524 



SCIENCE, 



[N. S. Vol. XI. No. 275. 



conjunction with the First Reserve Hos- 

 pital. We went or were frequently called 

 to the other hospitals to make clinical and 

 bacteriological examinations. 



With few exceptions, all the dead were 

 subject to autopsy. Post-mortem examina- 

 tions were made at the Civil Hospitals upon 

 natives and at the Military Hospital upon 

 all that died. Exceptions were made only 

 in the cases of those dead from gunshot 

 wounds, when, if pressed for time, necrop- 

 sies were sometimes omitted. 



PREVAILING DISEASES. 



The subject of the prevalent diseases may 

 be considered as they affect (1) the natives, 

 and (2) Europeans and Americans, especi- 

 ally the American garrison. 



Diseases affecting Natives. — (a) Skin Dis- 

 eases. Of the skin diseases prevailing among 

 the natives, aside from smallpox and other 

 specific exanthemata, may be mentioned 

 (1) diseases of the scalp, which are very 

 frequent; (2) dhobie itch; and (3) an af- 

 fection which resembles closely and which 

 is probably identical with Aleppo boil 

 (Delhi boil, Biskra button, epidemisehe Beul- 

 enkrankheit) .' (6) Smallpox. This disease 

 has been so generally prevalent in Luzon 

 that the natives have to a large extent lost 

 fear of it. All evidence points to the greatest 

 carelessness in preventing its spread during 

 Spanish times. Isolation of the sick and 

 disinfection of the habitations seem not to 

 have been attempted, and vaccination, even 

 among the Spanish garrison, had not been 

 carried out. Under these circumstances it 

 could be no surprise that after the Ameri- 

 can occupation the disease should appear 

 and even become epidemic. The epidemic 

 which appeared early last year was promptly 

 met by Br. Bournes, who caused the Span- 

 ish garrison still in Manila and the natives 

 and Chinese within the city to be vacci- 

 nated. In order to insure satisfactory re- 

 sults he found it necessary to establish a 



vaccine farm in which young carabao were 

 used for the preparation of the virus. Under 

 the influence of this measure and by the aid 

 of isolation of tlie sick the disease had in 

 May practically disappeared within the 

 military lines about Manila, (c) Lejyrosy. 

 A definite focus of this disease exists 

 in Luzon. The cases, in the neighbor- 

 hood of 100, which were confined in the 

 San Lazaro Hospital came from Manila and 

 the country immediately surrounding that 

 city. The disease affected both sexes, being 

 more frequent in adults, although also 

 present in half-grown boys and girls. The 

 commonest forms were the tubercular and 

 mutilating. Autopsies were performed upon 

 several cases that had died during our stay. 

 (d) Tuberculosis. Accurate statistics of the 

 extent of the prevalence of this disease are 

 difficult if not impossible to obtain. That 

 the disease is a common one is indicated by 

 several facts. It is frequently met with in 

 the native hospitals, where it may have 

 been recognized during life or is disclosed 

 at autopsy. Many cases of supposed beri- 

 beri which we autopsied at San Juan de 

 Dios proved to be tuberculosis. It is pos- 

 sible that the two diseases had co-existed, 

 for we found such combinations freely recog- 

 nized by Japanese physicians in the hos- 

 pitals in Japan. Tuberculosis of the lungs 

 was also found as a common complication 

 in leprous individuals that came to autopsy. 

 A not very infrequent spectacle met with 

 on the streets are much emaciated and 

 wealc natives, affected with suggestive 

 coughs and free expectoration. While it is 

 not certain that these individuals were ex- 

 amples of tuberculosis, there is strong 

 probability that this explanation of their 

 condition is the correct one. (e) Venereal 

 Disease. Syphilis, by general agreement 

 (statistics not available), does not pre- 

 vail unduly. Chancroids and gonorrhoea 

 are, on the other hand, very common. 

 Th§ majority of the prostitutes confined 



