XIII. B, 2 



Maul: Bone and Joint Lesions of Yaws 



69 



her, several ulcers were present in both legs, of irregular shape, thin mar- 

 gins, rather deep and without much secretion; the left tibia was arching 

 forward; moreover on one of the ribs an indolent gumateous-like swelling 

 was present. In the secretions of the ulcers no spirochaetes were found. 

 The girl has been treated with potassium iodide and the ulcers have healed 

 leaving large whitish irregular scars. 



Case 2. Singhalese girl about 11 years of age. Sister of the previous 

 patient. No history of syphilis; genital organs intact. Five years ago she 

 suffered from yaws at the same time as her sister. She recovered and 

 remained in good health until three months ago when an ulcerative process 

 developed on the soft palate which at the time I examined her, had already 

 destroyed the uvula. The patient presented the thickening of the metacar- 

 pal bones and phalanges which had caused a certain distortion of the right 

 hand. The potassium iodide treatment was begun two months ago, and 

 the patient is rapidly improving, the ulcerative process of the palate being 

 already arrested and healed. No spirochaetes were found in the ulcer. 



Ashburn and Craig (l) cite experiments produced by Neisser, 

 Baermann, and Halberstadter(l8) where three monkeys (Maca- 

 cus cynomolgus) were inoculated subcutaneously with the bone 

 marrow from a monkey (Macacus cynomolgus) infected with 

 framboesia, with the result that one of the three inoculated with 

 bone marrow developed the disease after an incubation period 

 of forty-four days. 



It is very evident that the majority of bone and joint lesions 

 of yaws is the result of a general infection. The explanation 

 of the peculiar selective bone manifestations in some cases may 

 be similar to that of the various manifestations of syphilis due 

 to variations in strains. (18, 21, 22, 23, 31) The experiments at- 

 tempted by me to reproduce the bone lesions in animals have 

 been so far unsuccessful. 



In the treatment of these cases the Castellani(5, 6) mixture 

 was used according to directions, except that a small amount of 

 glycerin was added to improve the taste and so get the patients 

 to take the treatment consistently. 



Table I.- 



—Castellani's 



mixture in the treatment of yaws. 







Quanti- 

 ty. 







_ grains 



1 

 10 



1 

 15 



1 







do — 







drachm . 



Sodium bicarbonate 









ounce 





Salvarsan was used in three of the cases, two of which received 



0.4 gram, while the third received 0.2 gram, given intravenously. 



In the observation of these cases, over a period of five months, 



