240 "^^^ Philippine Journal of Science 1917 



percentage. Also it does not include other conditions which in 

 some instances are no doubt of syphilitic origin, such as still- 

 births. A review of 712 autopsies at Manila, (3) performed dur- 

 ing 1913, showed 21 cases presenting recognizable syphilitic 

 lesions. However, there were only 11 of these occurring in Fili- 

 pinos, but of these 11 there were 9 cases where the aorta was 

 involved. This substantiates a fact mentioned by Crowell that 

 where syphilis is recognized at autopsy in Filipinos the vas- 

 cular lesions are the most frequent. In my series of 1,000 

 atheroma cases 4.33 per cent were definitely recognized as 

 syphilitic in origin. There is the probability that a number of 

 syphilitic atheroma cases were masked by an extensive atheroma 

 other than syphilitic and were thus overlooked at autopsy. 



Chronic intestinal disorders. — ^A personal examination of the 

 entire intestinal contents of more than 1,000 autopsies shows that 

 the intestines of from 80 to 90 per cent of subjects are laden with 

 fsecal material containing one, two, or more types of intestinal 

 zooparasites. It seems evident that such a condition extending 

 throughout years must produce a chronic toxaemia of intestinal 

 origin. Clinical observation shows that constipation is the rule 

 rather than the exception among the class of patients entering 

 the hospitals. From the amount of data at hand on this subject 

 any conclusion is hypothetical, but basing such a conclusion on 

 the preceding statements, it appears that chronic intestinal dis- 

 orders leading to chronic toxaemia are probably an important 

 factor in the production of atheroma in Filipinos. 



Strains. — Strains resulting from heavy and continued manual 

 labor are found among such classes as farmers and stevedores, 

 and a small percentage is found among workers in mines and 

 railroads. However, the Philippines does not possess the indus- 

 tries which require large numbers of laborers who perform heavy 

 manual labor over a long period of time. The women of the 

 working classes usually perform heavy work, such as carrying 

 burdens on their heads. On the whole, it is doubtful whether 

 any importance can be placed on strains as a prime factor in 

 producing atheroma or other arterial changes among the people 

 of this country. 



Alcohol. — Alcoholic drinks are partaken of by the Filipinos 

 throughout the Islands, but not as a rule to the extent of in- 

 toxication. It is rare that a Filipino is seen under the influence 

 of alcohol. There are a number of locally made drinks, such as 

 tuba, tapuy, vino, basi, and ginebra, some of which contain large 



