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Syphilis. —This disease is very common amongst the natives. I saw a great many cases of it, both in the secondary and tertiary stages. When it attacks a native it appears to be excessively virulent, which would indicate that syphilis had only been recently introduced—by recently I mean within the last hundred and fifty years. Syphilis was probably introduced into the South Sea Islands by the people engaged in the various navigating expeditions, and also by those engaged in trading in more modern times. M. Nollin, surgeon of the frigate " Boussole," commanded by La Perouse, when he visited the islands of the South Pacific, stated that syphilis was prevalent prior to the arrival of the Europeans. If this had been the case, Ido not think that one would come across cases, as one does nowadays in the islands, in which the symptoms are so severe. The longer a people have been under the influence of a specific poison like that of syphilis the less severe will be the symptoms when they are attacked by it; and conversely, the shorter the time and the less diffused the poison has become amongst them so much more grave will be the symptoms. Syphilis is no doubt one of the causes which predispose to phthisis, which is so common amongst the natives of Earotonga, and of which we shall speak later. Abortions are common in the islands, and to a large extent may be accounted for by the syphilitic condition of the mothers. I saw only one case of inherited syphilis (this one a case of pemphigus infantilis, which I haye alluded to under the heading of skin-diseases), but this would be explained possibly by the virulence of the complaint, which destroys the foetus in the uterus, few syphilitic children being born alive, and then probably only born to live a few weeks. Gonorrhoea appears to be common amongst the natives. They have their own remedies for it, which, according to them, are most efficacious, and so that those cases which I came across were only those which occurred in people suffering from some other complaint. I think that long-stand-ing neglected gonorrhoea (in the females), combined with a too early, frequent, and promiscuous intercourse of the sexes, will go a long way to explain the low birth-rate of the native population. lam indebted to Mr. P. J. Moss, the British Eesident at Earotonga, for the following figures: In 1892 the birth-rate for the Cook Islands was 175, and the population was between 6,000 and 7,000, so, taking 6,750 as the population, we have a birth-rate of 25-92 per thousand. In 1885 the birthrate in England and Wales was equal to 32-5 per thousand. Group B. — Animal Parasitic Affections. Worms. —I met one case of hydatid disease of the liver, and sub-peroniteal tissue in a native named Taukuru, which ended fatally. The man had been some time in New Zealand on a station, and it was shortly after leaving New Zealand that he first noticed the swelling in the region of the liver, and also to the right side and slightly above the umbilicus. Tania solium. —l did not meet with any one suffering from tape-worm (Tania solium). Ascaris lumbricoides, the common round worm, is very prevalent amongst the children. Alcoholism. —Drunkenness, thanks to the legislation of the island, is reduced to a minimum, intoxicating liquors being only obtainable at intervals of a week, and in moderate quantities, on the presentation to the excise officer of a written order signed by some responsible person. They can, however, become more or less inebriated by drinking orange-beer, a mild intoxicant which the natives themselves brew. The drinking of kava is unknown in the island. Group D. Rheumatism. —I met with numerous cases of this amongst the older people; but I was surprised not to meet with more cases than I did when one considers how much of their time the people spend in the water, either bathing or fishing. I should consider the climate of Earotonga one which would prove beneficial to any one suffering from rheumatic affections. Gout. — Unknown amongst the natives. Scrofula is common, as one would expect amongst a people with whom tubercular disease is so prevalent. It shows itself chiefly in enlargement and suppuration of the lymphatic glands, abscesses, and osteitis and caries of the bones. One case which occurred in a young married woman, in which there was extreme ulceration of the skin of the right foot and ankle, with caries and necrosis of three of the metatarsal bones of the same foot, old ulceration in the popliteal space and contraction of the ham-string tendons on that side following synovitis of the knee-joint, necessitated amputation of the right foot above the diseased skin. The patient prior to the operation was in a weak and miserable condition, but rapidly improved both in health and spirits after the amputation. At the time when we left Earotonga, nearly a month after the amputation was performed, she was doing well, and had regained her health very considerably. Local Diseases. Diseases of the Nervous System and Organs of the Special Senses. It has been said that the lower nations are in the scale of education and civilisation the less the frequency of insanity amongst them, a statement which is supported by the testimony of all those who have been brought in contact with savages and uncivilised or semi-civilised people, the reason for which is not far to seek. Man in his primitive condition suffers from none of the anxieties and worries inseparable from the life of man in a civilised country, where the struggle' for existence is carried on not with the hand but with the head. Primitive man leads a life only a little removed from that of the lower animals, and consequently his brain, only partially developed, and incapable of any great mental effort, is never unduly taxed, and therefore runs no risk of giving way under too great a strain. I saw no case of insanity on the island, nor did I hear of one. Idiocy, which arises from a different cause to insanity, is occasionally met with, but it is very rare. I met with one case of deaf-and-dumbness in a boy aged about twelve years. Neuralgia is a complaint the natives suffer from, but only to a small extent.