Art. IV. Remarks on the Sandwich Islands; their Situation, Climate, Diseases, and their suitableness as a resort for individuals affected with or predisposed to Pulmonary Diseases. By ALONZO CHAPIN, M.D., late a resident missionary at those Islands.

    The following remarks, founded on cursory observations, while at the Sandwich Islands, where I resided three and a half years, have been written since my return to this country. I did not, while on the spot, note facts and events as they occurred, not having had in view at the time, to present them to the public, and not having contemplated a return, till the circumstances of my family rendered it necessary to seek a colder climate. I consequently can offer my remarks as mere reminiscences only. My inability to state with more fullness [sic] and particularity, several of the subjects included, I much regret; but some apology may be found in the brief period of my residence at the islands,— the difficulties presented by the ignorance and prejudices of the people, to make correct and satisfactory medical observation,— and also in the great amount and variety of labours required, in the discharge of our missionary duties, which prevented an improvement of such means as were accessable.[sic]

    The Sandwich Islands, eight in number, are situated between 18° 50' and 22° 20' north latitude; and 154° 53' and 160° 15' West longitude. Two or three barren rocks are usually numbered with the other islands; but only eight are inhabited or have any vegetation. In their dimensions they vary greatly; the smallest not being more than eight or ten miles long, while the largest is ninety miles long, and fifty or sixty in breadth. The whole group is collectively called Hawaii* by the natives, because that is the largest island, and the others were all subjugated by Kamehameha, one of its kings.

    The interior of each island is uniformly elevated and among them are found mountains of the first order of elevation. Those on Hawaii rise to the height of about 14,000 feet, and have snow on their summits a great part of the year. The whole group are [sic]of volcanic origin. Numerous extinct craters of different periods and dimensions are scattered over the surface, and two large volcanoes are still in action, affording immense currents of liquid lava.

    The shores of the islands are much diversified, and furrowed with

*The term, Owhyhee, is still erroneously, applied by most foreigners to the largest of the Sandwich Islands. The letter o, which is sometimes prefixed by the natives, and sometimes omitted, is merely a sign of the nominative case. That being rejected and the European continental sound, the sound used by the natives, being given to a and i, and the name becomes clearly Hawaii.

frequent ravines, some of great depth, which furnish courses for the impetuous mountain streams. Plains of different dimensions, varying from a few rods to many miles in extent, are frequent. More commonly, however, the mountains extend with a gradual slope en- tirely to the beach, and here and there present bold and lofty precipices to the dashing of the waves. The sides of the mountains, if we except the loftiest, are verdant entirely to their summits, and present immense tracts of an exceedingly fertile soil.

    The leeward shores have generally an arid and even sterile aspect, owing to the infrequency of rain. Vegetation is there promoted mostly by irrigations from the streams, and it is only those tracts immediately contiguous to these which possess much verdure, or will admit of cultivation. The condensation of the vapour, from the damp trades in their passage over the mountains, produces continual rains on their summits, which, extending backward towards the sea, keep the earth wet much of the time, and give rise to a most luxuriant growth of vegetation. Hence the windward sides of all the islands are, unlike their leeward shores, extremely fruitful and productive.

    The productions are such as are common to all intertropical regions. The sweet potatoe [sic] and the kalo, (Arum esculentum,) are the vegetables in the most general use, and on them the natives mostly subsist If we except a few fruits, and a scanty and irregular supply of fish and other meats, they have little else to eat. The mountains abound in esculent roots, both mild and nutritious, which constitute a ready and abundant supply for their sustenance whenever, as sometimes happens, they are pinched by drought or famine. Other vegetables, and a considerable supply of fruits are cultivated, though the variety is not great. Sugar cane, bananas, and yams are abundant; and foreign productions are beginning to be extensively cultivated for the special purpose of supplying ships.

    The Arum esculentum, which is more generally eaten by the inhabitants than any other vegetable, grows like the Arum triphyllum, in wet or damp situations only, and when uncooked is like that, exceedingly styptic and acrimonious. These qualities are destroyed by heat. The natives prepare it for use by cooking it thoroughly, pounding it to a pulp, and adding water sufficient to make of it a thick paste, in which state it is called poi, and is eaten with one or two fingers, according to its consistency. As an article of diet, it is simple and nutritious; and after the fermentative process has commenced, it is preferred by the people.

