SUPPRESSION OF A CHOLERA OUTBREAK. Ill 



river and the removal of the pail system installed by the city of Manila, 

 when the inauguration of the new water system rendered these precau- 

 tions unnecessary for the protection of the Manila water supply. The 

 provincial and municipal authorities were urged to provide an efficient 

 substitute for the pail system removed from Mariquina. This they 

 failed to do. 



When left to themselves, there is no doubt that the local authorities, 

 with one or two remarkable exceptions, relapsed into their habitual 

 apathy. The president of the sanitary department of Mariquina, Vi- 

 cente Mallori, and the justice of peace of the same town, did probably 

 all that two individuals could do without support from the other muni- 

 cipal officials. 



As a result of the work of organization done by Dr. Jesus and Sanitary 

 Inspectors Percy and Palmer, and the campaign carried on under their 

 direction, cholera disappeared from the valley by November 16. The 

 entire district was free from cholera from November 16 to December 

 12, when one case occurred in San Mateo. This was followed by a 

 reappearance of the disease on the 14th in Mariquina, and in Pasig on 

 the 31st, the total for the valley for the month of December being 87 

 cases with 77 deaths. 



Medical Inspector Laughlin, late in December, made an inspection of 

 Pasig and other towTis and attempted to stir the local officials into ac- 

 tivity. On December 29 and 30, Medical Inspector Clements made an 

 inspection of the entire valley and did some strenuous work exhorting 

 the municipal councils to action. On December 31 the writer, after a 

 careful inspection of Pasig, Mariquina, San Mateo, and Montalban, 

 decided that the local authorities were unable to cope with the situation 

 quickly and placed the following organization at work on January 1, 

 1909. All of the men employed belonged to the regular Manila force : 



Pasig : Sanitary Inspector Hogle in charge ; 10 assistant sanitary in- 

 spectors; 1 disinfector. 



Mariquina: Sanitary Inspector Pauly in charge; Sanitary Inspector 

 Jacobsen; 10 assistant sanitary inspectors; 1 disinfector. 



San Mateo and Montalban : Sanitary Inspector Percy in charge ; 10 

 assistant sanitary inspectors; 1 disinfector. 



Daily inspection of the entire valley was made by Medical Inspector 

 Paul Clements, and inspection three times per week by the writer. 



On the 3d of January, upon request of the writer, the Governor- General 

 ordered two companies of Constabulary to assist in this work. They 

 were available for duty on January 5. The campaign was directed along 

 the lines of our work in Manila in the recent epidemic, recognizing that 

 the cardinal principle in fighting cholera is the proper disposition of the 

 faeces of the entire population. Every householder in Pasig, Mariquina, 

 and San Mateo was compelled to keep his premises clean, to dig a pit 



