554 SCIENCE IN AFRICA 



per cent of the population. In Nigeria steady advance has been 

 made in the treatment of yaws and although usually this cannot 

 be sufficiently prolonged to produce cure, the incidence of florid 

 yaws has decreased greatly. Little progress has been made in the 

 elimination of syphilis, which is rampant. Cases treated during 

 1936 were: 



The symptoms of yaws are generally quickly removed by a few 

 injections. This fact is of much value to the medical worker in 

 gaining the confidence of natives, but it complicates the treatment 

 of other diseases, since natives demand the needle for the cure of 

 every complaint and are disappointed when it is refused. On the 

 other hand they consider a cure is effected when obvious sym- 

 toms disappear, hence for the venereal diseases they seldom come 

 for treatment long enough to obtain a complete cure. 



An answer to the question whether yaws and syphilis are in fact 

 one or two diseases is urgently required. At present, there is no 

 simple laboratory test to differentiate the two, since all known 

 reactions for syphilis are the same as for yaws. J. A. Carman 

 (1935), Hewer (1934), and G. Mattlet (1933) have discussed this 

 question at some length. Doubt also exists whether yaws can pro- 

 duce lesions of the brain and spinal cord as does syphilis, a subject 

 discussed by H. L. Gordon ( 1 934a and b) . Furthermore, it has been 

 suggested that yaws and syphilis are so closely related that one 

 may confer immunity against the other, and hence it may be 

 inadvisable to complete the cure for yaws in that the patient may 

 thereby become susceptible to syphilis. This is discussed by P. D. 

 Connolly (1931). There can, however, be no dispute that treat- 

 ment which clears up cutaneous lesions does in fact lead to a 

 reduction of incidence in the disease in the next generation, 



