Beriberi, white rice and vitamin B. (Book Reviews).

Carpenter KJ, University of California Press, Berkeley, 2000, 282 pages, $83.00, ISBN 0-520-22053-6

Kenneth Carpenter is Emeritus Professor of Nutrition at the University of California in Berkeley, and his publications include The history of scurvy and vitamin C, (Cambridge University Press, 1986). Beriberi, white rice and vitamin B is an historical treatise on vitamin B1.

Thiamin deficiency once killed thousands and perhaps millions of people in different countries across the world and particularly in Asia. This book is mostly about beriberi of the heart and the peripheral nervous system; often people in robust health were worse affected than those in poverty.

The content of the book has been summarised by the author in the preface, and ranges from germ theory to toxins, to food factors, protein--and finally the vitamine (vitamin). The amphitheatre of observations were the sea voyages, the Far East, bird and animal and plant experiments, laboratories, prisons, mental hospitals, and war. The investigations were carried out by people of different nationalities.

It is as much about the processes, personalities, controversies and politics of science and nutrition across many countries and over 50 years, as it is about vitamin B. In retrospect, the unravelling of the cause of beriberi and the discovery of its cure was a mammoth detective task, much of which is revealed here.

Thiamin deficiency still has the potential to be lethal to each one of us, because it is an essential nutrient. Thiamin enrichment of staple foods protects most people from the deficiency, but even this is a controversial subject.

Kenneth Carpenter is an international nutritionist of distinction. This is a wide ranging and scholarly but easily read text, illustrated by photographs. He has searched the libraries of the world for the early literature, and his interpretations of it are now his gift to us.

The book is never boring, although the unfolding events and numerous attempts to discover what was responsible for the many deaths in Asia are necessarily circuitous in nature, and are reflected in the structure of this account. Only one error (a reference) was sighted. There is an index and the bibliography is comprehensive; the main features have been linked to page footnotes.

In the last three chapters there is little information about current cases, research and treatment but indications are given that the history of vitamin B1 (thiamin) is still unfolding. Perhaps more on this subject would have made a useful theoretical contribution, together with more historical consideration of thiamin requirements, and potential innate toxicity levels. The distinction is made between the manifestation of beriberi in different ways in people of different ethnicity. A genetic difference may yet prove to be the explanation for this.

The more recent (in time) contribution of cerebral thiamin deficiency (Wernickes encephalopathy) to some cases of alcohol-related brain damage in Australia is also mentioned. A second edition may extend to yet another unravelling of that controversy and its outcomes.

This book has a fair price tag and is of great value to anyone who aspires to be a competent nutritionist. It is of particular interest to clinicians and public health nutritionists. Thiamin is an essential nutrient and reduced thiamin intake is risky and potentially dangerous. This treatise is an account of how good science at a clinical level and an in depth understanding of nutrition, food and society can eventually lead to improvements in public health nutrition and the health of all people.