TYPHOID FEVER IN THE PHILIPPINES. 329 



10 respectively, would indicate that the patients came into the hospital in the 

 first few days of their typhoid course. It appears, therefore, that the infection of 

 these first cases was gained after the troops arrived at Camp Eldridge. As far 

 as could be learned, there was no typhoid fever in the adjacent town of Los 

 Banos except for the case of a soldier who while on furlough had been living 

 at the hotels in Los Bauos and developed typhoid there. He subsequently died 

 of the disease in the Division Hospital. (8) The ice and bottled waters produced 

 by a commercial company in Los Banos fell under suspicion, since they were in use 

 among the soldiers. Samples of the bottled products examined by the Bureau of 

 Health in Manila were negative for the bacillus of Eberth. 



It was found impossible to locate the origin of the epidemic. Its manner of 

 spread was not definitely determined but was very probably due to flies which 

 were numerous at that time and may have carried the organism from the dry 

 earth closets infected by the first case. :. , 



Of the 11 cases reported as typhoid 10 presented temperature charts with 

 febrile periods ranging from twelve to forty-one days and averaging 23.1 days. 

 All but one of these showed a well-marked fastigium. From the blood of 4 the 

 Bacillus typhosus was isolated, four others gave positive Widal reactions and in. 

 the two remaining cases no Widal reaction was performed but the diagnosis was 

 clear on clinical grounds. 



The eleventh case diagnosed as typhoid is of a doubtful nature. The tem- 

 perature curve is not characteristic and one Widal reaction and one blood culture, 

 both done on the 11th day, were negative. 



A large number of mild cases of fever occurring in the command at the time 

 were negative for Widal reaction and blood culture at the Laboratory of the 

 Board for the Study of Tropical Diseases. As dengue was epidemic in the post 

 at the same time as the typhoid outbreak, the number of cases requiring labora- 

 tory observations was considerable. 



The progress of the disease in this epidemic was characterized by lassitude, 

 headache, constipation, rose spots, enlarged spleen and dicrotic pulse. The 

 charts indicate that constipation existed in 7 patients, regularity in 1, and 

 abnormal frequency of bowel movement in two. Abdominal pain was marked in 

 one case, delirium in another and intestinal haemorrhage in two. There were no 

 deaths. 



CAMP GREGG (BAYAMBANG) EPIDEMIC. 



. Fifteen cases of typhoid are recorded among the Philippine (native) Scouts 

 at this post between November 26, 1909, and April 5, 1910. Thirteen of these 

 gave positive Widal reactions at the laboratory of the Board. As the other 

 two had an irregular fever and as Widal and stool cultures were negative, We 

 have excluded them from consideration. 



This epidemic is of ihuch interest because the entire command at this post is 

 native with the exception of the commissioned officers and a half dozen non- 

 commissioned staff officers. 



The post is built on a slight elevation, located in a broad, poorly drained 

 plain. The region is very malarious. The barracks are in rather poor condition. 

 Faeces are disposed of by the dry earth closet system. Flies are not common. 

 Drinking water is distilled. Water for bathing is piped over the post and drawn 

 .from the Agno River, a muddy and badly contaminated stream. There is no 

 doubt that the Scouts frequently drink this water in the post and in the town .of 

 Bayambang, which adjoins the post. Lieutenant Huber in his report of the epi- 

 demic expresses the opinion that typhoid is constantly present in Bayambang and 

 states that he has seen several cases in the families of Scouts living in the towii. 



