FRAMBCESIA OR YAWS 525 



would appear to be definitely related to the activity of the 

 syphilitic lesions. A positive reaction is practically always present 

 in general paralysis and in the large majority of cases of tabes, 

 and may be given by the cerebro-spinal fluid as well as by the 

 blood serum in these diseases. As regards other diseases, a 

 positive reaction has been recorded as occurring in leprosy 

 (p. 314) and sleeping-sickness and also in yaws, but apart from 

 these diseases it is practically never met with. At present little 

 can be said in explanation of the Wassermann reaction. It seems 

 to depend on the interaction of lipoidal substances in the extract 

 with proteins in the serum, which are apparently contained in 

 the globulin fraction ; but we know nothing as to why this 

 peculiar modification of the serum should be present in syphilis. 

 It is now generally accepted that it does not depend on the 

 presence of an anti-substance (immune-body), which in association 

 with the antigen (the spirochsete) fixes complement. 



FKAMBCESIA OR YAWS. 



Framboesia is a 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 to 

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

 has been the subject of much controversy. It is accordingly a 

 matter of great interest that an organism of closely similar 

 characters to the spirochsete pallida has been found in the lesions 

 of framboesia. This organism was discovered by Castellani, who 

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

 logically, it is practically identical with the spirochaete pallida ; 

 when ulceration has occurred other spirochsetes 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 are seen in the case of syphilis. Castellani 

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

 pithecus 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, 



