likely to have their attention arrested by the large proportion of cases of partial paraplegia, of cases of œdema of the legs, and of cases of general dropsy. These, for the most part, are cases of beriberi.
Fig. 74.—Paraplegic beriberi. (Bentley.)
Paraplegic cases.—On examining one of the paraplegic cases referred to (Fig. 74), it will be found that, besides paraplegia of greater or lesser degree, there is a certain amount of anæsthesia or of numbness of the skin; particularly of the skin over the front of the tibiæ, the dorsa of the feet, the sides of the thighs, perhaps also of the fingertips, and of one or two areas on the arms and trunk. The visitor may be struck with the thinness of the patient's calves, the flabby state of the gastrocnemii; and by the fact that if, whilst making the examination, he should handle these and the neighbouring muscles somewhat roughly, particularly if he should squeeze them against the underlying bones, the patient will call out in pain and try to drag the limb away. The thigh muscles may be found to be similarly affected, and so may the thenar, the hypothenar, and the arm muscles; like the calf muscles, these too may be wasted and flabby. Very probably there is a loss of fat as well, the panniculus adiposus being every-
