According to Osler, it is difficult to classify sprue, as various views of its etiology are held. It is a disease of tropical or subtropical countries, more often occurring in the newcomer and in the better class of people. The disease is characterized by a distinctive sore tongue and mouth, a peculiar type of diarrhea, marked anemia, loss of weight and a tendency to remissions and exacerbations. Its etiology is unknown; various theories are given, some of which are pancreatic disease, mold, infection with Monilia or bacteria or deficiency in fat.
In this paper we shall deal more especially with the study of sprue as we have found it in thirty-six patients who have entered our clinic in the past five and one-half years. Most of these patients were missionaries, and most of them came from the Orient. There were sixteen patients from China, seven from India, five from Korea,
BAUMGARTNER EA, JEWETT CH. TROPICAL SPRUE: EXPERIENCE WITH THIRTY-SIX CASES. Arch Intern Med (Chic). 1930;46(4):597–604. doi:10.1001/archinte.1930.00140160047005
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