64 EDITORIAL. 



Dean C. Worcester: I remember Doctor Heiser complained that Doc- 

 tor Gilman's diagnoses were not confirmed. 



Dr. R. P. Strong: I think Doctor Oilman told me some of the cases 

 which came to the morgue were not cholera. Of the cases of cholera I 

 know that some were identified bacteriologically. 



Dr. Paul G. Freer, Director of the Bureau of Science; dean of the 

 Philippine Medical School: All were confirmed after Doctor Heiser 

 mentioned the matter. I have been surprised at the great number of 

 bacilli carriers discovered this year. Over a year ago the Bureau of 

 Science asked the Bureau of Health to send cholera stools of contacts 

 from all stations. We started the work on January 22, 1908 but some- 

 how we failed to get a very large number of stools. We found two 

 Japanese carriers and then we obtained no more material until lately 

 during this epidemic, and these examinations gave us a total of about 

 7 per cent. This number seems to me usually high. I wish to ask 

 Doctor Strong what the percentage was in the El Tor epidemic. 



There is another question that has not been discussed this evening, 

 namely that of vaccination against cholera. What have the other na- 

 tions that have had to deal with cholera done in this respect? We have 

 done nothing this year, but I think vaccination is being employed in 

 Europe. 



I was very much interested in Doctor McLaughlin's statements regard- 

 ing the nipa houses and the general sanitation of the city. I recall the 

 history of a few years ago, during the early days of the Board of Health, 

 when strenuous efforts were made to clean up various districts of the 

 city. A great many houses had their foundations changed and their 

 ground floors raised above the street levels. Several old and insanitary 

 markets were destroyed, others rebuilt and many insanitary houses 

 burned. An ordinance was passed giving a minimum of 3 meters' dis- 

 tance between nipa houses and insuring a certain height of the ground 

 floor above the street. Public latrines were put in as far as possible. 

 The continuation of these improvements was side-tracked, because of the 

 lack of adequate authority to back up the work of the Board of Health. 

 One example of radical improvement was the remodelling of Calle Car- 

 vajal. The discussion leading up to this improvement lasted over four 

 months, but finally the owners of the property were persuaded to do the 

 right thing. Much controversy took place as to the best sanitary code 

 that could be produced, and finally we have a sanitary code combined 

 with the building ordinance, so that in the future the Bureau of Health 

 is in shape to accomplish results by ordinance where the former Board of 

 Health had had to do everything by persuasion, excepting where houses 

 were destroyed by burning. As soon as the pressure of an epidemic dis- 

 appeared, the capability and power of the old Board of Health to do 

 things was limited by the available ordinances. 



Dr. R. P. Strong : In regard to bacilli carriers, that is individuals who 

 carry cholera spirilla in their stools and apparently have no symptoms 



