UNSOLVED HEALTH PROBLEMS. 173 



hand to show that the mosquitoes of Manila are more serious than a 

 physical annoyance. We can well imagine how a similar proposition 

 would be received in the United States or any other country. Should 

 we expect it of these Islands, overburdened as they are with more acute 

 problems? It seems to the writer more logical to begin mosquito elim- 

 ination in Manila, at least, by educating the individual householder to 

 make the breeding of mosquitoes on his premises impossible, and then 

 by an organized inspection service to enforce regulations which will 

 compel the use of such knowledge. In the meantime, a definite engi- 

 neering project should be adopted and carried out in a limited way. 

 Drainage and filling and oiling might be tried with the regular sanitary 

 corps as far as possible. 



Water supply. — The water supply of the Philippine Islands is another 

 serious question. All surface waters found in the Islands except the 

 thermal waters, or those strongly charged with certain minerals, are 

 infected with amoeba?. Improved health conditions in Manila can to a 

 certain extent be traced to the new city water supply which now comes 

 from a comparatively uninhabited watershed, but even as tap water it 

 should be boiled for all but the most ordinary purposes. Fortunately, 

 artesian-well water is as a rule free from amoeba?, and is in every way 

 an ideal drinking water. In towns where artesian well-water is almost 

 exclusively used the death rate has fallen 50 per cent. These wells are 

 being drilled as rapidly as possible, but there are many localities where 

 they are impracticable, so that the question of how to make available 

 for the people an unlimited and safe water supply, exclusive of artesian- 

 well water, must be considered one of our unsolved problems. 



Disposal of excreta. — We are still pondering the practical disposal of 

 excreta. Many plans have been proposed, all more theoretical than 

 practical. Of those who are familiar with local conditions and who 

 realize the resources and, limitations of the average community, but 

 who are seriously searching for a practical solution, none as yet has 

 put forth a well-defined scheme. 



In large communities where water carriage of sewage is possible 

 septic tanks are used successfully. In communities in which cholera 

 has prevailed the pail system, the digging of pits and covering of ex- 

 creta with lime or clean earth at regular intervals, has been found 

 effective, but the cost of maintenance and inspection as a regular measure 

 is prohibitive and only warranted by emergency conditions. 



Some years ago the writer suggested a plan of installing a pail 

 system with an after treatment of the night soil which would render it 

 suitable for fertilizing mulberry trees, thus promoting the silk industry, 

 the income from which would in a short time place this particular 

 sanitary measure upon a self-paying basis. 



The plan followed in many oriental countries of letting out private 

 contracts for the collection of night soil from private residences is not 



