OBSERVATIONS ON THE AFRICAN YAWS (FRAMBCESIA, RU- 
BULA, PIAN, EPIAN, SYPHILIS iETHIOPICA, SYPHILIS VEL 
LUES iETHIOPICA, SYPHILIS AFRICANA); AND ON LEP- 
ROSY (LEPRA TUBERCULOSA, LEPRA HiEBR-ZEORUM, LE- 
PRA iEGYPTICA, LEPRA LEONTINA, LEPRA ARABIUM) IN 
INSULAR AND CONTINENTAL AMERICA. 
JOSEPH JONES, M.D., 
Professor of Chemistry and Clinical Medicine, Medical Departmect University 
of Louisiana; Visiting Physician of Charity Hospital, New Orleans; 
Member of Board of Health, State of Louisiana. 
(Extract from Proceedings of New Orleans Medical and Surgical Association.) 
At a meeting of the New Orleans Medical and Surgical Asso- 
ciation, held October 27th, 1877, Dr. Joseph Jones presented the 
following case of Yaws, with the accompanying observations 
upon the history of this disease in the West Indies and Southern 
States, together with certain facts establishing the existence of 
Leprosy in Louisiana, during the French and Spanish domina- 
tion, and at the present time. 
Case of Yaws. Augustin Faind, aged 22 years; 5 feet 7 inches 
in height; weighs about 150 lbs.; black hair; dark eyes; copper- 
colored skin; in the color of the skin and his straight black hair, 
resembles more nearly the Mongolian race; native of the Isle of 
Bourbon, off the coast of Africa. 
The patient states that his father was a native of France and 674 
Original Communications. 
[Mar. 
his mother a native of Africa. Sailor by occupation, Admitted 
to Charity Hospital, ward 30, bed 440, October 1877. The patient 
states that he contracted the disease with which he is now suffer- 
ing, on the the coast of Africa three months ago. He says that 
the ship upon which he was employed was visited by natives, 
several of whom were suffering with a similar disease, and he 
supposed that the disease was contracted from them. Had lived 
on the Island of Bourbon until thirteen years of age, and from 
that time until his admission into the Charity Hospital has fol- 
lowed the seas, and ten months ago suffered with scurvy, his 
gums being swollen and livid, and the surface of the body mottled 
with purpuric spots. He states that the yaws first made its 
appearance on the face in the form of two or three vesicles, about 
the size of a pin’s head, which gradually enlarged to the size of 
a pea. The number of the vesicles increased, several of which 
united or became confluent on the face, forming irregular eleva- 
tions about an inch in diameter. In ten or twelve days after 
their first appearance, each vesicle became umbilicated and burst, 
discharging sanious fluid, and then drying up, formed scabs, 
which gradually fell off. In the meantime other vesicles formed 
upon the face and extremities. After the eruption had continued 
about six weeks, any abrasion of the skin upon any part of the 
body would result in the formation of raw suppurating sores, 
upon which scabs would form. The disease attacked with greatest 
violence the soles of the feet, toes and fingers, causing swelling, 
ulceration and destruction of the joints and phalauges. The 
patient states that he came on a sailing ship from Havre, France, 
to New Orleans, and suffered severely with pains in his head, 
back aud extremities, attended with high fever and delirium, 
which continued throughout the voyage. Entered the Charity 
Hospital in a prostrated and almost insensible condition. 
When I first saw this patient he complained of severe pain in 
the head, defective vision and memory, insomnia, and pains in 
the limbs and back. Body emits an exceedingly offensive and 
disgusting odor. An eruption of raised pustules, of various sizes 
and ages; varying from the size of a pin’s head to the size of a 
half dollar, and filled with an opaque whitish fluid, occupy various 
portions of the face and forehead, and trunk. Marks of the suc- 
cessive crops of eruptions can be discerned upon the face, and 
upon various portions of the trunk and extremities. When the 1878] 
Jones—Obseraations on the African Yaws, etc. 
675 
pustules burst, a thick viscid matter is discharged, which forms 
a foul, dense crust or scab upon the surface. From some of the 
pustules, aud especially those upon portions of the body most 
subjected to pressure and abrasion, as the hips, elbows, knees 
and feet, red fungous excrescenses have arisen, resembling a 
large mulberry, and emitting a foul, disgusting odor. On the 
right cheek, over the region of the malar bone, there is an aggre- 
gation or confluent mass of these eruptions forming an elevated 
fungus surface of irregular shape, varying from one to two inches 
in diameter. On the left side of the angle of the inferior maxillary, 
there is another irregular mass of pustules or fungus formation, 
which are covered with a scab of the dead exudation. About 
twenty of the pustules, of various sizes, occupy the forehead. 
The right eyelid presents a nodulated appearauce, and the left 
eyelid has three small pustules. Both elbows are occupied by 
oblong fungus, mulberry-like eruptions, discharging foul sanies; 
and a similar eruption is observed over both trochanters aud 
both knees. Upon the left side numerous cicatrices, marking 
the site of former eruptions, are visible. This observation applies 
also to other portions of the body. The scrotum and integuments 
of the penis much swollen, and very painful. No chancres nor 
chancroids, nor marks of syphilitic ulcerations, observable upon 
penis. No induration or enlargement of the lymphatics of the 
groin or axilla are observable. 
Fungous eruptions exist upon the joints of several of the fin- 
gers, some of which have lost the first joiut, and the nails are 
partially or entirely missing. Several of the fingers are retracted. 
