Apeil 6, 1900.] 



SCIENCE. 



525 



in the San Lazaro were victims of these 

 two diseases. A very common complica- 

 tion of the soft sore, owing to lack of clean- 

 liness, is swelling and suppuration of the 

 inguinal glands. (/) Beri-Beri. This dis- 

 ease is well known among the natives. It 

 would appear to be epidemic and endemic 

 in Luzon. It is, judging from cases met 

 with in San Juan de Dios Hospital and the 

 statements of native physicians, constantly 

 appearing in a sporadic form. During our 

 stay an epidemic appeared among the Fili- 

 pino prisoners confined at Cavite. Some 

 200 eases developed in a few weeks ; the 

 mortality ranged from 20 to 30 per cent. 

 The several recognized forms of the disease 

 — oedematous, paralytic, and mixed — were 

 encountered. Clinical and bacteriological 

 studies were made upon the living, and the 

 dead were subjected to autopsy and bac- 

 teriological examination. The difficulty of 

 getting to and fro between Manila and Ca- 

 vite on account of the impossibility of land 

 communication, made this part of our work 

 difficult and time-consuming. A consider- 

 able collection of pathological material and 

 other data has been made. This material 

 is now in process of study and arrangement. 

 Diseases affecting Americans. — The chief 

 causes of disability among the American 

 land forces are the enteric diseases. These 

 are diarrhcsa, dysentery, typhoid fever, and 

 gastro-intestinal catarrhs. Many of the 

 diarrhoeas are merely preliminary to the 

 symptoms of dysentery. ' Other infectious 

 fevers are relatively infrequent. A small 

 number of cases of scarlet fever and diph- 

 theria only were encountered. The ma- 

 larial fevers prevailed but not seriously 

 during the months of May, June and July. 

 (a) Dysentery. This disease is responsible 

 for the greatest amount of invalidation and 

 the highest mortality. It appears in acute, 

 sub-acute, and chronic forms. The chronic 

 form is sometimes attended by secondary 

 abscess of the liver. The acute form may 



end in 24, 48, or 72 hours. In it the whole 

 of the large intestine and usually the lower 

 portion of the ileum is involved. The mu- 

 cous membrane of the gut is swollen, con- 

 gested and oedematous, in places hemor- 

 rhages have taken place into the mucous 

 membrane and the sub-mucosa is swollen 

 and its blood-vessels greatly dilated. N"o 

 ulcers existed in such cases. Amoebse 

 were absent or very diflScult to find in the 

 fresh stools and in the intestinal contents 

 immediatelj' after death. In the sub-acute 

 and chronic forms ulcers are present in the 

 mucosa ; the coats of the intestine are 

 greatly thickened ; at times large sloughs 

 of mucous membrane, partly detached, 

 occur, and the lesions are confined to the 

 large intestine. Amoebse are more com- 

 monly present in these cases but are vari- 

 able as to actual occurrence and num- 

 bers. Large hepatic abscesses, usually 

 single, were encountered in a number of 

 these cases. Amoebae were variable in the 

 contents of the abscesses. In one very 

 large abscess, occupying both right and left 

 lobes of the liver, no amoebte but a pure cul- 

 ture of the Staphylococcus pj'ogenes citreus 

 was obtained. The clinical study of the 

 cases of dj'sentery with reference to amoebse 

 was equally unsatisfactory. In cases with 

 marked symptoms both in patients con- 

 fined to bed and those beginning to go 

 about but still with persistent loose bowels, 

 these organisms were frequently missed ; 

 while in instances ready to be discharged 

 they might, at certain examination, be 

 found to be very abundant. In morphol- 

 ogy, the amoebse studied corresponded with 

 the amoeba coli found in Egypt and in this 

 country. The bacteriological study of cases 

 of dysentery was carried out upon the fresh 

 stools of acute and chronic cases and with 

 the intestinal contents, mesenteric glands, 

 liver, etc., of cases dying and subjected to 

 autopsy. The intestinal flora was studied 

 in its entirety by means of plate cultures. 



