016 REPORT OF THE HARVARD AFRICAN EXPEDITION 
and Cornil. No spirochaetes were found in the tissues especially stained for these 
organisms. Three somewhat oval bodies measuring 25 to 30u were observed in 
one section, but their significance was not determined. In the cases which Roy 
studied clinically a generalized enlargement of the lymphatic glands was also 
common, often associated with an osteitis affecting both long and short bones. 
Roy, however, believes that the etiology of goundou is unknown and that he 
excluded both syphilis and yaws as etiological factors. Stannus,’ however, who 
reviewed Roy’s work, points out that there was a history of yaws in many of 
Roy’s cases and a very great deal of evidence presented by Roy showing that 
goundou is a manifestation of yaws. Roy apparently believes that the goundou- 
like affection which has been described as occurring in monkeys is a similar con- 
dition to that which occurs in man. 
MeNaughton,? Moore,? and Chesterman‘ are all in favor of the fact that 
goundou is a tertiary lesion of yaws. McNaughton reports a case of a boy aged 
ten years with a typical paranasal swelling. The child had suffered from yaws 
two years before, while the paranasal swellings appeared a year later. No treat- 
ment had been given for yaws. Neither the patient nor his father and brother, 
who both had yaws, showed any manifestations of syphilis. The patient was 
given two injections of Bis. Sod. Tart. with Soamin at an interval of a week, but 
with no improvement. Moore has reported a typical case of goundou which at 
the same time showed ‘‘sabre tibiae,’ serpiginous yaws, ulceration in the nose, 
and complained of nocturnal bone pain. The paranasal tumors were removed 
by operation and the general condition of the patient was said to improve after 
a long course of salvarsan. 
Chesterman has also reported a case of a girl aged twelve who suffered from 
yaws witha well-marked general eruption for four years before. The swelling of the 
nose was noticed for the past two years. The condition of the nasal bones was 
associated with the periostitis of proliferating type on the mandible to the left 
of the point of the chin, and also with very well-marked ‘‘sabre tibiae,’’ both 
conditions appearing concurrently with the goundou. He remarks that anterior 
posterior bowing of the tibiae is one of the commonest bony lesions of tertiary 
yaws in his district. The goundou swellings in his case were removed by opera- 
tion and the patient made a good recovery, aided by injections of neosalvarsan. 
Pasqual,’ Carroll ° and Araujo,’ however, do not regard goundou as a tertiary 
manifestation of yaws. Pasqual points out that it has not yet been established 
that yaws and goundou are of common origin. There was no history of syphilis 
or of yaws in his patient or other members of the family in a district said to be 
yaws-free. After searching inquiry regarding the history it appeared that small 
swellings about the size of a pea were noticed on the bridge of the nose by the 
parents at birth. Pasqual believes that the case was congenital. Roy also re- 
Stannus: Trop. Dis. Bull. (1925), X XIT, 650. 
McNaughton: Trans. Royal Soc. Trop. Med. and Hyg. (1926), XX, 310. 
Moore: Nigeria Ann. Med. and San. Reports (1925), Ap. D., p. 58. 
Chesterman: Trans. Royal Soc. Trop. Med. and Hyg. (1926-1927), XX, 554. 
Pasqual: Trans. Royal Soc. Trop. Med. and Hyg. (1928), XXII, 59. 
Carroll: 16th Ann. Report, United Fruit Co., Medical Dept., Boston (1927), p. 165. 
Araujo: Bull. Soc. Path. Exot. (1928), X XI, 387. 
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