EDITORIAL. 63 



Dr. Allan J. McLaughlin: Yes; I think he has. The list I presented 

 here shows practically all the cholera cases, and the onl}- month without 

 cholera was April, and in April we had many of the suspicious cases. 



Dr. R. P. Strong: That shows that there was no difficulty in making 

 a bacteriologic diagnosis of the cases as far back as January; that is, at 

 a time before the disease l:)ecame epidemic. 



Dr. Allan J. McLaughlin: There was no cholera present at times, yet 

 the surprising fact is that cases which resemble cholera clinically, but in 

 which we did not find cholera vibrios occurred. Koch says this failure to 

 identify the infecting agent is due to faulty technique, but I do not 

 think so. 



Dr. R. P. Strong: I do not think there was any mistake in the diag- 

 nosis of the cases; The bacteriologic diagnosis of cholera is a very definite 

 one. A great deal depends, however, on the technique and the care with 

 which the examination is made. 



Dr. Van R. Hoff: You were not here. Doctor Strong, but last year 

 (1907) we had a little epidemic of cholera beginning about July and 

 running up to the latter part of December and January, and then it 

 subsided. During the first six months of 1908 we had practically no 

 cholera, excepting occasional, sporadic cases, and then about the same 

 time this year as last, the cases increased in number until they culminated 

 the other day. Why that should be, I do not know, but there may be 

 some relation in it. In studying the history of the Philippines, the 

 epidemics seem always to come about this time, and they cover a period 

 of three or four months in their intensity. Looking back and considering 

 the epidemics for the entire Archipelago and particularly the Island of 

 Luzon, the following appears to be true, when the epidemic last year 

 ceased in Manila it seemed to begin in Dagupan. The first report of any 

 large number of cases I believe came from Dagupan, and the infection 

 worked its way through Paugasinan and appeared in Manila. There 

 were apparently no cases between Manila and Dagupan, at least according 

 to the reports I saw. Cholera jumped from here to Dagupan, and from 

 Dagupan back. All over the Archipelago and in various points in Min- 

 danao we have had cholera, a little here and a little there, but in no 

 great amount, until it developed in Pangasiuan. I presume up to the 

 present time, in round numbers, we have twenty-five or twenty-six thousand 

 cases with about fifteen thousand deaths. 



Dr. Allan J. McLaughlin : There were something over twenty thousand 

 cases. 



Dean C. Worcester: Were Doctor Gilman's diagnoses of cholera all 

 confirmed ? 



Dr. R. P. Strong: I know some certainly were, after I returned. I 

 came back in April. Doctor Oilman told me he had reported cholera 

 cases in Januarv, before I got back. 



