440 STRONG. 



It was found that in every instance for the cases of yaws treated a 

 single injection of the drug was sufficient to produce a cure, even though 

 a number of them showed tertiary lesions with ulcerations. No local 

 treatment was used with any of the patients, nor was any other treatment 

 internal or otherwise administered after the injection. A few cases had 

 previously been treated with iodides ; these were discontinued a few days 

 before the injection of dioxy-diamido-arsenobenzol was given. 



NOTES OF THE CASES TREATED. 



The notes of the cases treated are as follows. Photographs before 

 and after treatment frequently were secured where opportunity was 

 favorable. 



Case I. — (Plates 1 and 11.) Felixberto; male, age 11 years. Diagnosis., yaws 

 secondary stage ; duration of tlie disease, about one year. 



The lesions are situated anteriorly over the forehead, nose, cheeks, upper lip, 

 chin, chest, upper arms and forearms, thighs and legs. These consist of raised, 

 mushroom like, sharply circumscribed granulomata measuring from 1 to 5 centi- 

 meters in diameter and about 1 to 1.5 centimeters in thickness. They are in 

 general circular in outline. Frequently the lesions have coalesced. On the right 

 ankle is an excoriated lesion apparently the result of traumatism, and on the 

 right forearm just above the wrist is an ulcerated granuloma. The patient has 

 been under treatment at the St. Luke's dispensary for the past two months. For 

 nbout seven weeks he lias taken five grains of potassium iodide three times daily. 

 Before this lie took syrup of iodide of iron. Locally, he was treated with 

 bichloride and salicylic acid dressings, these being applied every few days. The 

 treatment has apparently had no effect whatever on the disease. A smear from 

 one of the granuloma stained with Giemsa's solution showed a few spirochsetse. 

 Plate I shows the patient as he appeared after two months of the treatment as 

 described above. All of these measures were then discontinued and the patient 

 given an injection of a solution of 0.28 gram of dioxy-diamido-arsenobenzol, half 

 of the solution being injected into each buttock. On the fourth day after the 

 injection it was reported that the lesions were disappearing. The patient was 

 seen by the author one week after the injection. The granulomatous lesions had 

 almost entirely disappeared. In twelve days the skin was perfectly smooth; the 

 lesions had entirely disappeared, and only pigmentation of the skin remained where 

 the granulomatous lesions formerly existed. Plate II represents a photograph 

 taken at this time. The skin was everywhere perfectly smooth. Examination of 

 the urine one week after the injection showed it to be normal. The case since 

 has remained entirely well. 5 



Case II. — (Plates III and IV.) Gonzales; male, age 5 years; duration of 

 the disease 8 months. The lesions are scattered over almost the entire face, 

 neck, upper arms and forearms, hypogastric region, thighs, legs, ankles, and 

 feet; posteriorly over the neck, shoulders, arms and forearms, back, buttocks, 

 thighs, legs and ankles. The chest and abdomen are particularly clear. The 

 lesions consist of granulomata measuring usually from about 0.3 to 1.5 centi- 

 meters in diameter, being slightly raised above the skin and being covered, 

 particularly on the face by yellow crusts. On the arms, forearms and legs, the 

 lesions are more distinctly papular in character. A smear from one of these 



* I am indebted to Dr. Eleanor Pond of St. Luke's Dispensary for having notified 

 me of this case. 



