HEALTH IN THE PHILIPPINES. 277 



more. The death rate per thousand for the city of Manila has been 

 reduced from 40.99 last year to 36.91; the rate for Americans being 

 5.59, which is a reduction of 3.75 over the previous year, and among 

 Spaniards the rate dropped from 17.40 to 15.84." 



It is expected that the death rate per thousand for the city of Ma- 

 nila for the current fiscal year will be reduced to 30 or below. For 

 comparison, the death rates in the following cities and countries as 

 shown by the last census and subsequent reports were as follows : Cities — 

 Cairo, 1907, Egyptians 38.4, foreigners 27.4; Bombay, for three-fourths of 

 the year 1903, Hindus 86.06, Mussulmen 77.21, Parsees 31.17, Europeans 

 16.73; Calcutta 37; Batavia 46; Madrid 32.1; Barcelona 30.7; Shreve- 

 port 45.5;. Savannah 34.3; Nashville 39.7; St. Petersburg 31.1; Eich- 

 mond 29.7; New Orleans 29.9; Washington, D. C, 22.8; Boston 20.1. 

 Countries — Hungary 27 ; Austria 25 ; Italy 22.1 ; German Empire 21.5 ; 

 France 21.1; United States 17.8; Switzerland 17.3. 



At the time of American occupation of the Philippines, the principles 

 of modern sanitary science were not applied. Habitations and other 

 buildings were unclean and insanitary and frequently set in unhealthful 

 surroundings. The people were not being instructed in personal and 

 domestic hygiene. The mortality of infants under one year of age among 

 the natives is shown to have exceeded "the combined mortality of Asiatic 

 cholera, bubonic plague, smallpox, dysentery, malarial fever, typhoid 

 fever, and beri-beri." What wonder that the mortality rates of natives 

 were high and are still excessive ? 



The English-speaking population in Manila does not include the usual 

 proportion of old and young persons, and some have returned to the 

 homeland because of illness, which, however, from the best information 

 obtainable, has rarely resulted in death. The death rate, 15.84, among 

 the Spanish population in Manila, which is generally composed of the 

 usual members of families, is lower than in the United States according 

 to the last census and gives a fair basis of comparison of health condi- 

 tions in Manila. 



A striking illustration of the value of the persistent and thorough 

 application of proper sanitary measures is the reduction of the mortality 

 rate in Bilibid Prison from over 100 per thousand in 1905 to 20 per 

 thousand toward the close, of the fiscal year 1907. The number of 

 deaths in Bilibid was formerly enormous, the number during the last 

 fiscal year being less than one-half of that for the preceding year. 

 Pneumonia has been epidemic in this institution. 



Misleading articles 7 on the unhealthfulness of the Philippines written 



7 The American Physician in the Philippine Civil Service. Amer. Med. (1905), 

 9, 513. Tropical Neurasthenia and its Relation to Tropical Acclimation. Amer. 

 Journal Med. Sciences (1907), 133, 582. 



