H.—3l

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No records have been kept at the Hospital. (2.) Typhoid : There have been no oases of typhoid amongst the Natives, but one or two oases have occurred in an English family, probably due to the coffee-refuse which was allowed to drain into the well. (3.) Dysentery is more or less common in certain seasons of the year, due probably to the food. (4.) Erysipelas has occurred in isolated cases. (5.) Two or three have died from tetanus. (6.) Rheumatism is quite common. (7.) Worms of the Ascaris lumbricoides are to be met with, (8) but the Twnia solium I did not see. (9.) Tuberculosis, the great white plague, though not alarming, is to be feared, for I saw many cases. It is more or less the product of civilisation. When the Natives lived naturally, wearing little or no clothes, they were numerous, but when false modesty and clothes were introduced consumption became rife. The souls were perhaps redeemed by the deaths of the bodies. The changing of a nation's habits is a grave responsibility. Shelter-sheds on some mountain-peak will have to be erected some day, and segregation of the afflicted ones attempted if we are going to do any good. Perhaps the reason why tuberculosis is not any worse than it is is because the Natives live a great deal out of doors. (10.) I saw only one idiot, and heard of one case of (11) lunacy. (12.) Neuralgia is as common as amongst white races. (13.) Considering the number of syphilitics, I was astonished to find no cases of tabes dosalis, whereas fully 70 per cent, of locomotor-ataxic cases in Europeans are due to syphilis. (14.) While at Rakahanga and Manihiki I came across five cases of myelitis, due to the after-effect of what was probably a severe attack of la grippe. (15.) A case of partial paralysis, due to a gumma on the brain, was interesting, owing to the fact that it was the only nerve case I saw that was directly due to syphilis. Eye : (16) I came across only two cases of cataracts ; conjunctivitis was common, probably due to the extreme heat, and light from the white sand, and diving ; (17) there were several esophorics and exophorics, several cases of stoppage of tKe lachrymal duct, and one case of iritis and corneaitis. (18.) Heartdiseases are rare, though I saw two or three cases, and a number of varicose conditions. (19.) Eardiseases are also common : I saw several cases of otitis media. Pulmonary Cases : (20) Bronchial asthma and (21) pleurisy are quite plentiful; (22) I saw two tubular pneumonias. (23.) Dyspepsia is rare, and what sufferers I saw were hypopeptics. (24.) Elephantiasis is to be seen at Rarotonga and Aitutaki, but principally at the latter place ; it is not bad in the other islands. Wherever there are large taro-plantations we have it most plentifully. (25.) I came across the following skin-diseases : Pemphigas, pemphigas eonatorum, scleroderma, lupus vulgaris, eczema, and psoriasis. (26.) There were a terrible lot of menstrual irregularities, due probably to specific causes. SyphUlis and^Gonorrhcea. These two diseases are in reality the true cause of the majority of deaths occurring in these Islands. Ever since the whaling-days the white man has left the Natives of these fair isles a legacy of disease and death, and one would almost think that time would establish a certain amount of immunity. Perhaps it has, but a rich harvest is annually reaped from this source alone. I dread these two diseases tenfold more than consumption and a hundred times more than leprosy. We have at least some knowledge of the consumptive, and an absolute control of the unfortunate leper, but the syphilitic is allowed to sow the seeds of his loathsome disease broadcast. And what is the result ? Death—death to the unfortunate woman confiding in him, death to the children, and death to the race. lam positive that gonorrheal infection and syphilis play the leading role in producing sterility amongst the women and death amongst all. There is a foreign island not far from Rarotonga to which many of her sons go as labourers. Well, that island is one hotbed of disease, and not a steamer retarns but some of these men come back fully diseased. I would suggest, sir, though I know the aesthetic taste oi some will rebel against the suggestion, yet, in the interest of humanity and of the unborn Rarotongans, I urge that all people landing in these Islands should be examined, when practicable, before being allowed to land. This is done at Tonga : why not here ? If we are in earnest, and intend to save this glorious race, then this is one of the first things to be done. The percentage of diseases directly and indirectly due to syphilis and gonorrhoeal infection is astounding : why, in one place alone, out of forty cases which I saw, fourteen were syphilitics. | ! Leprosy. The alarming reports which were circulated some time ago re the spread of this malady were entirely unfounded. I tcok particular care to make a thorough examination, and but for a few suggestions nothing more could be done than was being done by the Federal Government. The history of leprosy in the Cook Group is a very interesting one. Perhaps I had better deal with it as I saw the cases. I heard at Rarotonga of a case isolated at Palmerston Island, and so upon arrival there I took a guide and proceeded to the isolated camp, and I found a boy nine years of age. Case A.—Father died of heart-disease and mother of childbirth. Never been away from island. Has sister at Penrhyn with leprosy. Sister was said to have developed disease through eating lice from adopted mother, who had leprosy. Boy never came in contact with sister. Mother went to nurse her daughter in the leper island, and a doctor from a British man-of-war declared her free from leprosy years afterwards. The father isolated the son because he thought the boy was suffering from leprosy. It appears that at about this time a steamer called at Palmerston from which some old clothes were bought. The buyer of the clothes got the itch, and from him it spread to nearly every one on the island—amongst them the patient. The father, who had been at Penrhyn amongst the lepers, immediately isolated him, chinking it was leprosy. The boy was isolated at seven years of age with a real leper from Penrhyn. For a long weary year they lived together and then the real leper died and the boy buried him, at the same time accidentally, perhaps providentially, setting fire to their whare. The people then built