disorders
paper · pdf · doi:10.1215/00182168-69.4.677
openalex publication_date 1989/11/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/25
IN 1970, a World Health Organization consultant wrote that [B]eriberi has never been endemic in the large areas in the tropics and subtropics where rice is not a staple food.' This study has three aims: (i) to prove the consultant wrong by demonstrating through the discovery process of beriberi in Brazil that it was, in fact, endemic there in the nineteenth century and earlier, especially among the slaves although rice was not an important part of their diet; (2) to explain how this could have been the case; and (3) to indicate the implications of widespread beriberi in Brazil for slave infant and child mortality and thus for slave demography. Among the methods I use is one of shining present-day medical knowledge on the past, which is fraught with some danger. Disease descriptions of yesterday can frequently mislead, and therefore presentism of this sort is sometimes frowned on by medical historians. On the other hand, beriberi has a number of distinctive symptoms, and thus, if Brazilian diets should have produced the disease, and if the symptoms of that disease were widespread, then it seems a reasonable supposition that the disease itself was rampant in Brazil. Beriberi is normally associated with the rice-eating cultures of Asia because the basic cause of beriberi is thiamine or vitamin B1 deficiency, and the practice of stripping away the rice husk to prevent spoilage also strips away almost all of the thiamine that the grain contains. Thus, persons whose diets center too closely on rice become thiamine deficient, and, as this occurs, they lose their appetites, further exacerbating the deficiency and rendering them even more beriberi-prone. Women with bodies nutritionally depleted by pregnancy or the process of giving birth and males