The toes of the left foot are retracted and deformed, and several 
are without nails, having lost the first phalanx. The external 
surface of the left ankle is covered by a fungous nodulated erup- 
tion. The right leg, ankle aud foot is much swollen, and pre- 
sents somewhat the appearance of elephantiasis; but the enlarge- 
ment of the limb is clearly due to the effects of inflammatory 
action, in and around the bones of the instep and foot. A large 
corroding ulcer, discharging an offensive sanious fluid, exists on 
the posterior surface or palmar aspect of the right foot, about 
three inches in diameter. On the dorsal aspect of the foot there 
are several ulcers, resembling those formed over carious bones, 
which discharge a foul sanious fluid. These ulcerations commu- 
nicate with the dead bones of the foot, and it appears that the 
continuous discharge is due to the presence of the dead bones, 676 
Original Communications. 
[Mar 
which act like foreign bodies. The outer or smallest toe, as well 
as the next toe, have been completely destroyed. The disease 
has also invaded the remaining toes, and the third toe from the 
exterior lost one of the phalanges, after the entrance of the patient 
into my wards; and upon careful examination, I could discover 
no erosions of the surface of the bone, as in the sequestra of 
diseased bones and those segments thrown oft after amputation 
of the extremities. 
The increase in the size of the left foot and leg is shown by the 
following measurements: circumference of ankle, 13£ inches; cir- 
cumference of instep, 14 inches.* 
Yaws in the West Indies. 
The existence of yaws in the West Indies was, without doubt, 
coeval with the importation of slaves from the coast of Africa, 
but the first English writer who observed and described the dis- 
ease in the West Indies, was the learned physician and natura- 
* Progress of this Case. Up to this date, January 23d, 1878, the patient has 
presented various changes, in accordance with the phases of the disease, but upon 
the whole has improved upon the plan of treatment instituted. The appearance 
of fresh crops of pustules has been attended with pain in the head and back, and 
extremities, anorexia, depression of spirits, moaning insomnia, and febrile excite- 
ment. Opium was administered to induce sleep, and iodide of potassium and 
tincture of iodine administered to induce some constitutional impression on the 
disease. After a fair trial these remedies were abandoned, and the patient placed 
upon bitart, of potassa £ij., three times a day in cup of water, and 15 drops of the 
tincture sesquichloride of iron three times a day in wineglassful of water. Gentle 
purgation, combined with the tonic action of the tincture of iron, and daily use 
of warm baths, and local applications of carbolic and iodine salves, yielded the 
best results. At this present moment all the ulcers are healed, except the large 
ones on the right foot, and the pustules have ceased to form, and the patient is 
cheerful and walks about the hospital grounds. As a local application the follow- 
ing was found beneficial. H—Acidi carbolici, %i.; acidi tannici, gij.; tinct. 
iodinii, f^iij.; tinct. opii, f^ij.; cerati simplicis, Jij; mix, apply locally to 
abraded surfaces with fungous growths, and to the corroding phagadenic ulcera- 
tions of the extremities. This ointment was spread upon soft prepared or Eng- 
lish lint, and applied continuously to the ulcerated surfaces. Under this treat- 
ment, conjoined with frequent ablutions in warm water, the ulcerations and fun- 
gous surfaces have healed, and the patient is able to walk about the hospital 
grounds. About the middle of December, one of the phalanges of the middle toe 
was extracted. It presented no erosions. Since its removal, the swelling of the 
foot has progressively subsided. I have used the above ointment, or one of 
similar composition, since 1866, with satisfactory results in the treatment of gun- 
shot wounds, and ulcerations resulting from various causes. 1878] 
Jones—Observations on the African Yaws, etc. 
677 
list, Hans Sloane, M.D., who, in 1GS7, went as physician to the 
Duke of Albemarle to Jamaica. 
The great work of Dr. Hans Sloane, on the Natural History of 
Jamaica, was published in Loudon in 1707. From that portion 
of the Introduction which relates to the diseases which he ob- 
served iu Jamaica, and the method by which he “used to cure 
them,” we extract the following observations relating to the 
yaws. “A negro woman, belonging to Mr. Firwood, was brought 
tome. She had a great many ulcers iu the extremities of the 
fingers and toes, and about the joints. There was also several 
bladders filled with serum on several of her joints, as if cautha- 
rides had been applied there to raise a blister. ,These bladders 
or cuticula, filled with serous matter, came on either her fingers 
or toes every full and new moon, and in process of time each of 
the bladders brought an ulcer, leaving the flesh raw, and some- 
times deeper, sometimes shallower corroded, so that the longer 
the bladders had been raised, the deeper were the ulcerations. 
The virulency of the humour was such, as that after it had eaten 
into the bone, the fingers and toes would drop off, and they die, 
as I have been assured by those who had lost several negroes of 
this disease, I was assured was peculiar to blacks.” * * * 
“A negro lusty fellow was taken ill of the yaics-, he had not 
been long from Guinea, and was all broke out into hard whitish 
swellings, some greater, some lesser, from the bigness of a beau 
to that of a pin’s head, of which last size there were many which 
appeared like the glands of the skin, swelled and white. When 
these tumors are large, they are usually white at top, from some 
of the cuticula and humors, dried, lying in scales over it, and 
sometimes they weep out an ichor. At other times the ulcers are 
much larger. They likewise complained sometime of great pain 
iu the bones, and the fellow whom I cured was broke out very 
much about the penis, scrotum aud elbows. I fluxed him by 
unction in an outhouse, feeding him with as much water-gruel as 
he could eat or drink. The flux proceeding as it was expected 
to do, he was quite cleared of this filthy distemper, only on his 
elbow he had oue swelling, not quite dry, to which I applied 
vitriol, which made the scales fall off and heal as the rest. 
“This distemper is thought to be contagious, aud to be com- 
municated from oue to another, from blacks to whites, aud from 
parents to children, but I couldu’t observe it to be more or less 
contagious than the pox. There are few plantations without 678 
Original Communications. 
