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Tous les autres exemplaires originaux sont filmAs en commenpant par la premiere page qui comporte une empreinte d'impression ou d'illustration et en terminant par la dernidre page qui comporte une telle empreinte. Un des symboles suivants apparattra sur la derniAre image de cheque microfiche, selon le cas: le symbole — ^ signifie "A SUIVRE ", le symbole V signifie "FIN ". Les cartes, planches, tableaux, etc., peuvent dtre filmAs d des taux de reduction diffArents. Lorsque le document est trop grand pour dtre reproduit en un seul clichA. il est fiimd d partir de Tangle supArieur gauche, de gauche d droite, et de haut en bas, en prenant le nombre d'images nAcessaire. Les diagrammes suivants iliustrent la mAthode. 1 2 3 4 5 6 X \j t NOTES ON \ . ( DISEASES AMONG THE INDIANS rUIXiLKNTIN(; YORK FACTORY, HUDSON'S BAY. BY PERCY W. MATHEWS, M.R.C.S.E., M.R.C.P. (Lond.), MEDICAL OFFICER TO THE HUDSON'S BAY COMl'ANV. (Rmdhaforethn Medico- Chirurgical Sooietv nf Montreal, Febnuvv, 1885.) GAZETTE PRINTING COMPANY. 1885. ,1 I f NOTES • IN 7 I > DISHASHS AMONG THH INDIANS KlttXiUlCNTINO YORK FACTORY, HUDSON'S BAY. II Y PERCY W. MATHEWS, M.R.C.S.E., M.R.C.P. (Lond.), MEDICAL ori'ICEU TO THE HUDSON'S HAY COMl'ANY. (Uiidlhifiin llii MiiiifO-('/iin(iii!c"l S'iclili/ III' M'liitriti/, /■'////•(((((•;/, IHS,"),) GAZETTE PRINTING COMPANY. 1885. i i RK-PHrNTRD PltoM rrrK 'TAVArJA MlirurAl. * MClUIH'Ar, JonilNAf.." NOTMS ON DISF.ASKS AMoNfl TIIR INDIANS FHR- (jLENTlNli VUHK bACTCUlV, llUDSOiN'S BAY. Ilv PKIICV VV. MATUHVVS, M !l C.H.E , M.U.O.P. (London), Moiliiiil OtlinT lo t\w lludHoij's May Company. {Ihnil hffnir lh< MriHr'i-riimiroinfilS'mlrtv i,f MmiriaU F>h. 1HH5.) In trcatin^j; of discascvs in tlu; district under conaidoration, it is Iir])(M.sil»k', ovon were it dcsinihlo, within the liniitn of this pajier to touch upon othnr .han thoao whicsh aro most ooiiiinon, and to refer to any niodil'yinf:; or exaLj^cratiii;^ inthiencos wliich endemic circumstances may seem to liave over tlicm. Thorotbro, for the |iur|ioso of cnsurinj^ what 1 deemed to he a fair avera<^e, I have taken account of the last twenty years ('1S»)4-H4), and tlierehy ascertained the death-rate to he 12 per 1,000 of the Indian jx^pulation, which somewhat exceeils 500 ; hut it is neces- sary to explain tluit this refers to re;^i.stered (Ujatlis at York sottkMnent only, as it is for no lon^^er a j eriod than the space of six weeks or possibly two montiis that this population is ^^athcred in and around York, thou;^li it must he roeo;4nized that the [lerioil in (juc.'stion may he (!onsi(h.'re(l the most uuhealtiiy of the whole year — Juu<', July and August. lleucc, during some ten months, tlie [)opul!iiion is reduc^ed possiiiiy hy some -iOO souls ; although, when it is jirac'ticahle, sick Indians aro hrou^ht in to the local hospital at any time of tin' year. iStill, it all deaths in connection with this po[)ulation were taken into consideration, the ratio per thousand, as far as 1 am ahle to ascertain, would I .1 hft ROOM two or throe in cxcom of that already stated . Hoforo (liHiijiaHln;X thn sulijcct of population, it inuy poHnihly he ititficHt- in;^ to tiotf that th<» hirth-nite lor tho last 20 years is '.