Dr. Guiteras, formerly physician to the Philadelphia Hospital, and Lecturer on Physical Diagnosis in the University of Pennsylvania, now in the United States marine hospital service, has for several years been on duty, most of the time, in Florida, the West Indies, and the Gulf of Mexico. In answer to an inquiry made by me, he writes: “Hysteria prevails with extraordinary frequency amongst the Cubans. It presents itself in the shape of excito-motory and mental phenomena, almost to the exclusion of all other manifestations. The motory anomalies comprise the whole range from mild hysterics to the gravest hystero-epilepsy. The latter is incomparably more frequent in Key West than in Philadelphia. The confirmed hystero-epileptics are few, but it is the rule for well-marked cases of hysteria to present occasionally, often only once in the course of the disease, hystero-epileptic seizures which may be of frightful intensity. By mental disorders I do not mean only the acute attacks of excitement and delirium which attend upon or take the place of convulsive attacks, but I mean also to include the chronic form of hysterical insanity, which is generally some variety of melancholia. These are the peculiarities of hysteria as seen by myself in the Latin race in the tropics. My experience teaches me that the Saxon race in the tropics shows the same peculiarities to a less extent.” In the region referred to by Guiteras it will be remembered there is a mixed population composed largely of Spanish, French, and Portuguese. Climatic and other local influences may have something to do with the particular form which this disorder assumes in these tropical or semitropical districts, but race would seem to be the most important factor. In the section on Hystero-epilepsy I will speak of the irregular type of this disorder, which has fallen most frequently under my own observation. Hysteria in the negro is of somewhat frequent occurrence, and is more {218} likely to be of the demonstrative or convulsive than of a paralytic or negative form. Hysterical convulsions, particularly of the purposive kind, and hysterical mania, are often met with in the colored population of our large city hospitals and asylums. The influence which climate exerts, like that of race, is rather on the type of hysteria than upon the disease itself. Hysteria is found in every climate, but in warm countries the disorder seems more likely to be mobile and dramatic than when found in the more temperate or colder zones. Season and meteorological conditions have some influence on the production of hysterical attacks. It is well known that hysteria, chorea, and other allied nervous disorders are more likely to appear in the spring than at other seasons. This fact has been shown by various observers.