REVIEW — TROPICAL MEDICINE, ETC. 235 



successfully inoculated with material obtained from the granulomata of a typical case of Yaws- 

 yaws and from the glands of the arm of a case in full eruption. In the lower monkeys the continued 

 first symptoms appeared in twenty-two to ninety-one days after inoculation, and in the 

 anthropoid apes the symptoms appeared in thirteen days. 



Yaws then can be transmitted from man to monkey, and once in three attempts the 

 authors succeeded in infecting another monkey from the first. Of the internal organs and 

 tissues, only the bone-marrow and the cubital glands gave positive results after inoculation. 

 These observers further noted an important point, namely, that a monkey could be infected 

 with yaws fifteen days after the appearance of a sypliilitic chancre, proving that monkeys 

 inoculated with syphilis were not immune to yaws. Castellani,' in some further observa- 

 tions, showed that the infection of yaws in monkeys is a general one, spirochaetes being 

 found in the spleen and lymph glands. He confirmed the observation of Neisaer and others 

 that monkeys successfully inoculated with syphilis do not become immune to yaws, and 

 vice-versa ; and by means of the Bordet-Gengou reaction he detected specific yaws anti- 

 bodies and antigen. Further, he proved that the specific yaws antibodies and antigen 

 were entirely diiferent from syphilitic antibodies and antigen, thus adding to the chain of 

 evidence that yaws and sj'philis are two entirely different entities. 



Ashburn and Craig- further support the work of Castellani, and undoubtedly their 

 experiments prove that the Treporiema pertenuis is constantly present in the lesions of yaws. 



Eeference may be made to the histological characteristics of the yaws nodules studied 

 by Charlouis, Unna, Glogner and others, including Marshall, ^ who found that the 

 Treponema pertenuis causes a colliquative necrosis of the epithelial structures in which the 

 parasite is found in large numbers. Ulceration follows this necrosis, and there is a new 

 formation of epithelium in the form of down growths, which, in time, often degenerate, 

 vascular dilatation, leucocyte infiltration and oedema occurring in the corium. There is no 

 endarteritis. There is a peculiar distribution of the polymorphonuclear eosinophiles, and 

 Glogner demonstrated the presence of giant cells. 



That yaws and syphilis are two different diseases has been proved now beyond doubt 

 by the experimental researches of Castellani, Neisser and others, in monkeys, and by the 

 observation of Charlonis, who, in 1881, showed that patients suffering from yaws could be 

 infected with syphilis. 



Yaws not only differs from syphilis in its clinical features, but also in its geographical 

 distribution. The most important points bearing on the specific entity of these two 

 diseases may be briefly summarised : — 1. In non-ulcerative papules, in the spleen, in the 

 lymphatic glands of yaws, patients as well as in inoculated monkeys, the Treponema pertenuis 

 is the only organism present. 2. The extract of yaws material containing the Treponema 

 pertenuis is infective to monkeys. 3. The extract of yaws material from which the 

 Treponema pertenuis has been removed by filtration becomes inert and monkeys inoculated 

 with it do not contract the disease. 



Neisser, ■* while pointing out the directions in which yaws and syphilis resemble one 

 another, decides that yaws cannot be merely a degenerate form of syphilis, because 

 (o) Yaws does not protect against syphilis, and (6) syphilis does not protect against yaws. 



Eobertson' advances evidence to prove that flies can carry the virus. 



The communicability of yaws still requires investigation. It is well known that in 

 most cases yaws is conveyed by direct contact from person to person, usually by absorption 

 of the virus through a pre-existing abrasion or wound on the surface of the skin. Among 

 the natives in Ceylon, the primary lesion frequently develops in women on the skin of 

 the trunk just above the hip, due, no doubt, to their method of carrying their children 

 astride of their hips. 



According to Jeanselme," the disease is propagated among the adult natives in Indo- 

 China by the chopsticks used instead of forks, by the water-pipe which is handed from 

 mouth to mouth, and the sleeping mats common to all. 



• Castellani, A. (July, 1907), " Experimental Investigation on Framboesia." Journal of Hyi/iene. 



■ Ashburn, P. M., and Craig, C. P. (October 1st, 1907), " Observations on Treponema Pertenuis (Castellani) 

 of Yaws, and the Experimental Production of the Disease in Monkeys." Philippine Journal of Science. 



' Marshall (October 1st, 1907), " A Histologic Study of Yaws." Philippine Journal of Science. 



■• Neisser, A. (March, 1908). Arch, fur Schiffs-und Trap. Hijy., No. 2. 



" Robertson, A. (July 15th, 1908), "Plies as Carriers of Contagion in Yaws." Journal of Tropical Medicine 

 and Hygiene. 



° Jeanselme, E. (November 11th, 1905), " Notes on Plan," translated by Sandwith. British Medical Journal. 



