EDITORIAL. 



DISCUSSION OF THE PAPER BY DR. THOMAS W. JACKSON. 



Dr. Victor G. Heiser, Director of the Bureau of Health of the Insular 

 Government and professor of hygiene in the Philippine Medical School: 

 I feel grateful to Dr. Jackson for presenting this paper because it gives 

 me an opportunity to reply to a great many criticisms as to the manner 

 in which local hygienic measures are carried out. The point of view 

 makes a good deal of difference. Some persons think that it would be 

 easy to remedy these unfortunate conditions. Those of us who have 

 had most experience in dealing with them know that this is not true. 

 Hygienic methods have passed beyond the stage where the cleaning up 

 of backyards, or the penning up of pigs are considered matters of funda- 

 mental importance. 



It is not well for a health officer to occupy himself too much with 

 these matters. His legitimate work is much deeper and is more far- 

 reaching in its effects. It is probable that we could have the hogs 

 kept in their proper places, but after all such measures would result in 

 raising a strong opposition which might interfere with the more im- 

 portant measures which we have in view. 



We do not at present attempt to interfere to any considerable extent 

 with the personal habits of the residents of these Islands in spite of the 

 fact that some of these habits are very unsanitary, but are occupying 

 ourselves with matters of greater importance. We are attempting to 

 vaccinate the entire population against smallpox and are bringing about 

 very gratifying results. In the provinces immediately adjacent to Ma- 

 nila the annual deaths from smallpox until very recently amounted to 

 at least 6,000, but last year there was not a single death in these provinces 

 from this disease. 



We have been urging the boring of artesian wells, particularly in towns 

 where the water supply has been found to be especially bad. We find 

 that the people are glad to utilize the comparatively pure artesian well 

 water for drinking purposes, instead of the contaminated water from 

 shallow wells and open springs and streams which they formerly drank. 

 We find, furthermore, that in a number of towns where artesian wells 

 have been bored the death rate has fallen from 30 to 50 per cent, and I 

 contend that this is a much more important reform than would be the 

 putting of all the hogs in pens. 