[Mar. 
several of these diseased persons, who are usually cured as 
above. Though ?tis commonly thought that fluxing does not 
cure without relapse, yet I, by what I could observe, find it 
does, and do believe the return of this disease comes from not 
being thoroughly fluxed by anoiuting, or being kept too warm, 
or wrong treated afterwards, whence some remains of it staying 
behind m the body, these dregs by degrees bring the same dis- 
temper again. * * Some sorts of this distemper seem to me 
to be the, elephantiasis or true leprosie of the ancient and Arabian 
physicians. Others said to have this disease were plainly scro- 
fulous, or had the king’s evil, and most said to have it had the 
lues venera. Though this disease is thought to be propagated 
by ordinary conversation, or trampling with the bare feet on the 
spittle of those affected with it, yet it is most certain that it is 
mostly communicated to one another by copulation, as some 
other contagious diseases are.”* 
Dr. John Hume, Surgeon to the Naval Hospital in Jamaica, 
and a commissioner of the sick and hurt, drew the attention of 
British practitioners to the phenomena of this disease in an ac- 
count of it published in the sixth volume of the Edinburgh 
Medical Essays, in 1744. Dr. Hume pointed out the resemblance 
of the yaws to the disease described in the thirteenth chapter of 
Leviticus, as affecting the Israelites in their passage through the 
wilderness, and Adams has expressed his belief of their identity 
(Obs, on Morbid Poisons, page 200). Dr. Hillary supposes that 
Haly Abbas, who lived in the tenth century, refers to the yaws 
under the general term lepra, both kinds of the Arabian leprosy 
having been described in a preceding chapter under the name 
(as it is translated) elephantia.— (Inquiry into the Means of Im- 
proving Medical Knowledge, by W. Hillary, M.D.) The yaws 
were next treated of by M. Virgile, who practised for several 
years in the Island of St. Domingo, and subsequently by M. 
Desportes, Peryrilhe, Dr. James Grainger, of St. Christophers, 
Dr. Hillary, of Barbadoes, Abbe Raynal, Bryan Edwards, Drs. 
Winterbottom, Dancer, Mosely, Ludford, Thomson, Thomas, 
Wright, and others. 
* A Voyage to the Islands of Madeira, Barbadoes, Nieves, St. Christophers, and 
Jamaica, with the Natural History of the Herbs and two and four-footed Beasts, 
Fishes, Birds, Insects, Reptiles, etc., of the last of these Islands, etc. Illustrated 
with Figures of the things described as big as Life. By Hans Sloane, M.D., 
Fellow of the College of Physicians and Surgeons, and Secretary of the Royal 
Society. 2 vols., London, 1707. VoL 1, Introduction, cvi., cxxvi. 1878] 
Jones—Observations on the African Yaws, etc. 
679 
Abbe Raynal, in his Philosophical and Political History of the 
Settlements and Trade of the Europeans in the Hast and West In- 
dies, vol. v., pp. 272-274, says: “The yaws, which is the second 
disorder peculiar to negroes, and which accompanies them from 
Africa to America, is contracted in the birth, or by communica- 
tion between the sexes. Ho age is free from it, but it more par- 
ticularly attacks at the period of infancy and youth. Old people 
have seldom strength sufficient to support the long and virulent 
treatment which it requires. 
“There are said to be four species of yaws: the yaws with pus- 
tules, large and small, as in the small pox; that which resembles 
lentils; and lastly, the red yaws, which is the most dangerous 
of all. 
“The yaws attack every part of the body, but more especially 
the face. It manifests itself in granulated red spots, resembling 
a raspberry. These spots degenerate into sordid ulcers, and the 
disorder at length affects the bones. It is not in general at- 
tended with much sensibility. 
“Fevers seldom attack the persons who are affected with the 
yaws; they eat and drink as usual, but they have an almost in- 
superable aversion for every kind of motion, without which, how- 
ever, no cure can be expected. The eruption lasts about three 
months * * All the negroes, as well male as female, who 
come from Guinea, or are born in the islands, have the yaws ouce 
in their lives. It is a disease they must necessarily pass through; 
but there is no instance of any of them being attacked with it a 
second time, after having been radically cured. The Europeans 
seldom or never catch this disease, notwithstanding the frequent 
and daily connection which they have with the negro women. 
These women suckle the children of the white people, but they 
do not give them the yaws. How is it possible to reconcile these 
facts, which are incontestible, with the system which physicians 
seem to have adopted with regard to the nature of the yaws? 
Can it be allowed that the semen, the blood, and the skin of the 
negroes, are susceptible of a virus peculiar to their species I 
The cause of this disorder, perhaps, is the same as that which 
occasions their color. One difference is naturally productive of 
another; and there is no being or quality that exists absolutely 
detached from others in nature.”* 
* Philosophical and Political History of the Settlements and Trade of the Euro - 680 
Original Commnnications. 
[Mar. 
