Previous to the year 1889 Hawaii had been tolerably free from the “Flu.” Such cases which had appeared in former years were of a mild character, as were also those which prevailed during the 1889–90 epidemic. Epidemic Catarrh has been known in the Hawaiian Islands for many years. The Annals of the early Missionary Fathers mention it. Dr. Alonzo Chapin, an early Missionary physician, refers to it; on page 39 of the Author’s “Monograph on Leprosy,” is the following quotation taken from the Doctor’s writings in the years 1836–37: (in Hawaii) “Diseases occur epidemically, as was the case with Catarrh, repeatedly.” This epidemic catarrh was probably Influenza in a mild form; or it may have been the epidemic catarrh of the kind known to the physicians of today, as that caused by the Micro-coccus Catarrhalis, a globular or spheroid shaped micro-organism. South Wind Catarrh: In Hawaii during the season when the South wind prevails, from November to March, epidemic and infectious colds are very common. They are attended with disagreeable frontal headache, nasal discharge, sore throat, fever, aching limbs and body; these are cases of mild “Flu.” Elderly people, middle aged and old foreign residents, and our Aboriginal population are those mostly affected. Hawaii today, due to great increase of travel, greater speed of ocean steamers, and its cosmopolitan population, is probably infected, like all other ports of the U. S. A., with several different species or strains of the Influenza Bacillus, and also those of the Micro-coccus Catarrhalis. _Contagious Nature of Colds or Catarrhs, so Called._ It is a well known fact, that when isolated peoples are visited by strangers, whether they arrive by sea or land, epidemic colds speedily appear amongst the residents of these localities. The Esquimaux, Indian tribes, residents of South Sea Islands, Caroline, Marshall and Marquesa groups, Pitcairn Island, etc.; isolated peoples and out of the track of travel, when visited by strangers, become affected with epidemic catarrh and cough, which may attack great numbers of them and cause high mortality. Those visitors who carry the germs of the Catarrh show no visible signs of disease themselves. Possible sources of Disease: During the past four centuries there is clear evidence that Hawaii has been infected with diseases from certain sources; there is also evidence that is not so clear, yet it is worthy of consideration. From what countries could ships carry diseases to Hawaii before the opening up of the Islands to foreign trade? Spain, China, Japan and Russia. Since the opening up of the islands to foreign commerce, the ships of all nations have carried to Hawaii a varied assortment of diseases, some nearly harmless, but others of the deadliest kind.