236 The Philippine Journal of Science 1923 



at the site of inoculation. Treatment with neosalvarsan was 

 commenced. 



Some of the earlier observers report the successful inoculation 

 of yaws in normal individuals with the production of a gener- 

 alized eruption but without the development of a primary lesion 

 at the site of inoculation. Usually, however, a mother yaw 

 develops just as in the spontaneous disease. Paulet(9) inocu- 

 lated 14 normal men successfully with yaws and in 10 a local 

 lesion developed. Charlouis(4) inoculated 32 Chinese prisoners, 

 in 28 of whom yaws developed; in each case a local lesion 

 appeared at the point of inoculation. Nicholle(8) inoculated 8 

 men successfully but in 3 no primary lesion developed. 



There is no evidence that any of the reinoculations of our 

 three cases was successful. Another group of four patients 

 was selected and inoculated in the same manner. These patients 

 were well advanced in the secondary stage. Indeed, the onset of 

 the disease had occurred so long ago that it was not possible to 

 determine with certainty even the approximate date. In all of 

 these cases, however, the secondary stage had existed for at 

 least eight months. The inoculations were made in the same 

 manner as in the three cases mentioned, two incisions being 

 made in the skin over the deltoid. The incisions healed promptly 

 and no fresh granulomata developed elsewhere over the body. 

 Two weeks later three patients of the second group were 

 reinoculated on the opposite arm. Care was taken to implant 

 a small piece of tissue from the yaws granuloma. A superficial 

 incision was made in the patient's skin and the piece of yaws 

 tissue was caught in a nick in the cut edge. The incision soon 

 filled with blood which clotted firmly over the implanted tissue. 

 Subcutaneous implantation was avoided on account of the 

 possibility of secondary infection. In two of these patients the 

 result was entirely negative. In the third, one week after 

 inoculation, the upper incision had healed completely. A slight 

 but distinctly elevated ridge had formed along the entire line 

 of the lower incision 0.5 centimeter in length. At the end of 

 the second week a small round lesion, 3 millimeters in diameter 

 and 2 millimeters in height, had developed. One week later, 

 this granuloma had increased a little in size and the skin 

 immediately surrounding it was slightly hypersemic. At this 

 time, it seemed that the lesion was commencing to grow rapidly. 

 However, one week later the granuloma was distinctly smaller 

 and the hypersemic zone had disappeared. A photograph was 



