xiii, b, 6 Haughwout: Endemic Malaria 291 



All this should help us to form an opinion as to the extent 

 of the fundamental problem that will be presented by the impor- 

 tation into Manila and its vicinity of several thousand men, 

 drawn from the various provinces in the Islands 3 and destined 

 to form the ranks of a military unit. That a not inconsiderable 

 proportion of these men will prove to be carriers of the malarial 

 parasite is a probability that it will not be safe to disregard; 

 that, as such, they will constitute a source of danger naturally 

 follows. 



•First, they will be a source of danger locally; for Manila 

 harbors mosquitoes of the malaria-transmitting type, and local 

 conditions show a tendency to become increasingly favorable to 

 their development. However, it is not particularly my purpose 

 to deal with the Manila problem in its especial reference to 

 the danger to the civilian population of that city. 



Secondly, they will constitute a serious source of danger to 

 their camp mates wherever an encampment may be established. 

 Before such an encampment is established a careful preliminary 

 survey of the site proposed should be made by thoroughly com- 

 petent men. Neglect to do so may give rise to an exceedingly 

 discouraging and depressing experience, especially if the camp 

 be located in proximity to a native village where malaria is 

 almost certain to be endemic, if not epidemic. In this connec- 

 tion Hoffman (14) lays stress on the value to the army medical 

 corps of the services of an expert entomologist. 



Lastly — and herein lies a duty to those with whom they may 

 be called upon to serve, and that duty involves a heavy obliga- 

 tion — there is the danger to troops from other countries, should 

 the fortunes of war send the Philippine contingent to associate 

 with them. Unless the work of weeding out or sterilizing mala- 

 ria carriers is conscientiously and effectively carried out before 

 leaving the home country, the troops may do far more harm 

 than good. They are certain to be the bearers of new and malig- 

 nant strains (5) of the parasites. It would not be a new ex- 

 perience, for other troops have come from the Far East bearing 

 similar indirect aids to the enemy. 



Important and destructive as they are, the intestinal parasitic 

 diseases constitute a more controllable problem among troops at 

 war than does malaria. Trench hygiene will, within certain 

 bounds, control the diseases conveyed by contaminative methods ; 



* Attention is particularly directed to the returns from Ambos Cama- 

 rines, Oriental and Occidental Negros, and Pangasinan, which report 

 deaths caused by malaria varying from 1,000 to more than 3,000 during 

 1916. 



