Note 40 — Chapter V

oulder-strap in carrying loads be a predisposing cause of goitre, by inducing congestion of the laryngeal vessels? The Lepcha is certainly far more free from this disease than any of the tribes of E. Nepal I have mixed with, and he is both more idle and less addicted to the head-strap as a porter. I have seen it to be almost universal in some villages of Bhoteeas, where the head-strap alone is used in carrying in both summer and winter crops; as also amongst the salt-traders, or rather those families who carry the salt from the passes to the Nepalese villages, and who very frequently have no shoulder-straps, but invariably head-bands. I am far from attributing all goitre, even in the mountains, to this practice, but I think it is proved, that the disease is most prevalent in the mountainous regions of both the old and new world, and that in these the practice of supporting enormous loads by the cervical muscles is frequent. It is also found in the Himalayan sheep and goats which accompany the salt-traders, and whose loads are supported in ascending, by a band passing under the throat.