Sir.—I note that in LETTERS TO THE EDITOR (Journal 1980;134:1098-1099), Anteski questions the recommendations of Moran and Greene for the management of thiamin deficiency-related cardiac failure, in which they suggest thiamin as the major therapy for cardiac failure in beriberi. Many years ago,1 I observed a neonate with congenital beriberi with all the classic signs of cyanosis, grossly enlarged heart, convulsions, and aphonia. Following administration of oxygen and a total of 100 mg of thiamin over an eight-hour period, a most dramatic change occurred: the cyanosis cleared and the convulsions ceased. Within 72 hours the cardiac size had became normal, and the tachycardia was eliminated.
I am quite in accord with the recommendation of Moran and Greene that thiamin is the prime therapy for cardiac failure associated with beriberi.