EDITORIAL. 73 



Philippines hookworm infections play a part more nearly resembling 

 that of the other common intestinal worms to which no definite pathol- 

 ogy or severe symptomatology is usually attributed. 



In other words, the population of the Philippines presents a higher 

 percentage of infection with intestinal worms than has ever been defin- 

 itely reported from any other people and the condition is essentially a 

 chronic one, the results of which manifest themselves indirectly in the 

 general physical impoverishment of the people and the high rate of 

 morbidity and mortality accredited to other diseases. 



In this connection it is interesting to mention the startling results 

 apparently accomplished by the Bureau of Health, in cooperation with 

 the Bureau of Science, at Bilibid Prison, where the original annual rate 

 of mortality was reduced from about 238 per thousand to about 75 per 

 thousand by the institution of general sanitary measures; then resisted 

 further reduction until the prisoners began to be systematically treated 

 for intestinal worms; after which, the death rate dropped to about 13 

 per thousand. Whether or not this apparent relationship between intes- 

 tinal worms and the death rate at Bilibid will be substantiated by future 

 records at the prison or by the institution of a similar campaign through- 

 out the Islands, its significance can scarcely be overestimated even 

 though ultimately the results should prove to be but a fraction of what 

 was apparently accomplished among the Bilibid prisoners, and it 

 sharply emphasizes the fact that the absence of direct, acute manifesta- 

 tions of intestinal helminthiasis should not blind us to the vital im- 

 portance of this so nearly universal prevalence of intestinal worms as 

 a factor in the present hygienic and industrial status of the Pilipino 

 people. 



When we consider that there are about 6,000,000 inhabitants in the 

 Islands and that, if present indications are verified, nearly 5,000,000 are 

 infected with intestinal worms, and when we consider further the sani- 

 tary conditions which universally exist outside of the, larger cities, the 

 magnitude of the problem presents itself, and while we believe thor- 

 oughly in the local efficacy of the immediate institution of vigorous 

 crusades by such means as are already at hand, it would seem perfectly 

 apparent that any means which are to reach conditions in the mass of 

 the population must aim at the education and training first of the 

 native physicians and ultimately of the people themselves. 



By giving medical zoology a prominent position in the course of 

 instruction it is intended properly to emphasize the local importance 

 of the subject which the above indications would seem to warrant, and 

 it is the purpose of the school not only to train its native students in 

 the diagnosis and treatment of parasitic diseases, but also to instruct 

 them thoroughly in the life cycles of the parasites, modes of infection, 

 66027—6 



