1554 



FRAMBCESIA TROPICA 



part, at least — ^to the presence of intestinal worms, as revealed by 

 the microscopic examination of the stools, which shows frequently 

 ova of Ascaris lumbricoides , Trichuris trichiura, and in a few 

 instances of Ancylostoma duodenale. Density and viscosity of 

 blood seem to be normal according to Violle, and the coagulability 

 is not impaired. Auto-agglutination is generally absent, but has 

 been recorded in certain cases. 



Complement- Fixation Reactions. — Wassermann reaction is posi- 

 tive in the great majority of recent cases, but is fairly often negative 

 in old cases. According to Schtiffner and Violle, in framboesia there 

 is often fixation if an alcoholic extract of syphilitic liver is used as 

 antigen, while there is no fixation if an aqueous extract is used. 

 In syphilis there is generally complete fixation. 



Cuti-Reactions. — The cuti-reaction with ' framboesin,' prepared with cultures 

 of T. pertenue according to the technique used by Noguchi in the preparation 

 of luetin, is often positive. Luetin also may at times give a positive reaction, 

 though less marked. 



Fig. 700. — ^Frambcesia: Pseudo-Mycetoma. 



Cerebro-spinal Fluid. — The liquid is in all cases perfectly clear, 

 like distilled water. No cellular sediment on centrifugalization is 

 found in most cases. In a few some rare mononuclear cells are 

 found. The pressure is not increased. The physical and chemical 

 characters do not show much variation from what is found in normal 

 conditions. The density varied in our cases between 1003 to 1005. 

 A certain amount of globulin was present, and a substance (dex- 

 trose ?) reducing Fehling's solution. This reducing substance was 

 in several cases distinctly in excess of what is observed in the normal 

 fluid. No cholin is found. The reaction of the fluid is alkaline. 

 The liquid is sterile; no treponemata can be detected. 



Tertiary or Late Stage. — ^The disease often terminates with the 

 secondary stage. In some cases, however, the infection does not 

 become extinct, and tertiary lesions appear. These have been 



