XII, B, 6 Manlove: Incidence of Age 239 



atheromatous changes than did the males. The heart changes 

 recorded show that after the age of 40 hypertrophy of the heart 

 as associated with atheroma is found to occur in the males almost 

 twice as frequently as in the females. The kidney changes re- 

 corded show that after the age of 40 years chronic interstitial 

 nephritis is found almost as frequently in the females as in the 

 males and is found in both on an average of 75.77 per cent. 



ETIOLOGIC AGENTS OF ATHEROMA 



Among the conditions which enter for consideration as possible 

 factors in producing atheroma with its associated heart and 

 kidney changes in Filipinos are increased blood pressure, syphilis, 

 strains, alcohol, and chronic intestinal disorders. 



Blood pressure. — Recently the blood-pressure picture in Fili- 

 pinos was determined by Concepcion and Bulatao. (2) Their ex- 

 periments show that the average blood pressures in Filipinos ex- 

 pressed in millimeters of mercury are as follows: Between the 

 ages of 15 and 40 years the systolic pressure is 114.45, the 

 diastolic pressure 80.76, and the pulse pressure 33.69 ; above the 

 age of 40 years the systolic pressure is 131.27, the diastolic 

 pressure 88.72, and the pulse pressure 42.55. The systolic pres- 

 sure of the Filipinos is very much lower than that of Americans 

 living in temperate climates (Woley) , but is the same as that of 

 Americans living in the tropics whose ages range between 18 and 

 50 years, the average being 26.6 years, (l) These findings sug- 

 gest that in the tropics systolic pressures are very much lower 

 than in temperate climates and that with increase of age there 

 is a general rise of systolic, diastolic, and pulse pressures in the 

 Filipinos. (2) 



An examination of the preceding statements, which give a fair 

 estimate of the blood-pressure picture in Filipinos, is at least 

 indicative that blood pressure is not a primary factor in produc- 

 ing atheroma in Filipinos. 



Syphilis. — Syphilis appears to be on the increase in the Philip- 

 pines, but will only be mentioned from a statistical view. The 

 amount of syphilis cannot be stated in percentage for the entire 

 Islands, but the Wassermann laboratories show it to be very 

 common. A conservative estimate regarding the number of 

 patients treated in the Philippine General Hospital suffering 

 from syphilis was 3 per cent. Although the Philippine Health 

 Service reported that 1.4 per cent of 16,431 cases were treated 

 in the wards of the Philippine General Hospital during 1914 for 

 syphilis, this did not include the incidence in 25,000 or more 

 dispensary cases, which would undoubtedly make a much higher 



