X, B, 8 Barber et al.: Malaria in the Philippines 935 
Annual death rates and morbidity rates from malaria in the Philippine 
Islands, 1909 to 1913, inclusive. 








| Year, “hom | qlettl | averaze, Cases, | Pople = 
DASTOTS js eee a ee a25,751 | 179,355 14.35 | 216,516 |6, 331, 695 0. 26 
OI O}e ee Soca o lee oe Se eee eek Lb 26,859 | 191,576 13.75 10, 225 |6, 956, 979 0.14 
OT eee ene ee. ee eae 28,181 | 188, 412 14. 95 19, 363 |7, 007, 081 0.27 
OT 2 eee area Selec eee ee 27,229 | 184, 639 14, 74 11, 555 6, 857, 892 0.16 
NOISEAK CECEEE & oe Soe ee cud tee eee 17,619 | 147,544 11. 94 20, 378 |6, 770, 736 0.30 


8 In the first four years the deaths from malaria exceeded the cases reported because of 
incomplete returns from the provinces. 
Dr. Arlington Pond, district health officer for Cebu Province, 
gave us the following information by letter: 
In this year (1912) there were over 4,000 deaths reported from malarial 
fever (Province of Cebu). The following year I employed eight doctors 
and divided the province up into districts. As the result of this the number . 
of cases of so-called malaria dropped to 400 instead of the 4,000 of the 
previous year. 
From results obtained during our survey of the province in 
1914, it would seem that even this figure is far above the actual 
rate. It is probable that if facilities were available for more 
accurate diagnosis in all provinces a far lower morbidity and 
mortality rate for malaria would be reported. 
If, as our results indicate, the greater part of the transmission 
of malaria is due to a species of mosquito of rather limited 
habitat, the outlook is encouraging for eradicating or greatly 
reducing the mosquito carriers of malaria in many malarious 
localities. An anopheles-mosquito survey, and wherever prac- 
ticable a malarial survey, should be made of every locality where 
antimalarial work is contemplated. Wherever children in 
schools are available for blood and spleen examination, the ex- 
amination of 50 persons can be completed by a trained worker 
within three days at the most. The data thus obtained are of 
the greatest importance as a basis for antimalarial work. Cli- 
nical evidence alone is much less satisfactory unless obtained by 
a trained diagnostician who has resided some time in a locality. 
With the scientific data at hand the next step is to choose the 
point of attack best suited to the locality and the resources 
available. In the “ditch” towns, for example (Table VIII), the 
attack can be most advantageously made against the larvee in the 
ditches. The most radical measure would be simply to abolish 
the ditches by cutting off the main canal and to rely on water 
