﻿160 ^^6 Philippine Journal of Science 1914 



and administers medicine. He may also send cases to the 

 hospital, but as indicated by the above reports and by the com- 

 mission's investigations he does so with comparative rarity. 

 The clinical thermometer may be a familiar diagnostic instru- 

 ment to him, but the clinical microscope apparently is not. This 

 service should scarcely be dignified with the name "dispensary." 



A STUDY OF THE CAUSES OF THE HIGH MORBIDITY AND 

 MORTALITY RATES AT SAN JOSE 



Doctor Schapiro of the Bureau of Health gave as the cause 

 of sickness, at the time of his inspection in 1911, the following 

 9 factors: (1) Long hours of work; (2) overcrowding in hot 

 houses; (3) low nourishment in a poor class of laborers; (4) 

 unsafe water supply; (5) lack of mosquito protection; (6) de- 

 layed medical attention; (7) poor hospital facilities; (8) no 

 sanitary control of garbage and faeces collection; and (9) fly 

 propagation in the corral, strewn garbage, and faeces about 

 residences. 



With regard to (1) long working hours, (2) overcrowding 

 in hot houses, and (3) low nourishment in a poor class of 

 laborers, it may be said that all of these causes still operate, 

 although some attention has been given to all of them by the 

 companies. (4) Unsafe water and (5) lack of mosquito pro- 

 tection have received a great deal of attention, and are no longer 

 active factors of sickness, except that individual mosquito pro- 

 tection is not practiced. However, a square kilometer and a 

 half of territory have been practically freed from mosquitoes, 

 and this, it must be admitted, is an accomplishment of great 

 value. The artesian wells and distribution system have com- 

 pletely and satisfactorily solved the water question. Supply, 

 quality, and service are highly satisfactory for present needs. 

 (6) Delayed medical attention — not due to fault upon the part 

 of medical officers, however — and (7) poor hospital facilities 

 still continue to operate in the manner I have pointed out else- 

 where in this report. By the reforms inaugurated and operated 

 by the companies, factors (8), garbage and faeces collection, 

 and (9), fly propagation and soil pollution by garbage and faeces, 

 have ceased to operate. This does not mean that breakdowns 

 in the machinery of the sanitary system never occur. On the 

 contrary, I think that they are rather frequent in occurrence. 

 The important thing is the fact that a system of collection and 

 disposal has been installed and will eliminate the dangers from 

 those wastes and insects if properly supervised. 



