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suffering from tertiary ulceration, and that ankylostomiasis has run 
the total to an abnormally high figure, it must be admitted that this 
percentage shows well the prevalence of syphilis. 
F or some time I conducted an out-patient department at the 
hospital, as a single-handed effort to deal with some of the tertian 
cases of the island. Between July, 1903, and March, 1905, that 
is, in twenty-one months I treated 600 cases of syphilis. 
In the four years of hospital work referred to, a large number oi 
amputations have been necessitated by syphilis. Of 51 amputations 
of the leg at the seat of election, 27 were performed for syphilis and 
11 for elephantiasis. And even of the latter several were brought to 
the knife by extensive syphilitic ulceration. 
In the reports of the Medical Officers for the district work for 
twelve months July, 1903, to June, 1906 -no less than 1,996 cases 
of syphilis are returned. This for a population of 45,000 is equal to 
4'4 P er cent, per annum of the inhabitants. Of these 1 attended 
myself 539 cases, which form about 21 per cent, of all the district 
cases treated by me in that time. It must be understood that these 
figures referring to syphilis have not been swelled by the inclusion 
of the cases of yaws. I hough it is true that only one Medical 
Officer in St. Vincent now returns yaws as such, yet this condition is 
not often brought to our notice, and the few cases of frambesial 
eruption which we have treated would not affect the general truth of 
the figures. The one Medical Officer referred to whose district is 
that most infected with yaws, only returned 24 cases in the twelve 
months. 
There is no compulsory medical certification of death in 
St. Vincent, except for infants under one year, but nearly all the 
deaths are certified by medical men. I went through the register for 
two years March, 1904, to March, 1906—to pick out and classify 
the causes of death. From the vital statistics I may quote the 
following: — 
Total deaths . Ii i I 8 
Still Births . ,,1 
Syphilis . ..... ’ ’ ’’ ’ ’ ’ ’ ’ 56 
Hereditary Syphilis (infants) . 149 
Syphilis, therefore, causes on the average about 14 per cent, of the 
deaths in St. Vincent. 
