208 GARRISON. 



In tliis connection.; one practical suggestion would seem to offer itself. 

 The source of all infections with intestinal worms, followed back to its 

 origin, is necessarily the fasces of persons already infected. 10 With this 

 fact in mind, we have carefully inquired into the different methods of 

 the disposal of excreta customary among the Filipino people and it 

 would appear that it would scarcely be possible to establish more ideal 

 conditions for the spreading of intestinal parasites throughout the 

 Islands. The native, if living near a stream, defecates along its banks, 

 either in, or at varying distances from the water; in the rainy season, 

 the streams overflow their banks and naturally scatter any infection 

 they carry over the adjacent country. Another manner of disposing 

 of the fasces, equally or perhaps more prevalent, is simply through a hole 

 in the floor of the bamboo house, the excreta falling to the ground to 

 be partly devoured and partly scattered about by the universally present 

 hogs and chickens. 



Such conditions go together with the extremely high prevalence of 

 intestinal worms among the p>eople, and we can scarcely escape the conclu- 

 sion that the one sanitary measure preeminently demanded for the preven- 

 tion of infection with intestinal worms in the Philippines is a proper 

 disposal of human excreta. In fact it would appear scarcely too strong 

 a statement to say that the spread of infections with intestinal worms 

 could be in time satisfactorily controlled by the proper establishment of 

 this measure alone. The urgency of the demand for a proper disposal 

 of human excreta is further emphasized by the effect which it might 

 reasonably be expected to bear directly upon the prevalence of other 

 diseases, in that it would lessen the distribution of pathogenic organisms 

 other than animal parasites which escape in the fasces. 



To devise a working system, practical, economical, and adapted to 

 Philippine conditions, is a special problem which requires special and, 

 perhaps, experimental study. That a radical sanitary measure can be 

 effectively and promptly enforced in the Philippines has been strikingly 

 exemplified by the campaign of vaccination against smallpox so success- 

 fully carried out by the Bureau of Health. 



In conclusion, we believe that the most valuable practical lesson to 

 be drawn from the results of the examination of the Bilibid prisoners 

 is the imperative need of establishing throughout the Philippines a 

 system for the proper disposal of human excreta. Moreover, it does not 

 seem unreasonable to expect, in the light of the striking results apparently 

 accomplished at Bilibid by treating infections with intestinal worms, 

 that with the reduction in the present exceedingly high prevalence of 



10 Those cases in which the parasite may infect other animals as well as man 

 would, of course, constitute rare exceptions to this statement; for example, 

 Bymenolepsis in rats, Tccnia solium in hogs. 



