CAUSE OF THE REAPPEARANCE OF CHOLERA. 91 



between 1897 and 1902 there is no record of any other disease in the 

 Philippine Islands which shows such a large mortality, nor was any 

 such infection present in so many portions of the Islands as has been 

 the case since 1902. The commencement of the disease in 1902 was 

 ascribed to a shipment of presumably infected Canton cabbage arriving 

 in Manila from Hongkong which upon being refused landing, was thrown 

 overboard in the harbor, with the result that the whole bay was literally 

 covered with this vegetable. Much of the cabbage was gathered and 

 consumed and within forty-eight hours from the time of its reaching the 

 beach, cases of cholera commenced to occur in the Farola district 3 (see 

 Pis. I and II), which is situated at the junction of the Pasig Paver and 

 Manila Bay. An Army transport which left Manila at about the same 

 time these vegetables were thrown overboard, proceeded directly to Nueva 

 Caceres and the disease was discovered among some steerage passengers of 

 this ship after they had landed, so that cholera appeared simultaneously 

 in two widely separated places in the Philippine Islands. 



The infection spread rapidly in Manila in spite of the most energetic 

 measures which were taken to combat it. The cordon which was placed 

 around the city was entirely ineffective and apparently offered little 

 resistance to the onward march of cholera. Infected persons gradually 

 introduced the disease into the other islands. The outgoing maritime 

 quarantine imposed upon vessels was ineffective because people traveled 

 overland to ports at which there was no adequate quarantine inspection, 

 and sailed from there. Cholera raged with great severity for nearly six 

 months in and about Manila (over 6,000 cases occurring in this city 

 alone) and it continued for about an equal length of time in other portions 

 of the Islands, after the date of its first appearance. There was a rather 

 severe recrudescence during the following year in Iloilo and Cebu. The 

 Board of Health for the Philippine Islands on April 27, 1904, officially 

 declared the disease to have been completely arrested, and stated that no 

 cholera was then in the Islands. 



The next appearance in recognizable form took place in August, 1905, 

 when persons in the neighborhood of Jala Jala, in the Province of Eizal, 

 on Laguna de Bay (see Map No. 1), commenced to die from the disease, 

 and from there it apparently spread rapidly down the Pasig River to 

 Manila. Since 1905 the disease has been practically confined to Manila 

 and the provinces which are accessible by land from this city. The only 

 exceptions to this rule are the outbreaks which occurred in the Provinces 

 of Iloilo, Occidental Negros, northern Samar, Mindanao, and Leyte. 



3 The Farola district is a narrow neck of land running out into the sea and 

 having the main harbor light at its point. It was occupied at the time of the 

 outbreak of this epidemic by warehouses, coal piles and a crowded mass of small, 

 insanitary huts. 