    Climate. Situated in the very midst of the vast Pacific, without any extensive inland causes to affect the temperature, and remote

from the cold chilling winds of the temperate and frigid zones, the Sandwich Islands possess a remarkable evenness in the degrees of atmospheric temperature. Cool breezes by day from the sea, and by night from the mountains, serve to mitigate the burning heat produced by a vertical sun, and to render the climate pleasant. The thermometer varies but little from day to day, and even from month to month; and what is particularly to be remarked, all portions of the islands, along the shores, are alike in this respect. Districts most parched by heat and drought do not differ essentially in temperature from those sections where almost daily showers and perpetual trade winds prevail. As, however, we recede from the low lands along the sea and ascend the mountains, a change is immediately perceived, and along their extended sides we may procure almost any degree of temperature. Retreats have been fitted up in elevated situations for the benefit of invalids relaxed by the long and continuous heat below, but have been found objectionable on account of the great dampness caused by the frequent showers, and have been abandoned.

    The register of the thermometer, which I subjoin, was furnished by the missionaries residing at Hanolulu, [i.e., Honolulu] on the southern side of Oahu. Their observations were made during the years 1821 and 1822, at the hours of 8, A. M., and 3 and 8, P. M. I copy it from Ellis' Polynesian Researches.

    By this register it will be seen that the greatest heat during the year was 88°, the least heat was 59°, the mean temperature 75.

    Rev. William Richards, residing at Lahaina on the island of Mani [i.e., Maui], has, during the past ten years, been in the habit of noting the changes of the thermometer. He has made his observations with great care, having sought those situations most favourable to exactness. I have a copy of his journal in my possession. It exhibits the highest thermometrical elevation at 86°, the lowest at 54°, the extreme difference

32° and no day during the whole period exhibits a difference of more than 19°. June has the highest range, January the lowest. Lahaina is situated near the north-western extremity of the island, and is not affected by the trade winds except as they occasionally break with great violence over the northern end of the mountains. It is one of the most arid districts of the group, and has seldom rain sufficient to moisten the soil through its whole depth, except in the winter or rainy season. For months in succession the sun is scarcely obscured by clouds, and its exemption the direct influence of the trades might lead us to expect several degrees of the thermometer above the more wet and windy portions, but so far as my observation has extended, and I have visited every important island, it is not the case.

     Diseases. Such is the equableness of the climate, and the simplicity of the natives in their regimen and most of their habits of life, that compared with civilized countries, the variety of their diseases is neither numerous nor complex. Their remoteness from other lands is so great that but few contagious diseases are imported among them. Even the cholera which has of late passed over almost the whole surface of our planet, became inert and powerless before it reached those islands.

     The diseases most common within my circle of observation, were fevers, ophthalmia, catarrhs and asthma, rheumatism, venereal, diarrhea, dysentery, cutaneous diseases, scrofula, dropsy, etc., and they occurrred [sic], in frequency, in about the order in which I have mentioned them. Diseases sometimes occur epidemically, as was the case with catarrh repeatedly, and croup once during my residence at the islands. Many other diseases not specified, were often met with.

     Fevers. Though these are the most frequent and numerous class of diseases among the native population, they are by no means the most malignant and fatal. They occur in almost every form, but when idiopathic are usually remittent. They are, however, most frequently symptomatic of other diseases.

     The excitable state of the system, which predisposes so strongly to febrile attacks is not common at these islands. The continued and oppressive heat is there not sufficient of itself to produce it; and the universal custom among the people, to repose during the hottest part of the day, will aid in counteracting other unfavourable influences. The simplicity, too, of their diet and habits of life are not calculated to promote a state of excitability. Their food, as I have before remarked, is mostly vegetable, with but a scanty and irregular supply of meat. Until of late they have made use of none of the stimulating condiments so profusely employed in civilized countries. Their only

drink is water. The laws of most of the islands prohibit the use of ardent spirits, and the mass of the people can but rarely obtain it. In their movements, the natives are extremely moderate. They walk with a slow step, rest long and often when tired, and placing no value on time they do everything leisurely and to suit their convenience.

