BUBONIC PLAGUE 103 



are extremely favourable for its extension, it has been 

 kept within reasonable bounds and, indeed, the latest 

 reports indicate that it has been practically extermin- 

 ated by the persistent efforts of the medical officers 

 of our army, charged with the duty of protecting the 

 public health in those islands. 



The monthly report of the Board of Health for 

 the city of Manila for September, 1902, the last at 

 hand, records but one death from plague during that 

 month. During the same period there were ten 

 deaths from typhoid fever, thirty-five deaths from 

 dysentery, and seventy-six deaths from " the great 

 white plague," pulmonary tuberculosis. 



Bubonic plague, cholera, and typhoid fever have 

 long been classed as " filth-diseases," and in a certain 

 sense this is correct, although we now know that the 

 germs of these diseases not only are not generated 

 by filth, but do not multiply in accumulations of filth. 

 They are' present, however, in the alvine discharges 

 of the sick, and when this kind of filth is exposed 

 in the vicinity of human habitations or gains access 

 to wells or streams, the water of which is used for 

 drinking, the germs are likely to be conveyed to the 

 alimentary canals of susceptible individuals, and thus 

 the disease is propagated. Until quite recently the 

 attention of sanitarians was so firmly fixed upon the 

 demonstrated transmission of cholera and typhoid 



