EDITORIAL. 



DISCUSSION OF DR. MCLAUGHLIN'S PAPER ON "THE SUP- 

 PRESSION OF A CHOLERA EPIDEMIC IN MANILA."^ 



Dr. N. M. Saleehy, superintendent of the University Hospital, Manila: 

 I would like to ask Doctor McLaughlin for his opinion as to whether or 

 not at the time of this outbreak cholera was endemic in Manila, or if it 

 was brought from the provinces? Did the first case come from Panga- 

 sinan? I believe it to be of the greatest importance to Manila at the 

 present time, for the Manila Medical Society at least to espress an 

 opinion. Did this present epidemic of cholera come from the provinces 

 or from endemic cases in Manila? I would like to hear some discussion 

 on this point. 



Dr. Allan J. McLaughlin, Acting Director of the Bureau of Health 

 for the Philippine Islands: Doctor Saleeby's question is a very difficult 

 one to answer and it will require a great deal of study. I am not 

 prepared to answer it at the present time. If the suspicious cases during 

 January were connected with the epidemic of September it was not 

 necessary to have it brought down the railroad. There was undoubtedly 

 much reenforcement from neighboring provinces, cases being brought in 

 repeatedly, but Avhetlier or not this explains all the cases it is difficult to 

 say. We were unable to trace the first cases in July to the provinces. 



In reply to the question as to the condition of the provinces now, 

 Pangasinan, Tarlac, and Pampanga are clean; Bulacan shows from one 

 to four cases per day in the whole province; in Eizal cases occur every 

 few days, and there are very few cases in Cavite. There is not much 

 cholera at the present time excepting around Manila. 



Colonel Van R. Hoff, chief surgeon of the Division of the Philippines, 

 United States Army: I would like to ask Doctor McLaughlin how many 

 of the cases, reported as suspicious, turn out actually to be cases of 

 cholera? The reason the question comes to my mind is (in studying as 

 I do the daily reports of the Bureau of Health) that you have reported 

 so many cases of suspected cholera. If any cases are reported as 

 suspected cholera and later prove to be actual cases, how are they 

 included in the report? 



Doctor McLaughlin: We have no exact figaires on that point, but I 

 remember six cases in one day that were reported as suspicious and all 

 six were later discharged as not cholera. I think the majority turn out 

 not to be cholera, but I have no complete statistics. Cases which are 



' Held at the meeting of the Manila Medical Society, October 19, 1908. 



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