014 REPORT OF THE HARVARD AFRICAN EXPEDITION 
the histopathological lesions is that they give evidence in many respects of a 
chronic inflammatory condition in which there is a tendency to destruction of 
newly-formed tissue, with little tendency to invasion by micro-organisms from 
the air or from the surface of the skin. 
GOuUNDOU 
Several cases of goundou were observed in children. This disease has long 
been known in West Africa and was originally described in 1882, on account of 
the striking paranasal lesions, under the designation of the ‘‘Horned Men of 
Africa.’”’ A number of investigators who have more recently studied the ques- 
tion regard goundou as a late manifestation of yaws, or incline to such an opinion. 
However, not all do so. 
Botreau-Roussel,! who made a most careful and extensive study of the disease 
in the Ivory Coast and published a monograph upon it in 1925, having observed 
130 cases and operated upon 113, came to the conclusion that goundou is a mani- 
festation of yaws. He excluded syphilis by the history in all but one case and 
points out that Schuffner’s work shows the uselessness of serum reactions in the 
differential diagnosis of the condition. He admits, however, that the evolution 
of the osteitis, as he has seen it in his goundou patients, resembles exactly that 
seen in congenital syphilis, excepting only the paranasal tumors, which have 
never been described in syphilis, unless leontiasis ossea can be so considered. 
Twenty-eight cases of the total 130 showed marked glandular enlargement. 
Associated osteitis affecting both long and short bones was also frequently noted. 
Except for the bony deformations, other tertiary manifestations of yaws were 
not observed and no mention is made of juxta-articular nodules. 
Botreau-Roussel and Cornil? studied from the histological standpoint, 
material obtained from eight cases of goundou occurring in the Ivory Coast. 
They concluded that the hyperostosis presents the general characteristics of 
syphilitic osteitis. The adjacent tissues show especially a perivascular infiltra- 
tion and hyperplasia of the fibrous reticulum with fair numbers of fibroblasts 
and myelocytes, and an increase of collagen fibers in some of the areas. The 
inflammatory exudate consisted for the most part of plasma cells suggesting the 
condition commonly seen in “‘plasmome syphilitique”’ which, they remark, is 
especially characteristic of Treponema infections. They conclude that the 
paranasal outgrowths are not truly tumor formations but the result of an in- 
flammatory hyperplastic osteitis in which there are changes in the bony trabecula 
and medulla comparable with those of syphilitic osteitis, the lesions being similar 
to those produced both by the Treponema of syphilis and the 7’. pertenue. They 
believe that their histological studies support the view of a framboesial origin. 
Roy * who also studied 34 cases of goundou on the Ivory Coast examined 
histologically the paranasal tumors from two cases. The histological-pathological 
changes he describes coincide generally with those given by Botreau-Roussel 
1 Botreau-Roussel: Col. de la Soc. de Path. Exot., Paris, Masson et Cie., 20 Blvd. St. Germain 
Paris (1925). 
2 Botreau-Roussel and Cornil: Bull. Soc. Path. Exot. (1924), XVII, 863. 
3 Roy: Rev. Méd. et Hyg. Trop. (1925), XVII, 33. 
