Abstract
Keshan disease is a chronic endemic cardiomyopathy, which was first discovered in the rural areas of China. The author proposes that Keshan disease is a nutritional bio-geochemical disease. The differences between the endemic and non-endemic areas consist of the water-soil factors (bio-geochemical elements) in the natural environment. The etiological factor of the natural environment in the endemic region acts on the human body by way of the food consumed. Those who lived on a "single type of food", which was produced from their own fields, were liable to suffer from Keshan disease. Young females of child-bearing age and children after lactation were the most frequent victims of the disease. The use of soy-beans to improve the diet and oral administration of sodium selenite will prevent Keshan disease. Experiments on animals fed on cereals and vegetables from the endemic areas areas have shown that there might be some myocardial necrotizing factor and/or growth inhibition factor in the water-soil elements.