X, B, 6 Calderon: Tropical Obstetrical Problems 877 
where it was sometimes even impossible for us to obtain clean 
water to use for the patient and her baby. The patients were, 
in the majority of cases, so poor that they could not afford to 
furnish even basin, soap, or towel. 
In spite of all these difficulties students were taught to con- 
duct labor, make application of the forceps, and perform podalic 
version and other operations. 
The death rate was high, due to the ignorance of the Filipino 
women in matters of hygiene and to the fact that they were 
opposed to calling in a physician, except when they were already 
in a very serious condition, and when it was impossible or al- 
most impossible to do anything for them. With the object of 
enlightening the people, several movements were begun in the 
department to improve the service and to educate the people, 
such as the organization of the out-patient service with resident 
physicians and internes at the hospital, the distribution of 
pamphlets and letters among the poor Filipino women in Manila, 
and lectures and conferences in the different health districts 
of the city. 
These lectures and conferences dealt chiefly with those sub- 
jects pertaining to the pregnant woman, care of children, and 
midwives, and we always tried, in so far as possible, to gather 
at our meetings the pregnant women and midwives of the 
district. Our work was satisfactory, as it resulted in the grad- 
ual increase of our cases and decreases of our death rate, 
especially in the out-patient department, as shown in Table I. 
TABLE I.—Obstetrical cases from 1907 to 1914, showing increase of 
hospital and decrease of outside service. 
Deliveries and - 
miterpeniumt Abortions. 
Year. 
Hospital.| Outside. |Hospital. |} Outside. 






TOOTAtOPL OL Ole eae eae ese? SARIN re Mere ee eh 110 454 10 24 
19 [ites ean Ree aE IOeE NANA eM ene | 241 282 21 6 
FG 1D Meme SL esshODN Sta Nie ee Pre WR Ue oN 336 515 46 8 
SITE pe ehe unde ae Le UEC ee eet ie aed Sea ae 513 378 3 1 
SUH ES is Mien RA Ee ST aceasta 567 316 45 7 
| FTesteslp to COnCL  Secey Namlt st thes ieias, Veena 1,767 | 1,940 | 125 | 46 

It is only just, however, to state that the success in educating 
the people in the advantages of hospital care was not entirely, 
although it was mainly, due to the activities of our department, 
because we have, also, to consider the influence of other insti- 