Dr. William Hillary, in his treatise on the Diseases of the 
West India Islands, or the Torrid Zone, devotes a special chapter 
to the yaws, from which we extract the following, 
“That disease which the negroes in Africa, and we from them 
in the West Indies, call the yaws, is a native ot and seems to be 
indigenous in Africa and Arabia, and was first brought from the 
former by the negroes into America and its islands.' This is a 
distemper which has been well known for many ages in Africa, 
and some of the neighboring countries which are situated within 
the torrid zone; but I do not find that any of the Greek phy- 
sicians, nor yet any of the Arabians, do mention it, except Haly 
Abbas, the Persian Magus. * * We are credibly told that 
the yaws seldom fail to attack the negroes in Africa at one time 
or other in their lifetime, but most frequently the children and 
young people; and that they very rarely or never have it a 
second time, if they have been perfectly cured the first time. * * 
“This disease generally makes its first appearance without any 
previous sickness or pain, and when the patient thinks himself 
perfectly well, in very small pimples, no bigger than the head of 
a small pin, and are smooth and level with the skin; these daily 
increase and become protuberant pustules. Soon after the 
cuticle turns whitish, cracks, and rubs oft, and a very small 
quantity of serum or clear ichor exudes out and dries, and be- 
comes white; but neither pus nor any quantity of ichor is found 
in the tumor, but a pretty thick, white slough appears, and 
under that a red fungous flesh thrusts itself out of the skin, 
which gradually increases to different magnitudes, some not so 
large as the smallest wood strawberry, some larger; others ex- 
cee ing the size of the largest mulberry, which last they very 
much resemble, being red, and composed of little round knobs 
as they are. They appear differently on all parts of the body, 
but most frequently, and generally are the largest, about the 
groin, private parts, anus, under the arms, and in the face; and 
it is remarkable, that in general when the yaws are very large, 
they are fewer in number, and e contra, when they are more 
numerous they are generally smaller in size. And as the yaws 
are thus increasing and coming to their height, the black hairs, 
peans in the East and West Indies. Revised, augmented and published in ten 
volumes, by the Abb£ Raynal, M.D., London, 1787, p. 272. 1878] 
Jones—Observations on the African Yaws, etc. 
681 
which grow out of the places where the yaws are, gradually turn 
to be perfectly white, like the hairs of an old man; aud the ichor 
which oozes out ot the yaws, drying upon the skin, makes it 
appear of a whitish color, and renders the patient a disagreeable 
loathsome sight: and now the disease is become very infectious 
to those who handle or cohabit with them. * * The time 
from their first appearance in the before-mentioned pimples to 
their full height or growth, is very different in different consti- 
tutions, as they are stronger or weaker, and according to the 
negroes being well fed or the contrary; for when the negro is 
strong, lusty, aud of plethoric habit, and is well fed, the yaws 
will often arrive at their full growth, aud be as large as a mul- 
berry, in a month’s time from their first appearance; but when 
the negro is weak, low in flesh, and poorly fed, the yaws will be 
small, and often no larger than a strawberry, at the end of three 
months. 
“This disea.se is known to be infectious, but there is also a 
peculiar aptitude in some constitutions to receive it more readily 
than in others, aud probabty, in the same person to receive the 
infection more readily at one time than another.” 
Dr. William Hillary presents the foregoing description as re- 
lating to .the disease when left entirely to nature, but he adds 
that when improperly treated, and interfered with in its natural 
course, the fungous eruptions in the yaws may in time become 
phagadeuic ulcers, which corrode and eat away the flesh even to 
the bones, and then produce nodes, exostosis and caries in them, 
and at last totally consume and destroy them also. 
Bryan Edwards, in his History of the British Colonies in the 
West Indies (vol. ii., p. 352), says: “Among the diseases which 
negroes bring with them from Africa, the most loathsome are 
the cacahay aud the yaws, and it is difficult to say which is the 
worst. The former is the leprosy of the Arabians, aud the latter 
(much the most common) is supposed, by some writers, to be the 
leprosy mentioned in Leviticus, chap. xiii. * * Young negro 
children often catch the yaws, aud get through it without medi- 
cine or much iuconvenience. At a later period it is seldom or 
never thoroughly eradicated; and as, like the small-pox, it is 
never had but once, the Gold Coast negroes are said to commu- 
nicate the infection to their infants by inoculation. I very much 
doubt if medicine of any kind is of use in this disease.” 
Dr. James Grainger, in his Essay on West India Diseases, 682 
Original Communications. 
[Mar. 
affirms that the yaws attacks the negroes but once, and is both 
tedious and difficult to cure; and when repelled, infallibly ruins 
the constitution. 
Dr. John Williamson* says that “the yaws is a disease of such 
a contagious character, that white people naturally feel a horror 
in exposing themselves to the risk of infection. It may be com- 
municated by flies alighting from the yawy patient and pene- 
trating in the usual manner any part of the body, by which 
inoculation is effected; but I must acknowledge my doubts in 
the extent of this contagion in an equal degree to the whites as 
to the African or Creole negroes. White people may expose 
themselves with less risk than negroes. * * Some few in- 
stances came within my knowledge of white persons being infected 
with yaws from sexual intercourse; and it is dreadful to imagine 
the hard fate to which such persons are condemned, but absolute 
exclusion from society of their own color is necessary until a cure 
is completed. It is additionally unfortunate that the evil does 
not cease then. A white person who has had yaws, ever after 
has an onus attached to him, affecting his disposition, particu- 
larly should he feel inclined to form a connection by marriage 
with any reputable female of the country.” 
It appears that in general, if not always, the occurrence of the 
yaws is consequent to the application of its specific virus to an 
abraded surface of an individual in whom it has not previously 
existed; and this, although frequently by accident, is not unfre- 
queutly by design. According to Dr. Wright, the most usual 
circumstances under which it is contracted are, first, by sleeping 
in the same bed, and the ichor getting on the wounds or scratches 
of the uninfected;* secondly, by handling the infected, and allow- 
ing the virus to touch scratches or excoriations; thirdly, by the 
use of the same bowl or basin in washing their sores which had 
been previously used for similar purposes by the infected negroes; 
fourthly and most usually, by small flies, which, having gorged 
themselves with the virus of the diseased, alight on the ulcers of 
the hitherto uninfected, its propagation being as certain by the 
minutest quantity as if it were ever so considerable. 
The progress of the operation of the virus of yaws iu the 
animal economy, unlike that of small pox, is very variable in 
different individuals; but from the experiments of Dr. Thomson 
* Medical and Miscellaneous Observations relative to the West India Islands, 
vol. ii., Edinburg, 1817, pp. 141-161. 1878J 
Jones—Observations on the African Yaws, etc. 
