Monilia Psilosis 693 



furnishing a total of 1,136,096 cases, with 275,308 deaths (a total 

 mortality for the entire period of 24.23 per cent.).* 



The serums prepared according to Shiga's plan have since been 

 found to be speciiic in activity against the particular variety of 

 dysentery bacillus used in the immunization. Todd, Kraus and 

 Doerrt have shown that serum prepared from Shiga's bacillus con- 

 tained antitoxin. Shiga and later Kruse found the serums to be 

 bacteriolytic. They are agglutinating according to the height of 

 immunity attained, i : 5000 being observed in some cases. They 

 also contain specific precipitins and opsonins. 



Prophylaxis. — ^The prophylaxis of bacillary dysentery by the use 

 of killed cultures as vaccines has been attempted by Shiga { and by 

 Kruse. § Monovalent, polyvalent and sensitized vaccines, have been 

 tried, but not upon a sufficient scale to enable a satisfactory judg- 

 ment to be formed. 



SPRUE OR PSILOSIS 



Monilia psilosis (Ashfoee) 



Parasaccharomyces Ashfordi (Anderson) 



Sprue is an interesting .form of catarrhal inflammation of the 

 mucous membrane of the whole or part of the alimentary canal. It 

 is common to most hot and moist climates, and chiefly affects 

 immigrants from the temperate zones. According to Manson it 

 "is characterized by irregularly alternating periods of exacerbation 

 and of comparative quiescence; by an inflamed, bare and eroded 

 condition of the mucous membrane of the tongue and mouth; by 

 flatulent dyspepsia, by pale, copious and generally loose, fermenting 

 stools; by wasting and anemia; and by a tendency to relapse. It 

 may occur as a primary disease or it may supervene on other affec- 

 tions of the bowels. It is very slow in its progress ; and unless prop- 

 erly treated, tends to terminate in atrophy of the intestinal mucosa, 

 which sooner or later, proves fatal." 



It is variously known as sprue, "tropical diarrhea," ''diarrhea 

 alba," "aphthffi tropica," "Ceylon sore mouth,". "psilosis lingu*" 

 "Cochin China diarrhea," etc. 



Ashfordll studied 379 cases and deduced the following from the 

 data collected: 



1. Sprue is usually a mild disease with a veiled picture, a tendency to spon- 

 taneous cure and a usually ready submissiveness to a non-carboliydrate diet. 



2. Tongue lesions are often cUnically and histopatliologically indistinguishable 

 from ordinary thrush, a disease, as a rule, due to Monilia albicans. 



3. Clinically and histopathologically the picture of the tongue is projected on 

 through stomach and intestine. 



* "Public Health Reports," Jan. 5, 1900, vol. xv, No. i. 

 t "Zeitschrift fiir Hygiene," 1902, xli, 355. 

 t "Deutsche med. Wochenschrift," 1901. 



I "Deutsche med. Wochenschrift," 1903. 



II "American Journal of Tropical Diseases and Preventive Medicine, 1895, 

 ni, No. I, p. 32. 



