EPIDEMIC DROPSY

EpJ])E.\lIC DIWPSY was for many years regarded as a deficiency disease. It was even at times c~nfus:-cl with beri-beri. 'Vithin the past few years Its dIStinction from beri-beri has been clearly established, and a considerable amount of evidence has accumulated to the effect that it is not caused by vitamin deficiency. At one time or another it has. been suggested that the ingestion of mustard Ollar some adulterant of mustard oil might be the main retiological factor. Mustard oil is used freely in many parts of India in the cooking of rice. It h!~s been pointed out that persons who use mustard 011 are far more liable to the disease than other persons in the same community. In 1926 Sarkar suggested that an!;emone oil, which sometimes occurred as an adulterant of mustard oil, might be responsible. In 1933 Chopra and Chaudhuri propounded a theory that the disease was caused by infection with organisms of the oulqctu» group. In househo~ds where epidemic dropsy occurred they found the rrce to be heavilv infected with these organisms, and they found that "the serum of patients caused agglutination of certain strains of the organism at a high titre. The interest in mustard oil was revived by work carried out by Lal and Roy, reported in 1937. A number of voluri'teers were given food cooked in samples of mustard oil that had been used by persons suffering from epidemic dropsy. These volunteers became affected, whereas no member of a control group, fed with pure mustard oil, had any symptoms of the disease. Lal and Roy did not recognize the impurity in the oil that seemed to be responsible. ~ Further investigations have been made by R. X. Chopra, C. L. Pasricha, R. K. Goyal, S. Lal an.d A. K. Sen.' They examined samples of mustard 011 obtained from houses in which outbreaks of epidemic dropsy had occurred; in the majority they found traces of argemone oil. A plant known as odi88irnari, which bears seeds very like mustard seeds, grows freely in many mustard fields in India. It has been sho,,:n to be identical with Argemone meeicana. Argemone oil must therefore occur frequently, either by accident or design, as a contaminant of mustard" oil. Chopra and his co-workers gave food cooked in mustard oil and argemone oil (both expressed in the laboratory) to five volunteers. To four others they gave food cooked in mustard oil (contaminated with argemone oil) obtained from households where outbreaks of epidemic dropsy had occurred. The members of a third group were given food cooked in pure mustard oil. None of the members of this group suffered from symptoms of illness. All members of the first group became affected with cedema and other symptoms indistinguishable from