632 The Philippine Journal of Science 1921 
disease is allowed to run many days without adequate treatment. 
Among patients belonging to the laboring class, who disregard 
their ailments during the first days of disease and who have 
low resistance because of their unhygienic mode of living 
and deficient diet, morbidity is naturally high and mortality 
correspondingly so. The patients that I have handled were 
mostly of the laboring class. 
Let me state, however, that it was impossible to obtain an 
adequate supply of serum; consequently it became necessary to 
select the most serious cases for 'the administration of serum 
and to deny the benefits-of such treatment to those who did not 
seem to be very ill. Even in some of the serious cases we were 
compelled to discontinue the treatment owing to lack of serum. 
In addition to the handicap just mentioned, it should be 
stated that, on admission to the hospital, most of these charity 
patients were in bad condition. Many of them remained in 
their homes from three to seven days without any treatment 
and applied for admission only when the disease had already 
made much progress, and thus were suffering from severe tox- 
zmia and marked involvements of the larger gut. In many 
cases they collapsed on admission. In such exceptional cases 
the use of serum is not efficacious. 
With the application of the serum the mortality rate is from 
9 to 12 per cent, according to Shiga;(9) Rosenthal, in Russia, has 
obtained 5.1 per cent; Bahr,(1) in Fiji Islands, obtained 1.8. 
Of the one hundred sixty-four patients suffering from dysentery 
who were admitted during 1918 to the medical wards of the 
Philippine General Hospital fourteen died, giving a mortality 
rate of 8.53 per cent. Of the one hundred five who received anti- 
dysenteric serum twelve died, giving a mortality rate of 10.47 
per cent. 
Without the use of the serum, there is distinct increase in the 
mortality rate, as was observed in the Philippine General Hos- 
pital in the fiscal year 1912-19138. During this period the 
death rate among one hundred ninety-one males and seventy- 
five females amounted to 17.8 and 20 per cent, respectively. 
According to Musgrave and Sison,(8) the mortality rates in 
hospitals in other countries, where treatment with drugs is 
practiced, are as follows: 
Per cent. 
Japan 16.5 to 30.2 
Singapore (1902) 25.4 
Ceylon (1903) 28.4 
Hongkong (1902) 37.3 
