In 1759 William Hillary1described a peculiar chronic type of diarrhea associated with sore tongue, pallor and emaciation which he had observed in Barbados. Then for nearly a century there appear to have been no further distinctive clinical accounts of the disorder. In 1864 Julien2enunciated the view that "Cochin-China dysentery" was a specific condition different from other forms of dysentery. Despite his arguments and the views of other first-hand observers,3the French pathologists at home remained unconvinced. In 1880 both Manson,4in Amoy, and van der Burg,5in Java, described the features of the disease which Hillary had observed. Each of these observers adopted as a scientific name for the disease its popular designation in Java. Since then the individuality of "sprue" has been established and its features have been described by many authors. Various theories of the cause of the disease have been