Small-pox is dreaded, and infected persons often cruelly shunned: a suspicion of this or of cholera frequently emptying a village or town in a night. Vaccination has been introduced by Dr. Pearson, and it is much practised by Dr. Campbell; it being eagerly sought. Cholera is scarcely known at Dorjiling, and when it has been imported thither has never spread. Disease is very rare amongst the Lepchas; and ophthalmic, elephantiasis, and leprosy, the scourges of hot climates, are rarely known. Goitre prevails,[40] though not so conspicuously as amongst. Bhoteeas, Bhotanese, and others. Rheumatism is frequent, and intermittent fevers, with ague; also violent and often fatal remittents, almost invariably induced by sleeping in the hot valleys, especially at the beginning and end of the rains. The European complaints of liver and bowel disease are all but unknown. Death is regarded with horror. The dead are burnt or buried, sometimes both; much depending on custom and position. Omens are sought in the entrails of fowls, etc., and other vestiges of their savage origin are still preserved, though now gradually disappearing. [40] oulder-strap in carrying loads be a predisposing cause of goitre, by inducing congestion of the laryngeal vessels? The Lepcha is certainly far more free from this disease than any of the tribes of E. Nepal I have mixed with, and he is both more idle and less addicted to the head-strap as a porter. I have seen it to be almost universal in some villages of Bhoteeas, where the head-strap alone is used in carrying in both summer and winter crops; as also amongst the salt-traders, or rather those families who carry the salt from the passes to the Nepalese villages, and who very frequently have no shoulder-straps, but invariably head-bands. I am far from attributing all goitre, even in the mountains, to this practice, but I think it is proved, that the disease is most prevalent in the mountainous regions of both the old and new world, and that in these the practice of supporting enormous loads by the cervical muscles is frequent. It is also found in the Himalayan sheep and goats which accompany the salt-traders, and whose loads are supported in ascending, by a band passing under the throat.