260 The Philippine Journal of Science ms 



nel are already available. In these it would be entirely feasible 

 to treat yaws continuously. There are other regions, heavily 

 infected, in which traveling dispensaries could be operated in- 

 termittently. The expense of neosalvarsan for Government use 

 is remarkably low; namely, 20 cents United States currency (40 

 centavos Philippine currency) for 0.9-gram quantities. There- 

 fore, for a series of three injections of 0.6 gram each for an adult, 

 the total cost of the drug would be 80 centavos Philippine cur- 

 rency. The majority of the cases, however, occur in children; 

 for an infant the neosalvarsan for a series of three injections 

 costs 10 centavos. 



The total expenditure in money that would be required to 

 bring yaws under control in a given community would neces- 

 sarily vary widely in different countries. Moreover, if the work 

 were to be pressed rapidly, it would be correspondingly much 

 more expensive. The time required must also vary widely. It 

 would depend in the main upon three factors ; namely, (a) the 

 readiness with which patients present themselves for treatment; 

 (6) the consistency with which they return for repeated in- 

 jections; and (c) the total percentage of cases that report for 

 treatment. 



In primitive communities we have found that the people would 

 await with interest the result of the injection of the first few 

 patients. Then they would present themselves even more rapidly 

 than desired. There are always, however, a few stragglers. 

 Moreover, with the striking benefit following one or two injec- 

 tions, there are many who do not bother to return for repeated 

 injections. Furthermore, one cannot expect that 100 per cent 

 of the cases will report voluntarily and with reasonable prompt- 

 ness. The operation of a dispensary for a single period of a few 

 weeks for the treatment of all accessible patients in a given 

 area would certainly be altogether inadequate to bring the 

 disease under permanent control. Repeated visits would be re- 

 quired at intervals of perhaps six or twelve months. Six 

 months after closing the dispensary at Paranaque, an inspection 

 showed the presence of 76 cases of yaws. They were classified 

 as follows : Fifty-six cases were reported to have developed since 

 the closing of the dispensary; 8 were old cases that failed to 

 report for treatment; 12 were only partially cured or were 

 relapses. Too much confidence cannot be placed on this small 

 number of relapses, since two-thirds of the cases received only 

 one injection. In several places a good beginning has been 

 made, only to have the preliminary advantage lost through a 



