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secondaries appear even while his patient is still taking mercury. 
When treating a case of syphilis, one is thinking not of the 
secondaries but of the tertiaries. The second stage will usually run 
its course and the patient get well in time without mercury. But it 
is, as a rule, only the mercury given early that saves the patient from 
a life of tertiaries later on. 
If the papillomata are all that there is, then yaws is hardly worth 
much trouble; but the observations, especially of Numa Rat and 
Daniels, have established the fact that there is an aftermath of evils. 
They could not help but attribute to the effects of yaws the vast 
amount of exaggerated ulceration, periostitis, necrosis, and dactylitis 
which they saw around them. Numa Rat boldly calls these the 
tertiaries of yaws, though he still believes yaws to be distinct from 
syphilis. If the diseases are different, then yaws is the worse of the 
two, and it is the most terrible scourge from which the human race 
suffers. 
If even yaws is not syphilis, then there is still abundant 
indication that the treatment is the same, and we should insist on the 
early and persevering use of mercury ; for the time for treatment of 
tertiary syphilis is in the early secondary stage, and by inference the 
same must be true of yaws. 
If, however,, we decided to regard yaws as syphilis, its importance 
would be at once recognised by every member of the profession ; and 
the people, educated in time to pay proper attention to the disease, as 
Europeans do to syphilis, would assist in the effort to limit its spread 
and cut short its dire results. 
A systematic and conscientious treatment of the cases, and a 
persistent education of public opinion, would at length effect what all 
the yaws asylums, dispensaries and commissions have failed even to 
begin. 
In view of the theory of Hutchinson that yaws is the original 
disease, we may abandon the name syphilis, which bears but an 
indifferent repute, and speak of yaws. Recognising’ its nature, we 
m ay teach the prophylaxis of syphilis under its various local names. 
The writer has already prepared, with this view, a primer of hygiene 
for West Indian negro children, at the request of the Board of 
Education of St Vincent. 
i 
