373 
YAWS 
BY 
C. VV. BRANCH, M.B, C.M. (Edin.), 
MEDICAL OFFICER, COLONY HOSPITAL, ST. VINCENT, W.I. 
(. Received May 13th, 1907) 
THE PREVALENCE OF SYPHILIS IN THE 
WEST INDIES 
The most striking feature of the medical practice in the West 
Indies is the prevalence of tertiary syphilis and infantile inherited 
syphilis among the labouring class. In some of the islands this 
prevalence is quite extraordinary. 
On the contrary, in the classification of diseases returned by the 
Colonial medical officers, as well as in the reports of hospitals, syphilis 
is credited with so few cases that it is incredible that the figures can 
be correct. In part this is due to the custom of classing diseases by 
the local manifestations, e.g. iritis, necrosis, paralysis, &c. The cases 
are thus scattered through the classification, and even if their true 
nature has been recognized it is not shown. But it is nevertheless a 
fact that great misconception does exist in the minds of many of the 
medical profession in the West Indies, and no doubt elsewhere in the 
tropics, as to the extent to which syphilis is responsible for the sicknesses 
that occur. The chief causes of this failure to recognize the disease 
are ignorance of the original nature of syphilis and the tendency to 
regard it as a venereal disease. 
hailing to attribute a given lesion to syphilis the medical man 
naturally turns to tubercle, the effects of which on the natives of the 
ropics are in consequence vastly over-rated. Tubercular bone and 
joint disease is rare among negroes. Lupus I have never seen, 
though I have seen cases classed as such, the scars and subsequent 
history of which abundantly proved the syphilitic origin of the lupoid 
ulceration. Phthisis is very common among the negroes in some 
^est Indian Colonies, but in view of the undoubted rarity of othei 
