22,3 Sellards and Goodpasture: Immunity in Yaivs 243 



This work was repeated with the introduction, however, of 

 some modifications. Neosalvarsan was injected intravenously, 

 and serum was obtained by taking a specimen of the patient's 

 blood several days later. 



An adult yaws patient in the active secondary stage was 

 injected with 0.75 gram neosalvarsan. Four days later blood 

 was drawn by direct puncture from a vein of the arm. The 

 specimen was kept on ice for three hours and the serum re- 

 moved. Three patients with typical granulomata of yaws were 

 injected. A child of 11 years of age received 20 cubic centi- 

 meters intramuscularly; another, 6 years old, received 10 cubic 

 centimeters intravenously; and another, 4 years old, received 

 5 cubic centimeters intramuscularly. No improvement followed 

 in the succeeding week. These patients were then injected with 

 neosalvarsan and responded promptly. 



A second adult patient with florid secondary yaws was given 

 0.6 gram neosalvarsan intravenously. Two days later, 200 cubic 

 centimeters of blood were withdrawn and stored overnight on 

 ice. Serum was injected into two patients showing active sec- 

 ondary lesions. One, 14 years old, received 20 cubic centimeters 

 intravenously, but no improvement followed. The other, a child 

 of 5 years, was given 12 cubic centimeters intramuscularly. 

 Three days later some of the granulomata were slightly drier 

 than at the time of injection. The change however was very 

 slight and not greater than might occur spontaneously. Another 

 injection was given intramuscularly of the serum, which had 

 been stored on ice, using 12 cubic centimeters. No improve- 

 ment followed. Both of these cases responded promptly to 

 neosalvarsan. 



Taking into full consideration the modifications we have 

 introduced, it is difficult to explain the discrepancy between our 

 results and those obtained by Alston. 



The reinoculation of yaws patients before and after treat- 

 ment with salvarsan appears to us to afford a valuable proce- 

 dure for the study of immunity in this disease. The data 

 recorded in this paper are rather meager, but the results are 

 fairly clear-cut and at least serve as an outline of the various 

 types of reaction that may be expected. The following inter- 

 pretation is based upon the character of the reaction obtained 

 and is entirely independent of the percentage of successful 

 inoculations : 



