GEOGRAPHICAL DISTRIBUTION 



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disease in various parts of the tropics are Neisser, Daniels, Wellman, 

 Jeanselme, Powell, Braush, Martin, Halberstadter, von Prowazek, 

 Ashburn, J. Craig, Nichols, Strong, Flu, Noc, Stevenel, Iman, 

 Da Matta/Spronk, Shennan, Schiiffner, Maul, and many others. 



Geographical Distribution.— Framboesia is essentially a tropical 

 disease, as few, if any, genuine cases have been reported from 

 places outside the tropical and subtropical zone, and in the tropics 

 it is never found on the mountains and cold districts, as we remarked 

 in the previous editions of this manual. Bahr states that cases 

 who have contracted the disease at a higher elevation than 800 feet 

 are very rare. At the present time a skin disease not unlike 

 framboesia has been reported from Greece by several writers. 



Fig. 685. — Distribution of Frambcesia Tropica. 



Africa.— The disease till recently was said to be very rare in 

 the northern regions of the continent, though some cases were 

 reported from Algeria; the researches of Gabbi and Sabella have 

 demonstrated, however, that it is common inTripoh. It is appar- 

 ently rare in Egypt, though, according to some writers, it is 

 observed fairly frequently in the vSudan. It is very common on 

 the West Coast, especially on the Gaboon River, in the Congo Free 

 State, and in Angola. The disease is quite common in Nigeria. 

 It is also found in Mozambique, in Madagascar, and the Comoro 

 Islands. In Uganda and the region of the Great Lakes it is occa- 

 sionally met with. It has been noted among the Kaffirs in South 

 Africa, near Kimberley, by Griffith, and by many other observers 

 in several other districts of South Africa, Rhodesia, and Nyasaland._ 



Asia. — ^The disease is very common in the Malay Peninsula, 

 Assam, Upper Burma, Siam, Java, Batavia, and is extremely 

 frequent in Ceylon, where the number of cases treated in the 

 Government Hospitals during the last ten years has been on the 

 average 3,500 per year, and it must be noted that the patients 

 treated in hospitals represent only a small portion of all the cases. 



