402 
give a flat surface. Such frambesiae are indistinguishable from 
ordinary condylomata. 
We have seen that it is only in the frarnbesial eruption that yaws 
differs irom syphilis, but even the frambesia is identical with the 
syphilitic papilloma on a moist surface. 
There is left, therefore, only the occurrence of condylomata all 
over the skin which can be held to be distinctive of yaws, lonathan 
Hutchinson points out that a general papillomatous (frambesiform) 
eruption does occasionally occur in Europe. It has even been 
suggested that “ Sibbens ” was a syphilide of this form. 
It is quite feasible to argue that on the thick, highly-developed 
and active skin of the dark races this exuberant form of eruption 
takes the place of the milder papules known in Europe. The higher 
infectiveness and greater prevalence of the frarnbesial syphilis is 
readily explained. Syphilis ordinarily (that is, as known among 
whites) is contracted from the primary and from moist papillomata- 
mucous plaques and condylomata. Yaws, however, has so many of 
the moist infective lesions on the surface of the body that contagion 
is far more easily effected under any conditions of "life; and in the 
circumstances, and by reason of the habits of the natives, it must be 
ost impossible foi each patient not to infect someone else 
Infection can, of course, be effected venereally. Dr. Hatton, of 
D R * have known cases occur from sexual connection.” 1 
r /’ y ’ . ,f" ada - re P° rts a case, presumably of venereal infection 
■ ’ T ' W ' ; 1 Cre ° le ' A ‘ 10 ' — perfectly healthy and 
“ Ma-t a ° Ct , n ^ source contagion, until deflowered by a man in 
“ the 1 . ourteen days after this she found some tubercles on 
« It th ' gh ’ f ° r Whlch 1 ad ™ tted *>er to the 
and the nT * l**" 5 ' S suggestion tha t the man had yaws, 
after L?r aranCe ; * ™ the «* «« thigh so soon 
syphil s r:° n r “ e ‘l the Case Unrdiabfe - Neither secondary 
primary I yaWS “m '’ erdeS " appear -me while after tire 
pnma y sol tho° S 1 *“*«=»« -re all small 
1 ‘ ^icholls’ Report, p. 17 # 
tolls’ Report, p. lg8 ' 
