288 REPORT OF THE HARVARD AFRICAN EXPEDITION 
experimental work still believe that immunity in syphilis depends upon a latent 
infection. 
Manteufel and Herzberg! after reviewing the recent work on the differen- 
tiation of the virus of yaws and syphilis by animal experimental inoculation, 
emphasize the want of uniformity in the results of different workers in many 
cases, and the necessity for gaining an insight into the reasons for these dif- 
ferences. From their own experiments, as well as those of previous observers, 
they conclude that so far there is no certainty as to either the unity or duality 
of the viruses of the two diseases. 
Jahnel and Lange, while they say that all the evidence at the present time 
goes to prove that yaws remains yaws and syphilis, syphilis, also add that 
except for the typical secondary exanthem yaws cannot be distinguished from 
syphilis, and even in this connection they remark that a framboesial form of 
syphilide may occur. They further point out that it is only recently and in 
countries where syphilis is believed to be absent that many tertiary mani- 
festations have been claimed as due to yaws. 
Treponematosis. Butler, however, who has had unusual opportunities to ob- 
serve these conditions in Haiti, is among those who have come to the conclusion 
that yaws and syphilis are one and the same disease, a condition which has 
also been especially emphasized by Bory, Muller, and Peterson, and Manteufel 
and Herzberg.” Butler and, subsequently, Peterson * have suggested the term 
‘‘treponematosis”’ as including both infections. They take the view that there 
is morphological identity of Treponema pertenue and T. pallidum and that the 
two organisms show parallel serum reactions, that the clinical course is identi- 
cal in the two conditions and that also the specifics are the same in the two. 
However, many other observers with very wide experience in the subject will 
not accept entirely these views. 
The recent discussion upon the subject by such eminent authorities as 
Manson-Bahr, Stannus, Chesterman and others, published in the British Medi- 
cal Journal of Venereal Diseases * emphasizes the great diversity of opinion 
still held with reference to the identity of the two diseases in Great Britain. 
One must frankly admit that from a clinical standpoint the term ‘‘trepone- 
matosis”’ or treponemiasis is especially convenient for the tertiary lesions of 
yaws and syphilis which cannot often be distinguished, except sometimes by 
the history of the case — and the history is very frequently a very doubtful 
point among many of the peoples who commonly suffer with yaws. 
The term “yaws” is also most satisfactory clinically in its application to 
the characteristic secondary granulomatous cutaneous lesions. Colonel Har- 
rison,’ recently speaking of the relationship of the two affections, has expressed 
the opinion that nothing has been said which disproves the hypothesis that the 
differences between yaws and syphilis lie in the soil rather than in the seed. 
1 Manteufel and Herzberg: Abhandl. a. d. Gebiet d. Auslandskunde Hamburg (1927). 
2 [bid., Arch. Schiffs-u. Tropen-Hyg. (1929), XX XIII, 661. 
’ Butler and Peterson: Jour. Lab. & Clin. Med. (1927), XII, 670. Butler: U.S. Naval Med. 
Bull. (1928), X XVI, 553; Ann. Intern. Med. (1929), III, 175. 
4 Brit. Med. Jour. Ven. Dis. (1928), IV, 44. ®> Harrison: Brit. Jour. Ven. Dis. (1928), IV, 70. 
