Up to the present time only twenty-one cases of this unusual disease have found their way into the medical literature. First described by Gaucher,1 in 1882, it was not mentioned again until 1895, when Picou2 published his first article, followed by a second,3 in conjunction with Ramond, in 1896. Collier,4 in England, had, in the meantime, published a report in 1895. Bovaird5 was the first to describe it in America, and it was only in 1906 that Schlagenhaufer6 reported the first German cases. F. S. Mandelbaum, of New York, has undoubtedly done the most to put the pathologic peculiarities of the disease on a sound footing.7 Working alone and with various collaborators, notably Brill (who published two articles independently8) and Downey, he has given a most comprehensive survey of the clinical and pathologic aspects of these cases.
According to him, the disease