EDITORIAL. 263 



intestinal parasites with which the inhabitants of these Islands are 

 afflicted ; we think we have statistics from Bilibid Prison that are fairly 

 conclusive on this point. Several years ago the death rate was something- 

 over 200 per thousand. Ordinary sanitary methods were instituted — 

 more air space was provided, drains were put in and other needful things 

 done. These measures reduced the mortality to 60 per thousand, but 

 this rate was still far in excess of what an institution of that character 

 should have. We spent some six months examining into the various 

 causes which might influence it. It finally occurred to us that intestinal 

 parasites had some connection with the result, and I think the statistics 

 will bear us out in our conclusions as they show that in each brigade of 

 the 200 examined the mortality came down in a marked manner after the 

 institution of remedial measures. When the prison was remodeled and 

 the prisoners cured of their parasitic intestinal diseases, the mortality fell 

 to 12 per thousand and has remained at that figure for the last six months. 

 I think this result is one of the greatest triumphs of modern prophylactic 

 medicine that has occurred in these Islands, and I believe that when the 

 facts become known they will induce the laity to look with favor upon a 

 campaign in these Islands for the elimination of intestinal parasites. 



Dr. Philip E. Garrison, assistant surgeon, United States Navy; medical 

 zoologist, Biological Laboratory, Bureau of Science; associate professor 

 of medical zoology in the Philippine Medical School. — We have reports 

 of several hundred Ascaris removed from one individual. I think Dr. 

 Musgrave recently recovered about 150 from a Filipino child at one 

 treatment. 



In our examinations a positive diagnosis of Amoeba was made only 

 when the moving organism was found in the stool. 



A systematic clinical study of infected cases was not included in the 

 purpose of my investigations and I am not prepared to offer any new 

 information regarding the symptoms or pathology found in these infec- 

 . tions. In considering the importance of intestinal worms as factors in 

 either the death or sick rate of a community, the fact must be recognized 

 that they play their most important role by predisposing to other diseases. 

 Intestinal worms are 'rarely mentioned in mortality statistics, and it is 

 exceedingly difficult to measure the relative participation in the death of 

 the patient of the infection with intestinal worms which lowers the 

 resistance of the host and the terminal infection which the mortality 

 table recognizes as the immediate cause of death. The remarkable fall 

 in the death rate at Bilibid following the institution of a systematic 

 treatment for intestinal worms, of which Dr. Heiser has already spoken, 

 is a striking contribution to our information on this very point, and if 

 future records at the prison and the institution of similar measures in 

 other communities should confirm the results which appear to have been 

 accomplished there, even in a much less striking degree than the figures 



