3*4 
left leg, but when considered fit he declined operation and was discharged. He 
has not been heard of since. This is a class of case that is never seen in 
Europe. I "have notes of several as severe cases in St. Vincent. 
Case io. —L. B.; 9 years; Black. 
November 21st, 1902. Perforating ulcer at junction of hard and soft palate. 
A very young case of “ rhinopharyngitis." 
Case it.—C. A.; 16 years; Black. Says, “never had yaws.” 
March 1st, 1906. Scar of veluin palati with a perforation and a cleft of the 
palate. Scar on the face, one on the arm, and several on the legs, of tertian- 
ulcers. Two of these involved loss of bone from the tibia. Gummatous ulcer 
of one foot and the other leg. 
Case t2.—A. S-; 12 years; Black. 
1 -ebruary nth, 1903. Fistula of lachrymal duct from disease of maxillary 
bone. Left ala nasi deformed and nostril contracted by a scar. Cartilage of 
septum has gone. There is an ulcer of soft palate and fauces. Uvula has 
disappeared. Another young case of “ rhinopharyngitis.” 
Case 13.— E. W.; 12 years; Black. Had disease of the nose two years ago. 
November 22nd, 1902. Ulcer and necrosis of palate. Ulcers of right thigh, 
knee and skin. Ulcer and bone disease of first metatarsal. Ulcers of left 
thigh, knee and shin. Both knees contracted and legs wasted. Ulcers of right 
arm and hand. Extensive scars on left forearm ; large periosteal node on fifth 
metacarpal. Some wasting of both arms. 
This case is known to have had yaws when two years old. 
Cases of tertiary with history of previous yaws may be multiplied 
indefinitely. 
Among 17 children under the age of 15 years suffering from 
tertiary syphilis, yaws was admitted in the case of 12. Of the others 
only two had marks of inherited taint. I regret that I cannot quote a 
greater number, but one has been so in the habit of expecting the 
history of syphilis, that enquiry was not often made on this point, and 
I can only find a reply to this question in the notes of seventeen 
children. 
NON-VENEREAL SYPHILIS 
How often do we hear it inferred that a condition cannot be 
syphilitic because the patient is young and there is no evidence of 
eritance. And how often is there a reluctance to attribute syphilis 
to an adult, from a feeling that this is an unjustifiable slander of his 
racter. Yet thoughtful writers have warned us against this 
attitude. 
The physician must forget the local primary lesion, and 
„ put aside the idea that the diagnosis of syphilis carries with 
11 any stl £ ma of impurity.” (Fagge, by Pye Smith.) 