     Worms in the intestinal canal are not, so far as my observation has extended, of usual occurrence. The children of the mission, who numbered more than sixty were entirely exempt, and no case of the existence of worms among the native population came to my knowledge. One individual, a native of this country, who had been for several years a resident of the islands, was affected with ascarides, and this was the only case I met with.

     Malaria. Before going out to the Sandwich Islands, I spent several years in our southern states, much of the time in the low country of South Carolina; and was, during the hot seasons of the year, accustomed to recoil at every standing body of water, on account of the poisonous exhalations which they there emit, endangering the lives of every individual exposed to their influence. On my arrival at the islands, I more than once made the inquiry, "why the numerous kalo ponds are not productive of sickness." Thousands of acres are entirely converted into ponds of standing water in which the natives cultivate their kalo, while their houses are built on the narrow spaces between. These are never dry, and are often so numerous as to exhaust entire rivers in keeping them filled. I could not at once reconcile my mind to the belief of their innoxious tendency, notwithstanding circumstances are such as to make the fact very obvious. Though the ponds are subject to the perpetual influence of a torrid sun, they cannot become putrid by reason of the continual supply of fresh water, and multitudes of fish live and thrive in them, such is their freshness and purity.

     The streams originate from springs and rain on the summits of the mountains, pour down their sides with great impetuosity and after a w meanderings are turned aside from their courses to irrigate the lands and replenish the ponds, or are discharged directly into the sea; and I know of no body of water emitting sufficient miasma to create sickness along its borders. I have occasionally met with stagnant ponds which emit a foul and offensive odour, and could in no way satisfy myself of the reason for the exemption of the inhabitants; along their borders from fevers, but by supposing the effluvia to be diluted rendered inert by the continual currents of winds.

     Small marshes abound but are fed by springs, and the pure mountain streams, and are thus prevented becoming noxious. They

speedily dry up during a few weeks absence of rain; and the rivers also disappears unless kept alive by frequent showers, and the small pools, which remain at such times and which abound after every rainy season, do not become sufficiently putrid to exhale a fever-generating miasma.

     If any one variety of soil has a specific power to produce malaria it does not appear to exist at those islands. The upland soil is there formed of decomposed lava the lowland plains along the sea are constituted of a mixture of alluvion washed from the mountains, and decomposed coral. Its immunity from noxious exhalations is the same, whether parched with drought, or merely moist, as when the evaporation is most abundant, after the rains.

     The habitations of the natives are for the most part considerably scattered, but are in a few instances crowded together in such numbers as to exhibit the dense appearance of our large towns and villages. There is, however, throughout an entire exemption from those pestiferous exhalations which, so extensively, poison the atmosphere of populous places in hot climates. All animal and vegetable substances thrown away by the people, or cast up by the sea, are quickly devoured by the multitudes of starving dogs and swine, so that no detriment is experienced from their putrefaction.

     With so entire an exemption from the existence of miasmata, there is also an entire exemption from those affections induced by it. Malignant bilious fevers do not occur, and as I shall, hereafter, have occasion more particularly to state, derangements of the liver and biliary organs do not prevail, neither is the stomach and intestinal canal, and other organs of the abdominal viscera subject to the numerous and complicated affections so common in every miasmatic region.

     Having enumerated several causes which do not operate to affect diseases at the Sandwich Islands I shall next state some particulars of a cause which operates more extensively than any other morbific agent, and produces probably more than one-half of all the diseases which exist, and more than three quarters of all the idiopathic fevers at the Islands.

     Cold. The dwellings of the native population are merely slender frames of posts and poles tied together with strings and covered only with thatch. They are generally small, often so low as not to admit of standing erect within, and in their best condition serve as an imperfect protection from the wind and rain and the excessive beat of a vertical sun. Every atmospheric change is quickly felt. Cold and dampness easily penetrate, and no sooner exist without than they are felt within. Add to this, their leaky condition, the almost naked state

of the inhabitants, their common practice of sleeping at night on the bare earth, outside of their houses, and their habits of continuing long in the water and exposing their bare bodies to strong currents of wind, when overcome with heat and covered with perspiration, and it will not be surprising that diseases incident to such causes should abound. Fevers, induced thereby, are hence numerous. They, however, are commonly simple in their type, and may often be relieved by merely restoring the skin to its healthful action.

