In 1877, the Japanese Emperor Meiji witnessed his aunt, Princess Kazu, die of a widespread disease: kakke. Her condition was typical for all patients: swollen legs, sluggish, slow speech, numbness and paralysis of the limbs, muscle contraction and vomiting. Death was often the result of heart failure.
The emperor himself, from time to time, suffered from the same disease all his life. At some point, he decided to fund research into this strange disease. It was a matter of life and death: for the emperor, his family and the ruling class of Japan. While most diseases affected the poor and the weak, it affected the rich and powerful, especially urban dwellers. This curious fact gave a different name - Edo wazurai (Edo - as Tokyo was called earlier). But the most interesting thing is that the cause of kakke has been overlooked for centuries: finely polished white rice.
Emperor Meiji and his family.
Polished white rice was a status symbol - it was expensive because it required painstaking labor: it had to be peeled, polished and washed. In Japan, the poor ate brown rice or other carbohydrates such as sweet potatoes or barley. The rich ate polished white rice, among other foods.
And that was the crux of the problem. Stripping off the outer layers of a grain of rice removes one important nutrient: thiamine, or vitamin B1. With a lack of thiamine, animals and humans develop kakke, a disease now known as "take-take". However, the cause of the disease remained unknown for too long.
In his book Take-Take in Modern Japan: Creating a National Disease, Alexander R. Bey describes the efforts of Edo-era doctors to research kakke. Most believed the reasons were damp and wet. One doctor prescribed herbal medicine and fasting to the samurai, which did not help, and he died a few months later. Other doctors burned dried wormwood on their patients to stimulate Qi and improve circulation.
Some remedies did work - even if they were not used because of a true understanding of the disease. Katsuki Guzan, an 18th century physician, believed that Edo himself was the culprit in kakke. He wrote that a samurai who arrived in Edo fell ill with kakke due to water and soil. And only those who returned to their provincial homes - through the Hakone Pass - were healed. Patients who suffered from a severe form of the disease, according to Katsuki, had to act quickly, since "the most serious cases always ended in death." Because milled white rice was less readily available outside of Edo and in the countryside, avoiding eating it was the cure. Doctors also advised patients to consume barley and red beans, which are rich in vitamin B1.
Moxibustion procedure.
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By 1877, the beriberi situation had deteriorated markedly. Special devices made polished rice available to the masses. The government decided to introduce it into the diet of the army and navy. (White rice, as it turned out, was stored longer, unlike brown rice, which could turn rancid in warm weather.) Soldiers and sailors inevitably faced B1 vitamin deficiency.
This problem has ceased to concern only the upper class. In his article "British India and the Take-Take Problem," David Arnold writes that by the time the Emperor decided to fund the kakke research, the disease had ravaged South and East Asia, especially "soldiers, sailors, plantation workers, prisoners and patients in psychiatric hospitals."
At this point, a doctor named Takaki Kanehiro intervened. Almost immediately after joining the navy in 1872, he noticed that most sailors were suffering from beriberi. However, it was only after Takaki graduated from medical school in London and returned home to take up the position of director of the Tokyo Maritime Hospital that he was able to do anything about it. After interviewing sailors who suffered from beriberi, he found that "most often the disease struck prisoners, followed by sailors and junior officers, and then officers."
Rice grinder.
Since their diet was very different, Takaki concluded that protein deficiency was the cause of the disease. (This contradicted the widespread theory at the time that beriberi was an infectious disease caused by bacteria.) Takaki even asked to meet with the emperor to discuss his theory. “If the cause of this disease is found outside Japan, it would be dishonorable,” he told the emperor. However, the changes were not quick. As of 1883, out of 1,000 Japanese sailors, 120 suffered from beriberi.
Takaki also noted that the Western Navy did not suffer from kakke. Western-style food was expensive, however; moreover, the sailors did not eat bread. Soon, an incident occurred that allowed Takaki to confirm his theory. In 1883, a training ship returned home with cadets on board, who had visited New Zealand, South America and Hawaii. Of the 370 cadets and crew members, 169 fell ill with beriberi, another 25 died from it.
Takaki suggested that an experiment be conducted with another training ship, the Tsukuba, which would travel the same route. He used all his connections to replace white rice in the cadets' diets with bread and meat. While the Tsukuba traveled the world, Takaki could not find a place for himself: if the crew members died from beriberi, he would become a laughing stock. He later told one of his students that he would commit suicide if the experiment failed.
A man suffering from take-take.
Instead, Tsukuba returned to Japan in triumph. A total of 14 crew members fell ill with beriberi - and they were the ones who refused the prescribed diet. Takaki's speculations were not entirely accurate: he believed that the problem was protein, not thiamine. But since meat was expensive, Takaki suggested giving the sailors a protein-rich (as well as vitamin B1) barley. A few years later, beriberi disease was almost defeated.
But only among the soldiers of the navy. In 1885, Takaki became a military surgeon, but other doctors continued to attack his theory and question his findings. The unfortunate consequence was that while the navy ate barley, the army ate exclusively on rice.
Japanese military hospital during the Russo-Japanese War.
The results were fatal. During the Russo-Japanese War in 1904, beriberi killed 27,000 soldiers. Eventually, barley became an essential part of the military's diet after the true source of the disease was identified - polished white rice.
However, vitamins had not yet been discovered, and the debate over what actually caused beriberi dragged on for decades. However, few denied that Takaki had solved the deadly secret of white rice. In 1905, for his efforts, he became a member of the titled aristocracy. He was jokingly nicknamed "The Barley Baron".
