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 Posadas 1 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 Rixford 3 in 1894, and, together with a case which was observed in the same year by Thorne 4 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