310 



CHAMBERLAIN. 



It will be seen that the percentage of positive results was much less 

 than among adults. These children ranged from four to thirteen years 

 of age and the majority were under eight years old. If typhoid were 

 common among the Filipino school children, it is probable that the per- 

 centage of positive reactions among them would be considerable. It is 

 possible, of course, that the disease may occur widely among infants and 

 that the agglutinating influence in nearly all cases had passed away before 

 the time at which we saw these children. However, such an explanation 

 does not appear to us probable. 



Our clinical records, to be discussed later, indicate that a considerable 

 number of the cases which give positive laboratory finding present clinical 

 appearances entirely different from the classic description of typhoid 

 fever. Patients with a short course, little fever and few symptoms, 

 were found commonly among both Americans and Filipinos. It is by 

 no means unlikely that such cases throughout the native population are 

 very common and that the true nature of the malady is overlooked. The 

 disease in this form can be diagnosed by laboratory procedures alone, 

 and it is only by working along this line that the true incidence of typhoid 

 fever among the Filipinos can be determined. 



INFLUENCE OF SEASON ON PREVALENCE OF TYPHOID. 



In Europe and America typhoid fever may occur at any season, 

 but its incidence is greatly increased in August, September, and October. 

 In India, as a whole, Roberts has shown that the disease is very generally 

 distributed throughout the year as follows; first quarter 18.1 per cent; 

 second quarter 31.3 per cent;, third quarter 38.1 per cent; fourth quarter 

 32.4 per cent. The experience for four years (the only ones for which 

 monthly records are available to us) shows that in the Philippines 

 the disease is distributed throughout the year in a quite regular manner. 



Table VIII. — Incidence of typhoid fever by months in the Philippines. 



Month. 



January 



February .. 



March 



April 



May 



June 



July 



August 



September. 



October 



November. 

 December . 



Total 



1904 



1008 



23 



3 



5 

 13 

 8 

 9 

 14 

 25 

 23 

 14 

 12 

 17 

 13 



156 



1909 



1 



7 

 7 

 1 

 2 

 2 

 5 

 8 

 3 

 43 

 3 

 5 



87 



1910 



10 

 21 

 2 

 

 

 4 

 

 1 

 2 

 

 4 



51 



Total. 



Number. Per cent 



13 

 23 

 42 

 12 

 11 

 21 

 38 

 33 

 19 

 60 

 21 

 24 



317 



Quarter. 



78 



44 



90 



105 



24.61 



13.88 



28.39 



33.12 



