379 
the inherited syphilis, and it is well known that nowhere is the 
occurrence of inherited taint in proportion to the number of infected 
parents. If this were not so the human race would have disappeared 
at an early period of its existence. I have rarely seen a black or 
coloured child over three years of age whose syphilis was undoubtedly 
inherited. Eye lesions, sabre shins and cranial malformations occur, 
but by no means commonly among the juvenile cases of syphilis. 
Hutdiinson’s teeth I have never seen in a dark-skinned person, and 
doubt if this mark affects the negro race. 
Moreover, the manifestations of disease in young persons are 
usually of a severity that one does not associate with inherited taint. 
Under the unfavourable conditions of child life among the black 
peasants, the bad cases of inherited disease die early. The milder 
cases we should not expect to run to such virulent tertiaries as we 
commonly see. Those writers who try to prove that some of these 
lesions, such as necrosis of the palate, are not caused by syphilis urge 
the youth of many of the patients, and thus they indirectly admit the 
improbability of their being due to inherited taint. I can therefore 
produce these writers in evidence. J. Numa Rat is perhaps the most 
careful and accurate observer of yaws. He does not believe that this 
condition has any relation to syphilis, but finding a prevalence of 
lesions apparently identical with those of tertiary syphilis, he did not 
attribute them to inheritance, but to yaws itself. 
The very common lupoid ulceration is rarely ascribed to syphilis 
in the West Indies for the same reason of the youth of the patients ; 
it is called lupus. Yet it invariably gets better under iodide, and often 
spontaneously. Just as common in St. Vincent is ulceration and 
necrosis in the throat and nose, affecting young people more frequently 
than adults. In a recent correspondence in the Journal of Tropical 
Medicine, James Leys 1 and Numa Rat 2 discuss this condition, 
which the former found as prevalent at Guam in the Philippines as it 
is in the West Indies. It is said to be very common also in Fiji. 
Leys suggests the name “ rhinopharyngitis mutilans for the 
condition, and both the above writers agree that it cannot be syphilis 
because the patients are often young, fourteen to nineteen years. As 
a matter of fact, sexual life begins so early with the dark races^ that 
i Jour. Trop. Med. February 15th, iqofi. 
2 - Jour. Trop. Med. May 1st, 1906. 