683 
it may be inferred, that from seven to ten weeks is the usual 
period which elapses between the insertion of the virus and the 
development of the eruption. In one instauce, however, for 
which we have the authority of Dr. Adams, the interval appears 
to have been ten mouths. It has been remarked that the blood 
of yaw patients does not differ in appearance from that of healthy 
persons, and that, when used for inoculation, it fails to commu- 
nicate the disease; moreover, that the infected are as liable to 
other diseases as persons in a healthy condition. 
Notes on the History of Yaws in the Southern States. 
The first recorded observations on the yaws, as appearing 
amongst the negroes of Louisiana, were those of the historian, 
M. Le Page du Pratz, who came over with a colony of eight 
hundred men in 1718, when New Orleans consisted of only a few 
huts, and who purchased slaves upon his arrival in the colony, 
was a planter for sixteen years, and was likewise overseer or 
director of the public plantations, both when they belonged to 
the West India Company and afterwards when they fell to the 
Crown—by which means he had the best opportunities of know- 
ing the nature of the soil, climate and diseases of Louisiana. 
Du Pratz published his history of Louisiana one hundred and 
twenty years ago, namely, in 1758. 
That the negroes of Louisiana, as early as 1718-1734, suffered 
with the yaws, syphilis and scurvy, is evident from the directions 
given by M. Le Page du Pratz as to uthe choice of negroes; of 
their distempers, and the manner of curing them;v* from which we 
extract the following: “The first thing you ought to do when 
you purchase negroes, is to cause them to be examined by a 
skilful surgeon, and an honest man, to discover if they have the 
venereal or any other distemper. When they are viewed, both 
men and women are stripped naked as the hand, and are care- 
fully examined from the crown of the head to the sole of the feet, 
then between the toes and between the fingers, in the mouth, in 
the ears, not excepting even the parts naturally concealed, 
though then exposed to view. You must ask your examining 
surgeon if he is acquainted with the distemper of the yaws, 
which is the virus of Guinea, and incurable by a great many 
* History of Louisiana, vol. ii., pp. 255-260. 684 
Original Communications. 
[Mar. 
French surgeons, though very skilful in the management of 
European distempers. Be careful not to be deceived in this 
point, for your surgeon may be deceived himself; therefore 
attend at the examination yourself, and observe carefully over 
all the body of the negro, whether you can discover any parts of 
the skin which, though black like the rest, are, however, as 
smooth as a looking-glass, without any tumor or rising. Such 
spots may be easily discovered, for the skin of a person who 
goes naked is usually all over wrinkles. Wherefore if you see 
such marks, you must reject the negro, whether man or woman. 
There are always experienced surgeons at the sale of new negroes, 
who purchase them; and many of these surgeons have made 
fortunes by that means, but they generally keep their secret to 
themselves.” * * 
“You must never put an iron instrument into the yaw; such 
an application would be certain death. 
“In order to open the yaw, you take iron rust reduced to an 
impalpable powder, and passed through a fine search; you after- 
wards mix that powder with citron juice, till it be of the con- 
sistence of an ointment, which you spread upon a linen cloth 
greased with hog’s grease, or fresh lard without salt, for want of 
a better; you lay the plaster upon the yaw, and renew it evening 
and morning, which will open the yaw in a very short time with- 
out any incision. 
“The opeuing being once made, you take about the bulk of a 
goose egg of hog’s lard without salt, in which you incorporate 
about an ounce of good terebinthiue, after which take a quantity 
of powdered verdigris aud soak it half a day in good vinegar, 
which you must then pour off gently with all the scum that floats 
at the top. Drop a cloth all over with the verdigris that remains, 
and upon that apply your last ointment. All these operations 
are performed without the assistance of fire. The whole oint- 
ment being well mixed with a spatula, you dress the yaw with 
it; after that put your negro into a copious sweat, aud he will 
be cured. Take special care that your surgeon uses no mercurial 
medicine, as I have seen, for that will occasion the death of the 
patient.” 
Bernard Bomaus,* whose work on Florida was published in 
1770, says: “I have seen three or four instances of the disease 
* Concise Natural History ot East and West Florida, p. 256. 1878J 
Jones—Observations on the African Yaws, etc, 
685 
called body yaws (iu the islands'*, aud in Carolina the lame dis- 
temper. This is said to proceed from hereditary venereal taints; 
it appears in cancerous corroding sores iu the mouth and throat, 
and spreading ulcers, together with fleshy protuberances, chiefly 
on the face, breast and thighs, with a swelling of the shiu aud 
knee bones, and commonly corrodes the cartilages of the nose, 
its first symptoms showiug themselves about the throat aud 
palate, having caused ignorant people to mistake it for the An- 
gina Suffocativa before described. Mercurial medicines are used 
against it, afterwards diet drinks of China root, nut grass, etc.; 
the sores in the mouth are often to be rubbed with a feather 
dipped in syrup of roses, to an ounce of which two drops of sp. 
vit. have been added: unctuous, salt, spiced meats and spiritu- 
ous liquors are absolutely to be avoided; frequent sweats are 
also prescribed, and a great care against catching cold.” 
It is evident from the statements of these authors that the 
yaws afflicted the Africans imported to the colonies of America. 
It is also well established, that this disease is of comparatively 
rare occurrence at the present day amongst the descendants of 
the native Africans. These facts sustain the following proposi- 
tions. 
1st. The yaws is an African disease, aud disappears gradually 
when introduced upon the North American Continent. 
2d. The disease is not of a venereal nature, and is not propa- 
gated aud spread in the same manner as syphilis. 
3d. If hereditary, the tendency to its reproduction may be lost 
by change of climate, habits, aud dress aud diet. It is probable 
that increased cleanliness, more abundant supplies of clothing 
and wholesome food, may have been the chief causes of its dis- 
appearance amongst the negroes born on the soil of the Southern 
States. 