     Ophthalmia, of the purulent form, abounds in every portion of the group, and opaque corneas and thickened coats of the eyes, are very numerous. The old and the young are alike affected by the disease; very small children are occasionally met with nearly blind from its effects. I at one time attributed its prevalence to the effects of the clouds of sand often raised and blown about with great violence by the strong trade-winds; but finding it equally common in than districts where frequent rains prevent the dust from ever rising, there appeared to be no other cause so active as the trade winds, which are constantly prevalent, and come mingled with salt spray.

     Pulmonary diseases. Sudden and severe atmospheric vicissitudes, the main exciting cause of pulmonary affections, do not occur at the Sandwich Islands, and with the accommodations for protection and comfort which are possessed in every civilized land, diseases of the respiratory organs would be far more rare. Such, however, are, the habits and practices of the people, and so exposed are they to the influence of every atmospheric change that asthmas and catarrhs in particular, are of very frequent occurrence. The latter are, however, usually mild in their character, ephemeral in their existence, easily yield to remediate applications, and rarely pass into the more inveterate and fatal stages of pulmonic diseases. Another very prevalent cause of the production of asthma, is a habit among, the chiefs and wealthier portion of the common people, of inordinate eating, amounting even to gluttony. Their capacious stomachs are distended not less than four or five times a day with truly surprising quantities of flesh and poi; in connexion with this their indolent habits, their aversion to mental or bodily efforts, and their practice of sleeping often, produce a gross appearance of their persons, an extreme corpulency of their systems, and powerfully predisposes them to apoplexy also, and the acute forms of other diseases. This class of the population is not however large.

     Rheumatism is of very frequent occurrence, notwithstanding the very prevalent belief, that "it is almost peculiarly a disease of cold and variable climates, and is rarely met in warm and more uni—

form latitudes." Indeed there is so much similarity in the custom and habits of savages in all portions of the torrid zone, that I can no reason why the Sandwich Islanders in particular should be affected with rheumatism, and am irresistibly led to the conclusion, that it is equally prevalent at the adjacent islands, and at all places throughout the intertropical regions, where the same exciting causes exist. The disease is usually mild in its attacks, soon passes off even without the application of medicinal means, and is seldom followed by severe secondary effects. Gout might be expected to be common as a consequence of the gross and intemperate habit of eating practiced by the chiefs; but the mild quality of their food is not suited to promote a gouty diathesis.

     Venereal diseases. If it be a fact that the aborigines of America were affected by syphilis and gonorrhœa before Europeans visited them, or if, as is presumed by Dr. Thompson, "syphilis has been thousands of times generated de novo by impure sexual intercourse," it is certain that neither disease existed, or was known at the Sandwich Islands before the visit of Captain Cooke in 1779. The natives had ever lived in the practice of promiscuous and almost unrestrained sexual intercourse, so that the women were often unable to designate the father of their children; still their practices were not attended with those consequences which follow the licentious in all civilized countries. Those who have the credit of the discovery of the islands, and of exhibiting first to the astonished gaze of the simple and ignorant natives, some of the ingenious and useful implements and commodities of enlightened lands, and who sailed in ships so enormous in size as to have been regarded as floating islands, inhabited by supernatural beings, must also receive the credit of having introduced among these islanders two of the vilest and most loathsome diseases ever sent as a punishment for transgression. And upon the same page on which is recorded the benevolent efforts made to improve their condition and circumstances— the friendly interference to reconcile contending parties and stay the desolating ravages of war and effusions of blood; and the liberal donations made in return for the boundless hospitality and princely presents received from the natives; let it also be recorded that they entailed on their benefactors, a disease which has "grown with its growth and strengthened with its strength," which has extended its course with destruction and death, till all portions of the group have become infected, and countless multitudes have fallen victims to its power.

     With such an introduction, the venereal disease has for the past fifty-seven years continued to spread and increase; perpetuated and

extended too by almost every vessel which touches at the inlands, till words would fail to express the wretchedness and woe which have been the result. Foul ulcers, of many years standing, both indolent and phagedenic, every where abound and visages horridly deformed— eyes rendered blind— noses entirely destroyed— mouths monstrously drawn aside from their natural position, ulcerating palates, and almost useless arms and legs, mark most clearly the state and progress of the disease among that injured and helpless people.

