SYPHILIS 



227 Q, 



has been opened up. Syphilis is very frequently observed now also 

 in all the other regions of Africa, and is very common in tropical 

 Asia. It has been noted by Fox that in America it is much more 

 frequent among negroes than among whites. In our experience, the 

 virulence, as well as the symptoms of the disease, are not much 

 different from what one sees in Europe. We can, however, confirm 

 Brault's observation on the frequency of the primary sore on the 

 supra-pubic region of natives, who regularly shave their pubis. 

 Perhaps the general enlargement of the lymphatic glands is more 



Fig. 905. — Pustular Syphilide 



marked in natives, and circinate and pustular syphilides, as ob- 

 served by H. Fox, are more common. The tertiary ulcerative 

 lesions are apt to become of enormous proportions, owing to second- 

 ary infections, and to the patient not seeking proper medical advice 

 for a long time. Of great interest is the fact that in unciviUzed 

 native races the so-called parasyphilitic affections (progressive 

 paralysis and tabes dorsalis) are extremely rare. 



As regards the treatment of syphilis in the tropics, inunctions are 

 very unpleasant in a hot damp climate. We generally prefer the 



