HEALTH IN THE PHILIPPINES. 281 



the lepers from the rest of the inhabitants of the Philippines as a 

 leper colony on the island of Culion has resulted in clearing all of 

 the Islands, except a portion of Luzon, of persons known to the health 

 authorities to be leprous and in already reducing the number from 

 approximately 4,000 to somewhat more than 3,000. The constant with- 

 drawal of leprous persons from among the inhabitants of the Islands 

 reduces to a mininuvm the chances of infection. The presence of this 

 loathsome disease, except an occasional case, must be practically limited 

 by the lives of those assembled at Culion. Only one American and one 

 European are known to have developed leprosy during the decade of 

 American occupation of the Philippines. 



While living in the Tropics is generally supposed to be detrimental 

 to the health of white people as compared with people of the dark races, 

 statistics show that in Manila, Bombay, Cairo, and other cities situated 

 in the Tropics or subtropics there is a wide difference in favor of the 

 white race between the death rates of foreigners and natives. 



All the ills to which flesh is heir have been attributed in the Philip- 

 pines to the tropical climate. There is no intention in this paper to 

 discuss the climatic phase of health conditions in the Philippines. In a 

 paper 9 on the relation between climate and health which I presented at 

 a meeting of this association three years ago, among others the conclusion 

 was reached that failures of people of the white race to live in the Tropics 

 and maintain health, excluding localities characterized by excessive heat, 

 high relative humidity, -or unheal thful soil conditions, appear to have 

 been due principally to nonobservance of the rules of personal, domestic, 

 or public hygiene. Along this line the following simple health rules, 

 published by the Bureau of Health on cards for general distribution, are 

 quite to the point: 



It is easier to maintain good health in the tropics than in the United States, 

 but in order to do so you should observe the following simple rules : 



1. Be vaccinated to-day. The Bureau of Health will do it free of charge. 



2. Never drink any water unless it has been either boiled or distilled, nor eat 

 any raw vegetables. If you observe this rule carefully you will probably never 

 contract dysentery, typhoid fever, cholera, or any other disease that originates in 

 the intestines. Disregard of this rule is responsible for the return to the United 

 States of over 50 per cent of the invalids who leave these Islands. 



3. Fruit is wholesome, and may generally be eaten raw with impunity, provided 

 it is of a kind that grows upon trees, well above the ground. 



4. Avoid patent medicines. "Do not put drugs of which you know nothing into 

 bodies of which you may know less." 



5. Alcoholic stimulants are not necessary, the advice of "old resident" to the 

 contrary notwithstanding. 



6. Generally, disease-carrying mosquitoes fly only at night; therefore, always 

 sleep under a good mosquito net. 



7. Finally, observe the same hygienic rules that are applicable to temperate 

 climates, including those of physical exercise. 



8 Am. Jour. Med. Sciences, September (1905), 130, 497. 



