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This is a monograph of about sixty pages profusely illustrated, covering the author's personal experience with this disease, known as parangi in Ceylon. Observations on variations and commutations of individual lesions are given, illustrated by photographs and sketches. The author does not doubt the existence of tertiary manifestations of yaws. He admits that tertiary parangi closely simulates tertiary syphilis, and he gives a summary of pathologic characters. As tertiary yaw lesions, Spittel includes localized gumma or nodes of the bones; periostitis and osteitis; gumma of the soft parts; nodular cutaneous gumma; juxta-articular nodules; tertiary erythema (rare), joint, fascial, tendon, bursa, lymphatic gland involvements and leukoderma. Nervous symptoms have never been noticed, if indefinite findings such as headache, backache and pain in the calves may be excluded. Minor changes in the spinal fluid have been found, but this work has only been begun. Congenital parangi never exists. Treatment with arsphenamin is
FRAMBOESIA TROPICA (PARANGI OF CEYLON). Arch Derm Syphilol. 1923;8(2):319. doi:10.1001/archderm.1923.02360140156011
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