EREMASCACEAE IMPERFECTAE 



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would now place in different genera. On the other hand, some authors are 

 still willing: to assign all sorts of organisms from all types of organs and with 

 varying degrees of pathogenicity to this species, very much as some consider 

 various animal pathogens identical with Saccharomtjces cerevisiae, the common 

 beer yeast ! 



In sprue, the organism flourishes in the lower digestive tract accompany- 

 ing, if not causing, a severe anemia which usually disappears after the or- 

 ganism no longer is found in the stools. This disease, mostly confined to the 

 white migrants to the tropics, has been studied extensively in the Dutch East 

 Indies, India, and Puerto Rico. Its etiology has been ascribed to many condi- 

 tions, from climate and vitamins to fungi. It is usually more severe in the 

 well-to-do white immigrant or native whose food is often not well adapted to 

 a tropical climate than to the poor native. A prolonged diarrhea is followed 

 by anemia which may prove fatal. Ashford has had success with patients fol- 

 lowing a careful diet over a long period, designed to eliminate the organism 

 from the intestines. Since practically no worker has critically studied the 

 disease in all three regions, it seems quite possible that similar clinical symp- 

 toms have been taken for identities. Attempts to extend the findings of 

 sprue to pernicious anemia, which it resembles in many respects, have not been 

 very successful. Ashford has called the common intestinal organism in Puerto 

 Rico Monilia psilosis and provided it with a diagnosis which makes it include 

 several of the species separated by Castellani on the basis of their fermentation. 

 Others have found variants to which they either have or have not given specific 

 names, until the number of species reported from the intestines is quite large. 

 A third substratum where these organisms are commonly found, includes 

 the genitalia. They are rather rare in the urethra or about the glans, but very 

 common about the vagina. Their action is largely a mechanical irritation re- 

 sulting from small creamy colonies scattered over the mucous membranes. 

 However, they are often difficult to eradicate by application of local anti- 

 septics. They are especially likely to be present in diabetics, owing to the sugar 

 in the urine which encourages their growth. Very rarely they penetrate the 

 bladder and set up a gaseous fermentation, causing pneumaturia. 



Finally, we have the skin as a possible substrate. Many species cause 

 cutaneous or subcutaneous lesions. There are also several species which have 

 been rather inadequately described which cause lesions closely resembling 

 dysidrosis on the palmar and plantar surfaces and interdigital spaces, rarer 

 in other moist situations. Such lesions are rather more common between the 

 fingers than elsewhere and are locally known as "Jewish washerwomen's 

 disease." The greater frequency among Jews is attributed to the nonuse of 

 soap among these women, since they fear that the animals which the fat is 

 taken from were not slaughtered in accordance with kosher rules. Several 

 species have been reported as attacking the nails in chronic paronychia. Mem- 

 bers of this group have frequently been reported from cases of perleche. 

 Except for the infections of nails, few of the species causing the more super- 

 ficial cutaneous lesions have been adequately described or named. 



