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March 23, 1946


Author Affiliations

Nashville, Tenn.

From the Departments of Medicine and Biochemistry, Vanderbilt University School of Medicine.

JAMA. 1946;130(12):780-786. doi:10.1001/jama.1946.02870120026006

In recent years the view that no essential differences exist between tropical and nontropical sprue has become acceptable. Hanes1 has emphasized this point and has further pointed out the relative frequency of reported instances of this disease from the entire United States and from northern Europe. He reports 66 cases of sprue encountered in the Duke University Hospital during a period of eight years. One hundred and fifty-eight cases of pernicious anemia were admitted during this same period, giving a ratio of 1 patient with sprue to 2.5 cases of pernicious anemia.

The fundamental defect in sprue appears to be impaired absorption of various substances from the gastrointestinal tract, whereby a deficiency of a number of factors may be brought about. Various micro-organisms suspected as causal agents in the past have been excluded as playing an etiologic role. The work of Castle, Rhoads and their associates2 in Puerto

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