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afterwards cleared up. A physician of far longer experience than 
mine of the West Indies tells me he has never seen syphilitic alopecia 
in a black patient. 
(5.) The absence of itching.— This is admitted to be by no means 
an absolute rule in syphilis. Nor is itching at all the rule in yaws. 
When we consider the irritation of the small flies around a yawsy 
patient, the admission of itching in some cases is not remarkable. 
(6.) The exanthem. — It is difficult to understand which particular 
eruption is referred to. All or most of the syphilides have been seen 
in yaws. 
(7.) The iritis.— This is distinctly uncommon in negro syphilis, 
and is a comparatively rare symptom anywhere. It is quite feasible 
to imagine that, where syphilis is profusely manifested on the skin, 
the deeper structures, particularly the nerve system and its 
appendages, may escape. 
(8.) The affection of the permanent teeth.— This must be 
extremely rare, at any rate, among West Indian negroes. I cannot 
remember ever having seen notched incisors in a black person. 
Finucane and Corney, as mentioned by Hutchinson, report ha\ing 
seen such occasionally in Fiji, where syphilis is not admitted to be 
present. One has the impression that either the negro race is exempt 
from this affection, or that it is caused by mercury given in infancy. 
I very frequently look at patients’ teeth to note the tolerance to 
mercury, and also to note the irregularities which constitute a stigma 
of degeneration. 
(9) The bone affections. — These have been described frequently 
as tertiaries of yaws. But the author has already denied them to us 
by saying that they are due to an independent intercurrent syphilis. 
(10.) The congenital lesion. There are none in syphilis, except 
the rare pemphigus neonatorum, and the syphilitic causes of still 
birth. No one has attempted to prove that miscarriage is any less 
frequent among yawsy mothers than among the syphilitic. 
(11.) The polymorphism of the eruptions.—This is abundantly 
evident in yaws, and is referred to by Manson himself. 
('2.) The nerve lesions and the gummata of syphilis. The negro 
race is not prone to suffer from nerve syphilis, but all teitiaries and 
Parasyphilis are taken from us by the simple assumption of no inter¬ 
ment syphilis, of which there may be no other evidence. 
