448 STRONG. 



However, the lesions eventually entirely healed as a result of the primary 

 injection. The dose of the preparation for the treatment of yaws should 

 be from 0.25 to 0.3 gram for children and from 0.4 to 0.5 gram for 

 adults. Smaller amounts may not give such favorable results. 



Some observers believe that it is not advisable to attempt to repress 

 the eruption of yaws, as this may be accompanied by considerable consti- 

 tutional disturbance. The employment of dioxy-diamido-arsenobenzol 

 simply caused the eruption to fade away. There were no unfavorable 

 constitutional symptoms other than an occasional transitory rise of tem- 

 perature produced thereby, and the patients seemed improved in health 

 following the disappearance of the eruption. 



A number of authors have also laid great stress upon the local treatment 

 of the disease. If dioxy-diamido-arsenobenzol is employed, the local 

 treatment is entirely unnecessary, except in cases of severe ulceration and 

 where organisms •other than Treponema pertenuis have invaded the 

 lesions. Case IV would undoubtedly have been cured more quickly if 

 the ulcerating granulomatous masses had been curetted, disinfected, and 

 dressed daily with sublimate solutions, since spirochsetae other than 

 Spirochaeta pertenuis and bacilli and cocci were present in the lesions. 

 However, even in this case they eventually entirely healed without local 

 treatment. 



The cure of yaws by this preparation, and the successful results which 

 have been obtained with it in the treatment of certain cases of syphilis, 

 may suggest again the identity of yaws and syphilis. It does not appear 

 strange that this preparation should have such a destructive action against 

 both Treponema pertenuis and Treponema pallidum, since both from a 

 morphologic and biologic standpoint these two organisms appear closely 

 related. Indeed, potassium iodide, which is so valuable in the treatment 

 of syphilis, has hitherto been the most successful remedy employed in 

 the treatment of yaws. As has been pointed out by other observers, the 

 therapeutic argument for the identity of yaws and syphilis and hence 

 for the identity of their specific organisms, is very fallacious. Many 

 instances in medicine might be quoted in support of this statement. 

 Quinine which destroys certain forms of Plasmodium malaria, Plas- 

 modium vivax, and Laverania malaria?, also destroys Amaba dysenterice. 



In conclusion it would appear that dioxy-diamido-arsenobenzol is as 

 important a specific for yaws as quinine is for malaria. Therefore, a 

 fourth medicinal specific in medicine has been discovered. 



EEFERENCES. 



(1) Bltjmenthal. Berl. klin. Wchnsch. (1908), 45, I, 572. 



(2) Bowman. This Journal, Sec. B (1910), 5. 



(3) Bruce. Die Serodiagnose der Syphilis. (1909), 50. 



(4) Castellani. Journ. Hyg., Cambridge (1907), 7, 65. 



(5) Castellani & Chalmers. Manual of Tropical Medicine, London (1910), 



855. 



