The main point in prophylaxis is to prevent flies from having access to abrasions on the skin, so that all cuts or sores should be protected by dressings. The sound skin is a barrier to infection.
Treatment.—It can certainly be stated that in salvarsan we have an absolute specific for yaws, the results which obtain in a few days being almost miraculous when one considers the protracted normal course of the disease.
The drug is given intravenously although neosalvarsan intramuscularly is more convenient for those not prepared to give intravenous injections.
The methods of administration are exactly as for the treatment of syphilis. The drug gives best results when used early in the course of the disease.
Doses of 0.4 gram of salvarsan usually suffice and frequently one dose effects a cure. The dose for women, children and thin individuals should be less than for strong adult men. Atoxyl does not seem to be effective in yaws. In other words the methods of treatment are the same for the two treponemata, except that the effect of salvarsan may be termed specific for yaws and less so for syphilis. Bergen found that about 4% of cases treated with salvarsan or neosalvarsan relapsed. The average time to effect a cure was eleven days.
Many of the older writers have reported the value of mercury in the treatment of yaws but the present view is that this drug has very little if any place in the therapy of the disease. Potassium iodide does seem to be a very useful drug in the absence of opportunity for obtaining some arsphenamine product. Where the specific remedy cannot be secured the next best treatment is Castellani’s yaws mixture. The formula for the preparation is the following:
| Tartar emetic | one grain | (0.06 gm.) |
| Potassium iodide | twenty grains | (1.3 gms.) |
| Sodium salicylate | ten grains | (0.6 gm.) |
| Sodium bicarbonate | fifteen grains | (1 gm.) |
| Chloroform water and syrup | one ounce | (30 cc.) |
The above is a single dose and it is given well diluted about three times daily. This treatment is continued for about a week and after an interval of another week is resumed according to the response to such treatment. In children between seven and fifteen years the dose is reduced one-half and for younger children correspondingly. It would seem well to start treatment with a smaller dosage than the standard one, being guided by the ability of the patient to stand an increase in the dose of the drugs.
For local treatment use antiseptic dusting powders as iodoform or boric acid.