xiii, b, 4 Guerrero et al.: Treatment of Yaws 193 



provement of symptoms, 7 showed no improvement at all, and 

 5 had relapses in from two to five months after the lesions had 

 entirely healed. 



The details of the cases treated and the results of the treatment 

 are given in the subjoined protocols : 



Case I. — M. P., female, 45 years old, a native of Bulacan. The duration 

 of the infection was about nine months. The lesions consisted mainly of 

 granulomatous ulcers on the labia majora and a few papillomatous growths 

 about the nasal fosss and the left angle of the mouth. The growth was 

 covered with a thick yellowish crust. The ulcerations on both labia excreted 

 a purulent fetid material. The general appearance of the growth simulated 

 "granuloma pudendi." The patient received 44 doses of Castellani's mix- 

 ture in nineteen days, and sixteen days later the lesions were completely 

 healed. 



Case II. — F. P., female, 24 years old. The infection was of six months' 

 duration. The lesions consisted of warty growths on the forehead, face, 

 neck, abdomen, and genitals. The mother yaw was an ulcer with irregular 

 borders, 2 centimeters in diameter, on the anterior surface of the left ankle. 

 The patient entered the hospital to obtain relief from pain in the bones and 

 joints. The joints of the fingers and hands were swollen and painful. She 

 received 23 doses in ten days and left the hospital after fifteen days with 

 complete disappearance of arthritic pain and cicatrization of the lesions. 



Case III. — C. F., male, 30 years, married, denied having had venereal 

 diseases. The duration of the infection was one year and four months. 

 The patient thought that he had contracted the disease from his children, 

 who had yaws. The primary lesion appeared as a bed bug bite on the 

 left thigh. On scratching the skin over it, the lesion gradually increased 

 in size to about 10 centimeters in diameter. Two months later eruptions 

 appeared all over the body, but after a year they disappeared without 

 treatment. Last January he was admitted to the hospital, complaining 

 of pain in the bones. He presented extensive ulcerations on the soles of 

 both feet. The Wassermann test was negative. The patient was given 

 15 doses in eleven days. He left the hospital completely cured. 



Case IV. — E. Y., female, 19 years old, contracted yaws six months ago. 

 She said she had had yaws when she was 12 years old. The scars were 

 plainly visible on the face and on other parts of the body. She had an 

 ulcer on the anterior aspect of the right leg, which measured 3 centimeters 

 in diameter and 1 centimeter deep. The edges were irregular, and the base 

 was formed by necrotic tissue and exposed bone. Wassermann reaction 

 was positive. The patient was given 5 drops of saturated solution of potas- 

 sium iodide and 5 milligrams of protoiodide of mercury three times daily. 

 Aseptic dressing was applied to the ulcer. She experienced no improvement 

 from this treatment. Castellani's formula was then given three times daily, 

 and 25 per cent protargol ointment was applied locally. After 54 doses 

 the ulcer completely healed, although the pain in the bones persisted for 

 some time. 



Case V. — M. Santa Ana, male, 38 years old. The duration of the illness 

 was five months. The lesions consisted of granulomatous growths of 

 varying size, whose summits were covered with yellow crusts. They were 

 distributed on the scalp, forehead, chin, neck, shoulder, back, and buttocks. 

 The lesions appeared in crops, accompanied by severe pain in the bones and 



