SPRUE 627 
tionship between the incidence of the disease and the use of rice. 
The disease occurs more frequently in women than men and the incu- 
bation period is unknown, but as a rule the disease appears in the 
individual several months after arrival in the endemic area. I^sually 
older people are infected although children are not immune. 
Sprue consists essentially of a chronic, catarrhal inflammation of 
the alimentary canal, with characteristic ulcerations of the mouth 
and especially of the tongue. The symptoms advance and recede 
somewdiat irregularly. There is a persistent diarrhea associated with 
the passage of pale, somewhat frothy stools, but without tenesmus 
as a rule. 
The etiology is as yet undetermined. Bahr^ has observed the so- 
called Russell bodies (fuchsin bodies) in the submucosa of 6 patients 
who died of sprue, and also in the spleen, but was not inclined to attri- 
bute etiological significance to them. 
An etiological significance has been attached to certain yeasts, 
especially those of the genus Monilia, and yeasts have been found rather 
consistenth- in the deeper layers of the tongue of the sprue cases, as well 
as in the deeper layers of the intestinal mucosa in the few cases that 
have been studied postmortem. The organisms were not observed 
by Bahr in cadavers who had succumbed to tropical infections other 
than sprue. He was inclined to attribute some pathological signifi- 
cance, therefore, to Monilia albicans, the yeast which he found most 
frequently at autopsy in the deeper layers of the mucosa of the ali- 
mentary canal. This observation, how^ever, is regarded by Bahr as 
suggestive rather than definite. Ashford,^ also has obtained Monilia 
from sprue cases (Monilia pik)sis), which, upon repeated passage, 
caused diarrhea upon feeding in rabbits. 
' Jleport on Researches on Sprue in Ceylon, 1912-1914, Cambridge, 1915. 
2 Am. Jour. Med. Sci„ 1917, 154, 159. 
