120 The Philippine Journal of Science 1923 



substituted for the native inhabitants and made to live under 

 native conditions, the European population would be wiped out 

 in a short time as the result of plague. As to some of the other 

 important diseases, I submit the following remarks. 



It is hardly proper to mention smallpox as an example of 

 racial immunity, as we have been able to vaccinate a sufficient 

 number of the population to keep it in check. The few cases 

 that do develop in the unprotected are very mild compared to 

 the type of smallpox of which the older physicians in Bangkok 

 speak. The average number of cases per year for the last three 

 years has been thirteen. This is considered an excellent mor- 

 bidity rate for an eastern city like Bangkok. 



We have had in the local general hospital during the last 

 year seven cases of fully developed tetanus with four recoveries. 

 This is of course a small number to cite in support of any theory, 

 yet in the case of a disease like fully developed tetanus we feel 

 justified in recording our experience. We do not feel that it 

 was the treatment that saved these patients ; of course, credit is 

 given for the specific effect of the treatment, but it seems almost 

 a certainty that four of these patients with fully developed teta- 

 nus could not possibly have recovered had they not possessed a 

 great reserve of what may be termed "general infection im- 

 munity." 



In one of the institutions under the supervision of the med- 

 ical officer of health practically all of the emergency surgery 

 for the entire City of Bangkok is taken care of, as well as a 

 large part of that coming from the interior. To cite the number 

 and variety of cases that illustrate, beyond the shadow of a 

 doubt, the fact that these people do enjoy a marked immunity 

 to infection and primary shock resulting from extensive bodily 

 injury is not the purpose of this paper; but in general it may 

 be stated, without fear of serious contradiction, that they can 

 suffer more-extensive injury, and recover from the effects of 

 the same, than is the case with any other people. In the class 

 of cases that come to operation it has been demonstrated that 

 the peritoneum will take care of a very extensive contamina- 

 tion without showing signs of infection. Space permits me to 

 cite but one case that markedly illustrates the reserve these 

 people possess in the way of bodily resistance. 



Female patient, aged 32 years, native Siamese. Brought to hospital 

 suffering from extensive stab wounds in abdomen. Injury so extensive 

 that abdominal contents were protruding and wrapped up in an old dirty 

 cloth. Patient several hours previous had been stabbed, wrapped in a 