     I have seen more than one case of marasmus induced by the difficulty of mastication and deglutition. The mouths of these patients were almost closed in the process of cicatrisation, and the gums and fauces were destroyed by ulceration. In one of my patients suffering with the secondary symptoms of the disease, in which I was successful in stopping its progress by a mercurial course, the external nose had entirely disappeared, and its place was occupied by a concavity and a foramen of an irregularly oblong form. The left eye was totally blind, and both so disfigured by ulceration as almost to lose their identity. The mouth was shockingly deformed; the lips and alveolar processes mostly removed by absorption, and the teeth having their necks and a portion of their roots divested of integuments, were irregular in their distances and positions, pointed in every direction, and but slenderly adapted to the purpose of utility. The whole countenance was much disfigured by deep eschars, and the body greatly emaciated; no food could be masticated by him, to bad was the condition of his mouth.

     The reflection is melancholy, that there is no prospect of this disease, so disgusting in its effects and destructive in its course, being soon eradicated. The natives possess, among themselves no curative means which will control it. But a small portion have ready access to foreign physicians, and many within reach appear too indifferent to their condition to make application, while most permit the disease to go on till secondary symptoms appear before they seek assistance. These circumstances together with their prevailing and inverate of promiscuous sexual intercourse, will serve still, to perpetuate and extend the disease.

     Diarrhoea and dysentery have besides the usual exciting causes which prevail in. most places, an additional fruitful source, in a blind and barbarous practice of using immoderately the most powerful and drastic cathartics. The inside of the calabash (Cucurbita lagenaria,) triturated seeds of the castor oil, the fruit of the candle nut, (Aleurites triloba,) two or three species of Ipomœa and some other drastic articles are given in such doses as sometimes to create the most obstinate and dangerous dysenteries. I have known a case in which the average

operations of four cathartics, given to disperse dropsy, were twenty-one, the aggregate eighty-four, and another case in which a man from a fear that he would be sick, took such an enormous dose of the calabash as to produce a hemorrhagy which proved fatal within a few hours.

    Cutaneous diseases and Scrofula. Though the Sandwich islanders are remarkably fond of the water and are fastidiously particular in their practices of washing and bathing, they are, nevertheless, extremely filthy and squalid in their habits of life. With their beasts and fowls in the same habitation, and not unfrequently [sic] on the same mats with themselves, their often repeated ablutions will be regarded as timely. The kapa or native cloth used by the inhabitants is worn without cleansing till having become foul with dirt and vermin, an too ragged to serve longer the purposes of covering or protection, it is lain aside. Hence diseases induced or exacerbated by such causes have at those islands a fruitful soil and flourish luxuriantly. The itch is extremely prevalent, and often assumes a virulence unseen in this country, the pustules sometimes becoming confluent are converted into large and troublesome ulcers. Other scabious affections exist. Scrofula is not only frequent but extremely malignant. The difficulty of inducing a salutary change in the habits of the people, has rendered hopeless the expectation of effecting its entire cure.

    Hepatitis. The frequent occurrence of hepatitis in hot climates is ascribed by Dr. Saunders and others to the prevalence of a peculiar miasm [sic] in those regions, and if this be true, hepatitis will not be expected to predominate at the Sandwich Islands, where there is no evidence of the existence of any miasm whatever. Indeed hepatic disorders are not merely uncommon there, but they do not appear to be incident to those seas.

    The Pacific is thronged with American and English whaling ships, which cruize [sic] from three to four years, and as they change their ground to the north or south of the equator, with the change of the seasons, they am continually exposed to the hottest latitudes, and are much of the time within the torrid zone. Of these, a large number touch semi-annually at the islands for supplies, and though my practice among the seamen has been extensive, I have been called to prescribe for only two or three cases of inflammation of the liver, and in no instance have I met with the disease in its acute form. The heat to which the sailors are subjected during calms at sea, is often intense; and if the existence of hepatic disorders is owing mainly to the close sympathy between the biliary and respiratory organs, the etiology proposed by Dr. Johnson, I certainly ought to have met oftener

with it. I introduce this digression because it agrees fully with my experience and observation among the native population, and accords with the view that heat is not sufficient of itself to induce hepatitis.

