Because the first known case in North America of what is now called coccidioidal granuloma was reported from Cooper Medical College, in San Francisco, by Rixford and because the disease was proved by Ophüls, also of Cooper Medical College, to be caused by infection with a pathogenic fungus and not with a protozoan organism, coccidioidal granuloma has always aroused much interest in that school, which later became the Stanford University School of Medicine. Many patients with coccidioidal granuloma, representing practically all the known clinical types of the disease, have been studied and treated in the hospitals of this institution. For many years there has been more or less intensive study of the fungus in the laboratories of the medical school.
The generally accepted conceptions of the disease have gradually changed during the past thirty years, from the time when the disease was believed to be very rare and almost always