Belations of Yaws to Syphilis, 
The yaws and syphilis have frequently been considered as 
modifications of the same disease. This view has found its most 
distinguished and able advocate in Dr. James Copland,* who 
says: “This distemper has existed iu Africa for ages before the 
epidemic outbreak of syphilis in Europe at the end of the 15tli 
* Dictionary of Practical Medicine. Amer. ed., vol. iii., p. 1473. 686 
Original Communications. 
[Mar. 
century, and if not identical with, is at least a form or modifica- 
tion of the the disease which existed in the West India Islands, 
when they were discovered by Columbus, and which was con- 
sidered as intimately resembling, if not the same as the epidemic 
spyhilis of the 15th aud lGth centuries. 
“The African syphilis, or the yaws as commonly termed, in all 
respects more closely resembles the earlier manifestations of 
syphilis in Europe than the modern occurrences of this distem- 
per. Indeed, the few cases of yaws which I saw in Africa, in 
1817, agreed with the early accounts of syphilis as prevalent in 
Europe in the 15th and lGth centuries; not only as respected 
the character aud severity of the distemper, but also as regarded 
the inodes of its communication and the treatment of it found 
most beneficial. That the yaws iu Africa is identical with the 
yaws or pian of the West Indies, is also undoubted; and it is 
most probable that the identity existed before the discovery of 
America.” 
A comparison between the symptoms of syphilis aud yaws 
will at once establish some important distinctions. 
Whilst it is true that the yaws will affect the cartilages of the 
nose and palate, like syphilis, on the other hand, in primary 
syphilis neither eruptions nor fungi appear, as in the yaws, ex- 
cept in the pudenda, and then only iu the form of warts. 
Syphilis will never cease spontaneously like the yaws. Persons 
suffering from the yaws may contract syphilis, and the latter 
disease cannot be cured until the yaws begin to decline. 
The febrile symptoms in yaws are more marked than iu syphi- 
lis, aud the progress of the disease depends largely upon the 
state of the constitution, habits and diet of the patient. 
The period of iucubation after inoculation varies in the two 
diseases; in the case of yaws it varies from seven to ten weeks. 
The eruptions or cutaneous manifestations in yaws are wholly 
different from those of syphilis. 
Leprosy in the West Indies. 
That leprosy was introduced into the West Indies from Africa 
and the south of Europe at an early day, is evident from the 
statements of various authors. Thus Dr. Hans Sloane, whose 
observations were commenced in 1687, in the Island of Jamaica, 
records a case which he regarded as the Lepra Graicorum, and 1878] 
Jones—Observations on the African Yaws, etc. 
687 
also describes the indigenous plants which were supposed to be 
useful in the treatment of this disease. 
Dr. James Grainger, in his aEssay on the more common West 
India Diseases,” published in Edinburgh, 1802, says that although 
the white people in the West Indies are not exempted from this 
dreadful calamity, the negroes are most subject thereto. “I 
could write a great deal upon this disorder, and but little to the 
purpose. Like the gout, it is the disgrace ot art. I am doubtful 
whether it be infectious or not. The children of infected parents 
are not always seized with the leprosy, and I have known the 
wives of the leprous remain free from it for years. It is, how- 
ever, the part of prudence to remove the distempered from the 
sound. * * I once saw a negro man whose wrool grew white, 
and whose skin put on a farinaceous appearance. He was a 
hideous spectacle. His appetite was gone.” 
Dr. William Hillary states that the leprosy of the Arabians 
was first brought to the West Indies by the negroes from Africa, 
and “is undoubtedly a native of that quarter of the world and 
Arabia, and is not originally of the western part of it; neither 
was it ever known here before it was brought hither by the 
negroes, among whom it is now too frequeut here, and has made 
its way into several famdies of the white people also; and it is 
much to be feared that it will spread further in this warm climate, 
into many more both white and black families, if the legislative 
power do not interfere, and endeavor to prevent its spreading 
by some suitable, wise and effectual laws, as we see the Freuch 
and Spaniards have done.* 
Notes on the History of Leprosy in the Southern 
States. 
The earliest description of leprosy in these Southern States, 
drawn from direct observations, appears to be that given by 
Captain Bernard Romans, in his rare and valuable “Concise 
Natural History of East and West Florida;” printed in New York 
in 1776. 
The account given by Bernard Romans ot the diseases of the 
negroes in western Florida, shortly after its passage into the 
* A Treatise on such Diseases as are most frequent in or are peculiar to the 
West India Islands, or the Torrid Zone. 688 
Original Communications. 
[Mar. 
Lands of the English, and which without doubt also applied to 
Louisiana, under the French and Spanish, is much more circum- 
stantial and important than that of Du Pratz. Bernard Romans 
says that the chronic diseases amongst the blacks were leprosy, 
elephantiasis, and body yaios, called in Carolina the lame dis- 
temper. 
The following description of elephantiasis and leprosy, as they 
prevailed in Florida more than a century ago, as given by this 
writer and accurate observer, will enable us to understand why, 
about the same time, there should have been any necessity for 
the foundation of a hospital for lepers near New Orleans. 
“A loathsome disease appears sometimes among the negroes 
after severe acute disorders, especially if the patient has been 
obliged to keep his bed long, likewise after a violent exercise 
has brought on a surfeit: this is called the elephantiasis, from 
the swelling of the feet and legs. It is most frequently seen to 
affect one leg only. In the first stages of this disorder the 
patient becomes wretched through excessive lassitudes, which 
bring on an emaciation of the body, then the corrupted juices 
subside into the leg or legs and feet, there swell; the skin be- 
coming distended, shines and shows the distended veins every- 
where below the knee; now the skin by degrees loses its gloss, 
and becomes unequal and sometimes scaly. After this chaps 
make their appearance, the glands are stretched, and the scales 
are daily enlarged, appearing as hard and callous as the hide of 
an alligator, notwithstanding which, the slightest prick with a 
pointed instrument will cause the blood to exude. This disease 
affects neither the appetite nor the digestive powers of the body; 
on the contrary, the patient in this and cheerfulness of spirits 
resembles the healthiest of men, and the inconvenience of his 
heavy leg only prevents his ability for the more laborious part 
of his duty. 
