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CHAPTER XV. 



DISEASES ASSOCIATED WITH 



IN THE TISSUES. 



SYPHILIS is a fairly common disease in most tropical 

 countries, both amongst the Europeans and the natives. 

 In some countries, as in Central Africa ,and some of the 

 Pacific Islands, it is not met with amongst the natives. 



Neither race nor warm climate alone have any 

 influence on the manifestations of the disease. It is 

 indigenous in the more highly civilized countries, such 

 as India and China, and has been carried to other coun- 

 tries chiefly by Arabs and other traders, including 

 Europeans. Travellers are apt to mistake all kinds of 

 ulceration for syphilis, and there can be no doubt that 

 much exaggeration as to the frequency and violence of 

 the disease in native races is due to such inaccuracies. 



Circumcised races, both Mahommedans and others, 

 are quite frequently attacked, but in them a considerable 

 proportion of the chancres are urethral. The primary 

 sores are not so often seen in natives as in Europeans. 

 These are frequently extra-genital or within the rectum 

 or anus as the result of sodomy, or on the abdomen or 

 pubes or scalp, from the custom among certain natives 

 of shaving these parts, barbers being employed ; occasion- 

 ally also syphilitic infection follows tattooing, saliva being 

 largely used to mix the pigments. 



Syphilitic ulceration ; among native races in the Tropics 

 is apt to be severe^ or even phagedsenic at all stages of 

 the disease, owing to neglect of both cleanliness and 

 treatment. This is less common amongst prostitutes, 

 who are careful as_ to personal cleanliness, e.g., Japanese, 

 than amongst those who are less so, e.g., Cantonese. 



