Dr. Keith Guild, M.D., district surgeon of East Griqualand, in a pamphlet published this year on leprosy, arrives at the conclusion that “leprosy is a blood poison arising from the combination of two other blood poisons, tubercular and syphilitic,” and goes on to assert that “leprosy among the natives of South Africa is neither more nor less than a form of tertiary syphilis.” There is a manifest inconsistency between these two statements, but if the latter be a correct one it must also apply to leprosy in general, which I myself would be very sorry for one moment to admit, for obvious reasons. Looking upon this frightful picture, is it not time, I will ask, we were “up and doing” before it be too late? To come down to figures: the cost of each leper on Robben Island is £63 per annum: while the total expenditure of the island annually, including lunatics in 1885, was £15,482, of which £5,000 was expended in salaries. The following is a return of the leper patients admitted in the general infirmary, Robben Island, from the year 1845 to July 31, 1883, inclusive, the number remaining about the same, as fresh cases were only admitted as old ones died off: 1845 37 1846 35 1847 17 1848 26 1849 18 1850 14 1851 7 1852 13 1853 21 1854 14 1855 16 1856 15 1857 16 1858 19 1859 16 1860 13 1861 21 1862 22 1863 22 1864 12 1865 34 1866 19 1867 20 1868 21 1869 15 1870 24 1871 27 1872 17 1873 17 1874 19 1875 13 1876 17 1877 26 1878 19 1879 13