2o4 CAIiDERON. 



iii conjunction with the municipal physicians, gratuitous .services to 

 parturients of the poor classes in the suburbs of Manila. 



The Philippine Medical School was established by act of the Philip- 

 pine Commission, December 1, 1905. It began operations July 1, 1907, 

 and the chair of obstetrics was organized with its clinic in St. Paul's 

 Hospital. Here several beds were reserved for poor parturients of this 

 city. Similar action was taken by the San Juan de Dios Hospital, in 

 consequence of the adoption of a new curriculum by the medical depart- 

 ment of the Santo Tomas University. 



ADVANCES IN" THE USE OF INSTRUMENTS. 



Iii the last, two decades many obstetrical operations have been per- 

 formed in the Philippines, such as the application of the forceps in its 

 several varieties, versions by external, internal and mixed manipulation; 

 the Caesarian section on living patients, embryotomy, basiotripsy, provoca- 

 tion of premature labor, curettage, and perineorrhaphia of all kinds, with 

 the exception of symphysiotomy and pubiotomy. 



CONCLUSIONS. 



It has clearly been demonstrated that in the Philippine Islands work 

 has been going on for some time which tends to lead obstetrics into 

 modern channels and to eradicate from the minds of the people the 

 charlatanism, superstitions and irrational practices predominating, in 

 this branch of medicine. What has been the result of this scientific 

 evolution ? That it has been efficacious and useful to a large number of 

 women belonging to the cultured families of this country who have at 

 least realized that for confinements a physician should be called, is un- 

 disputed ; but it has been negative in regard to the nameless mass of 

 parturients of the lower classes who are completely given over to the 

 illegal practitioners and midwives, with great danger to their own lives 

 and to those of their new-born babes. 



The services of a physician are, as a rule, dispensed with among .the 

 people of this stratum of society, even in the most serious cases of 

 dystocia, and the patient is left to her fate. If a physician is sent for, 

 he is almost always called after the moment has passed when a simjDle 

 intervention on his part might have prevented the death of the mother, 

 or of the child, or of both. 



A few instances might be cited in this connection: Last September 

 (190?) I received an urgent call to attend a parturient in Calle C, 

 district of Malate. It was a very serious case of retention of the 

 placenta and the woman, who had been delivered of a live child at 2 

 o'clock in the morning, was, five hours later, at 7 o'clock in the morning 

 when I was summoned to her bedside, in the last moments of a terrible 

 haemorrhage. Intervention at that time was useless and the life of 