\.'2 por cent, in excess f»l' thi' (Icath rate, or 1 1 per thousand uotnpared with i'2 pur thousand. I will now proceeil to classify those diseases whieh arc most fatal. Ilroncliitis ;uid pncuuionia (ioine first, rcprt'scnfin;^ Jl.'i per ('(Mit. in the ih';itli rate. Next, tulMM'oular distjuse, ineludiii;; scrofula, tahcs niesenteiica and pulmonary phthisis, M) per cent. Heart diseafle, inctudin;^ rheuuiatisiu, 1(> percent. Infantile convulsions, 10 percent.; and variou» cau.scH, V> por cont. |{efore 1 refer to the first mentioned (hronchitis), it is, I think, desirahle to doacrihe hrielly the positioti and surroundin;^s of York, as indicatin;.; possihlo climatic influence. York is situated on the west hank, five miles from the tnouth of the Hayes, and Home six miles to the oast of the Nelson river, arid is surrounded on tiu' north-west ami south hy maske;^ or swamp, with small tamarac jj;rowth here and there, and is fully exposed to ;;ale8 from ill! tpiarters, hut more parLiculaily the cant — a raw, hitin^ wind swi'cpin,:^ ovei' Hudson's JJay. In the month of April, when the snow 1» ''^ins to melt and stagnant jiools to form, an epidi'mic of catarrli, inlluenza, hroiuihitis, or, certainly, some malarial cachexia will very shortly make itself evident, ;4ivin;^ rise to dyspepsia, diarrhoea or dysentery. When wo considcu" the or;^nn- isms of disease that must evolve from the surroundin;.^ swamp hy docomin)sition of l>oth animal and vi",i;etaMe life, it camiot ho dillicult to realise at least some poisonous principle at work. An«l, a;^ain, later on, when the sun attains almost tropical power, some epidemic of a very serious nature is certain to develop. I may hear this out hy only instancing the month of Au;;ust of 188-5. An epidejnic of capillary, vesicular and acute hronchitis attacked upwards of -OU pco[)le, including one case of acute phthisis and tour of vesicular emphysema ; 10 deaths ensued in less than one mouth —acute phthisis, 1 ; emphyse/na, 1 ; l)ron- chitis. 1-1:. My small lios|)ital could only admit ten patients ; therefore, the majority of these poor Indians were treated in their wigwams, pitched hero and there ou rising ground, the Miin'ouMiiiii;^ v(«){(«t(ition ol it!4elf im'cc itutin;^ a iliuii|i iiinl lu>uti*il eoiich, to Huy notliiii;; of tlio Mciinty |irotoction uHorikMl Ity the imtutc of till' tiMit itHcIf ii;;uiiiMt tlio lu'itvy \\\\U oi' rnin. Tlio only iliHtiiu'tiv' troatni<*nt I adopt \n tlio «»\|>i<'M; uw \1 vhm'h oljiiuMimonia in their scvi'ial ilillrriMit st,i;^0M. ('i'lifro had hooii othn-M wJiicii won* tlwMi convaloHcont ) 'I'ITh may Instaiict" tin* ('|iifloini(! lorni that ilisuast' asMiuncs in a small isolat«'d iiiace liko York. WhtMi tho Hun*oiinilin;:s, mod" of living, and iiattiro of food aro vory much the Ham**, individual susccptihilitifs Hcom to ho done away with, and disoaHo then takes a ^^cnt'rally a;^;^rcssivc oharactor. To hoar out the ('fleet ol' isolation ro;^ardin<; nervous develop- ment, ovoii axe wounds are popularly said to he infectious. When one does occur, it is followed hy many — the whole mind hoin;^ abflorhed in tho contemplating of tho '' comin;; wound," and tho nervousness induced thorohy often consummates tho catastrophe. PhtfiisiH. — (jomin;^ next to pulmonary phthisis, it is a matter of some surprise that phthisis is not more prevalent amon;^ tho In- dians, when one takes into consideration that nothin;^ is wantiii;^ to oxa;^;!;(!rat(! their strumous hahit or devcdop it mor«! ;;enerally as complicateil with scrofula. Within the last six years, I have had three cases only — one acute y)hthisis and two tuhercular phthisis. The first case was that of a woman aj^ed 4U, who lin^^ercd on in the hri^ht and hracin^i; winter, with porfo'-ation and painful dyspiuxia, till the coming spring developed an un- manageahlo diarrhoea and death ensued. The second form, acute phthisis hoing rare, I will hriefly