The syndrome which will be discussed in this paper has acquired many names during its curious history. The term "sprouw" was first used by Vincent Ketelaer1 in 1669 in his description of an aphthous stomatitis occurring among the Belgians and associated with feces so copious "that several basins or pots scarcely hold these accumulations." William Hillary2 is usually credited with the first description of the sprue syndrome, which he observed in the Barbados in about 1754, but the clearest modern reports were those by Manson, in China, and by Van der Burgh, in Java, both of which were published in 1880.
The disease soon became known as "tropical sprue," an unfortunate designation since it has contributed to the erroneous impression that sprue does not occur in temperate climates. For many years, however, sprue has been known to be endemic in North Carolina and Virgina, and from the states farther south many cases have been recorded.