VIII, B, 1 Willets: Public Health in the Batanes Islands 53 



months to twenty years. Ringworm is common. Two cases of 

 herpes zoster were found. Three patients were suffering from 

 poisoning similar to poison ivy, but in each case the process 

 seemed to be more severe than that caused by poison ivy. The 

 marked frequency and severity of skin disease is attributed 

 largely to the uncleanliness of the inhabitants. 



Rheumatism is a rather common disease. Several cases of the 

 chronic form were seen, and the previous history of a number of 

 persons presenting themselves at the clinic suggested the occur- 

 rence of this disease. 



Bright's disease is also a common affection. 



Upon first meeting residents of the Batanes the writer was 

 told of a rapidly fatal fever endemic and at times epidemic on the 

 Island of Itbayat. The disease is said to be more frequent from 

 July to December than in other parts of the year, and it is the 

 consensus of opinion of those best informed relative to its occur- 

 rence that it has been less common during recent years than 

 formerly. It is claimed, however, that deaths occur every year 

 from the disease and that the residents of Batan and Sabtang 

 who visit Itbayat are especially apt to contract it. Several 

 persons from these two islands have undoubtedly died of the 

 fever shortly after returning from Itbayat, but the number of 

 such deaths has been greatly exaggerated. Probably not exceed- 

 ing an average of one person a year from Batan and Sabtang 

 has died from this cause during the past ten years. 



Investigation revealed the facts that the disease is character- 

 ized not only by fever but also by chills, vomiting, and sweating. 

 Hence malaria was suspected. However, in the examination of 

 a number of persons from Itbayat only one enlarged spleen was 

 found. The blood of this patient, as well as that of a number 

 of others from Itbayat and a few from Batan who claimed to have 

 had the fever within the past two years, was examined for mala- 

 rial organisms with negative results. The only case in which 

 malarial parasites were found in the blood was in an acute infec- 

 tion contracted by the writer, apparently on Itbayat Island. The 

 parasites were of the sestivo-autumnal type, and the objective 

 symptoms present were recognized by several residents of Santo 

 Domingo de Basco as being identical with those exhibited in 

 typical cases of the Itbayat fever seen previously by them. I 

 became convinced finally that the "fever" so greatly feared by 

 the natives is probably malarial fever of a pernicious form. 

 Further investigation is considered necessary to prove this 

 definitely. 



