IMMUNITY IN YAWS 



By Andrew Watson Sellards 

 Of the Bureau of Science, Manila 



Ernest W. Goodpasture 



Of the Department of Pathology and Bacteriology, College of Medicine and 



Surgery, University of the Philippines 



two plates 



The question of immunity in yaws has received scanty atten- 

 tion, notwithstanding its clinical importance and its theoretical 

 interest. The experimental data and even the clinical observa- 

 tions are extremely meager. 



The clinical evidence bearing upon the immunology of yaws 

 is complicated by wide variation in opinion concerning the 

 spontaneous course of the natural infection. Since the intro- 

 duction of salvarsan therapy the opportunity no longer exists 

 of following individual patients through the entire course of 

 the disease. The clinical picture must be built up from the 

 composite study of many individual cases seen at varying stages 

 of the infection. Some observers question the existence of a 

 tertiary stage, believing that the disease ends with the dis- 

 appearance of the secondary eruption. Others lean decidedly 

 toward the view that, after the secondary stage, the infection 

 lies dormant or continues with tertiary manifestations practi- 

 cally throughout life. 



The evidence of tertiary manifestations rests chiefly upon 

 clinical grounds and not upon any exact demonstration in the 

 laboratory. Perhaps the clearest indication of tertiary involve- 

 ment is to be found in the bone lesions. These develop not 

 uncommonly in children during a typical attack of yaws. The 

 Wassermann reaction is positive, and the symptoms yield to 

 salvarsan therapy. The possibility must be considered of a 

 double infection of syphilis and yaws. However, in a community 

 where syphilis is uncommon, and when the patient and his family 

 show no taint of the disease, a syphilitic etiology of these bone 

 lesions is practically excluded. 