touch upon the outlines of the case referred to. A man aged 50, whose history was phthisical, was admitted to the hospital for scrofulous enlarge- ment of tho knee joint, [Symptoms of phthisis suddenly set in, firofuse sweating and diarrhoea markedly ; tuhercle formed in the lower lohes of hoth lungs, and ra{)idly sjireading upwards, death from exhaustion took place in five weeks. The last case is that nf n woumn n;;ooon xiilUM-iit^ I'rom tuhcrculnr phtliiNirt lor tipwui'iU ol h«'vuii yciuM ; iit titiH'M *)w hiu« ncvoru nttuckn of luDinoptyMiM, taxing n\y utiiKmt uft'ortM (o clicok ; on on6 ooormioti ct)iiunoii rtult wum iNud, iiliiUHt iim u laitt roMoitrco, luid Muccoodud ; i\w Mputu (tontuiiuMl moMt of tlio « tlicn tMM;atiu* pro^niuit, iudI iim hIk* ml- vuiii'ctl ill |ir(>;^iiuii('y mIio iiu|irov(>ll and ubli' to ^»«t uKout. lUd'orf concliidiri;; my remarks on tuttcrclc, I may tiK'ntiun that H(>v<>ral <'as(>s of druth have taken plucc from tuhorculur monin^^itm and tahcs nx'scntrrica. Si'rofii/ti will now he rofi-rrod to hrit^lly. Whatever ponition is tenahle re;:;ardin;; its somewhat dehated cause, assuredly York can houst (save the mark!) of hoth hereditary inlluence and every other excitant, only exceptin;^ syphilis. Diseased nutrition in infancy ; food insulHcicnt in ipiantity, ininitritious in yeais I have noted, and even longer is reported), nasty living, and, in short, every adjunct to the porpetuatini^ of this terrihle hane to hunmnity. The more marked characteristics in the scrofulous Indian hahe are : eyes Homewhat projecting, ohli(|Ue, edges of eyelids everted, lower nearly straight, with considerahle arch of the upper lid, and colorless ; development of alio nasi ; early cutting of teeth and soon I)(!Cuming carious ; later on, forms of strumous dyspepsia tjhow themselves, nnjre or less mudilied ; purulent discharge from the ear and nose ; vesicular eruntion of the head ; enlargement of the glands of the neck and tonsils, and again of the axilhu ; and aphlhic, very connnon. The raising of the temperature in scrofula, with tuhercle, can be thoroughly borne out ut York. The Intlian child, if weaned early, which is exceptional, is fed on uncooked oatmeal and often grease, and very soon partakes of its parents' food. Scrofula, without tubercle, so far as it lofers to glandular swellings, more or loss ulceration -i and indo- lent abscesses, is far from uncommon, and several cases of stru- mous disease of joints have also come under observation during My prtetlef ut York. I tttvc uUihml muvohU Mlvii'>r |ioitti>i'ior ii|iiiml iMirvatiiri*. uihI oiit> iiiro cdto of Aiitorior cMirvntiiro, Hero* fiiloiiM iiiciTH nrv iiU» ii)i>t with, nml arc iiioKt tronltliMonic to tront, the mulii ililTlciihy \>v\un to nvourit cli'iiiiliiioM in ilri»MNHiily |)lii('t> ;;tciit tcliniKM* on roriNtifuti'Miul trciUiiK nt nn luatiMin, inastniich as 1 have only met with two caHUH of oi';;aniu (lirtonMo, huth mitral ; hut ftuictional, cardiac drraiii^tMnent i« vury common, and may pi'ihuMy ho attrihiitrd to many caiMus. In particular, dyHpcpKia and uxcosHivu and continuous walkin;^ and runnin;^ Applicationri arc continually huin;;; mado to mu for " luart mcdiciiu'," which generally conrtiHtrt of Homo simple uthuroal mixtun*. As one caimot hu iit a position to remove thu yxcitiii;^ cause, the ellieacy of tht; treatment us ro^anU tho allay- ing of thu symptomH is somewhat dillieult. Old (t(/f, althou;^h a cause of (U'ath, and can hardly ho classed as a disease, is stddom attained to any ;.;ruat de;^rce uinon;; tho Indians. Within the last twenty years