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Originally published in 1915, this book presents the findings of an investigation into outbreaks of tropical sprue on the island of Sri Lanka.
List 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.
Summary
Originally published in 1915, this book presents the findings of an investigation into outbreaks of tropical sprue, an intestinal inflammation, on the island of Sri Lanka. Bahr analyses the various symptoms of the disease, which appeared to affect predominantly non-native inhabitants of Sri Lanka, as well as suggesting possible solutions and treatments.
