[Skip to Content]
[Skip to Content Landing]
December 16, 1983


Author Affiliations

From the Uniformed Services University of the Health Sciences, Bethesda, Md.

JAMA. 1983;250(23):3225-3226. doi:10.1001/jama.1983.03340230077035

The retrospectroscope is a marvelous instrument. To place Dr Francis' LANDMARK ARTICLE into perspective, it seemed most appropriate to review the sections on tularemia in current representative textbooks of internal medicine and infectious diseases.1-4 These texts generally present history, etiology, epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prevention. Contrast this with the subtitles in Francis' article: "Synonyms and History," "Geographic Distribution in Man and Rodents," "Symptoms and Course," "Agglutination Tests," "Portal of Entry," "Insect Transmission," "Non-contagiousness," "Immunity," "Diagnosis," "Laboratory Tests," and "Treatment." After reading the current texts and then rereading Francis, the déjà vu is most striking.

The synthesis of the original observations of a serologist, a clinician, and a bacteriologist that Francis reports in his 1925 article based then on 49 cases provides most of the information that is needed to diagnose tularemia in 1983. The causative bacterium of the "plague-like disease of rodents" prevalent among California ground