In the latter half of the nineteenth century the Japanese army medical bureau struggled to prevent beriberi in its ranks. In Japan, traditional medicine effectively treated beriberi, a nutritional deficiency illness, with food therapies. The army medical bureau, in line with western medical practice, viewed the disease as microbial in origin. Army leadership was driven, in part, by a desire to be seen as advanced and civilized by western nations, and demonstrating sound western medical protocols served this purpose. By the mid -1880s unit level medical officers adopted a mixed staple of rice and barley, which was a common food practice in rural households. This modification provided the necessary vitamin B1 in the soldiers' daily diet to prevent the onset of beriberi. The leadership of the army medical bureau allowed this dietary change on an ad hoc basis, but during times of war reinstated the official white rice staple. During wartime the army repeatedly suffered high rates of beriberi.
