TUBERCULOSIS AMONG FILIPINOS. A STUDY OF ONE 

 THOUSAND CASES OF PHTHISIS. 1 



By W. E. Musgeave and A. G. Sison. 



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



Manila, P. I.) 



The present status of the tuberculosis problem in the Philippine 

 Islands may be summed up in one sentence : A remarkably high incidence, 

 unusually favorable conditions for the spread of the disease, and an almost 

 complete absence of organized effort to combat it. It may be stated in 

 general that conditions favorable for the spread of tuberculosis are prac- 

 tically perfect in this Archipelago. Overcrowding in unsanitary houses 

 located too close together in unsanitary places and closed at night is all 

 but universally prevalent. Our records show many instance of from six 

 to ten or more people living and sleepting in a single room with from one 

 to several individuals among them suffering from advanced pulmonary 

 tuberculosis. Children are born and reared under these circumstances 

 and very frequently nursed b) r their tubercular mothers. 



The dormitories of many of the schools contain tubercular patients to 

 a startling degree. We have records of dormitories in which fifteen to 

 twenty students are sleeping in the same room, with two or more of 

 them suffering from fairly advanced phthisis. Even in our public schools, 

 tubercular patients are often found mingling with other pupils in too 

 close contact for the safety of the whole. 



The disease is very prevalent among all classes of people whose occupa- 

 tions are such as to keep them in close relationship with healthy persons. 

 In this class ma}' be mentioned street car conductors and motormen, 

 carriage drivers, house servants, cooks and nurses of infants. During 

 the last year we have caused the dismissal of no less than fifteen women 

 suffering from phthisis who were caring for and in some instances sleep- 

 ing in the same rooms with the children of their employers. The partic- 

 ular dangers from promiscous coughing and expectoration are unknown 

 to the majority of the patients, and these acts are practiced unrestrictedly 

 at all times and in all places. 



J 'oor food and lack of exercise are very potent predisposing factors to 

 tuberculosis among the poor of these Islands. The influence of food 

 poor in fats and proteins and excessively rich in carbohydrates is shown 

 by the very marked improvement which so often follows the administra- 

 tion to tubercular patients of good food or cod liver oil. The average 

 Filipino of the poorer class has a peculiar manner of breathing with 

 but slight chest motion, and the vast majorhy not only have no concep- 



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

 Medicine, held at Manila, March 12, 1910. 



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