Gerrit Grijns in Java: Beriberi and the Concept of ‘Partial Starvation’

Dutch physician Gerrit Grijns (1865-1944) from the University of Utrecht. Courtesy of the Journal of Nutrition.

At the end of the 19th century, Dutch physician Gerrit Grijns (1865-1944) from the University of Utrecht, working in Java in the Dutch East Indies (now Indonesia), developed a dietary deficiency explanation of the nutritional neuropathy beriberi that presaged the “vitamin doctrine.” Although Grijn’s work was overshadowed by that of Christiaan Eijkman (1858-1930), his predecessor, Grijns developed a new pathophysiological concept — dietary deficiency of a micronutrient causing neurological disease, while Eijkman recognized a role of dietary factors, but never fully moved beyond increasingly improbable bacteriological mechanisms.

Initially, Grijns had been an assistant to Eijkman, and was later expected to continue Eijkman’s investigations after the latter returned to Holland in 1896. Eijkman had determined that beriberi was not due to a protein deficiency, and Grijns subsequently excluded potential deficiencies of minerals or fats in polished rice that might be responsible for beriberi. Therefore, by this point, deficiencies of the various components of a physiologically complete diet as then understood — proteins, carbohydrates, fats, inorganic salts, and water — had been excluded as possibilities. Grijns also excluded a toxic effect of rice starch by demonstrating that polyneuritis also developed in chickens fed on autoclaved meat or on potato flour plus a protein supplement.

In 1901, Grijns considered two possibilities to explain the known facts concerning the etiology of beriberi: a “deficiency or partial starvation” of a substance that was necessary in small amounts for maintaining metabolic functions of nerves and muscles; or lack of a protective dietary factor that normally acts to maintain resistance to a neurotoxic microorganism. In either case, Grijns proposed that beriberi was caused by a dietary deficiency of a specific natural substance. Although Grijns was unable to extract an antineuritic factor from rice bran, he showed that the protective factor had been destroyed by the processing method he used.

From 1902 to 1904, Grijns was on leave in Europe because of poor health, but he returned to Batavia in 1904 and resumed his position as subdirector in the laboratory, and eventually in 1912 was appointed director. Over the next five years, Grijns built and equipped a new laboratory and then returned to Holland in 1917. Subsequently, he briefly taught tropical hygiene in the Colonial Institute in Amsterdam and was conservator in Eijkman’s laboratory in Utrecht.  From 1921 until mandatory retirement in 1935 at age 70, he was professor of Animal Physiology at the Agricultural University of Wageningen.

Unfortunately, Grijns’ important work presaging the “vitamin doctrine” was published in Dutch and not widely recognized at the time. In 1929, Eijkman shared the Nobel Prize in Physiology or Medicine with British biochemist Frederick Gowland Hopkins (1861-1947) for “their discovery of the growth stimulating vitamins,” an overstatement on both counts. The Nobel Prize Committee overlooked Grijns, and Eijkman also failed to give Grijns appropriate recognition in his Nobel Prize Lecture. Grijns’ research achieved wider recognition only after colleagues had his work translated and published in English in 1935. The Dutch government did belatedly recognize Grijn’s contributions by making him Commander in the Order of Orange-Nassau, a military and civil order of the Netherlands recognizing those “who have earned special merits for society” (comparable with the Order of the British Empire in the United Kingdom).