1556 



FRAMBCESIA TROPICA 



observed. The malady does not appear to be hereditary; in fact, it 

 is worth noting that, in contrast to syphiHs, parents generally 

 contract the malady from their children. 



Fourth Stage : Paraframbcesial Affections. — Cases of tabetic 

 symptoms and symptoms pt)inting to paralysis progressiva believed 

 to be due to an old framboesial infection have been placed on record 

 by Harper and others. 



Communicability. — Framboesia is usually conveyed by direct 

 contact from person to person. It appears, however, that the 

 germ is unable to enter through the normal skin, and that there must 

 be some pre-existing abraded surface, small wound, or ulcera- 

 tion. Women are frequently infected by their children, the 

 primary lesion appearing often on the mammae. In the native 

 women of Ceylon the primary lesion frequently develops on the skin 



Fig. 702. — Framboesia: Tertiary Stage. 



of the trunk just above the hip, slight abrasions caused by friction 

 being usually present on this part, owing to the habit they have of 

 carrying their children astride of the hip. Among certain Congo 

 tribes it is a common dictum that a woman affected with the Nkoulou 

 (yaws) should not sleep with her child, or he will certainly contract 

 the malady. The natives, however, believe that the infection may 

 be contracted also by partaking of contaminated food. In our 

 opinion there can be little doubt that in certain cases insects may 

 carry the disease. It is very noticeable that flies eagerly crowd 

 on the open sores of framboesia patients. In the hospitals, as soon 

 as the dressings are removed, the framboetic ulcerations become 

 covered with flies, sucking with avidity the secretion, which they 

 may afterwards deposit in the same way on ordinary ulcers of other 

 patients. Ants also are occasionally seen to go on to the framboetic 



