236 The Philippine Journal of Science 1922 
children under 1 year of age. According to Table 1 there were 
100 deaths, or 34 per cent, due to infantile debility out of a 
total of 290 deaths from all causes in children under 1 year of 
age. Therefore, the proportion of deaths from infantile debility 
is relatively higher than in nonleper communities, which may 
be presumed to be due to the weakened condition of the parents. 
The increase in deaths from infantile debility is partly com- 
pensated by the small number of deaths from infantile beriberi, 
which is one of the important causes of infant mortality in 
nonleper populations. This is due to the use of unpolished rice 
in the diet in the colony. 
THE SITE OF THE EARLY LESION 
Our data regarding the site of the initial lesion of leprosy are 
based on comparison of the physical and bacteriological exami- 
nations of the skin and nose. Bacteriological examination was 
made of the skin of all children showing suspicious or charac- 
teristic lesions, and in practically all of these the secretion and 
scrapings from the nose have also been examined. Dr. Felisa 
Nicolas, of the eye, ear, nose, and throat department of the Phil- 
ippine General Hospital, on a visit to Culion, kindly made inspec- 
tion of the noses of twenty-six children who either were 
nonlepers or showed suspicious or definite lesions of leprosy in 
the skin. The findings of Doctor Nicolas, compared with results 
of the physical and bacteriological examinations of the skin 
lesions and the nose, are shown in Table 2. 
The physical examination of the skin comprised, besides in- 
spection, the testing for tactile and thermal anzsthesia and the 
determination of areas of anhidrosis by the injection of pilo- 
carpine solution. Tactile anzesthesia was tested by the light ap- 
plication of the point of a pin and asking the child to point out 
the location where the pin was applied. Thermal anzsthesia 
was tested by applying alternately hot water and cold water in 
test tubes; this test was applied to older children who could 
give intelligent answers. To test the anhidrosis a solution of 
1 milligram of pilocarpine nitrate to 1 cubic centimeter of water 
was prepared, and subcutaneous injection was made of an 
amount that was proportionate to the age of the child as figured 
by the formula of Young,' on the basis of 5 milligrams as 
the average dose for the adult; and, in addition to the pilo- 
carpine, hot tea was given to drink, and the child wrapped in a 
412 + age 
on 
= the denominator of a fraction the numerator of which is 1. 
