The Incidence of Sprue Amongst Indians

The area I refer to is a bit of country lying between two rivers with my headquarters as the centre. The country is fertile at both ends-, being fed by rivers. But the affected area is arid, the climate is hot and dry, and the soil consists mainly of conker and to a less extent of black clay and red earth. It is fed by rain and the people draw their water supply almost exclusively from rain-fed tanks open to foul contamination. The people are Hindus, poor, and generally constipated. They are nonvegetarians, but they eat little meat and not much vegetables, living mainly on the cereals they grow in their fields. The disease presents the three cardinal signs, viz., flatulent diarrhoea, glazed tongue with superficial erosions, and anaemia. It is very insidious in its onset, lasts for months with periods of comparative ease and gradually makes the person a physical wreckIt affects men in their prime. My youngest patient was 22 years and my oldest 55. So far I have seen only one woman affected, but I cannot offer this as a proof that it is rare in the female sex. I have not been able to get a history of dysentery?bacillary or amoebic?-in