Productions of Boutan and Thibet. 99 
the difeafe might arife from an impregnation of the water by 
thefe plants, or the foil probably pofleffing fimilar qualities, 
the fpontaneous productions of both countries, with very few 
exceptions, being fo nearly alike. It however appears more 
probable, that the difeafe is endemial, proceeding from a pe- 
culiarity in the air of fituations in the vicinity of mountains 
with fuch foil and vegetable productions. I am the more 
inclined to think fo, that I have univerfallv found this diieafe 
raoft prevalent among ft the lower clafs of people, and thofe 
who are moft expofed to the unguarded influence of the wea- 
ther, and various changes that take place in the air of fuch 
fituations. The primary caufe in the atmofphere producing 
this is, perhaps, not more inexplicable than what we 
meet with in the low-lands of Effex and fens of Lincolnfhire. 
An accurate analyfis of the water ufed in common by the 
natives, where this difeafe is more or lefs frequent, and where 
it is not known in fimilar expofures, might throw fome light 
on this fubjedt. 
This very extraordinary difeafe has been little attended to, 
from obvious reafons ; it is unaccompanied with pain, feldom 
fatal, and generally confined to the poorer fort of people. The 
tumor is unfightly, and grows to a troublefome fize, being 
often as large as a perfon’s head. It is certainly not exag- 
gerating to fay, that one in fix of the Rungpore diftrict, and 
country of Boutan, has the difeafe. 
As thofe who labour moft, and are the leaft protected from 
the changes of weather, are moft fuhjeft to the diieafe, we 
univerfally find it in Boutan more common with the women 
than men. It generally appears in Boutan at the age of thir- 
teen or fourteen, and in Bengal at the age of eleven or twelve ^ 
fo that in both countries the difeafe fhows itfelf about the age 
O 2 of 