    No place can be found more exempt from biliary diseases than these islands, and yet the sun is vertical twice each year, and the heat is perpetual. Such also is the belief of Dr. Judd, my medical associate, who has been a resident more than eight years, and whose means for observation have been ample. Two or three gentlemen of the mission, who had chronic diseases of the liver when they went to the islands, have not only spent several years without any exacerbation, but one of them is quite relieved of the complaint. Among the natives I had no evidence of its frequency, though Lahaina, the place of my residence, contains a population of from three to four thousand. The island of Maui on which it is situated, has more than thirty thousand inhabitants. I was the only physician among them, and had numerous patients from the adjacent islands, Hawaii, Molokai and Lanai.

    The fine rows of teeth possessed by the natives will attract the notice of every stranger. The oldest inhabitants have generally their teeth in perfect order, except such as they have knocked out from time to time, on occasions of the death of chiefs or of their friends. The reasons are obvious: they make no use of acids or other substances which tend to effect rapidly the destruction of the enamel; they are free from those diseases of the stomach and of the nervous system which operate most actively in producing carious teeth; and they rarely eat their food while hot, and the water which they drink is usually no colder than that of our rivers during the beat of summer.

    Surgery. Having among them no rail-roads or steam-boats or machinery of any kind to cause fractures and contusions, and being surrounded by few of those causes which produce accidental injuries, operative surgery is less frequently brought into requisition than in this country. The extirpation of tumours employed the scalpel oftener than all other cases, and occasionally an incurable ulcer or other cause rendered amputation necessary.

    Diseases of Females. The females mostly marry before the age of puberty, and but few pass the first catamenial period without having had sexual intercourse; and the opinion is. prevalent that the menses are the eff'ect of coition, and their appearance in an unmarried girl is regarded as evidence of illicit conduct. This universal practice of premature sexual intercourse, is probably the principal cause of unfruitfulness among the women. How far they are affected by the venereal disease is not certain. Multitudes live childless, and cases

are rare of a woman's giving birth to more than four or five children. Fluor albus is universal, and exists abundantly in its worst forms; uterine hemorrhage is frequent and. obstinate. Displacements of the womb are of common occurrence.

    In parturition the women are not specially favoured, but suffer equally with the labouring class of females elsewhere. In this assertion I believe that I am opposed by the general opinion of the medical profession. Uncivilized life is regarded by the highest authorities as peculiarly favourable to women in child-birth. Cases are stated by them "of the barbarian female turning aside from her wandering tribe to some secluded spot, delivering herself, and after bathing herself and her new-born infant in the pure stream, overtaking her companions and pursuing with them her course." All this may have occurred, and every accoucheur of experience must have had cases nearly parallel. On this subject, however, I believe that further information is needed, founded on more correct and extensive observation. I draw this conclusion from my own experience, in a situation peculiarly favourable for observation. The females of the Sandwich Islands have every advantage from the relaxing influences of a hot climate, great simplicity in diet and habits of life, and constitutions invigorated by free and unrestrained exercise. I have indeed witnesses among them, labours in which the parturient and after pains seemed not to exceed the same in the brute creation; and I have also had my severest cases of midwifery among them. In several instances the uterine and vaginal rigidity has been excessive, and the suffering severe and protracted. Their midwives can do nothing in preternatural labours; and in mal-positions of the fœtus, the woman dies unless delivery can take place by spontaneous evolution.

    Diseases of Children. The ignorance of parents, and their frequent indifference to the comfort of their offspring, subject them to a great amount of unnecessary suffering and disease, during the period of infancy and childhood. The only covering provided for them is merely a fold of kapa. This is ordinarily all that is needed, but being wrapped loosely around them, they may at any time divest themselves thereof and become exposed to the full influence of the severest atmospheric change; and if this happen in the night, the sluggish parents either wrapt [sic] in deep sleep, or averse to moving during the hours of darkness, suffer their helpless little ones to lie, benumbed with cold and exhausted by crying, till morning at length comes to their relief. Catarrhs, asthmas, and particularly fevers, are hence abundant, and the seeds of numerous future diseases are, doubtless, laid at such times.

    Their cleanliness is also greatly neglected. An occasional immersion at mid-day is perhaps the only ablution performed, and the constantly accumulating filth over the surface of their bodies, subject them to the prevailing cutaneous diseases and scrofula; while the folds of their joints, the nates and vagina being so much neglected, are extensively affected with excoriations and ulcers. Add to these the practice of feeding them with the crudest and most indigestible food nearly as soon as born, and it is a. matter of wonder that so many survive the infantile discipline.

