214 Treatment of Human Trypanosomiasis and Yaivs. 



The following short notes give an abstract of the eases : — 



1. Lesions small, but generally distributed with septic or impetiginous patches in the 

 beard. Four doses of antimony were given — two of 1 gr. and two of l£ gr. Lesions 

 were all healed in 12 days. 



2. Lesions general and larger than in preceding case. Treatment, four doses of lj gr. 

 All lesions healed in 11 days. 



3. Extensive ulceration of scrotum. The ulcers had moist surfaces and an exceedingly 

 offensive discharge. Treatment, four doses of lj gr. All healed in 11 days. 



4. A large crusted patch on perineum and several small lesions on face. Treatment 

 in four doses of \\ gr. Healed in 10 days. 



5. Extensive ulceration on soles of feet. Treatment four doses of lj gr. ; local treat- 

 ment, perchloride of mercury 1/1000 as a lotion. Quite healed in 14 days. 



6. Discharging ulcers between toes. Treatment, four doses of \\ gr. Healed in 

 14 days. 



7. Generalised eruption. There were large confluent patches all over the face, trunk, 

 perineum, and limbs. There was also a large primary ulcer on the scrotum 3 inches in 

 diameter, with very foul discharge. The patient was debilitated, and three doses of 

 1 gr. were given. There was some improvement, but it was very slow, so a dose of 2 gr. 

 was given, and all the lesions were completely healed in six days, except the ulcer, which 

 was reduced to less than 1 inch in diameter. 



8. Some patches on the face with thick raised limpet crusts, and many small lesions on 

 the scrotum, perineum, and buttocks, with moist discharging surfaces. Treatment, 

 one dose of 1J gr., followed by two doses of 2 gr. and a fourth of \\ gr. All healed in 

 10 days. 



9. Small patches on scrotum, penis, and perineum. Treatment, one dose of lj gr. and 

 two of 2 gr. All healed in 10 days. 



10. Small patches on scrotum, penis, perineum, and axillse. Treatment, one dose of 

 l£ gr. and two of 2 gr. All lesions healed in 11 days. 



In all cases the lesions were characteristic of the various stages of yaws, 

 from minute vesico-pustules up to confluent, crusted lesions, rupioid patches 

 with limpet-shell crusts, or late plantar-ulcers. 



The diagnosis was confirmed in the earlier cases by examination of scrapings 

 from the deeper parts of the lesions. Films were examined by dark ground 

 illumination and spirochaetes were found, sometimes in large numbers. 



After the first dose the discharging ulcers showed signs of drying up and 

 they skinned over rapidly. In 48 hours a distinct improvement was seen ; 

 the crusted lesions had shrunk somewhat and no longer contained fluid. 

 The yellow colour disappeared and was replaced by a pearly grey ; the 

 underlying raw surface healed very quickly, and soon there was only a 

 desquamating flake representing the site of the lesion. Accompanying the 

 local changes there was improvement in the patient's general condition. 



The number of cases treated is small, but they have been uniformly 

 successful. The treatment can easily be carried out on a large scale, and 

 it may be possible to cure large numbers of persons affected with this 

 most unsightly, and hitherto long-enduring disease, without causing too 



