A Report on Researches on Sprue in Ceylon
1912–1914

Table of Contents

1. Origin and objects of the expedition
2. Acknowledgments
3. A description of Ceylon, its inhabitants, vegetation, geology and prevalent diseases
4. A definition of sprue and a description of its symptoms
5. Hill diarrhoea
6. Explanation of the term 'sprue'
7. Summary of the past literature of sprue
8. General geographical distribution of sprue
9. Distribution of sprue in Europeans in Ceylon
10. Certain factors in their bearing on the incidence of sprue
11. Sprue regarded as an infectious disease
12. Symptoms of sprue as met with in Ceylon
13. Investigations on the clinical pathology of sprue
14. The morbid anatomy and pathology of sprue
15. The aetiology of sprue
16. A study of the yeasts found in sprue lesions and attempts at their classification on a rational basis
17. Evidence in favour of and against regarding sprue as a blastomycotic infection
18. Treatment
19. Differential diagnosis
20. Conclusions
21. Bibliography
Appendices:
1. The population of Ceylon in 1911
2. The number of Europeans resident in the different provinces
3. Temperature and rainfall in Ceylon
4. Clinical account of cases of sprue in natives
5. Details of various estate bungalows and their relation to sprue
6. A list of Ceylon mosquitoes
7. Incidence of sore sprue-like tongues in natives
8. Details of Noguchi reactions
9. Table showing the relationship between the amount of fluid and proteid ingested and the amount of urine and urea excreted in two cases of sprue
10. Blood counts of sprue cases
11. Detailed history of sprue cases with an account of post-mortem examination, morbid anatomy and microscopic pathology
12. Weights of organs in sprue and a comparison with those of normal subjects and those of a case of pernicious anaemia
13. Tables showing the presence of yeast cells in cultures and in smears made from sprue post-mortems, and a comparison with similar preparations made from other post-mortems, mostly cases of diarrhoea
14a. Table showing sugar reactions of a yeast as obtained after varying periods of incubation
14b. Provisional classification of the yeasts of the genus Monilia, together with the sources from which these organisms were obtained
14c. Variations in the sugar reactions given by these yeasts at different periods and on different media
15. Various details of five sprue cases under treatment
16. Details of twelve cases of apparent recovery from sprue, all still resident in Ceylon.

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