Strumous ulcerations of the limbs are the commonest diseases in Fiji. Thus, out of 621 cases admitted to the hospital in 1892, including people of many races and every kind of disease, there were 104 cases of "ulcers" in Fijians alone--the total number of Fijians admitted being only 246; that is to say, more than 40 per cent. of the Fijians were admitted for ulcerations of strumous origin. This disease, which the natives call _vindikoso_, takes the usual form of an indolent, excavated ulceration, sometimes extending down to the bone. It generally runs a slow course, and when of large size, the resulting _cachexia_ is serious. It is generally left uncovered, or at most wrapped in a filthy piece of native cloth, and unwashed for days together--a fruitful breeding-ground for flies and parasites. [Pageheader: FIJIANS ARE TAINTED WITH STRUMA] To the same taint are due tubercular glandular enlargements, chronic disease of the bones, with deformity and enlargements, necrosis of the long bones, and the tuberculosis of abdominal glands, which is believed to cause many deaths among children, and not improbably also tubercular diarrhoea both in children and adults. Yaws (_thoko_) occurring in children of tubercular parents is probably intensified, and children whose constitution has been weakened by a prolonged attack of yaws are more prone to die of some form of tuberculosis. It has also been noticed that adults who bear the scars of severe yaws in childhood are more prone to contract some form of tuberculosis in after-life. The possible identity in the origin of all these diseases offers a wide and most interesting field for scientific investigation. It is but a step, for instance, from yaws to syphilis, and from syphilis to strumous diseases of bone and skin (especially those prevalent among the Pacific Islanders), and from struma to pulmonary or general tuberculosis. If such an investigation be too long delayed there is the danger that the races who furnish the material may have ceased to exist. The undoubted facts are these:-- (1) That the Fijian race is tainted by various forms of tubercle, acquired and inherited; (2) That the taint is more marked where there is an infusion of Polynesian or European blood; (3) That females are more affected than males; (4) That the disease is on the increase; (5) That the inherent debility of the race is partly due to this taint. FOOTNOTES: [Footnote 100: I am indebted to Dr. Lynch, who has made a special study of the subject, for the medical portion of this chapter.] CHAPTER XX TRADE