326 



CHAMBERLAIN. 



this water was contaminated. For flushing of closets and for bathing the supply 

 was obtained from the Nitwan river, a rapid mountain stream draining a country 

 inhabited by Moros and but little known. The water was piped about the post 

 and in the adjacent town of Parang which is largely frequented by the soldiers. 

 That this water at times was used for drinking, dish washing, and cleansing of 

 the teeth can not be gainsaid. (4) 



The Nitwan river is undoubtedly extensively contaminated with fecal matter. 

 (7) It is a custom of the Moros to defecate in running water. That typhoid 

 fever is by no means infrequent among the natives in Mindanao seems certain 

 from the opinions referred to near the beginning of this report and from our own 

 work. The Nitwan water was examined at the times of the two visits made to 

 the post by members of the Board. No typhoid bacilli were isolated from it 

 but its bacterial count was very high and it was extensively infected with the 

 colon baeilus. (5) (6) Examination of the dock water (piped from a spring- fed 

 stream) and of the Alphonso XIII spring, which supplied the swimming pool, 

 showed high bacterial counts and the presence of a few colon bacilli. 



The town of Parang is a small village immediately adjacent to the post and 

 depending for its support entirely upon the American garrison. A series of 

 serum reactions with Bacillus typhosus made by this Board during the epidemic 

 on 84 of the inhabitants of Parang gave the following results: 



Table XVIII. — Widal tests on the inhahitants of Parang, Mindanao. 



Race. 



Chinese -_. 

 Japanese .. 



Moros 



Hindoos... 

 Filipinos ._ 



Total 



Number 

 exam- 

 ined. 



10 



n 

 1 



53 



84 



Positive 

 reaction. 



Negative 

 reaction. 



13 



7 

 i 



11 

 1 



■18 



Sick at 



time of 



test. 



71 



The five reported sick were all suffering from a disease clinically typhoid 

 while two others who gave positive reactions had slight fever but no other 

 symptoms. One of the latter was Japanese and the other a Filipino. A number 

 of these sick persons were Japanese and Filipina prostitutes and their houses 

 were still open to soldiers while the inmates were ill and not in any way 

 isolated. (7) The opportunities to contract infections are obvious. 



Major Page, who was Surgeon at Ludlow Barracks during October, November, 

 and December, in a report dated December 22, 1909, expressed the opinion that 

 the epidemic was water-borne, the source of infection being the Nitwan River. 

 He considered that the peculiar grouping of the cases in certain barracks was 

 due to the Nitwan water supply having been first installed in those barracks, 

 shortly before the outbreak. The evidence as to the coincidence of the dates 

 of installing the pipes and the development of the cases in October seemed to 

 us rather conflicting. Dm-ing the later period of the epidemic, after Major 

 Page's departure, the same peculiar grouping of cases was evident although at 

 that time the water was installed for all the barracks. 



The disease continued to occur after Major Page left Ludlow Barracks, flared 

 up in March and April and then disappeared entirely following the departure 

 of the 2Sd Infantry and a very complete and thorough disinfection of the 



