MDJ Hulshoff-Pol, physician to the Buitenzorg Mental Asylum
“Beri-beri is one of the most frequent diseases and causes of most deaths in the mental asylums of the Dutch East Indies. The fight against this health problem, which, as with other epidemics, particularly affects the natives, is a constant worry among mental health doctors.
Up till now, no specific treatment for this disease has been identified. One has strongly recommended many times a new treatment, but it resulted from prolonged trials that the latest was never more successful than others. In my view, the cause of this is that systematic studies have not been done and, above all, even less frequently were results checked.”
“The report of my colleague Roelfsema suffered the limitation of lacking a control group. For example, in suggesting that the favourable effect of this treatment had been recognised, he had arranged to always have a pot filled with the remedy, from which anyone could take as much as he wished, and following this, beri-beri no longer appeared among his coolies. From this fact, he concluded that the beans had a prophylactic effect.
One physician, familiar with the illness, wondered straight away whether the reduction was really due to the treatment in question, or whether one ought to ascribe it to chance. The complete absence of proofs from controls in the face of such favourable results gave rise to doubts on this matter.”
“Given that I did not have much confidence in the new treatment, I asked the medical director of the asylum for permission to modify the regulation prescribing the treatment for all the inmates and to keep a number of them as controls, thus providing a solid and scientific basis for my investigations.”
“From the point at which it was decided to prescribe the new treatment from 1 August, the study was divided into two parts.
The first, to which we shall return later, was concerned with its prophylactic value.
The second, with Katjang-idjo’s action as a treatment.
For the latter objective, 31 patients were divided into two groups: the first received 50 grams of Katjang-idjo 3 times a day, in addition to the usual diet, the second [group] didn’t receive any [Katjang-idjo]. No other modification was made to the diet.
If the treatment truly helped, the patients who consumed the beans would recover more quickly than the others.”
Translation by Ulrich Tröhler