“No manner of cure has yet been found for this cruel disorder, 
but the patients often live to a very advanced age under the 
pressure of its yoke, even when it has been contracted in early 
youth. It is said that the amputation ot the affected limbs is 
no cure, for the disease will immediately attack the souud leg; 
this I find also affirmed by Hughes, in his Natural History of 
Barbadoes. * * * 
“The leprosy, so-called, whether the same as was the cause of 
proscription to the unhappy patients under the Mosaic laws, I 1878] 
Jones—Observations on the African Yaws, etc. 
689 
shall not pretend to determine. Certain it is, that it is a nau- 
seous, loathsome and infectious disease, sometimes seen among 
the blacks. This appears first with the loss of beard and hair 
from the eyebrows, swelling of the lobes of the ears; the face 
begins to shine, and brown protuberauces appear thereon; the 
lips and nose swell to a monstrous size, the fingers and toes will 
in the end drop off, and the body becomes at last so ulcerated as 
to make the poor incurable patient really a miserable object of 
pity.”* 
Establishment of a Hospital for Lepers in New Or- 
leans, in 1785. 
One of the first measures of Miro’s administration, which suc- 
ceeded that of Galvez, in 1785, was one of a most remarkable 
character iu its purpose, namely, the foundation of a hospital for 
lepers. 
Judge Martin says: ‘‘There being a number of persons in the 
Province afflicted with leprosy, the Cabildo erected an hospital 
for their reception, in the rear of the city, on a ridge of high 
land, between it and the Bayou St. John, which is probably the 
ridge anciently separating the waters of the Mississippi from 
those of Lake Pontehartrain.”t 
The account given by the historian GayarreJ is more detailed 
and circumstantial, and is as follows : 
“It is remarkable that leprosy, which is now so rare a disease, 
was then not an uncommon affection in Louisiana. Those who 
were attacked with this loathsome infirmity generally congre- 
gated about New Orleans, where they obtained more abundant 
alms than in any other part of the colony. They naturally were 
objects of disgust and fear, and the unrestrained intercourse 
which they were permitted to have with the rest of the popula- 
tion was calculated to propagate the distemper. Ulloa had 
attempted to stop this evil, by confining some of the lepers at 
the Balize, but this measure had created great discontent, and 
had been abandoned. Miro now determined to act with more 
* Concise Natural History ot East and West Florida, etc., by Captain Bernard 
Bomans, 1776, pp. 255-257. 
f The History of Louisiana from the Earliest Period, by Francois Xavier Mar- 
tin, vol. ii., p. 75. 
I History of Louisiana: Spanish Domination, pp. 166-167. 690 
Original Communications. 
fMar. 
efficacy in this matter, and in his recommendation, the Cabildo 
or Council caused a hospital to be erected, for the reception of 
these unfortunate beings, in the rear of the city, on a ridge of 
laud lying between the river Mississippi and Bayou St. John. 
The ground they occupied was long known and distinguished 
under the appellation of La terre des Lcpreux, or Lepers' Land. 
In the course of a few years the number of these patients gradu- 
ally diminished, either by death or transportation, the disease 
disappeared almost entirely, the hospital went into decay, and 
Lepers’ Land remained for a considerable length of time a wild- 
looking spot, covered with brambles, briars, woods, and a luxu- 
rious growth of palmettoes. It is in our day a part of Suburb 
Treme, and is embellished with houses and all the appliances of 
civilization.” 
I possess no data by which to determine the precise nature of 
the leprosy of Louisiana, during the days of the French and 
Spanish domination; but it may with reason be supposed that 
several affections were confounded with the leprosy of the ancient 
Egyptians, Hebrews and Greeks, such as constitutional syphilis, 
elephantiasis and the yaws of Africa. Some twenty five years 
ago, I observed upon the cotton and.sugar and rice plantations 
on the coast of Georgia, amongst the surviving natives of Africa 
imported upon the slavers 01 former times, two cases of yaws 
and one case of leprosy; also a case closely resembling leprosy 
in the white race. In Louisiana I have observed two cases of 
yaws in negroes born in the State, and the case in which the 
patient was a native of Africa; three cases of elephantiasis 
amongst the native whites, one case in a native of Austria, one 
case in a native of China. In the case of a white woman, a 
native of New Orleans, the entire face and much of the trunk 
and the upper and lower extremities, were disfigured by the 
nodular hypertrophy of the skin. 
Four cases of leprosy have come under my observation in Loui- 
siana. 
In 1872, a case was brought from Vermillion Parish, for the 
purpose of obtaining my medical advice and treatment. Upon 
examination, I concluded that the case was one of leprosy. I 
lost sight of this case up to the present month (October, 1877), 
when the following information was furnished by Dr. W. G. 
Kibbe, of Abbeville, Vermillion Parish, Louisiana. 1878] 
Jones—Observations on the African Yaws, etc. 
691 
Prof. Joseph Jones, N. 0.: 
Dear Sir—I have been requested by Dr. W. D. White aud Dr. 
R. Segrera, of Abbeville, Vermillion Parish, to present the follow- 
ing facts with reference to certain cases of leprosy. I am in- 
formed by Drs. White and Segrera that one of these cases, 
Felicien Ourblanc, visited New Orleans in 1872, for the purpose 
of obtaining your medical opinion aud advice as to treatment. 