    Medical Views and Practices.— Did they possess sufficient dignity and importance, I might detail some of the medical views and practices of the natives. Suffice it to say they are made up of a mixture of absurdities the most ridiculous, and often dangerous.

    The native medicines have, some of them, value, were they skillfully [sic] employed; but, used without principle or judgment, they are, as has been already stated, often the means of irremediable injury.

    Charms and incantations have a conspicuous place in their therapeutics, and often lead to practices the most shocking. Many have been pounded and roasted to death from a belief that their diseases were the effect of an indwelling spirit. Nor is it in all cases needful that the patient should be actually suffering with disease; the mere apprehension of future sickness is sufficient reason for having recourse to remediate measures, and truly fortunate is he who has sufficient strength of constitution to withstand the baneful influence of their more drastic doses.

    Population.— When Captain Cooke visited the Sandwich Islands in 1779, the population was estimated, and probably with correctness, at 400,000. According to a late census there are now about 135,000, making a decrease of 270,000 in the space of fifty-seven years; and it is computed by the Rev. W. P. Alexander, one of the missionaries, who has with considerable pains ascertained the births and deaths of a large section, that there are annually 6838 deaths and 3335 births on the group, making more than twice as many deaths as births. If this be correct, it will not seem incredible that the population should have so greatly diminished, and that, too, in so short a period. And it will further appear that not many years will be required, at this rate, to depopulate the islands of the native inhabitants.

     The causes of this decrease are too numerous to specify, but some of them may be enumerated.

     Captain Cooke found the Sandwich Islanders living, like all savage people, in habits of the greatest simplicity, seeking only the supply of their necessary wants; and in a climate requiring so little clothing,

and with a soil producing spontaneously so many of their articles of consumption, that but little labour was requisite to satisfy every desire. They were then unacquainted with the infinite multitude of unnatural wants and practices which deteriorate mankind in all civilized lands. They were a hardy and athletic people. The process of alcoholic fermentation was indeed well understood by them, and they could make intoxicating drinks from a variety of vegetables, but they had not used them in such quantities and so frequently as to make drunkards of themselves. The reasons of this devastation must then be looked for on the catalogue of changes and innovations introduced from abroad; and to the influence of visiters [sic] from enlightened and civilized countries chiefly from England and the United States, are to be attributed the great alteration in the native character, and this appalling diminution of their numbers. During the past fifty-seven years, the time since their first discovery, we ought, after making every allowance for losses by their wars, to find the population increased at least one-half. But instead of 600,000 there are now only 135,000, leaving an actual loss to the nation of 465,000 inhabitants, chargeable directly to the customs and vices carried there from other places.

    The venereal disease has destroyed its thousands, and by its influence in inducing barrenness of the females, has probably prevented tens of thousands from ever seeing the light.

    The introduction of alcoholic liquors has produced its accustomed amount of wretchedness and misery, and consigned great numbers to untimely death.

    The use of tobacco has evidently a deleterious influence on the natives, whatever may be its effects on others. In smoking, the natives do not sit down deliberately and finish a cigar or a pipe, but take one or two quiffs, inhaling the full volume of smoke directly into the lungs, and retain it there as long as the breath can well be retained. Individuals have been killed by its effects, and how much disease may have been induced or exacerbated thereby remains to be ascertained.

    The large quantities of foreign commodities carried to the islands, and the increasing intercourse of the inhabitants with foreigners, have created such an amount of new and superfluous wants as to destroy their native character, and to make of them an artificial and degenerate race.

    The introduction of Christianity within the past few years has exerted its usual benign influence, but the changes of every kind have nevertheless been great and rapid, and the people have fallen and are

continuing to fall under the effects of these changes; and their end may be read on the same page which records the fate of the wandering tribes of America. Such must inevitably be the case, unless a kind Providence greatly bless those measures used for their present and future interests.

    The Sandwich Islands as a resort for individuals predisposed to, or affected with, Pulmonary Diseases.— As a residence for consumptive patients, two circumstances will here require attention: the voyage to the islands, and the residence there.

