﻿TREPONEMA PERTENUIS CASTELLAXI OF YAWS. 44?> 



very kindly has examined several of my specimens, but that if future investigation 

 w ill prove that yaws is a spirochsetae disease, the yaws spirochete will have to be 

 considered to be biologically different from the spirochete of syphilis." 



Careful and frequent inquiries among the medical officers of the Army 

 and civilian practitioners in Manila, during a period of almost a year, 

 had but confirmed the impression gained from the literature (1 and 2), 

 that yaws is a rare disease in the Philippine Islands, when we were 

 shown some cases at Paraiiaque, through the courtesy of Dr. Luis Gue- 

 rrero. At the time of our first visit there we saw four cases and at 

 subsequent visits four others, while we were informed by the patients 

 and their friends that the disease is very common throughout all the 

 region about Paraiiaque, and Ave have since heard of it as common in 

 certain towns of Tarlac Province, Luzon, and in the neighborhood of 

 Parang-Parang, Mindanao, and it is quite probable that it is frequently 

 seen and well known by the natives in most parts of the Archipelago. 



We have also seen five cases in San Lazaro Hospital, Manila, all in 

 lepers. We have not had an opportunity to treat any case that we have 

 seen, but we have examined all and in ten we looked for Treponema perte- 

 iiuis, finding it in all of them. 



Our examinations of yaws cases, which have been made at relatively 

 infrequent intervals for the reason that we had none under our im- 

 mediate control and supervision, embraced inquiries into the clinical mani- 

 festations of the disease. In this regard they brought out nothing new 

 that is important and the description which we might give of the clinical 

 appearance of the disease would not differ greatly from those of most 

 recent authors and even from those of a century ago' by Winterbottom 

 and Bateman(22), except that we think the large, ulcerative lesions are 

 probably due to secondary infections and should not be credited to 

 pure yaws, any more than suppuration in syphilitic lesions should be 

 attributed to Treponema pallidum. 



The observations which we shall discuss herein consist principally; 

 then, of studies of the fresh and stained serous exudate from yaws 

 lesions, which contained the Treponema pertenuis. as described by Castel- 

 lani and others. As the serum presented nothing peculiar or charac- 

 teristic of yaws except the treponema, the great bulk of our work 

 consisted in observations on that parasite. These observations were made 

 on three varieties of preparations of the serum. 



METHODS OF EXAMINATION. 



A. Stained smears. — These were prepared by removing the yellowish., beeswax- 

 like tops from the papillomatous lesions, either by pulling them off entire or 

 by washing them off by friction with wet gauze, and taking on the end of a 

 slide a bit of the clear serum which then exudes from the lesion and making a 

 very thin smear of it across a thoroughly cleaned slide. Preparations so made 

 were then stained with either Wright's or Giemsa's stain, preferably the latter. 



A more profuse flow of serum is obtained if the crust or cap of the swelling 



