396 
on the evidence offered by Rat himself. Since then, after further 
investigation, he has delivered, so to speak, an ex cathedra opinion 
to the same effect in Fasciculus XIV of the new Sydenham Sodety’s 
Atlas, and presented the evidence for his opinion. Notwithstanding, 
the medical profession, with few exceptions, are in the same attitude 
of indifference. The new student of tropical medicine will hardly get 
from his text-books any indication that there is any serious or 
reasonable doubt about the independence of yaws. The 1903 edition 
of Manson makes a misleading reference to Hutchinson as holding 
that yaws is possibly syphilis modified." The English edition of 
Scheube, 1903, only refers to Hutchinson to misunderstand him in a 
similar way. 
Somewhat in consequence of this, those who believe in the 
identity of syphilis and yaws are in a small minority. Not many take 
much account of yaws at all. Of those who believe in the 
independence of yaws, it is only the few enthusiasts who have studied 
the matter that think it a serious disease. It is not to be wondered 
at therefore, that in most places yaws is not treated at all. Trinidad, 
especially in the island of Tobago, is the only colony in which I have 
heard of any rational and systematic attempt to deal with the disease, 
but even there, because they do not realise its gravity and true 
nature, the measures taken by the medical officers must be incomplete. 
In some othei places the yawsy are in effect regarded as social 
offenders, and forcibly removed to yaws hospitals for treatment. Such 
a course can never obtain the sympathy and support of the people 
whom it is meant to benefit. 
In the treatment at all yaws asylums and dispensaries, as far as 
one can judge from the literature of the subject and the reports, the 
am esial eruption is regarded as the disease. When this dries, the 
^ 1S . Sa ^ t0 cure d ; when another crop appears this is 
a re apse. All physicians that have given mercury find that the 
eiup ion isappears rapidly as a rule, and that it is apt to recur when 
e mercury is stopped. Some think that the mercury has a bad 
ect, and that the yaws should better be allowed to run its course. 
Lertamly the frambesiae disappear under the mercurial treatment, 
and as. certa , nl y hey sometjmes ^ ^ ^ ^ ^ 
nor Hn h ° S ^ > ^^ ls because a crop of secondaries has faded; 
does he stop mercury on that account ; nor is he surprised if more 