there are four instances, roHpectivoly estimated at 80,H"»,l)0and 100 ; thu lattor I should (jueHtion. When we take into consideration the life the Indian loads, tho hittor winter ami scanty clothing, the continuous exer- cise and precarious food supply, it ciiiuiot he won hours. For treatment, 1 tried calomel and Jalap, iced milk, warm hath, hot hottlo to extremities, sinaj/isms to ahdominal walid^and all sanitary measures that were [iracticablc with such surroundings and with constitutions so vitiated. In the treatment of a disease like this, when its first princi{)les arc undecided, and the subject of much controversy among the highest authorities of the past and present, a disease at whose call the whole pharmaco[)oeia has at one time or another been tried, and which has incontestalily been acknowledged to have no antidote, chance recoveries being accredited to chance " spe- cifics," can it be wondered at that the practitioner soon be- comes involved in a maze of i)erplexity and bewilderment V I wfjuld say, in all humanity, that if our endeavors, while awaiting the result of the philanthro[)ic Pasteur's investigations, were directed to the destruction of the agencies, where practic blc, through which the dread disease ojierates, instead of essaying the extravagant treatment advocated l)y many authorities, that obnoxious word, empiridsnt, would not suggest itself. The blind man at Laporta employed himself in mixing colors for his brother painters. It was acknowledged that he often made mistakes, yet he was much encouraged and esteemed by his brethren of the Grand Academy. r* 9 r? At the tiino of writiii;;, I Imvo scvorni caso« of malarial ly tlRvtrizin;; that the rapidity of the cure will he in proportion to the strength ol the " ruhhiu'C Htnir." EliilepHij i.s a diacase to which the Indiana are peculiarly auh- ject, and when it is realized that lour per cent, of the j)opiilation are afHicted, the statement is warranted. I must note that 50 per cent, of the deaths that take place at York are (tf children under five years of ai^e, and those deaths have almost, without exco])tion, heen of eases who labored under a scrofulous or cpi- loptoid diathesis. To proceed, there were six cases of idiocy at one time (four in two families), two of ej)ilcpiuid convulsions and one of epileptoid insanity. Tht' first case of convulsions was a somewhat strange one. An Indian, aged oO, was attacked by the fit ivith but Utile warnimj. Perfect prostration ensued for about half an hour ; then violent convulsions followed by his seeming to ])ass into a condition of acute mania, then seizing hold of the first thing (on more than one occasion an axe), would rush off to the woods and commence felling trees right and left. Tins individual being a tall, powerful man, was not considered harmless, so he was somewhat expeditiously des- patched to Winnipeg. The next case of convulsions came within my own cognizance. Heavy doses of bromide of potassium (15 to 20 grs. three times within the twenty-iour hours) apparently jjrevented a recurrence. The next case is a remarkable one of e{)ilc[)toid insanity, and the instance of recovery must excuse a somewhat lengthy account of it : — An Indian, aged 20, was sent to me as insane. He was confined to a small l)uilding, erected for a jail, two keepers hav- ing been provided, and everything removed from an inner room of the jail. T examined him, and, possibly from excitement, C[»ilei)toid convulsions set in during my first visit. In the after- noun u[ the same dav T ay;ain v'sited him. and havinii; had some experience