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It is a fact that yaws is far more common than syphilis in the 
villages, and in towns vice versa. When a medical man sees yaws in 
an adult, he never thinks of enquiring as to the possibility of its 
having been acquired venereally, and when he sees a case of ordinary 
syphilis he assumes the venereal infection, in spite, perhaps, of the 
asseverations and protests of the patient. In the country districts of 
yaws countries the syphilis, however acquired, probably for the most 
part shows frambesiae ; while in the towns the non-venereal infection 
gives rise to the better-recognised forms of syphilis associated in our 
minds with venereal infection. Dr. I ulloch, of 1 obago, remarks 
that the “ primary sore .... is especially rare in the outlying 
districts where yaws is most common.’ 
More observations are wanted on two points: 
(i.) Syphilis (without frambesiae) contracted from yaws. 
(2.) Yaws (with frambesiae) contracted from ordinary syphilis. 
As the date of infection will be three weeks or more, in both 
cases, before the first manifestation of the primary, and usually two 01 
three months before the appearance of the secondaries, it will be 
extremely difficult to get histories, especially from ignorant peasants, 
to illustrate these two points. I have already described one instance 
of syphilis contracted from yaws (Case 19). Some cases aie 
available of yaws supervening on venereal chancre, but the history of 
these does not include any proof of the nature of the disease from 
which the women suffered before they transmitted it as a venereal 
chancre. 
I shall describe one such case. Similar cases, though not 
interpreted as 1 do, arc reported by Numa Rat, W. Boyd and 
H. Bennett in the West Indies, and by Wallbridge in Fiji. 
Rat’s case is as follows:—" A man consulted the doctor about an 
" indurated sore of the prepuce, and had at the same time a small 
“ulcer on the ankle. During two months he was under mercurial 
“ treatment, and had in this time sore throat, roseola, psoriasis and 
“enlarged glands. He then noticed a change in the ulcer; the 
gradations became pale and large. Three weeks after this the 
ulcer healed. A week, again, after this came a wide-spread cro P° 
“papules. A few of these developed into frambesiae. e 
syphilitic roseola co-existed with the yaws papules, and 
