62 HEISER— AMERICAN SANITATION 



There were no adequate building laws, and, as a result, too fre- 

 quently the case in Oriental countries, small dark interiors with no 

 light or air were the rule. Street cleaning was most indifferently 

 carried out. Large quantities of garbage and other filth accumu- 

 lated in the back yards and upon the streets. Tuberculosis was prob- 

 ably responsible for at least 50,000 deaths per annum, and no gen- 

 eral education measures were in operation with a view to teaching 

 the people how to combat disease. 



There was no food law in the modern sense. Perishable provi- 

 sions were sold under insanitary conditions. The vilest class of 

 food products was often shipped into the country. There was prac- 

 tically no inspection of animals before slaughter, neither were there 

 suitable slaughter-houses. Dysentery soon caused sad havoc among 

 the American troops and among those who came in civil capacities. 

 Subsequent investigation showed that the native population also suf- 

 fered severely from this cause. 



Hospitals for the masses, with modern operating rooms and 

 surgical equipment, were practically unknown. Persons died on 

 every hand with diseases which could have been relieved by ordi- 

 nary medical procedures. It was not uncommon to find victims 

 horribly deformed by conditions resulting from injuries or disease 

 that could have been cured without deformity if skilled attention and 

 facilities had been available in the beginning. There were perhaps 

 a half million persons living in a wild state, for whom there was no 

 medical relief. 



In the days prior to American control, maritime quarantine was 

 often conducted upon a basis of graft. Naturally the result of such 

 lax methods was the introduction from nearby foreign countries of 

 dangerous communicable diseases such as plague, cholera, and small- 

 pox. jNIore than 5,000 lepers were at large throughout the Philip- 

 pine Islands. A few hundred were cared for by charity, but there 

 was no attempt to segregate lepers with a view to avoiding the 

 danger of infection or bringing the disease under control in the 

 entire archipelago. Malaria, likewise, prevailed in hundreds of 

 towns and there was no quinine with which to combat it. Imita- 

 tion quinine pills were frequently sold at fabulous prices in the 



