Book excerpt: In 1778 Captain James Cook made his first visit to the Hawaiian Islands. The members of his expedition and subsequent visitors brought to the previously isolated Hawaiian people new things, novel ideas, and, of greatest consequence, devastating alien germs. The infectious diseases introduced since 1778 have claimed more Hawaiian lives than all other causes of death combined. During their long isolation in space and time, Hawaiians had not been exposed to the many microbes that afflicted populations in other parts of the world. They had developed no immunity to those germs and gained no experiences to enable them to endure the sicknesses the newly introduced germs caused. That terrible vulnerability to foreigners' diseases has almost destroyed Hawaiian society and culture. The nine essays in this collection discuss the impact of these "gifts of civilization" upon the native Hawaiian people and upon the social history of Hawai‘i. Dr. Bushnell constructs a concise historical framework, including an examination of the native medical profession, and interprets the few facts known about it in light of present knowledge in the medical sciences. He presents information, opinions, and conclusions harvested from many years of thinking about the fate of native Hawaiian people, studying all the relevant documents, and writing about this and related subjects.