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pian gratelle especially are noted by them as being characteristic of 
yaws. In my own experience, psoriasis and lichen are just as frequent 
in occurrence in cases which develop frambesiae as in those which do 
not. The rheumatoid pains are almost always a feature of yaws, and 
these, as well as the less frequent palmar and plantar psoriasis and 
vesicular syphilides, are identical in both diseases. 
In short, the vox -pofuli has declared the truth, which the medical 
profession has not yet generally accepted, that yaws is non-venereal 
(or sometimes venereal) syphilis of the tropics. At any rate, the 
people name syphilitic manifestations and associate them with the 
frambesial eruption under the one name yaws. 
A few recent writers on yaws, under its various names, have seen 
and recorded these facts; proving that yaws is more than the eruption 
of frambesiae, as described in text-books (e.g. Scheube). Even those 
writers who have not included these symptoms as part of the same 
disease have noted the frequency of the occurrence of syphilitic 
manifestations together with frambesiae. They regard the smaller 
syphilides as evidence of syphilis and reserve the frambesial eruption to 
be called yaws, and then speak of the concurrence of the two diseases. 
Daniels and Wallbridge note that “ a fair number of such cases are 
recorded, and in all the syphilis preceded the yaws.” 1 It is doubtful 
whether by ‘ syphilis ” they refer to primary syphilis, i.e. the genital 
chancre from their point of view, or to small syphilides. Blanc, of 
Tobago, observes : —“ I have not seen any yaws patients with syphilis 
in the primary or early secondary stages, but have very commonly 
<( seen tbem in the early stages of yaws with well-marked papular 
“ eru P tlons - whi ch, however, might have been either syphilitic or the 
u P recursor s of yaws tubercules. These symptoms commonly 
‘‘disappear under treatment, but sometimes give rise to a scaly 
“ eruptlon ver y hke psoriasis. . . . Syphilis, as evinced by severe 
„ cachexia > or indurated and enlarged glands, enlargements of bones, 
„ n ° deS ’ &c * has been a ver y frequent complication in the cases of 
yaws. 2 
There can be no doubt that the other secondary manifestations of 
yaws are identical with symptoms elsewhere ascribed to syphilis 
ome write rs attribute them to yaws, others to a concurrent syphilis 
•• J. Hutchinson, Fasciculus, p. i 9 . 
2. Nicholls’ Report, p. 165. 
