GANGOSA, RHINOPHARYNGITIS MUTILANS, AND GOUNDOU 317 
ferred to the possibility of the condition being congenital. Araujo, who has ob- 
served six cases of goundou in Brazil, also states that there was no evidence of 
yaws in any of his cases. Sharpe! has recently reported a case as apparently 
identical with goundou in a white man aged forty-three who had always resided 
in London, and in which there was a strongly positive Wassermann reaction. 
It is stated that the patient had not suffered from yaws but that he had had 
syphilis. It is also noted that antisyphilitic remedies made no impression on 
the lesions. Carroll? has also called attention to a case diagnosed as goundou 
in which the lesion was unilateral on the left side of the nose. The blood test 
was positive for syphilis (Meinicke’s test). He was given six doses of neosal- 
varsan, 0.6 gram each, and iodide of potash in increasing doses for one month, 
without any noticeable change in the size or consistence of the tumor. There 
was a history of injury in this case four years previously. 
Manson-Bahr * has recently reported a similar condition that has been ob- 
served in the higher apes, especially the chimpanzees, and points out that a good 
example was to be seen in one of these anthropoids in the Zoological Gardens of 
London. Hanschell * also mentions the occurrence of goundou in a Cynocephalus 
monkey at the Seaman’s Hospital in London. This animal became savage and 
had to be killed. Hanschell macerated the tissues of the skull and thus uncovered 
a hard, bony tumor, obviously starting from the socket of the canine tooth. 
Bouffard,’ Marchoux and Mesnil,® Ziemann,’ and Seques § have also reported 
upon goundou in the monkey, chimpanzee, and gorilla, and have made histologi- 
eal studies of the condition. Mouquet® has reported recently upon a condition 
resembling goundou in Cercocebus aethiops. He is inclined to consider the disease 
as an osteomalacious condition to which the generally bad conditions of life in 
captivity may predispose. He suggests that the etiology of the goundou of man 
and of the ape may be different. Balfour ’ has also referred to lesions in a circus 
pony encountered on the steamer from Mauritius to Bombay, which in their site, 
general appearance and consistence suggested goundou. Ziemann does not con- 
sider that the proof has yet been brought that the condition, either in man or 
monkey, is a tertiary manifestation of framboesia. 
We had no opportunity to remove or study these nodules in the African cases 
we observed clinically. 
1 Sharpe: Trans. Royal Soc. Trop. Med. and Hyg. (1928), XXII, 293. 
2 Carroll: 16th Ann. Report, United Fruit Co., Medical Dept. (1927), p. 165. 
3 Manson-Bahr: Brit. Jour. Ven. Dis. (1928), IV, 50. 
4 Hanschell: Jbid., 67. 
5 Bouffard: Bull. Soc. Path. Exot. (1909), II, 216. 
6 Marchoux and Mesnil: Bull. Soc. Path. Exot. (1911), IV, 150. 
7 Ziemann: Abhandlungen aus dem Gebiet der Auslandskunde, Hamburg (1927), X XVI, 618. 
8 Seques: Rev. Méd. et Hyg. Trop. (1929), X XI, 50. 
: 
Mouquet: Bull. Soc. Path. Exot. (1929), XXII, 918. 
10 Balfour: Trans. Royal Soc. Trop. Med. and Hyg. (1928), XXII, 295. 
