Unusual Types of Primary Lesions in Yaws

us (Dey, 1930 and FitzGerald and Dey, 1931), but the primary lesion, when discovered, is remarkably constant. It seems therefore of interest to record two types, which, whilst they have been previously described, are undoubtedly of great clinical rarity. I. Gumma-like 'primary lesion.?A Lalung woman, aged 20, came to one of our yaws centres, presenting a sore on the ulnar border of the forearm. She gave a history of about one month's duration (though this cannot be relied on) and as far as could be ascertained the sore had started as a papule which had rapidly broken down. In appearance it was indistinguishable from a gumma, being an indolent punched-out circular sore about f inch in diameter, but not indurated nor adherent to the underlying bone. There was slight lymphatic involvement, but no pain. No other lesions suggesting yaws were present. The village from which she came was heavily infected. The serum gave a positive Sachs-Georgi test and treponemata were recovered in large numbers from the sore. Syphilis could be definitely excluded; it is in any case unknown amongst the Lalungs. After three weekly injections of Halarsol, totalling 12 c.cm., the lesion was cured. Primary lesions of this nature are recorded by Manson-Bahr.