MEDICAL SURVEY OF THE TOWN OF TAYTAY. 281 



joint lesions and 7 adults had unmistakable clinical signs of tuberculosis 

 without showing tubercle bacilli in the sputum. A great many of the 

 people complained of some trouble Avith the lungs, and 51 of these, consid- 

 ered possibly tubercular, were examined a month or two later, 11 or 

 about one-fifth were then found to be affected, 5 showed tubercle bacilli 

 in the sputum and 6 definite clinical signs of the disease. The rest had 

 either asthma or heart disease or had entirely recovered from what had 

 evidently been attacks of bronchitis. 



No focus of tuberculosis was found. Tlie disease was distributed 

 evenly over the town. (Plate No. V.) No special family infection 

 could be observed. Very few patients had been sick over two years and 

 it wou.ld appear that they generally do not live much longer than two or 

 three years after having been infected. The death rate is about 4 per 

 thousand, or 25 per year. 



Pulmonary tuberculosis was most frequently observed; one case of 

 spinal tuberculosis, 2 cases of tuberculosis of the skin and 3 cases of joint 

 ijivolvement were encountered. The larynx was involved in 3 cases. In 

 young adults the disease ran a relatively rapid course. 



It is our belief that something could be done here in combating tuber- 

 culosis by segregation of the patients in a sanitarium and by the disinfec- 

 tion of their sputum. The chief need of those affected is nourisliing food. 



Typlioid fever. — Four cases of typhoid fever were seen among the 

 natives of Taytay and one in a resident of Manila who was taken sick 

 five days after arrival in Taytay. The location of these eases is shown 

 in the map. ( Plate V. ) Two of the cases were typical from a clinical 

 standpoint, the fever continuing for four weeks. One of these, a male 

 aged 24 years, gave a Widal reaction on the 19th day of the disease and a 

 positive one on the 36th day. The other case, a girl of 14 years, gave a 

 positive Widal on the 16th day; typhoid bacilli, a l)lue strain, was 

 recovered in plate cultures from her fa?ces. The other two cases were in 

 girls, aged 6 and 7 years respectively, who had fever of ten and fourteen 

 days, and in wh'ich the blood showed a Widal reaction after the sul)sidence 

 of tlie fever. None of the patients had been out of Taytay for one month 

 before becoming sick.* No connection between the cases could be traced. 

 The wife of the first ease gave a Widal reaction and an indefinite history 

 of fever, but no bacilli were found in her faeces. Tlie blood from the 

 members of the family in which the cases occurred and of peo])k' wlu) liad 

 been in contact with the sick ones was examined by the Widal reaction 

 l)ut none gave a positive reaction. 



Some of the early reports of the Surgeon General's Office and of the 

 Bureau of Health give tlie impression that typhoid fever is a comparati- 

 vely rare disease in the Philippines and that those cases which are found 

 have been imported. The same idea was formerly held in India but 

 recenth- it has been shown bv Pogers and olhci's to he cii'oneous and does 