     A passage to the islands may now be obtained at almost every season of the year. Merchant ships bound directly there, or to touch there on their way to Columbia river and the north-west coast, frequently sail from our cities; and whaling ships are continually leaving for the Pacific, more particularly in the fall, and many of them, without delay, make their way directly to the islands— opportunities will therefore be sufficiently frequent. The voyage occupies from four to five months; and by leaving this country in the fall, Cape Horn is doubled in the season the warmest at that place. Still, however, the latitude is so high, that the cold, even at that season, is severe; and, amid storms of snow or islands of ice, and furious gales of wind, it may be necessary to spend many weeks in beating around. Another route, much shorter, and on many accounts preferable, is to sail for Vera Cruz, and cross the isthmus with one of the caravans continually travelling there. Numerous trading vessels pass and repass from the western coast to the islands, and would afford a passage. The whole route may be made in two months, should a vessel be ready to sail the isthmus; but as that would be uncertain, a considerable delay might be caused in waiting for one. As, however, the place detention is within the tropics, almost on the equator, the climate could not be an objection to a short residence there.

    On arrival at the islands, the climate will be found, as has been already stated, extremely pleasant and equable, and not surpassed in salubrity by any in the world. Indeed, what place can be found more uniform?— the thermometer, during a space of ten years, not having varied more than thirty-two degrees; and where no day during the same period has a variation of more than nineteen degrees; where the same clothing is found comfortable the whole year, and where no other regulator of the temperature is needed than simply to open or close a window. I have reference here to the western sides of the islands. The eastern or windward sides, receiving the continued influence of piercing trades during the cooler season, some additional protection is needed.

     In further confirmation of the salubrity and healing influence of the climate, it may be remarked that several of the members of the mission have entered the field with pulmonary affections, who were regarded as doomed to certain and premature death if they remained in this country, who now enjoy good health, and are entirely free from any abiding symptoms of disordered lungs.

     Accommodations, recreation, &c.— There are scattered over the group probably five or six hundred foreign residents, of whom at least three-quarters live at Honolulu, on the island of Oahu, (Waohoo of Cooke.) This place has a population of six or seven thousand inhabitants, is laid out with some regularity as to streets, and has a considerable number of buildings, very respectable for size and appearance. The houses of the natives are mostly constructed after their own style-upright poles covered with thatch. There is a neat chapel, in which there is preaching twice every Sabbath by an intelligent American clergyman, and in the same building are a public library and reading rooms, well supplied with the various periodicals.

     Several American and English gentlemen have their wives and families with them, and there is constituted a small circle of refined and intelligent society. There are also several physicians-men of skill and intelligence. Boarding may he procured, with the comforts, and even luxuries and elegancies of life. Gentlemen can get comfortably accommodated for six or seven dollars per week, and plain board may be had for three or four dollars a week.

     The market is well stocked with beef, pork, fowls of different kinds, fish, oysters, milk, and a variety of excellent culinary vegetables. Fruits also are abundant and cheap, such as melons, bananas and pine apples; berries and some other fruits are plenty in their season.

     The means of gestation are abundant. Good horses and carriages can be procured, and the natural scenery is grand, inviting the lovers of nature in every direction. The harbour is well furnished with boats of every description, and vessels are continually sailing from island to island, and furnish pleasant excursions to the volcano, or elsewhere. A constant communication is also kept up with other portions of the world by vessels entering and leaving almost every week.

     Honolulu is more particularly noticed here, because it is the only place on the islands where comfortable accommodations can be procured. Lahaina on the island of Maui, and Kailua on Hawaii are both more favourably located as to climate, and are not subject to the force of the trades.

     The invalid will not look for sources of improvement or edification among the native population. He will there find a strange language,

an unenlightened population and barbarous customs. If, however, he possess benevolent and philanthropic feelings, he may find any amount of employment in the laudable work of promoting the improvement of the natives.

     Of the sources of gayety and dissipation, I have nothing to say. Neither will be recommended to the invalid seeking restoration to health. But no stranger residing at the Sandwich Islands need suffer for want of recreation or employment.

     In concluding my remarks, I must distinctly state, that I do not take upon myself the responsibility of recommending unqualifiedly the Sandwich Islands as a resort for consumptive invalids. The long voyage and other circumstances, will render the project in most cases doubtful and often out of the question. I merely offer them to the consideration of such as they may specially concern, and leave it to such persons to judge of the attention they may deserve.