1538 



FRAMBCESIA TROPICA 



In India it is very rare, though small outbreaks of the disease 

 have been described by various observers. It occurs in certain 

 par,ts of China, but is unknown in Japan and the central and western 

 regions of the Asiatic continent. It is present in the Philippine 

 Islands. 



America. — It is very common in the West Indies, and occurs in 

 British Guiana, Venezuela, Colombia, and Brazil. Cases have been 

 reported from the southern United States, but never from the 

 northern States nor from Canada. Recently Wood has recorded 

 a case in a white child in North Carolina. 



Australasia. — ^The disease is present in Northern Australia, and 

 occurs frequently in many of the Pacific Ocean islands — Samoa, 

 New Hebrides, New Caledonia, and Fiji. It is absent in New 

 Zealand and Tasmania. 



-Etiology. — ^Different kinds of bacteria have been described as 

 causative agents of framboesia. Eijkman found some peculiar 

 bacilli; Pariez observed numerous micrococci; Powell, in 1896, culti- 

 vated from two cases a yeast; Nicholls and Watts, in 1899, isolated 

 a coccus which, inoculated into animals, failed to reproduce the 

 disease. In February, 1905, Castellani observed a Treponema, or 

 spirillum, as he thought it at the time. This organism, which he 

 called T. pertenue, is now generally admitted to be the cause of the 

 disease. For the description of the organism, see p. 457. 



Incidence of the T. pertenue in Framboesia Lesions.- — ^The presence 

 of the Treponema is constant in the primary lesion and in the un- 

 broken papules of the general eruption. It may be found in the 

 spleen, lymphatic glands, and bone-marrow. In the blood it has 

 not yet been demonstrated microscopically, though there is no 

 doubt that the blood of the general circulation is infectious, inas- 

 much as monkeys inoculated with it develop typical yaws lesions 

 in which the Treponema is abundantly present. The Treponema is 

 absent in the cerebro-spinal fluid, and generally in the tertiary 

 lesions. 



Bacteriological Flora found in Open Sores of Framboesia. — ^While 

 T. pertenue is the only germ found in the non-ulcerated lesions, the 

 ulcerated lesions of framboesia are soon invaded by all kinds of germs. 

 Apart from innumerable bacteria, various kinds of spirochsetes are 

 present. One form is rather thick, and takes up the stain easily. 

 It is morphologically very similar to the Spirochceta refringens of 

 Schaudinn. Another form is thin, delicate, with coils varying in 

 size and number, and with blunt extremities — 5. obtusa Castellani. 

 A third form is likewise thin and delicate, but tapers at both ends 

 — S. acuminata Castellani; T. pertenue is also present in many 

 cases. 



Inoculation Experiments of Framboesia in Man. — Paulet, in 

 1848, inoculated fourteen negroes with the secretion taken from 

 framboetic granulomata. All of them developed framboesia, the 

 inoculation period varying from twelve to twenty days, when at 

 tjie seat of inoculation in ten cases the first nodule appeared, soon 



