318 HEISER AND CALDERON. 



An effort to reduce the mortality by one-fourth would be worth, it neces- 

 sary, an investment of $5,500,000,000. The cost of treating patients at 

 sanatoria is repaid many times over in lengthened working lives. The 

 erection of isolation hospitals for tuberculosis is probably the most profit- 

 able method at present of reducing the cost of tuberculosis. 



Upon the above bases there are 25,000 deaths or more per year in the 

 Philippines. 



SECOMMENDATIONS. 



1. That the compulsory registration of cases of pulmonary tuberculosis be put 

 into effect immediately, at least in the city of Manila. 



2. That one or more dispensaries solely for the outpatient treatment of 

 tuberculosis be opened in Manila, to which one or more nurses be attached for the 

 purpose of visiting patients in their homes. Also that provision be made for 

 the microscopical examination of sputa. 



3. That the necessary funds be provided for a trial of the "open-air method" 

 in Benguet or some other place where an equally low temperature may be had, 

 for the treatment of not to exceed twelve tubercular patients. 



4. That provision be made on an elevated site near Manila for treating a 

 limited number of incipient cases of tuberculosis, for a period of not to exceed 

 three months each, by requiring their presence only during the night in order 

 that the advantages of the open air method, the disposal of sputa, and the 

 precautions to be taken to avoid transmitting the infection to others may be 

 demonstrated. 



5. That in order to furnish a practical object lesson, sanitary cuspidors be 

 provided and used in all public buildings, including public schools, and that the 

 sweeping or cleaning of such buildings be done in such manner as to prevent the 

 formation of clouds of dust. 



6. That the public streets be swept only when in a wet condition, so as to 

 avoid the unnecessary blowing about of dust. In this connection, it is suggested 

 that the cleansing of streets by flushing, as is now done in Cincinati and other 

 cities of the United States, be thoroughly investigated with the view of dis- 

 continuing street sprinkling and sweeping in Manila. 



7. That arrangements be made for supplying the public press with information 

 relative to tuberculosis. 



8. That instruction on tuberculosis be continued in the public schools and 

 begun in all other schools where it is not taught at present. 



9. That in communities where hookworms prevail, steps be taken to eradicate 

 them, because the lowered vitality which they induce predisposes strongly to 

 tuberculosis. 



10. That as many of the above recommendations as possible be put in force in 



the provinces. 