with lunatics in the Channel Islands Lunatic Asylum, I did not anticipate much trouble, as he was a slightly built man ; but before the door was bolted he had torn down a shelf and leaped at me. 1 avoided the shelf, as it was a big bit of wood, IS ,4 and tripped liim. I then roali/od that moral suasion would not work, so there and then, thou;ih with dilliculty, I Htrai;i;iit-wai8t- coated a»id nianacled him. After that day he never attempted to attack me, but fur the lirat two months lits were of tre(iucnt, daily occurrence, sometimca several in the day, durin;^ all which time ho was utterly insane. As to treatment, the tincture of Camiahis Indicus, with bromide of potassium, seemed to modify and in some measure control the fits ; and regidar, wholesome food, daily exercise and cleanliness, to^^ether with firm, consistent kind- ness, contributed lar;^ely to his physical improvement. Latterlyhe was taking 15 j^rs. of bromide of potassium (hvily, during which period the fits and ;^eneral excitement decreased ; then he be^^an to appear pleased at seein;^ a visitor, ynd •gradually the raving ;j;ave way to something; approaching intelligible utterance. This went on until the eighth month, when sometimes he talked sen- sit)ly, l)ut again at times wildly. At the beginning of the ninth montii he had expressed a wish " to go to the doctor's house," so he was brought, and the first thing he " felt it right to tell me was that his veins were returned to him," and he was anxious to work. Expressing my pleasure, but with some close watching, I allowed him to try, but he soon gave up, saying that " his bones were all broken." However, with continued care and treatment, he became what he is now — a rational, good, hard- working, and, further, what is strange in an Indian, a thoroughly grateful man. 1 am tully aware that epilepsy with insanity is stated to be incurable. I can only assert that the foregoing is a faithful resume of the case, and that epilepsy with insanity in this case was and is cured. This is a practical argument, as the man has been working for two years without a relapse. Before dismissing epileptic and epileptoid disease as endemic at York, I would lay greater stress on the term endemio than perhaps its casual employment mdicates, basing the rationale of my assertions not only on hereditary influence, consanguineous marriages, excessive sexual intercourse, and other recognized causes generally, but to some considerable extent upon climatic, and thereby miasmatic, influence. For the sake oJ exemplifica- tion, it is necessary to be somewhat discursive. In the first I in be^'an instance, lactic acid was and in ri;^htly presumed to bo the cause of rlieuinatiarn, hocauso its tox(»lo;;iciil t'tlV-ct on the livin;:; animal produces one of the most strikiii;^ complications of rheumatism — endocarditis ; hut it is 0(|ually allowed that climate and surround- in/|?s ;^cnerate the same [loison. A;^ain, with endemic cretinism, the more •generally stated cause is endomic^)r()chocele and con- san^^uinoous marriages, thou;^h miasmatic poisonin;^ is e((ually allowed. Instances could he ;^reatly multiplied, hut hardly 8<» within the scope of unpreten(lin<^ notes. Therefore, takin^f into consideration that some swamps, marshes and jungles produce cholera, some yellow lever, some a;^ue, in malarious districts, tlie (piestion seems to me to devolve itself into one only of suit- able conditions of moisture and temperature. It is, I think, feasible to admit that e|)ilepHy, allowed as it is to result from the poison of rheumatism, scarlet