236 



REVIEW — TROPICAL MEDICINE, ETC. 



Yaws — 



The role of biting-flies in spreading this disease still requires to be investigated. 



continued Castellaui'* has shown that under certain conditions the disease may be spread by flies 



(Miisca domestica). Modder- suggests that the Ixodes hovis might be the transmitting 



agent, but, in a more recent paper, is inclined to believe that the Argas ticks are concerned 



in the spread of this disease. 



As regards treatment, Castellani^ has found, in obstinate cases, the mixed method of 

 treatment to be best. That observer obtained the most satisfactory results with iodide of 

 potassium, followed either by atoxyl or quinine or sodium cacodylate. The iodide of 

 potassium was administered in doses of 1 gramme in milk thrice daily ; the atoxyl by daily 

 subcutaneous injections of 0-05 grammes, and one injection of cacodylate of soda or quinine 

 cacodylate containing 0-05 grammes of the drug. As regards local treatment, the same 

 observer recommends the application of perchloride of mercury 1 in 1000, and dusting the 

 granulomata with iodoform or boric acid. For ulcerative lesions he recommends the use 

 of 20 per cent, protargol ointment. 



Campbell, Graham,* obtained encouraging results with sodium bicarbonate internally 

 in 4-grain doses, together with the local application of copper sulphate. 



Yaws does not appear to be indigenous in the Sudan, but Ensor has reported one 

 undoubted and one doubtful case at Kassala. In both instances children were afi'ected. 

 He suggests that the disease may have been introduced into this part of the Sudan by Hausa 

 pilgrims from the West Coast on the way to Mecca. 



(I have seen one case of supposed yaws in a Sudanese soldier at Khartoum. My own 

 opinion is that the disease was syphilis, and it yielded very rapidly to large doses of iodide 

 of potassium. I failed to find S. fertenuis in smears from the lesions. — A.B.) 



Yellow Fever. It was the excellent investigation of Major Eeed and his 

 co-workers which led, in 1900, to the discovery of the chief agent in propagating the virus. 

 They found that a Stegomyia fasciata, which had fed on an infected case within the first 

 three days of the disease could, after an interval of twelve to twenty days, infect a non- 

 immune patient and invariably transmit the disease. They further observed that fomites 

 of all kinds, clothing, bedding, etc., played no part in the transmission of the virus, and that 

 the disease could be transmitted by the injection of the blood of patients affected with 

 yellow fever during the first three days of the disease. 



Marchoux, Salimbeni and Simond^ during their investigations at Eio confirmed 

 Eeed's observations, and found that the serum of a patient suffering from yellow fever, 

 although virulent on the third day of the attack, was not so on the following day. They 

 observed that the virus will pass through a Chamberland F. bougie. They failed to find, 

 either in the blood of man or in the mosquito, the causative agent of yellow fever, but they 

 favoured the idea that the micro-orgauism was of the nature of a spirillmn."* 



The B. icteroides of Sanarelli, Tombleson's bacillus and Finlay's protozoou must now be 

 looked upon as matters of historical interest only, for the organism of yellow fever, which 

 has been declared by some to be ultra-microscopic, has yet to be discovered. 



As regards the transmitting agent, the Stegomyia fasciata, some interesting facts have 

 been elucidated. Marchoux' and his colleagues found that the Stegomyia was not 

 dangerous till after an interval of at least twelve days had elapsed since its last feed on the 

 virulent blood of yellow fever cases, and that the mosquito bite was much more dangerous 

 later than shortly after the insect acquired infection. Some further investigation 

 by Marchoux and Simond'* into the life-history of S. fasciata, shows that it can bite man, 



' Castellani, A. (Jaly Ist, 1907), " Experimental Investigation on Pramboesia Tropica." Journal of Hygiene. 



= Modder, E. E. (June 1st, 1907, and November 15th, 1907), "Transmission of Yaws by Ticks." Journal of 

 Tropical Medicine and Hygiene. 



' Castellani, A. (November 23rd, 1907), " Observations on the Treatment of Yaws." Lancet. 



* Graham, Campbell (November 11th, 1905), " Notes on Pramboesia Tropica." British Medical Journal. 



^ Marchoux, E., Salimbeni, I., and Simond, P. L. (November, 1903), "Report of French Mission at Rio." 

 Ann. de Vlnstilut Pasteur. 



" (June 15th, 1906), " Prench Yellow Pever Mission to Rio." Journal of Tropical Medicine. 



' Marchoux, E., and Simond, P. L. (January and February, 1906), "Report of French Mission." Ann. de 

 I'Institut Pasteur. 



' (December 1st, 1906), 2nd, 3rd, 4tli " Memoirs of Prench Mission to Rio to study Yellow Fever." Journal 

 of Trn/iicul .tfi-iUcine. 



' Article not consulted in the original. 



