A discussion of that form of oidiomycosis which is known as coccidioidal granuloma would seem to be appropriate at this congress, since it is a disease which is apparently confined to the American continents. The first reported case was observed by Posadas1 in Buenos Aires, and was described by that author and by Wernike.2 The remaining thirtynine cases have been observed in North America, the majority in California, and of the latter the greater number seem to have acquired the disease in the San Joaquin Valley. The first case which was recognized in California was reported by Rixford3 in 1894, and, together with a case which was observed in the same year by Thorne4 and Robinson, was later described in detail by Rixford and Gilchrist.5 Posadas and Wernike, as well as Rixford and Gilchrist, believed that the infecting organism was a protozoan belonging to the group of Coccidia, and on that account the latter authors suggested the name of Coccidioides immitis. In 1900 another case was observed by Oph\l=u"\ls and Moffit,6 who found that the parasite grew readily on artificial mediums, and that it developed as a mold which apparently