fever, diphtheria, kc, may result from a jjoisonous principle that ])roduces these diseases. Then may not iho brain equally, directly or indirectly, bo influenced by a like poison of a miasmatic nature. In short, if so many diseases can be traced to miasmatic influence, as a direct excit- ing cause, may it not bo recognized as an exciting or exaggerat- ing iniluonce in ojiilepsy, since epilepsy is itself attributed to such varied causes, themselves induced by malarious poisons. Fevers. — It may seem somewhat strange, yet it is most for- tunate, that of late years, beyond symptomatic fevers, this class of disease is almost unknown at Y'ork ; one death only from measles being recorded. Many yi'ars ago typhus i'ever " was landed" by a ship and carried off m;iny of the natives; and a^ain, 18()2-?.>, tliirtv-fivc deaths took place from scarlet fever, introduced originally from Manitolja. ,S/cln Dis-cuses. — II may l)c m^tcd of diseases of the skin, that they have, without exception, a scrofulous diathesis. Enveloped as the Indians are with the dirt of ages, skin diseases seem hardly to have a fair chance of satisfactorily developing ; or such immunity may ])«;ssibly bo attributable to the antiseptic qualities of mother-earth. Were an isolated portion of cuticle to be examine(l at any time, the enterjorising histologist must needs relegate its owner to the order of the pachyderms, and 14 the condition of their foot is certainly sn^^gostivo of that torrihle form of lo[>rosy — HcphatitJaxtH. Not Ion;; since an old Indian was asked wIkmi ho last washed. " Ah ! that was many years a;;(), when 1 was yoiin,L; and foolish," was the atill ro;j;rctful reply. I atn not aware of ilistinotive skin diseases amon;; the Indians, witji the o\cei)tion of, perhaps, one or two, which I will tonch upon, to;j;et}\or with tlie more markiid of those that are met with. A few cases of Kn/ffn'ina and f/rtlaarid are noticed. IIcr/ii'H lah'mlU is very common, it hein;; induced hy the action of the sun and wind, and exposure .i^enerally. Vaaelijie ;;ivos great relief. I have not met with a case of Hhinnlen. Strophxhoi. — The children are piirticulariy subject to a very aggravated foriri of this generally nonsidoi-ed simple " tooth rash," but at York it assumes a distinctive character oi Lichen Scrofulosum^ and is extremely hard to treat. The only form of eczema I have noticed among the Indians is Eczema Mari/hiafnm, a seemingly modified form of Tinea circitinUi^ closely allied to the JJurmese ringworm, occurring about the fork of the legs, near the junction (»f the ihigh and scrotum, and is caused by dirt, heat, friction and moisture. It yields readily to treatment with a solution of bichloride of mer- cury (2 grs. to the ounce of fluid), ov a strong solution of hypo- sulphite of s;)da (r)Vi ad 5vi of fluid), washing well with soap and water |)rcviou8ly. Mai de Jlnquet. — " Snow-shoe sickness " is necessarily com- monly met with at York. In some cases, and where it is neces- sary " to carry on " or continue the journey, I have applied the moxa, Snoii'-bh'.ndness. — The upward reflection from the snow of the strong actinic sunlight of sj)ring soon sets up an inflammatory action of the ojitic nerve. The little intolerance of light and the sense of " sand in the eyes " is most painful. Cooling seda- tive lotions, or warm decoction of jioppy cai)sule.-4, and perfect [jrotection for the eyes is the general treatment. Scurvij is frequently met with among those of the Indians who live in houses. h\ fact, in winter, I may say that almost every disease met with is complicated with the scorbutic taint. 