THE SPECIFIC CURE OF YAWS. 443 



smear from one of these revealed spirochjetae. The patient was injected with 

 0.4 gram of the preparation in the usual manner. Twenty days later the active 

 lesions had entirely disappeared, leaving pigmented patches of smooth skin where 

 they had formerly existed. 



Case X. — Bernardo ; male ; age 22 years ; duration of disease one and one-half 

 years. There is an ulcer measuring 3 centimeters in diameter, evidently a 

 tertiary lesion, situated on the left ankle and a small fungating mass on the 

 left toe. There are numerous pigmented patches and scars over the posterior 

 surface of the legs and back. Spirochaete were found in a smear from the fun- 

 gating mass. The patient was given 0.4 gram of the preparation by injection 

 in the usual manner. Twenty days later the lesions had entirely healed. He 

 since has remained well. 



Case XI. — Tomas; age 11 years. The lesions consist of about thirty papil- 

 lomata situated over the shoulders, arms, forearms and knees. They are sharply 

 circumscribed, and measure from about 4 millimeters to 1 centimeter in diameter. 

 A smear from one of these shows a few spirochseta». Three-tenths of a gram 

 of the preparation was injected into the buttocks in the usual manner. Ten 

 days later the lesions had entirely disappeared, leaving only slightly pigmented 

 areas where they had previously existed. 



Case XII. — Castor; age 18 years; duration of disease about 1J years. The 

 lesions consist of granulomatous tumors measuring from 5 centimeters in 

 diameter, situated anteriorly over the right ankle, over the right external 

 malleolus, above the right knee, and posteriorly over the right ankle, over 

 the left ankle, above the heel and above the left knee. They are usually cov- 

 ered by yellow crusts. Over the left elbow posteriorly and the right ankle 

 there are old scars. A few spirochajtre were found in a smear from one of the 

 granuloma. The patient was given 0.3 gram of the preparation in the usual 

 manner. Fifteen days later the active lesions had entirely disappeared. I have 

 not been able to see this patient since that date. 



Case XIII. — (Plate IX.) Leon; age 12 years; duration of the disease a little 

 over a year. No others in the family have yaws. The lesions are situated 

 anteriorly over the forehead, neck, axillae, bends of the elbows, knees, legs, 

 ankles, scrotum, penis and foreskin, posteriorly over the neck, shoulders, posterior 

 surface of right arm and forearm, both elbows, back, left thigh, gluteal fold, 

 posterior surface of legs and left heel. The lesions consist of granulomatous 

 tumors varying in size from about 5 millimeters to 3 and 4 centimeters in 

 diameter, usually covered by yellow crusts. On the lower legs a number of the 

 granulomata are circular in outline, the skin in the center being depressed. 

 Evidently ulcerations will occur in these central areas should the case remain 

 untreated. There is an ulcer on the left heel measuring about 3 centimeters in 

 diameter. On the scrotum, penis and foreskin there are 9 papillomata measur- 

 ing about 4 to 5 millimeters in diameter. The granulomatous tumors are raised 

 from 0.5 to 1.5 centimeters above the surface of the skin. For the character 

 and distribution of the lesions Plate IX, flgs. 1 and 2 may be consulted. Three 

 tenths of a gram of the preparation was injected in the usual manner into the 

 buttocks. Twenty days later the lesions had entirely disappeared, the skin was 

 everywhere perfectly smooth and the ulcer on the heel entirely healed (see Plate 

 IX, figs. 3 and 4 ) . Since this time the patient has remained well. 



Case XIV. — ( Plate X.) Candido; age 10 years; duration of the disease 2 

 years. The lesions are situated anteriorly over the chin, left side of neck, below 

 the left shoulder, at the bend of the left elbow, the right forearm, the left thigh, 

 both knees, right leg and right ankle, and posteriorly over the neck, shoulders, 

 back, buttocks and right leg. The lesions consist of patches, round or irregular 

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