X, B, 1 Munson: Cholera Carriers 5 
themselves and others who could scarcely fall even within the 
class of suspects, and that those found positive were subjected to 
all the inconveniences of isolation, separation from family, loss 
of earning capacity, etc., and it is apparent that the work at 
the outset had to be expanded with caution and only as the orig- 
inal opposition could be removed and public opinion created in 
favor of it as an unpleasant but necessary measure. This was 
brought about rapidly in various ways, and by the middle of 
September the full support of every newspaper in Manila had 
been secured, together with that of practically all persons of 
prominence and of the intelligent classes. It is a credit to the 
people that they accepted the work as a necessity, for without 
their codperation the work could probably not have been car- 
ried out. By the unprecedented floods of September the greater 
part of Manila was put several feet under water for some days, 
sewers were back pressured, most of the public water closets upon 
which the great majority of the population of Manila depend 
were submerged, and the poorer people were forced to drink 
the foul fiood water which could be boiled with difficulty from 
Jack of fuel. There was also shortage of food, constant wet- 
ting and chilling from unceasing rain and flood, and crowding 
_together of people driven from their homes by rising waters 
and carrying their infection into new places. These conditions 
and the existence of a widespread cholera infection in car- 
riers apparently favored the development of one of the most 
destructive epidemics of cholera that ever occurred in Manila. 
That it did not so occur probably can be attributed largely to 
the campaign against carriers which shortly after began 
to be pushed more energetically, through better organization 
and allaying popular opposition. The flood began on September 
8. Within a week, the number of cases and carriers rose rap- 
idly. In the health districts of Manila and in Bilibid Prison 
together there were 226 carriers found and isolated for the 
period September 8 to September 30. On one day, September 
14, there were 41 carriers found, and on September 15 there 
were 52 carriers found. 
It is evident from the above that in effectively combating a 
cholera infection the use of laboratory facilities in the making 
of bacteriological diagnosis on a large scale is absolutely es- 
sential. Without such assistance as the Bureau of Science, has 
given, the results accomplished would not have been possible. 
The outbreak in Manila was unquestionably spread chiefly 
by personal contact. Cases were isolated so promptly as to 
do little harm. Lack of the use of toilet paper, certain habits 
