To the Editor:—
Dr. Howard Fox's article on "Yaws, Cutaneous Leishmaniasis and Pinta" (The Journal, Oct. 23, 1943) contained a few statements which I do not think should go unchallenged, especially as it was stated in a footnote that he will be writing on this subject in a book to be published shortly.
The macular eruption mentioned as nearly always absent in yaws is the earliest of the second stage lesions to appear in a typical case of yaws. It appears on the average three to four weeks after the primary lesion and not infrequently.
The statement "... in the early stages the disease may be permanently cured by three successive injections of neoarsphenamine, though much more treatment is required in the late stage" is misleading. Cure is not effected in a percentage of early cases treated with four to six injections of either neoarsphenamine or bismuth salicylate. I