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ulcer, which is very resistant to treatment. They seem to belong to the “ inter¬ 
mediate” stage of Hutchinson. This case is one of early tertiary in acquired 
disease, at an age which precludes the possibility of venereal infection. 
Case 4.— A. M.; 12 years; Black. Denies yaws. 
July 2nd, 1903. Left tibia sabre-shaped. Right with a very large node. 
Large scar on back of right thigh. Large ulcer inside the upper lip. Columna 
nasi has disappeared, and a large ulcer covers the surface of the nasal cavity, 
eroding the alae nasi. Several scars of previous skin gummata on the inner 
side of nates. Here it may be admitted there is a probability of heredity indicated 
by the sabre shin. 
Case 5.— W. C.; 18 years; Black. Has been five years in the Pauper Asylum 
as a hopelessly disabled person. 
October nth, 1902. Left arm has been amputated below the elbow. F.lbow 
scarred and ulcerated. Left leg is a scar from hip to toe, with the knee and 
ankle contracted in web-like keloids. Right leg is scarred below the knee. Both 
feet are masses of ulcers and bone disease. 
After more than two years’ treatment with iodide, and amputation of the left 
thigh, he was completely healed and left the Asylum. He has remained well to 
the present. I think that hereditary syphilis is not known to produce so frightful 
a condition. 
Case 6. — J. L.; 22 years; Black. Sent to the Pauper Asylum at the age of 
>6 years. 
October 17th, 1902. Both knees and elbows stiff and contracted; extensive 
scarring and lupoid ulceration on both shins. Multiple nodes on forearms and 
humeri which give them a distorted appearance. Hard palate perforated. Deaf. 
This case had since healed, but lately developed intense headaches and very 
marked mental dulness. There is no question of venereal infection in one who 
■s already hopelessly disabled at 16 years. 
W ^ ASE 7 '~J- ^*5 22 years; Coloured. Was disfigured at the age of 14 years, 
as sent to the Pauper Asylum at 17 years. 
u ° C .! ober x 7 tb » ! 9 02 - Nose is gone, lower lids retracted by scarring. Side of 
PPer lips drawn upwards. Face scarred generally. Left leg extensively scarred 
h gummatous ulcers on the lower half of the shin. Ulceration of throat. Since 
the C - U1K * er P°tassium iodide and sent out. Here again the early age at which 
Pa lent was considered incurable precludes the venereal infection. 
Case: 8.-W. s., 9 y8ars; Black. 
23rt ^’ I 9 02 - Large keloid on right elbow and a scar on the forearm. 
and° v C Uld SCar on le ^ 1 knee. Scar on outer malleolus. Large gummatous ulcer 
8ummafa S -vp an kle. The scarring here indicates deep or subcutaneous 
a w ich had been appearing during several years. 
Case 9 R. §. ; j 4 years; Hindu. 
arm 7tE ’ I 9 ° 2 - Extensive scar all round the left elbow and half of_ tbe 
^gers ;r nS1Ve scar on ^e back of the hand, and a scar on the wrist. Two 
scars at th racted and a few small ulcerated spots on the fingers. ExtensI ^ e 
Large scar 6 baCk ° f the ri S ht elbow > hack of lower forearm, and back of han . 
lhe lower “-TV 116 front of left knee, and another of the calf. Scarred all over 
° n e large a the tibia - Foot a distorted mass of scars and bone disease, «i 
tibia. \ a and severa l small ulcers. Scars on right knee and on lower end ot 
Septum naif 6 UlCCr ° f ankle - Seven superficial scars on cheek, nose and ip- 
' 8 ° ne - Was treated in hospital with a view to amputation of the 