I am informed that your former student, Mr. Isaac Wise, of 
Abbeville, Vermillion Parish, accompanied this patient to your 
office. 
After a careful examination you pronounced the case one of 
leprosy. I have seen several of the cases, and was consulted 
by Joseph Dreuet, 5th case. 
You will oblige Drs. White and Segrera, as well as myself, by 
giving us all the facts in your possession upon the history of this 
disease aud relative diseases in the Southern States. 
Respectfully, yours, 
W. G. Kibbe. 
New Orleans, Oct. 12th, 1877. 
Leprosy in Vermillion Parish, Louisiana. 
The first case was an old lady, Mdm. Ourblanc. She was the 
daughter of Drouet (who came from the soutli of France many 
years ago). In 18CC or 7 she showed symptoms of disease; there 
was no physician called iu. Her husband being a native of and 
raised in France, seemed familiar with the disease and recog- 
nized it to be that of leprosy, and it was useless to have her 
treated, as it was incurable. From the time of its appearance 
in his wife Ourblanc separated himself from her, fearing conta- 
gion. During the year 1870 she died, I am told from exhaustion, 
as there was extensive ulceration. She raised four sons and two 
daughters. One of the daughters died during the late war, from 
an acute disease; was grown and married at time of her death. 
The second daughter is living in Vermillion Parish, aud is re- 
ported to have leprosy, but I have no positive proof of its cor- 
rectness. 
The next case was Felicien, second son of Mdm. Ourblanc, 692 
Original Communications. 
[Mar. 
aged about 22 years when it made its appearance in 1871. He 
was clerking in a dry goods store in Abbeville at the time, and 
remained there about the year after, when he came to New Or- 
leans to be examined by Prof. Joseph Jones, who pronounced 
the disease leprosy. Soon after this he went to New York to be 
treated, and then to the Hot Springs in Arkansas; from there 
he went to Shreveport, La., and engaged in business, and is 
there at present, still suffering from the disease. 
The third and fourth cases appeared near the same time about 
1872, in the oldest sou, Denanceux, aged about 30 years, and the 
youngest son, Pierre, aged about 18 years at time of its appear- 
ance. In the case of Denanceux, the disease seems to be run- 
ning its course more rapidly than in the others. He is unable 
to do any kind of work, and much reduced in flesh and strength, 
is completely disfigured, scarcely looking like a human being, 
his beard, eyebrows and eyelashes having all fallen out, and hair 
is growing very thin on his head. Dr. Young, of Abbeville, in- 
forms me that there is complete anaesthesia of face, and hands 
and toes are in state of ulceration; he also tells me the first thing 
he observed in all the cases he saw, was a bright red spot on 
forehead. The above four cases originated in the town of Abbe- 
ville. 
The fifth case is that of Joseph Drouet, aged about 35 years, 
aud lives about eight miles from Abbeville. He is the son of 
Baptiste Drouet, who was a brother of Mdm. Ourblanc. He 
applied to me, during the summer of 1877, to be treated. He 
states he first noticed the disease in 1875; a small red spot on 
his face first attracted his attention. When I saw him, the red- 
ness was general over the face aud slightly purpled; there were 
several large red spots on chest aud a few yellow spots, and 
large dark brown spot on inner side of thigh extending nearly 
to knee; he said it had been bright red and gradually turned 
dark. His general health did not seem to be much impaired; 
his eyebrows had become very white, also lashes He has a wife 
aud five small children. As I was not practising I declined 
treating the case. 
Case six was Mdm. Albert Guedry, daughter of a Dubois 
who is of French descent, but as far as I have learned, is not 
related to the Ourblancs or Drouets. She has two children, 
and I am told the disease is making rapid progress. She was 1878] 
Jones— Observations on the African Yaws, etc. 
693 
married, I think, in 1873, and Dr. Young informs me, had the 
disease at the time. She is supposed to have contracted the 
disease from nursing Mdm. Ourblanc during her last illness. 
This young girl was the only one who would remain constantly 
with her, except an old negro woman who attended to the room. 
The old negro woman says the young girl would frequently lie 
on the bed occupied by Mdm. Ourblanc. 
Seventh case is of more recent occurrence. It is a young man 
by the name of Clemens, aged about 20 years, lives a few miles 
west from Abbeville, and is said not to be related to either of 
the families just named, and is suspected to have contracted the 
disease by contagion. In 1875, Pierre Ourblanc was peddling 
through the parish, and would frequently stop over night at the 
house where this young man was stayiug, and they slept in same 
bed. In 1877 the young man applied to a physician to be exa- 
mined and treated; the disease was recognized at once as leprosy. 
There are several other cases reported to be in the parish, but 
there is not sufficient evidence to justify me in stating the cases 
to be leprosy. The husband of the old lady who died of leprosy 
is now living in Abbeville, apparently in fine health. 
The description of the preceding cases by Dr. Kibbe corres- 
ponds with my own observations on this disease in Louisiana, 
which presented in well marked cases discoloration of the skin, 
dusky red or livid tubercles of various sizes on the face, ears and 
extremities; thickening or rugous state of the skin, a diminution 
ot its sensibility, and falling off of the hair, excepting that of the 
scalp; hoarse nasal or lost voice; ozoena; loul stinking breath; 
loss of mobility in the fingers and toes; ulceration of the surface, 
and especially about the joints of the toes and fingers; extreme 
fetor; difficult respiration; swelling of the fingers and toes, with 
fissures on the integuments; muscular atrophy; the face and 
countenance so disfigured with trferous knots as to appear de- 
formed and horrid, like that of a satyr or lion. 
The disease, as at present existing in Louisiana, demands care- 
ful investigation and isolation, and if it continues to spread, the 
power of the State Government, by legislative enactment, should 
be invoked for the legal insulation of restrictive and sanitary 
measures. 
495 St. Charles street, New Orleans, La.