qo6 
“ habitually gratify the desire of sailors for paedicatio mulierum, gel 
“ stricture of the rectum. Some of the determining factors we have 
“ no knowledge of, others we can now guess at." 
The frambesial eruption, therefore, though a striking and 
characteristic feature of yaws, we have seen is not unknown in 
syphilis. The difference between yaws and syphilis is only in the 
frequency of occurrence of this eruption. If all that is called so is 
yaws, it must be admitted that the frambesia is not even an essential 
of yaws. In face of all the other points of identification, it is 
impossible to give this one feature such pre-eminence as to 
exclude the others. We must accept the papillomatous eruption only 
as a phenomenon of syphilis, of which there are many others still 
awaiting explanation. The enquiry into the reason of the frambesial 
eruption may well produce a practical result, for if it were possible to 
prevent syphilis taking this form, we should thereby materially limit 
its infectiveness, and so lessen the amount of syphilis in the world 
Here, then, is the field for research into yaws, which may yield a vast 
store ol health for the unhappy natives of tropical lands. 
Syphilis as yaws is almost general in tropical countries wherever 
the conditions of damp, heat and dense vegetation obtain. It is 
lecognised that coko in Fiji, puru in the Malay Peninsula, parangi in 
Ceylon, galtoo in the West Coast of Africa, tomo in Samoa, are all 
identical with yaws in the West Indies. Yaws is well-enough known 
in every tropical country to bear a local name, and the synonyms are 
as numerous as the languages of the peoples affected. It was endemic 
m all parts of the tropical world before the European appeared on 
these scenes to confuse the geographical distribution of races and 
diseases by his facilities for inter-communication. Syphilis in all 
forms is now universal, and was probably so from very ancient times, 
ts wide spread proves. I think, that it must have been well 
,. a a * an early period before the differentiation and 
distribution of human races. 
It has been suggested by Hutchinson that yaws was the original 
lsease prevalent in the tropics, and that it was introduced into 
uiope rom them. Under the influence of a different climate, 
and the cleaner habits of the Europeans, it was limited and 
modified until it became usually venereal. He thinks that Sibbens 
an utton-scurvy were frambesial syphilis. Considering the wide 