16 Undouhtodly tho saraonossof diet, use of Halt moats, lack of frosh, oxposuro to impure air ami want of mifVicicMit li;;lit oxorlafltmng prodispoHin^ influonco. h\ the more Horious ousos, tlio snlts of potash and iron aro most otlicaci'Mia. Ah anti-scorbutics for dis- tinctive treatment, the cranberry ( Vaciniiium oxi/coaaoH), in- fusion of tho cones of t!.o coniterie j^enerally, Labrador tea (Ledum /(difolluin), the mountain tea, and the dried leaves of tho beautiful little partrid;^o liorry { Miti'liclhi n'pi'ns), are (»m- ployed. The latter is used as a bovera;4e wlien other tea fails. OhfttetricH. — As may well be inia;^ined, amon;^ a fioople but little removed from the 3ava:.',o, obstetrical complication is of somewhat rare occurrence. Within the last 'JO years, and pru- hably for many years [.revious, but three deaths have taken place. One a case of twin delivery (by-the-by, extn^mely raio amonj; the Indians), the other two (the hrst on record) bein;^ puerperal mania and insanity. Puttin;r; aside the fact of this disease being hi.^hly contagious in an isolated place like York, it is hii/hli/ Hympathdimllii infi'dfioun. Impressionable, suficr- stitious, and easily influenced as these Indians are, had circum- stances allowed (notwithstandiTii^ tny precautions as r('j:;ards direct contagion), 1 am (!onvinced that there would have been several cases. En /xiss/int, on" nui-se, who was past child- bearing, was perfectly fascinated, as if by mesmeric influence, and had to be removed and kept away by forc'>, and was com- j>letely demented for over a week, durinir which she had her first epileptic seizure. Itc.'ariling the first case, some two or three months before lal)or set in, symptoms of mental exeiteuicnt, together with sti-ange forebodings, made themselves evident. The cause of the subse(jnent fever and insanity was, I consider, primarily, a retention of a portion of the placenta, and, second- arily, the morbid condition she had woiked herself into regard- ing the irregularities of her j'ast life. The usual treatment was adopted with marked success. I)ut, bceoniing partially conva- lescent, she contracted a chill, which ended in double pneumonia and death. In the second ease, mania develoiicu the third day- after delivery with the usual syni})toms of agitation, excitement, violent dehrium and raving, continuing fnrfivc weeks, when she 16 ralliofl, hecamo perfectly scnsihle, and wns about to he discharged from the hospital when she died suddenly of syncope. This case, thou;^h occurring a year or ho after the other, was undoiihteiUy Byinpathetically inlhienoed hy it, inasmuch a« it was the first that has ever been noted at York, a)intly a primary disioa«io, it is usimlly soon in a form similar to tho ao-callod tertiary form of Ryphllis, and oxhiliits it«oarano(s and when fully developed, it is an olcvati'il greenish-yellow incrusted scah. When this is removed l)y friction (tr otherwise, a raw siirface is exposed, which, however, ;;ranulates and heals, to hrcak out in a conti;;uoua place, unhvss a;2;ain exjiosed to the issue of conta- gious sores. The lining memhrane of the mouth is also attacked, and a warty oxcrescenco of greater or hvss extent grows tliero. My informant has seen the whole of the tongue covered with tho growth, and at the same tirao, in the same individual, tho scalp matted with the incrusted scah. On the same man, also, old cuts opened and discharged a thin ichorous fluid. My in- formant heard that when the nose is attacked, the cartilaginous substance is not unfrefjuently