Report of the medical superintendent of Yaws Hospitals.

  • Nicholls, H. A. Alford (Henry Alfred Alford) 1851-1926.
Date:
1878-9]
Catalogue details

Licence: Public Domain Mark

Credit: Report of the medical superintendent of Yaws Hospitals. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    12/28 (page 10)
    weeks aftensards yaws crusts appeared upon the ulcerated sutL/ , There were many cases of yaws ia the neighbourhood at the time, a^ \ the man believes he became infected by direct contagion. Case 443. A man aged 24 years was admitted into the Central Hos- pital on August 8th, 1879, with large yaws crusts upon the chin—just over the spot where a mole formerly existed. He scratched the mole 80 that it bled, and about 2 weeks afterwards the yaws appeared. He was living near to persons affected with the disease. This case was discharged cured on on Ath September. It is thought by some that yaws may become developed sporadically, but my study of the malady leads me to conclude that this is is not the case. If yaws were developed spente sm, then I do not see how that islands in which the disease once existed are now free from the infec- tion. Take for instance Barbados, Antigua, and Saint Kitts, three largely populated islands where yaws \»ere once rife, and where now the disease is unknown. In these islands the peasantry are under condi- tions similar to those of their brethren in Jamaica and Dominica where yaws prevail. The people are of the same race, they lead much about the sam© lives, eat the same food, and are under similar sanitary conditions. Yet one^'colony is affected, and the other is not. Bad diet- ary, bad hygiene and bad sanitation, unquestionably by lowering the vital powers predispose to the accession of yaws as to every other like disease, but it appears to me that they cannot develop the malady de novo, or isolated cases would appear in Antigua and other places where the disease existed in past times. The disease is most common amongst the negroes, but coloured per- sons are frequently affected. I have known cases to occur amongst the poor whites, and the East Indian coolies, of which there are only a few in Dominica, are sometimes attacked. JPathology, 1 am unable at the present time to say much about the pathology of the disease. I hope however to give some definite infor- mation concerning this important subject upon a future occasion. Hiagnosis. The characteristic appearances of the yaws erup tion are themselves sufficient to distinguish the disease from all other maladies. The dartre, and the elongated ornst, may be confounded respectively with psoriasis and rupia, but the distinguishing marks of these two sta- ges have already been so described as to prevent any error if a careful examination be made. Many of the old writers on the disease, and especially the French, have confounded yaws with syphilis. Pere Labat in his ** Nouveau Voyage aux iles de rAmerique, published in 1742, states distinctly that Epian, as yaws is called by the French, is the venereal disease, and he is quoted as an authority by other French writers. By a careful pe- rusal of Pere Labat's chapter oa Epian, it will be seen that he describes syphilis, and it is therefore questionable whether the priest really saw a case of yaws at all. Labat says that the Lharib infants are nearly all attacked from birth ; but although there is a small Charib commu- nity in Dominica, as far as i know, yaws have never appeared amongst these aborigines. From syphilis the disease differs in its history, its mode of onset, the great proportion of children attacked, the small num- ber of cases in which the genitals are affected, and the rarity of the im- plication of the mucous membranes. The undeviating march of a spe- cial train of characteristic symptoms will always enable the observer to distinguish yaws from syphilis, and I do sot think it is possible to make an error in diagnosis if due care be taken. The affections known as Delhi sore, Bonton de Biskra, Bouton d'Alep, Caneotica, and the Parangi disease of Oeylon, bear in many symptoms a