270 WASHBURN. 



decade ISSN to 1S97, prior to the Spanish-American war, when sickness 

 and mortality were the lowest recorded. It appears from the records that 

 during the last five years of the decade, now nearly completed, of 

 American occupation of the Philippines, the Arm)' in the United States 

 proper has reached an almost unprecedented state of health, measured 

 by the death rate from all causes for the year 190G of r>.2S and a rate 

 from disease of 2.84, the lowest recorded, as against the death rate of 6.72 

 for all causes for the decade prior to the Spanish-American war, when 

 no troops were in the Tropics. A death rate of 5.61 for 1905 was 

 reported in the British army. The discharge, death, and total loss rates 

 were lower in Cuba for the last three months of 1906 — during which 

 time American troops were again stationed in Cuba — than in any other 

 country where American troops were serving, including the United 

 States. Since the days of Spanish occupation yellow fever, the scourge 

 of the Spanish army, has become nonexistent in Cuba and Porto Eico. 



It is my purpose to give a brief review of the advances made by the 

 American Government toward better health conditions in the Philippines, 

 and to indicate, though quite cursorily, the comparative health conditions 

 at the present time, as shown by records and reports. In July, 1901, 

 military government in the Philippines was formally succeeded by civil 

 government. Until the spring of 1905 the health department was under 

 the immediate charge "of officers detailed from the Medical Department 

 of the Army, and thereafter has been under the immediate direction of 

 a medical officer of the United States Public Health and Marine-Hospital 

 Service. The health phase of civil government responsibility has there- 

 fore been continuously under the immediate direction of men well trained 

 in matters of public health and sanitation, who have carried on the 

 work so well begun under the military regime and subsequently so faith- 

 fully supported in times of stress by the Medical Corps of the United 

 States Army and the Public Health and Marine-Hospital Service in the 

 fight against disease. 



When the marines and troops were landed in Cavite and Manila in 

 1898, these places were described as being filthy in the extreme. Other 

 cities and towns in the Archipelago were subsequently found to be also 

 generally insanitary and unsuitable for occupation. For three years the 

 work of sanitation was carried on under the military government, during 

 which period the troops were for the most part engaged in active opera- 

 tions in the field, necessitating exposure frequently to all manner of 

 disease and rendering difficult the observance of the laws of hygiene. 

 Notwithstanding such adverse conditions, the chief surgeon of the Phil- 

 ippines Division reached the conclusion in July, 1900, that the relatively 

 small percentage of sick in the army in the Philippines was largely due 

 to the care and attention given by officers and men to sanitation; that 

 increased appreciation on their part of its beneficial result to health and 



