TYPHOID FEVER IN THE PHILIPPINES. 



311 



The considerable increase in the last quarter may be considered accidental 

 since the 43 cases in October, 1909, all occurred at one post, the Ludlow Barracks 

 epidemic. 



The season varies considerably in the Philippines in different localities and 

 for diiferent years, but in general it may be said that the period from December 1 

 to June 1 represents the dry season. 



Since our militaiy patients mainly are drawn from a population 

 consisting almost exclusively of young adult males, it has been impossible 

 for the Board to draw any conclusions as to the influence of sex or 

 age on the incidence of typhoid in the Philippines except in so far 

 as we have mentioned the latter factor in the paragraph below Table YII. 



PART II. LABORATORY INVESTIGATIONS OF TYPHOID FEVER IN THE 



PHILIPPINES. 



During the two and one-half years that the Board has been working 

 on the subject of typhoid fever the following examinations have been 

 made in the case of persons having typhoid fever or suspected of having it. 



Table IX. — Examinations ty the Board on 'persons suspected of having typhoid, 

 Decemler 1, 1908 to April 30, 1910. 



Results. 



Widal 

 tests. 



Cultures from— 



Stools. 



Urines. 



Blood. 



1 

 Bile. 



Positive- 



192 

 261 



19 



498 



9 

 320 



17 

 139 



1 

 



Negative 



Total .. 





453 



517 



329 



156 



1 



< 





The 453 serum reactions were performed on the blood of 369 persons. The 

 192 positive Widal reactions were made on the blood of 177 persons, of whom 

 118 were Americans and 59 were Filipinos. The 517 stool cultures were made 

 on 199 individuals, the 329 urine cultures on 164 individuals, and the 156 blood 

 cultures on 141 individuals. 



BLOOD CULTUEES, 17 POSITIVE, 139 NEGATIVE. 



The organisms were sought in the blood by placing it in sterile bile, 

 incubating for twenty-four hours and plating on Endo medium. Many 

 of our specimens of blood were very old and the amount small, which 

 accounts partially for the small number of positive findings. The 

 fact that the disease in many instances was far advanced needs also 

 to be considered. All of our positive blood cultures were obtained 

 from patients in the Division Hospital or at posts we visited, and from 

 these patients we obtained a large amount of blood and placed it at 

 once in the bile medium. Since all of these cases came under our 

 immediate observation, we feel sure that the days of the disease, as 

 shown in the following table, are approximately correct. 



