After the mildest attacks of the Zanzibar remittent, the liver acts with excessive energy: sudden exercise causes a gush or overflow of bile, which is sufficient to bring on a second attack. The debility, which is inordinate, may last for months. It is often increased by boils, which follow one another in rapid succession, and which sometimes may be counted by scores. Besides the wet cloth, the usual remedy to cause granulation, and to prevent the sore leaving a head, is to stuff it with camphor and Peruvian bark. When boils appear behind the head, the brain is sometimes affected by them, and patients have even sunk under their sufferings. The recovery, indeed, as in the case of the intermittent type, is always slow and dubious, relapses are feared, and for six weeks there is little change for the better; the stomach is liable to severe indigestion; the body is emaciated, and the appetite is excessive, or sickly and uncertain. The patient suffers from toothaches and swelled face, catarrh, hepatitis, emesis, and vertigo, with alternations of costiveness and the reverse. As I have already said, change of air and scene is at this stage more beneficial than all the tonics and preventives in the pharmacopœia. Often a patient lying apparently on his death-bed recovers on hearing that a ship has arrived, and after a few days on board he feels well. Diarrhœa and dysentery are mostly sporadic; the former, however, has at times attacked simultaneously almost every European on the Island. It is generally the result of drinking bad water or sour wine, of eating acescent or unripe fruit, and of imprudent exposure. Dysentery is especially fatal during the damp and rainy weather. It was often imprudently treated with mere astringents, and without due regard to the periods of remission, and to the low form which inevitably accompanies it. As in remittents, the patient was weakened, and his stomach was deranged, with ‘slops,’ when essence of meat was required. The anti- diarrhœa or anti-cholera pill of opium, chalk, and catechu has been fatal wherever English medicine has extended; witness the Crimean campaign, where the bolus killed many more than did the bullet. A complication, rarely sufficiently considered, is the hepatic derangement, from which almost all strangers must suffer after a long residence in the Tropics. At Zanzibar some Europeans were compelled to give up breakfasting, to the manifest loss of bulk, stamina, and muscular strength—vomiting after the early meal, especially when eaten with a good appetite, was the cause. Yet it was a mere momentary nausea, and when the mouth had been washed no inconvenience was felt.