THE SECONDARY OR GRANULOMATOUS STAGE i545 



remain of practically the same size for many weeks, and disappear, 

 leaving occasionally some furfuraceous patches : others become 

 larger, several often coalescing, and frequently acquiring a dark 

 areola in natives, a reddish one in Europeans. Some of the larger 

 papules increase in size, and develop into the characteristic large 

 granulomatous nodules covered with a crust, honey-yellow or 

 brownish, formed of desiccated secretion. If the crust covering 

 the granulomata be removed, there will be seen a raw surface 

 throwing up red or yellowish fungoid granulations secreting a thin, 



Fig. 690. — Frambgesia (Secondary Stage): GrENERAL Eruption. 



slightly purulent secretion, which soon dries into a crust. These 

 framboetic granulomata are of various size, from a large pea to a 

 nut, and may be found on practically any part of the body. They 

 are extremely common on the upper and lower hmbs, and on the 

 face. On the scalp they are very rare. They may form rings round 

 the mouth and anus, and may enclose sound skin (so-called yaws 

 ringworm) . They may remain of the same size and appearance for 

 months. Often, after a few weeks, the secretion diminishes, and 

 a process of hyperkeratosis sets in. They then become of much 

 harder consistency, and some of them, especially those on the 

 dorsum of the feet and toes, may be covered with numerous small, 



