1536 



FRAMBCESIA TROPICA 



natives (Caribs), who called it ' pyans/ or ' yaya.' Bontius, in 1718, 

 reported that framboesia was endemic not only in the West Indies, 

 but also in Java, Sumatra, and other Dutch colonies of the East, 

 where it was known by the name of ' anboyna pox,' or ' pimple.' 

 In the days of the slave-trade, outbreaks of framboesia frequently 

 occurred in the crowded ships carrying African slaves to America. 

 Special hospitals for the isolation and treatment of slaves suffering 

 from the disease were built on all the important estates in the West 

 Indies. Occasionally in the countries in which it is endemic the 

 disease may increase to such an extent as to cause veritable epi- 

 demics. An example of such an epidemic occurred in Dominica in 

 1871, when two special segregation hospitals had to be built for 

 framboesia patients. 



In 1769 an outbreak of a peculiar disease occurred in Scotland. 

 It was called ' sibbens,' or ' sivvens ' [sivvi, Celtic for raspberry), 

 and was apparently imported by sailors belonging to a vessel coming 

 from the West Indies, which was wrecked off Wigton in Cumberland. 



The so-called ' button scurvy ' of Ireland, endemic there in the 

 eighteenth and the beginning of the nineteenth centuries; the 

 ' radesyge,' which broke out in Sweden and Norway in 1710; and 

 the ' mal de chicot ' in Canada, have likewise been considered by 

 some writers to be forms of framboesia. 



Several authors have endeavoured to distinguish between 'yaws/ 

 * pian,' ' boubas,' and ' parangi ' ; but those who have had the oppor- 

 tunity to study the disease in different countries have all come to 

 the conclusion that ' yaws,' * pian,' ' boubas,' and ' parangi,' are 

 simply different names for the same disease, though of course each 

 of these terms is often used by natives to cover several closely 

 allied conditions. The term ' boubas,' for instance, is used by the 

 inhabitants of Brazil for various ulcerative conditions, such as 

 framboesia, leishmaniasis, and blastomycosis, but most of the 

 medical South American authorities use it as a synonym for fram- 

 boesia. Unfortunately, Breda used it to denote a form of leish- 

 maniasis, and caused much confusion. The experimental researches 

 of one of us in cases of framboesia contracted in different parts of 

 the world (tropical America, East and West Africa, etc.) show that 

 'yaws,' 'pian,' 'boubas,' and 'parangi,' are merely synonyms, 

 but it is possible that there may be several varieties of the spiro- 

 chaete which is the cause of the disease. 



Since the time of Labat several authors have upheld the syphilitic 

 nature of framboesia. This theory was supported at one time by 

 Sir J. Hutchinson. In recent times the disease has been investi- 

 gated, both clinically and experimentally, by a large number of 

 observers. 



In 1882 Charlouis proved by actual experiment that syphilis and 

 framboesia are two different maladies. The clinical investigation of 

 the disease by Numa Rat was also of great value. His report, 

 published in 1891, has become classical. 



Among the more recent observers who have investigated the 



