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saw—flat and shallow, there is no fall by which the soil can reach the sea without being washed down. Such were the causes to which I attribute this sickness. E. The mortality is easily accounted for. In proportion to the number of cases it is not large. As will be seen by the accompanying diagram, there were 384 cases of sickness registered. This is not inclusive of many cases occurring during the first fortnight of the voyage, as I was told that only cases of sickness requiring admission to hospital were to be recorded. I found, however, that the amount of sickness became so alarming that it was necessary to keep an accurate record of all cases, slight and severe. Not that I put down every person who applied for an aperient, but every case requiring a prescription has been registered since the 16th of November. Now, there have been sixteen deaths, being at the rate of 41G per cent, of the registered cases of sickness. Considering the nature of the epidemics, and the extreme difficulties under which a physician on board an emigrant ship labours as to the treatment of cases, the want of skilled nursiug, the want of proper food, and the continual movement and noises of the ship depriving the sick of rest, my only wonder is that so many have recovered. I must take upon myself to say that it has only been by an amount of constant attendance, day and night, which has nearly killed me. I have worked pretty hard during most of my professional life, but never as I have done during this voyage. I made a point of visiting bad cases always once or twice during the night, thus keeping the night-nurses on the gui vive. As to the particular cases, two of the children who were suffering from tuberculosis would probably have died at home. The mother of one of them was in an advanced state of consumption when, she embarked, and was suckling an infant of four months. I urged her to wean the infant, telling her that if she did not she would kill both the child and herself. She obstinately refused until she was reduced to death's door, when she weaned the infant, who caught the prevailing epidemic, and died of it. She has only been kept alive by the greatest care through three attacks of tubercular enteritis, and a constantly advancing tubercular disease of the lunga. She is just alive, and that is all. Another child (Mockfird) was, the mother states, declared to be consumptive by the doctor who attended it before embarkation. It was saturated with tubercle. Of the seven typhoid cases, a mortality of 123 per cent, on the 57 cases of fever among the emigrants, two would probably have died if treated on shore. One of these, Alfred Evans, came from a consumptive family ; he was attacked in the course of the disease by double pneumonia, which proved fatal. Evcn'on shore, if his life had been prolonged a few weeks, cheesy degeneration of the effused matter would in all probability have taken place, and he would have died, as so many do, of pulmonary phthisis, after typhoid fever. The other was a man who had suffered from frequent epileptic seizures before embarkation. He was attacked several times during the fever with cpileptiform seizures, and died in one of them. On post-mortem examination the brain and its membranes were found highly congested ; the arachnoid was scmi-opaquo, and a large quantity of serum effused beneath it and in the ventricles. The choroid plexuses were gorged with blood. The rest of the body was not examined as I was very ill at the time. The remaining cases proved fatal from the rolling and movement of the ship, and the want of proper food, &c. jf' 7. Preventive and Itemcdial Measures ialcen. —As soon as the epidemic of typhoid declared itself, the bedding was ordered to be taken on deck every day when the weather would permit, and the people were encouraged to wash their clothes every day. The berths and deck were all washed over with disinfecting fluid once a week, and disinfecting powder (carbolate of lime) sprinkled all over the decks every day. Special measures of disinfection were also taken as often as our stock would admit, such as fumigating with the vapours of carbolic acid, and generating chlorine gas in the compartment by the action of acids on chloride of lime. I was unable to use disinfectants as largely as I could have wished, on account of the smallness of the stock. They had been largely used during the first part of the voyage on account of the diarrhoea, and I was afraid of running short for the hospitals and waterclosets. For this reason mainly, when tho captain informed mo that he was short of coals and water, and would probably have to put in at the Cape for them, I wrote to him officially, strongly urging him to do so, in order to procure additional medical comforts, which were nearly exhausted : medicines, of many of which wo were quite out; and a large supply of disinfectants. We obtained 500 lbs. of chloride of lime and several gallons of carbolic acid at tho Cape. Tho former, however, disappointed me. Most of the jars were wet and very feeble indeed. Tho carbolic acid was, as long as it lasted, daily sprinkled under all the berths by means of a largo syringe, and the tables, forms, and decks were washed with the chloride. Basins full of the latter were kept constantly in tho hospital, and tho gas was frequently generated during the day by the addition of a little acid. By these means the spread of the disease has been greatly checked. A few days after leaving the Capo there was a large outbreak of fever, all of which had been in a state of incubation before we reached tho Cape; yet when the disinfectants had had lime to act, the next batch of cases was very much smaller, and only four required admission to hospital. Since then we have had no more except to-day,* when there aro two cases of which the diagnosis is at present doubtful. As soon as I had arrived at an absolute diagnosis in the first case of typhoid —John Chandler, — a caso which was certainly marked at first by the occurrence of a measles rash, there being measles at tho time among the single men, he was placed under a tent in the forecastle, both for the purpose of isolation and of giving kiin purer air than ho could have in the 'tween decks. The other cases, as they occurred, were placed with him. As the weather became rougher, it wan necessary to move tho tent to the roof of the house amidships in which the petty officers live. This, though not so good a situation as the forecastle, answered very well so long as the weather was fine and warm, and the number of cases in the tent did not exceed five. Of the first eleven cases only t>ne died —Alfred Evans, whom I have before alluded to. 1 never saw typhoid cases go on so well. None of their temperatures exceeded 40 Cent., and only rarely did they reach beyond 896 at night. When one of the single girls was attacked (L7th February), I asked the captain to rig out one of the boats as a tent for her. The case went on very well indeed, though the fever was a severe one, and the temperature for many days reached 40 C. in the mornings. Nevertheless she recovered without a bad symptom. * Written on tlu draft cm the 14th. I.S. 16th. The diagnosis il now confirmed as that Oi t/phoid. 10—D. 1.