I-'KAMIUESIA OR YAWS 511 



FRAMBCESIA OR YAWS. 



l-'rambuesia is a contagious disease of the tropics, occurring in 

 the west coast of Africa, Ceylon, the West Indies, and other 

 parts. It is characterised by a peculiar cutaneous eruption, and 

 it is markedly contagious. Its resemblance in many respects 

 t syphilis has been noted, and the relation of the two diseases 

 1ms been the subject of much controversy. It is accordingly a 

 matter of great interest that an organism of closely similar 

 characters to the spirochuete pallida has been found in the lesions 

 of f ramboesia. This organism was discovered by Oastellani, who 

 gave to it the name spirochatte pertenuis or pallidula. Morpho- 

 logically, it is practically identical with the spirochaete pallida ; 

 when ulceration has occurred other spirochaetes of less regular 

 form may be present as contaminations. In the skin lesions 

 it has been shown by Levaditi's method to be present in con- 

 siderable numbers, especially in the epidermis and also amongst 

 the leucocytic infiltration, which comprises more polymorpho- 

 nuclear leucocytes than is seen in the case of syphilis. Castellani 

 showed that the disease could be transferred to monkeys (semno- 

 jiltkccus and macacus being used for this purpose), and that the 

 organism could be demonstrated in the unbroken skin lesions. 

 The lesions are as a rule confined to the site of inoculation, but 

 the infection is general, as is shown by the presence of spirochaetes 

 in the lymphatic glands and the spleen. These results with 

 regard to the presence of spirochaete pallidula in the lesions and 

 the inoculation of apes have been confirmed by other workers, 

 and the etiological relationship of the organism to the disease 

 may now be regarded as practically established. The immunity 

 reactions in monkeys infected with syphilis and frambcesia, as 

 experimentally studied by Castellani and by Neisser, Baermann, 

 and Halberstadter, go to show that the two diseases are distinct. 

 On the other hand, Levaditi and Nattan-Larrier found that, 

 although monkeys infected with syphilis were refractory to 

 framboesia (Fr. pian\ monkeys infected with frambcesia were sus- 

 cvptiblr to syphilis: they therefore concluded that frambcesia 

 is a modified or mild form of syphilis. The exact relationship 

 of the two diseases cannot be yet accurately defined, but they 

 are undoubtedly closely related, and probably have a common 

 parentage. 



