I540 FRAMBGESIA TROPICA 



in Ceylon, have proved that monkeys successfully inoculated with 

 framboesia do not thereby become immune to syphilis, and, vice 

 versa, monkeys successfully inoculated with syphilis do not thereby 

 become immune to framboesia. According to Levaditi, monkeys 

 immunized for yaws do not acquire any immunity for syphilis, but 

 monkeys immunized for syphilis ma^^ acquire a partial immunity 

 for framboesia. According to Ashburn and Craig, monkeys of the 

 species Cynomolgus philippinensis are susceptible to framboesia, 

 but not to syphilis. 



The following facts are in favour of the T. pertenue being the 

 specific cause of framboesia: — 



1. In the non-ulcerated papules, in the spleen, in the lymphatic 

 glands of framboesia patients, as well as in inoculated monkeys, 

 the T. pertenue is the only organism present. No other germ 

 can be demonstrated either microscopically or by cultural 

 methods. 



2. The extract of framboesia material containing the T. pertenue, 

 but, so far as our present methods of investigation permit us to say, 

 no other germs, is effective when inoculated into monkeys. 



3. The extract of framboesia material from which the T. pertenue, 

 has been removed by filtration becomes inert, and monkeys inocu- 

 lated with it do not contract the disease. 



Predisposing Causes. — As is the case in other infectious diseases, 

 dirt and other insanitary conditions favour to a certain extent 

 the development and dissemination of the disease. The malady 

 is rare among Europeans, and also among the better-class natives, 

 who live amidst good sanitary surroundings, while it is very 

 common among the villagers and low-caste natives, who live in 

 uncleanly overcrowded huts. Sex does not exercise any influence, 

 nor does age to any great extent, though the disease is more fre- 

 quently met with in children and young people. The native prac- 

 titioners of Ceylon are inclined to ascribe an important predis- 

 posing influence to certain foods. Some incriminate a kind of 

 fish called ' balla mai,' others a cereal known as ' kurrakan.' 

 Duprey inculpates in the West Indies the abuse of mango fruit. 



Histopathology. — ^The histopathology of framboesia has been in- 

 vestigated by Unna, Macleod, Jeanselme, Plehn, and more recently 

 by Schiiffner, Marshall, Shennan, Siebert, Ashburn, Craig, and Lohe. 

 In the framboetic papules the surface epithelium is greatly increased 

 in thickness, and numerous elongated down-growths are seen. The 

 epithelial layers show many patches, in which the epithelial cells are 

 swollen, vacuolated, and degenerating. Small, sharply circum- 

 scribed areas are also seen containing polymorphonuclear leucocytes 

 and detritus. The layers near the corium and its processes are, 

 however, almost normal in appearance. The connective-tissue 

 corium forms a thin layer, from which narrow, elongated, papillary 

 processes pass into the epithelium, some of them nearly reaching 

 the surface. The corium is the seat of marked oedema. There is a 

 diffuse cellular infiltration made up of polymorphonuclear leuco- 



