TWELFTH ANNUAL REPORT 21 



knowledge in view, studies have been made of the development 

 and life history of Paragonimus and CEsophagostomum (see 

 page 49). 



12. Yaws. — The occurrence and distribution of yaws and the 

 histology of the lesions of this disease have been investigated, 

 and three years ago a specific cure for yaws was discovered. 

 Dr. Paul C. Freer describes this on pages 13 and 14 of the Tenth 

 Annual Report as follows : 



Ehrlich and his pupils had found that dioxy-diamido-arsenobenzol had 

 produced very favorable results in the treatment of fowl spirochaetosis and 

 syphilis and, therefore, the idea suggested itself to try the remedy in 

 yaws, because of the morphologic and biologic relationship which exists 

 between the spirochaetae giving rise to yaws and syphilis respectively. It 

 was found that dioxy-diamido-arsenobenzol is an ideal specific for yaws. 

 Three or four days after the injection of the drug, the granulomatous 

 lesions begin to improve and in the course of from ten to twenty days 

 they usually have disappeared entirely, leaving a perfectly smooth, pig- 

 mented skin where the lesions previously existed. The absorption of tumor 

 masses measuring several centimeters in diameter and about a centimeter 

 in thickness in so short a time, and under the influence of no local treat- 

 ment, is very striking and surprising. Indeed, in the severe cases the 

 disappearance of the lesions and the cures produced can most aptly be 

 spoken of as marvelous. Even large granulomatous masses or deep ulcera- 

 tions heal within from two to four weeks. No more striking example in 

 medicine is known than that of the specific action of dioxy-diamido-arseno- 

 benzol on the lesions of yaws. It would appear that this chemical individual 

 is as important a specific for yaws as quinine is for malaria. Therefore, 

 a fourth specific in medicine has been discovered. 



13. Beriberi. — This oriental disease is prevalent in the Philip- 

 pines, and the deaths from beriberi among residents of Manila 

 during the years 1910, 1911, and 1912 were more than the deaths 

 from tuberculosis of the lungs and far more than the combined 

 deaths from cholera, smallpox, bubonic plague, and typhoid fever 

 during the same period. Investigations first undertaken by this 

 Bureau have demonstrated that the excessive infant mortality in 

 these Islands is chiefly due to infantile beriberi. Extensive 

 experiments on man made by this Bureau with different diets — 

 including red, or polished, and white, or decorticated, rice — have 

 proved that beriberi is a disease of nutrition and not an infection, 

 and have demonstrated that white or decorticated rice, which is 

 the staple article of diet of the Filipino, is the chief cause of the 

 prevalence of the disease in the Philippines. It has been demon- 

 strated that it can be prevented by the use of unpolished rice 

 instead of polished or decorticated rice, and by this means the 

 disease has been eradicated from all Philippine Government 

 institutions. 



