88 The Philippine Journal of Science 1915 
tablishment of a one-year school for midwifery in connection 
with the Philippine General Hospital is announced. 
The extension of hospitals and dispensaries in the provinces 
is most necessary, and the accomplishment of this purpose is one 
of the pressing problems now in process of solution. 
The continued improvement in general health conditions has 
received and will receive Governor-General Harrison’s most en- 
thusiastic support. Both he and Secretary Denison promise 
their whole-hearted codperation in progressive measures for the 
amelioration of the public health. 
PRESIDENT’S ADDRESS: THE MOST IMPORTANT MEDICO-ECONOMIC 
PROBLEM OF THE PHILIPPINE ISLANDS 
By Dr. N. M. SALEEBY 
Dispensary experience has shown the writer the widespread 
distribution of subacute, chronic, and recurrent beriberi. In 
1907 he examined in one day 64 patients at the dispensary and 
detected 40 cases with cardiac affections. Within the next few 
months new and acute cases of beriberi were definitely diag- 
nosed. This latter finding explains the etiology of the cardiac 
affections noted above. Emphasis is laid on the fact that mild 
or light symptoms of beriberi, particularly when cedema is not 
marked, often pass unnoticed by the general practitioner. Ear- 
lier observations are corroborated for the coincidence of beriberi 
and the puerperium after uneventful delivery; the mother may 
be partially paralyzed. In some cases the paralysis amounted to 
complete paraplegia, but the majority presented partial paral- 
ysis, accompanied by a group of symptoms generally referred 
to as polyneuritis. The new-born child of such mothers is af- 
fected; even subacute attacks, combined with deficiency of milk, 
suffice to produce the disease in the child. Weaned infants and 
children of all ages are as apt to contract the disease as adults. 
Diagnosis of mild cases in children is difficult, and treatment 
should be encouraged on grounds of suspicion alone. 
From data available and from his own experience Doctor 
Saleeby then reasserts the extensive existence of beriberi in 
mild form, which though benign in itself considerably lowers 
the vitality of the individual, reduces his capacity for labor, 
and puts him at a great disadvantage in combating tuberculosis 
and other diseases. Further, in certain states of reduced vital- 
ity—as in the puerperium and infancy and during famine and 
hard times—this benign beriberi becomes fatal, spreads rapidly, 
and does more harm than tuberculosis or any other affection. 
