TYPHOID FEVER IN THE PHILIPPINES. 301 



of typhoid fever are undoubtedly contracted in the Philippines the 

 disease can hardly be said to be prevalent here. To prevent its acquiring 

 a foothold regulations were prepared * * *."(9) 



For a number of years, especially since more settled conditions have 

 allowed general resort to laboratory methods, the belief has been growing 

 among medical officers of the army that typhoid fever is by no means 

 infrequent in the Archipelago. It is our opinion that the disease is 

 wide spread and veiy common in the Philippine Islands among both 

 white men and natives. ■ 



Nichols in 1908 called attention to the frequent occurrence of typhoid fever 

 among the Filipinos in the Visayas especially among the children. (H) Bruns, 

 about the same time, stated that in his opinion typhoid was endemic in Iloilo. (12) 

 Nichols also found typhoid fever among the natives at Taytay, a typical T?.galog 

 town located about 32 kilometers from Manila. (13) La Garde (15) and Jack- 

 son (10) have both expressed the opinion that the frequency of typhoid among 

 the natives is not sufficiently appreciated. Browalee, formerly stationed at 

 Malabang in Mindanao, states that he has found typhoid quite prevalent in 

 Mindanao. (4) Dulin, after a long tour of duty in the Cotabato Valley, reached 

 the conclusion that typhoid is endemic at all times and in all places in that 

 portion of Mindanao. (4) Shockley, who has seen much service in Mindanao, 

 confirms the above opinions as to the prevalence of the disease in that island. (4) 

 Arlington Pond in a personal letter gives it as his opinion that there is much 

 more typhoid in the Island of Cebu than is recognized. W. A. Powell from 

 Lucena mentions the occurrence of typhoid among both adults and children. 

 Huber states that he finds typhoid almost constantly present in the town of 

 Bayambang, Pangasinan Province, Luzon. (14) Phalen, for two years president 

 of this Board, voiced the belief that typhoid is an ever present endemic disease 

 throughout the Philippines. (4) Many other medical officers of the army have 

 verbally expressed the same opinion. Spanish and Filipino practitioners refer 

 to the frequent occurrence of a "calentura", a fever of two or three weeks' 

 duration which does not yield to quinine. 



As will appear later, our laboratory findings confirm the above opinions 

 as to the wide range of typhoid infection in the Philippines but can 

 not, of course, throw much light on the frequency of its occurrence 

 in the native population. 



TYPHOID STATISTICS FOE THE PHILIPPINES FUENISHED BY THE BUEEAU OF HEALTH. 



Vital statistics in the Philippines, particularly outside Manila, are 

 notably unreliable because of the scarcity of competent physicians and 

 because of the great number of natives who are never seen by any medical 

 attendant even in an illness terminating fatally. In view of the almost 

 universal tendency to ignore typhoid fever and to consider malaria the 

 cause of the doubtful fevers it is probable that the following figures, 

 obtained from the Bureau of Health, do not err in the direction of 

 exaggerating the death rate from enteric fever. 



