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.

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    Case 406. A boy, aged 3 years, was admitted on July 5th with en- crusted tubercles on the thighsl genitals and round the anus, and ony- cliia of the right thumb. The disease had existed a month. He was ordered to take sulphur and cream of tartar. On August §th, the tu- bercles were in about th© same state as on admission, but the end of the thumb was a mass of unhealthy ulceration partially covered with dirty yellow crusts, and there was an abscess over the right mastoid ]jrocess. The abscess was opened, the sulphur and cream of tartar isas stepped, and sulphide of calcium was ordered. On Sept. 7th, as the thumb was still very bad, although the yaws were dry, black wash was applied locally, and the iodide of potash mixture was ordered to be taken. The ulceration was improved on Sept. 17th, but as the general health wj^s affected cod liver oil with steel wine was ordered, and an acetate ©f lead lotion was applied to the sore. The patient was discharg- ed cured on Oct. 24th. Case 4l7, A boy 16 years of age was admitted on July 15th, 1878, jmd he had been suffering from yaws for six months. The following description appears in the Case-Book—Yaws crusts on both feet. Third toe of left foot has commencing onychia—the result of a tu- bercle. Leit forefinger has a tubercle sprouting out from the matrix —the nail being raised on one sid©. Crusts scattered about face. No dartres. Sulphide of calcium was ordered, and on July 24th the yaws commenced to dry. On ^ ugust 5th the following note appears— Yaws on forehead not yet dry. The tubercle on the left forefinger dry—and progress of onychia arrested. The finger nail is slightly pushed to the side opposite to the tubercle, and it is corrugated on the affected side. On August 18th iodide of potash was ordered; on August 26th the onychia was cur^d; and the boy was discharged on November 4th. From these cases it will be seen that sulphide of calcium has a most beneficial effect on the disease. Ihis drug has never before been recom- mended as a remedial agent in yaws, and I have not heard of a case in which it hS been employed. I was itiducad to prescribe it because, unlike sulphur, it is not liable to produce excessive action of the bow- els, and because of its known potency for good in cases of unhealthy ulceration. Its beneficial action is strikingly shown in the following case. A man thirty years of age was admitted to the Morne Bruce Hospital on Jany 20tb, 1877, and he was treated with corrosive subli- mate. When I took charge of the establishment at the end of April, the man came to my notice, and 1 wrote ihe following description in the Case-Book.— Large tubercles on body and limbs and nose and mouth. There is a huge open sore on the right leg, with a piece of necrosed bone in the centre. On June I8th the man was sent to the Prince iluperts Hospital Drugs of various kinds were administer- ed, and yet no effect was made on the disease. Pedunculated tuber- cles, attached to the eyelids, hung down ever both eyes, the man was pitted from small pox, and he presented a hideous appearance. On July 24th, I ordered sulphide of calcium, and within a week the yaws commenced to dry, and on August 26th he was discharged cured. At the time of writing this report the man is under my care in tlk.e Roseau Infirmary with injuries received by the upsetting of a canoe, but there is no sign of the yaws to be discovered except various scars about the skin. In chronic cases, which are unaffected by the various agents 4. have mentioned, arsenic may be given with advantage, as will be seen from .he following instance. A girl 14 years of age was admitted into the Oen- iral Hospital with the perineum and gluteal regions nearly covered with yaws crusts. Various remedies were administered with very little effect, imd the girl remained in the Hospital for several months without any pparent benefit from her stay. At last Dr. Duke who had charge of
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