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perhaps because the trade in its surroundings is still insignificant, and the riverside inhabitants, for lack of bridges, cannot easily dispose of their products. The most important transport is between Aldeia da Escada and Pindamonhangaba. Among the inhabitants of this region, there is an endemic swelling of the neck glands to such a high degree as never seen before in Europe. Sometimes all the neck becomes swollen, which gives these mostly colored people a horrible look. It seems, however, that in the country a goiter is considered to be more beautification than deformation, for it is not uncommon to see women with their monstrous neck decorated with gold and silver chains show themselves, with pipe in the mouth or with a spindle in the hand, sitting in front of their houses.

Blacks, mulattos and Mamelukes, who make up the bulk of the population, suffer from this disease; among whites, women are more subject than men. The causes of this deformation appear to be the same here as in other countries, that is, the disease does not occur in the cooler, ventilated highlands, but in the Paraiba Valley, it is almost always covered by dense fog. The direction of both mountains from south to north does not allow humidity to exit; these mists, which form during the day above the river and neighboring marshes, partly covered with woods, fall again into the valley at night. Beside that, the heat is intense, and the often murky, impure and warm river water replaces the clear water, the good spring water; The houses are also not clean, moist and exposed to the winds. Eating coarse cornmeal, which is more common than the actually more nutritious, on the other hand more indigestible cassava flour, and the use of too much bacon, may contribute to the development of the disease; Finally, sexual excesses should be considered, as in Rio de Janeiro, the joint cause of sarcoma and hydrocele, as well as that of the swollen thyroid. The sad spectacle of Cretinism is not seen here, which in Europe goes hand in hand with the endemic thyroid swelling. One notices, however, in the aspect of the attacked people, when the disease reached the greatest development, not only the drowsiness and lack of energy of the former, but also profound stupidity. They treat the disease, initially with warm pumpkin poultices, and internally with water exposed for a few days on the pounded mass of termite houses. The material of these termites, for which the insect uses a viscous substance proper for cement, appears to have curative virtue against the goiter. Perhaps also formic acid produces beneficial influence on the patient's relaxed nervous system, as well as