Volume 2

Atlas of clinical medicine, surgery, and pathology / edited under the direction of the Council by Jonathan Hutchinson.

  • New Sydenham Society.
Date:
1901-1907
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Atlas of clinical medicine, surgery, and pathology / edited under the direction of the Council by Jonathan Hutchinson. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    the balance fairly, and to allow the facts to exhibit themselves and to sueo-est their own appropriate conclusions. The New Sydenham Society has already taken some considerable part in endeavour- ing to supply materials for the solution of this important question. In vol. clxi. will be found reprints of, a “ Prize Essay on Yaws,” by Dr. Maxwell, published in 1839; an epitome of Dr. Nicholls' “ Government Report on Yaws”; an essay by Professor Breda on the Clinical and Bacteriological Study of the Brazilian form of the disease, and lastly, the very important, because experi- mental, monograph of Dr. M. Charlouis, of Java. This volume contains some good portraits of the skin eruptions, and also a plate from Dr. Breda’s paper showing lesions of the mucous membranes, &c. Char- louis’ observations, which constitute an epoch in the investigation, were published in 1881, but they were for some years overlooked in England, and the interest which has been manifested in the subject amongst ourselves dates from the publication in 1891 of an essay by Dr. Numa Rat, of St. Dominica, to which the present writer contributed a preface. In 1894 our Colonial Government published a well-illustrated and somewhat voluminous “ Report on Yaws,” by Dr. Alford Nicholls, then of Dominica. About the same time, and subsequently, many valuable con- tributions to our knowledge of the subject negroes. Bontius observed it specially in Amboyna and the Molluccas. It occurs only once in a life-time. It can be distinguished from syphilitic eruption especially by its “ insupportable itching.” When the venereal disease and Pian occur together, how- ever, it may be very difficult to distinguish the two diseases. Children are more subject to it than adults and old people. Loeffler observes that persons with open wounds are more likely to get Pian than others, and the negroes are “ habitually covered with wounds and ulcers.” Dr. Mason Good in 1822 wrote (p. 431): “ It is singular that we have no decided account of this malady among the early writers ; nor, indeed, any account whatever till after the appearance of syphilis ; whence as several of its symptoms, and especially where the bones become affected, bear a resemblance to those of syphilis, Yaws have been supposed by some writers to be a species of lues, and especially of that which in Scotland is denominated sibbens or sivvens . . . . but the eruptive fever and consequent efflorescence, the indemnity from a second attack, as well as the symptoms, draw a sufficient line of distinction.” have been made in the medical journals, and amongst those who have contributed them must be mentioned with honour those of Dr. Daniels, Dr. Powell, Dr. Wallbridge, Dr. Corney, and Mr. Finucane. The last-named observer contributed a most important paper on Yaws as observed in Fiji, to the Standing Committee on Yaws at the Polyclinic. It may be added that, in the Museum of the Poly- clinic,1 a large, and probably almost complete, collection of published illustrations of the disease has been arranged, and is supple- mented by many original photographs from various sources. It may be gathered from what has been said that the literature of Framboesia is now very large, and, as we have noted, our Colonial Government has felt the great importance of the matter, and has on several occasions pro- cured special reports upon it. It would be much to be regretted if these labours were thrown away, and if we were compelled to record that the solution of the matter appeared to be as distant as ever. But, in fact, it is not so ; the issues have been narrowed down and are now quite definite. It is admitted almost on all hands that it Yaws be not Syphilis it is, at any rate, a specific malady very closely resembling it. It is often suggested that a parallel may be found in the differences between Measles and German Measles, and the controversy concerns the question whether the observed differences in outward phenomena are such as to imply dis- tinctness in nature. That both observe stages which may be suitably named as “ primary or local,” “eruptive or secondary,” and “sequelae or tertiary,” is now determined beyond dispute. The first subject for our consideration is : The Period of Incubation after Inoculation. From Dr. Mason Good we have the follow- ing statement :— “ The time that elapses between the inocu- lation with Yaw matter and the first appear- ance of a Yaw tubercle on the spot where the 1 This Museum, at 22, Chenies Street, may be visited at any time.