SUPPRESSION OF CHOLERA IN MANILA. 



45 



defined on the chart showing the cases from September 1 to October 12, 

 1908. 



Date. 



Number 

 of cases. 



Date. 



Number 

 of cases. 



September 1 



3 



1 



6 



4 



4 



4 



5 



3 



7 



9 



17 



11 



10 



16 



37 



September 17 



25 

 24 

 43 

 60 

 55 

 38 

 45 

 40 

 44 

 37 

 14 

 18 

 13 

 11 



September 2 — ._ 



September 18__ 



September 4 ... 



September 19 



September 5 



September 20 



September 6. 



September 21 



September 7 „ 



September 22 



September 8 



September 9 



September 23 



September 24. 



September 10 



September 25 



September 11 



September 26 



September 12 



September 27 



September 13 



September 28 



September 14 



September 29 



September 15.. ... 



September 30 . 



September 16 







Date. 



Number 

 of cases. 



Date. 



Number 

 of eases. 



October 1 



12 



10 



5 



9 



11 



6 



October 7 .. . 



8 

 13 

 8 

 6 

 3 

 4 



October 2 



October 8— 



October 3 



October 9 



October 4 



October 10 



October 5 



October 11 



October 6 



October 12 







The high-water mark of the epidemic was reached on September 20, 

 when 60 cases were reported in twenty-four hours. 



When the number of cases reached 9, on September 11, I recognized 

 the probability of an epidemic, and took personal charge of the opera- 

 tions. Upon September 12 the number reached 17, 12 being in the 

 Meisic district. Upon investigating this district, I found that in 18 

 cholera houses — that is, houses in which cases of cholera had occurred — 

 the closet was in a filthy condition in every instance. These houses had 

 the following combination : Filthy closets, rats, flies, cockroaches, and 

 other insects, and a kitchen immediately adjoining the closet. With this 

 condition, all that is necessary is the presence of the bacilli carrier, who, 

 by using the closet, will furnish the infective material. 



Two additional disinfecting squads were put to work immediately for 

 the exclusive duty of disinfecting closets, and on the 13th the cases 

 dropped to 11, and on the 14th to 10. On the 15th sixteen cases oc- 

 curred, and 105 additional men were employed. This force was in- 

 creased as rapidly as possible without causing confusion and disorganiza- 

 tion, and by September 22 the complete organization of 500 men was 

 working smoothly. This force was increased by the 25th to 600 men. 