destroyed, ns in syphilis. Chancre is said to exist, hut no history of huho i-; traceable, as it was represented as being always the result of infected coition ; although I have since learnt that other means of infection must not be precluded, as the interchange of pipes, and using the same eating utensils, etc. The name known for this complaint in the settlement of olden times was Slvvens, which certainly points to a species of Frambaesia, the French nomenclature now taking the place of the old Celtic Hiavin, and so corrupted to sivvens, and the Scotch sibbens. This, however, is not generally known to be endemic to North America. A medical authority of the settlement told my informant that he believed it to be a form of syphilis. My informant himself saw several cases at Norway House, on Lake Winnipeg, and found it yielded readily U 18 to morcury intornfilly, and ojttorrmlly in tlio form of hhck wft«h. lod'ulo of potn^ium wiih fiMo u«»»«l. 'I'lio ofVi'ctM of t\\o i]im*iiMn itHi'lf wore not ho fearful m tlioHi' of ordinary Hyphilin, nnd tlio mouth oxcroscotjoo wan atnonaldo to nitrato of nilvor, appKu'd in tlio Holid firm liooally it goos hy tln< name of tin* NoImou River complaint, ntnl was vory provalont tlicro at ono tinie. Only in j^cncrations far liack, say over 100 yearn, coulil tliene Indians possihly have had exposure to syphilitie taint, as they were not in contact with either tlie lied River settlement or York, and the true disease was stated not to exist in those y many aiitlioritit'rt, and it ctpinlly assinncs an rndj'mic chanicti'r when localiz 'd in hccIikUvI dJHtrictH, and, Hprcadin;^ atnon^ individuals of similar lialiit«t. a('i(iiiro>< nn oMpccial cliaractor varying from ordinary HvpliiliM. Pus-tiMy it may l)0(!omo confoimdi'd with other dirtca.mvs, like th" " lladt'Z;ro" of Norway, which, if I ro- mcmhor ri;;htly, conHi^ts of nyphiliH and Icprony ; e<(ually m the " Ntilson Kivcr complaint " may consint of syphirn and scro- fula. In short, wore the matter thoroughly cntoreil into, I do not think it would ho very dilVu'ult to prove, notwithatandin;; many authorities to the contrary, that the Ya- s of .Jamaica, the Sihlx'iis of Scotland, the Mai An;^liiis of St. INuil's Hay, the Nelson llivor Complaint, and many others, arc Mimj)ly various endemic and modified forms of syphilis. Thinking that somo mot«'oroloi;ical data may he intoroatin;;, and also perhaps instructive, as hearing on climatic intluenco in epidemic di.scase, I am enahlod. through the courtesy of Mr. William Wood, our very zealous meteorologist of York, to give the following : — MnSTIII.Y MkAS TKMI'KIIATUnR, MoNTnt-Y MkAN lUllOVKTRH. 1883— .Inntmry -2r..:u K. 20.!t75 Ftliruiirv -1V'.78 3().()7;j Miirch -13. yo 31. B6 Ai.iil '1.92 31.78 Miiv *AGJ,:\ 2'J.UI50 Jiiilo •.')3.1!t 2y.!)tl8 July •67.4.1 29. It,-) I AiiKiiHt •55.46 29.978 S.ptombir •43,42 29.920 (•itobur •31.72 30.007 NdVciiilMT -0.25 31). 010 Doinmbor -22.27 29.999 Monthly Mkan ok Rkahmnr. nAnoMRTniOAr,. Winter —Oct., Nnv., IKc, .Jan., Feb., March, April 30.322 SpriiiK — Miiy 29.909 Siiiuniur — .June, .Inly, AukuhI 29.9»]G Autuiuu — Su|)tfmbi^r 29.920 Mny.,,, JlilM* ...I JiklWAU.. 0.:ii» filly II on 3.03 AUKiMl tf,3& H«<|»l)'miwr 9,113 Oi^tolit'r 0,6t IUmoh or TMVPRiiArriiii. July Aih, INNii .Iiiittiary :irit itit'l tilt, \nn\ MiLHAOM nr WiMi). .fiitiiiitry U.T'JIi) iiillim, H'l'liniary t>,!)(') lliiuh D.A.'lo A|>rli ••••• N,iMM) Mity M,;irii) Jiiii'i 7,iM0 July 7,ftlo AiiKiHt N,7;m S< |)t<'inlt«tr n.orio (1. tnlK'l' N,;(t() Mdvi iiiIk r uj-t'i UwcllllliT .... \),t\M ti II II II •I II It II I.