22,3 Goodpasture and De Leon: Reaction in Yaws 229 



Since the Wassermann reaction has become negative in the 

 course of five or six months after treatment in the majority of 

 cases, the indications are that, in the event that reaction continues 

 positive for a year or more, the treatment has been insufficient 

 and should be repeated even though no recurrence be evident. 

 Provided treatment at first is continued until there is a complete 

 healing of superficial lesions the number of such cases probably 

 would be exceedingly small. 



At the clinic in Paraiiaque several children with chronic in- 

 dolent ulcers, especially of the feet and ankles, presented them- 

 selves for treatment, some of them giving a history of yaws in 

 the past. Sera from six such individuals in whom the diagnosis 

 of yaws was questionable, though four gave a history of yaws, 

 were strongly positive. No doubt many ulcers of this kind are 

 based upon an original infection with Treponema pertenue and, 

 in an attempted eradication of the disease from an endemic 

 focus, they are an important factor. 



Castellani(3) was able to demonstrate specific fixation of com- 

 plement with an antigen prepared from yaws papules containing 

 Treponema pertenue and serum from a monkey that had been 

 successfully inoculated with yaws and afterwards treated at 

 intervals with subcutaneous inoculations of yaws material. This 

 fact encouraged the hope that by this means, using serum from 

 patients, yaws and syphilis might be differentiated. Bowman (2) 

 later reported positive fixation with such antigen and sera from 

 yaws patients, and negative tests with sera from syphilitics, but 

 the tabulation of his results indicates that the reaction was not 

 entirely specific. We repeated the test with an antigen prepared 

 from an early yaw containing treponemata, according to the 

 method used by Bowman, using otherwise the technic employed 

 for the Wassermann reaction. Two syphilitic sera and two 

 yaws sera, each strongly positive with cholesterinized antigen, 

 and two normal sera showed no fixation of complement. In view 

 of the close similarity of the Wassermann reaction in the two 

 diseases, it seems extremely doubtful that an antigen will ever 

 be prepared sufficiently specific for practical purposes in dif- 

 ferentiating yaws and syphilis. 



A positive Wassermann reaction in the Tropics does not bear 

 the same diagnostic significance that it does in the Temperate 

 Zone. It is present in a large proportion of cases of leprosy free 



