THE INCIDENCE AND COMPLICATIONS OF MALARIA IN THE 



PHILIPPINE ISLANDS WITH SPECIAL REFERENCE TO ITS 



TREATMENT WITH ARSENOPHENYLGLYCIN. 1 



By Fred B. Bowman. 



{From the Department of Tropical Medicine, Philippine Medical School, 



Manila, P. I.) 



Between the years 1904 and 1908 approximately 36,700 deaths occurred 

 in Manila. Of these, 762, or about 3 per cent, were reported to be due 

 to malaria. Ten per cent of the deaths from malaria occurred between 

 the ages of 1 and 5 years. The percentage is very low between 5 and 

 15 years; but from 15 to 30 we find recorded 50 per cent of the total 

 number. After the age of 30 the percentage rapidly drops until 50 

 is reached, after which the mortality from malaria is but 1 per cent. 



About 12,000 deaths are reported annually in the Philippine Islands as due 

 to malaria, 5 per cent of the total mortality. The following statistics were 

 obtained from a study of the histories of 100 consecutive cases admitted to St. 

 Paul's Hospital. 



Tertian malaria was found to be most common, 43 per cent of the total 

 number of cases being infected with this parasite. iEstivo-autumnal was more 

 frequent than quartan fever, the former constituting 37 per cent and the latter 

 but 13 per cent of the cases. 



Approximately 50 per cent of the cases had an enlarged spleen, the type 

 of malaria seeming to influence the extent of splenic enlargement little, if at all. 

 Two cases were sometimes seen side by side in the same ward with practically 

 identical histories, symptoms and blood pictures; one with a spleen reaching to 

 the umbilicus, the other with that organ not palpable. 



The average red blood cell count in these cases was 3,000,000, although in a 

 few malignant and cachectic cases it was much lower. Infection with intestinal 

 parasites, occurring as it does in so many of the natives, to a great extent 

 influences the blood picture, usually making differential counts of little value. 



Black water fever is rare in the Philippine Islands. I have never 

 seen a case here. Malarial dysentery is of quite common occurrence. 

 Malaria in itself rarely is a fatal disease in these Islands, but after 

 two years' work in the free dispensary and the wards of St. Paul's 

 Hospital, the fact is impressed on me more and more that many of the 



'Read at the first biennial meeting of the Far Eastern Association of Tropical 

 Medicine, held at Manila, March 10, 1910. 



291 



