Yaws : its nature and treatment an introduction to the study of the disease / by J. Numa Rat.
- Rat, Joseph Numa.
- Date:
- 1891
Licence: Public Domain Mark
Credit: Yaws : its nature and treatment an introduction to the study of the disease / by J. Numa Rat. Source: Wellcome Collection.
15/74 (page 3)
![stated by some to have been the Yaws, brought to Italy by the Spanish soldiers who had returned from America. But, as these soldiers did not reach Italy, until 1495, and the epidemic began early in 1493, the Yaws of the West Indies does not appear to have had anything to do with the introduction of syphilis into Europe. If syphilis did not originate in Europe, there is far greater probability of its having been brought there by the Moors who settled in Spain, seeing that Yaws and syphilis had both existed in Africa long before the discovery of America. Attempts have been made to distinguish between Yaws and the disease described by French writers as Pian or Epian, and again, between American and African Yaws ; but the different accounts given really refer to different stages or special manifestations of the same disease now known either as Yaws, Pian, or Framboesia. Other diseases resembling Yaws have prevailed as epidemics in Europe and Canada. In 1694, a disease called Sibbens or Swins (Swin, Celtic for raspberry) appeared on the West of Scotland, where it is supposed to have been imported by Cromwell’s soldiers ; and those who had seen both Yaws and Sibbens concluded that they were one and the same. The “ Button Scurvy ” of Ireland, the “ Radesyge ” which appeared in Sweden and Norway in 1710, whence it spread to Jutland and Holstein, and the coast of Finland, the “ Mai de Chicot,” in Canada, which began on the banks of Lake Huron, 1710, and other epidemics of the present century, known as Falcadina, Male di Scherlievo or Gronemico or Fiume, &c., according to the locaiities in which they were first observed, are other diseases intimately resembling Yaws, but, with the exception of the first, with certain differences to be noticed when treating of the nature of the latter affection. Yaws has never entirely disappeared from the West Indies. Under favourable circum¬ stances, in such places as Barbados and Antigua, it is said (truly or not) to have completely or almost completely disappeared, but in others and notably in Dominica, it has spread more exten¬ sively than formerly in localities which are mountainous and damp, and where the people are isolated, badly housed and badly fed. As an endemic, under ordinary circumstances, it is generally accepted as an unavoidable evil; but it sometimes assumes proportions, as an epidemic, which cannot be disregarded. In consequence of the severity of an epidemic of Yaws in Dominica, in 1871, the Government of that island established two Yaws Hospitals to segregate those already affected, and thus protect the rest of the community. Any hope, however, entertained of completely expelling the disease from the island by this means or by others subsequently adopted has not been realized. The attempts at isolation hitherto made in the other West Indian Colonies, even in such prosperous places as Trinidad, have never been on a sufficient scale to arrest the spread of the contagion, still less to ensure its extinction, and the same remarks apply to the West African and other British dependencies where the disease prevails. An enquiry into the nature of Yaws was made by Dr. Gavin Milroy, in the West Indies, in 1871, and in his report to the Secretary of State for the Colonies are recorded the experiences of the Chief Medical men of the British West Indies in those days, the views most fully given being those of Dr. Bowerbank, of Jamaica, and Dr. Imray of Dominica. Dr. Milroy deduces the following opinions from the facts laid before him :— “ From all the evidence that has now been adduced, we may fairly infer that, although there yet remains much respecting the origin and attributes of Yaws requiring more accurate investigation than has yet been applied to the subject, everywhere it is fostered, if not engendered, amid poverty and its ordinary accompaniments of squalor and semi-starvation. Proofs of this were given me alike in Berbice, Dominica and Jamaica.” “ Yaws is thus, obviously, another member of that multiform brood of evil, known by the family name of ‘ Mai de Misere.’ Cases are certainly extremely rare among the cleanly and well- oonditioned.” “ What is the exact part that contagion plays in the development and spread of the disease is a point which still, I think, waits for further and more searching enquiry. The disease appears to be comparatively rare in towns, and to be relatively most common and persistent in moun¬ tainous and other out-of-the-way localities where the people are left much to themselves, and not within the reach of frequent medical oversight. For many years past, the number of resident medical men in Jamaica has been very much less than it used to be. In 1834 there were rather more than 200, at the present time the number is not above 60 in actual practioe ; of these, more than one-half are under Government control. Thus a large portion of the population is obviously under very imperfect medical legislation. How to supply this serious default rests with the Government ; it can only be met by measures of enlightened liberality, inducing qualified professional men to take up their residence in the island, and encouraging them in every way to have their attention directed to the prevention, no less than to the curative treatment of disease.” ‘‘From numerous incidental observations already made, it will have been seen that, in my opinion, to judge aright of the causes of the existence of leprosy and of Yaws in a country, it is needful to study these diseases, not merely as distinct nosological entities, but also in connection with the general health-condition of the inhabitants, and with the type or leading character of the other endemic maladies most prevalent among them. Such information can only be obtained through the action of the Government, viz.: — By the annual registration of births and deaths, and secondly, by the regular publication in the Official Gazette of each colony of the Annual Reports of the Medical Officers of all the Institutions for the care and relief of the suffering poor.” “ The want of some authentic record of the general health and of the prevailing diseases in a Colony from one year to another is a serious defeot which might be easily corrected in future [174674] 4](https://iiif.wellcomecollection.org/image/b30556752_0015.jp2/full/800%2C/0/default.jpg)
