393 
Case 17—M. N t .; 14 years; Coloured. 
April 22nd, 1903. Has a small excavated ulcer about 6 mm. wide on a raised 
indurated base, on the outer side of the right foot. This has been present fox- 
several months. Hard enlarged glands in the right groin. Swollen tender glands 
in the right side of the neck. A chain of small tender glands in left side of neck. 
Fever, malaise. 
A patch of superficial flat large papules with crusted scabs, each 10 mm. in 
diameter, on the front of the sight thigh. These are like xnild rupia or ecthyma. 
Case 18.— L. P.; 21 years; Black. 
April 2nd, 1903. Has a deep excavated ulcer on the left outer malleolus. 
Does not admit venereal primary. Has no leucorrhoea to indicate cervical 
chancre. A coarse papular desquamating eruption of lichen on both hands and 
feet. Few papules on the face. Very profuse vesicular eruption on both legs 
and thighs. Glands enlarged in both groins and on both elbows. 
In spite of the age of the patient, I had no hesitation in attributing 
her syphilis to infection on the ankle. 
Case 19.— S. X.; 30 years; Black. 
March 15th, 1903. Has four small ulcers with indurated bases and raised, 
thickened, everted and irregular edges, round the right nipple. These appeared 
first three months ago while she was suckling an infant with yaws. They have 
all the appearance of primary chancres. 
On 6th May, 1903. Complains of pain all over the body, malaise, and 
constipation. Looks and says she is very ill. Has nervous sensations and 
sleeplessness. 
She never developed any eruption. Continued ailing and sickly for at least 
two years under treatment for which she attended irregularly, as she felt better or 
worse. Treated with small doses of mercury from the first. Never salivated. 
At length she complained mostly of gastric troubles. These were not due to 
mercury, for she only took doses of 10 minims of liq. hvdr. perch, three times a 
day. After two years recovered health. 
This was a case of visceral syphilis contracted from yaws. I have 
now under treatment a very severe case of gastric syphilis, in which 
fte gastritis followed a year after a genital chancre. In this, also, 
there was no eruption, but adenitis and iritis. 
Iase 20.—I. D.; 9 years; Black. 
February 25th, 1904. A wide ulcer on the left outer malleolus, with a dirty- 
yellow crust. Profuse patches of psoriasis and areas of lichen over legs, trunk 
and arms. 
I his would be called an early case of yaws, with the maman-pian, 
dartre and pian gratelle. By changing these names it becomes 
syphilis. 
Case 21. — G. P.; g years; Black. 
' 9 ° 6 . Small punched ulcer about 3 cm. wide on the back of the foot near * e 
lues ' with raised thickened edges. This has been present for several months. 
There are hard glands in both groins, large soft glands in the neck. History 
x” in successive crops for several weeks, some months ago. 
raes complaining of fever, malaise, and anaemia. 
